Effect of Isometric Handgrip Exercise on Blood Pressure in Pregnant Women (GRIP4HEALTH)

Effect of Isometric Handgrip Exercise on Cardiovascular and Cognitive Responses in Normotensive and Hypertensive Pregnant Women (GRIP4HEALTH)

Hypertension during pregnancy is a major public health concern, increasing the risk of cardiovascular complications for both the mother and the fetus. Women with chronic hypertension are at higher risk of adverse outcomes, and elevated blood pressure during pregnancy has also been associated with long-term cardiovascular and cognitive impairments.Regular physical activity is recognized as an effective non-pharmacological strategy to reduce blood pressure. Among different exercise modalities, isometric exercise has shown promising effects in lowering blood pressure in the general population, with minimal cardiovascular strain. However, its effects and safety in pregnant women, particularly those with hypertension, remain poorly understood.In addition to cardiovascular alterations, hypertension during pregnancy may also impact cognitive function, potentially through changes in cerebral perfusion and vascular function. Despite these associations, the combined cardiovascular and cognitive responses to exercise in this population have not been fully explored.This study aims to investigate the effects of isometric handgrip exercise on cardiovascular and cognitive responses in pregnant women with and without chronic hypertension, in order to better understand its potential as a safe and effective non-pharmacological intervention during pregnancy.

Study Overview

• Status: Recruiting
• Conditions: Pregnancy; Hypertension (HTN); Pregnancy - Prenatal Testing
• Intervention / Treatment: Behavioral: Isometric Handgrip Exercise; Behavioral: Control Rest

Detailed Description

Hypertension during pregnancy is a major public health concern associated with increased maternal and fetal morbidity, and long-term cardiovascular risk. Women with chronic hypertension are at higher risk of complications such as preeclampsia, preterm birth, and adverse neonatal outcomes. In addition, growing evidence suggests that hypertensive disorders of pregnancy may also be associated with long-term alterations in cardiovascular function and cognitive performance.During pregnancy, physiological changes in blood pressure regulation and vascular function may further complicate the management of hypertension. Pharmacological treatment options are limited due to potential risks for the fetus, highlighting the need for safe and effective non-pharmacological strategies.Physical exercise is recognized as an effective approach to reduce blood pressure and improve cardiovascular health in the general population. Among the different exercise modalities, isometric exercise has shown particularly promising effects in reducing blood pressure, with a low cardiovascular load. This modality may therefore represent an attractive option for pregnant women, as it can be performed safely with minimal physiological stress. However, despite these potential benefits, the effects and safety of isometric exercise during pregnancy, particularly in hypertensive women, remain poorly understood.In addition to cardiovascular alterations, hypertension during pregnancy may impact cognitive function, potentially through changes in cerebral perfusion and vascular regulation. Although physical activity has been associated with improvements in cognitive performance in the general population, the acute effects of exercise on cognitive function during pregnancy have not been well established.The aims of this study are:First, to evaluate the effect of isometric handgrip exercise on 24-hour blood pressure in pregnant women with and without chronic hypertension.Second, to compare cardiovascular responses to isometric exercise between normotensive and hypertensive pregnant women, including brachial and central blood pressure, arterial stiffness, and heart rate.Third, to examine differences in cognitive performance between normotensive and hypertensive pregnant women, and to explore the relationship between cardiovascular responses and cognitive outcomes.

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Carina ENEA; Phone Number: +33 549 454 495; Email: carina.enea@univ-poitiers.fr
• Study Contact Backup: Name: Mélanie Gréau Marias; Phone Number: +33 675 329 599; Email: melanie.greau.marias@univ-poitiers.fr

Study Locations

• France
  • Poitiers, France, 86000
    • Recruiting
    • Faculty of Sport Science - MOVE Laboratory - UR 20296
    • Contact: Mélanie Gréau Marias; Phone Number: +33 675 329 599; Email: melanie.greau.marias@univ-poitiers.fr

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Pregnant women covered by the French National Health Insurance system
• Pregnant women who do not object to participation in the study
• Women belonging to one of the following two groups:
• Women with chronic hypertension present before pregnancy (diagnosed within the past 5 years), defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, without antihypertensive treatment
• Normotensive pregnant women, defined as systolic blood pressure (SBP) < 140 mmHg and diastolic blood pressure (DBP) < 90 mmHg before pregnancy

Exclusion Criteria:

• Current treatment for chronic or gestational hypertension
• Known cardiovascular disease other than chronic hypertension
• Age under 18 years
• Persons deprived of liberty
• Inability to speak or adequately understand French
• Persons hospitalized without consent who are not subject to legal protection measures, and persons admitted to a health or social institution for purposes other than research
• Persons currently excluded from participation in another research study
• Persons under judicial protection or guardianship Type 1 or type 2 diabetes
• Severe or extreme obesity (BMI ≥ 40 kg/m²)
• Thyroid disease
• Heavy smoking

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Prevention
• Allocation: Randomized
• Interventional Model: Crossover Assignment
• Masking: None (Open Label)

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Other: Normotensive Pregnant Women; Pregnant women without chronic hypertension. Participants in this arm complete both the isometric handgrip exercise session and the control rest session in randomized order.	Behavioral: Isometric Handgrip Exercise; Isometric handgrip exercise performed at 30% of maximal voluntary contraction, consisting of four 2-minute contractions with one-minute rest intervals between efforts. The exercise is performed using a handgrip dynamometer.; Behavioral: Control Rest; Seated rest condition without exercise, used as a control comparison to the isometric handgrip intervention.
Other: Hypertensive Pregnant Women; Pregnant women with chronic untreated hypertension. Participants in this arm complete both the isometric handgrip exercise session and the control rest session in randomized order.	Behavioral: Isometric Handgrip Exercise; Isometric handgrip exercise performed at 30% of maximal voluntary contraction, consisting of four 2-minute contractions with one-minute rest intervals between efforts. The exercise is performed using a handgrip dynamometer.; Behavioral: Control Rest; Seated rest condition without exercise, used as a control comparison to the isometric handgrip intervention.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Systolic and diastolic blood pressure (ambulatory blood pressure measurement)	Post-exercise hypotension, using the Mobil-O-Graph (mmHg).	After sessions (24 hours)

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Systolic and diastolic blood pressure (resting)	Automated oscillometric tensiometer (mmHg)	Before and after sessions (15 minutes)
Central blood pressure	Central systolic and diastolic blood pressure assessed using pulse wave analysis derived from brachial oscillometric measurements.	Baseline and post-intervention during sessions (30 minutes)
Pulse wave velocity	Arterial stiffness assessed by carotid-femoral pulse wave velocity using applanation tonometry. This measurement is performed at rest to characterize vascular health.	Baseline
Heart rate	Heart rate measured during each experimental session and recovery period using a heart rate monitor to assess cardiovascular response to the intervention.	Basline, before and after sessions (15 minutes)
Cognitive Performance	Cognitive performance assessed at rest using a neuropsychological test battery including executive function, memory, attention, and processing speed tests. This outcome is used to compare cognitive function between normotensive and hypertensive pregnant women.; Stroop : higher scores indicate better executive function and inhibitory control. No universal minimum or maximum score.; Verbal Fluency Test: higher scores indicate better verbal executive functioning. No universal maximum score.; Rey Auditory Verbal Learning Test (RAVLT): Higher scores indicate better verbal learning and memory. Minimum score = 0; maximum score = 75.; Digit Span Test (forward and backward): higher scores indicate better working memory and attention. Minimum score = 0; No universal maximum score.	Baseline

Collaborators and Investigators

• Sponsor: University of Poitiers
• Collaborators: Poitiers University Hospital; Laboratory MOVE, Faculty of Sport Sciences, University of Poitiers, France

Study record dates

Study Major Dates

• Study Start (Actual): March 6, 2026
• Primary Completion (Estimated): August 31, 2027
• Study Completion (Estimated): September 30, 2027

Study Registration Dates

• First Submitted: May 6, 2026
• First Submitted That Met QC Criteria: May 21, 2026
• First Posted (Actual): May 26, 2026

Study Record Updates

• Last Update Posted (Actual): May 26, 2026
• Last Update Submitted That Met QC Criteria: May 21, 2026
• Last Verified: May 1, 2026

More Information

Terms related to this study

• Keywords: Hypertension; Pregnancy; Arterial Stiffness; Blood Pressure; Cognitive Function; Isometric Exercise; Ambulatory Blood Pressure Monitoring; Handgrip Exercise
• Additional Relevant MeSH Terms: Vascular Diseases; Cardiovascular Diseases; Hypertension
• Other Study ID Numbers: 2025-A00590-49

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No