- Design
- Randomised controlled trial, three arms, supervised
- Population
- 67 adults with controlled hypertension on medication
- Primary outcome
- Ambulatory blood pressure after 4 weeks
- Effect
- Awake systolic 121.8 vs 124.2 mmHg (P = 0.017); diastolic 76.3 vs 80.8 mmHg (P = 0.009) with handgrip vs control
In this small Brazilian trial, 67 adults with controlled hypertension on medication were randomised to no training, supervised handgrip isometric training or knee-extension isometric training, three sessions a week for four weeks at 30% of maximal effort.
Only handgrip training differed from control, and only for awake ambulatory pressure: about 122 versus 124 mmHg systolic and 76 versus 81 mmHg diastolic. Knee-extension training did not differ from control, and neither changed 24-hour or night-time pressure.
Isometric exercise has been proposed as a low-time, low-cost add-on for hypertension. This trial supports a modest daytime effect, but it was short, small and supervised, and the groups were analysed by adjusting for office pressure.
- Consider suggesting supervised handgrip exercise as an add-on for motivated patients, not a substitute for medication.
- Keep antihypertensive doses unchanged on the strength of this trial.
- Check home or ambulatory readings if patients take up isometric training, to see whether it helps them.
Why it matters
It suggests the cheapest equipment in the clinic may help a little, but not enough to replace anything.
Don't overread it
A four-week trial of 67 people does not show a lasting or outcome-relevant effect.
The statistics, in plain English
The differences are small and come from 22 people per group over four weeks, so a few patients could shift the result. Only one of several ambulatory measures differed, which makes chance a more plausible explanation than if every measure had moved together.
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