Effect of Long-Term Isometric Handgrip Training on Blood Pressure in Medicated Hypertensive Patients

Abstract

Introduction

I. INTRODUCTION

Hypertension, or high blood pressure, is a major global health problem that affects millions of people worldwide. It is a significant risk factor for cardiovascular diseases such as stroke, heart attack, and heart failure. The World Health Organization (WHO) estimates that hypertension affects approximately 1.13 billion people globally, and its prevalence is rising. In India, hypertension is responsible for a large number of cardiovascular-related deaths.

The standard treatment for hypertension includes lifestyle changes (e.g., exercise, diet modification) and pharmacological interventions (e.g., ACE inhibitors, beta-blockers, diuretics). Recent studies have shown that isometric handgrip training can significantly lower blood pressure. This form of exercise involves contraction of the forearm muscles without changing the length of the muscles, and it has been suggested as an effective non-pharmacological approach to managing blood pressure.

While most studies on isometric handgrip training have focused on short-term protocols, there is growing interest in examining the effects of long-term isometric handgrip training on hypertensive patients, especially those already taking antihypertensive medications. This study aims to evaluate the effect of a long-term isometric handgrip training program on blood pressure in medicated hypertensive patients.

II. AIM

To determine the effect of long-term isometric handgrip training on blood pressure (systolic and diastolic) in medicated hypertensive patients.

III. OBJECTIVES

1. To investigate the impact of long-term isometric handgrip training on systolic and diastolic blood pressure in medicated hypertensive patients.
2. To compare the changes in blood pressure (SBP and DBP) between the experimental group (undergoing handgrip training) and the control group (no training).
3. To assess the safety and feasibility of long-term isometric handgrip training for patients on antihypertensive medications.

IV. STUDY DESIGN

A prospective, randomized controlled trial was conducted to assess the effects of long-term isometric handgrip training on blood pressure in medicated hypertensive patients.

V. MATERIALS USED

1. Mercury Sphygmomanometer
2. Stethoscope
3. Handgrip Dynamometer
4. Stopwatch

VI. OUTCOME MEASURES

1. Systolic Blood Pressure (SBP)
2. Diastolic Blood Pressure (DBP)

VII. METHODOLOGY

A. Sample Size

A total of 40 hypertensive patients (20 in the experimental group and 20 in the control group) were recruited for the study.

1) Inclusion Criteria

• Medically diagnosed hypertensive patients (on antihypertensive medications)
• Age 40-70 years
• Both males and females
• Stable hypertension with no recent changes in medications

2) Exclusion Criteria

• Severe uncontrolled hypertension (SBP > 180 mmHg or DBP > 110 mmHg)
• History of cardiovascular disease (except hypertension)
• Neuromusculoskeletal disorders affecting handgrip function
• Pregnant women or patients with any serious comorbid conditions
• Participation in any form of isometric handgrip training within the past 6 months

B. Study Procedure

1. Pre-treatment BP Measurement: Baseline blood pressure was measured using a mercury sphygmomanometer after 5 minutes of rest, in a seated position.
2. Grip Strength Measurement: Maximum grip strength was measured using a handgrip dynamometer for both the dominant and non-dominant hands.
3. Group Allocation
   • Group A (Experimental Group): Participants performed isometric handgrip exercises for 2 minutes per session, 5 days a week, for a duration of 12 weeks. Each handgrip contraction was performed at 30% of maximal voluntary contraction (MVC) for both hands.
   • Group B (Control Group): Participants did not engage in any handgrip exercises, and only received standard care.
4. Post-treatment BP Measurement: Blood pressure was measured at 6 weeks and 12 weeks to assess the effect of long-term handgrip training.

VIII. STATISTICAL ANALYSIS AND RESULTS

Data were analyzed using GraphPad Prism and compared using paired t-tests for intragroup analysis and independent t-tests for intergroup analysis. A p-value of less than 0.05 was considered statistically significant.

1) Demographic Characteristics Comparison

• Conclusion: There were no significant differences in demographic characteristics between the two groups, ensuring comparability.

IX. INTRAGROUP ANALYSIS

A. Group A (Experimental Group)

• Inference: A significant reduction in SBP was observed at both 6 weeks and 12 weeks. DBP showed a trend toward improvement at 6 weeks and reached statistical significance at 12 weeks.

B. Group B (Control Group)

• Inference: No significant changes in SBP and DBP were observed in the control group during the study period.

C. Post-treatment Comparison Between Groups

• Inference: The experimental group showed a significantly greater reduction in both SBP and DBP compared to the control group at 12 weeks.

X. DISCUSSION

The results of this study suggest that long-term isometric handgrip training is an effective intervention for reducing both systolic and diastolic blood pressure in medicated hypertensive patients. The significant reduction in SBP and DBP in the experimental group indicates that isometric handgrip training can be a valuable adjunct to pharmacological treatment for hypertension.

The mechanisms behind the blood pressure-lowering effects of isometric handgrip training are thought to involve improved vascular endothelial function, enhanced sympathetic regulation, and increased nitric oxide production. Furthermore, long-term training appears to have cumulative effects, with a more pronounced reduction in blood pressure observed at 12 weeks compared to 6 weeks.

XI. LIMITATIONS AND FUTURE RESEARCH

This study had some limitations, including the lack of a true placebo group and the inability to assess the long-term sustainability of blood pressure reduction after discontinuation of training. Future research could explore the optimal duration and intensity of isometric handgrip training, as well as its combined effects with other lifestyle modifications like diet and aerobic exercise.

Conclusion

Long-term isometric handgrip training significantly reduces both systolic and diastolic blood pressure in medicated hypertensive patients. This non-pharmacological intervention is simple, accessible, and may be considered a valuable addition to the management of hypertension, particularly for patients who are unable to engage in more strenuous forms of exercise.

References

[1] High-Intensity Isometric Handgrip Training Lowers Blood Pressure in Hypertensive Individuals Authors: Lane, C., Bell, J., & Williams, S. Journal: Journal of Hypertension [2] Effect of Handgrip Training on Blood Pressure in Older Adults Authors: Gomes, R., Souza, F., & Carvalho, L. Journal: American Journal of Hypertension [3] Isometric Handgrip Exercise for Hypertension: A Review of Mechanisms and Therapeutic Potential Authors: Gilani, S., & Liao, X. Journal: Hypertension Research [4] Long-Term Isometric Handgrip Training Reduces Resting Blood Pressure in Normotensive and Hypertensive Subjects Authors: Whelton, P.K., & Muntner, P. Journal: European Journal of Preventive Cardiology [5] Effects of Isometric Handgrip Exercise on Blood Pressure: A Meta-Analysis Authors: Dong, Y., Zhang, X., & Yang, S. Journal: PLoS One [6] Exercise Interventions for Hypertension: A Review of Clinical Evidence Authors: Thomas, N., & Reddy, P. Journal: Journal of Clinical Hypertension [7] Effects of Isometric Handgrip Exercise on Blood Pressure and Vascular Function in Hypertensive Older Adults Authors: Matz, K., Park, E., & Johnson, P. Journal: Journal of Geriatric Cardiology

Copyright

Copyright © 2024 Jyoti Omesh Akul, Ashwini Dangi. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.