Isometric exercise training as a sustainable non-pharmacological strategy for blood pressure control in adults with hypertension: A systematic review

Abstract

Hypertension is a leading modifiable risk factor for cardiovascular disease. Although antihypertensive medications effectively reduce blood pressure, long-term adherence remains suboptimal, highlighting the need for sustainable non-pharmacological interventions. Isometric exercise training (IET) has a time-efficient and cost-effective strategy for blood pressure control. However, evidence regarding its effectiveness across different isometric exercise modalities remains comprehensive synthesis of the available literature. This study aims to evaluate the effect of isometric exercise training on the blood pressure in adults with hypertension. A systematic search was conducted in three databases: PubMed, Scopus and Cochrane Library 2016-2026. The study design involved a total of 11 articles, consisting of Randomized Controlled Trials (RCT), using a PRISMA diagram to compile the results of the search. The study quality was assessed using the JBI appraisal. A total of 46,234 articles were initially identified, of which eleven met the inclusion criteria and were included in this review. The systematic review identified a frequency, intensity, time, and duration of interventions. Based on the available evidence, an isometric exercise program performed three times per week, consisting of 4 × 2-minute per session, may contribute to achieving Sustainable Development Goal (SDG) 3 (Good Health and Well-being) by providing an accessible, cost-effective, and sustainable strategy for hypertension prevention and long-term blood pressure management.