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Table 1 Study characteristics and main results of included studies

From: Resting blood pressure reductions following handgrip exercise training and the impact of age and sex: a systematic review and narrative synthesis

Author and country Study design Participants Relevant comorbidities Exercise frequency and duration HG training prescription Total training tension-time product SBP training response Secondary outcomes reported Risk of bias (TESTEX)
Allen et al. [59]
USA
Cohort Men (n = 14), young (26 ± 5.7 years)   5/week for 4 weeks One contraction every 4 s unilateral (non-dom) at 60% MVC for 20 min 360,000 − 4 mmHg (non-sig) Diastolic BP,
Heart rate,
Arterial health and function (FMD),
Autonomic Nervous system indicators (HRV)
7/15
Alomari et al. [60] no country noted Cohort Men (n = 11), young (24 ± 4.8 years)   5/week for 4 weeks 300 × 2 s unilateral (non-dom) HG contractions at 60% MVC, separated by 2-s rest 720,000 − 2 mmHg (non-sig) Diastolic BP,
Heart rate,
Arterial health and function (reactive hyperamic blood flow + vascular resistance)
5/15
Badrov et al. [45] Canada RCT—traditional Men (n = 6), aged (67 years),
Women (n = 6), aged (63 years)
All hypertensive and/or receiving pharmacotherapy for at least 4 months 3/week for 10 weeks 4 × 2 min bilateral HG contractions at 30% MVC, separated by 1-min rest 432,000 Men: − 7 mmHg (grouped change sig),
Women: − 9 mmHg (grouped change sig)
Diastolic BP,
Heart rate,
Autonomic nervous system indicators (CV reactivity)
11/15
Badrov et al. [38] Canada RCT—traditional Women (n = 12), young (23 ± 4 years)   3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30% MVC, separated by 4-min rest 345,600 − 6 mmHg (sig) Diastolic BP,
Heart rate,
Autonomic nervous system indicators (HRV),
Arterial health and function (reactive hyperamic blood flow)
13/15
Women (n = 11), young (27 ± 6 years)   5/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30% MVC, separated by 4-min rest 576,000 − 6 mmHg (sig)
Badrov et al. [54] Canada Cohort Men (n = 9), young (21 ± 2 years),
Women (n = 11), young (23 ± 4 years)
  3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30% MVC, separated by 4-min rest 345,600 Men: − 9 mmHg (sig),
Women: − 6 mmHg (sig)
Diastolic BP,
Arterial health and function (FMD)
7/15
Baross et al. [44] *
United Kingdom
RCT—traditional Men (n = 6) and women (n = 16), young (20.7 ± 1.6 years)   4/week for 6 weeks 3 × 10 s bilateral HG contractions at 20% MVC, separated by 10-min rest 14,400 − 4.9 mmHg (sig) Diastolic BP 6/15
Bentley et al. [49] Canada Cohort Women (n = 17), aged (61.6 ± 4 years) At least pre-hypertensive or receiving pharmacotherapy 4/week for 8 weeks 32 × 5 s unilateral (non-dom) HG contractions at max MVC, separated by 5-s rest 512,000 − 5.2 mmHg (sig) Diastolic BP,
Heart rate,
Autonomic nervous system indicators (HRV and CV reactivity),
Arterial health and function (PWV and AIx)
9/15
Carlson et al. [41] * Australia RCT—“sham” Men and women (n = 18), aged (52 ± 8 years) At least pre-hypertensive or receiving pharmacotherapy 3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30%MVC, separated by 3-min rest 345,600 − 7 mmHg (sig) Diastolic BP,
Heart rate
11/15
Men and women (n = 20), aged (54 ± 8 years) At least pre-hypertensive or receiving pharmacotherapy 3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 5%MVC, separated by 3-min rest 57,600 − 2 mmHg (non-sig)
Dawson et al. [42] no country noted RCT—traditional Men (n = 8), aged (65 years),
Women (n = 1), young (47 years)
All patients required transradial catheterization for upcoming coronary angiography/angioplasty 3/week for 6 weeks 900 × 1 s unilateral (catheterized arm) HG contractions at 40% MVC, separated by 1-s rest 648,000 Men: + 1 mmHg (grouped change non-sig), Women:
+ 16 mmHg (grouped change non-sig)
Heart rate,
Arterial health and function (FMD)
5/15
Dobrosielski et al. [51] USA Cohort Men (n = 12), aged (81 ± 5 years)   4/week for 4 weeks 300 × 1 s unilateral (non-dom) HG contractions at 60% MVC, separated by 3-s rest 288,000 − 2 mmHg (non-sig) Diastolic BP,
Heart rate,
Arterial health and function (brachial artery reactivity and FMD)
8/15
Garg et al. [39] * India Cohort Men (n = 16) and women (n = 14), young (29.8 ± 6.3 years)   3/week for 10 weeks 5 × 3 min unilateral (dominant) HG contractions at 30% MVC, separated by 5-min rest 810,000 − 9.87 mmHg (sig) Diastolic BP 3/15
Goessler et al. [52] * Belgium RCT—traditional Men and women (n = 19), young (33.1 ± 2.1 years)   7/week for 8 weeks 4 × 2 min bilateral contractions at 30% MVC, separated by 1-min rest 806, 400 − 5.5 mmHg (sig) Diastolic BP 8/15
Hess et al. [61] * Australia RCT—“sham” Men (n = 6) and women (n = 4), young (38.8 ± 10.5 years)   3/week for 6 weeks 4 × 2 min unilateral (non-dom) contractions at 5% MVC, separated by 1-min rest 43,200 − 4.04 mmHg (non-sig) Diastolic BP,
Heart rate
11/15
Men (n = 6) and Women (n = 4), young (38.7 ± 12.6 years)   3/week for 6 weeks 4 × 2 min unilateral (non-dom) contractions at 10% MVC, separated by 1-min rest 86,400 − 5.62 mmHg (non-sig)
Kumar et al. [39] United Kingdom Cohort Men (n = 10), aged (avg: 63 years),
Women (n = 13), aged (avg: 66 years)
Stable (stage 3–4) chronic kidney disease 7/week for 4 weeks 600 × 1 s unilateral (self-selected arm) HG contractions at max effort, separated by 2-s rest 1,680,000 Men: − 2.2 mmHg (grouped change non-sig)
Women: 0 mmHg (grouped change non-sig)
Diastolic BP,
Arterial health and function (brachial and radial resting diameters)
7/15
McGowan et al. [55] Canada Cohort Men (n = 8), young (avg: 23 years),
Women (n = 3), young (avg: 39 years)
  3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30% MVC, separated by 4-min rest 345,600 Men: − 6 mmHg (grouped change sig)
Women: − 3 mmHg (grouped change sig)
Diastolic BP,
Arterial health and function (FMD)
9/15
McGowan et al. [46] Canada Cohort Men (n = 12), aged (avg: 63 years) Medicated hypertensive 3/week for 8 weeks 4 × 2 min unilateral (non-dom, n = 9) or bilateral (n = 7) HG contractions at 30% MVC, separated by 4-min rest 345,600 − 12 mmHg (grouped change sig) Diastolic BP,
Arterial health and function (FMD)
9/15
Women (n = 4), aged (avg: 68) − 13 mmHg (grouped change sig)
Millar et al. [47] Canada Cohort Men (n = 11), aged (avg: 66 years),
Women (n = 2), aged (avg: 73 years)
Medicated Hypertensive 3/week for 8 weeks 4 × 2 min unilateral (non-dom) HG contractions at 30% MVC, separated by 4-min rest 345,600 Men: − 2 mmHg (grouped change sig)
Women: − 15 mmHg (grouped change sig)
Diastolic BP,
Heart rate,
Autonomic nervous system indicators (HRV)
9/15
Millar et al. [53] Canada RCT—traditional Men (n = 14), aged (avg: 68 years),
Women (n = 11), aged (avg: 63 years)
  3/week for 8 weeks 4 × 2 min bilateral HG contractions at 30–40% MVC, separated by 1-min rest 345,600–460,800 Men: − 7 mmHg (grouped change sig)
Women: − 11 mmHg (grouped change sig)
Diastolic BP 4/15
Pagonas et al. [50] * Germany RCT—“sham” Men and women (n = 24), aged (58.8 ± 10.6 years) Hypertensive 5/week for 12 weeks 4 × 2 min bilateral HG contractions at 30% MVC, separated by 1-min rest 864,000 0 mmHg Diastolic BP,
Arterial health and function (PWV)
8/15
Men and women (n = 23), aged (62.1 ± 7.1 years) Hypertensive 5/week for 12 weeks 4 × 2 min bilateral HG contractions at 5% MVC, separated by 1-min rest 144,000 + 1.4 mmHg (non-sig)
Peters et al. [37] * USA Cohort Men (n = 8) and women (n = 2), aged (52 ± 5) Hypertensive 3/week for 6 weeks 4 × 45 s bilateral HG contractions at 50% MVC, separated by 1-min rest 162,000 − 13 mmHg (sig) Diastolic BP 3/15
Ray et al. [56] * USA RCT—traditional Men and women (n = 9), young (19 to 35 years)   4/week for 5 weeks 4 × 3 min unilateral (non-dom) contractions at 30% MVC separated by 5-min rest 432,000 − 3 mmHg (non-sig) Diastolic BP,
Heart Rate,
Autonomic Nervous System Indicators (MSNA)
6/15
Somani et al. [40] Canada Cohort Men (n = 13), young (24 ± 4 years),
Women (n = 13), young 25 ± 5 years
  3/week for 10 weeks 4 × 2 min bilateral HG contractions at 30% MVC, separated by 1-min rest 432,000 Men: − 5 mmHg (sig)
Women: − 3 mmHg (sig)
Diastolic BP,
Heart rate,
Autonomic nervous system indicators (CV reactivity)
10/15
Stiller-Moldovan et al. [48] * Canada RCT—traditional Men (n = 7) and women (n = 3), aged (60 ± 8.5 years) Medicated hypertensive 3/week for 8 weeks 4 × 2 min bilateral HG contractions at 30–40% MVC, separated by 1-min rest 345,600 − 1.9 mmHg (non-sig) Diastolic BP,
Heart rate,
Autonomic nervous system indicators (HRV)
10/15
Taylor et al. [43] * Canada RCT—traditional Men (n = 5) and women (n = 4), aged (69.3 ± 6 years) Hypertensive 3/week for 10 weeks 4 × 2 min bilateral HG contractions at 30% MVC, separated by 1-min rest 432,000 − 19 mmHg (sig) Diastolic BP,
Heart rate,
Autonomic nervous system indicators (HRV)
6/15
Thijssen et al. [58] United Kingdom Cohort Men (n = 11), young (22 ± 2 years)   4/week for 8 weeks 30 contractions/min bilateral contractions for 30 min at 30% MVC for 4 weeks, 40% MVC for 2 weeks and 50% MVC final 2 weeks 1,080,000 0 mmHg (non-sig) Diastolic BP,
Heart rate,
Arterial health and function (wall-to-lumen ration)
7/15
Wiley et al. [57] * USA Cohort Men or women (n = 8), young (20–35 years)   3/week for 8 weeks 4 × 2 min unilateral (dom) contractions at 30% MVC separated by 3-min rest 345,600 − 13 mmHg (sig) Diastolic BP,
Heart rate
6/15
Men or women (n = 10), young (29 to 52 years)   5/week for 5 weeks 4 × 45 s bilateral contractions at 50% MVC, separated by 1-min rest 216,000 − 9.5 mmHg (sig)
  1. MVC maximal volitional contraction
  2. *Unable to acquire raw data to segregate for age and/or sex