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

Journal article

Smart, N., Way, D., Carlson, D., Millar, P., McGowan, C., Swaine, I., Barros, A., Howden, R., Ritti-Dias, R., Wiles, J., Cornelissen, V., Gordon, B., Taylor, R. and Bleile, B. 2019. Effects of isometric resistance training on resting blood pressure: individual participant data meta-analysis. Journal of Hypertension. https://doi.org/10.1097/HJH.0000000000002105
AuthorsSmart, N., Way, D., Carlson, D., Millar, P., McGowan, C., Swaine, I., Barros, A., Howden, R., Ritti-Dias, R., Wiles, J., Cornelissen, V., Gordon, B., Taylor, R. and Bleile, B.
Abstract

Background:
Previous meta-analyses based on aggregate group-level data report anti-hypertensive 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 ≥3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure.

Results:
Anonymised 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 3-12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting systolic blood pressure (SBP) of -6.22 mmHg (95% CI -7.75, -4.68; p<0.00001); diastolic blood pressure (DBP) of -2.78 mmHg (95% CI -3.92, -1.65; p=0.002); and mean arterial blood pressure (MAP) of -4.12 mmHg (95% CI -5.39, -2.85; p<0.00001). The two-step approach yielded similar results for change in SBP -7.35 mmHg (-8.95, -5.75; p<0.00001), DBP MD -3.29 mmHg (95% CI -5.12, -1.46; p=0.0004) and MAP MD -4.63 mmHg (95% CI -6.18, -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 systolic, diastolic and mean arterial blood pressure.

KeywordsHypertension; individual patient data meta-analysis; isometric exercise
Year2019
JournalJournal of Hypertension
PublisherLippincott, Williams and Wilkins
ISSN0263-6352
Digital Object Identifier (DOI)https://doi.org/10.1097/HJH.0000000000002105
Publication dates
Online18 Mar 2019
Publication process dates
Deposited08 Mar 2019
Accepted08 Mar 2019
Accepted author manuscript
Output statusPublished
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