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Effect of home-based isometric handgrip exercise with a commercially available device on blood pressure in older adults with hypertension: a randomized controlled trial

Review written by Dr Xiaoqi Chen info

Key Points

  1. Eight weeks of home-based isometric handgrip training with an inexpensive commercial device (25-50% MVC, four 2-minute sets, three times weekly) reduced clinic systolic blood pressure by 7.3 mmHg in older adults with treated hypertension, while controls were unchanged (-0.1 mmHg; between-group p = 0.03).
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BACKGROUND & OBJECTIVE

Hypertension is highly prevalent in older adults and a major modifiable risk factor for cardiovascular and cerebrovascular disease. Non-pharmacological management is multi-factorial, and the most recent 2025 AHA/ACC guideline recommends 75-150 minutes per week of aerobic exercise, resistance training, or both (1), alongside dietary, sodium, alcohol and weight measures. Most of the current evidence involves aerobic exercise, but adherence to it in older adults is often limited by comorbidity, frailty and reduced physical function.

Isometric training is less studied but reported as the most effective for lowering resting systolic pressure (compared with combined, dynamic resistance and aerobic training) in a meta-analysis of 270 randomized controlled trials (2). Isometric handgrip training (IHT) has been found to be an effective adjunct for blood pressure control. A recent meta-analysis found it reduced systolic blood pressure (SBP) by 5.38 mmHg and diastolic blood pressure (DBP) by 2.71 mmHg compared with controls (3).

This trial tested whether IHT performed at home with an inexpensive commercial device could reduce blood pressure in older adults with hypertension.

Hypertension is highly prevalent in older adults and a major modifiable risk factor for cardiovascular and cerebrovascular disease.
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Isometric handgrip training is best regarded as an adjunct to, rather than a substitute for, aerobic and dynamic strengthening exercise in those able to perform them.

METHODS

  • This assessor-blinded, single-centre randomized controlled trial enrolled 30 adults aged 60 years or more with a clinical diagnosis of hypertension (with or without medication) and a maximum voluntary grip strength of 10-40 kg.
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