An evidence-based analysis of managing hypertension with isometric resistance exercise - are the guidelines current?

Title
An evidence-based analysis of managing hypertension with isometric resistance exercise - are the guidelines current?
Publication Date
2020-04
Author(s)
Smart, Neil A
( author )
OrcID: https://orcid.org/0000-0002-8290-6409
Email: nsmart2@une.edu.au
UNE Id une-id:nsmart2
Gow, Jeffrey
Bleile, Beatrice
( author )
OrcID: https://orcid.org/0000-0003-2254-6832
Email: bbleile@une.edu.au
UNE Id une-id:bbleile
Van der Touw, Thomas
Pearson, Melissa J
( author )
OrcID: https://orcid.org/0000-0003-2639-2615
Email: mpears28@une.edu.au
UNE Id une-id:mpears28
Type of document
Journal Article
Language
en
Entity Type
Publication
Publisher
Nature Publishing Group
Place of publication
United Kingdom
DOI
10.1038/s41440-019-0360-1
UNE publication id
une:1959.11/31731
Abstract
Exercise guidelines for managing hypertension maintain aerobic exercise as the cornerstone prescription, but emerging evidence of the antihypertensive effects of isometric resistance training (IRT) may necessitate a policy update. We conducted individual patient data (IPD) meta-analyses of the antihypertensive effects of IRT. We utilized a one-step fitted mixed effects model and a two-step model with each analyzed trial using a random effects analysis. We classified participants as responders if they lowered their systolic blood pressure (SBP) by ≥5 mmHg, diastolic (DBP) or mean arterial blood pressure (MAP) by ≥3 mmHg. Twelve studies provided data on 326 participants. IRT produced significant reductions in SBP, DBP, and MAP. The SBP responder rates for both groups, or the absolute risk reduction (ARR) between groups, was 28.1% in favor of the IRT group. The number needed to treat (NNT) to achieve one 5 mmHg reduction in SBP was 3.56, 95% CI [2.56, 5.83], or four people. The ARR for DBP was 20.0% in favor of IRT. Therefore, the NNT to achieve one 3 mmHg decrease in DBP was five people, 95% CI [3.22, 11.10]. The ARR for MAP was 28.2% in favor of IRT. Therefore, the NNT to achieve one 3 mmHg reduction in MAP was four people, 95% CI [2.80, 7.42]. Our analyses demonstrated that IRT (three times per week for a total of 8 min of squeezing activity) is able to reduce the participants’ SBP by 6–7 mmHg, equating to a 13% reduction in the risk for myocardial infarction and 22% for stroke.
Link
Citation
Hypertension Research, 43(4), p. 249-254
ISSN
1348-4214
0916-9636
Pubmed ID
31758166
Start page
249
End page
254

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