Effect of home‐based isometric training on blood pressure in older adults with high normal BP or stage I hypertension: A randomized controlled trial

OBJECTIVE: This trial analyzes the effects of home-based isometric handgrip training (IHT) and aerobic exercise training (AET) on ambulatory and office blood pressure (BP) in older adults with high normal to established hypertension. METHODS: This randomized controlled trial included 84 participants (46 women, 71.1 ± 3.6 years, systolic BP SBP 137.1 ± 13.8 mmHg, diastolic BP DBP 80.8 ± 8.3 mmHg). Participants were randomized into IHT (n = 28), AET (n = 28), or usual medical care plus lifestyle advice (UC, n = 28). Participants performed IHT or AET three times/week for 8 weeks. IHT consisted of 4 × 45 s bilateral contractions at 50% of maximum voluntary contraction with 1-min rest between sets. AET consisted of walking 30 min at 50%-70% of estimated maximum oxygen consumption. UC received standardized medical care including lifestyle advice. RESULTS: Seventy-six participants completed the intervention: 27 in IHT, 26 in AET, and 23 in UC. At baseline, BP values were similar among groups. No differences were observed in 24-h ambulatory, daytime, and nighttime SBP and DBP in any group (p > 0.05). IHT and AET reduced office SBP (-8.0 ± 13.4 mmHg; p = 0.004; -5.6 ± 12.2 mmHg; p = 0.027, respectively). IHT reduced office DBP (-3.3 ± 7.4 mmHg; p = 0.024), but AET did not. No differences occurred in office BP in UC. There was no difference in office BP among groups (p > 0.05). CONCLUSIONS: An 8-week home-based IHT and AET failed to reduce ambulatory SBP, while office SBP was reduced by 8/5 mmHg. Only IHT reduced office DBP by 3 mmHg. Thus, IHT and AET may be effective for lowering office BP in older adults with high normal to established hypertension.