Resistance Training for High Blood Pressure

(HEART Trial)

Overseen By Renaud Tremblay, M.Sc.

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Université de Sherbrooke

Disqualifiers: Orthopedic limitations, Unstable hypertension, Type 2 diabetes, Cardiovascular event, Others

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

Compensation: Varies

Number of Visits: 7

36 Participants Needed

Trial Summary

Will I have to stop taking my current medications?

The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your doctor.

What data supports the effectiveness of the treatment Resistance Training for high blood pressure?

Research shows that resistance training can lower blood pressure in people with prehypertension and hypertension, with reductions of about 7 mmHg in systolic (upper number) and 4 mmHg in diastolic (lower number) blood pressure. This effect is similar to taking blood pressure medication and can also improve overall heart health. ^{1 2 3 4 5}

Is resistance training safe for people with high blood pressure?

Resistance training, including isometric resistance training (IRT), is generally safe for people with high blood pressure when done properly. Studies show that it can be safely included as part of a treatment plan, especially for those who cannot do aerobic exercise, as long as it is supervised and tailored to the individual's health status. ^{1 2 3 5 6}

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

Resistance training is unique because it not only helps reduce blood pressure but also increases muscle strength, making it beneficial for overall fitness. Unlike medications, it involves physical exercises that can be tailored to individual needs, and it can be safely integrated with aerobic exercises for a comprehensive approach to managing high blood pressure. ^{1 2 3 7 8}

What is the purpose of this trial?

The goal of the clinical trial is to understand the effect of two resistance training protocols employing different loading intensities (% of 1 repetition maximum; 1-RM), but with standardized effort intensity (2 repetitions in reserve; RIR) on ambulatory blood pressure in aging females. The main questions it aims to answer are: * to examine the acute effects of low (50% 1-RM) and high (80% 1-RM) load intensity resistance exercise with a standardized high effort intensity on post-exercise hypotension and ambulatory blood pressure responses in aging females; * deepen the understanding of the mechanisms underlying acute reductions in blood pressure in response to resistance exercise performed at different load intensities. To this end, autonomic activity will be estimated alongside the measurement of central arterial compliance (i.e., carotid artery), and serum biomarkers of endothelial function; * document the affective valence and enjoyment associated with low (50% 1-RM) and high (80% 1-RM) load intensity resistance exercise when performed at a high perceived effort. Researchers will compare the effect of: 1) a low load (LL-RE) intensity protocol consisting of 3 sets of each exercise at 50% 1-RM, performed until reaching a hard perceived effort intensity (i.e., RIR-2); 2) high load (HL-RE) intensity protocol consisting of 3 sets of each exercise at 80% of 1-RM, performed until reaching a hard perceived effort intensity (i.e., RIR-2); 3) and a control condition (CON) consisting of a standardized non-fatiguing cognitive task. Participants will participate in: * A preliminary assessment visit; * Two familiarization visits to validate the exercise prescriptions; * Three experimental visits (CON, LL-RE, HL-RE).

Research Team

Eléonor Riesco, Ph.D.

Principal Investigator

Université de Sherbrooke

Eligibility Criteria

This trial is for aging females with high blood pressure. Participants should be able to perform resistance training exercises and undergo blood pressure monitoring. Specific eligibility details are not provided, but typically participants must meet certain health criteria.

Inclusion Criteria

I am between 50 and 70 years old.

Physically inactive (< 150 minutes of structured aerobic physical activity per week)

My blood pressure is either normal-high or at stage 1 hypertension.

Exclusion Criteria

I have been diagnosed with type 2 diabetes.

I am scheduled for surgery during the study period.

I started hormone replacement therapy less than 4 months ago.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

1 visit (in-person)

Preliminary Assessment

Preliminary assessment visit to collect baseline data such as resting heart rate, blood pressure, and metabolic profile

1 day

1 visit (in-person)

Familiarization

Two sessions to familiarize participants with the exercises and the concept of perceived effort

2 weeks

2 visits (in-person)

Experimental

Participants undergo three experimental conditions: control, low-load resistance exercise, and high-load resistance exercise

3 weeks

3 visits (in-person)

Follow-up

Participants are monitored for changes in blood pressure and other health metrics post-exercise

24 hours post each experimental condition

Continuous monitoring

Treatment Details

Interventions

• Resistance Training

Trial Overview The study compares the effects of low (50% of max strength) and high (80% of max strength) intensity resistance training on blood pressure, heart artery function, and enjoyment levels in aging females against a non-exercise control activity.

Participant Groups

Group I: Condition LL-RE Experimental Treatment 1 Intervention

Low-load resistance exercise

Group II: Condition HL-RE Experimental Treatment 1 Intervention

High-load resistance exercise

Group III: Condition CON Placebo Group 1 Intervention

Control condition

Who Is Running the Clinical Trial?

Université de Sherbrooke

Lead Sponsor

Trials

317

Recruited

79,300+

Findings from Research

Dynamic resistance training can be safely included in cardiac rehabilitation for selected patients, as it does not pose a higher risk than aerobic training when properly supervised and tailored to individual needs.

Low-intensity resistance training (40-60% of maximum voluntary contraction) with controlled repetitions leads to only modest increases in blood pressure, similar to moderate endurance training, making it a viable option for improving muscle strength and cardiovascular health in patients with good cardiac function.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. Bjarnason-Wehrens, B., Mayer-Berger, W., Meister, ER., et al.[2019]

In a study involving 25 patients with controlled hypertension, resistance exercise led to a significant increase in systolic blood pressure immediately after workouts, but diastolic pressure remained stable, indicating a safe acute response to this type of exercise.

The research suggests that while resistance exercise is generally safe for patients with hypertension, exercising larger muscle groups like the femoral quadriceps at high intensity may cause a greater increase in systolic blood pressure.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Pressure response after resistance exercise for different body segments in hypertensive people. Battagin, AM., Dal Corso, S., Soares, CL., et al.[2019]

Isometric resistance training (IRT) has been shown to significantly lower blood pressure by an average of 7.4/3.3 mmHg, which is comparable to the effects of antihypertensive medications, and can reduce the risk of major cardiovascular events by 13% to 22%.

IRT is safe for a variety of patient populations and is particularly beneficial for individuals who cannot engage in aerobic exercise or have resistant hypertension, requiring only about 17 minutes of training per week.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. Baffour-Awuah, B., Pearson, MJ., Dieberg, G., et al.[2023]

References

1. England pubmed.ncbi.nlm.nih.gov

Recommendations for resistance exercise in cardiac rehabilitation. Recommendations of the German Federation for Cardiovascular Prevention and Rehabilitation. [2019]

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

Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials. [2022]

3. Brazil pubmed.ncbi.nlm.nih.gov

Pressure response after resistance exercise for different body segments in hypertensive people. [2019]

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

Chronic effect of resistance training on blood pressure in older adults with prehypertension and hypertension: A systematic review and meta-analysis. [2023]

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

An evidence-based guide to the efficacy and safety of isometric resistance training in hypertension and clinical implications. [2023]

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

The effectiveness and safety of isometric resistance training for adults with high blood pressure: a systematic review and meta-analysis. [2023]

7. Switzerland pubmed.ncbi.nlm.nih.gov

Blood Pressure Increase in Hypertensive Individuals During Resistance Training Protocols With Equated Work to Rest Ratio. [2020]

8. England pubmed.ncbi.nlm.nih.gov

Resistance training to reduce resting blood pressure and increase muscle strength in users and non-users of anti-hypertensive medication: A meta-analysis. [2021]