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Eun Sun Yoon1
, Jina Choo2, Jang-Young Kim3, Sae Young Jae1
, Jina Choo2, Jang-Young Kim3, Sae Young Jae1
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, 69±6 years; systolic blood pressure, 131.2±14.7; diastolic blood pressure, 80.2±7.9 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, 10.9±2.3 to 9.9±2.1 m/s [p<0.001]; AE, 10.5±2.0 to 9.4±1.6 m/s [p=0.001]), without any change in the control group.
Figures and Tables
Fig. 2
Isometric handgrip exercise device and exercise protocol. MVC: maximum voluntary contraction.
Fig. 3
Changes in pulse wave velocity (PWV) and flow-medicated dilation (FMD) from pre- to post-intervention. Values are presented as mean±standard error. Δ: the difference between post and pre each data, IHE: isometric handgrip exercise group, AE: aerobic exercise group, CON: control. *Significantly different from pre-intervention (p<0.05).
Table 1
Physical characteristics of the subjects (N=54)
Values are presented as mean±standard deviation. Continuous variables were compared with one-way analysis of variance. Categorical variable was compared with chi-square test.
IHE: isometric handgrip exercise group, AE: aerobic exercise group, CON: control group, BMI: body mass index, SBP: systolic blood pressure, DBP: diastolic blood pressure, HR: heart rate, AIx: augmentation index, AIx@75 bpm: AIx standardized to 75 beats per minute, PWV: pulse wave velocity, FMD: flow-mediated vasodilation, ARB: angiotensin II receptor blocker, CCB: calcium channel blocker.
*Least significant difference post-hoc analysis p<0.05 vs. IHE group.
Table 2
Changes in anthropometrics, blood pressure, arterial stiffness and endothelial function from pre- to post-intervention
Values are presented as mean±standard deviation.
IHE: isometric handgrip exercise group, AE: aerobic exercise group, CON: control, Δ: the difference between post and pre each data, BMI: body mass index, SBP: systolic blood pressure, DBP: diastolic blood pressure, HR: heart rate, AIx: augmentation index, AIx@75 bpm: AIx standardized to 75 beats per minute, PWV: pulse wave velocity, FMD: flow-mediated vasodilation.
p-values for between-group changes were compared with one-way analysis of variance, *p≤0.01 vs. pre, **p≤0.001 vs. pre, †p<0.05 vs. Δcontrol group.
Table 3
Correlation between change systolic and diastolic blood pressure and vascular function in after intervention
Adjusted for age and baseline blood pressure.
IHE: isometric handgrip exercise group, AE: aerobic exercise group, Δ: the difference between post and pre each data, SBP: systolic blood pressure, DBP: diastolic blood pressure, AIx: augmentation index, AIx@75 bpm: AIx standardized to 75 beats per minute, PWV: pulse wave velocity, FMD: flow-mediated vasodilation.
Notes
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