Dose-response effects of isometric wall squats on postexercise hypotension in older women with hypertension

The isometric wall squat (IWS) is a promising nonpharmacological intervention for blood pressure (BP) management, but its optimal dosage in older adults remains unclear. This study compared postexercise hypotension (PEH) after two IWS doses in medicated older women with systemic arterial hypertension (SAH).

Thirty older hypertensive women (68.8 ± 10.0 years) were randomized into three groups: control (CG), 8-min IWS (G8-IWS; 4 × 2-min sets), and 12-min IWS (G12-IWS; 6 × 2-min sets). BP and heart rate (HR) were assessed at rest and at 0, 5, 10, 15, 30, 45, and 60 min postexercise and analyzed using linear mixed-effects models with Bonferroni correction ( P  < 0.05).

G12-IWS significantly reduced systolic BP and mean arterial pressure (MAP) at 45-60 min and 30-60 min postexercise ( P  < 0.05), while G8-IWS showed no BP changes. G12-IWS decreased HR (30-60 min) and rate-pressure product (RPP; 15-60 min); G8-IWS reduced RPP from 30 to 60 min only. Diastolic BP and pulse pressure remained unchanged in both groups.

A single G12-IWS session induced clinically meaningful PEH (~8-10 mmHg), exceeding reported with isometric handgrip exercise (~4-6 mmHg), with greater RPP suppression than G8-IWS. This equipment-free protocol represents a relevant nonpharmacological strategy for BP management in older women with SAH.