An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications.

Journal article

Baffour-Awuah, Biggie, Pearson, Melissa J, Dieberg, G., Wiles, Jonathan D and Smart, Neil A 2023. An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. Clinical Hypertension. 29 (1), p. 9. https://doi.org/10.1186/s40885-022-00232-3
AuthorsBaffour-Awuah, Biggie, Pearson, Melissa J, Dieberg, G., Wiles, Jonathan D and Smart, Neil A
AbstractMore than 30 randomized controlled trials, supported by individual patient-level and group-level meta-analyses and a Delphi analysis of expert opinion, unequivocally show isometric resistance training (IRT) elicits antihypertensive benefits in healthy people and those with chronic illness. We aim to provide efficacy and safety evidence, and a guide for IRT prescription and delivery. Recommendations are made for the use of IRT in specific patient populations and appropriate methods for IRT delivery. Published data suggest IRT consistently elicits mean blood pressure reductions of 7.4/3.3 mmHg systolic blood pressure/diastolic blood pressure, equivalent to antihypertensive medication monotherapy. Blood pressure reductions of this size are associated with an approximate 13% to 22% reduction in major cardiovascular events. Moreover, IRT is safe in a range of patient populations. We suggest that IRT has the greatest potential benefit when used as an antihypertensive therapy in individuals unwilling and/or unable to complete aerobic exercise, or who have had limited adherence or success with it; individuals with resistant or uncontrolled hypertension, already taking at least two pharmacological antihypertensive agents; and healthy or clinical populations, as an adjunct to aerobic exercise and dietary intervention in those who have not yet attained control of their hypertension. IRT is efficacious and produces clinically meaningful blood pressure reductions (systolic blood pressure, 7 mmHg; diastolic blood pressure, 3 mmHg). IRT is safe and typical program delivery requires only about 17 min weekly. IRT should be used as an adjunct to other exercise modalities, in people unable to complete other types of exercise, or in resistant hypertension.
KeywordsHypertension; Blood pressure; Exercise; Isometric Resistance Training
Year2023
JournalClinical Hypertension
Journal citation29 (1), p. 9
ISSN2056-5909
Digital Object Identifier (DOI)https://doi.org/10.1186/s40885-022-00232-3
Official URLhttps://clinicalhypertension.biomedcentral.com/articles/10.1186/s40885-022-00232-3
Publication dates
Online15 Mar 2023
Print01 Mar 2023
Publication process dates
Deposited29 Mar 2023
Accepted20 Dec 2022
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Swaine, I., Hunter, A., Carlton, K., Wiles, J. and Coleman, D. 2010. Reproducibility of limb power outputs and cardiopulmonary responses to exercise using a novel swimming training machine. International Journal of Sports Medicine. 31 (12), pp. 854-859. https://doi.org/10.1055/s-0030-1265175
The effect of sodium bicarbonate ingestion on 1500-m racing time
Bird, S., Wiles, J. and Robbins, J. 1995. The effect of sodium bicarbonate ingestion on 1500-m racing time. Journal of Sports Sciences. 13 (5), pp. 399-403. https://doi.org/10.1080/02640419508732255
Validity and reliability of the Ergomopro Powermeter
Kirkland, A., Coleman, D., Wiles, J. and Hopker, J. 2008. Validity and reliability of the Ergomopro Powermeter. International Journal of Sports Medicine. 29 (11), pp. 913-916. https://doi.org/10.1055/s-2008-1038621
The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test
Wiles, J., Allum, S., Coleman, D. and Swaine, I. 2007. The relationships between exercise intensity, heart rate, and blood pressure during an incremental isometric exercise test. Journal of Sports Sciences. 26 (2), pp. 155-162. https://doi.org/10.1080/02640410701370655
A novel method for the performance of isometric exercise in the home
Wiles, J., Coleman, D., Dunford, M. and Swaine, I. 2005. A novel method for the performance of isometric exercise in the home. Journal of Sports Sciences. 23 (8), pp. 795-803. https://doi.org/10.1080/02640410400021658
The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial
Wiles, J., Coleman, D., Tegerdine, M. and Swaine, I. 2006. The effects of caffeine ingestion on performance time, speed and power during a laboratory-based 1 km cycling time-trial. Journal of Sports Sciences. 24 (11), pp. 1165-1171. https://doi.org/10.1080/02640410500457687
Validity and reliability of a new isometric hand dynamometer
Wiles, J., Boyson, H., Balmer, J. and Bird, S. 2001. Validity and reliability of a new isometric hand dynamometer. Sports Engineering. 4 (3), pp. 147-152. https://doi.org/10.1046/j.1460-2687.2001.00080.x
Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels
Perkins, G., Owen, A., Swaine, I. and Wiles, J. 2006. Relationships between pulse wave velocity and heart rate variability in healthy men with a range of moderate-to-vigorous physical activity levels. European Journal of Applied Physiology. 98 (5), pp. 516-523. https://doi.org/10.1007/s00421-006-0303-9
Differences in efficiency between trained and recreational cyclists
Hopker, J., Coleman, D. and Wiles, J. 2007. Differences in efficiency between trained and recreational cyclists. Applied Physiology, Nutrition and Metabolism. 32 (6), pp. 1036-1042. https://doi.org/10.1139/H07-070
Reliability of sprint test indices in well-trained cyclists
Coleman, D., Wiles, J., Nunn, M. and Smith, M. 2005. Reliability of sprint test indices in well-trained cyclists. International Journal of Sports Medicine. 26 (5), pp. 383-387. https://doi.org/10.1055/s-2004-821226
Power output measurement during treadmill cycling
Coleman, D., Wiles, J., Davison, R., Smith, M. and Swaine, I. 2007. Power output measurement during treadmill cycling. International Journal of Sports Medicine. 28 (6), pp. 525-530. https://doi.org/10.1055/s-2006-955888