The Optimal Dosage of Isometric Handgrip Exercise for Blood Pressure Reduction: Systematic Review and Meta-Analysis.
Level 1 - systematic review of randomized trials
Systematic review and meta-analysis of clinical trials
PubMed 41922197 · doi:10.1111/jch.70246
What was done
A systematic review and meta-analysis (PROSPERO CRD420251154235) searched EMBASE, MEDLINE/PubMed, and Cochrane CENTRAL through June 2025 to evaluate the dose-response relationship of isometric handgrip (IHG) training on resting blood pressure in normotensive and hypertensive populations. Quality and risk of bias were evaluated using the PEDro scale and RoB-2. Meta-regression evaluated dose-response effects on systolic (SBP) and diastolic blood pressure (DBP).
What was found
Across 31 studies with 905 participants (51% male; mean PEDro score 5.9 ± 1.0), IHG training significantly reduced SBP (-5.38 mmHg, 95% CI -6.91 to -3.85; p < 0.001; I² = 86%) and DBP (-2.71 mmHg, 95% CI -3.75 to -1.66; p < 0.001; I² = 90%), with larger reductions in hypertensive groups. Training intensity <30% maximal voluntary isometric contraction (MVIC) yielded smaller reductions in SBP (p = 0.043) and DBP (p = 0.032). Higher training frequency (>3 to 7 days/week) was associated with diminished SBP reduction (p = 0.032). The identified evidence-informed protocol was 4 sets of 2-minute unilateral contractions at ≥30% MVIC, ≤3 times per week, for ≥8 weeks.
Why it matters
This review identifies concrete dosing parameters for isometric handgrip exercise, indicating that excessive weekly frequency (>3 days/week) or low intensity (<30% MVIC) reduces blood pressure-lowering efficacy.
Limits
Statistical heterogeneity was high across trials (I² = 86% for SBP, 90% for DBP). Individual trial sample sizes were small (averaging ~29 participants), average methodological quality was fair to good (PEDro 5.9/10), and long-term cardiovascular endpoints were not reported.
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