Acute and Chronic Effects of Isometric Handgrip Exercise on Cardiovascular Variables in Hypertensive Patients: A Systematic Review

Breno Q Farah, Antônio H Germano-Soares, Sergio Luiz C Rodrigues, Camila X Santos, Sávio S Barbosa, Lauro C Vianna, Véronique A Cornelissen, Raphael M Ritti-Dias, Breno Q Farah, Antônio H Germano-Soares, Sergio Luiz C Rodrigues, Camila X Santos, Sávio S Barbosa, Lauro C Vianna, Véronique A Cornelissen, Raphael M Ritti-Dias

Abstract

The aim of this study was to describe, through a systematic review, the acute and chronic effects of isometric handgrip exercise on cardiovascular variables in hypertensive individuals. In this systematic review, we included studies that analyzed whether a single bout or a program with isometric exercises affect cardiovascular variables in hypertensive adults. The electronic database PubMed/Medline was searched for relevant studies published until May 2017. Of the 2927 studies initially identified, 2916 were excluded based on title and abstract and five on the basis of full-text assessment, leaving six studies remaining. In addition, one further study cited in the references of the included articles was included in this review, totaling seven studies included (five studies on the chronic effects of isometric handgrip exercise on cardiovascular parameters). None of the acute studies observed post-exercise hypotension. The majority of the chronic studies found decreases in office blood pressure after isometric handgrip training, with training ranging from 6 to 10 weeks, while heart rate variability parameters were improved in one study and did not change in another. Reduction in oxidative stress was observed; however, this variable was only analyzed in one study. In hypertensives, acute responses to isometric handgrip exercise are very limited due to the small number of studies, therefore more research is required. Furthermore, chronic isometric handgrip training reduces blood pressure; however, there is still a gap in the knowledge on the effects of this modality of exercise on other cardiovascular variables-such as endothelial function, oxidative stress, and cardiac autonomic modulation-which should be addressed in future studies.

Keywords: cardiovascular variables; exercise; hypertension.

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Figures

Figure 1
Figure 1
Literature search strategy used for the PubMed database.
Figure 2
Figure 2
Identification and selection of articles included in the review.

References

    1. Franco V., Oparil S., Carretero O.A. Hypertensive therapy: Part I. Circulation. 2004;109:2953–2958. doi: 10.1161/01.CIR.0000132614.41493.B5.
    1. Lewington S., Clarke R., Qizilbash N., Peto R., Collins R. Age-specific relevance of usual blood pressure to vascular mortality: A meta-analysis of individual data for one million adults in 61 prospective studies. Lancet. 2002;360:1903–1913. doi: 10.1016/S0140-6736(03)13064-4.
    1. Cornelissen V.A., Smart N.A. Exercise training for blood pressure: A systematic review and meta-analysis. J. Am. Heart Assoc. 2013;2:e004473. doi: 10.1161/JAHA.112.004473.
    1. Cornelissen V.A., Fagard R.H., Coeckelberghs E., Vanhees L. Impact of resistance training on blood pressure and other cardiovascular risk factors: A meta-analysis of randomized, controlled trials. Hypertension. 2011;58:950–958. doi: 10.1161/HYPERTENSIONAHA.111.177071.
    1. Kelley G.A., Kelley K.S. Isometric handgrip exercise and resting blood pressure: A meta-analysis of randomized controlled trials. J. Hypertens. 2010;28:411–418. doi: 10.1097/HJH.0b013e3283357d16.
    1. Owen A., Wiles J., Swaine I. Effect of isometric exercise on resting blood pressure: A meta analysis. J. Hum. Hypertens. 2010;24:796–800. doi: 10.1038/jhh.2010.13.
    1. Carlson D.J., Dieberg G., Hess N.C., Millar P.J., Smart N.A. Isometric exercise training for blood pressure management: A systematic review and meta-analysis. Mayo Clin. Proc. 2014;89:327–334. doi: 10.1016/j.mayocp.2013.10.030.
    1. Inder J.D., Carlson D.J., Dieberg G., McFarlane J.R., Hess N.C., Smart N.A. Isometric exercise training for blood pressure management: A systematic review and meta-analysis to optimize benefit. Hypertens. Res. Off. J. Jpn. Soc. Hypertens. 2015;39:88–94. doi: 10.1038/hr.2015.111.
    1. James P.A., Oparil S., Carter B.L., Cushman W.C., Dennison-Himmelfarb C., Handler J., Lackland D.T., LeFevre M.L., MacKenzie T.D., Ogedegbe O., et al. 2014 evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the eighth joint national committee (JNC 8) JAMA. 2014;311:507–520. doi: 10.1001/jama.2013.284427.
    1. Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Bohm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., et al. 2013 ESH/esc guidelines for the management of arterial hypertension: The task force for the management of arterial hypertension of the European society of hypertension (ESH) and of the European society of cardiology (ESC) Eur. Heart J. 2013;34:2159–2219.
    1. Jin Y.Z., Yan S., Yuan W.X. Effect of isometric handgrip training on resting blood pressure in adults: A meta-analysis of randomized controlled trials. J. Sports Med. Phys. Fit. 2017;57:154–160.
    1. Brook R.D., Appel L.J., Rubenfire M., Ogedegbe G., Bisognano J.D., Elliott W.J., Fuchs F.D., Hughes J.W., Lackland D.T., Staffileno B.A., et al. Beyond medications and diet: Alternative approaches to lowering blood pressure: A scientific statement from the American heart association. Hypertension. 2013;61:1360–1383. doi: 10.1161/HYP.0b013e318293645f.
    1. Moreira S.R., Cucato G.G., Terra D.F., Ritti-Dias R.M. Acute blood pressure changes are related to chronic effects of resistance exercise in medicated hypertensives elderly women. Clin. Physiol. Funct. Imaging. 2014;36:242–248. doi: 10.1111/cpf.12221.
    1. Nobrega A.C. The subacute effects of exercise: Concept, characteristics, and clinical implications. Exerc. Sport Sci. Rev. 2005;33:84–87. doi: 10.1097/00003677-200504000-00005.
    1. Sharman J.E., La Gerche A., Coombes J.S. Exercise and cardiovascular risk in patients with hypertension. Am. J. Hypertens. 2015;28:147–158. doi: 10.1093/ajh/hpu191.
    1. Smart N.A., Waldron M., Ismail H., Giallauria F., Vigorito C., Cornelissen V., Dieberg G. Validation of a new tool for the assessment of study quality and reporting in exercise training studies: Testex. Int. J. Evid. Based Healthc. 2015;13:9–18. doi: 10.1097/XEB.0000000000000020.
    1. Porro T., Colombo F., Azzola F.L., Orlandi L., Merati M.G., Libretti A. Diurnal blood pressure variability in essential hypertension and vascular reactivity to isometric stress. J. Hum. Hypertens. 1995;9:329–335.
    1. Araujo C.G., Duarte C.V., Goncalves Fde A., Medeiros H.B., Lemos F.A., Gouvea A.L. Hemodynamic responses to an isometric handgrip training protocol. Arq. Bras. Cardiol. 2011;97:413–419.
    1. Olher R.R., Bocalini D.S., Bacurau R.F., Rodriguez D., Figueira A., Jr., Pontes F.L., Jr., Navarro F., Simoes H.G., Araujo R.C., Moraes M.R. Isometric handgrip does not elicit cardiovascular overload or post-exercise hypotension in hypertensive older women. Clin. Interv. Aging. 2013;8:649–655.
    1. Carlson D.J., Inder J., Palanisamy S.K., McFarlane J.R., Dieberg G., Smart N.A. The efficacy of isometric resistance training utilizing handgrip exercise for blood pressure management: A randomized trial. Medicine. 2016;95:e5791. doi: 10.1097/MD.0000000000005791.
    1. Badrov M.B., Horton S., Millar P.J., McGowan C.L. Cardiovascular stress reactivity tasks successfully predict the hypotensive response of isometric handgrip training in hypertensives. Psychophysiology. 2013;50:407–414. doi: 10.1111/psyp.12031.
    1. Stiller-Moldovan C., Kenno K., McGowan C.L. Effects of isometric handgrip training on blood pressure (resting and 24 h ambulatory) and heart rate variability in medicated hypertensive patients. Blood Press. Monit. 2012;17:55–61. doi: 10.1097/MBP.0b013e32835136fa.
    1. Peters P.G., Alessio H.M., Hagerman A.E., Ashton T., Nagy S., Wiley R.L. Short-term isometric exercise reduces systolic blood pressure in hypertensive adults: Possible role of reactive oxygen species. Int. J. Cardiol. 2006;110:199–205. doi: 10.1016/j.ijcard.2005.07.035.
    1. Taylor A.C., McCartney N., Kamath M.V., Wiley R.L. Isometric training lowers resting blood pressure and modulates autonomic control. Med. Sci. Sports Exerc. 2003;35:251–256. doi: 10.1249/01.MSS.0000048725.15026.B5.
    1. Millar P.J., Bray S.R., McGowan C.L., MacDonald M.J., McCartney N. Effects of isometric handgrip training among people medicated for hypertension: A multilevel analysis. Blood Press. Monit. 2007;12:307–314. doi: 10.1097/MBP.0b013e3282cb05db.
    1. Schroeder E.B., Liao D., Chambless L.E., Prineas R.J., Evans G.W., Heiss G. Hypertension, blood pressure, and heart rate variability: The atherosclerosis risk in communities (ARIC) study. Hypertension. 2003;42:1106–1111. doi: 10.1161/01.HYP.0000100444.71069.73.

Source: PubMed

Sponzoři a spolupracovníci

Zdravotní podmínky

Drogové intervence

3
Předplatit