BACKGROUND: Blood pressure variability and central SBP are independent markers of cardiovascular risk. Data on lifestyle-interventions to reduce these parameters are sparse. The present work reports the differential effects of aerobic versus isometric handgrip exercise on blood pressure variability and central SBP in a prospective randomized trial. METHODS: Seventy-five hypertensive patients were randomized to one of the following 12-week programs: isometric handgrip training five times weekly; 'sham-handgrip training' five times weekly; aerobic exercise training (30 min three to five times/week). Blood pressure variability was assessed by the coefficient of variation in 24-h ambulatory blood pressure monitoring (ABPM). Central SBP was measured noninvasively by the SphygmoCor device (AtCor Medical, Australia). RESULTS: The aerobic exercise program significantly decreased systolic daytime variability (12.1 +/- 2.5 versus 10.3 +/- 2.8, p = 0.04), whereas diastolic daytime blood pressure variability was not significantly altered (p = 0.14). Night-time variability was not significantly affected (p > 0.05). Central SBP was reduced from 145 +/- 15 to 134 +/- 19 mmHg (p = 0.01). Isometric handgrip and sham-handgrip exercise did not significantly affect blood pressure variability (p > 0.05 each). Isometric exercise tended to reduce central SBP (142 +/- 19 to 136 +/- 17 mmHg, p = 0.06). ANCOVA revealed significant intergroup differences for the change of daytime SBP and DBP variability (p = 0.048 and 0.047, respectively). CONCLUSION: Aerobic exercise reduces blood pressure variability and central SBP. Isometric handgrip exercise does not reduce blood pressure variability but tends to lower central SBP in this hypertensive population.
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