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The antihypertensive effects of aerobic versus isometric handgrip resistance exercise

Ash, Garrett I.; Taylor, Beth A.; Thompson, Paul D.; MacDonald, Hayley V.; Lamberti, Lauren; Chen, Ming-Hui; Farinatti, Paulo; Kraemer, William J.; Panza, Gregory A.; Zaleski, Amanda L.; Deshpande, Ved; Ballard, Kevin D.; Mujtaba, Mohammadtokir; White, C. Michael; Pescatello, Linda S.

doi: 10.1097/HJH.0000000000001176
ORIGINAL PAPERS: Exercise

Background: Aerobic exercise reduces blood pressure (BP) on average 5–7 mmHg among those with hypertension; limited evidence suggests similar or even greater BP benefits may result from isometric handgrip (IHG) resistance exercise.

Method: We conducted a randomized controlled trial investigating the antihypertensive effects of an acute bout of aerobic compared with IHG exercise in the same individuals. Middle-aged adults (n = 27) with prehypertension and obesity randomly completed three experiments: aerobic (60% peak oxygen uptake, 30 min); IHG (30% maximum voluntary contraction, 4 × 2 min bilateral); and nonexercise control. Study participants were assessed for carotid-femoral pulse wave velocity pre and post exercise, and left the laboratory wearing an ambulatory BP monitor.

Results: SBP and DBP were lower after aerobic versus IHG (4.8 ± 1.8/3.1 ± 1.3 mmHg, P = 0.01/0.04) and control (5.6 ± 1.8/3.6 ± 1.3 mmHg, P = 0.02/0.04) over the awake hours, with no difference between IHG versus control (P = 0.80/0.83). Pulse wave velocity changes following acute exercise did not differ by modality (aerobic increased 0.01 ± 0.21 ms, IHG decreased 0.06 ± 0.15 ms, control increased 0.25 ± 0.17 ms, P > 0.05). A subset of participants then completed either 8 weeks of aerobic or IHG training. Awake SBP was lower after versus before aerobic training (7.6 ± 3.1 mmHg, P = 0.02), whereas sleep DBP was higher after IHG training (7.7 ± 2.3 mmHg, P = 0.02).

Conclusion: Our findings did not support IHG as antihypertensive therapy but that aerobic exercise should continue to be recommended as the primary exercise modality for its immediate and sustained BP benefits.

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aUniversity of Connecticut, Storrs

bYale University, New Haven

cHartford Hospital, Hartford, Connecticut, USA

dUniversity of Rio de Janeiro State, Rio de Janeiro

eSalgado de Oliveira University, Niteroi, Brazil

fThe Ohio State University, Columbus

gMiami University, Oxford, Ohio

hInstitute for Systems Genomics, Farmington, Connecticut, USA

Correspondence to Garrett I. Ash, Yale University West Campus, School of Nursing; P.O. Box 27399; West Haven, CT 06516–7399, USA. Tel: +1 203 444 3079; fax: +1 203 785 6455; e-mail: Garrett.Ash@yale.edu

Abbreviations: AHA, American Heart Association; BMI, body mass index; BP, blood pressure; HOMA, homeostatic model assessment of insulin resistance; IHG, isometric handgrip; MVC, maximum voluntary contraction; PEH, postexercise hypotension; PWV, pulse wave velocity; VO2peak, peak oxygen consumption

Received 7 September, 2016

Accepted 12 October, 2016

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (http://www.jhypertension.com).

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