Hypertension (HTN), Pregnancy, Pregnancy - Prenatal Testing
Conditions
Keywords
Isometric Exercise, Handgrip Exercise, Blood Pressure, Ambulatory Blood Pressure Monitoring, Pregnancy, Hypertension, Arterial Stiffness, Cognitive Function
Brief summary
Hypertension during pregnancy is a major public health concern, increasing the risk of cardiovascular complications for both the mother and the fetus. Women with chronic hypertension are at higher risk of adverse outcomes, and elevated blood pressure during pregnancy has also been associated with long-term cardiovascular and cognitive impairments.Regular physical activity is recognized as an effective non-pharmacological strategy to reduce blood pressure. Among different exercise modalities, isometric exercise has shown promising effects in lowering blood pressure in the general population, with minimal cardiovascular strain. However, its effects and safety in pregnant women, particularly those with hypertension, remain poorly understood.In addition to cardiovascular alterations, hypertension during pregnancy may also impact cognitive function, potentially through changes in cerebral perfusion and vascular function. Despite these associations, the combined cardiovascular and cognitive responses to exercise in this population have not been fully explored.This study aims to investigate the effects of isometric handgrip exercise on cardiovascular and cognitive responses in pregnant women with and without chronic hypertension, in order to better understand its potential as a safe and effective non-pharmacological intervention during pregnancy.
Detailed description
Hypertension during pregnancy is a major public health concern associated with increased maternal and fetal morbidity, and long-term cardiovascular risk. Women with chronic hypertension are at higher risk of complications such as preeclampsia, preterm birth, and adverse neonatal outcomes. In addition, growing evidence suggests that hypertensive disorders of pregnancy may also be associated with long-term alterations in cardiovascular function and cognitive performance.During pregnancy, physiological changes in blood pressure regulation and vascular function may further complicate the management of hypertension. Pharmacological treatment options are limited due to potential risks for the fetus, highlighting the need for safe and effective non-pharmacological strategies.Physical exercise is recognized as an effective approach to reduce blood pressure and improve cardiovascular health in the general population. Among the different exercise modalities, isometric exercise has shown particularly promising effects in reducing blood pressure, with a low cardiovascular load. This modality may therefore represent an attractive option for pregnant women, as it can be performed safely with minimal physiological stress. However, despite these potential benefits, the effects and safety of isometric exercise during pregnancy, particularly in hypertensive women, remain poorly understood.In addition to cardiovascular alterations, hypertension during pregnancy may impact cognitive function, potentially through changes in cerebral perfusion and vascular regulation. Although physical activity has been associated with improvements in cognitive performance in the general population, the acute effects of exercise on cognitive function during pregnancy have not been well established.The aims of this study are:First, to evaluate the effect of isometric handgrip exercise on 24-hour blood pressure in pregnant women with and without chronic hypertension.Second, to compare cardiovascular responses to isometric exercise between normotensive and hypertensive pregnant women, including brachial and central blood pressure, arterial stiffness, and heart rate.Third, to examine differences in cognitive performance between normotensive and hypertensive pregnant women, and to explore the relationship between cardiovascular responses and cognitive outcomes.
Interventions
BEHAVIORALIsometric Handgrip Exercise
Isometric handgrip exercise performed at 30% of maximal voluntary contraction, consisting of four 2-minute contractions with one-minute rest intervals between efforts. The exercise is performed using a handgrip dynamometer.
BEHAVIORALControl Rest
Seated rest condition without exercise, used as a control comparison to the isometric handgrip intervention.
Sponsors
University of Poitiers
Poitiers University Hospital
Laboratory MOVE, Faculty of Sport Sciences, University of Poitiers, France
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
This is a randomized crossover study. Each participant completes two experimental conditions (isometric handgrip exercise and control rest) in a random order.
Eligibility
Sex/Gender
FEMALE
Age
18 Years to 45 Years
Healthy volunteers
Yes
Inclusion criteria
* Pregnant women covered by the French National Health Insurance system * Pregnant women who do not object to participation in the study * Women belonging to one of the following two groups: * Women with chronic hypertension present before pregnancy (diagnosed within the past 5 years), defined as systolic blood pressure (SBP) ≥ 140 mmHg or diastolic blood pressure (DBP) ≥ 90 mmHg, without antihypertensive treatment * Normotensive pregnant women, defined as systolic blood pressure (SBP) \< 140 mmHg and diastolic blood pressure (DBP) \< 90 mmHg before pregnancy
Exclusion criteria
* Current treatment for chronic or gestational hypertension * Known cardiovascular disease other than chronic hypertension * Age under 18 years * Persons deprived of liberty * Inability to speak or adequately understand French * Persons hospitalized without consent who are not subject to legal protection measures, and persons admitted to a health or social institution for purposes other than research * Persons currently excluded from participation in another research study * Persons under judicial protection or guardianship Type 1 or type 2 diabetes * Severe or extreme obesity (BMI ≥ 40 kg/m²) * Thyroid disease * Heavy smoking
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Systolic and diastolic blood pressure (ambulatory blood pressure measurement) | After sessions (24 hours) | Post-exercise hypotension, using the Mobil-O-Graph (mmHg). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Systolic and diastolic blood pressure (resting) | Before and after sessions (15 minutes) | Automated oscillometric tensiometer (mmHg) |
| Central blood pressure | Baseline and post-intervention during sessions (30 minutes) | Central systolic and diastolic blood pressure assessed using pulse wave analysis derived from brachial oscillometric measurements. |
| Pulse wave velocity | Baseline | Arterial stiffness assessed by carotid-femoral pulse wave velocity using applanation tonometry. This measurement is performed at rest to characterize vascular health. |
| Heart rate | Basline, before and after sessions (15 minutes) | Heart rate measured during each experimental session and recovery period using a heart rate monitor to assess cardiovascular response to the intervention. |
| Cognitive Performance | Baseline | Cognitive performance assessed at rest using a neuropsychological test battery including executive function, memory, attention, and processing speed tests. This outcome is used to compare cognitive function between normotensive and hypertensive pregnant women. * Stroop : higher scores indicate better executive function and inhibitory control. No universal minimum or maximum score. * Verbal Fluency Test: higher scores indicate better verbal executive functioning. No universal maximum score. * Rey Auditory Verbal Learning Test (RAVLT): Higher scores indicate better verbal learning and memory. Minimum score = 0; maximum score = 75. * Digit Span Test (forward and backward): higher scores indicate better working memory and attention. Minimum score = 0; No universal maximum score. |
Countries
France
Contacts
CONTACTCarina ENEA
CONTACTMélanie Gréau Marias
Outcome results
None listed