EFFECT OF ISOMETRIC HANDGRIP EXERCISE ON BLOOD PRESSURE REDUCTION IN PATIENTS DIAGNOSED WITH HYPERTENSION. SYSTEMATIC REVIEW

J.A. Carranza Paredes¹, A. Dubey Malagon², D. Yepez Quiroz¹

¹ENES León, Physiotherapy, Leon, Mexico, ²Instituto Mexicano del Seguro Social, Physical Medicine and Rehabilitation, Mexico City, Mexico

Background: Hypertension is a modifiable risk factor for preventing coronary heart disease and renal failure. Current treatment involves the use of two or more drugs. The American Heart Association proposes isometric handgrip exercise as an alternative non-pharmacological treatment for blood pressure control.

Purpose: To review previous literature on the effects of isometric handgrip exercise at different intensities on blood pressure reduction in patients with hypertension. In addition, to document the doses and the variability of the training effect in people with different blood pressure stages.

Methods: A systematic review was performed using the PRISMA methodology. A search for studies indexed in Ebscohost, PubMed, Elsevier, and OVID. All randomized clinical trials and quasi-experimental studies that investigated the effect of isometric hand grip on blood pressure in prehypertensive, hypertensive, and normotensive individuals were considered, with or without medical treatment. Studies that included older adults with other chronic degenerative diseases and additional dietary changes were excluded. The PEDro methodology was used to assess the risk of bias in the articles analyzed.

Results: 2,611 articles were identified, and only 20 articles met inclusion criteria and were analyzed, totaling 642 participants. The average score for measuring methodological quality using the PEDro scale was six points. Of the 20 articles, 15 were randomized clinical trials, and the remaining five were quasi-experimental studies. The studies included various populations, from young people with normal blood pressure to older people with hypertension, obesity, and a sedentary lifestyle. The study participants ages range from 29.2 to 73.2 years. Twelve articles report four sets with 2 minutes of isometric hand grip contraction with a minute rest at 30% of a maximal voluntary contraction, at a frequency of three times per week for eight weeks, with both hands or unilateral in the non-dominant hand. Eight studies reported post-training blood pressure reduction, reported decreased systolic, diastolic, and mean blood pressure. Thirteen studies reported a drop in systolic blood pressure with an average of 8mmHg. No article reported post-intervention adverse events, except those randomized clinical trials that analyzed training at 24 hours, in which an increase in blood pressure was observed.

Conclusions: This review provides favorable evidence of a professionally supervised isometric hand grip protocol for blood pressure reduction in patients diagnosed with hypertension and normotensive. Future studies are required to verify the intervention's effectiveness and the characteristics of participants who may obtain desired results.

Implications: The results suggest that an isometric handgrip at 30% of a maximal voluntary contraction can be used as a strategy for the reduction and prevention of hypertension. Therefore, physical therapists and physicians should consider encouraging isometric handgrip among their patients, especially those who find it challenging to perform aerobic exercise or as an adjunct.

Funding acknowledgements: This review was not funded by any institution or person.

Keywords:
Hypertension
Handgrip
Isometric

Topics:
Cardiorespiratory
Non-communicable diseases (NCDs) & risk factors
Health promotion & wellbeing/healthy ageing/physical activity

Did this work require ethics approval? No

Reason: Not applicable because it is a systematic review.