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Is isometric exercise training the best FIT for exercise prescription in the prevention and treatment of arterial hypertension?
  1. Henner Hanssen1,
  2. Linda S Pescatello2
  1. 1 Department of Sport, Exercise and Health, University of Basel, Basel, Basel-Stadt, Switzerland
  2. 2 Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
  1. Correspondence to Prof Henner Hanssen, Department of Sport, Exercise and Health, University of Basel, Basel, Basel-Stadt, Switzerland; henner.hanssen{at}

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For patients with hypertension, recent international guidelines and expert statements based on comprehensive reviews of the literature recommend exercise as a first-line non-pharmacological treatment.1–6 There is a general agreement in the guidelines that aerobic exercise training (AET) at moderate intensity be performed for >150 min per week, for 20–30 min on five or more days per week, complemented by low to moderate intensity dynamic resistance exercise training (DRT) 2–3 times per week.1–4

The current guidelines and expert statements acknowledge the merits of isometric resistance training (IRT), particularly for those with normal blood pressure (BP) and the prevention of hypertension. However, the literature on IRT is limited in size with conflicting findings for patients with hypertension requiring more evidence before definitive recommendations regarding IRT can be made as antihypertensive therapy.5 6 A recent network meta-analysis of randomised controlled trials (RCTs) by Edwards and colleagues concluded that IRT was the most effective modality in reducing BP, with mean reductions of −8.2 mm Hg for systolic and −4.0 mm Hg for diastolic BP, followed by DRT (−4.6/–3.0 mm Hg), concurrent exercise training (–6.0/–2.5 mm Hg), AET (−4.5/–2.5 mm Hg) and high-intensity interval training (–4.1/–2.5 mm Hg).7 The meticulous work by Edwards and colleagues represents an important contribution to …

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