Middle East J Rehabil Health Stud. 2021 January; 8(1):e106789. Published online 2021 February 9. doi: 10.5812/mejrh.106789. Research Article Effect of Different Types of Lower-Limb Exercise on Blood Pressure in Hypertensive People: A Randomized, Double-blind Controlled Clinical Trial Rozita Hedayati 1 , Salimeh Mahmoodi 1 , Rasool Bagheri 1, * , Marjan Biglary 2 , Amir Hoshang Bakhtiary 1 and Majid Mirmohammadkhani 3 1 Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran 2 Department of Internal Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran 3 Social Determinants of Health Research Center, Department of Epidemiology and Biostatistics, Semnan University of Medical Sciences, Semnan, Iran * Corresponding author: Neuromuscular Rehabilitation Research Center, Semnan University of Medical Sciences, Semnan, Iran. Email: rasool.bagheri@ymail.com Received 2020 June 24; Revised 2020 November 28; Accepted 2020 November 29. Abstract Objectives: The current study aimed at determining the immediate and long-lasting effects of eccentric and concentric exercises on hypertension in individuals with high blood pressure. Methods: A total of 45 hypertensive volunteers were randomly assigned to three intervention groups as eccentric exercise (n = 15), concentric exercise (n = 15), and control (n = 15) groups. All the volunteers underwent exercise interventions for four weeks, three sessions per week (12 sessions in total) as treadmill walking with +10% gradient (concentric group), -10% gradient (eccentric group), or neutral gradient. Before the intervention, immediately after the first session of the intervention, after the end of the intervention, and 48 hours after the end of the intervention, systolic and diastolic blood pressure, heart rate, and maximum oxygen consumption were measured and compared between the groups. Results: The positive gradient group had higher diastolic blood pressure 48 h after the intervention than the negative and neu- tral gradient groups (P < 0.05). There was no significant difference in the other study variables between eccentric and concentric exercise groups (P > 0.05). Statistical analysis showed that eccentric exercises immediately reduced systolic and diastolic blood pressure (P < 0.05). Eccentric and constrictive exercises reduced systolic and diastolic blood pressure for the long term (P < 0.05). Exonerative and constrictive exercises improved the heart rate, maximum oxygen consumption, and systolic blood and diastolic blood pressure in the short and long term (P < 0.05). Conclusions: Eccentric and concentric exercises with immediate and long-lasting effects improved systolic and diastolic blood pressure, as well as heart rate and maximum oxygen consumption. No significant difference was found between the two types of exercises in terms of the variables studied. Keywords: Exercise Therapy, Eccentric, Concentric, High Blood Pressure, Heart Rate, Maximum Oxygen Consumption 1. Background High blood pressure, or the chronic increase in arte- rial pressure at rest to above 140 mmHg for systolic and/or 90 mmHg for diastolic blood pressure, is one of the most notable and modifiable risk factors for cardiovascular dis- ease (i.e., coronary artery disease, stroke, and heart fail- ure) (1). The prevalence of high blood pressure varies by ethnicity and gender, but was reported between 25% and 43% in the US population (2) and 17.37% in Iran in 2006 (3). Patients with hypertension have significant changes in their cardiovascular systems in comparison with healthy people, which is mainly addressed by reduced vascular ca- pacity and congested pulmonary arteries (3). This con- dition, if not treated appropriately, may lead to mortal- ity in 50% of patients with hypertension from coronary artery disease or heart failure, 33% from stroke, and 10 - 15% from kidney failure (1, 2). Although hypertension is a chronic disease associated with many complications, using cost-effective strategies for controlling this disease seems necessary (4). Despite that antihypertensive drugs are effective and often have minimal side effects, health care costs are rising (1). Treatment guidelines for primary and secondary prevention of high blood pressure recom- mend that lifestyle changes, including increased physi- cal activity, should be considered as the first-line non- pharmacological treatment. Considerable evidence indi- Copyright © 2021, Middle East Journal of Rehabilitation and Health Studies. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.