PulseExploreJournal ClubDebatesTrendingResearchersJournals
Instagram
HomeExploreJournal ClubTrending
Synapse
⌘+K
Synapse
May 30, 2026Frontiers in Public Health0 citationsOpen Access

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

YYYu YanCSChu SunLPLidan Pan

Key Result

Isometric training significantly reduced systolic blood pressure by a weighted mean difference of -6.62 mmHg and diastolic blood pressure by -2.63 mmHg.

Key Points

  • To assess the effects of isometric training on blood pressure regulation through a systematic review and meta-analysis of randomized controlled trials.
  • Included randomized controlled trials evaluating isometric training effect on blood pressure.
  • Analyzed data using weighted mean differences, meta-regression, and subgroup analyses.
  • Assessed publication bias with funnel plots and Egger's test.
  • Systolic blood pressure reduced by WMD -6.62 mmHg (95% CI, -8.13 to -5.10, p < 0.0001).
  • Diastolic blood pressure reduced by WMD -2.63 mmHg (95% CI, -3.50 to -1.76, p < 0.0001).
  • Greatest reductions associated with wall squat training and intensity over 85% HR peak.

Study Design

Type

Meta-Analysis (n=839)

Structured PICO

Does isometric training reduce systolic and diastolic blood pressure in the general population?

P
Population
Participants from at least 39 randomized controlled trials (described as the entire population)
I
Intervention
Isometric training (including wall squat training, typically 3 sessions weekly, 85-95% HR peak, for a duration exceeding 8 weeks)
O
Outcome
Reduction in systolic blood pressure and diastolic blood pressuresurrogate

Isometric training, particularly regimens like wall squat training for more than 8 weeks, significantly reduces both systolic and diastolic blood pressure.

Main Result

Effect estimate: WMD -6.62 mmHg (95% CI -8.13 to -5.10)

p-value: p=< 0.0001

Limitations

  • Substantial heterogeneity in both systolic and diastolic blood pressure outcomes
  • Potential presence of publication bias or small-study effects
  • Subgroup analyses are exploratory and susceptible to ecological bias
  • Potential presence of publication bias or small-study effects for systolic blood pressure

Abstract

Abbreviations:K(n),the number of studies included in the pooled effect analysis (total number of participants across pooled studies);Pd,the P-value used to assess differences in effect size between subgroups; Pm, the P-value for the heterogeneity test. Abbreviations:K(n),the number of studies included in the pooled effect analysis (total number of participants across pooled studies);Pd, the P-value used to assess differences in effect size between subgroupps; Pm, the P-value for the heterogeneity test. The original version of this article has been updated.Adding/removing textIn the abstract, (WMD, -6.72; 95% CI, -8.21 to -5.23, p < 0.0001, I 2 = 74%) and DBP (WMD, -2.72; 95% CI, -3.57 to -1.87, p < 0.0001, I 2 = 48%). This has been corrected to read: (WMD, -6.62; 95% CI, -8.13 to -5.10, p < 0.0001, I 2 = 75%) and DBP (WMD, -2.63; 95% CI, -3.50 to -1.76, p < 0.0001,I 2 = 50%)The original version of this article has been updated. A correction has been made to the section 3 Results, 3.3 Main effect, 1: "Isometric training can effectively reduce systolic blood pressure. (WMD, -6.62; 95% CI, -8.13 to -5.10, p < 0.0001, I 2 = 75%, Figure 2) and diastolic blood pressure (WMD, -2.63; 95% CI, -3.50 to -1.76, p < 0.0001, I 2 = 50%). Meta-analysis indicated substantial heterogeneity in both systolic and diastolic blood pressure outcomes. To explore potential sources of this variability and identify modifiable exercise-related factors, additional analyses including meta-regression, subgroup analysis, and sensitivity analysis were performed. It should be noted that the following subgroup analyses are exploratory in nature, aimed at generating hypotheses, and their findings are susceptible to ecological bias. They should not be interpreted as definitive evidence of causal relationships."A correction has been made to the section 3 Results, 3.4 Meta-regression, 1 and 2: "As shown in Figure 4, the results of the meta -regression suggest no significant association between health status (p = 0.55, Figure 4A), duration (p = 0.97, Figure 4B), frequency (p = 0.13, Figure 4C), baseline blood pressure (p = 0.94, Figure 4D), and the reduction in systolic blood pressure achieved through isometric training.As shown in Figure 5, meta-regression analysis indicates no significant association between health status (p = 0.40, Figure 5A), duration (p = 0.22, Figure 5B), frequency (p = 0.52, Figure 5C), baseline blood pressure (p = 0.12, Figure 5D), and the reduction in diastolic blood pressure achieved through isometric training."A correction has been made to the section 3 Results 3.5 Subgroup analysis 3.5.1 Systolic blood pressure, 3 "Furthermore, the greatest blood pressure reduction was associated with isometric exercise regimens that involved wall squat training (WMD, -10.29; 95% CI, -13.60 to -6.98, p < 0.00001, I 2 = 61%), three sessions weekly (WMD: -7.19; 95% CI, -8.85 to -5.53, p < 0.00001, I 2 = 69%), an intensity of 85% HR peak (WMD, -9.99; 95% CI, -13.60 to -6.38, p < 0.00001, I 2 = 0%), and a duration of more than 8 weeks (WMD, -6.82; 95% CI, -9.20 to -4.44, p < 0.0001, I 2 = 72%)."A correction has been made to the section 3 Results 3.5 Subgroup analysis 3.5.2 Diastolic blood pressure, 3 "Furthermore, the greatest blood pressure-lowering outcomes were associated with the following exercise regimens: wall squat training (WMD, -5.26; 95% CI, -7.02 to -3.51, p < 0.00001, I 2 = 0%), three sessions weekly (WMD, -2.89; 95% CI, -4.02 to -1.76, p = 0.0004, I 2 = 52%), an intensity of 95% HR peak (WMD, -4.87; 95% CI, -7.17 to -2.57), p < 0.0001, I 2 = 0%), and an intervention duration exceeding 8 weeks (WMD, -2.70; 95% CI, -4.25 to -1.16, p = 0.007, I 2 = 56%)."A correction has been made to the section 3 Results 3.8 Publication bias, 1, 2 and 3 "Funnel plots were employed to analyses publication bias. Visual inspection of the funnel plot (Figure 7A) combined with the Egger test (t = -2.07, p = 0.045, Table 5). This suggests the potential presence of publication bias or small-study effects, where smaller studies showing larger effect sizes might be more likely to be published.To estimate and adjust for the potential impact of any missing studies, we applied the Trim and Fill method. The raw pooled effect size for isometric exercise on systolic blood pressure was -6.62 mmHg, and it remained unchanged after adjustment (-6.62 mmHg, 95% CI: -8.131 to -5.099, p < 0.0001). This analysis indicated that no studies needed to be imputed to achieve symmetry in the funnel plot. Thus, the pooled effect estimate for systolic blood pressure reduction was robust to this adjustment. While the Egger's test indicates asymmetry, the lack of imputation by the Trim and Fill procedure suggests that any potential publication bias may not be substantial enough to qualitatively alter the main conclusion that isometric exercise significantly reduces systolic blood pressure. Nevertheless, the possibility of a modest overestimation of the true effect size due to small-study effects cannot be ruled out.Similarly, funnel plots were employed to detect publication bias across across all 39 trials for diastolic blood pressure. Visual inspection of the funnel plots (Figure 7B) and the Egger test (t = -0.52, p = 0.606, Table 6) indicated no evidence of publication bias, rendering the results suitable for meta-analysis."The original version of this article has been updated.

Expert Takes3 quotes

1/3

“Although any exercise is beneficial, we've been learning more about which type of exercise benefits specific issues, and isometric exercise has a measurable impact on lowering blood pressure.”

Dr. John Hoyle, CardiologistHealth First Medical Groupgemini_groundedSupportiveView source
Ask AI
Helpful
Bookmark
Share
View Full Paper

Cite This Study

Yan et al. (2026) conducted a meta-analysis in Blood pressure regulation (n=839). Isometric training vs. Control was evaluated on Systolic blood pressure (WMD -6.62 mmHg, 95% CI -8.13 to -5.10, p=< 0.0001). Isometric training significantly reduced systolic blood pressure by a weighted mean difference of -6.62 mmHg and diastolic blood pressure by -2.63 mmHg.

synapsesocial.com/papers/6a1a7ded0307b78509430dbdhttps://doi.org/10.3389/fpubh.2026.1866759
Ask AI
Helpful
Bookmark
Share
View Full Paper