Current evidence on the hemodynamic and blood pressure effects of isometric exercise in normotensive and hypertensive persons

Abstract

Isometric exercise is associated with acute hemodynamic changes consisting of increases in systolic, diastolic, and mean arterial pressure and also an increase in heart rate and cardiac output. The peripheral vascular resistance is either not changed or decreased. These hemodynamic changes return to baseline values soon after the completion of exercise. Since isometric exercise is not an aerobic exercise, it was not recommended to hypertensive patients by national and international committee guidelines. Recent studies and meta-analyses of the subject have demonstrated, however, that isometric or resistance exercise does not raise resting blood pressure and frequently leads to a small decrease, which could be enhanced with the concomitant administration of antihypertensive drugs. Besides blood pressure, isometric exercise is associated with other beneficial effects consisting of an increase in muscle bulk, upper and lower body strength, increase in bone density, and a decrease in bone fractures. These changes are extremely beneficial to older patients by making them more mobile and increasing their quality of life. Based on these changes, the authors believe that isometric exercise, whether alone or in combination with dynamic exercise, should be recommended to hypertensive patients and be part of a comprehensive treatment regimen.

Figure 1

 The acute blood pressure response to sustained handgrip and upright tilt in 26 normotensive and 18 hypertensive patients. C indicates control; G, handgrip; T, tilt. Adapted with permission from Chrysant.

Figure 2

 The acute effects of sustained handgrip and upright tilt on cardiac index, stroke index, and heart rate in 26 normotensive and 18 hypertensive patients. Adapted with permission from Chrysant.

Figure 3

 The acute effects of sustained handgrip (SHG) and upright tilt (UT) on peripheral vascular resistance (PVR) index and the diastolic blood pressure (DBP) response to the Valsalva maneuver in 26 normotensive and 18 hypertensive patients. Adapted with permission from Chrysant.

Figure 4

The Zona Plus hand‐held dynamometer (Zona Health, Boise, ID).