This expert-informed review examines the role of isometric exercise training (IET) in the prevention and treatment of arterial hypertension. IET, which involves sustained muscle contractions without changes in muscle length, has emerged as a novel and effective exercise intervention with evidence of superior blood pressure (BP) reductions compared to traditional aerobic and dynamic resistance exercises. Despite its potential benefits, IET remains underutilized in clinical practice. The review explores the efficacy, prescription protocols, evidence quality, acute cardiovascular stimulus, and physiological mechanisms underlying IET's anti-hypertensive effects. Key findings include: 1. **Efficacy**: IET has been shown to produce significant reductions in resting BP, ambulatory BP monitoring (ABPM), and BP variability, with some protocols demonstrating even greater effects than standard anti-hypertensive medications. 2. **Prescription Protocols**: Commonly studied IET protocols include handgrip, wall squat, and leg extension, with wall squats and leg extensions showing promise due to their higher intensity and potential for larger BP improvements. 3. **Evidence Quality and Certainty**: While the current evidence base supports the effectiveness of IET, there are concerns about methodological quality, including the lack of blinding, allocation concealment, and intention-to-treat analysis. 4. **Acute Cardiovascular Stimulus**: IET can induce acute increases in BP, but these are generally short-lived and do not pose significant safety concerns. 5. **Physiological Mechanisms**: IET may reduce BP through various mechanisms, including improved endothelial function, reduced sympathetic activity, and enhanced baroreflex sensitivity. 6. **Future Research Directions**: The review suggests that future research should focus on optimizing IET protocols, comparing IET with other exercise modes, and investigating sex-based differences in response. The review concludes by highlighting the need for larger-scale, high-quality clinical trials to further validate the effectiveness and safety of IET as a complementary tool in the management of hypertension.This expert-informed review examines the role of isometric exercise training (IET) in the prevention and treatment of arterial hypertension. IET, which involves sustained muscle contractions without changes in muscle length, has emerged as a novel and effective exercise intervention with evidence of superior blood pressure (BP) reductions compared to traditional aerobic and dynamic resistance exercises. Despite its potential benefits, IET remains underutilized in clinical practice. The review explores the efficacy, prescription protocols, evidence quality, acute cardiovascular stimulus, and physiological mechanisms underlying IET's anti-hypertensive effects. Key findings include: 1. **Efficacy**: IET has been shown to produce significant reductions in resting BP, ambulatory BP monitoring (ABPM), and BP variability, with some protocols demonstrating even greater effects than standard anti-hypertensive medications. 2. **Prescription Protocols**: Commonly studied IET protocols include handgrip, wall squat, and leg extension, with wall squats and leg extensions showing promise due to their higher intensity and potential for larger BP improvements. 3. **Evidence Quality and Certainty**: While the current evidence base supports the effectiveness of IET, there are concerns about methodological quality, including the lack of blinding, allocation concealment, and intention-to-treat analysis. 4. **Acute Cardiovascular Stimulus**: IET can induce acute increases in BP, but these are generally short-lived and do not pose significant safety concerns. 5. **Physiological Mechanisms**: IET may reduce BP through various mechanisms, including improved endothelial function, reduced sympathetic activity, and enhanced baroreflex sensitivity. 6. **Future Research Directions**: The review suggests that future research should focus on optimizing IET protocols, comparing IET with other exercise modes, and investigating sex-based differences in response. The review concludes by highlighting the need for larger-scale, high-quality clinical trials to further validate the effectiveness and safety of IET as a complementary tool in the management of hypertension.