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Review article
Digital Magazine: Physical Activity and Sports

Digital Magazine: Physical Activity and Sports

January-June 2023-Volume 9 No. 1:e2209
ISSN: 2462-8948 online
http://doi.org/10.31910/rdafd.v9.n1.2023.2209

Isometric exercises as a therapeutic measure to control

arterial hypertension in adults. Literature review
Isometric exercises as a therapeutic measure for the control of
arterial hypertension in adults. literature review
Víctor A. López-Mejía1 ; Ricardo Nochebuena-Serna1; María F. Hernández-Alvarado1 ;
Julio C. Méndez-Ávila2 ; Arely G. Morales-Hernández3*
1Autonomous University of Querétaro, Bachelor's Degree in Physiotherapy. Querétaro, Mexico; e-mail: sandrolopez1 82@gmail.com ;
riki003z@gmail.com; lftfernandaalvarado@gmail.com
2Autonomous University of Querétaro, Head of Research and Postgraduate Studies, Faculty of Nursing. Querétaro, Mexico; e-mail:
julio_uaq@hotmail.com 3Autonomous University of Querétaro, Master of Rehabilitation Sciences in Human Movement. Querétaro, Mexico; e-mail:
arely.morales@uaq.mx
* corresponding author: arely.morales@uaq.mx

How to cite:López-Mejía, VA; Christmas Eve-Serna, R.; Hernández-Alvarado, MF; Méndez-Ávila, JC; Morales-Hernández, AG 2023. Isometric exercises as a
therapeutic measure to control high blood pressure in adults. Literature review. Digital Magazine: Physical Activity and Sports. 9(1):e2209. http://doi. org/
10.31910/rdafd.v9.n1.2023.2209

Open access article published by Digital Magazine: Physical Activity and Sports, under a Creative Commons CC BY-NC 4.0 license

Official publication of the University of Applied and Environmental Sciences UDCA, High Quality Accredited Higher Education Institution by the Ministry of
National Education.

Received::February 8, 2022Accepted:June 15, 2022Edited by:Néstor Ordoñez Saavedra

SUMMARY
existing treatments for high blood pressure, due to
its short duration and easy application.
Introduction:The implementation of isometric
exercises, as a therapeutic measure in patients with Keywords:Hypertension; Isometric training;
high blood pressure, can help maintain or reduce Blood pressure; Circulatory system; Healthy life
blood pressure, therefore, it is important to style.
evaluate the response to treatment and prevent the
progression of the hypertensive state.General ABSTRACT
objective:Analyze the application of protocols
isometric exercises in patients with hypertensionIntroduction:The implementation of isometric
arterial, to reduce its prevalence in the population exercises as a therapeutic measure in patients with
adult.Materials and methods:search was carried out arterial hypertension can help keep or reduce blood
on the effects of isometric pressure training. Therefore, it is important to evaluate the
adult patients with arterial hypertension, in response to treatment and prevent the advancement
the databases: PubMed, Cochrane Library, SciELO of the hypertensive state.Objective:To analyze the
and Medline, between 2015 and 2021.Results application of isometric exercise protocols in patients
and discussion:Isometric training programs, with arterial hypertension to reduce its prevalence in
such as isometric squat and isometric grip, the adult population.Materials and methods:
periodized between 4, 8 and 12 weeks, show Research was carried out on the effects of isometric
significant reduction in blood pressure (BP), in 4-5 training in adult patients with arterial hypertension in
mmHg, 4-7 mmHg and 8-9 mmHg, in population the databases: PubMed, Cochrane Library, SciELO
adult.Conclusion:From the different and Medline, between the years (2015 - 2021). reviews,
isometric exercises are considered Results and discussion:Isometric training programs
as a safe therapeutic tool, under a good dosage such as isometric squat and isometric grip periodized
and a great complement to between 4, 8 and 12 weeks show significant reduction

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 López-Mejía, VA; Christmas Eve-Serna, R.; Hernández-Alvarado, MF; Méndez-Ávila,
JC; Morales-Hernández, AG: management of high blood pressure

in blood pressure (BP) in 4-5 mmHg, 4-7 mmHg and mmHg or Diastolic Blood Pressure - DBP ≥ 90-99
8-9 mmHg in adult population.Conclusion:Based on mmHg (Williamset al.2019).
the different reviews, isometric exercises are
considered a safe therapeutic tool under good dosage In the 2017 guideline, from the American Heart
and a great complement to existing treatments for Association and the American College of Cardiology,
arterial hypertension due to their short duration and AHA/ACC, it is proposed to reduce the cut-off point
easy application. for the diagnosis of HTN to >130/80mmHg, as well
as to initiate pharmacological treatment in patients
Keywords:Hypertension; Isometric training Blood in stage 1 (130-140/80-90 mmHg) and at high risk
pressure; Circulatory system; Healthy Lifestyle. (Wheltonet al.2018). On the other hand, the
European Society of Cardiology and the European
INTRODUCTION Society of Hypertension, ESC/ESH point out that, in
patients with borderline or high blood pressure
Data provided by the World Health Organization, (130-139/80-89 mmHg), lifestyle modifications
WHO (2021) estimate that, in the world, there are should be indicated, diet and exercise. At the same
1,280 million adults between 30 and 79 years of time, it is highlighted that physical exercise has
age, with High Blood Pressure-HTN and that, the been considered one of the crucial elements in
majority of them (about two-thirds), live in low- controlling BP levels, and it has also been shown
and middle-income countries. According to that aerobic resistance training, dynamic resistance
estimates, 46% of hypertensive adults are and isometric exercise reduce BP. /DBP at rest,
unaware that they have this condition. 2.5-3.5, 2.8-3.2, 6.2-10.9 mmHg, respectively
Hypertension is diagnosed and treated in less (Williamset al.2019).
than half of the adults who have it; only 42%. Only
one in five hypertensive adults (21%) is controlled. Thus, currently, the diagnosis and treatment
guidelines for HBP indicate that a reduction of 5 -
In Mexico, in adults over 19 years of age, about 10 mmHg in SBP is associated with significant
25.5 million people are carriers of HTN; Of these, reductions in serious cardiovascular
40% ignore it. Of the 60% who know, only half complications (20%), mortality from all causes
take medication and of this half, their control ( 10-15%), stroke (35%), coronary complications
figures are <140/90 mmHg. Different surveys (20%) and heart failure (40%) (Williamset al.2019).
carried out in Mexico, between 1993 and 2012,
report a prevalence of around 30%. Although a Muscular system.Muscles are translating
study based on the results of the National Health elements that convert chemical energy into
and Nutrition Survey reports a prevalence of useful electrical, thermal or mechanical energy.
arterial hypertension of 25.5%, in adults aged 20 Muscles have different shapes and sizes and
years and older (Campos-Nonatoet al.2018). differ in the forces they can exert and the
speed of their action (Córdova Martínez, 2013).

Blood Pressure-BP is the resistance force The basic physiological property of muscle
exerted by the walls of blood vessels on blood tissue is contractility, responsible for the
flow (Grossman & Porth, 2014) and a persistent functions of movement, pressure and force, as
increase in it is known as HBP, considered by well as the properties of excitability, due to the
the WHO, as the number one risk factor, presence of special neuromuscular structures
worldwide, associated with the appearance of in the membrane of the muscle cell, the motor
serious disorders that significantly increase the plate. Extensibility and elasticity depend on the
risk of connective component that protects and covers
suffer from heart disease, encephalopathy, nephropathy, contractile structures and, on the other hand,
among other diseases and even reaching the They provide elastic and mechanical properties to the
death. Álvarez-Aguilar (2015) described that tissue (Córdova Martínez, 2013).
lack of treatment can shorten people's lives by
up to 5 years. High blood pressure is defined as
a Systolic Blood Pressure - SBP ≥ 140-159.

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Rev. Digital Act. Phys. Sport 9(1):e2209. July-December, 2023

Types of muscle action.Muscular movement is MATERIALS AND METHODS

classified into the following types of actions: a)
isokinetic, it is carried out by keeping the angularThis article is an exhaustive review of the
literature of existing knowledge about
velocity of the muscular lever constant, it is not a pure
contraction, since it is achieved through the use ofisometric exercise protocols and their
devices (Córdova Martínez, 2013); b) concentric, effectiveness in people who have a state of
skeletal muscle has high blood pressure displacement. The literature review is positive and
shortens (Contraction) (Wilmore & Costill, carried out in two stages. The first was an
2016); c) eccentric, the skeletal muscle has electronic search of databases, such as PubMed,
negative displacement and lengthens (Relaxation) Cochrane Library, Scielo and Medline, to identify
(Wilmore & Costill, 2016); d) isometric, the skeletal muscle contracts, but the joint angle does not
randomized clinical trials, non-randomized clinical
presents variation (Maintained) (Wilmore & Costill, trials, published between 2015 and 2021. The
2016). keyword search in these articles and the key
search terms included were Blood pressure AND
Isometric actions.In this action, myosin Excercise, OR Isometric Excercises AND Arterial
crossbridges form and are recycled, producing hypertension OR Isometric Excercises protocol
force, but the external force is too great for the OR Strength excercises and combinations
actin filaments to move; They remain in their between them (66 articles).
normal position, so shortening (contraction)
cannot take place. Only if enough motor units Then, in the second stage, titles and summaries
can be recruited to produce the force of the results obtained were reviewed. As
inclusion criteria, only the
necessary to overcome resistance, a static action can be converted into a dynamic action
men and women between 18 and 80 years of age.
(Wilmore & Costill, 2016). Additionally, articles only belonging to journals
indexed in Spanish, English or Portuguese
This is why this muscular “contraction” acts languages were included (11 articles). Articles
without generating movement; The muscle where the study population was diagnosed with
generates force, but its length remains static pre-hypertension and those where there was no
(unchanged), that is, the ends of the muscle are in diagnosis of HTN were excluded (48 articles).
a fixed position and muscle shortening cannot Those articles that were repeated or where the
occur. Under these conditions, muscle intervention was not based solely on isometric
contraction will exclusively produce changes in exercise (7 articles) were eliminated.
force or tension (Guyton & Hall, 2016).
RESULTS AND DISCUSSION
Therefore, the objective of this article is to analyze
the application of isometric exercise protocols Recent research (Table 1) suggests,
in patients with arterial hypertension, to consistently reduce its prevalence in the adult
population and, isometric resistance, ERI can be equal to or
thereby, guiding clinical decision-making, based on superior to aerobic training, EA, as well as
recommendations supported by the best available dynamic resistance training, ERD to reduce BP;
evidence. All of the above, with the intention of Therefore, ERI is a real and emerging
improving the quality and effectiveness of health therapeutic alternative to the conventional
services, contributing to the well-being of people, training that is being applied.
which constitutes the main objective of health and
rehabilitation services.

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 López-Mejía, VA; Christmas Eve-Serna, R.; Hernández-Alvarado, MF; Méndez-Ávila,
JC; Morales-Hernández, AG: management of high blood pressure

Table 1. Description of some research articles on isometric exercises and their

relationship with high blood pressure.

#
Frequency/
Author Intervention Muscles I repeated Intensity Population Age Variables
Duration
tions
Frequency
Training Cardiac
resistance Leg 3 x week Men Cardiac output
(Wileset 4x2
isometric (Quadriceps, for 4 NR n=28 (30 +- 7 Endurance
to the.2017) min
Squats buttocks) weeks years) Total Peripheral
against the wall Volume
Systolic
Hand/Forearm Blood pressure
Training or (Muscles 5 - 30% Men Systolic
(Carlson 3 x week
resistance intrinsic of 4x2 contraction /Women Blood pressure
et al. for 8 n=40
isometric hand – flexors min volunteer (36 - 65 Diastolic
2016) weeks
(handle) and extenders maximum years) Blood pressure
forearm) Half
Leg Aerobics
(Quadriceps, 60%
Exercises
hamstrings, 30 min consumption
aerobics
buttocks, Maximum of
Men Carotid
gastrocnemius) oxygen
(Ashet al. NR/8 /Women Femoral
Hand/Forearm n=27
2017) weeks (18 - 55 Blood pressure
or (Muscles IHG 30%
exercises years) (MAP)
intrinsic of 4x2 contraction
handle
hand – flexors min maximum
isometric
and extenders volunteer
forearm)
Training Hand/Forearm
grip or (Muscles 2x2
5 x week
isometric intrinsic of min
for 12
Training hand – flexors by
weeks Men
(Pagonas drill and extenders arm 30%
/Women Blood pressure
et al. grip forearm) contraction n=75
(40 - 75 (MAP)
2017) Leg maximum
years)
(Quadriceps,
Training 3-5 times x
hamstrings, 30 min
aerobic week
buttocks,
gastrocnemius)
Training Men Blood pressure
Leg
(Wileset Isometric hypertensive Systolic
(Quadriceps, NR/NR NR NR n=26
to the.2018) Squat os (45 +- Blood pressure
buttocks)
against wall 8 years) Diastolic
Shoulder/
Arm/Forearm
Training Men
or (waist
(Rodrigue isometric /Women Endurance
scapular,
z Penaet Test NR/NR NR NR n=97 average Vascular
flexors and
to the.2018) Weight of 19 Peripheral
extenders
Sustained years
arm and
forearm)
Arterial stiffness
Hand/Forearm
Speed of the
eleven

(Cahu or (Muscles men

3 x week 30% pulse wave
Rodrigues Handle intrinsic of 4x2 and 22
for 12 contraction n=33 central and
et al. isometric hand – flexors min women
weeks maximum peripheral
2020) and extenders (61 +- 2
Function
forearm) years)
endothelial
NR: Not registered -NA:Does not apply

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Rev. Digital Act. Phys. Sport 9(1):e2209. July-December, 2023
The results of these isometric resistance training
protocols, ERI (Table 2) agree that an exposure of
the population to an exercise regimen of between
3 to 12 weeks and a frequency of 3 to 5 sessions
per week, which, shows which is optimal to
maintain and begin to reduce the population's
hypertension levels. According
Table 2. Description of intervention methods and results of research on the use of isometric exercises in
populations with high blood pressure.
Author Methods
Resting heart rate, BP, cardiac output, total
(Wileset peripheral resistance, and stroke volume were
to the.2017) taken at baseline and after each session.
Randomized 2 groups at 30% and 5% of
(Carlsonet
maximum contraction with isometric handgrip.
to the.2016)
Comparison of antihypertensive effects between
aerobic exercises and IHG exercise in the same
individuals. Middle-aged adults with pre-
hypertension and obesity randomly completed 3
experiments: Aerobic (60% maximal oxygen
consumption, 30 min); IHG (30% maximal
(Ashet al.
voluntary contraction, 4 × 2 min bilateral); and
2017)
control without exercise.
Participants were assessed for carotid-femoral
PWV before and after exercise, and left the
laboratory with an ambulatory BP monitor.
Study carried out in 3 randomized groups of
hypertensive patients.
IHT (2 contractions of 2 minutes at 30% of
maximum power). (n=25).
Mock grip training, (2 2-minute contractions at
(Pagonas 5% of maximum power). (n=25).
et al.
2017) Aerobic exercise training (n=25). Patients
underwent 24-h ambulatory BP measurement
and non-invasive evaluation of arterial
compliance and systemic vascular resistance
before the study and after a short period of time.
period.
Resting heart rate, BP, cardiac output, total
(Wileset peripheral resistance, and stroke volume were
to the.2017) taken at baseline and after each session.
Randomized 2 groups at 30% and 5% of
(Carlsonet
maximum contraction with isometric handgrip.
to the.2016)
Comparison of antihypertensive effects between
aerobic exercises and IHG exercise in the same
individuals. Middle-aged adults with pre-
hypertension and obesity randomly completed 3
experiments: Aerobic (60% maximal oxygen
consumption, 30 min); IHG (30% maximal
(Ashet al.
voluntary contraction, 4 × 2 min bilateral); and
2017)
control without exercise.
Participants were assessed for carotid-femoral
PWV before and after exercise, and left the
laboratory with an ambulatory BP monitor.
The physiological adaptations that the body goes
through when exposed to exercise is how, after the
second to fourth week of regular exercise,
improvements in resistance and strength in physical
condition are seen. Already in the period from the
fourth to the eighth week of exercise, improvement in
explosive strength and speed begins.
Results Conclusions
Effect: Significant reductions in resting SBP (
−4 ± 5 mmHg), DBP (−3 ± 3 mmHg), and
MAP (−3 ± 3 mmHg) compared to the control Findings suggest that the wall squat provides an
condition (P < 0.001). effective method of reducing resting BP, resulting
primarily from a reduction in resting heart rate.
Clinically relevant reductions (≥2 mmHg) in
SBP and DBP were recorded in 68 and 71% of
participants, respectively.
Effect: 7 mmHg reduction in SBP (136 ± 12 to
There is a reduction in SBP after 8 weeks of IRT.
129 ± 15; P = 0.04), in the 30% group.
Handgrip at 30% maximal voluntary contraction
significantly reduced SBP and MAP, indicating that
4 mmHg reductions in TAM (100 ± 8 to 96 ±
IRT may be an alternative for people who cannot
11; P = 0.04), in the 30% group.
achieve the current recommendations of 2.5 hours
There were no statistically significant
of weekly aerobic exercise, to control can.
reductions in DBP for the 30% group or any
data for the 5% group.
Effect: Lower SBP and TAD after aerobic
activity compared to isometric grip (4.8 +-
1.8 / 3.1 +- 1.3 mmHg, P= 0.01 / 0.04) and
IHG is not supported as an antihypertensive
control (5.6 +- 1.8 / 3.6 +- 1.3 mmHg, P= 0.02 /
therapy, but aerobic exercise should continue to
0.04).
be recommended as the primary exercise modality
Changes in PWV after acute exercise did not
for its immediate and sustained BP benefits.
differ by modality (aerobic increased 0.01
0.21 ms, IHG decreased 0.06 0.15 ms, control
increased 0.25 0.17 ms, P > 0.05 ).
Effect: Aerobic exercise, the primary
endpoint, 24h systolic ambulatory blood
pressure decreased significantly from 126.1
+- 10.1 to 121.2 +- 11.8 mmHg (P = 0.025). The IHT did not reduce BP in hypertensive patients.
24-h ambulatory diastolic blood pressure Aerobic exercise, even as a strict, uncontrolled
decreased from 77.6 +- 8.6 to 75.9 +- 10.9 regimen, led to a significant reduction in office and
mmHg, without reaching statistical ambulatory BP.
significance (P = 0.14). There were no
statistically significant changes in TAS, TDA in
isometric exercise, or in sham handgrip.
Effect: Significant reductions in resting SBP (
−4 ± 5 mmHg), DBP (−3 ± 3 mmHg), and
MAP (−3 ± 3 mmHg) compared to the control Findings suggest that the wall squat provides an
condition (P < 0.001). effective method of reducing resting BP, resulting
primarily from a reduction in resting heart rate.
Clinically relevant reductions (≥2 mmHg) in
SBP and DBP were recorded in 68 and 71% of
participants, respectively.
Effect: 7 mmHg reduction in SBP (136 ± 12 to
There is a reduction in SBP after 8 weeks of IRT.
129 ± 15; P = 0.04), in the 30% group.
Handgrip at 30% maximal voluntary contraction
significantly reduced SBP and MAP, indicating that
4 mmHg reductions in TAM (100 ± 8 to 96 ±
IRT may be an alternative for people who cannot
11; P = 0.04), in the 30% group.
achieve the current recommendations of 2.5 hours
There were no statistically significant
of weekly aerobic exercise, to control can.
reductions in DBP for the 30% group or any
data for the 5% group.
Effect: Lower SBP and TAD after aerobic
activity compared to isometric grip (4.8 +-
1.8 / 3.1 +- 1.3 mmHg, P= 0.01 / 0.04) and
IHG is not supported as an antihypertensive
control (5.6 +- 1.8 / 3.6 +- 1.3 mmHg, P= 0.02 /
therapy, but aerobic exercise should continue to
0.04).
be recommended as the primary exercise modality
Changes in PWV after acute exercise did not
for its immediate and sustained BP benefits.
differ by modality (aerobic increased 0.01
0.21 ms, IHG decreased 0.06 0.15 ms, control
increased 0.25 0.17 ms, P > 0.05 ).
5
 López-Mejía, VA; Christmas Eve-Serna, R.; He rnández-Alvarado, MF; Menu dez-
Ávila, JC; Morales- Hernández, AG: management andhigh blood pressure

Cocontinuation tabla 2
Study carried out in 3 randomized groups of
hypertensive patients. Effect: Aerobic exercise, the criterion d and
IHT (2 contractions of 2 minutes at 30% of to Primary assessment, 24-h systolic to
maximum power). (n=25). ambulatory blood pressure decreased either

Mock grip training, (2 minute contractions at 2 significantly from 126.1 +- 10.1 to 121.2 + - IHT did not reduce BP in hypertensive patients. He
(Pagonas 5% of maximum power). (n=25). to 11.8 mmHg (P = 0.025). The 24-h ambulatoryn Aerobic exercise, even as a strict, uncontrolled n
et al. diastolic blood pressure decreased from either regimen, led to a significant reduction in office n
2017) Aerobic exercise training (n=25). Patients 77.6 +- 8.6 to 75.9 +- 10.9 mmHg, without n and ambulatory BP. he
underwent 24-h ambulatory BP measurement to reaching statistical significance (P = 0.14).
and non-invasive evaluation of arterial and There were no statistically significant and
compliance and systemic vascular resistance to changes in TAS, TDA in the isometric either

before the study and after the study. either exercise, or in the handgrip drill.
period.
Effect: Compared to men, women have yes,
reduced ADR (9.1 ± 0. 5
Participants were randomly assigned into two yes It is concluded that 12 weeks of IHT have reduced
vs. 8.0 ± 0.3 m/s; Control: 8.7 ± 0.5 vs. 8.8 ± 0.5 and
either

groups: blood pressure and arterial stiffness, improving yes

m/s, p = 0.043).
(Cahu Control group. markers of endothelial function in hypertensive yes
No significant changes were observed and n
Rodrigues The IHT group with 3 weekly sessions d and patients.
PWV (8.4 ± 0.3 vs 8.5 ± 0.3 m/s; Control: 9. 3
et al. isometric handgrip, BP, arterial stiffness, central and No significant correlation was observed between
± 0.4 vs 9.4 ± 0.4 m/s, pa 0.924). PWV was
2020) peripheral pulse wave velocity (PWV) and endothelial changes in SBP and TAD after IHT and changes in
reduced only in patients who responded to IHT
function were measured before and after a 12-week arterial stiffness and markers of endothelial function.
(responsive: 9.3 ± 0.6 vs 8.2 ± 0.3 m/s, pa 0.004;
period.
non-responsive: 9.0 ± 0.6 vs 8.6 ± 0.4 m/s, pa
0.587).
IRT (3 times a week for a total of 8 min of compression
activity) is able to reduce participants' SBP by 6 to 7
Randomized controlled trials of IRT. Effect: Reduction of TAS on average
(Smartet mmHg, which is equivalent to a 13% reduction in the
Pre- and post-IRT BP values and patient − 6.8 mmHg (95% CI −7.9, −5.6) and −10.9 mmHg
to the.2020) risk of myocardial infarction and of 22% stroke.
demographics were collected. (−14.5, −7.4), respectively.

TA:Blood pressure,TAS:Systolic Blood Pressure, PAM:Mean arterial pressure,TAD:Diastolic Blood Pressure,VS:Stroke Volume,IC:heart
rate,IRVS:Systemic Vascular Resistance Index,BMI:Body Mass Index,PPS:Sustained Weight Test,PWV:Pulse Wave Velocity,IHT:Isometric
Grip Training,IHG:Isometric grip,IE:isometric training,RMax:Maximum Repetition,IRT: Isometric resistance training.

Thus, it is concluded that the effect of aerobic One of the first articles that analyzes and
exercise is superior to isometric grip strength evaluates the hemodynamic responses of
exercise, IHG, as an antihypertensive treatment and hypertensive participants to isometric exercise
its recommendation should continue, due to its (wall squat) is the following: using this standard
immediate and sustained benefit on BP. Aerobic protocol it is feasible to suggest that similar
exercise induced a post-exercise hypotension effect, responses can be expected, regardless of the
PEH, due to the circadian variation from 4 to isometric training used; it is recommended,
6 mmHg, during waking hours; On the contrary, strongly, a more IHG-based approach obtained
no hypotension effect. OK the evidence when prescribing unsupervised ETI
with Ashet al.(2017), aerobic exercise training to people with suboptimal BP control. In these
reduced resting SBP by 7 mmHg during waking circumstances, an “individualized” ETI
hours, while DBP was not different. In contrast, prescription would be provided for better control
IHG resistance exercise training increased and higher risk patients (Wileset al.2018)
resting DBP by 5 mmHg during waking hours
and 7 mmHg during sleeping hours, while SBP Rodriguez Penaet al.(2018) point out that the
was not different. values of TAS, TAD and TAM rise in all categories
during exercise; diastolic was the one that
showed the greatest increase in both genders, a
Likewise, as mentioned in the following article, fact that is explained by the significant increase in
the information collected and provided in the systemic vascular resistance. In relation to
studies that precede the research with gender, although no statistical differences were
isometric strength protocols lacks data with obtained, the values achieved by women in the
which a comparison can be made with what isometric test were slightly higher than men,
was done with aerobic resistance exercises. , except in the hypertensive group.
demonstrating that grip training
isometric-IHT does not reduce BP in patients On the other hand, the study by Cahu Rodrigueset al.
(2020), indicates
hypertensive patients, on the other hand, aerobic exercise, carried out that
as aTAS and
strict TAD
and have a
uncontrolled
regimen, led to a significant reduction in ambulatorysignificant reduction
BP (Pagonas after isometric grip
et al.2017).
training (IHT); In the same way, it is observed

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Rev. Digital Act. Phys. Sport 9(1):e2209. July-December, 2023
that, compared to men, women reduced ADR
more; women 9.1 ± 0.5 versus, men 8.0 ± 0.3;
Likewise, no significant correlation was
observed between changes in systolic and
diastolic blood pressure after IHT and changes
in arterial stiffness and markers of endothelial
function.
Among the studies analyzed, those carried out
and focused on the effects of muscle strength
programs stand out, in which 72% of subjects
were sedentary, a fact that attributes the fourth
cardiovascular risk factor, worldwide and
represents 9 % of premature deaths, in patients
with some cardiovascular disease. 29% of the
articles studied the effect of strength training
on sedentary subjects, divided into weekly
frequency (2-3 times per week); number of
series (3-4); number of repetitions (6-10), with
gradual increase in exercise intensity; exercise
intensity (50% of 1 Rm), low level loads; rest
interval (1-3 min rest), between series and
recovery (5 min rest interval between exercises)
(Ocampo & Ramírez-Villada, 2018).
Finally, studies conducted with isometric
resistance training, IRT, show that when
performed 3 times a week, for a total of 8
minutes of compression activity, it can reduce a
patient's SBP by 6-7 mmHg. Likewise, Smartet
al.(2020) showed that a similar degree of BP
reduction from taking prescribed medications
is equivalent to a 13% reduction in the risk of
myocardial infarction and a 22% reduction in
the risk of stroke.
Recent research emphasizes the practice of
physical exercise as a preventive measure
against HBP, showing that, in a regular and
structured manner, it provides good results in
maintaining and reducing BP; The correct
monitoring of patients stands out, taking into
account the variables of exercise, such as
modality, volume, frequency, intensity and rest,
prioritizing the dosage of exercise to improve
therapeutic adherence to patients.
Wileset al.(2017) describe the effects of the
isometric wall squat exercise, performed in a
group of 14 adult participants aged 28 years.
7
of age, showing significant results in the
reduction of SBP at rest (-4 ± 5mmHg), DBP (-3
± 5mmHg). The resting values for SBP were
126 ± 7 mmHg, before the training phase; with
SBP at rest post-workout, reducing to 122 ± 8
mmHg. After the washout period, the control
phase began with a baseline value of 125 ± 7
mmHg, for SBP, in these 14 participants. These
values are compared to the initial baseline of
129 ± 7 mmHg, the post-control phase 128 ± 7
mmHg, and then the post-training values.
Likewise, Carlsonet al.(2016) show the effects of
isometric actions on BP in the adult population,
in nine randomized trials, divided into 6
normotensive and 3 hypertensive subjects (223
participants), of which 96 were controls, finding
reductions in BP = 6.77 mmHg, between
-7.93 to -5.62; DBP of 3.96 mmHg, between -4.80 to
- 3.12 and MAP, 3.94 mmHg, between -4.73 to
-3.16. The results show that the effect obtained
with isometric exercises is greater than with
resistance and dynamic strength training,
suggesting that this exercise has the potential
to produce significant BP reductions.
CONCLUSIONS
More research is required to determine how long
after the application of these isometric exercise
protocols the effects continue. This information
would help doctors and rehabilitators determine
the precise moment of its implementation in the
treatment of people, so that patients can obtain
the maximum possible benefit from these
protocols and thus reduce the evolution of the
disease and, at the same time, At the same time,
improve their physical capabilities as people.
The literature analyzed shows that training with
isometric exercises has a greater effect on
reducing BP, with a greater impact on SBP,
compared to dynamic aerobic exercise or
conventional resistance training, requiring less
time for its application ( Cobo-Mejíaet al.2016).
For this reason, physical exercise should be prioritized
and be a fundamental part of the treatment of HTN,
complementing strength and resistance training.
Isometric exercises demonstrated
 López-Mejía, VA; Christmas Eve-Serna, R.; Hernández-Alvarado, MF; Méndez-Ávila,
JC; Morales-Hernández, AG: management of high blood pressure

be a good complement for the control of HTN,
because they are a therapeutic measure that
reduces costs, is minimally invasive and easy to
apply; At the same time, they have been shown
to significantly maintain and reduce BP better
than with resistance training.
Due to the above, we consider that the health
sector can intervene with a battery of isometric
exercises, as a non-pharmacological treatment,
monitoring patients with HTN. In short, it
should be a priority for physical rehabilitation
to increase actions and efforts in
creation and innovation of plans that prioritize
non-pharmacological rehabilitation treatments,
which improve the activity and quality of life of
patients.
Thanks.We thanked the Nursing faculty of the
Autonomous University of Querétaro. Conflict
of interest: The authors declare that there is no
conflict of interest. Funding: This project did not
receive funding from the public or private
sector.

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