Effects Of Home-based Isometric Handgrip On Blood Pressure In Older Adults With High Blood Pressure

High blood pressure (BP) is the major modifiable cardiovascular disease risk factor. Isometric handgrip exercise (IHT) has been shown to reduce BP in individuals with hypertension. PURPOSE: The primary purpose of the HoldAge Trial (NCT04275037) was to examine the effectiveness of a home-based IHT or home-based aerobic exercise training (AET) in reducing ambulatory and office BP in older adults with high normal BP to stage 1 hypertension. METHODS: Participants (n = 84, 38 men, 71.1 ± 3.6 years, systolic BP (SBP) 137.1 ± 13.8 mmHg, diastolic BP 80.8 ± 8.3 mmHg) were randomized based on sex and SBP into IHT (n = 28), AET (n = 28), or attention control group (AC, n = 28). Participants performed IHT or AET 3 times/week for 8 weeks. IHT consisted of 4x45 bilateral contractions at 50% of the maximum voluntary contraction with 1 minute rest between sets. AET consisted of walking at 50-70% of estimated peak oxygen consumption. ACG received standardized optimal medical care including lifestyle advice. RESULTS: Seventy-two participants were included in the analysis for the ambulatory blood pressure (ABPM) variables and 76 for the office BP. The self-reported adherence was 93.5 ± 15.6% for IHT and 85.9 ± 30.4% for AET. There were no significant differences between the three groups at baseline for any office and ambulatory BP. IHT significantly reduced office systolic BP (OSBP, -8.0 ± 13.4 mmHg; p = 0.004), office diastolic BP (ODBP, -3.4 ± 7.4 mmHg; p = 0.024), and office pulse pressure (OPP, -4.6 ± 8.5 mmHg; p = 0.009), while AET only reduced OSBP (-6 mmHg±12.2 mmHg; p = 0.027). There were no significant changes over time in office BP in the AC group over time. No significant differences over time in ABPM were observed following IHT, AET, or AC group, except for the AC group, which reduced 24 h-DBP (-1.3 mmHg±3.1 mmHg; p = 0.048). CONCLUSIONS: The results from HoldAge trial suggest that home-based IHT and home-based AET decrease office BP in older adults with high normal to stage I hypertension. Work financially funded by FEDER funds through COMPETE 2020 (Ref:POCI-01-0145-FEDER-030646), Portuguese FCT (Ref:PTDC/SAUDES/30646/2017) and the following project UIDB/04045/2020 (https://sciproj.ptcris.pt/157498UID). DP PhD funded by Portuguese FCT (Ref:SFRH/BD/147082/2019)