Clinical trial NCT06601738: Isometric and Dynamic Handgrip Training Effects on Hypertension
Official title: Effects Of Isometrics and Dynamic Handgrip Exercise Training On Cardiovascular Parameters In Hypertensive Patients
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Hypertension
Keywords: Systolic Blood Pressure
Diastolic Blood Pressure
Mean Arterial Blood Pressure
Pulse Pressure
Lead sponsor: Riphah International University
Sponsor class: OTHER
First posted: 2024-09-19
Enrollment: 60
Sex: ALL
Minimum age (years): 30
Maximum age (years): 55
Standard ages: ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: Essential hypertension accounts for 13 percent of total deaths worldwide, accounting for one of the major risk factors. Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher). Dynamic exercises, sustained hand grip contractions elicit lower systolic blood pressure and heart rate responses. So for patients undergoing exercise therapy, low intensity isometric exercises are preferable. Significant reduction is seen in mean arterial blood pressure and systolic blood pressure in individuals conducting isometric for 8 weeks in 30%. The reduction in systolic blood pressure will be clinically significant. The main objective of this study will be to determine the effects of dynamic and isometric handgrip exercise training on cardiovascular parameters in hypertensive patients Grade 1 hypertensive patients are included as per AHA and JNC7 criteria. A sample of 100 hypertensive patients will be recruited and divided into two treatment groups; G1: dynamic exercise in hypertensive patients, and G2: isometric exercise in hypertensive patients. Outcome measure will include systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and pulse pressure. Outcome measures will be assessed at baseline and 2nd and 4th weeks posttreatment.

Detailed description: Hypertension is one of the most prevalent diseases leading to morbidity and mortality, affecting millions of people every year. Pharmaceutical management is the main treatment method used. Exercise therapy mainly isometrics and dynamic handgrip exercises provide a non pharmacological management leading to decrease in symptoms. The association of hypertension with physical inactivity, sedentary behavior, and occupational exposure to chemicals, obesity, older age, genetics, being overweight or obese, not being physically active, ,high-salt diet, job insecurity, job loss, and the psychosocial work environment and drinking too much alcohol. Lifestyle changes like eating a healthier diet, quitting tobacco, and being more active can help lower blood pressure. Hypertension rates are strongly associated with age. Acute effects of isometric and dynamic handgrip exercise on cardiovascular parameters in hypertensive subjects are numerous . They may also have some adverse effects on the cardiorespiratory system, particularly, through the elevation of blood pressure.

Since an acute bout of exercise can transiently improve cardiovascular endothelial function, arterial stiffness, and ambulatory blood pressure. The dynamic handgrip exercise is performed by repetitive contraction and relaxation of the hand at a maximum frequency. In order to determine the intensity of handgrip exercises, maximum isometric handgrip strength of the right and left hand was measured with a handgrip dynamometer. Isometric exercises differ from dynamic exercises because in this there is no change in muscle length or static force. Single handgrip exercise could reduce the blood pressure for couple of hours so a patient can perform this exercise several times a day if not being fatigue.

Eligibility criteria: Inclusion Criteria:

* Gender (both)
* Age (30-55 years)
* Grade 1 hypertensive patients as per AHA and JNC7 criteria

Exclusion Criteria:

* Patients having hypertension associated due to other diseases.
* Patients having joint problems of wrist, hand fingers, ligament and tendon injuries of hand and fingers.
* Patients having recent hand surgeries, fracture, history of arthritis, carpal tunnel syndrome.
* Patient having history of any symptoms of chest pain.
* Patients having loss of consciousness during physical activity.

Primary outcomes:
measure: 6 Minute Walk test
timeFrame: Baseline; 4nd Week; 8th Week
measure: Blood Pressure Measurements (SBP & DBP)
timeFrame: Baseline; 4nd Week; 8th Week
Secondary outcomes:
Other outcomes:
Locations:
city: Lahore
country: Pakistan
facility: Riphah Rehabiliation Clinic
state: Punjab
Study officials:
affiliation: Riphah International University
name: Arisha Noor, MS*
role: PRINCIPAL_INVESTIGATOR
References:
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citation: Ogbutor GU, Nwangwa EK, Uyagu DD. Isometric handgrip exercise training attenuates blood pressure in prehypertensive subjects at 30% maximum voluntary contraction. Niger J Clin Pract. 2019 Dec;22(12):1765-1771. doi: 10.4103/njcp.njcp_240_18.
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citation: Punia S, Kulandaivelan S. Home-based isometric handgrip training on RBP in hypertensive adults-Partial preliminary findings from RCT. Physiother Res Int. 2020 Jan;25(1):e1806. doi: 10.1002/pri.1806. Epub 2019 Aug 16.
citation: Polito MD, Papst R, Goessler K. Twelve weeks of resistance training performed with different number of sets: Effects on maximal strength and resting blood pressure of individuals with hypertension. Clin Exp Hypertens. 2021 Feb 17;43(2):164-168. doi: 10.1080/10641963.2020.1833024. Epub 2020 Oct 10.
citation: Kappus RM, Bunsawat K, Brown MD, Phillips SA, Haus JM, Baynard T, Fernhall B. Effect of oxidative stress on racial differences in vascular function at rest and during hand grip exercise. J Hypertens. 2017 Oct;35(10):2006-2015. doi: 10.1097/HJH.0000000000001433.
citation: Fecchio RY, de Sousa JCS, Oliveira-Silva L, da Silva Junior ND, Pio-Abreu A, da Silva GV, Drager LF, Low DA, Forjaz CLM. Effects of dynamic, isometric and combined resistance training on blood pressure and its mechanisms in hypertensive men. Hypertens Res. 2023 Apr;46(4):1031-1043. doi: 10.1038/s41440-023-01202-4. Epub 2023 Feb 9.