Key result
Isometric handgrip training lowers office systolic BP ~8 mmHg in treated hypertension, but ITT shows no benefit.
Why the study?
Most studies showing blood pressure reduction with isometric handgrip training were conducted in laboratory settings, leaving its effects in real-world primary healthcare settings unclear.
Does isometric handgrip training reduce office and ambulatory blood pressure in medicated hypertensive patients treated in primary healthcare?
RCT (n=63)
Single-blind (researchers collecting data and analyzing HRV were blinded to group allocations)
Block-randomized using a random number table, with stratification according to sex and baseline office systolic BP
No
Does isometric handgrip training reduce office and ambulatory blood pressure in medicated hypertensive patients treated in primary healthcare?
Absolute Event Rate: 121% vs 126%
p-value: p=<0.05
While isometric handgrip training can lower office systolic blood pressure in primary care patients, extremely high dropout rates challenge its real-world clinical feasibility.
High dropout rates limit conclusions on isometric handgrip training for medicated hypertension; leaves real-world efficacy open and requires adherence-focused trials.
BACKGROUND: Meta-analyses have demonstrated that isometric handgrip training (IHT) decreases blood pressure in hypertensive individuals. Nonetheless, most studies were conducted in laboratory settings and its effects in real-world settings remain unclear. OBJECTIVE: To analyze the effects of IHT on office and ambulatory blood pressure in hypertensive patients attended within primary healthcare. DESIGN AND SETTING: Randomized controlled trial conducted in primary healthcare units within the Family Health Program, Petrolina, Pernambuco, Brazil. METHODS: 63 hypertensive patients (30-79 years old; 70% female) were randomly allocated into IHT or control groups. IHT was performed three times per week (4 x 2 minutes at 30% of maximal voluntary contraction, one-minute rest between bouts, alternating the hands). Before and after the 12-week training period, office and ambulatory blood pressure and heart rate variability were obtained. The significance level was set at P < 0.05 (two-tailed testing) for all analyses. RESULTS: IHT significantly decreased office systolic blood pressure (IHT: 129 ± 4 versus 121 ± 3 mmHg, P < 0.05; control: 126 ± 4 versus 126 ± 3 mmHg, P > 0.05), whereas there was no effect on diastolic blood pressure (IHT: 83 ± 3 versus 79 ± 2 mmHg, P > 0.05; control: 81 ± 3 versus 77 ± 3 mmHg, P > 0.05). Heart rate variability and ambulatory blood pressure were not altered by the interventions (P > 0.05 for all). CONCLUSION: IHT reduced office systolic blood pressure in hypertensive patients attended within primary care. However, there were effects regarding diastolic blood pressure, ambulatory blood pressure or heart rate variability. CLINICALTRIALS.GOV IDENTIFIER: NCT03216317.
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Palmeira et al. (2021) conducted an RCT in Hypertension (n=63). Isometric handgrip training vs. Control group encouraged to increase physical activity level without specific guidance was evaluated on Office systolic blood pressure (p=<0.05). Isometric handgrip training significantly reduced office systolic blood pressure by approximately 8 mmHg compared to control (GxT p=0.049) in medicated hypertensive patients, though intent-to-treat analysis revealed no significant effect due to high dropout rates.
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