Effects of home-based isometric handgrip or aerobic exercise training in older adults with pre-hypertension and hypertension

Isometric handgrip exercise training (IHT) is a promising non-pharmacological treatment to hypertension. In HoldAge (NCT04275037) we compared the effects of a home-based IHT intervention to home-based aerobic exercise training (AET) intervention or usual care on blood pressure (BP) in older adults with high normal BP and hypertension.53 participants with high normal BP to stage I hypertension were (24 men, age 71.7 ± 4.2 years, systolic BP 138.2 ± 16.2 and diastolic BP 80.4 ± 8.7 mmHg) were randomized into IHT (n = 19), AET (n = 19) or an attention control group (AC, n = 15). Participants performed IHT or AET, 3 times/week, for 8 weeks. IHT consisted of 4x45 sec bilateral contractions, at an intensity of 50% of the maximum voluntary contraction, with a 1-min rest between sets. AET was walking at an intensity of 50-70% of the estimated peak maximal oxygen consumption. The AC group received standardized optimal medical care, including lifestyle advice.Of the 53 participants, 49 finished the intervention (92.5%) with one dropout in AET and 3 in AC. Three participants were excluded due to changes in the antihypertensive medication (AET:1 and AC:2). The self-reported exercise adherence was 96.6% for IHT and 83.8% for AET. There were no significant differences at baseline for SBP (p = 0.343), DBP (p = 0.107) and pulse pressure (PP, p = 0.386). Both exercise interventions elicited similar reductions in SBP from baseline to postintervention (IHT: 138.8 ± 14.9 vs 129.2 ± 10.4 mmHg; p = 0.003; AET: 139.8 ± 19.6 vs 132.6 ± 9.5 mmHg; p = 0.049). There were no changes in BP in the AC group (130.6 ± 12.7 vs 127.9 ± 18.3 mmHg; p = 0.392). DBP decreased after IHT (78.6 ± 7.9 vs 74.7 ± 8.1 mmHg; p = 0.025) but not AET (83.1 ± 9.2 vs 80.8 ± 9.5 mmHg; p = 0.360) or AC (76.5 ± 5 vs 76.5 ± 10.1 mmHg; p = 0.942). Both exercise interventions also elicited similar reductions in PP (IHT: 60.2 ± 10.5 vs 54.4 ± 8.9 mmHg; p = 0.014; AET: 56.7 ± 13.2 vs 51.7 ± 13.5 mmHg; p = 0.016) with no differences for the AC (54.1 ± 10.3 vs 51.2 ± 13.3 mmHg; p = 0.285).The preliminary results from HoldAge indicate home-based IHT and AET elicit significant reductions in office SBP among older adults with high-normal BP to Stage 1 hypertension.