Effects of isometric training based on the entire population on blood pressure regulation: systematic review and meta-analysis of randomized controlled trials.

Isometric training significantly reduced systolic blood pressure (SBP) compared to control conditions.

• WMD of -6.72 mmHg (95% CI: -8.21 to -5.23, p < 0.0001)
• Heterogeneity was substantial: I² = 74%
• Analysis based on 40 randomized controlled trials
• Search included PubMed, Web of Science, EBSCO, Cochrane, and Scopus databases with cutoff date of September 7, 2025

Isometric training significantly reduced diastolic blood pressure (DBP) compared to control conditions.

• WMD of -2.72 mmHg (95% CI: -3.57 to -1.87, p < 0.0001)
• Heterogeneity was moderate: I² = 48%
• Analysis based on 40 randomized controlled trials
• PRISMA guidelines were followed for the systematic review

Regression analysis revealed no significant influencing factors on the blood pressure reduction effects of isometric training.

• Meta-regression was conducted to identify potential moderating variables
• No statistically significant influencing factors were identified
• This finding was noted despite substantial heterogeneity observed in SBP outcomes (I² = 74%)

Subgroup analyses indicated that wall squat exercises performed three times per week for more than 8 weeks were associated with larger reductions in blood pressure.

• Wall squat exercise type showed larger blood pressure reductions compared to other isometric exercise modalities within the analyzed studies
• Training frequency of three times per week was associated with larger reductions
• Duration exceeding 8 weeks was associated with larger effect sizes
• These findings were derived from subgroup analyses across 40 included randomized controlled trials

Larger blood pressure reductions from isometric training were observed in males and hypertensive populations compared to other subgroups.

• Subgroup analysis by sex indicated males showed greater blood pressure reductions
• Subgroup analysis by health status indicated hypertensive individuals showed greater blood pressure reductions
• These subgroup findings inform individualized exercise prescription recommendations

The optimal training intensity associated with the largest effect size differed between systolic and diastolic blood pressure outcomes.

• 85% HR peak was associated with the largest effect size for systolic blood pressure reduction
• 95% HR peak was associated with the largest effect size for diastolic blood pressure reduction
• The paper notes that preferable intensity 'may differ between systolic and diastolic blood pressure and should be individualized'
• Higher intensities in the range of 85–95% HR peak were identified as effective

The systematic review included 40 randomized controlled trials identified through a multi-database search emphasizing studies published in the past decade.

• Databases searched: PubMed, Web of Science, EBSCO, Cochrane, and Scopus
• Search cutoff date was September 7, 2025
• Emphasis was placed on randomized controlled trials published in the past decade
• PRISMA guidelines were followed
• The review was registered in PROSPERO (CRD420251171800)