Isometric Exercise Training and Arterial Hypertension: An Updated Review

Jamie J Edwards; Damian A Coleman; Raphael M Ritti-Dias; Breno Q Farah; David J Stensel; Sam J E Lucas; Philip J Millar; Ben D H Gordon; Véronique Cornelissen; Neil A Smart; Debra J Carlson; Cheri McGowan; Ian Swaine; Linda S Pescatello; Reuben Howden; Stewart Bruce-Low; Christopher K T Farmer; Paul Leeson; Rajan Sharma; Jamie M O'Driscoll

doi:10.1007/s40279-024-02036-x

Isometric Exercise Training and Arterial Hypertension: An Updated Review

Sports Med. 2024 May 19. doi: 10.1007/s40279-024-02036-x. Online ahead of print.

Authors

Jamie J Edwards¹, Damian A Coleman¹, Raphael M Ritti-Dias², Breno Q Farah³, David J Stensel^{4

5

6

7}, Sam J E Lucas⁸, Philip J Millar⁹, Ben D H Gordon¹⁰, Véronique Cornelissen¹¹, Neil A Smart¹², Debra J Carlson¹³, Cheri McGowan¹⁴, Ian Swaine¹⁵, Linda S Pescatello¹⁶, Reuben Howden¹⁷, Stewart Bruce-Low¹⁸, Christopher K T Farmer¹⁹, Paul Leeson²⁰, Rajan Sharma²¹, Jamie M O'Driscoll^{22

23}

Affiliations

¹ School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK.
² Graduate Program in Rehabilitation Sciences, University Nove de Julho, São Paulo, Brazil.
³ Department of Physical Education, Universidade Federal Rural de Pernambuco, Recife, Brazil.
⁴ National Centre for Sport and Exercise Medicine, School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK.
⁵ NIHR Leicester Biomedical Research Centre, University Hospitals of Leicester NHS Trust and the University of Leicester, Leicester, UK.
⁶ Faculty of Sport Sciences, Waseda University, Tokyo, Japan.
⁷ Department of Sports Science and Physical Education, The Chinese University of Hong Kong, Hong Kong, China.
⁸ School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
⁹ Human Cardiovascular Physiology Laboratory, Department of Human Health and Nutritional Sciences, College of Biological Sciences, University of Guelph, Guelph, ON, Canada.
¹⁰ Department of Health and Human Development, University of Pittsburgh, Pittsburgh, PA, USA.
¹¹ Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.
¹² School of Science and Technology, University of New England, Armidale, NSW, Australia.
¹³ School of Health, Medical and Applied Sciences, CQ University, North Rockhampton, QLD, Australia.
¹⁴ Department of Kinesiology, University of Windsor, Windsor, ON, Canada.
¹⁵ Sport Science, University of Greenwich, London, UK.
¹⁶ Department of Kinesiology, University of Connecticut, Storrs, CT, 06269, USA.
¹⁷ Department of Applied Physiology, Health and Clinical Sciences, UNC Charlotte, Charlotte, NC, 28223, USA.
¹⁸ Department of Applied Sport and Exercise Science, University of East London, London, UK.
¹⁹ Centre for Health Services Studies, University of Kent, Canterbury, UK.
²⁰ Oxford Clinical Cardiovascular Research Facility, Department of Cardiovascular Medicine, University of Oxford, Oxford, UK.
²¹ Department of Cardiology, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, SW17 0QT, UK.
²² School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, CT1 1QU, UK. jamie.odriscoll@canterbury.ac.uk.
²³ Department of Cardiology, St George's University Hospitals NHS Foundation Trust, Blackshaw Road, Tooting, London, SW17 0QT, UK. jamie.odriscoll@canterbury.ac.uk.

PMID: 38762832
DOI: 10.1007/s40279-024-02036-x

Abstract

Hypertension is recognised as a leading attributable risk factor for cardiovascular disease and premature mortality. Global initiatives towards the prevention and treatment of arterial hypertension are centred around non-pharmacological lifestyle modification. Exercise recommendations differ between professional and scientific organisations, but are generally unanimous on the primary role of traditional aerobic and dynamic resistance exercise. In recent years, isometric exercise training (IET) has emerged as an effective novel exercise intervention with consistent evidence of reductions in blood pressure (BP) superior to that reported from traditional guideline-recommended exercise modes. Despite a wealth of emerging new data and endorsement by select governing bodies, IET remains underutilised and is not widely prescribed in clinical practice. This expert-informed review critically examines the role of IET as a potential adjuvant tool in the future clinical management of BP. We explore the efficacy, prescription protocols, evidence quality and certainty, acute cardiovascular stimulus, and physiological mechanisms underpinning its anti-hypertensive effects. We end the review with take-home suggestions regarding the direction of future IET research.

Publication types

Review