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Isometric handgrip exercise and resting blood pressure: a meta-analysis of randomized controlled trials
George A Kelley1, Kristi S Kelley
1Department of Community Medicine, School of Medicine, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia 26506-9190, USA. gkelley@hsc.wvu.edu
Objective:
To examine the efficacy of isometric handgrip exercise for reducing resting SBP and DBP in adult humans.
Methods:
Meta-analysis of studies retrieved from five electronic databases as well as cross-referencing from identified articles. The criteria for inclusion were randomized controlled trials published in any language over an approximate 38-year period (1 January 1971 to 1 February 2009), isometric handgrip training of at least 4 weeks performed by adults of at least 18 years of age, and data for changes in resting SBP and DBP available. Dual coding of studies was performed by both investigators. Data were analyzed a priori using random-effects models and nonparametric 95% bootstrap percentile confidence intervals (BCIs, 5000 iterations). Because of the small sample size, analyses were also performed using fixed-effects models post hoc.
Results:
Eighty-one men and women (42 exercise and 39 control) from three of 287 reviewed studies were pooled for analysis. Using random-effects models, statistically significant exercise minus control group reductions of approximately 10% were observed for both resting SBP and DBP (SBP: Xd , -13.4 mmHg; 95% BCI, -15.3 to -11.0 mmHg and DBP: X , -7.8 mmHg; 95% BCI, -16.5 to -3.0 mmHg). Results were also statistically significant when fixed-effects models were used (SBP: X , -13.8 mmHg; 95% BCI, -15.3 to -11.0 mmHg and DBP: X , -6.1 mmHg; 95% BCI, -16.5 to -3.2 mmHg).
Conclusion:
Isometric handgrip exercise is efficacious for reducing resting SBP and DBP in adult humans. However, the generalizability of these findings is limited given the small number of studies included.
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Physiological Factors:
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Prepare for the Procedure:
Assessment of blood pressure in brachial artery(two-step method)
Special considerations while measuring blood pressure
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
Pre-Procedural Guidelines for Assessing Blood Pressure
Measurement of Blood Pressure

