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Isometric exercise versus high-intensity interval training for the management of blood pressure: a systematic review and meta-analysis
  1. Jamie Edwards1,
  2. Anthony De Caux1,
  3. James Donaldson1,2,
  4. Jonathan Wiles1,
  5. Jamie O'Driscoll1
  1. 1 School of Psychology and Life Sciences, Canterbury Christ Church University, Kent, UK
  2. 2 Department of Sport Science, Nottingham Trent University, Nottingham, UK
  1. Correspondence to Dr Jamie O'Driscoll, Canterbury Christ Church University, Canterbury, UK; jamie.odriscoll{at}


Objective We aimed to compare the efficacy of isometric exercise training (IET) versus high-intensity interval training (HIIT) in the management of resting blood pressure (BP).

Design Systematic review and meta-analysis.

Data sources PubMed (MEDLINE), the Cochrane library and SPORTDiscus were systematically searched.

Eligibility criteria Randomised controlled trials published between 1 January 2000 and 1 September 2020. Research trials reporting the effects of IET or HIIT on resting BP following a short-term intervention (2–12 weeks).

Results 38 studies were analysed (18 IET and 20 HIIT), including 1583 (672 IET and 911 HIIT) participants, of which 612 (268 IET and 344 HIIT) were controls.

IET produced significantly greater reductions in resting BP compared with HIIT with systolic, diastolic and mean BP effect sizes of 8.50 mm Hg vs 2.86 mm Hg (Q=17.10, p<0.001), 4.07 mm Hg vs 2.48 mm Hg (Q=4.71, p=0.03) and 6.46 mm Hg vs 3.15 mm Hg (Q=4.21, p=0.04) respectively. However, HIIT reduced resting heart rate significantly more than IET (3.17bpm vs 1.34bpm, Q=7.63, p=0.006).

Conclusion While both modes are efficacious, IET appears to be the superior mode of exercise in the management of resting BP. However, HIIT may achieve wider physiological benefits, with greater reductions in resting heart rate.

  • exercise

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  • Contributors JE, ADC and JO’D contributed to the conception and design of the study. JE and ADC contributed equally to this work. JE, ADC and JO’D contributed to the development of the search strategy. JE and ADC conducted the systematic review. JE, ADC and JO’D completed the acquisition of data. JE, ADC, JD and JO’D performed the data analysis. All authors assisted with the interpretation. JE and JO’D were the principal writers of the manuscript. All authors contributed to the drafting and revision of the final article. All authors approved the final submitted version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.