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Baughman C, Gong Y, Wu Y, Hanlon E, Juraschek S. Nonpharmacologic Management of Hypertension in Older Adults. Clin Geriatr Med 2024; 40:615-628. [PMID: 39349035 DOI: 10.1016/j.cger.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
Hypertension is ubiquitous among older adults and leads to major adverse cardiovascular events. Nonpharmacologic lifestyle interventions represent important preventive and adjunct strategies in the treatment of hypertension and have benefits beyond cardiovascular disease in this population characterized by a high prevalence of frailty and comorbid conditions. In this review, the authors examine nonpharmacologic interventions with the strongest evidence to prevent cardiovascular disease with an emphasis on the older adults.
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Affiliation(s)
- Carter Baughman
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yusi Gong
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Yingfei Wu
- Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Emma Hanlon
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA
| | - Stephen Juraschek
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Deaconess Building, Suite 306, One Deaconess Road, Boston, MA 02215, USA.
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Giacona JM, Vongpatanasin W. Resistant Hypertension in Older Adults. Clin Geriatr Med 2024; 40:645-658. [PMID: 39349037 DOI: 10.1016/j.cger.2024.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/02/2024]
Abstract
Resistant hypertension is a complex disorder that requires a comprehensive evaluation of several patient characteristics. Attention should be paid to medication and lifestyle adherence, and investigation into potential secondary causes of resistant hypertension should occur as clinically indicated. Moreover, a shared, multidisciplinary decision-making approach with the patient, specialized care providers, and family members may enhance blood pressure control.
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Affiliation(s)
- John M Giacona
- Department of Applied Clinical Research, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, H4.130, Dallas, TX 75390-8586, USA; Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, H4.130, Dallas, TX, USA. https://twitter.com/GiaconaJohn
| | - Wanpen Vongpatanasin
- Cardiology Division, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, H4.130, Dallas, TX, USA.
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Barbosa AR, Pais S, Marreiros A, Correia M. Impact of a Mediterranean-Inspired Diet on Cardiovascular Disease Risk Factors: A Randomized Clinical Trial. Nutrients 2024; 16:2443. [PMID: 39125324 PMCID: PMC11314620 DOI: 10.3390/nu16152443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Revised: 07/15/2024] [Accepted: 07/18/2024] [Indexed: 08/12/2024] Open
Abstract
Cardiovascular diseases (CVDs) are the leading cause of death worldwide. This study focused on evaluating the impact of a Mediterranean-type diet combined with physical exercise on CVD risk factors of high-risk individuals. A randomized clinical trial (RCT) recruited individuals (≥50 years old) with no history of acute myocardial infarction, but with high CVD risk criteria according to the SCORE2/SCORE2 OP. Anthropometric and biochemical parameters were assessed at baseline and after 12 weeks of diet and exercise intervention. Participants were randomly assigned into 3 groups: no intervention group (Group 1a), physical exercise group (Group 1b), and physical exercise (±2 h/week) plus diet group (Group 2). Briefly, the dietary intervention was based on the principles of an isocaloric Mediterranean diet (MD), with seven main meals/week centered on plant-based foods (legumes and pulses). The combined effect of exercise and the diet showed significant decrease in WC (p = 0.002), BST (p < 0.001), visceral fat (p < 0.001), and TG (p = 0.029), compared with control groups. The intervention significantly increased legume intake (p < 0.001), as well as adherence to the MD, which associates with WC decrease (p = 0.024) and visceral fat (p = 0.017). A combined intervention of exercise and diet should be endorsed as an efficient modifier of cardiometabolic parameters.
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Affiliation(s)
- Ana Rita Barbosa
- Comprehensive Health Research Centre—CHRC, Universidade de Évora, Colégio Luís António Verney, Gab:269-a, Rua Romão Ramalho 59, 7002-554 Évora, Portugal
- Algarve Biomedical Center Research Institute, Universidade do Algarve, FMCB Ed. Campus de Gambelas, 8005-139 Faro, Portugal
| | - Sandra Pais
- Comprehensive Health Research Centre—CHRC, Universidade de Évora, Colégio Luís António Verney, Gab:269-a, Rua Romão Ramalho 59, 7002-554 Évora, Portugal
| | - Ana Marreiros
- Algarve Biomedical Center Research Institute, Universidade do Algarve, FMCB Ed. Campus de Gambelas, 8005-139 Faro, Portugal
- Faculty of Medicine and Biomedical Sciences, Universidade do Algarve, FMCB Ed. Campus de Gambelas, 8005-139 Faro, Portugal
| | - Marta Correia
- CBQF—Centro de Biotecnologia e Química Fina—Laboratório Associado, Escola Superior de Biotecnologia, Universidade Católica Portuguesa, Rua Diogo Botelho 1327, 4169-005 Porto, Portugal
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Bavaresco Gambassi B, Chaves LFC, Sousa TMDS, Ribeiro MJS, Souza TA, Schwingel PA. Short-duration dynamic power training with elastic bands combined with endurance training: a promising approach to hypertension management in older adults. J Hypertens 2024; 42:735-742. [PMID: 38441186 DOI: 10.1097/hjh.0000000000003681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/07/2024]
Abstract
Previous studies have investigated the effects of different combined training programs involving traditional resistance training and aerobic exercise on hemodynamic parameters and arterial stiffness in older adults. However, little is known about the impact of power training combined with endurance training on these variables in hypertensive older adults. Therefore, this study aimed to investigate the effects of dynamic power training with elastic bands combined with endurance training on arterial stiffness and hemodynamic parameters in hypertensive older adults. Twenty-six participants were randomly assigned to the control group (CG; n = 13) and the intervention group (n = 13). IG participants performed power training with elastic bands combined with endurance training twice a week for 8 weeks. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP were assessed before and after 8 weeks using the triple pulse wave velocity method. Pulse pressure, central pulse pressure, pulse wave velocity, SBP, DBP, central SBP, and central DBP significantly improved after 8 weeks of intervention (P < 0.05). These findings indicate that power training with elastic bands combined with endurance training reduces arterial stiffness and significantly improves hemodynamic parameters in older adults diagnosed with grade 1 hypertension. In addition, underscores the potential of this approach as a promising strategy for the management of hypertension in older adults.
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Affiliation(s)
- Bruno Bavaresco Gambassi
- Department of Physical Education
- Postgraduate Program in Programs Management and Health Services
- Postgraduate Program in Physical Education, Federal University of Maranhão, São Luís, MA, Brazil
- Interuniversity Network for Healthy Aging, Latin America and the Caribbean, Talca, Maule, Chile
- Human Performance Research Laboratory, University of Pernambuco, Petrolina, PE
| | | | | | | | | | - Paulo Adriano Schwingel
- Interuniversity Network for Healthy Aging, Latin America and the Caribbean, Talca, Maule, Chile
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Safonicheva O, Kryuchkova K, Lazareva I, Chekulaev P, Ovchinnikova M, Kurshev V, Budanova E, Gameeva V, Gavrilov V, Epishev V, Zaborova V. Study of Morpho-Functional Characteristics of the Cardiovascular System According to Electrocardiography, Phonocardiography, Echocardiography in Masters Athletics. Clin Interv Aging 2023; 18:2079-2092. [PMID: 38107188 PMCID: PMC10725634 DOI: 10.2147/cia.s432202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 11/18/2023] [Indexed: 12/19/2023] Open
Abstract
Background Many authors have noted the lack of knowledge on the causal relationship between the degree of physical activity, the dynamics, and outcomes of diseases, as well as the influence of sports history on the rehabilitation potential of former athletes. Purpose Assessment of the functional state of the cardiovascular system according to the indicators of electrocardiography, polycardiography, echocardiography and the level of physical performance in masters athletes. Patients and Methods The study included a main group consisting of 100 athletes, who had undergone electrocardiography, poly-electrocardiography, ultrasound echocardiography, heart rate and blood pressure measurement to determine their level of physical performance. The subjects were then divided into 2 groups. The first group included 75 people who continue to be active in regular sports activities. The second group consisted of 25 people who completely stopped training or had only occasional, unsystematic physical activities. A control group of 31 people, consisting of people of the same age who had not been involved in sports earlier, was examined according to the same program. Results The data obtained by us show that sports activities do contribute to the increasing stability of the body and maximize the deployment of the capabilities of the circulatory system, including their long-term preservation in masters athletic. Athletes who have stopped training have signs of age-related changes in the heart and blood vessels, which seem to be more frequent and earlier than those who continue training. A higher degree of myocardial contractility (in 90.67% of cases) can also be seen in the main group. Conclusion Masters athletes and those who stopped training after completing their sports career, should have notably thorough medical supervision and undergo regular annual in-depth examination.
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Affiliation(s)
- Olga Safonicheva
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Kira Kryuchkova
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Irina Lazareva
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Pavel Chekulaev
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Marina Ovchinnikova
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Vladislav Kurshev
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - Elena Budanova
- Institute of Public Health, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | | | - Victor Gavrilov
- Moscow Institute of Physics and Technology (National Research University), Moscow Region, Russia
| | - Vitaly Epishev
- Research Center for Sports Science, South Ural State University, Chelyabinsk, Russia
| | - Victoria Zaborova
- Institute of Clinical Medicine, Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
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