Key result
Isometric training reduces SBP by ~7 mmHg.
Why the study?
Does isometric training reduce systolic and diastolic blood pressure in the general population?
Meta-Analysis (n=839)
Does isometric training reduce systolic and diastolic blood pressure in the general population?
Isometric training, particularly regimens like wall squat training for more than 8 weeks, significantly reduces both systolic and diastolic blood pressure.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“Although any exercise is beneficial, we've been learning more about which type of exercise benefits specific issues, and isometric exercise has a measurable impact on lowering blood pressure.”
“Most previous studies on isometric handgrip exercise were conducted in Western populations. Our findings provide important early evidence that this simple intervention may also benefit the Malaysian population.”
“For decades, studies on exercise and hypertension relied on readings taken during a quick visit to the doctor's office. Researchers measured blood pressure with one cuff, in one moment, using one number. That snapshot misses what happens the other 23 hours – the spike before a meeting, the dip during sleep, the slow climb of a stressful afternoon.”
Supports isometric training for hypertension management; reinforces efficacy across randomized trials.
Abbreviations：K(n),the number of studies included in the pooled effect analysis (total number of participants across pooled studies);Pd,the P-value used to assess differences in effect size between subgroups; Pm, the P-value for the heterogeneity test. Abbreviations：K(n),the number of studies included in the pooled effect analysis (total number of participants across pooled studies);Pd, the P-value used to assess differences in effect size between subgroupps; Pm, the P-value for the heterogeneity test. The original version of this article has been updated.Adding/removing textIn the abstract, [(WMD, -6.72; 95% CI, -8.21 to -5.23, p < 0.0001, I 2 = 74%) and DBP (WMD, -2.72; 95% CI, -3.57 to -1.87, p < 0.0001, I 2 = 48%)]. This has been corrected to read: [(WMD, -6.62; 95% CI, -8.13 to -5.10, p < 0.0001, I 2 = 75%) and DBP (WMD, -2.63; 95% CI, -3.50 to -1.76, p < 0.0001,I 2 = 50%)]The original version of this article has been updated. A correction has been made to the section [3 Results, 3.3 Main effect, 1]: "[Isometric training can effectively reduce systolic blood pressure. (WMD, -6.62; 95% CI, -8.13 to -5.10, p < 0.0001, I 2 = 75%, Figure 2) and diastolic blood pressure (WMD, -2.63; 95% CI, -3.50 to -1.76, p < 0.0001, I 2 = 50%). Meta-analysis indicated substantial heterogeneity in both systolic and diastolic blood pressure outcomes. To explore potential sources of this variability and identify modifiable exercise-related factors, additional analyses including meta-regression, subgroup analysis, and sensitivity analysis were performed. It should be noted that the following subgroup analyses are exploratory in nature, aimed at generating hypotheses, and their findings are susceptible to ecological bias. They should not be interpreted as definitive evidence of causal relationships.]"A correction has been made to the section [3 Results, 3.4 Meta-regression, 1 and 2]: "[As shown in Figure 4, the results of the meta -regression suggest no significant association between health status (p = 0.55, Figure 4A), duration (p = 0.97, Figure 4B), frequency (p = 0.13, Figure 4C), baseline blood pressure (p = 0.94, Figure 4D), and the reduction in systolic blood pressure achieved through isometric training.As shown in Figure 5, meta-regression analysis indicates no significant association between health status (p = 0.40, Figure 5A), duration (p = 0.22, Figure 5B), frequency (p = 0.52, Figure 5C), baseline blood pressure (p = 0.12, Figure 5D), and the reduction in diastolic blood pressure achieved through isometric training.]"A correction has been made to the section [3 Results 3.5 Subgroup analysis 3.5.1 Systolic blood pressure, 3] "[Furthermore, the greatest blood pressure reduction was associated with isometric exercise regimens that involved wall squat training (WMD, -10.29; 95% CI, -13.60 to -6.98, p < 0.00001, I 2 = 61%), three sessions weekly (WMD: -7.19; 95% CI, -8.85 to -5.53, p < 0.00001, I 2 = 69%), an intensity of 85% HR peak (WMD, -9.99; 95% CI, -13.60 to -6.38, p < 0.00001, I 2 = 0%), and a duration of more than 8 weeks (WMD, -6.82; 95% CI, -9.20 to -4.44, p < 0.0001, I 2 = 72%).]"A correction has been made to the section [3 Results 3.5 Subgroup analysis 3.5.2 Diastolic blood pressure, 3] "[Furthermore, the greatest blood pressure-lowering outcomes were associated with the following exercise regimens: wall squat training (WMD, -5.26; 95% CI, -7.02 to -3.51, p < 0.00001, I 2 = 0%), three sessions weekly (WMD, -2.89; 95% CI, -4.02 to -1.76, p = 0.0004, I 2 = 52%), an intensity of 95% HR peak (WMD, -4.87; 95% CI, -7.17 to -2.57), p < 0.0001, I 2 = 0%), and an intervention duration exceeding 8 weeks (WMD, -2.70; 95% CI, -4.25 to -1.16, p = 0.007, I 2 = 56%).]"A correction has been made to the section [3 Results 3.8 Publication bias, 1, 2 and 3] "[Funnel plots were employed to analyses publication bias. Visual inspection of the funnel plot (Figure 7A) combined with the Egger test (t = -2.07, p = 0.045, Table 5). This suggests the potential presence of publication bias or small-study effects, where smaller studies showing larger effect sizes might be more likely to be published.To estimate and adjust for the potential impact of any missing studies, we applied the Trim and Fill method. The raw pooled effect size for isometric exercise on systolic blood pressure was -6.62 mmHg, and it remained unchanged after adjustment (-6.62 mmHg, 95% CI: -8.131 to -5.099, p < 0.0001). This analysis indicated that no studies needed to be imputed to achieve symmetry in the funnel plot. Thus, the pooled effect estimate for systolic blood pressure reduction was robust to this adjustment. While the Egger's test indicates asymmetry, the lack of imputation by the Trim and Fill procedure suggests that any potential publication bias may not be substantial enough to qualitatively alter the main conclusion that isometric exercise significantly reduces systolic blood pressure. Nevertheless, the possibility of a modest overestimation of the true effect size due to small-study effects cannot be ruled out.Similarly, funnel plots were employed to detect publication bias across across all 39 trials for diastolic blood pressure. Visual inspection of the funnel plots (Figure 7B) and the Egger test (t = -0.52, p = 0.606, Table 6) indicated no evidence of publication bias, rendering the results suitable for meta-analysis.]"The original version of this article has been updated.
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Yan et al. (2026) conducted a meta-analysis in Blood pressure regulation (n=839). Isometric training vs. Control was evaluated on Systolic blood pressure (WMD -6.62 mmHg, 95% CI -8.13 to -5.10, p=< 0.0001). Isometric training significantly reduced systolic blood pressure by a weighted mean difference of -6.62 mmHg and diastolic blood pressure by -2.63 mmHg.
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