Blood Pressure Changes Following a 12-Week Isometric Wall Squat Training Program in Adults with Hypertension: A Quasi-Experimental Longitudinal Study

Background/Objectives: Hypertension remains one of the leading modifiable risk factors for cardiovascular disease worldwide. Although exercise is widely recommended as a first-line non-pharmacological intervention, adherence to conventional exercise programs is often limited. Isometric training, particularly wall squat exercise, has emerged as a promising alternative for blood pressure (BP) management. This study evaluated blood pressure changes following a 12-week isometric wall squat training program in adults with hypertension and explored whether these changes differed according to subsequent antihypertensive medication initiation. Methods: A quasi-experimental longitudinal study was conducted in 119 adults with medically diagnosed hypertension. Participants completed a 12-week isometric wall squat training program consisting of three weekly sessions, each including four 2 min contractions separated by 2 min recovery periods. Blood pressure was assessed at baseline, week 8, and week 12 using standardized procedures. Mixed repeated-measures analysis of variance (ANOVA) was performed to assess changes over time in systolic blood pressure (SBP) and diastolic blood pressure (DBP), with antihypertensive medication initiation included as a between-subject factor. Results: Mean blood pressure progressively decreased throughout the intervention. Mean SBP decreased from 148.0 ± 7.1 mmHg at baseline to 132.0 ± 10.7 mmHg at week 12 (Δ = −16.0 mmHg), whereas mean DBP decreased from 94.4 ± 4.9 mmHg to 85.1 ± 5.6 mmHg (Δ = −9.3 mmHg). Significant main effects of time were observed for both SBP (F = 321.61, p < 0.001, ηp2 = 0.733) and DBP (F = 191.60, p < 0.001, ηp2 = 0.621). No significant time × antihypertensive medication initiation interaction was observed for either SBP (p = 0.526) or DBP (p = 0.126). Conclusions: A 12-week isometric wall squat training program was associated with clinically meaningful reductions in systolic and diastolic blood pressure in adults with hypertension. These findings suggest that isometric wall squat exercise may represent a feasible, low-cost, and time-efficient complementary strategy for non-pharmacological blood pressure management. However, because of the quasi-experimental design and the absence of a control group, randomized controlled trials are needed to confirm these findings and establish the effectiveness of this intervention.