Effects of isometric resistance training on resting blood pressure: individual participant data meta-analysis.
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
10 2019
10 2019
Historique:
pubmed:
20
3
2019
medline:
14
7
2020
entrez:
20
3
2019
Statut:
ppublish
Résumé
Previous meta-analyses based on aggregate group-level data report antihypertensive effects of isometric resistance training (IRT). However, individual participant data meta-analyses provide more robust effect size estimates and permit examination of demographic and clinical variables on IRT effectiveness. We conducted a systematic search and individual participant data (IPD) analysis, using both a one-step and two-step approach, of controlled trials investigating at least 3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure. Anonymized individual participant data were provided from 12 studies (14 intervention group comparisons) involving 326 participants (52.7% medicated for hypertension); 191 assigned to IRT and 135 controls, 25.2% of participants had diagnosed coronary artery disease. IRT intensity varied (8-30% MVC) and training duration ranged from 3 to 12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting SBP of -6.22 mmHg (95% CI -7.75 to -4.68; P < 0.00001); DBP of -2.78 mmHg (95% CI -3.92 to -1.65; P = 0.002); and mean arterial blood pressure (MAP) of -4.12 mmHg (95% CI -5.39 to -2.85; P < 0.00001). The two-step approach yielded similar results for change in SBP -7.35 mmHg (-8.95 to -5.75; P < 0.00001), DBP MD -3.29 mmHg (95% CI -5.12 to -1.46; P = 0.0004) and MAP MD -4.63 mmHg (95% CI -6.18 to -3.09: P < 0.00001). Sub-analysis revealed that neither clinical, medication, nor demographic participant characteristics, or exercise program features, modified the IRT treatment effect. This individual patient analysis confirms a clinically meaningful and statistically significant effect of IRT on resting SBP, DBP and mean arterial blood pressure.
Sections du résumé
BACKGROUND
Previous meta-analyses based on aggregate group-level data report antihypertensive effects of isometric resistance training (IRT). However, individual participant data meta-analyses provide more robust effect size estimates and permit examination of demographic and clinical variables on IRT effectiveness.
METHODS
We conducted a systematic search and individual participant data (IPD) analysis, using both a one-step and two-step approach, of controlled trials investigating at least 3 weeks of IRT on resting systolic, diastolic and mean arterial blood pressure.
RESULTS
Anonymized individual participant data were provided from 12 studies (14 intervention group comparisons) involving 326 participants (52.7% medicated for hypertension); 191 assigned to IRT and 135 controls, 25.2% of participants had diagnosed coronary artery disease. IRT intensity varied (8-30% MVC) and training duration ranged from 3 to 12 weeks. The IPD (one-step) meta-analysis showed a significant treatment effect for the exercise group participants experiencing a reduction in resting SBP of -6.22 mmHg (95% CI -7.75 to -4.68; P < 0.00001); DBP of -2.78 mmHg (95% CI -3.92 to -1.65; P = 0.002); and mean arterial blood pressure (MAP) of -4.12 mmHg (95% CI -5.39 to -2.85; P < 0.00001). The two-step approach yielded similar results for change in SBP -7.35 mmHg (-8.95 to -5.75; P < 0.00001), DBP MD -3.29 mmHg (95% CI -5.12 to -1.46; P = 0.0004) and MAP MD -4.63 mmHg (95% CI -6.18 to -3.09: P < 0.00001). Sub-analysis revealed that neither clinical, medication, nor demographic participant characteristics, or exercise program features, modified the IRT treatment effect.
CONCLUSION
This individual patient analysis confirms a clinically meaningful and statistically significant effect of IRT on resting SBP, DBP and mean arterial blood pressure.
Identifiants
pubmed: 30889048
doi: 10.1097/HJH.0000000000002105
pmc: PMC6727950
doi:
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1927-1938Références
Cardiovasc J Afr. 2011 Sep-Oct;22(5):257-60
pubmed: 21161116
J Hypertens. 2017 Nov;35(11):2199-2206
pubmed: 28622156
Int J Vasc Med. 2012;2012:964697
pubmed: 22991668
Hypertension. 2001 May;37(5):1199-208
pubmed: 11358929
Postgrad Med J. 2007 Feb;83(976):109-14
pubmed: 17308214
Arch Intern Med. 2000 Oct 9;160(18):2847-53
pubmed: 11025795
PLoS Med. 2015 Jul 21;12(7):e1001855
pubmed: 26196287
J Am Coll Cardiol. 2018 May 15;71(19):e127-e248
pubmed: 29146535
Am J Hypertens. 2007 Aug;20(8):825-30
pubmed: 17679027
Med Sci Sports Exerc. 1992 Jul;24(7):749-54
pubmed: 1501558
Int J Evid Based Healthc. 2015 Mar;13(1):9-18
pubmed: 25734864
Blood Press Monit. 2012 Apr;17(2):55-61
pubmed: 22322195
J Hypertens. 2013 Apr;31(4):639-48
pubmed: 23325392
J Am Heart Assoc. 2013 Feb 01;2(1):e004473
pubmed: 23525435
Hypertension. 2005 Oct;46(4):667-75
pubmed: 16157788
Mayo Clin Proc. 2014 Mar;89(3):327-34
pubmed: 24582191
Open Access J Sports Med. 2013 Jan 30;4:33-40
pubmed: 24379707
Eur J Appl Physiol. 2013 Aug;113(8):2091-100
pubmed: 23588257
Eur J Appl Physiol. 2017 Jan;117(1):83-93
pubmed: 27853886
J Cardiopulm Rehabil Prev. 2008 May-Jun;28(3):203-7
pubmed: 18496321
BMJ Open. 2013 Aug 30;3(8):e003423
pubmed: 23996822
Eur J Appl Physiol. 2010 Feb;108(3):419-28
pubmed: 19280213
Eur Heart J. 2018 Dec 1;39(45):4040-4041
pubmed: 30165378
Medicine (Baltimore). 2016 Dec;95(52):e5791
pubmed: 28033302
J Sports Sci. 2015;33(6):616-21
pubmed: 25277169
Med Sci Sports Exerc. 2003 Feb;35(2):251-6
pubmed: 12569213
Psychophysiology. 2013 Apr;50(4):407-14
pubmed: 23418955
J Am Soc Hypertens. 2018 Apr;12(4):285-293
pubmed: 29472030
Circulation. 2003 Aug 5;108(5):530-5
pubmed: 12874192
J Sports Sci. 2011 Apr;29(7):715-24
pubmed: 21400346
Lancet. 2012 Dec 15;380(9859):2224-60
pubmed: 23245609
Hypertension. 2003 Dec;42(6):1206-52
pubmed: 14656957
Front Physiol. 2018 Jul 23;9:961
pubmed: 30083107
Hypertens Res. 2016 Feb;39(2):88-94
pubmed: 26467494
BMJ. 1997 Sep 13;315(7109):629-34
pubmed: 9310563
Eur J Appl Physiol. 2016 Jul;116(7):1289-96
pubmed: 27137950
Blood Press Monit. 2007 Oct;12(5):307-14
pubmed: 17890969
Hypertension. 2013 Jun;61(6):1360-83
pubmed: 23608661
Stroke. 2015 May;46(5):e121-2
pubmed: 25873596
Sports Med. 2014 Mar;44(3):345-56
pubmed: 24174307
JAMA. 2015 Apr 28;313(16):1657-65
pubmed: 25919529
BMJ. 2001 Mar 31;322(7289):763-7
pubmed: 11282860
Can J Cardiol. 2018 May;34(5):506-525
pubmed: 29731013
Physiol Res. 2016 Jul 18;65(3):461-8
pubmed: 27070747
J Hypertens. 2019 Apr;37(4):827-836
pubmed: 30817465
Med J Aust. 2016 Jul 18;205(2):85-9
pubmed: 27456450
BMJ. 2010 Feb 05;340:c221
pubmed: 20139215
Lancet. 1993 Feb 13;341(8842):418-22
pubmed: 8094183
Circulation. 2016 Aug 9;134(6):441-50
pubmed: 27502908
Can J Cardiol. 2016 May;32(5):569-88
pubmed: 27118291
Lancet. 2003 Nov 8;362(9395):1527-35
pubmed: 14615107
Hypertension. 2011 Nov;58(5):950-8
pubmed: 21896934
BMJ. 2003 Sep 6;327(7414):557-60
pubmed: 12958120