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Effects of Isometric Handgrip Exercise versus Aerobic Exercise on Arterial Stiffness and Brachial Artery Flow-Mediated Dilation in Older Hypertensive Patients
Korean J Sports Med 2019;37:162-170
Published online December 1, 2019;  https://doi.org/10.5763/kjsm.2019.37.4.162
© 2019 The Korean Society of Sports Medicine.

Eun Sun Yoon1, Jina Choo2, Jang-Young Kim3, Sae Young Jae1

1Department of Sport Science, College of Arts and Physical Education, University of Seoul, Seoul, 2Department of Community Health Nursing, College of Nursing, Korea University, Seoul, 3Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea
Correspondence to: Sae Young Jae
Department of Sport Science, College of Arts and Physical Education, University of Seoul, 163 Seoulsiripdae-ro, Dongdaemun-gu, Seoul 02504, Korea
Tel: +82-2-6490-2953, Fax: +82-2-6490-5204, E-mail: syjae@uos.ac.kr
*This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2016 S1A 5A2A 03928101).
Received August 13, 2019; Revised September 16, 2019; Accepted September 19, 2019.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: Isometric handgrip exercise (IHE) is an easy and accessible form of exercise that has beneficial effects on blood pressure (BP). However, it remains unclear whether IHE is similar benefits on arterial stiffness and endothelial function compared with aerobic exercise (AE) in elderly hypertensive patients. The aim of this study was to compare the effects of IHE versus AE on arterial stiffness and endothelial function in elderly hypertensive patients.
Methods: We conducted a randomized controlled trial with a three-arm design. Fifty-four elderly hypertensive patients (15 men; mean age, 69짹6 years; systolic blood pressure, 131.2짹14.7; diastolic blood pressure, 80.2짹7.9 mm Hg) were randomized to IHE training (n=18), AE training (n=21), or non-exercise control group (n=21) for 12 weeks. Bilateral IHE training was performed four times of 2 minutes at 30% of maximal voluntary contraction with three times per week. AE training was performed brisk walking for 30 minutes at moderate intensity with three times per week. Carotid-femoral pulse wave velocity (PWV), augmentation index heart rate corrected (AIx@75 bpm) and brachial artery flow-mediated vasodilation (FMD) as indices of arterial stiffness and endothelial function were measured at baseline and after the intervention.
Results: Following 12-week intervention, resting BP was significantly decreased in both IHE (p=0.001) and AE groups (p=0.002). AIx@75 bpm and FMD were unchanged in the all groups. However, PWV was significantly decreased in both IHE and AE groups (IHE, 10.9짹2.3 to 9.9짹2.1 m/s [p<0.001]; AE, 10.5짹2.0 to 9.4짹1.6 m/s [p=0.001]), without any change in the control group.
Conclusion: These findings suggest that both IHE and AE trainings were comparable effect in improving arterial stiffness in elderly hypertensive patients.
Keywords : Aged, Hypertension, Isometric contraction, Vascular stiffness, Vasodilation
References
  1. Chung K. 2017 National survey of older Koreans: findings and implications. Sejong: Korea Institute for Health and Social Affairs; 2018.
  2. Mancia G, Fagard R, Narkiewicz K, et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31:1281-357.
    Pubmed CrossRef
  3. Pescatello LS, Franklin BA, Fagard R, et al. American College of Sports Medicine position stand: exercise and hypertension. Med Sci Sports Exerc 2004;36:533-53.
    Pubmed CrossRef
  4. Millar PJ, McGowan CL, Cornelissen VA, Araujo CG, Swaine IL. Evidence for the role of isometric exercise training in reducing blood pressure: potential mechanisms and future directions. Sports Med 2014;44:345-56.
    Pubmed CrossRef
  5. Carlson DJ, Dieberg G, Hess NC, Millar PJ, Smart NA. Isometric exercise training for blood pressure management: a systematic review and meta-analysis. Mayo Clin Proc 2014;89:327-34.
    Pubmed CrossRef
  6. Cornelissen VA, Smart NA. Exercise training for blood pressure: a systematic review and meta-analysis. J Am Heart Assoc 2013;2:e004473.
    Pubmed KoreaMed CrossRef
  7. Whelton PK, Carey RM, Aronow WS, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA /PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary. A report of the American College of Cardiology/American Heart Association Task Force on clinical practice guidelines. Circulation 2018;138:e426-83.
  8. Inaba Y, Chen JA, Bergmann SR. Prediction of future cardiovascular outcomes by flow-mediated vasodilatation of brachial artery: a meta-analysis. Int J Cardiovasc Imaging 2010;26:631-40.
    Pubmed CrossRef
  9. Anderson TJ. Arterial stiffness or endothelial dysfunction as a surrogate marker of vascular risk. Can J Cardiol 2006;22 Suppl B:72-80.
    CrossRef
  10. Sun Z. Aging, arterial stiffness, and hypertension. Hypertension 2015;65:252-6.
    Pubmed KoreaMed CrossRef
  11. Badrov MB, Freeman SR, Zokvic MA, Millar PJ, McGowan CL. Isometric exercise training lowers resting blood pressure and improves local brachial artery flow-mediated dilation equally in men and women. Eur J Appl Physiol 2016;116:1289-96.
    Pubmed CrossRef
  12. Millar PJ, Bray SR, McGowan CL, MacDonald MJ, McCartney N. Effects of isometric handgrip training among people medicated for hypertension: a multilevel analysis. Blood Press Monit 2007;12:307-14.
    Pubmed CrossRef
  13. Ash GI, Taylor BA, Thompson PD, et al. The antihypertensive effects of aerobic versus isometric handgrip resistance exercise. J Hypertens 2017;35:291-9.
    Pubmed KoreaMed CrossRef
  14. Pescatello LS, MacDonald HV, Lamberti L, Johnson BT. Exercise for hypertension: a prescription update integrating existing recommendations with emerging research. Curr Hypertens Rep 2015;17:87.
    Pubmed KoreaMed CrossRef
  15. Wallen MP, Gomersall SR, Keating SE, Wisloff U, Coombes JS. Accuracy of heart rate watches: implications for weight management. PLoS One 2016;11:e0154420.
    Pubmed KoreaMed CrossRef
  16. Van Bortel LM, Duprez D, Starmans-Kool MJ, et al. Clinical applications of arterial stiffness, Task Force III: recommendations for user procedures. Am J Hypertens 2002;15:445-52.
    CrossRef
  17. Wiley RL, Dunn CL, Cox RH, Hueppchen NA, Scott MS. Isometric exercise training lowers resting blood pressure. Med Sci Sports Exerc 1992;24:749-54.
    Pubmed CrossRef
  18. Farah BQ, Rodrigues SL, Silva GO, et al. Supervised, but not home-based, isometric training improves brachial and central blood pressure in medicated hypertensive patients: a randomized controlled trial. Front Physiol 2018;9:961.
    Pubmed KoreaMed CrossRef
  19. Badrov MB, Horton S, Millar PJ, McGowan CL. Cardiovascular stress reactivity tasks successfully predict the hypotensive response of isometric handgrip training in hypertensives. Psychophysiology 2013;50:407-14.
    Pubmed CrossRef
  20. McGowan CL, Levy AS, McCartney N, MacDonald MJ. Isometric handgrip training does not improve flow-mediated dilation in subjects with normal blood pressure. Clin Sci (Lond) 2007;112:403-9.
    Pubmed CrossRef
  21. McGowan CL, Visocchi A, Faulkner M, et al. Isometric handgrip training improves local flow-mediated dilation in medicated hypertensives. Eur J Appl Physiol 2007;99:227-34.
    Pubmed CrossRef
  22. Green DJ, Cable NT, Fox C, Rankin JM, Taylor RR. Modification of forearm resistance vessels by exercise training in young men. J Appl Physiol (1985) 1994;77:182933.
    Pubmed CrossRef
  23. McGowan CL, Levy AS, Millar PJ, et al. Acute vascular responses to isometric handgrip exercise and effects of training in persons medicated for hypertension. Am J Physiol Heart Circ Physiol 2006;291:H1797-802.
    Pubmed CrossRef
  24. Dauphinot V, Kossovsky MP, Gueyffier F, et al. Impaired baroreflex sensitivity and the risks of new-onset ambulatory hypertension, in an elderly population-based study. Int J Cardiol 2013;168:4010-4.
    Pubmed CrossRef
  25. Montero D, Roche E, Martinez-Rodriguez A. The impact of aerobic exercise training on arterial stiffness in pre- and hypertensive subjects: a systematic review and meta-analysis. Int J Cardiol 2014;173:361-8.
    Pubmed CrossRef
  26. Cahu Rodrigues SL, Farah BQ, Silva G, et al. Vascular effects of isometric handgrip training in hypertensives. Clin Exp Hypertens 2019:1-7.
    Pubmed CrossRef
  27. Ashor AW, Lara J, Siervo M, Celis-Morales C, Mathers JC. Effects of exercise modalities on arterial stiffness and wave reflection: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2014;9:e110034.
    Pubmed KoreaMed CrossRef
  28. Lind L, Granstam SO, Millgard J. Endothelium-dependent vasodilation in hypertension: a review. Blood Press 2000;9:4-15.
    CrossRef
  29. Spieker LE, Noll G, Ruschitzka FT, Maier W, Luscher TF. Working under pressure: the vascular endothelium in arterial hypertension. J Hum Hypertens 2000;14:617-30.
    Pubmed CrossRef