Handgrip Training for High Blood Pressure

Recruiting at 1 trial location

Overseen By João L. Marôco, MS

Age: 18 - 65

Sex: Any

Trial Phase: Academic

Sponsor: University of Massachusetts, Boston

Must not be taking: Antihypertensives, Vasoactives, Cardioactives

Disqualifiers: Cardiovascular, Musculoskeletal, Metabolic, Kidney, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 5

50 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial requires that participants are not taking antihypertensive (blood pressure-lowering) or other vasoactive (affecting blood vessel function) and cardioactive (affecting heart function) medications. If you are on these medications, you would not be eligible to participate.

What data supports the effectiveness of the treatment Isometric handgrip training for high blood pressure?

Research shows that isometric handgrip training can lower resting blood pressure in people with high blood pressure, even those taking medication. This type of exercise is a non-drug method that has been recommended as a first-line treatment for managing high blood pressure. ^{1 2 3 4 5}

Is handgrip training safe for humans?

Research suggests that isometric handgrip training is generally safe for humans, including those with coronary artery disease and hypertension, as it does not cause harmful changes in blood pressure. ^{2 3 6 7 8}

How does isometric handgrip training differ from other treatments for high blood pressure?

Isometric handgrip training is unique because it involves brief, static handgrip exercises that can lower blood pressure without medication. This treatment is performed by squeezing a handgrip device at a specific intensity for short periods, several times a week, and is effective even for those already on blood pressure medication. ^{4 5 9 10 11}

What is the purpose of this trial?

The goal of this intervention is to compare the blood pressure response of young females and males to a single bout of static handgrip exercise before and after static handgrip training (4 weeks). The main questions this study aims to answer are: * Are the lowering blood pressure effects of static handgrip exercise training different between young females and males? * Which factors explain the lowering blood pressure effects of static handgrip training and possible differences between sexes? Is it an improved blood vessel dilation? Is it a reduced stiffening of blood vessels? Is it a reduced fight or flight response resulting in a lower heart rate and blood pumped by the heart into the vessels? All the above? * Which factors regulate blood pressure response during and immediately after a single bout of static handgrip exercise? All participants will be asked to: * Visit the laboratory to perform static handgrip exercise - first visit; * Participants will be randomized (like flipping a coin) to static handgrip exercise training or to a non-exercising phase, with each phase lasting four weeks. Participants will also complete the other condition (handgrip or no handgrip) after completing the first four-week condition * Return to the laboratory after the completion of both static handgrip training and no training to perform the static handgrip exercise of the first visit. The investigators will compare participants' blood pressure response to a single bout static of handgrip exercise after training to their own blood pressure response to the same bout of exercise after the non-training period.

Research Team

Tracy Baynard, PhD

Principal Investigator

University of Massachusetts, Boston

Eligibility Criteria

This trial is for young adults with high blood pressure. Participants will be tested on their response to handgrip exercises, considering factors like improved blood vessel function and stress responses. They must commit to a training phase and a non-training phase, each lasting four weeks.

Inclusion Criteria

BMI < 30 kg/m2

Normal blood pressure as defined by the American Heart Association (<130/90 mmHg)

Being recreationally active (≤ 2 days of structured physical activity)

Exclusion Criteria

I have been diagnosed with a heart, bone, metabolic, or kidney disease.

I am pregnant or have irregular periods.

I have been diagnosed with depression or anxiety.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Initial Laboratory Visit

Participants visit the laboratory to perform static handgrip exercise

1 day

1 visit (in-person)

Training Phase

Participants undergo isometric handgrip training or no training for 4 weeks

4 weeks

3 visits per week (in-person) for training group

Crossover Phase

Participants switch to the alternate condition (training or no training) for another 4 weeks

4 weeks

Post-Intervention Laboratory Visit

Participants return to the laboratory to perform static handgrip exercise after both training and non-training phases

1 day

1 visit (in-person)

Follow-up

Participants are monitored for blood pressure response and other physiological measures

Within 5 days after each intervention phase

Treatment Details

Interventions

• Isometric handgrip training

Trial Overview The study investigates how static handgrip exercise affects blood pressure differently in males and females. It involves initial lab tests, random assignment to either the exercise or no-exercise group for four weeks, followed by another lab test to compare results.

Participant Groups

Group I: Handgrip training Experimental Treatment 1 Intervention

Participants will perform isometric handgrip training 3 days per week for a month.

Group II: Control Active Control 1 Intervention

Participants will not perform isometric handgrip training for a month.

Who Is Running the Clinical Trial?

University of Massachusetts, Boston

Lead Sponsor

Trials

42

Recruited

17,800+

Findings from Research

A high-intensity isometric handgrip exercise protocol significantly reduced systolic blood pressure from 141 mmHg to 127 mmHg and diastolic blood pressure from 79 mmHg to 74 mmHg in older adults with pre or stage-1 hypertension after eight weeks of training.

The study involved 23 participants aged 73.8 years on average, who performed the exercise twice a week, indicating that this type of exercise can be an effective non-pharmacological intervention for managing hypertension in older populations.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effects high intensity isometric handgrip training on blood pressure of hypertensive older people]. Zulantay, SB., Cancino-López, J.[2021]

In a study involving 21 male patients with coronary artery disease (CAD), low-intensity isometric handgrip exercise was found to be safe for participants.

Despite its safety, the isometric handgrip exercise did not result in a temporary reduction in blood pressure, indicating it may not be effective as a nonpharmacologic tool for lowering BP in CAD patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Low-intensity isometric handgrip exercise has no transient effect on blood pressure in patients with coronary artery disease. Goessler, K., Buys, R., Cornelissen, VA.[2022]

In a study of 4597 participants from the NHANES, increased handgrip strength was found to be positively related to higher diastolic blood pressure (DBP) in both men and women.

Specifically in men, particularly those who are overweight or obese, greater handgrip strength was linked to a higher risk of developing hypertension, suggesting that stronger grip may not always indicate better cardiovascular health.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Handgrip strength is positively related to blood pressure and hypertension risk: results from the National Health and nutrition examination survey. Ji, C., Zheng, L., Zhang, R., et al.[2022]

Isometric handgrip (IHG) training can lead to significant increases in left ventricular end-systolic pressure (LVESP) and heart rate in patients with heart failure, without negatively impacting cardiac function or ventricular-arterial coupling.

The response to IHG exercise differs between heart failure patients with reduced ejection fraction (HFrEF) and those with preserved ejection fraction (HFpEF), indicating that patient background and exercise type/intensity can influence cardiovascular responses.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparison of haemodynamic response to muscle reflex in heart failure with reduced vs. preserved ejection fraction. Moriwaki, K., Fujimoto, N., Omori, T., et al.[2022]

Isometric handgrip (IHG) training for 8 weeks did not significantly lower resting or 24-hour ambulatory blood pressure in 11 medicated hypertensive patients, indicating that this intervention may not be effective for those already on medication.

The study also found no improvement in heart rate variability (HRV) with IHG training, suggesting that alternative training methods may be needed for better outcomes in well-managed hypertensive patients.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of isometric handgrip training on blood pressure (resting and 24 h ambulatory) and heart rate variability in medicated hypertensive patients. Stiller-Moldovan, C., Kenno, K., McGowan, CL.[2012]

Isometric handgrip training (IHGT) significantly reduces systolic blood pressure (SBP) by an average of 6.7 mmHg and diastolic blood pressure (DBP) by 4.5 mmHg in individuals with hypertension, based on a systematic review of 9 randomized controlled trials involving adults without comorbid conditions.

In contrast, isometric handgrip exercise (IHGE) did not show any effect on blood pressure, indicating that while IHGT is an effective intervention for managing hypertension, IHGE may not provide the same benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Isometric handgrip training, but not a single session, reduces blood pressure in individuals with hypertension: a systematic review and meta-analysis. Oliveira, PC., Silva, MR., Lehnen, AM., et al.[2023]

Isometric handgrip training (IHT) is safe and well-tolerated in patients with heart disease, showing no adverse reactions during the exercise protocol involving 41 participants.

IHT resulted in a modest and transient increase in blood pressure and heart rate, indicating it can effectively modulate autonomic function without the rapid cardiac responses seen in dynamic exercises.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Hemodynamic responses to an isometric handgrip training protocol. Araújo, CG., Duarte, CV., Gonçalves, Fde A., et al.[2019]

Isometric handgrip (IHG) exercise at 30% of maximal voluntary contraction significantly reduced systolic blood pressure in hypertensive elderly individuals, showing a decrease of up to 20.2 mm Hg after 60 minutes post-exercise.

The study suggests that IHG exercise can be a practical and effective strategy for managing hypertension in older adults, despite no observed changes in blood lactate or nitric oxide levels, indicating that the mechanism behind the blood pressure reduction may not involve these substances.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Acute Hypotension After Moderate-Intensity Handgrip Exercise in Hypertensive Elderly People. Souza, LR., Vicente, JB., Melo, GR., et al.[2019]

Isometric handgrip exercise training can significantly lower resting blood pressure, with one study showing an average decrease of 12.5 mm Hg in systolic and 14.9 mm Hg in diastolic pressure after 8 weeks of training.

Another study demonstrated that even with a different training regimen, participants experienced notable reductions in resting blood pressure (9.5 mm Hg systolic and 8.9 mm Hg diastolic) after 5 weeks, indicating the effectiveness of isometric exercises in managing blood pressure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Isometric exercise training lowers resting blood pressure. Wiley, RL., Dunn, CL., Cox, RH., et al.[2022]

Isometric handgrip training over five days did not significantly lower blood pressure more than simply sitting for 15 minutes each day, indicating that both methods can be effective for reducing blood pressure in middle-aged women.

Both the treatment group (isometric training) and the control group (sitting) showed reductions in blood pressure, suggesting that the training may not be necessary for achieving similar benefits.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effect of short-term isometric handgrip training on blood pressure in middle-aged females. Mortimer, J., McKune, AJ.[2021]

An 8-week isometric handgrip (IHG) training program in 17 healthy older adults led to significant reductions in resting systolic blood pressure, which were correlated with cardiovascular reactivity during stress tasks, particularly the serial subtraction task.

The study suggests that the hypotensive effects of IHG training may be linked to specific myocardial mechanisms, providing insights into how to identify individuals who could benefit from this type of training.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cardiovascular reactivity to psychophysiological stressors: association with hypotensive effects of isometric handgrip training. Millar, PJ., Bray, SR., MacDonald, MJ., et al.[2009]

References

1. Chile pubmed.ncbi.nlm.nih.gov

[Effects high intensity isometric handgrip training on blood pressure of hypertensive older people]. [2021]

2. United States pubmed.ncbi.nlm.nih.gov

Low-intensity isometric handgrip exercise has no transient effect on blood pressure in patients with coronary artery disease. [2022]

3. England pubmed.ncbi.nlm.nih.gov

Handgrip strength is positively related to blood pressure and hypertension risk: results from the National Health and nutrition examination survey. [2022]

4. England pubmed.ncbi.nlm.nih.gov

Comparison of haemodynamic response to muscle reflex in heart failure with reduced vs. preserved ejection fraction. [2022]

5. England pubmed.ncbi.nlm.nih.gov

Effects of isometric handgrip training on blood pressure (resting and 24 h ambulatory) and heart rate variability in medicated hypertensive patients. [2012]

6. England pubmed.ncbi.nlm.nih.gov

Isometric handgrip training, but not a single session, reduces blood pressure in individuals with hypertension: a systematic review and meta-analysis. [2023]

7. Brazil pubmed.ncbi.nlm.nih.gov

Hemodynamic responses to an isometric handgrip training protocol. [2019]

8. United States pubmed.ncbi.nlm.nih.gov

Acute Hypotension After Moderate-Intensity Handgrip Exercise in Hypertensive Elderly People. [2019]

9. United States pubmed.ncbi.nlm.nih.gov

Isometric exercise training lowers resting blood pressure. [2022]

10. South Africa pubmed.ncbi.nlm.nih.gov

Effect of short-term isometric handgrip training on blood pressure in middle-aged females. [2021]

11. England pubmed.ncbi.nlm.nih.gov

Cardiovascular reactivity to psychophysiological stressors: association with hypotensive effects of isometric handgrip training. [2009]