Souza, LR, Vicente, JB, Melo, GR, Moraes, VC, Olher, RR, Sousa, IC, Peruchi, LH, Neves, RV, Rosa, TS, Ferreira, AP, and Moraes, MR. Acute hypotension after moderate-intensity handgrip exercise in hypertensive elderly people. J Strength Cond Res 32(10): 2971-2977, 2018-Isometric handgrip (IHG) training is effective in reducing blood pressure (BP), but little is known about the occurrence of acute hypotension by postisometric exercise hypotension (PIEH) and the underlying mechanisms. Ten sedentary hypertensive elderly people (7 women and 3 men) individuals, with a mean age of 73.2 ± 2.2 years and systolic BP (SBP) of 135.1 ± 6.5, were included; they were hypertensive for 13.2 ± 3.1 years and were receiving medications. These patients underwent 2 experimental sessions of isometric exercise using a portable hydraulic handgrip dynamometer: (a) sham session with 3% of maximal voluntary isometric contraction (MVIC) and (b) experimental isometric session with 30% MVIC, completing a total of 8 sets of 1-minute contraction and 1-minute rest-pause (overload of work = 51.7 kgf·min). Blood pressure and heart rate were evaluated at rest and 1, 5, 10, 15, 30, 45, and 60 minutes postexercise. Blood lactate (Lac) and salivary nitric oxide (NO) were collected at rest, 0, 30, and 60 minutes postexercise. The SBP presented a reduction as of the tenth minute postexercise to session 30% MVIC (Δ = -14.4 at -18.7 mm Hg, p < 0.05). At 60-minute postexercise, the SBP was 30% lower vs. 3% MVIC (-20.2 mm Hg, p = 0.006). There were no differences for the other cardiovascular parameters and vasoactive substances for both sessions (p > 0.05). These results demonstrated that the IHG exercise with a higher overload of work induced PIEH in hypertensive elderly people, but there was no association with Lac and NO. Therefore, this IHG model with easy execution, quick adherence, short duration, and a portable equipment can be an excellent adjuvant strategy for the control and prevention of hypertension.