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Aerobic versus isometric handgrip exercise in hypertension: a randomized controlled trial |
Pagonas N, Vlatsas S, Bauer F, Seibert FS, Zidek W, Babel N, Schlattmann P, Westhoff TH |
Journal of Hypertension 2017 Nov;35(11):2199-2206 |
clinical trial |
6/10 [Eligibility criteria: Yes; Random allocation: Yes; Concealed allocation: No; Baseline comparability: Yes; Blind subjects: No; Blind therapists: No; Blind assessors: No; Adequate follow-up: Yes; Intention-to-treat analysis: Yes; Between-group comparisons: Yes; Point estimates and variability: Yes. Note: Eligibility criteria item does not contribute to total score] *This score has been confirmed* |
OBJECTIVES: Aerobic dynamic exercise reduces blood pressure (BP) and is broadly recommended by current American and European hypertension guidelines. Isometric exercise is currently not recommended, since data from only a few studies are available. We compare for the first time the effects of isometric handgrip training and aerobic exercise in a randomized controlled trial. METHODS: A total of 75 hypertensive patients were randomized to one of the following 12-week programmes: Isometric handgrip training five times weekly (two contractions of 2 min at 30% of maximal power with each arm); 'Sham-handgrip training' five times weekly (two contractions of 2 min at 5% of maximal power with each arm); Aerobic exercise training of 30 min three to five times per week. All patients underwent office BP measurement, 24-h ambulatory BP measurement and noninvasive assessment of arterial compliance and systemic vascular resistance at baseline and after 12 weeks. RESULTS: Baseline epidemiological and hemodynamic characteristics did not differ between groups. Aerobic exercise led to a significant reduction of systolic 24-h BP (p = 0.025), office SBP (p = 0.03), systemic vascular resistance (p = 0.001) and small artery elasticity index (p = 0.005). There were no statistical significant changes of these parameters in the isometric exercise and the 'sham exercise' groups (p > 0.05 each). CONCLUSION: Isometric handgrip training, performed according to a typical protocol, did not reduce BP in hypertensive patients. Aerobic exercise, even as an uncontrolled and unsupervised exercise regimen, led to a significant reduction of ambulatory and office BP.
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