Acute effect of isometric wall squat on hemodynamic and autonomic status according to hypertensive subtypes in adults

Isometric wall squat training (IWST) is effective at lowering blood pressure (BP), primarily through reductions in total peripheral resistance (TPR). However, it remains unclear whether the effects of IWST differ according to hypertension (HTN) subtypes. This study aimed to evaluate the acute hemodynamic and autonomic responses to IWST across hypertensive subtypes in adults. Quasi-experimental study that included adults with newly diagnosed HTN, according to a 24-hour ambulatory blood pressure monitoring. The hemodynamic and autonomic responses during an IWST session (4-repetition) were evaluated using the Task Force®Monitor device according to their hypertensive subtypes: Isolated diastolic hypertension (IDH) and systolic-diastolic hypertension (SDH). The participants (n = 74) had an average age of 53.0±6.8 years; 56.7% (n = 42) were men. None of the participants were receiving antihypertensive pharmacological treatment. Compared to SDH subtype, IDH showed a lower increase in TPR (–198.2; 95%CI:–386.4 to − 10.1 dyn·s·m²·cm−⁵; p = 0.039) but a greater increase in sympathetic activity (LF/HF ratio) (1.0; 95%CI:0.3 a 1.8; p = 0.008), during the averaged isometric squat repetitions. Likewise, during the averaged resting intervals, IDH subtype showed greater reductions in TPR (–181.8; 95%CI:–358.8 to − 4.7 dyn·s·m²·cm−⁵; p = 0.044) and a smaller decrease in LF/HF ratio compared to SDH subtype. Following an IWST session, both IDH and SDH subtypes exhibited significant reductions in TPR and DBP (p < 0.001). Acute responses to IWST differ by HTN subtype in untreated individuals. In particular, the IDH subtype appears to derive a more favorable peripheral vascular response. However, the intervention effectively reduced BP across subtypes, supporting its effectiveness as a low-cost, non-pharmacological strategy.