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Review
. 2019 Oct;37(10):1927-1938.
doi: 10.1097/HJH.0000000000002105.

Effects of isometric resistance training on resting blood pressure: individual participant data meta-analysis

Neil A Smart  1 , Damien Way  1 , Debra Carlson  1 , Philip Millar  2 , Cheri McGowan  3 , Ian Swaine  4 , Anthony Baross  5 , Reuben Howden  6 , Raphael Ritti-Dias  7 , Jim Wiles  8 , Véronique Cornelissen  9 , Ben Gordon  10 , Rod Taylor  11 , Bea Bleile  1
Affiliations
Review

Effects of isometric resistance training on resting blood pressure: individual participant data meta-analysis

Neil A Smart et al. J Hypertens. 2019 Oct.

Abstract

Background: Previous meta-analyses based on aggregate group-level data report antihypertensive effects of isometric resistance training (IRT). However, individual participant data meta-analyses provide more robust effect size estimates and permit examination of demographic and clinical variables on IRT effectiveness.

Methods: We conducted a systematic search and individual participant data (IPD) analysis, using both a one-step and two-step approach, of controlled trials investigating at least 3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure.

Results: Anonymized individual participant data were provided from 12 studies (14 intervention group comparisons) involving 326 participants (52.7% medicated for hypertension); 191 assigned to IRT and 135 controls, 25.2% of participants had diagnosed coronary artery disease. IRT intensity varied (8-30% MVC) and training duration ranged from 3 to 12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting SBP of -6.22 mmHg (95% CI -7.75 to -4.68; P < 0.00001); DBP of -2.78 mmHg (95% CI -3.92 to -1.65; P = 0.002); and mean arterial blood pressure (MAP) of -4.12 mmHg (95% CI -5.39 to -2.85; P < 0.00001). The two-step approach yielded similar results for change in SBP -7.35 mmHg (-8.95 to -5.75; P < 0.00001), DBP MD -3.29 mmHg (95% CI -5.12 to -1.46; P = 0.0004) and MAP MD -4.63 mmHg (95% CI -6.18 to -3.09: P < 0.00001). Sub-analysis revealed that neither clinical, medication, nor demographic participant characteristics, or exercise program features, modified the IRT treatment effect.

Conclusion: This individual patient analysis confirms a clinically meaningful and statistically significant effect of IRT on resting SBP, DBP and mean arterial blood pressure.

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Figures

FIGURE 1
FIGURE 1
Forest plot of change in SBP using two-step analysis model.
FIGURE 2
FIGURE 2
Forest plot of change in DBP using two-step analysis model.
FIGURE 3
FIGURE 3
Forest plot of change in mean arterial blood pressure using two-step analysis model.
See this image and copyright information in PMC

References

    1. Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet 2012; 380:2224–2260. - PMC - PubMed
    1. Joffres M, Falaschetti E, Gillespie C, Robitaille C, Loustalot F, Poulter N, et al. Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: a cross-sectional study. BMJ open 2013; 3:e003423. - PMC - PubMed
    1. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, Jr, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42:1206–1252. - PubMed
    1. Vidal-Petiot E, Elbez Y, Luscher TF, Fox KM, Steg PG. The 2018 ESC-ESH guidelines for the management of arterial hypertension leave clinicians facing a dilemma in half of the patients. Eur Heart J 2018; 39:4040–4041. - PubMed
    1. Nerenberg KA, Zarnke KB, Leung AA, Dasgupta K, Butalia S, McBrien K, et al. Hypertension Canada. Hypertension Canada's 2018 Guidelines for Diagnosis, Risk Assessment, Prevention, and Treatment of Hypertension in Adults and Children. Can J Cardiol 2018; 34:506–525. - PubMed