Title

Isometric Handgrip Exercise: Does Device Matter?

Prize Winner

Viable, Healthy, and Safe Communities

Type of Proposal

Visual Presentation (Poster, Installation, Demonstration)

Start Date

22-3-2018 2:30 PM

End Date

22-3-2018 4:30 PM

Location

Atrium

Faculty

Faculty of Human Kinetics

Faculty Sponsor

Cheri McGowan

Abstract/Description of Original Work

Hypertension (HTN), or high blood pressure (BP), is the leading cause of cardiovascular disease-related death and disability worldwide (1). Deemed a global epidemic by the World Health Organization (2-6), HTN is the most commonly diagnosed chronic condition in primary care (7-9). BP control is inadequate world-wide, with more than half of patients not treated to within clinical target ranges (10). Thus, there is an urgent need to implement effective therapies that adequately lower and maintain BP. Newly incorporated into the American College of Cardiology/American Heart Association Guidelines for the Prevention and Management of High Blood Pressure (11), isometric handgrip (IHG) training is one such therapy (four, 2-min sustained squeezes at 30% of maximal effort, separated by 1-min rest, performed 3X/week on a computerized handgrip dynamometer). The high costs associated with the computerized devices (upwards of ~$400 CAD) may impede the main stream utilization of IHG training for BP management. As a first step in determining the effectiveness of an inexpensive (mechanical, ~$10 CAD) device to lower BP, this study compared systolic and diastolic BP responses to an acute bout of IHG performed using the mechanical and computerized devices. Young, healthy adults (N=12; 5 women; resting BP: 114/65 mmHg) randomly performed a bout of IHG on each device, with a 30-minute resting period between protocols. BP was acquired every minute using the Dinamap ProCare 200 BP Monitor. Across all contractions, the peak systolic BP response was similar between devices (all P > 0.05). With the exception of the 2nd contraction eliciting a higher BP response in the mechanical device (P = 0.013), diastolic BP changes were also similar (all P > 0.05). These findings suggest that more affordable devices may be an acceptable, low-cost alternative to the computerized IHG device, and that groundwork has been laid for a future training study. 1. Pan American Health Organization/World Health Organization. (2013). World health day: In the Americas, one in three adults has hypertension, the leading risk factor for death from cardiovascular disease. Retrieved from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=8466&Itemid=1926&lang=en 2. World Health Organization. (2013). A global brief on hypertension: Silent killer, global public health crisis. Retrieved from: http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1 3. Joffres, M., Falaschetti, E., Gillespie, C., Robitaille, C., Loustalot, F., Poulter, N., … Campbell, N. (2013). Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. British Medical Journal, 3(8). doi:10.1136/bmjopen-2013-003423. 4. Danaei, G., Ding, E., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C., & Ezzati, M. (2011). The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. Public Library of Science Medicine, 8(1). doi:10.1371/annotation/0ef47acd-9dcc-4296-a897-872d182cde57. 5. Benjamin, E., Blaha, M., Chiuve, S., Cushman, M., Das, S., Deo, R., … Muntner, P. (2017). Heart disease and stroke statistics – 2017 update: A report from the American Heart Association. Circulation, 135(10). doi: 10.1161/CIR.0000000000000485. 6. Ezzati, M., Lopez, A., Rodgers, A., Vander Hoorn, S., & Murray, C. (2002). Selected major risk factors and global and regional burden of disease. The Lancet, 360(9343). doi:10.1016/S0140-6736(02)11403-6. 7. Hemmelgarn, B., Chen, G., Walker, R., McAlister, F., Quan, H., Tu, K., … Campbell, N. (2008). Trends in antihypertensive drug prescriptions and physician visits in Canada between 1996 and 2006. The Canadian Journal of Cardiology, 24(6). 8. James, P., Oparil, S., Cushman, W., Dennison-Himmelfarb, C., Handler, J., Lackland, D., … Ortiz, E. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). The Journal of the American Medical Association, 311(5). doi:10.1001/jama.2013.284427. 9. Centers for Disease Control and Prevention. (2017). National ambulatory medical care survey: 2013 State and national summary tables. Retrieved from: https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2013_namcs_web_tables.pdf 10. Go, A., Bauman, M., Coleman King, S., Fonarow, G., Lawrence, W., Williams, K., & Sanchez, E. (2014). An effective approach to high blood pressure control: A science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension, 63. doi:org/10.1161/HYP.0000000000000003. 11. Whelton, P., Carey, R., Aronow, W., Casey, D., Collins, K., Dennison Himmelfarb, C., … Wright, J. (2017). 2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology. doi:10.1016/j.jacc.2017.07.745.

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Mar 22nd, 2:30 PM Mar 22nd, 4:30 PM

Isometric Handgrip Exercise: Does Device Matter?

Atrium

Hypertension (HTN), or high blood pressure (BP), is the leading cause of cardiovascular disease-related death and disability worldwide (1). Deemed a global epidemic by the World Health Organization (2-6), HTN is the most commonly diagnosed chronic condition in primary care (7-9). BP control is inadequate world-wide, with more than half of patients not treated to within clinical target ranges (10). Thus, there is an urgent need to implement effective therapies that adequately lower and maintain BP. Newly incorporated into the American College of Cardiology/American Heart Association Guidelines for the Prevention and Management of High Blood Pressure (11), isometric handgrip (IHG) training is one such therapy (four, 2-min sustained squeezes at 30% of maximal effort, separated by 1-min rest, performed 3X/week on a computerized handgrip dynamometer). The high costs associated with the computerized devices (upwards of ~$400 CAD) may impede the main stream utilization of IHG training for BP management. As a first step in determining the effectiveness of an inexpensive (mechanical, ~$10 CAD) device to lower BP, this study compared systolic and diastolic BP responses to an acute bout of IHG performed using the mechanical and computerized devices. Young, healthy adults (N=12; 5 women; resting BP: 114/65 mmHg) randomly performed a bout of IHG on each device, with a 30-minute resting period between protocols. BP was acquired every minute using the Dinamap ProCare 200 BP Monitor. Across all contractions, the peak systolic BP response was similar between devices (all P > 0.05). With the exception of the 2nd contraction eliciting a higher BP response in the mechanical device (P = 0.013), diastolic BP changes were also similar (all P > 0.05). These findings suggest that more affordable devices may be an acceptable, low-cost alternative to the computerized IHG device, and that groundwork has been laid for a future training study. 1. Pan American Health Organization/World Health Organization. (2013). World health day: In the Americas, one in three adults has hypertension, the leading risk factor for death from cardiovascular disease. Retrieved from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=8466&Itemid=1926&lang=en 2. World Health Organization. (2013). A global brief on hypertension: Silent killer, global public health crisis. Retrieved from: http://apps.who.int/iris/bitstream/10665/79059/1/WHO_DCO_WHD_2013.2_eng.pdf?ua=1 3. Joffres, M., Falaschetti, E., Gillespie, C., Robitaille, C., Loustalot, F., Poulter, N., … Campbell, N. (2013). Hypertension prevalence, awareness, treatment and control in national surveys from England, the USA and Canada, and correlation with stroke and ischaemic heart disease mortality: A cross-sectional study. British Medical Journal, 3(8). doi:10.1136/bmjopen-2013-003423. 4. Danaei, G., Ding, E., Mozaffarian, D., Taylor, B., Rehm, J., Murray, C., & Ezzati, M. (2011). The preventable causes of death in the United States: Comparative risk assessment of dietary, lifestyle, and metabolic risk factors. Public Library of Science Medicine, 8(1). doi:10.1371/annotation/0ef47acd-9dcc-4296-a897-872d182cde57. 5. Benjamin, E., Blaha, M., Chiuve, S., Cushman, M., Das, S., Deo, R., … Muntner, P. (2017). Heart disease and stroke statistics – 2017 update: A report from the American Heart Association. Circulation, 135(10). doi: 10.1161/CIR.0000000000000485. 6. Ezzati, M., Lopez, A., Rodgers, A., Vander Hoorn, S., & Murray, C. (2002). Selected major risk factors and global and regional burden of disease. The Lancet, 360(9343). doi:10.1016/S0140-6736(02)11403-6. 7. Hemmelgarn, B., Chen, G., Walker, R., McAlister, F., Quan, H., Tu, K., … Campbell, N. (2008). Trends in antihypertensive drug prescriptions and physician visits in Canada between 1996 and 2006. The Canadian Journal of Cardiology, 24(6). 8. James, P., Oparil, S., Cushman, W., Dennison-Himmelfarb, C., Handler, J., Lackland, D., … Ortiz, E. (2014). 2014 Evidence-based guideline for the management of high blood pressure in adults: Report from the panel members appointed to the Eighth Joint National Committee (JNC 8). The Journal of the American Medical Association, 311(5). doi:10.1001/jama.2013.284427. 9. Centers for Disease Control and Prevention. (2017). National ambulatory medical care survey: 2013 State and national summary tables. Retrieved from: https://www.cdc.gov/nchs/data/ahcd/namcs_summary/2013_namcs_web_tables.pdf 10. Go, A., Bauman, M., Coleman King, S., Fonarow, G., Lawrence, W., Williams, K., & Sanchez, E. (2014). An effective approach to high blood pressure control: A science advisory from the American Heart Association, the American College of Cardiology, and the Centers for Disease Control and Prevention. Hypertension, 63. doi:org/10.1161/HYP.0000000000000003. 11. Whelton, P., Carey, R., Aronow, W., Casey, D., Collins, K., Dennison Himmelfarb, C., … Wright, J. (2017). 2017 Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Journal of the American College of Cardiology. doi:10.1016/j.jacc.2017.07.745.