Discover the power of isometric exercises in combating hypertension, a prevalent issue among half of American adults. In this episode, we delve into a groundbreaking review from the British Journal of Sports Medicine, examining non-pharmacological interventions for managing blood pressure. Analyzing data from 270 trials with nearly 16,000 participants, we find that aerobic, resistance, and high-intensity interval training are effective, but isometric exercises, like wall sits, stand out by doubling the blood pressure-lowering effects. Join us as we explore these findings and their potential impact on future health recommendations.
Discover the power of isometric exercises in combating hypertension, a prevalent issue among half of American adults. In this episode, we delve into a groundbreaking review from the British Journal of Sports Medicine, examining non-pharmacological interventions for managing blood pressure. Analyzing data from 270 trials with nearly 16,000 participants, we find that aerobic, resistance, and high-intensity interval training are effective, but isometric exercises, like wall sits, stand out by doubling the blood pressure-lowering effects. Join us as we explore these findings and their potential impact on future health recommendations.
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Introducer:
Welcome to the Dr Journal Club podcast, the show that goes on to the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Continue your learning after the show at www. drjournalclub. com.
Josh:
Please bear in mind that this is for educational and entertainment purposes. Only Talk to your doctor before making any medical decisions, changes, etc. Everything we're talking about that's to teach you guys stuff and have fun. We are not your doctors. Also, we would love to answer your specific questions. On www. drjournalclub. com you can post questions and comments for specific videos, but go ahead and email us directly at josh at drjournalclub. com. That's josh at drjournalclub. com. Send us your listener questions and we will discuss it on our pod.
Josh:
Hello and welcome to another SuperSpeedy summary. This is your host, Dr. Joshua Goldenberg, and today we're going to talk about exercise for hypertension exercise for blood pressure. I was quite surprised by the results of this study, so I'm really excited that Dr Adam Sadowski decided to do it for this month. So let's jump in. This is a major systematic review and network meta-analysis massive, actually. That came out in 2023 in the British Journal of Sports Medicine. So okay, hypertension is a big problem. We all know that. That's 50% of American adults have hypertension. That's kind of mind-blowing, but less than 25% have it adequately controlled also terrifying. So the question is what is the efficacy of exercise on resting, systolic and diastolic blood pressure levels? So basically, we've got just a zillion technical term studies of exercise for blood pressure. And the idea is, when you have a situation like that, it's really useful if, a you can meta-analyze it to sort of see the forest from the trees, and B do this fancy thing called a network meta-analysis. And if you want more information on that, check out the skills videos on this on the Dr Journal Club website. The main advantage is you can compare interventions that haven't been compared formally. So if you have a whole bunch of studies that look at you know, hiit exercise, high intensity interval training compared to placebo, or a whole bunch of studies on cycling versus placebo, but you've never had, you know, hiit versus just straight up normal cycling or something like that, you're still able to make that comparison using a network meta-analysis. So that's one of the advantages here. So again, like I said, systematic review and network meta-analysis massive. So 270 randomized controlled trials have been conducted on this, which is just insane to me. Almost 16,000 individuals are involved in these studies, so just a huge data set looking at all different types of exercise versus any control and looking at the effect on blood pressure.
Josh:
When we look at the pairwise meta-analysis, that's sort of a standard meta-analysis of all of aerobic exercise versus control. You're dropping about four and a half millimeters of mercury. Systolic Resistance training is about the same. You're dropping four and a half millimeters of mercury. Weight training you're dropping 4.1 systolic and then, amazingly, isometric you're dropping 8.2. All of these are statistically significant, by the way, and for the detailed breakout of individual types of exercise within these categories, again watch the basic and in-depth level videos.
Josh:
But so you're basically seeing aerobic resistance and HIIT. You're having four, four and a half point drop on systolic. You're basically doubling that with isometric. That just kind of freaking, blew my mind. That's like old school exercise, like wall sits if you've ever done that and hated it in gym class. Apparently they were right. Just kind of nuts to me. And then when they do this network meta-analysis, where they're actually comparing them against each other, not against a control, they're seeing that, yeah, it's pretty much what it looks like on the pairwise, which is that isometric wins out over all the others. It's superior to aerobic resistance and HIIT by about four additional milligrams of mercury systolic. So very, very interesting study. A huge amount of data gives you a good sense of how much you can expect patients to drop on their systolic levels based on these different exercise types and, at least in my read, paints a pretty clear picture on the winner.
Josh:
If you had to pick one type of exercise that a patient was willing to do, it might be the wall sits. Sorry about that, at least it's not burpees. All right, talk to you . For more detail watch the Dr. Journal Club basic and in-depth level video.
Josh:
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Introducer:
Thank you for listening to the Dr Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Be sure to visit www. drjournalclubcom to learn more.