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.

Publication dates
Authors	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.
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.
Keywords	Hypertension; individual patient data meta-analysis; isometric exercise
Year	2019
Journal	Journal of Hypertension
Publisher	Lippincott, Williams and Wilkins
ISSN	0263-6352
Digital Object Identifier (DOI)	doi:10.1097/HJH.0000000000002105
Online	18 Mar 2019
Publication process dates
Deposited	08 Mar 2019
Accepted	08 Mar 2019
Accepted author manuscript	18036_IPD Feb 20 2018-Revised submssion.pdf

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Accepted author manuscript

18036_IPD Feb 20 2018-Revised submssion.pdf

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