Characteristics associated with responsiveness to isometric handgrip training in medicated hypertensive patients: secondary data analysis

Breno Q Farah; Claudia L M Forjaz; Jamie M O'Driscoll; Philip J Millar; Marcelo S Oliveira; Rafael Fecchio; Helcio Kanegusuku; Julio C S Sousa; Marilia A Correia; Raphael M Ritti-Dias

doi:10.1097/HJH.0000000000003749

Characteristics associated with responsiveness to isometric handgrip training in medicated hypertensive patients: secondary data analysis

J Hypertens. 2024 Apr 23. doi: 10.1097/HJH.0000000000003749. Online ahead of print.

Authors

Affiliations

¹ Graduate Program in Physical Education, Universidade Federal Rural de Pernambuco, Recife.
² Postgraduate Program in Rehabilitation Sciences, Universidade Nove de Julho.
³ Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil.
⁴ School of Psychology and Life Sciences, Canterbury Christ Church University, Kent.
⁵ Department of Cardiology, St George's Healthcare NHS Trust, Tooting, London, UK.
⁶ Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, Ontario, Canada.
⁷ Postgraduate Program in Nutrition, Universidade Federal de Pernambuco, Recife.
⁸ Hospital Israelita Albert Einstein, São Paulo, Brazil.

PMID: 38690928
DOI: 10.1097/HJH.0000000000003749

Abstract

Objective: Isometric handgrip training (IHT) has been shown to reduce blood pressure (BP) in hypertensive patients. However, factors that predict responsiveness to IHT are largely unknown. The aim of this study was to investigate the patient characteristics associated with the antihypertensive response to IHT using a recommended statistical approach for evaluating interindividual responses.

Methods: Data from four randomized controlled trials were joined, totaling 81 patients undergoing IHT (48.8% women; 60 ± 11 years) and 90 control patients (45.6% women; 62 ± 12 years). IHT consisted of 4 × 2 min isometric contractions at 30% of maximal voluntary contraction, performed three times/week for 8-12 weeks. BP was measured at baseline and following IHT and control interventions. The interindividual variation was assessed by the standard deviation of the individual responses (SDir), and linear regression analyses were conducted to explore response predictors.

Results: IHT significantly decreased both SBP (-5.4; 95% confidence interval (CI) -9.5 to -1.3 mmHg) and DBP (-2.8; 95% CI -5.1 to -0.6 mmHg). The interindividual variation of BP change was moderate for systolic (SDir = 5.2 mmHg, 0.30 standardized units) and low for diastolic (SDir = 1.7 mmHg, 0.15 standardized units). Sex, age, and BMI were not associated with the antihypertensive effect of IHT. However, a higher baseline SBP (b = -0.467, P < 0.001) and absence of dihydropyridine calcium channel blockers use (b = 0.340, P = 0.001) were associated with greater BP reductions.

Conclusion: IHT reduced BP in medicated hypertensive patients regardless of age, sex, and BMI. Patients with a higher baseline SBP and those not prescribed dihydropyridine calcium channel blockers were more responsive to IHT.