Effect of isometric resistance training at different intensities on blood pressure: A systematic review of randomized controlled trials
Keywords:
exercise, resistance training, hypertension, systematic reviewAbstract
There are currently 1.28 billion adults with hypertension worldwide, the majority (two-thirds) living in low- and middle-income countries (World Health Organization, 2021). Isometric resistance training (IRT) generates antihypertensive benefits in this population (Baffour-Awuah, Pearson, Dieberg, & Smart, 2023; Baffour-Awuah, Pearson, Dieberg, Wiles et al., 2023; Hansford et al., 2021; Loaiza-Betancur et al., 2020; Loaiza-Betancur & Chulvi-Medrano, 2020). No systematic review has compared the effectiveness and safety of different intensities of IRT in adults. Therefore, we aimed to identify, evaluate, and synthesize the benefits and harms of IRT at different intensities on blood pressure in normal, prehypertensive, and hypertensive adults.
This systematic review followed the recommendations of the PRISMA statement (Page et al., 2021) and has been registered in PROSPERO (CRD42019132393). We searched MEDLINE, Embase, CENTRAL, CINHAL, clinical trial registries, and gray literature repositories from their inception to September 3, 2023. We included randomized controlled trials (RCTs) in normal, normal to high blood pressure, and high blood pressure adults comparing different intensities of IRT on blood pressure and adverse events. Two reviewers independently performed title, abstract, and full-text screening, data extraction, assessment of the risk of bias, and the certainty of the evidence.
This systematic review included 12 RCTs (n = 467) (Baross et al., 2012; Carlson, 2017; Carlson et al., 2016; Decaux et al., 2022; Gill et al., 2015; Gregory, n.d.; Hess et al., 2016; Javidi et al., 2022; Kharva & Thakar, 2023; Pagonas et al., 2017; Seidel et al., 2021; Wiles et al., 2010). The RCTs had a high risk of selection and attrition bias. Three intensities of IST (very low intensity, low intensity, and high intensity) were compared. Very low certainty of evidence showed that compared with high intensity, IRT at low intensity significantly but not clinically important may reduce SBP (MD -6.82 mm Hg, 95% CI -10.96 to -2.69, I2 = 32% (Javidi et al., 2022; Kharva & Thakar, 2023) and MAP (MD -4.3 mm Hg, 95% CI -7.11 to -1.49, I2= NA (Javidi et al., 2022). No significant differences were found in any other comparisons and subgroup analyses. No adverse events were reported by the studies.
Very low-quality evidence reports no differences between IRT intensities on reductions in blood pressure in normal, normal to high blood pressure, and high blood pressure adults. Our confidence in this body of evidence was limited due to small studies with methodological problems. Finally, the true effect is likely substantially different from those found in this research.
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Copyright (c) 2024 Andrés Felipe Loaiza-Betancur, Lisette Ethel Iglesias González, Víctor Díaz-López
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