Essential hypertension accounts for 13 percent of total deaths worldwide, accounting for one of the major risk factors. Hypertension (high blood pressure) is when the pressure in your blood vessels is too high (140/90 mmHg or higher). Dynamic exercises, sustained hand grip contractions elicit lower systolic blood pressure and heart rate responses. So for patients undergoing exercise therapy, low intensity isometric exercises are preferable. Significant reduction is seen in mean arterial blood pressure and systolic blood pressure in individuals conducting isometric for 8 weeks in 30%. The reduction in systolic blood pressure will be clinically significant. The main objective of this study will be to determine the effects of dynamic and isometric handgrip exercise training on cardiovascular parameters in hypertensive patients Grade 1 hypertensive patients are included as per AHA and JNC7 criteria. A sample of 100 hypertensive patients will be recruited and divided into two treatment groups; G1: dynamic exercise in hypertensive patients, and G2: isometric exercise in hypertensive patients. Outcome measure will include systolic blood pressure, diastolic blood pressure, mean arterial blood pressure and pulse pressure. Outcome measures will be assessed at baseline and 2nd and 4th weeks posttreatment.
Hypertension is one of the most prevalent diseases leading to morbidity and mortality, affecting millions of people every year. Pharmaceutical management is the main treatment method used. Exercise therapy mainly isometrics and dynamic handgrip exercises provide a non pharmacological management leading to decrease in symptoms. The association of hypertension with physical inactivity, sedentary behavior, and occupational exposure to chemicals, obesity, older age, genetics, being overweight or obese, not being physically active, ,high-salt diet, job insecurity, job loss, and the psychosocial work environment and drinking too much alcohol. Lifestyle changes like eating a healthier diet, quitting tobacco, and being more active can help lower blood pressure. Hypertension rates are strongly associated with age. Acute effects of isometric and dynamic handgrip exercise on cardiovascular parameters in hypertensive subjects are numerous . They may also have some adverse effects on the cardiorespiratory system, particularly, through the elevation of blood pressure. Since an acute bout of exercise can transiently improve cardiovascular endothelial function, arterial stiffness, and ambulatory blood pressure. The dynamic handgrip exercise is performed by repetitive contraction and relaxation of the hand at a maximum frequency. In order to determine the intensity of handgrip exercises, maximum isometric handgrip strength of the right and left hand was measured with a handgrip dynamometer. Isometric exercises differ from dynamic exercises because in this there is no change in muscle length or static force. Single handgrip exercise could reduce the blood pressure for couple of hours so a patient can perform this exercise several times a day if not being fatigue.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
Patients will be instructed to squeeze and sustain the dynamometer for 2 min at 30% M.V.C. The dynamometer pointer which read the scale provided visual feedback to the subjects for the maintenance of the 30% M.V.C. This procedure will be repeated twice for each training session with a 5-minute rest in between.
Dynamic handgrip exercise was performed with both-sided, metronome-guided rhythmic hand contractions for 2min. The handgrip ring, closest to 20% of MVC, was chosen for DHE which was performed at a frequency of 30/min, acoustically indicated by a metronome beat.
Riphah Rehabiliation Clinic
Lahore, Punjab Province, Pakistan
6 Minute Walk test
It is a standard method for measuring exercise capacity in patients with cardiopulmonary disease such as PAH. The 6MWT measures how far a patient can walk in 6 minutes. Walking is an activity performed every day by most patients except for those most severely limited. By assessing patients\' ability to exercise, the 6MWT provides a global assessment of respiratory, cardiovascular, neuromuscular, and cognitive function. The 6MWT does not differentiate what limits the patient nor does it assess maximal exercise capacity. Instead, the 6MWT allows the patient to exercise at a daily functional level and is a useful tool for assessing severity of disease, and increasing walk distance correlates with a subjective improvement in dyspnea
Time frame: Baseline; 4nd Week; 8th Week
Blood Pressure Measurements (SBP & DBP)
An appropriately sized cuff for the arm circumference was installed on the non-dominant arm. Blood pressure was measured every 20 minutes by 24 hours, and awake and sleep periods were determined according to information provided by the patients, the following are 7 strategies recommended by the AHA/AMA for accurate attainment of BP: 1) no conversation, 2) empty bladder, 3) use correct cuff size, 4) place BP cuff on bare arm, 5) support arm at heart level, 6) keep legs uncrossed, and 7) support back and feet
Time frame: Baseline; 4nd Week; 8th Week
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