IS ISOMETRIC EXERCISE WITH LARGE MUSCLE MASS THE BEST MODEL FOR EXERCISE PRESCRIPTION IN SYSTEMIC ARTERIAL HYPERTENSION? AN INTEGRATIVE REVIEW

Abstract

Isometric exercise (IE) is a promising strategy for reducing blood pressure levels, especially in hypertensive patients. The acute effects of IE, observed immediately after a session, include a transient reduction in blood pressure, attributed to the activation of hemodynamic and neurohormonal mechanisms, known as post-isometric exercise hypotension. On the other hand, the chronic effects, resulting from repeated sessions over time, show a sustained reduction in blood pressure, associated with vascular adjustments and improvements in endothelial function. A comparison of IE studies using smalland largemuscle mass reveals that IE with large muscle mass seems to promote more significant reductions in blood pressure. However, there is a gap in the literature analyzing this context. We conducted comprehensive searches in electronic databases: PubMed, Scopus, Cochrane Central Register of Controlled Trials (CENTRAL), Google Scholar, Embase, Enhancing the Quality and Transparency of Health Research (EQUATOR) and Web of Science. The inclusion criteria adopted for this review were studies on the acute and chronic effects of IE on cardiovascular parameters in humans, published between 2014 and 2024, in English or Portuguese. We excluded studies with small or inadequate sample sizes; acute studies with post-exercise isometric blood pressure analysis of less than 30 minutes; and chronic studies with less than four weeks of intervention. A critical analysis of the selected studies was carried out by three experienced evaluators on IE and hypertension, focusing on the methods, populations studied, type and duration of exercise and them a in findings related to blood pressure. Both acute and chronic IE performed with large muscle mass can be a viable alternative as an adjuvant in the post- exercise hypotensive response in normotensive and, above all, hypertensive patients. However, additional precautions regarding vascular, cerebrovascular, and musculoskeletal safety should be considered, especially in patients with cardiac risk and musculoskeletal problems.