Evidence mapPaperPMID 41647769Full record

ArticleNIHR open research2025

Randomised controlled effectiveness study (RCT) of isometric exercise (IE) in adults with stage 1 and 2 hypertension - ISOFITTER study.

Melanie Rees-Roberts, Ellie Santer, Rachel Borthwick, Timothy Doulton, Pauline A Swift, Tracy Pellatt-Higgins, Katerina Gousia, Douglas MacInnes, Alan West, John Darby and 4 more

Abstract read
In one paragraph

Article in NIHR open research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Isometric Handgrip Training and Cardiovascular Risk Modulation: State of the Art.Journal of cardiovascular development and disease · 2026
    Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Melanie Rees-RobertsCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NZ, UK.ORCID https://orcid.org/0000-0002-7121-0414
Ellie SanterCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NZ, UK.ORCID https://orcid.org/0000-0002-5437-0045
Rachel BorthwickCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NZ, UK.
Timothy DoultonEast Kent Hospitals University NHS Foundation Trust, Canterbury, England, CT1 3NG, UK.
Pauline A SwiftEpsom and St Helier University Hospitals NHS Trust, Carshalton, Surrey, SM5 1AA, UK.
Tracy Pellatt-HigginsCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NZ, UK.
Katerina GousiaPersonal Social Services Research Unit, University of Kent School of Social Policy Sociology and Social Research, Canterbury, England, UK.
Douglas MacInnesCanterbury Christ Church University, Canterbury, England, CT1 1QU, UK.ORCID https://orcid.org/0000-0002-3723-7859
Alan WestPublic co-applicants, Canterbuy, UK.
John DarbyPublic co-applicants, Canterbuy, UK.
Anusree BiswasPublic co-applicants, Canterbuy, UK.
Caroline CowleyEast Kent Hospitals University NHS Foundation Trust, Canterbury, England, CT1 3NG, UK.
Christoher K FarmerCentre for Health Services Studies, University of Kent, Canterbury, England, CT2 7NZ, UK.
Jonathan WilesPersonal Social Services Research Unit, University of Kent School of Social Policy Sociology and Social Research, Canterbury, England, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background High blood pressure (BP) affects more than one in four adults in England and only one in three patients are being treated effectively. Treatment of high BP includes changes to lifestyle such as more physical activity and/or taking medication. However, low adoption and high attrition are common with the large amounts of exercise currently recommended (>150 minutes moderate exercise per week plus 2 strength sessions). Evidence suggests that isometric exercise (IE), holding a fixed body position for a period of time, for example a wall squat, results in greater long term BP reductions, with less time and effort, than other recommended exercise. This ISOFITTER study aims to evaluate the effectiveness of IE to help reduce BP in hypertension in a real world setting. Methods A multi-centre, randomised, controlled trial of an isometric exercise wall squat intervention for hypertension employing an effectiveness-implementation hybrid type-1 design. Adults (n = 542) with Stage 1 or Stage 2 hypertension, on no more than one antihypertensive, and no other medical contra-indications will be randomised to either a standard care plus IE intervention group or standard care control group. Blood pressure readings, fidelity measurements, medications, adverse events, quality of life, participant satisfaction and health service use will be collected at baseline, week 4, month 3 and month 6 with a subgroup (n = 50) of the IE arm invited to continue for 12 months. Qualitative participant focus groups and interviews with wider stakeholders will collect implementation data. Results The ISOFITTER study will establish effectiveness of a self-administered, home-based IE intervention in lowering blood pressure in people with uncomplicated stage 1 and 2 hypertension. Implementation evidence will support patient delivery, context for scaling up of the intervention and intervention cost. Conclusion Lifestyle changes for the treatment of hypertension in the absence of other risk factors should not be overlooked. For long term hypertension management, easily adopted, evidenced exercise interventions are needed. This study will help to address this evidence gap.

Indexed as

blood pressureHypertensionisometric exerciselifestyle interventionpreventionwall squat

Identifiers

PMID41647769
PMCPMC12869024

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.