Grant: Project Grant

Hypertension (HTN) is the leading risk factor for death and disability worldwide. The global burden of HTN is distinctly skewed, with 75% of diagnosed individuals living in low- and middle-income countries (LMIC). In Uganda, studies have estimated the prevalence of HTN to be upwards of 32% among adults. There is an urgent need to offer effective, low cost BP-lowering therapies in SSA that have a high potential for uptake and long-term use. Isometric handgrip training (IHT) is one such therapy. IHT is a simple, cost-effective, time efficient, and highly tolerable intervention, making this treatment appealing in a LMIC context. The main objective of our proposed study is to determine the efficacy of IHT in a population of hypertensive patients compared to usual care at the Allan Stone Community Health clinic in eastern Uganda. We will evaluate if there are BP reductions after 16 weeks of IHT in resting systolic BP when compared to standard care. For this work, we will conduct a randomized controlled trial with 250 participants, and equal number of participants will be randomized to either IHT or to usual care. Participants will conduct the IHT sessions three times a week in the clinic. For the main analysis, an ANCOVA will be used to estimate change in systolic blood pressure from baseline at 16 weeks. Our study will provide important insight into the efficacy of a promising, accessible, cost-efficient therapy as a BP-lowering treatment. If found to be efficacious in this study, this will directly inform HTN management at the Allan Stone Health Clinic. Furthermore, our next step will then be to conduct a multi-site pragmatic trial within Uganda to determine the effectiveness of IHT in the real-life Ugandan context. The longer-term goal of this work is to help inform develop evidence-based HTN management in Uganda as well as in other high burden LMIC contexts.