Effects of home-based isometric handgrip or aerobic training on blood pressure variability and vascular health in older adults with elevated blood pressure and hypertension: secondary results from The HoldAge Trial

BACKGROUND: Hypertension is a multifactorial condition that is likely to affect older adults. We evaluated the effects of home-based isometric handgrip training (IHT) or aerobic exercise training (AET) on vascular health of older adults with elevated blood pressure (BP) and hypertension. METHODS: The HoldAge trial (NCT04275032) was a two-center prospective randomized controlled trial. Eighty-four participants (46 women, 71.1 ± 3.6 years, BP: 137.1 ± 13.8/80.8 ± 8.3 mmHg) were randomized into IHT, AET, or usual medical care. Participants performed IHT or AET three times/week for 8 weeks. IHT consisted of 4 × 45 bilateral contractions at 50% of maximum voluntary contraction with 1-min rest between sets. AET consisted of walking 30 min at 50-70% of maximum oxygen consumption. Usual medical care received standard medical care. Outcome comprised blood pressure variability (BPV), flow-mediated dilation (FMD), aortic pulse wave velocity (aoPWV), and endothelial function and inflammation biomarkers. RESULTS: No significant group × time interaction effects occurred for 24-h and daytime BPV, FMD, aoPWV, and circulating biomarkers (P > 0.05). A significant group × time interaction occurred for nighttime systolic BPV (P = 0.005). IHT decreased nighttime systolic BPV over time (-1.5 ± 3.0 mmHg; P = 0.011), while AET (1.1 ± 2.9 mmHg; P = 0.064) and usual medical care (0.6 ± 2.7 mmHg; P = 0.344) did not. CONCLUSION: Home-based IHT effectively reduces nighttime systolic BPV in older adults with elevated BP and hypertension, suggesting it could serve as a valuable nonpharmacological strategy to improve vascular health.