Isometric Exercise Training Trumps HIIT

Isometric glutes and quads training

An article in the Straits Times last year showed that an increasing number of Singaporeans have hypertension or high blood pressure. 

This is not just in Singapore, hypertension is a global health problem that is largely treated by anti-hypertensive medication. However, even though anti-hypertensive medication is mostly effective, other than being costly over the long term, it has adverse side effects and also poor adherence rates. My own grandmother used to take one pill a day, then she reduced the dose to half herself before stopping altogether.

Traditionally, moderate intensity aerobic exercise is currently recognised as the recommended modality for managing blood pressure problems. Current exercise compliance to benefit long term cardiovascular risk is also poor. Hence, a different approach may be needed to manage hypertension.

The paper referenced below investigated the effects of isometric exercises versus high intensity interval training (HIIT) to find out which is more effective at reducing resting and ambulatory blood pressure (BP).

Both IET and HIIT were found to be effective, however IET was significantly more effective at reducing resting BP compared to HIIT. Systolic and diastolic BP were reduced by 8.50 mmHG and 4.07mmHG after IET versus 2.86 mmHG and 2.48 mmHG following HIIT.

HIIT lessened the resting heart rate significantly by 3.17 beats per minute (bpm) versus 1.34 bpm for IET. 

Duration of exercise, subject's medication status and time of diagnosis of hypertension had no effect on the results.

Compared to HIIT, IET had superior results in the management of resting BP with reductions similar to or greater than anti-hypertensive medication. HIIT was still found to be highly effective at reducing resting BP and may have wider physiological benefits than IET since it was more effective at reducing resting heart rate. 

Teaching patients to use IET to reduce hypertension should definitely be considered. Most of the studies that studied IET used hand grip exercises for the upper limb and stationary wall squats or leg extension for the lower limb. Cycling intervals were the most common for HIIT studies.

The authors concluded that getting patients with hypertension to do IET for controlling their blood pressure should be considered, while HIIT better for maintenance of good health.

Now you know IET trumps HIIT when it comes to lowering blood pressure.

Reference

Edwards J,  De Caux A, Donaldson Jet al (20). Isometric Exercise Versus High-Intensity Interval training For The Management Of Blood Pressure: A Systematic Review And Meta-Analysis. BJSM. DOI: 0.1136/bjsports-2021-10442.

*Thanks to Megan for getting me the article

Increase Of Strokes In Young Adults

Last December, one of my colleagues needed to take urgent leave to go to Taiwan. He found out that his 36 year old brother had a suspected stroke and their whole family went to Taiwan to be with him.

I was shocked as his brother seemed relatively young to suffer a stroke (although I remember while still working in the hospital my youngest stroke patient was just 29 years young). The same colleague mentioned that at least four other friends younger than his brother also had a stroke!

Though it may seem shocking to you for such a young person to experience a stroke, evidence shows that this is becoming more common in young adults.

An article published in JAMA Neurology found that the number of men aged between 35 to 44 hospitalized for stroke increased by a staggering 42 percent when they compared 2003-2004 to 2011-2012.

It seems to be more common among males (41 percent versus 30 percent for females). The authors found significant increased risk of getting a stroke if you are diabetic, have hypertension, heart disease, smoking cigarettes currently and long term alcohol consumption.

The majority of the above listed factors are definitely easily modified, correctable or can be stopped. So prevention strategies definitely have the potential to reduce the impact of stroke in this young age group.

I'd add that exercising will definitely reduce your risk too.


Reference

George MG, Tong X and Bowman BA (2017). Prevalence Of Cardiovascular Risk Factors And Risk Factors And Strokes in Younger Adults. Jama Neurol. 74(6): 695-703. DOI: 10.1001/jamaneurol.2017.0020.