An evidence-based analysis of managing hypertension with isometric resistance exercise - are the guidelines current?

Smart, Neil A. and Gow, Jeffrey and Blelie, Beatrice and van der Touw, Thomas and Pearson, Melissa J. (2019) An evidence-based analysis of managing hypertension with isometric resistance exercise - are the guidelines current? Hypertension Research. ISSN 0916-9636


Abstract

Exercise guidelines for managing hypertension maintain aerobic exercise as the cornerstone prescription, but emerging evidence of the antihypertensive effects of isometric resistance training (IRT) may necessitate a policy update. We conducted individual patient data (IPD) meta-analyses of the antihypertensive effects of IRT. We utilized a one-step fitted mixed effects model and a two-step model with each analyzed trial using a random effects analysis. We classified participants as responders if they lowered their systolic blood pressure (SBP) by ≥5 mmHg, diastolic (DBP) or mean arterial blood pressure (MAP) by ≥3 mmHg. Twelve studies provided data on 326 participants. IRT produced significant reductions in SBP, DBP, and MAP. The SBP responder rates for both groups, or the absolute risk reduction (ARR) between groups, was 28.1% in favor of the IRT group. The number needed to treat (NNT) to achieve one 5 mmHg reduction in SBP was 3.56, 95% CI [2.56, 5.83], or four people. The ARR for DBP was 20.0% in favor of IRT. Therefore, the NNT to achieve one 3 mmHg decrease in DBP was five people, 95% CI [3.22, 11.10]. The ARR for MAP was 28.2% in favor of IRT. Therefore, the NNT to achieve one 3 mmHg reduction in MAP was four people, 95% CI [2.80, 7.42]. Our analyses demonstrated that IRT (three times per week for a total of 8 min of squeezing activity) is able to reduce the participants’ SBP by 6–7 mmHg, equating to a 13% reduction in the risk for myocardial infarction and 22% for stroke.


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Item Type: Article (Commonwealth Reporting Category C)
Refereed: Yes
Item Status: Live Archive
Additional Information: Published online: 22 November 2019. Permanent restricted access to ArticleFirst version, in accordance with the copyright policy of the publisher.
Faculty/School / Institute/Centre: Current - Faculty of Business, Education, Law and Arts - School of Commerce (1 July 2013 -)
Faculty/School / Institute/Centre: Historic - Institute for Resilient Regions - Centre for Health, Informatics and Economic Research (1 Aug 2018 - 31 Mar 2020)
Date Deposited: 03 Feb 2020 02:17
Last Modified: 09 Feb 2020 23:02
Uncontrolled Keywords: Exercise, hypertension, epidemiology
Fields of Research : 11 Medical and Health Sciences > 1106 Human Movement and Sports Science > 110602 Exercise Physiology
Socio-Economic Objective: C Society > 92 Health > 9202 Health and Support Services > 920201 Allied Health Therapies (excl. Mental Health Services)
Identification Number or DOI: 10.1038/s41440-019-0360-1
URI: http://eprints.usq.edu.au/id/eprint/37769

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