Handgrip exercise: An innovative non-pharmacological strategy for chronic hypertension in pregnancy

• Chronic hypertension (CH) during pregnancy significantly increases risks of maternal and neonatal complications. • Pharmacologic options for managing blood pressure in pregnant women are limited due to potential risks to fetal development. • Regular exercise reduces hypertensive disorders of pregnancy but its impact on women with pre-existing CH is under-studied. • The article hypothesizes that handgrip exercises may be a safe, nonpharmacological method to manage BP in CH pregnant women. • This approach could offer a low-risk intervention to improve maternal cardiovascular health during pregnancy. Chronic hypertension (CH) during pregnancy is associated with significantly higher risks for both the mother and the baby, yet there are limited therapeutic options due to concerns over fetal safety. We hypothesise that regular isometric handgrip exercise (IHE) could be a safe and effective non-pharmacological approach to improving blood pressure (BP) control in pregnant women with CH. This hypothesis is based on evidence that IHE induces favourable haemodynamic and vascular adaptations, including reductions in systolic and diastolic BP, enhanced endothelial function, and improved autonomic regulation, with minimal cardiovascular stress. Unlike exercises involving larger muscle groups, IHE produces only modest increases in BP, making it a potentially safe intervention even in risky populations. If this approach is supported by clinical evidence demonstrating its efficacy, safety, and feasibility, it could offer a simple, low-cost addition to traditional care, reducing reliance on antihypertensive medication and addressing disparities in hypertension management during pregnancy.