Acute and Chronic Effects of Combined Training on BP in Hypertensives

NCT07470450 | Completed

• 1 other identifier: 84584824.4.0000.5347
• Study Type: interventional
• Target: 60
• Locations: 1 country
• Sites: 1

Brief Summary

Dynamic strength training (DST) is widely recognized for promoting neuromuscular adaptations such as increased strength and hypertrophy. It is currently endorsed by treatment and prevention guidelines for systemic arterial hypertension (SAH) due to its significant effect on lowering blood pressure (BP). However, when comparing BP reduction values, isometric strength training (IST) stands out with greater magnitudes of BP reduction, although without the neuromuscular adaptations seen in DST. Given their similarities, a combination of these strategies through combined strength training (CST) is possible but has not yet been evaluated. Our hypothesis is that CST may have an additive effect compared to DST and IST alone in reducing ambulatory BP. Thus, our objective is to evaluate and compare the effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients. This thesis is structured in two parts: 1) A crossover study with medicated middle-aged hypertensive patients to identify autonomic, endothelial, and vascular responses on ambulatory BP after a single session of CST, DST, and IST. 2) A randomized clinical trial to assess the chronic effects of CST, DST, and IST on regulatory variables of ambulatory BP in medicated middle-aged hypertensive patients.

Conditions

Dynamic Strength Training; Combined Strength Training; Isometric Strength Training; Dynamic Strength Exercise Session; Isometric Strength Exercise Session; Combined Exercise Session; Control Session (CON)

Keywords

Ambulatory Blood Pressure Monitoring; Resistence training; Isometric exercise; Post-Exercise hypotension; Endothelial Function

Outcome Measures

Primary Outcomes (1)

• 24-hour Ambulatory Blood Pressure (Systolic, Diastolic, and Mean)

  Average systolic blood pressure measured over a 24-hour period using an automated ambulatory monitor (ABPM). This measure assesses the chronic effect of the 8-week training protocols compared to baseline.

  Baseline and 8 weeks

Secondary Outcomes (10)

• Acute 24-hour Ambulatory Blood Pressure (Systolic, Diastolic, and Mean)

  24 hours post-intervention

• Acute Post-Exercise Blood Pressure Response

  Baseline, 30 minutes, and 60 minutes post-exercise.

• Vascular Endothelial Function - Chronic (Flow-Mediated Dilation)

  Baseline and 8 weeks

• Vascular Endothelial Function - Acute Response (Flow-Mediated Dilation)

  Baseline, 30 minutes, and 60 minutes post-exercise.

• Cardiac Autonomic Modulation - Chronic (Heart Rate Variability)

  Baseline and 8 weeks.

Study Arms (4)

Dynamic strength training

EXPERIMENTAL

8 dynamic strength exercises, with 14 repetitions, 3 sets, 1 second concentric phase and 2 seconds eccentric phase. 30 seconds of rest between sets and 1 minute and 30 seconds of rest between exercises.

Other: Dynamic strength training

Isometric strength training

EXPERIMENTAL

8 isometric strength exercises. 10 seconds of isometric strength. 3 sets, 1 second concentric and 2 eccentric. 30 seconds rest between sets and 1 minute and 30 seconds rest between exercises.

Other: Acute Isometric Exercise Session.

Control group

EXPERIMENTAL

The control group consists of maintaining their habits for 8 weeks, without strength exercises.

Other: Control Session and Follow-up

Combined strength training

EXPERIMENTAL

8 resistance exercises combining dynamic repetitions with isometric components. Protocol: 3 sets of 11 repetitions, with a concentric phase of 1 second and an eccentric phase of 2 seconds combined with 10 seconds of isometric hold at the end of each set. Includes 30 seconds of rest between sets and 90 seconds between exercises.

Other: Combined strength training

Interventions

Combined strength training OTHER

Participants in this group undergo two phases. Phase 1: A single acute exercise session consisting of 8 resistance exercises (3 sets of 11 repetitions with a 10-second isometric hold at the end of each set; 1s concentric/2s eccentric phases). Phase 2: An 8-week chronic intervention period, performing the same combined protocol 3 times a week, with intensity progressing from 50% to 65% of 1RM.

Combined strength training

Dynamic strength training OTHER

Participants in this group go through two phases. Phase 1: A single acute exercise session consisting of 8 resistance exercises (3 sets of 14 repetitions, 1 second concentric phase and 2 seconds eccentric phase, 30 seconds of rest between sets and 90 seconds between exercises) at 50% of 1RM. Phase 2: An 8-week chronic intervention period, performing the same dynamic resistance protocol 3 times a week, with intensity progressing from 50% to 65% of 1RM.

Dynamic strength training

Acute Isometric Exercise Session. OTHER

Participants in this group undergo a single acute exercise session consisting of 8 resistance exercises performed isometrically. The protocol includes 3 sets per exercise, with each set consisting of a 10-second static contraction at 50% of 1RM, with 30 seconds of rest between sets and 90 seconds between exercises

Isometric strength training

Control Session and Follow-up OTHER

Participants in this group undergo two phases. Phase 1: A single acute control session consisting of quiet rest in a seated position for the same duration as the exercise sessions. Phase 2: An 8-week follow-up period where participants maintain their usual daily activities and pharmacological treatment without any structured exercise program.

Control group

Eligibility Criteria

• Age: 30 Years - 60 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64)

You may qualify if:

• Diagnosis of Stage 1 or 2 Hypertension (according to current guidelines). Sedentary (not engaged in structured exercise programs for at least 6 months). Aged between 18 and 60 years. Stable pharmacological treatment for at least 4 weeks. Ability to perform resistance exercises.

You may not qualify if:

• Presence of symptomatic cardiovascular disease, heart failure, or unstable angina. Diagnosis of uncontrolled diabetes (HbA1c \> 8%) or renal failure. Musculoskeletal conditions or physical limitations that contraindicate resistance training. Recent changes in antihypertensive medication within the 4 weeks prior to or during the protocol. Current smoking or excessive alcohol consumption.

Sponsors & Collaborators

• Federal University of Rio Grande do Sul: lead

Study Sites (1)

Universidade Federal do Rio Grande do Sul

Porto Alegre, Rio Grande do Sul, 91420-550, Brazil

Location

MeSH Terms

Conditions

Post-Exercise Hypotension

Condition Hierarchy (Ancestors)

Orthostatic Intolerance; Primary Dysautonomias; Autonomic Nervous System Diseases; Nervous System Diseases; Hypotension; Vascular Diseases; Cardiovascular Diseases

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Masking Details: While it was not possible to mask the participants and the exercise instructors due to the nature of the training sessions, a clear separation was maintained between the team supervising the exercises and the team responsible for data collection and analysis. Specifically, the outcomes assessors responsible for the Ambulatory Blood Pressure Monitoring (ABPM) and Flow-Mediated Dilation (FMD) measurements were completely blinded to the participants' group allocation and had no involvement in the training protocols.
• Purpose: TREATMENT
• Intervention Model: SEQUENTIAL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Professor at Universidade Federal do Rio Grande do Sul

Model Details: "The study follows a sequential design divided into two distinct phases. In Phase 1 (Acute), a randomized crossover design is employed where all participants undergo four experimental sessions (Control, Dynamic Strength, Isometric Strength, and Combined Exercise) in a randomized order, with a minimum washout period of 48 to 72 hours between sessions to evaluate 24-hour post-exercise hypotension. In Phase 2 (Chronic), participants are then randomized into three parallel groups (Control, Dynamic Strength Training, and Combined Strength Training) for an 8-week intervention period. This phase aims to evaluate long-term cardiovascular adaptations, including 24-hour ambulatory blood pressure and endothelial function. Data collection for both phases has been completed."

Study Record Dates

• First Submitted: March 9, 2026
• First Posted: March 13, 2026
• Study Start: July 26, 2025
• Primary Completion: December 23, 2025
• Study Completion: December 23, 2025
• Last Updated: March 13, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

BR (1)