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Hasan MJ, Hossain MZ, Hossain MA, Dalal K, Baset MA, Sutradhar P, Alam M, Tabassum T, Fardous J, Zaman P, Rafi MA, Khan MAS, Hawlader MDH. Health-care-seeking behaviour in patients with hypertension: experience from a dedicated hypertension centre in Bangladesh. Blood Press 2024; 33:2339434. [PMID: 38696746 DOI: 10.1080/08037051.2024.2339434] [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: 05/16/2023] [Accepted: 03/22/2024] [Indexed: 05/04/2024]
Abstract
Objective: The study aimed to assess health-seeking behaviour (HSB) and associated factors among hypertensive patients in Bangladesh.Methods: This cross-sectional study was conducted in the Hypertension & Research Centre, Rangpur, Bangladesh, between January 2022 and June 2022. A total of 497 hypertensive adults were recruited consecutively. A pre-tested structured questionnaire was deployed by the research team for data collection. Multivariable logistic regression analysis was used to explore the predictors of HSB.Results: The mean age of the hypertensive patients was 52 ± 11 (SD) years. Most of them were aged between 51 and 60 years (33%), female (55%), came from rural areas (57%), and belonged to middle socioeconomic class (68%). One-fourth of the patients (27%) had chosen informal healthcare providers for their first consultation. Fear of stroke (244, 45%), headache (170, 36%), and neck pain (81, 17%) were the three most common compelling causes of their visit to the hypertension centre. Age (aOR 0.78, 95% CI 0.68 - 0.89), male sex (aOR: 1.79, 95% CI 1.05 - 3.10), living in semi-urban (aOR 4.68, 95% CI 1.45 - 15.10) and rural area (aOR 1.68, 95% CI 1.01 - 2.80), farmers as occupation (aOR: 3.24, 95%CI: 1.31 - 8.06) and belonging to lower social economic class (aOR 4.24, 95% CI 1.68 - 10.69) were predictors of visiting informal providers of hypertensive patient. One-fourth of the hypertensive patients received consultation from informal healthcare providers.Conclusions: Raising awareness among patients and proper referral to specialised hypertension centres could promulgate the patients towards appropriate behaviour.
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Affiliation(s)
| | | | | | - Koustuv Dalal
- Division of Public Health Science, Department of Health Sciences, Mid Sweden University, Sundsvall, Sweden
| | | | | | - Mahabubul Alam
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
| | | | | | - Paramita Zaman
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
| | - Md Abdur Rafi
- Tropical Disease and Health Research Center, Dhaka, Bangladesh
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Abstract
PURPOSE The current review is to describe the definition and prevalence of resistant arterial hypertension (RAH), the difference between refractory hypertension, patient characteristics and major risk factors for RAH, how RAH is diagnosed, prognosis and outcomes for patients. MATERIALS AND METHODS According to the WHO, approximately 1.28 billion adults aged 30-79 worldwide have arterial hypertension, and over 80% of them do not have blood pressure (BP) under control. RAH is defined as above-goal elevated BP despite the concurrent use of 3 or more classes of antihypertensive drugs, commonly including a long-acting calcium channel blocker, an inhibitor of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a thiazide diuretic administered at maximum or maximally tolerated doses and at appropriate dosing frequency. RAH occurs in nearly 1 of 6 hypertensive patients. It often remains unrecognised mainly because patients are not prescribed ≥3 drugs at maximal doses despite uncontrolled BP. CONCLUSION RAH distinctly increases the risk of developing coronary artery disease, heart failure, stroke and chronic kidney disease and confers higher rates of major adverse cardiovascular events as well as increased all-cause mortality. Timely diagnosis and treatment of RAH may mitigate the associated risks and improve short and long-term prognosis.
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Schock S, Hakim A. The Physiological and Molecular Links Between Physical Activity and Brain Health: A Review. Neurosci Insights 2023; 18:26331055231191523. [PMID: 37600456 PMCID: PMC10436988 DOI: 10.1177/26331055231191523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/17/2023] [Indexed: 08/22/2023] Open
Abstract
There is currently an epidemic of sedentary behavior throughout the world, leading to negative impacts on physical health and contributing to both mortality and burden of disease. The consequences of this also impact the brain, where increased levels of cognitive decline are observed in individuals who are more sedentary. This review explores the physiological and molecular responses to our sedentary propensity, its contribution to several medical conditions and cognitive deficits, and the benefits of moderate levels of physical activity and exercise. Also presented is the recommended level of activity for overall physical health improvement.
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Affiliation(s)
- Sarah Schock
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
| | - Antoine Hakim
- Brain and Mind Research Institute, University of Ottawa, Ottawa, ON, Canada
- Division of Neurology, University of Ottawa, Ottawa, ON, Canada
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Park JH, Lim NK, Park HY. Association of leisure-time physical activity and resistance training with risk of incident hypertension: The Ansan and Ansung study of the Korean Genome and Epidemiology Study (KoGES). Front Cardiovasc Med 2023; 10:1068852. [PMID: 36776249 PMCID: PMC9912934 DOI: 10.3389/fcvm.2023.1068852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 01/05/2023] [Indexed: 02/14/2023] Open
Abstract
Hypertension is the most common preventable risk factor for the onset of cardiovascular disease and mortality. We aimed to investigate the association between incident hypertension and 4-year leisure-time physical activity (PA) levels and resistance training (RT). In this community-based Korean cohort, 5,075 participants without hypertension were included. To evaluate cumulative PA, the average PA time (the total time of moderate-intensity leisure-time PA) at baseline, 2-year follow-up, and 4-year follow-up were calculated. Based on participation in RT and compliance to PA guidelines (≥150 min/week of PA time), the participants were divided into the following four groups: Low-PA, Low-PA+RT, High-PA, and High-PA+RT. A multivariate Cox proportional hazards regression model was used to evaluate the 12-year incidence of hypertension in relation to leisure-time PA levels and RT regularity. During a mean 7.86 ± 4.20-year follow-up, 2,544 participants (1,366 women) were diagnosed with hypertension. Compared with Low-PA, High-PA, and High-PA+RT decreased the risk for hypertension by 30 and 39%, respectively. Participation in RT without compliance to PA guidelines did not affect the incidence of hypertension. The additive effect of RT on hypertension in the High-PA group was further examined. Although sex-based comparisons indicated that men had a significantly longer training period for RT than women, an additional reduction in the risk for hypertension in relation to the addition of RT was observed only in women (35%). PA may confer protective effects against hypertension, whereas the addition of RT to high levels of PA can further reduce the risk for hypertension in women.
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Affiliation(s)
- Jae Ho Park
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Nam-Kyoo Lim
- Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea
| | - Hyun-Young Park
- Department of Precision Medicine, Korea National Institute of Health, Korea Disease Control and Prevention Agency, Cheongju, Republic of Korea,*Correspondence: Hyun-Young Park,
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Wu T, Yan Y, Luo Y, Wang Z, Wang Y. 12-week Brisk Walking Improved Chronotropic Response in Hypertensive Patients. Int J Sports Med 2023; 44:376-384. [PMID: 36377188 DOI: 10.1055/a-1978-5907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
We investigated the effects of 12-week brisk walking on chronotropic response in hypertensive patients aged 40-69. 77 participants in exercise group underwent 12-week brisk walking, while 66 participants in control group received health education. Chronotropic parameters, resting blood pressure, and physical fitness including peak oxygen consumption (VO2peak) were measured. After 12 weeks, the systolic blood pressure (SBP) was decreased (-6.104 mmHg, 95%CI -8.913 to -3.295 mmHg, P<0.0001), while metabolic chronotropic relationship (MCR) slope and VO2peak were increased (0.073, 95%CI 0.001 to 0.145, P=0.046; 1.756 mL/kg/min, 95%CI 0.891 to 2.622 mL/kg/min, P<0.0001) in exercise group compared to baseline. The chronotropic response index (CRI) at 25-75 W load were decreased (-0.210, 95%CI -0.307 to -0.112, P<0.0001; -0.144, 95%CI - 0.204 to -0.083, P<0.0001; -0.078, 95%CI -0.135 to -0.022, P=0.007) in control group after 12 weeks. The relative changes (%Δ) of systolic and diastolic blood pressure were negatively correlated with %ΔVO2peak (r=-0.233, r=-0.187), while %ΔMCR and %ΔCRI at 50-75 W load were positively correlated with %ΔVO2peak after 12 weeks (r=0.330, r=0.282, r =0.370). %ΔSBP was also positively correlated with %ΔMCR (r =-0.213). In conclusion, 12-week brisk walking reduced SBP by improving chronotropic response in hypertensive patients aged 40-69. The enhanced chronotropic response was associated with enhanced cardiorespiratory fitness.
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Affiliation(s)
- Tong Wu
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yan Yan
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China.,College of Physical Education, Guangxi University, Nanning, China
| | - Yong Luo
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Zhengzhen Wang
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
| | - Yan Wang
- School of Sport Medicine and Rehabilitation, Beijing Sport University, Beijing, China
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Domaradzki J, Koźlenia D, Popowczak M. Prognostic Potential of the Body Composition Indices in Predicting Positive Changes in Resting Blood Pressure after High-Intensity Interval Training in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14658. [PMID: 36429371 PMCID: PMC9690772 DOI: 10.3390/ijerph192214658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/04/2022] [Accepted: 11/06/2022] [Indexed: 06/16/2023]
Abstract
This study aimed to investigate the prognostic potential of body composition indices in predicting the improvement in resting blood pressure after 10 weeks of high-intensity interval training (HIIT) implemented in physical education lessons. The participants were 141 adolescents aged 16 years. Independent variables were body mass index (BMI), fat mass index (FMI), muscle mass index (SMI), and mass to fat ratio (MFR); dependent variables were systolic and diastolic blood pressure (SBP, DBP) and its indices: pulse pressure (PP), mid-blood pressure (MBP), and mean arterial pressure (MAP). The receiver operating curve (ROC) method was employed. SMI and MFR are body composition indices with prognostic potential to predict positive changes in SBP in males (SMI: AUC = 0.82; p < 0.001, MFR = 0.70; p = 0.039) and MFR in females (AUC = 0.72; p = 0.035). The respective cut-off point values used to classify participants as a beneficiary of HIIT intervention concerning SBP were SMI = 7.84 and MFR = 2.43 in males, and for SMI = 10.12 and MFR = 1.94 in females. Body composition indices based on skeletal muscle (SMI, MFR) were more likely to predict positive changes in SBP after HIIT intervention in adolescents. PP, MBP, and MAP did not reflect the detecting power of SMI and MFR. However, these thresholds' utility is limited to adolescents of 16 years of age.
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Affiliation(s)
- Jarosław Domaradzki
- Unit of Biostructure, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, Al. I. J. Paderewskiego 35, 51-612 Wroclaw, Poland
| | - Dawid Koźlenia
- Unit of Biostructure, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, Al. I. J. Paderewskiego 35, 51-612 Wroclaw, Poland
| | - Marek Popowczak
- Unit of Team Sports Games, Faculty of Physical Education and Sport, Wroclaw University of Health and Sport Sciences, Al. I. J. Paderewskiego 35, 51-612 Wroclaw, Poland
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Zhou L, Feng W, Xiang N, Cheng Y, Ya X, Wang M, Wang X, Liu Y. Association between physical activity dimensions and the risk of hypertension among middle and older adults: A cross-sectional study in China. Front Public Health 2022; 10:995755. [PMID: 36217539 PMCID: PMC9547049 DOI: 10.3389/fpubh.2022.995755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/09/2022] [Indexed: 01/26/2023] Open
Abstract
Background It is known that insufficient physical activity is associated with the risk of hypertension, but the relationship to different physical activity dimensions within hypertension risk remains to be elucidated. Objective The objective of this study is to identify the association between physical activity intensity, frequency, duration, and volume with hypertension risk. Meanwhile, a dose-response experiment is conducted to determine the relationship between physical activity level and hypertension risk. Methods Data came from the 2018 China Health and Retirement Longitudinal Study (CHARLS, 2018), which included 14266 participants over the age of 45. Binary logistic regression models were established to assess the associations between different dimensions of physical activity and the risk of hypertension. Restricted cubic spline analysis was used to examine possible non-linear associations between physical activity volume and hypertension risk. Results For frequency, lower hypertension risk was associated with performing vigorous physical activity 6-7d/w (OR 0.82, 95%CI 0.73-0.93) and moderate physical activity 6-7d/w (OR 0.89, 95%CI 0.80-0.99). No significant association between any light physical activity frequency and hypertension was observed before and after being adjusted. For the duration, lower hypertension risk was observed in performing vigorous physical activity ≥240 min/d (OR 0.85, 95%CI 0.75-0.97) and moderate physical activity ≥240 min/d (OR 0.83, 95%CI 0.71-0.97). For volume, the risks of hypertension in the participants who reported TPA in the 3th and 4th of quantiles were reduced by 18% (OR 0.82, 95%CI 0.72-0.95) and 22% (OR 0.78, 95%CI 0.68-0.91). A non-linear dose-response association between total physical activity and the risk of hypertension was shown among all of the participants (P non-linearity < 0.05). Conclusion Higher frequency and longer duration of vigorous physical activity or moderate physical activity were significantly associated with a lower risk of hypertension. Higher physical activity levels were associated with a lower risk of hypertension and there was an inverse non-linear dose-response relationship between weekly total physical activity and the risk of hypertension. These findings provide further proof that hypertension could be prevented through increased physical activity.
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Affiliation(s)
- Linlin Zhou
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Wei Feng
- Department of Physical Education, Suzhou University, Suzhou, China
| | - Na Xiang
- Caoxian People's Hospital, Heze, China
| | - Yue Cheng
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xudong Ya
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Mingxia Wang
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xingqi Wang
- School of Life Science, Biomedical R&D Center, Jiangsu Normal University, Xuzhou, China,*Correspondence: Xingqi Wang
| | - Yujia Liu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China,Yujia Liu
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8
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Jones S, Schultz MG, Park C, Tillin T, Chaturvedi N, Hughes AD. Antihypertensive treatment effect on exercise blood pressure and exercise capacity in older adults. J Hypertens 2022; 40:1682-1691. [PMID: 35881442 DOI: 10.1097/hjh.0000000000003201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND An exaggerated blood pressure (BP) response to exercise and low exercise capacity are risk factors for cardiovascular disease (CVD). The effect of pharmacological antihypertensive treatment on exercise BP in older adults is largely unknown. This study investigates these effects accounting for differences in exercise capacity. METHODS Participants enrolled in the Southall and Brent Revisited (SABRE) study undertook a 6-min stepper test with expired gas analysis and BP measured throughout exercise. Participants were stratified by antihypertensive treatment status and resting BP control. Exercise systolic and diastolic BP (exSBP and exDBP) were compared between groups using potential outcome means [95% confidence intervals (CIs)] adjusted for exercise capacity. Exercise capacity was also compared by group. RESULTS In total, 659 participants were included (mean age ± SD: 73 ± 6.6 years, 57% male). 31% of normotensive and 23% of hypertensive older adults with controlled resting BP had an exaggerated exercise BP. ExSBP was similar between normotensive and treated/controlled individuals [mean (95%CI): 180 (176 184) mmHg vs. 177 (173 181) mmHg, respectively] but was higher in treated/uncontrolled and untreated/uncontrolled individuals [mean (95% CI): 194 (190 197) mmHg, P < 0.001 and 199 (194 204) mmHg, P < 0.001, respectively]; these differences persisted after adjustment for exercise capacity and other confounders. Exercise capacity was lower in treated vs. normotensive individuals [mean (95% CI) normotensive: 16.7 (16.0,17.4) ml/kg/min]; treated/controlled: 15.5 (14.8,16.1) ml/kg/min, P = 0.009; treated/uncontrolled: [15.1 (14.5,15.7) ml/kg per min, P = 0.001] but was not reduced in untreated/uncontrolled individuals [mean (95% CI): 17.0 (16.1,17.8) ml/kg per min, P = 0.621]. CONCLUSION Irrespective of resting BP control and despite performing less exercise, antihypertensive treatment does not fully mitigate an exaggerated BP response to exercise suggesting residual CVD risk in older adults.
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Affiliation(s)
- Siana Jones
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science & Experimental Medicine, Institute for Cardiovascular Science, University College London, UK
| | - Martin G Schultz
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Chloe Park
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science & Experimental Medicine, Institute for Cardiovascular Science, University College London, UK
| | - Therese Tillin
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science & Experimental Medicine, Institute for Cardiovascular Science, University College London, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science & Experimental Medicine, Institute for Cardiovascular Science, University College London, UK
| | - Alun D Hughes
- MRC Unit for Lifelong Health & Ageing at UCL, Department of Population Science & Experimental Medicine, Institute for Cardiovascular Science, University College London, UK
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9
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Cheng C, Zhang D, Chen S, Duan G. The association of cardiorespiratory fitness and the risk of hypertension: a systematic review and dose-response meta-analysis. J Hum Hypertens 2022; 36:744-752. [PMID: 34168273 DOI: 10.1038/s41371-021-00567-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 05/25/2021] [Accepted: 06/14/2021] [Indexed: 01/03/2023]
Abstract
Established evidence has indicated a negative correlation between cardiorespiratory fitness (CRF) and hypertension risk. In this study, we performed a meta-analysis to investigate the categorical and dose-response relationship between CRF and hypertension risk and the effects of CRF changes on hypertension risk reduction. The PubMed, Web of Science, and Embase databases were searched for relevant studies. The summarized relative risk (RR) and 95% confidence interval (95% CI) were estimated using the DerSimonian and Laird random effect model, and the dose-response relationship between CRF and hypertension risk was characterized using generalized least-squares regression and restricted cubic splines. Nine cohorts describing 110,638 incident hypertension events among 1,618,067 participants were included in this study. Compared with the lowest category of CRF, the RR of hypertension was 0.63 (95% CI: 0.56-0.70) for the highest CRF category and 0.85 (95% CI: 0.80-0.91) for the moderate category of CRF. For a 1-metabolic equivalent increment in CRF, the pooled RR of hypertension was 0.92 (95% CI: 0.90-0.94) in the total population. The RR of hypertension was 0.71 (95% CI: 0.64-0.79) for participants with CRF increased compared with those whose CRF was decreased over time. In conclusion, our meta-analysis supports the widely held notion of a negative dose-dependent relationship between CRF and hypertension risk.
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Affiliation(s)
- Cheng Cheng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Dongdong Zhang
- Department of Nutrition and Food Hygiene, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Shuaiyin Chen
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Guangcai Duan
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, China.
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10
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Carreira-Míguez M, Belinchón-deMiguel PP, Clemente-Suárez VJ. Behavioural, odontological and physical activity patterns of hypertense and control population. Physiol Behav 2022; 252:113841. [PMID: 35561809 DOI: 10.1016/j.physbeh.2022.113841] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 01/04/2023]
Abstract
Behavioural and multifactorial factors such as odontological and physical activity habits are controlling factors in hypertension. The aim of the present study was to analyze differences in behavioral, odontological and physical activity patterns of hypertense and control population. Fifty participants with hypertension (57.5±13.6 years) and 100 participants as control group with no hypertension disease (48.9±7.9 years) were interviewed via online questionnaire. Multifactorial items in oral behavioral, health habits and physical activity profile were analyzed by a compendium of questionnaires. Result showed how control group showed significantly lower age, weight, body mass index, TV hours per day, gastritis or heartburn, dental sensibility, and sick days last year, and significantly higher level of academic education, quality of sleep and daily toothbrushing than hypertension group. In conclusion our results showed that hypertense patients presented higher levels of overweight, poor sleep quality and sedentary behaviors than control participants. In addition, hypertense patients also presented poor odontological health, showing higher indices of gastritis, dental sensibility, and sick days per year. Both groups presented a low physical activity pattern. This information allows to better understand of a multifactorial disease, as well to the creation of protocols for intervention and prevention of this disease at the behavioral level and lifestyle.
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Affiliation(s)
- María Carreira-Míguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain.
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain; Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia.
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11
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Almeida FR, Ostolin TLVDP, Almeida VR, Gonze BB, Sperandio EF, Simões MSMP, Godoy I, Tanni SE, Romiti M, Arantes RL, Dourado VZ. Cardiorespiratory fitness as a mediator in the relationship between lung function and blood pressure in adults. Braz J Med Biol Res 2022; 55:e11754. [PMID: 35894380 PMCID: PMC9322832 DOI: 10.1590/1414-431x2022e11754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 05/25/2022] [Indexed: 12/03/2022] Open
Abstract
It is unclear whether physical activity and cardiorespiratory fitness (CRF) are
pathways that link low pulmonary function (LPF) to increased blood pressure
(BP). Therefore, we investigated the extent to which CRF and
moderate-to-vigorous physical activity (MVPA) mediate the relationship between
LPF and high BP in adults. We conducted a cross-sectional study with 1,362
participants that underwent cardiopulmonary exercise testing (CPET), spirometry,
and wore an accelerometer to determine physical activity patterns. We performed
mediation analyses using structural equations considering peak oxygen uptake
(V̇O2) and MVPA as mediators, forced vital capacity (FVC) and
forced expiratory volume in the first second (FEV1) as independent variables,
and systolic and diastolic blood pressure (SBP, DBP) as dependent variables. The
probability of alpha error was set at 5%. We found a significant total effect of
FVC on SBP and DBP considering V̇O2 as mediator (P<0.01). Indirect
effects were also significant, with 42.6% of the total effect of FVC on SBP and
77% on DBP mediated by V̇O2 (P<0.01). We did not observe a direct
effect of FVC on SBP and DBP. Considering FEV1 as an independent variable, the
total effect on SBP was also significant, as were the indirect effects, mediated
by V̇O2 at 14.8% for SBP and 7.6% for DBP (P<0.01). We did not
find an indirect effect of FVC or FEV1 considering the MVPA as a mediator. CRF
mediates the pathway that links LPF and elevated BP. Therefore, CRF is more
sensitive to variations in FVC and FEV1 than MVPA.
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Affiliation(s)
- F R Almeida
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - T L V D P Ostolin
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - V R Almeida
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - B B Gonze
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - E F Sperandio
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - M S M P Simões
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil
| | - I Godoy
- Disciplina de Pneumologia do Departamento de Clínica Médica da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - S E Tanni
- Disciplina de Pneumologia do Departamento de Clínica Médica da Faculdade de Medicina de Botucatu, Universidade Estadual Paulista, Botucatu, SP, Brasil
| | - M Romiti
- Angiocorpore Instituto de Medicina Cardiovascular, Santos, SP, Brasil
| | - R L Arantes
- Angiocorpore Instituto de Medicina Cardiovascular, Santos, SP, Brasil
| | - V Z Dourado
- Departamento de Ciências do Movimento Humano, Universidade Federal de São Paulo, Santos, SP, Brasil.,Lown Scholars Program, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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12
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Denche-Zamorano Á, Pérez-Gómez J, Mendoza-Muñoz M, Carlos-Vivas J, Oliveira R, Brito JP. Risk of Hypertension and Use of Antihypertensive Drugs in the Physically Active Population under-70 Years Old—Spanish Health Survey. Healthcare (Basel) 2022; 10:healthcare10071283. [PMID: 35885810 PMCID: PMC9319692 DOI: 10.3390/healthcare10071283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/28/2022] [Accepted: 07/07/2022] [Indexed: 11/17/2022] Open
Abstract
Introduction: Reducing the prevalence of hypertension is a major priority of the World Health Organization (WHO). Its high prevalence and associated risks generate high economic and social costs. Physical activity (PA) is associated with a decrease in hypertension and in the use of antihypertensive drugs. Objective: To explore the association between PA levels (PAL), prevalence of hypertension and the use of antihypertensive drugs in Spanish population. To calculate risks of hypertension and use of antihypertensive in the inactive versus physically active population. Method: This cross-sectional study used data from 17717 individuals, sampled in the 2017 National Health Survey. Interaction by sex, age groups, body mass index (BMI), hypertension prevalence, antihypertensive drugs use and PAL, using a pairwise z-test, and dependence relationships between variables, were studied using a chi square test. Odds ratios of hypertension and antihypertensive drug use were calculated among the inactive and the physically active populations. Results: The findings showed a significant inverse association between prevalence of hypertension, antihypertensive use, and PAL in both sexes and different age and BMI groups, with lower prevalence of hypertension and antihypertensive use when PAL were higher. The risks of hypertension and antihypertensive use seems to be reduced when related to higher PAL compared to inactive people. Conclusions: High PAL is associated with lower prevalence of hypertension and lower antihypertensive use. Thus, being physically active or very active may reduce the risks of suffering from hypertension and the need to use antihypertensives compared to inactive people or walkers.
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Affiliation(s)
- Ángel Denche-Zamorano
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Jorge Pérez-Gómez
- Health Economy Motricity and Education (HEME) Research Group, Faculty of Sport Science, University of Extremadura, 10003 Cáceres, Spain
| | - Maria Mendoza-Muñoz
- Research Group on Physical and Health Literacy and Health-Related Quality of Life (PHYQOL), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, 7004-516 Évora, Portugal
| | - Jorge Carlos-Vivas
- Promoting a Healthy Society Research Group (PHeSO), Faculty of Sport Sciences, University of Extremadura, 10003 Cáceres, Spain
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, 2040-413 Rio Maior, Portugal
- Research Center in Sport Sciences, Health Sciences and Human Development, Quinta de Prados, Edifício Ciências de Desporto, 5001-801 Vila Real, Portugal
- Life Quality Research Centre, 2040-403 Rio Maior, Portugal
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Patel PH, Gates M, Kokkinos P, Lavie CJ, Zhang J, Sui X. Non-Exercise Estimated Cardiorespiratory Fitness and Incident Hypertension. Am J Med 2022; 135:906-914. [PMID: 35235822 PMCID: PMC9233001 DOI: 10.1016/j.amjmed.2022.01.048] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND The purpose of the current study is to examine the association between non-exercise estimated cardiorespiratory fitness and incident hypertension by sex. METHODS A total of 5513 participants (4403 men and 1110 women) free of hypertension from the Aerobics Center Longitudinal Study were followed for incident hypertension, which was determined as resting systolic or diastolic blood pressure at least 130/80 mm Hg or physician diagnosis. Non-exercise estimated cardiorespiratory fitness was estimated in metabolic equivalents (METs) with sex-specific algorithms. Age, body mass index, waist circumference, and resting heart rate were used as continuous variables, whereas being physically active and current smoking were dichotomous variables. Multivariable Cox regression models were used to examine the association between cardiorespiratory fitness and risk of developing hypertension. Hazard ratios and 95% confidence intervals (CIs) were reported as an index of strength of association. RESULTS During an average follow-up of 5 years, 61.7% of men and 39.5% of women developed hypertension. In men, the upper and middle tertiles of cardiorespiratory fitness had 22% (95% CI, 0.71-0.86) and 10% (95% CI, 0.82-0.99) lower risk, respectively, of developing hypertension compared with those in the lower tertile. In women, the upper and middle tertiles of cardiorespiratory fitness had 30% (95% CI, 0.55-0.88) and 6% (95% CI, 0.74-1.18) lower risk, respectively, of developing hypertension. Each 1-MET increment was associated with a 10% higher risk of incident hypertension in the overall sample. CONCLUSION Cardiorespiratory fitness estimated using a non-exercise algorithm is inversely associated with risk of developing hypertension in men and women.
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Affiliation(s)
| | - Mitchell Gates
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Peter Kokkinos
- Department of Kinesiology and Health, Rutgers University, New Brunswick; Veterans Affairs Medical Center, Washington, DC
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School- The University of Queensland School of Medicine, New Orleans
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia
| | - Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
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Prevalence of and factors associated with hypertension, diabetes, stroke and heart attack multimorbidity in Botswana: Evidence from STEPS 2014 survey. PLoS One 2022; 17:e0265722. [PMID: 35324986 PMCID: PMC8947240 DOI: 10.1371/journal.pone.0265722] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 03/07/2022] [Indexed: 11/21/2022] Open
Abstract
Background Botswana, like other Sub-Saharan Africa (SSA) countries is currently undergoing demographic and epidemiological transitions which are shown by an increase in chronic non-communicable diseases (NCDs) and their associated risk factors. The aim of this study was to examine the prevalence of and factors associated with hypertension, diabetes and stroke/heart attack multimorbidity in Botswana. The definition of multimorbidity used in this study is the presence of two or more NCDs in an individual. Methods This study used secondary data derived from the Botswana WHO STEPS 2014 survey. The survey employed a nationally representative multi-stage sampling design. The study sample consisted of 3527 respondents aged 20–69 years of age who had successfully completed the questionnaire and met the inclusion criteria. Multivariable logistic regression analyses were used to assess factors associated with multimorbidity. All comparisons were considered to be statistically significant at 5% level. Statistical tests were performed using Statistical Package for Social Sciences (SPSS) version 25. Results Prevalence of hypertension, diabetes and stroke/heart attack multimorbidity was estimated to be at 3.5% in the sampled population. The odds of reporting multimorbidity were highest among females (AOR = 9.73, 95% CI = 8.30–11.42) than males and among respondents aged 35–49 (AOR = 1.20, 95% C.I. = 1.10–1.31) and 50–69 years (AOR = 1.52, 95% C.I. = 1.23–1.67) than individuals aged 20–24 years. Moreover, the odds of multimorbidity were significantly higher among married (AOR = 15.92, 95% C.I. = 13.40–18.92) and living together (AOR = 6.68, 95% C.I. = 5.72–7.81) couples; and individuals who reported that they earn an average annual household income of BWP ≥20 000 (AOR = 2.25, 95% CI = 1.84–2.75) compared to their counterparts. Behavioural risk factors significantly associated with higher odds of multimorbidity were obesity (AOR = 6.79, 95% C.I. = 6.20–7.90), physical inactivity (AOR = 4.41, 95% C.I. = 3.65–5.31) and hazardous alcohol consumption (AOR = 1.49, 95% CI = 1.23–1.81). On the other hand the odds of reporting multimorbidity were significantly low among individuals with sufficient consumption of fruits and vegetables (AOR = 0.47, 95% C.I. = 0.39–0.56) and non-tobacco users (AOR = 0.58, 95% CI = 0.49–0.68). Conclusion Multimorbidity was more common among females, the elderly people and was associated with obesity, poor fruit and vegetable intake, and tobacco use. Strategies to combat NCDs and multimorbidity should be aimed to target early stages of life since behavioural factors and lifestyles that increase the likelihood of disease are entrenched in earlier stages of life.
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15
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The high-intensity interval training introduced in physical education lessons decrease systole in high blood pressure adolescents. Sci Rep 2022; 12:1974. [PMID: 35132123 PMCID: PMC8821617 DOI: 10.1038/s41598-022-06017-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 01/19/2022] [Indexed: 11/25/2022] Open
Abstract
Increased resting blood pressure (BP) is a risk factor for many health complications. The prevalence of elevated BP is growing among adolescents. There is a need to investigate effective ways of decreasing excessive blood pressure in this age group. The study aim was to determine the effect of 10-weeks High-Intensive Interval Training (HIIT)—Tabata protocol—introduced in physical education (PE) lessons on resting blood pressure in adolescents. The sample included 52 boys aged 16.23 ± 0.33 years body height176.74 ± 6.07 (m), body weight 65.42 ± 12.51 (kg), BMI 20.89 ± 3.53 (kg/m2) and 89 girls aged 16.12 ± 0.42 years, body height 164.38 ± 6.54 (m), body weight 56.71 ± 10.23 (kg), BMI 20.93 ± 3.08 (kg/m2) from secondary school. Based on resting BP, the fractions of boys and girls with normal BP and high BP were identified and divided into experimental (EG) and control (CG) groups. EG completed a 10-weeks HIIT program (three cycles of Tabata protocol) implemented in one PE lesson during a week. The duration of the effort was 14 min. The intensity was at 75–80% of maximal heart rate. Changes in systolic and diastolic BP after the experiment were examined. The results indicated the improvement in SBP in EG with high BP compared to the rest of the groups (average reduction of 12.77 mmHg; p < 0.0001). The EG normotensive had a statistically significant higher reduction of SBP comparing CG normotensive (average decrease of 1.81 mmHG; p = 0.0089). HIIT effectively decreases BP in adolescents. Implementing HIIT in PE lessons in secondary school is recommended to improve BP parameters.
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Yang J, Tan H, Sun M, Chen R, Zhang J, Liu C, Yang Y, Ding X, Yu S, Gu W, Ke J, Shen Y, Zhang C, Gao X, Li C, Huang L. Prediction of High-Altitude Cardiorespiratory Fitness Impairment Using a Combination of Physiological Parameters During Exercise at Sea Level and Genetic Information in an Integrated Risk Model. Front Cardiovasc Med 2022; 8:719776. [PMID: 35071338 PMCID: PMC8782201 DOI: 10.3389/fcvm.2021.719776] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/30/2021] [Indexed: 11/25/2022] Open
Abstract
Insufficient cardiorespiratory compensation is closely associated with acute hypoxic symptoms and high-altitude (HA) cardiovascular events. To avoid such adverse events, predicting HA cardiorespiratory fitness impairment (HA-CRFi) is clinically important. However, to date, there is insufficient information regarding the prediction of HA-CRFi. In this study, we aimed to formulate a protocol to predict individuals at risk of HA-CRFi. We recruited 246 volunteers who were transported to Lhasa (HA, 3,700 m) from Chengdu (the sea level [SL], <500 m) through an airplane. Physiological parameters at rest and during post-submaximal exercise, as well as cardiorespiratory fitness at HA and SL, were measured. Logistic regression and receiver operating characteristic (ROC) curve analyses were employed to predict HA-CRFi. We analyzed 66 pulmonary vascular function and hypoxia-inducible factor- (HIF-) related polymorphisms associated with HA-CRFi. To increase the prediction accuracy, we used a combination model including physiological parameters and genetic information to predict HA-CRFi. The oxygen saturation (SpO2) of post-submaximal exercise at SL and EPAS1 rs13419896-A and EGLN1 rs508618-G variants were associated with HA-CRFi (SpO2, area under the curve (AUC) = 0.736, cutoff = 95.5%, p < 0.001; EPAS1 A and EGLN1 G, odds ratio [OR] = 12.02, 95% CI = 4.84–29.85, p < 0.001). A combination model including the two risk factors—post-submaximal exercise SpO2 at SL of <95.5% and the presence of EPAS1 rs13419896-A and EGLN1 rs508618-G variants—was significantly more effective and accurate in predicting HA-CRFi (OR = 19.62, 95% CI = 6.42–59.94, p < 0.001). Our study employed a combination of genetic information and the physiological parameters of post-submaximal exercise at SL to predict HA-CRFi. Based on the optimized prediction model, our findings could identify individuals at a high risk of HA-CRFi in an early stage and reduce cardiovascular events.
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Affiliation(s)
- Jie Yang
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Hu Tan
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Mengjia Sun
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Renzheng Chen
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jihang Zhang
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chuan Liu
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yuanqi Yang
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xiaohan Ding
- Department of Health Care and Geriatrics, The 940th Hospital of Joint Logistics Support Force of PLA, Lanzhou, China
| | - Shiyong Yu
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Wenzhu Gu
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Jingbin Ke
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Yang Shen
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chen Zhang
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Xubin Gao
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Chun Li
- Department of Ultrasound, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Lan Huang
- Department of Cardiology, The Second Affiliated Hospital, Third Military Medical University (Army Medical University), Chongqing, China
- *Correspondence: Lan Huang
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Shin J, Hong SG, Choi SY, Rath ME, Saredy J, Jovin DG, Sayoc J, Park HS, Eguchi S, Rizzo V, Scalia R, Wang H, Houser SR, Park JY. Flow-induced endothelial mitochondrial remodeling mitigates mitochondrial reactive oxygen species production and promotes mitochondrial DNA integrity in a p53-dependent manner. Redox Biol 2022; 50:102252. [PMID: 35121402 PMCID: PMC8818582 DOI: 10.1016/j.redox.2022.102252] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 01/25/2022] [Accepted: 01/26/2022] [Indexed: 12/12/2022] Open
Abstract
Tumor suppressor p53 plays a pivotal role in orchestrating mitochondrial remodeling by regulating their content, fusion/fission processes, and intracellular signaling molecules that are associated with mitophagy and apoptosis pathways. In order to determine a molecular mechanism underlying flow-mediated mitochondrial remodeling in endothelial cells, we examined, herein, the role of p53 on mitochondrial adaptations to physiological flow and its relevance to vascular function using endothelial cell-specific p53 deficient mice. We observed no changes in aerobic capacity, basal blood pressure, or endothelial mitochondrial phenotypes in the endothelial p53 mull animals. However, after 7 weeks of voluntary wheel running exercise, blood pressure reduction and endothelial mitochondrial remodeling (biogenesis, elongation, and mtDNA replication) were substantially blunted in endothelial p53 null animals compared to the wild-type, subjected to angiotensin II-induced hypertension. In addition, endothelial mtDNA lesions were significantly reduced following voluntary running exercise in wild-type mice, but not in the endothelial p53 null mice. Moreover, in vitro studies demonstrated that unidirectional laminar flow exposure significantly increased key putative regulators for mitochondrial remodeling and reduced mitochondrial reactive oxygen species generation and mtDNA damage in a p53-dependent manner. Mechanistically, unidirectional laminar flow instigated translocalization of p53 into the mitochondrial matrix where it binds to mitochondrial transcription factor A, TFAM, resulting in improving mtDNA integrity. Taken together, our findings suggest that p53 plays an integral role in mitochondrial remodeling under physiological flow condition and the flow-induced p53-TFAM axis may be a novel molecular intersection for enhancing mitochondrial homeostasis in endothelial cells.
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Ezzatvar Y, Izquierdo M, Núñez J, Calatayud J, Ramírez-Vélez R, García-Hermoso A. Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2021; 10:609-619. [PMID: 34198003 PMCID: PMC8724619 DOI: 10.1016/j.jshs.2021.06.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 05/13/2021] [Accepted: 05/24/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Cardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association. METHODS We searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses. RESULTS Data were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28-0.61) and 0.27 (95%CI: 0.16-0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74-0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48-1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26-0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76-0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36-1.32). CONCLUSION A better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population.
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Affiliation(s)
- Yasmin Ezzatvar
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, Universitat de València, Valencia 46010, Spain
| | - Mikel Izquierdo
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Navarra Medical Research Institute (IdiSNA), Pamplona 31008, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Julio Núñez
- Department of Cardiology, Valencia University Hospital, Biomedical Research Institute (INCLIVA), Valencia 46010, Spain; CIBER in Cardiovascular Diseases (CIBERCV), Madrid 28029, Spain
| | - Joaquín Calatayud
- Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, Universitat de València, Valencia 46010, Spain
| | - Robinson Ramírez-Vélez
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Navarra Medical Research Institute (IdiSNA), Pamplona 31008, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid 28029, Spain
| | - Antonio García-Hermoso
- Navarrabiomed, Navarra Hospital Complex (CHN), Public University of Navarra (UPNA), Navarra Medical Research Institute (IdiSNA), Pamplona 31008, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Instituto de Salud Carlos III, Madrid 28029, Spain; Sciences of Physical Activity, Sports and Health School, University of Santiago of Chile (USACH), Santiago 71783-5, Chile.
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19
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Comparison of Fitness and Physical Activity Levels of Obese People with Hypertension. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app112110330] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
This study assessed the relationships between the current level of physical activity (PA) and PA in childhood and the level of physical fitness (PF) of obese people aged 40+ with co-existing hypertension (HT). The study included 82 obese patients with co-existing HT in their history. In order to assess the level of PA, we used the IPAQ. PF was assessed by observing the performance of patients in a fitness test (a 30-s chair stand, a handgrip strength test, a sit-and-reach test, a one leg stand test, a plank test, a wall squat test, and a 2-min step-in-place test). According to the IPAQ category, 24.4% were classified as having a high level of PA, 45.1% a sufficient level of PA, and 30.5% an insufficient level of PA. We noted that the higher the level of PA, the higher the PF—even in obese participants with HT. On the other hand, co-existing diabetes lowered almost all analysed parameters, both biochemical and fitness. The current PA level, a deficiency in which seems to be related to low PF and/or HT, does seem to be related to the degree of PF.
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20
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Association of Primary Hypertension and Risk of Cerebrovascular Diseases with Overweight and Physical Activity in Korean Women: A Longitudinal Study. Healthcare (Basel) 2021; 9:healthcare9091093. [PMID: 34574867 PMCID: PMC8465631 DOI: 10.3390/healthcare9091093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Cerebrovascular diseases include stroke, intracranial stenosis, aneurysms, and vascular malformations; primary hypertension is typically associated with cerebrovascular disease. The incidence of these diseases is higher in men than in women, and low physical activity and obesity are known to increase the risk of cerebrovascular disease. This study aimed to longitudinally analyze the adjusted relative risk (ARR) of primary hypertension and cerebrovascular diseases, in relation to body mass index (BMI) and physical activity (PA), in Korean women. The study retrieved the data of 1,464,377 adult Korean women (aged 50–79 years), who participated in the national health screening program from 2002 to 2003. The participants had no history of primary hypertension or cerebrovascular diseases, and were followed up by the International Statistical Classification of Diseases and Related Health Problems (ICD) until 2013. The participants were divided into the following groups: normal weight (18.5–24.9), overweight (25.0–29.9), and obese (≥30.0) kg/m2, based on the World Health Organization (WHO) classification. The frequency of PA (days) was determined using a physical activity questionnaire, and defined as low (0–2), medium (3–4), and high (5–7) days. The RR was calculated using Cox regression. Three models were created based on the adjusted variables. The ARR for hypertension was 0.933 (95% CI; 0.920–0.955, p < 0.001) in obese patients with medium PA. Primary hypertension was lower (ARR: 0.943; 95% CI; 0.928–0.961, p < 0.001) in overweight participants with medium PA, than in those with low PA. The incidence of cerebrovascular disease was lower in overweight individuals with medium PA (ARR: 0.945, 95% CI; 0.925–0.976, p < 0.001), than in those with low PA. The risk of cerebrovascular disease was reduced in normal-weight participants with medium PA (ARR: 0.889; 95% CI: 0.854–0.919; p < 0.001), than in those with high PA (ARR 0.913; 95% CI; 0.889–0.953, p < 0.001). In the obese group, there was no significant difference in the risk of cerebrovascular disease, based on the frequency of PA. In conclusion, the relative risk of primary hypertension in women was lower with moderate activity than with low activity, in the normal-weight and overweight groups. The relative risk of cerebrovascular disease was lower in the participants with moderate and high activity than in those with low activity, even at normal weight. In obese individuals, moderate and high activity reduced cerebrovascular disease compared to low activity. Therefore, regardless of obesity, PA may contribute to the prevention of primary hypertension and cerebrovascular disease in adult women.
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Schumann M, Chen Z, Wang X, Le S, Zhang T, Waller K, Cheng S. Maximal isometric strength indices are associated with the oxygen cost of walking and running in recreationally active men and women. Res Sports Med 2021; 30:540-553. [PMID: 33870810 DOI: 10.1080/15438627.2021.1917404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study assessed the associations of maximal isometric strength and movement economy in 126 recreationally active men and women. Oxygen consumption was assessed through a graded treadmill test with 4-minute increments (4-12 km∙h-1). Maximal isometric leg extensor, leg flexor and handgrip strength were assessed by isometric dynamometry. Models of best fit for gross oxygen cost and gross caloric unit cost were observed across the majority of velocities when the leg extensor/flexor strength ratio and handgrip strength were combined (R2 = 0.207-0.525 and R2 = 0.152-0.475, respectively). Additionally, the oxygen cost differed statistically for the majority of velocities when participants were split by the median of leg extensor strength (12.3-26.3 ml∙kg-1∙km-1, p < 0.05) and the average of all strength variables (13.9-30.3 ml∙kg-1∙km-1, p < 0.05). Our data underline the importance of maintaining maximal strength in order to perform activities with low to moderate oxygen demands.
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Affiliation(s)
- Moritz Schumann
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University, Cologne, Germany.,Exercise Translational Center, the Key Laboratory of Systems Biomedicine, Ministry of Education, Shanghai Jiao Tong University, China
| | - Ziyuan Chen
- Exercise, Health and Technology Center, Faculty of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Xiuqiang Wang
- Exercise, Health and Technology Center, Faculty of Physical Education, Shanghai Jiao Tong University, Shanghai, China
| | - Shenglong Le
- Exercise, Health and Technology Center, Faculty of Physical Education, Shanghai Jiao Tong University, Shanghai, China.,Faculty of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Tao Zhang
- Exercise Translational Center, the Key Laboratory of Systems Biomedicine, Ministry of Education, Shanghai Jiao Tong University, China
| | - Katja Waller
- Faculty of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Sulin Cheng
- Institute of Cardiovascular Research and Sports Medicine, Department of Molecular and Cellular Sports Medicine, German Sport University, Cologne, Germany.,Exercise Translational Center, the Key Laboratory of Systems Biomedicine, Ministry of Education, Shanghai Jiao Tong University, China.,Exercise, Health and Technology Center, Faculty of Physical Education, Shanghai Jiao Tong University, Shanghai, China.,Faculty of Sport Sciences, University of Jyväskylä, Jyväskylä, Finland
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Kasović M, Štefan L, Petrić V, Štemberger V, Blažević I. Functional endurance capacity is associated with multiple other physical fitness components in 7-14-year-olds: a cross-sectional study. BMC Public Health 2021; 21:669. [PMID: 33827500 PMCID: PMC8028765 DOI: 10.1186/s12889-021-10702-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/24/2021] [Indexed: 12/23/2022] Open
Abstract
Background Although evidence suggests that functional endurance capacity is the most important component associated with future health, little is known of how it is associated with multiple other physical fitness components. Since various physical fitness aspects do not change the same as functional endurance capacity during childhood, it is necessary to establish possible associations between functional endurance capacity and other physical fitness components in children. Therefore, the main purpose of the study was to test the associations between functional endurance capacity with other physical fitness components in 7–14-year-old children, stratified by gender. Methods In this cross-sectional study, we recruited 1612 children [mean age ± standard deviation (SD) = 9.72 ± 2.37 years; 52.5% girls). Health-related physical fitness components included: 1) body-mass index (kg/m2) calculated from height and weight (measure of body size), 2) sit-and-reach test (measure of flexibility), 3) standing broad jump (measure of explosive strength of lower extremities), 4) sit-ups in 30 s (measure of repetitive strength of the trunk), 5) 10 × 5 shuttle run test (measure of agility) and 6) 20-m shuttle run test (measure of functional endurance capacity). The associations were performed using generalized estimating equations with beta (β) coefficients. Results After adjusting for age, functional endurance capacity was associated with sit-and-reach test (β = 0.13, p < 0.001), standing broad jump (β = 0.59, p < 0.001), sit-ups in 30 s (β = 0.53, p < 0.001) and 10 × 5 shuttle run test (β = − 0.56, p < 0.001) in boys. In girls, functional endurance capacity was associated with body-mass index (β = − 0.12, p < 0.001), sit-and-reach test (β = 0.21, p < 0.001), standing broad jump (β = 0.25, p < 0.001), sit-ups in 30 s (β = 0.36, p < 0.001) and 10 × 5 shuttle run test (β = − 0.40, p < 0.001). No significant associations between functional endurance capacity and body-mass index in boys were observed. Conclusions Although significant, functional endurance capacity is weakly to moderately associated with other physical fitness components, pointing out that such measure should be tested separately from other aspects of physical fitness in school-aged children.
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Affiliation(s)
- Mario Kasović
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, Zagreb, Croatia.,Department of Sport Motorics and Methodology in Kinanthropology, Faculty of Sports Studies, Masaryk University, Brno, Czech Republic
| | - Lovro Štefan
- Department of General and Applied Kinesiology, Faculty of Kinesiology, University of Zagreb, Horvaćanski zavoj 15, Zagreb, Croatia.
| | - Vilko Petrić
- Department of Educational Studies, Faculty of Teacher Education, University of Rijeka, Rijeka, Croatia
| | - Vesna Štemberger
- Department of Primary Teacher Education, Faculty of Education, University of Ljubljana, Ljubljana, Slovenia
| | - Iva Blažević
- Department of Primary Teacher Education, Faculty of Educational Sciences, University of Pula, Pula, Croatia
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23
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Akpa OM, Okekunle AP, Ovbiagele B, Sarfo FS, Akinyemi RO, Akpalu A, Wahab KW, Komolafe M, Obiako R, Owolabi LF, Ogbole G, Fawale B, Fakunle A, Asaleye CM, Akisanya CO, Hamisu DA, Ogunjimi L, Adeoye A, Ogah O, Lackland D, Uvere EO, Faniyan MM, Asowata OJ, Adeleye O, Aridegbe M, Olunuga T, Yahaya IS, Olaleye A, Calys-Tagoe B, Owolabi MO. Factors associated with hypertension among stroke-free indigenous Africans: Findings from the SIREN study. J Clin Hypertens (Greenwich) 2021; 23:773-784. [PMID: 33484599 PMCID: PMC8263562 DOI: 10.1111/jch.14183] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/24/2020] [Accepted: 01/03/2021] [Indexed: 01/14/2023]
Abstract
Hypertension is one of the most important risk factors for stroke and cardiovascular diseases (CVD) globally. Understanding risk factors for hypertension among individuals with matching characteristics with stroke patients may inform primordial/primary prevention of hypertension and stroke among them. This study identified the risk factors for hypertension among community-dwelling stroke-free population in Ghana and Nigeria. Data for 4267 community-dwelling stroke-free controls subjects in the Stroke Investigative Research and Education Network (SIREN) study in Nigeria and Ghana were used. Participants were comprehensively assessed for sociodemographic, lifestyle and metabolic factors using standard methods. Hypertension was defined as a previous diagnosis by a health professional or use of an anti-hypertensive drug or mean systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg. Logistic regression analysis was used to estimate adjusted odds ratios (aOR) of hypertension and their 95% confidence intervals (CI) at p < .05. Overall, 56.7% of the participants were hypertensive with a higher proportion among respondents aged ≥60 years (53.0%). Factors including physical inactivity (aOR: 9.09; 95% CI: 4.03 to 20.53, p < .0001), diabetes (aOR: 2.70; CI: 1.91 to 3.82, p < .0001), being ≥60 years (aOR: 2.22; 95% CI: 1.78 to 2.77, p < .0001), and family history of CVD (aOR 2.02; CI: 1.59 to 2.56, p < .0001) were associated with increased aOR of hypertension. Lifestyle factors were associated with hypertension in the current population of community-dwelling stroke-free controls in west Africa. Community-oriented interventions to address sedentary lifestyles may benefit this population and reduce/prevent hypertension and stroke among them.
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Affiliation(s)
- Onoja M Akpa
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Preventive Cardiology Research Unit, Institute of Cardiovascular Diseases, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akinkunmi P Okekunle
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria.,The Postgraduate College, University of Ibadan, Ibadan, Nigeria
| | - Bruce Ovbiagele
- School of Medicine, Weill Institute for Neurosciences, University of California, San-Francisco, CA, USA
| | - Fred S Sarfo
- Department of Medicine, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Rufus O Akinyemi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria.,Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Albert Akpalu
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Kolawole W Wahab
- Department of Medicine, University of Ilorin Teaching Hospital, Ilorin, Nigeria
| | - Morenikeji Komolafe
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Lukman F Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Godwin Ogbole
- Department of Radiology, University of Ibadan, Ibadan, Nigeria
| | - Bimbo Fawale
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | - Adekunle Fakunle
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Christianah M Asaleye
- Department of Medicine, Obafemi Awolowo University Teaching Hospital, Ile-Ife, Nigeria
| | | | | | - Luqman Ogunjimi
- Department of Pharmacology and Therapeutics, Obafemi Awolowo College of Health Sciences, Olabisi Onabanjo University, Shagamu, Nigeria
| | - Abiodun Adeoye
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Okechukwu Ogah
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Dan Lackland
- Medical University of South Carolina, Charleston, SC, USA
| | - Ezinne O Uvere
- Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Osahon J Asowata
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | | | - Mayowa Aridegbe
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Taiwo Olunuga
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Isah S Yahaya
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Adeniji Olaleye
- Department of Medicine, Federal Medical Centre, Abeokuta, Nigeria
| | - Benedict Calys-Tagoe
- Department of Community Health, University of Ghana Medical School, Accra, Ghana
| | - Mayowa O Owolabi
- Center for Genomic and Precision Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria.,Department of Medicine, College of Medicine, University of Ibadan, Ibadan, Nigeria
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24
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Menyanu EK, Corso B, Minicuci N, Rocco I, Russell JC, Ware LJ, Chidumwa G, Naidoo NN, Biritwum RB, Kowal PR, Schutte AE, Charlton KE. Determinants of change in blood pressure in Ghana: Longitudinal data from WHO-SAGE Waves 1-3. PLoS One 2021; 16:e0244807. [PMID: 33417616 PMCID: PMC7793275 DOI: 10.1371/journal.pone.0244807] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 12/16/2020] [Indexed: 01/19/2023] Open
Abstract
The prevalence of hypertension is increasing in low- and middle-income countries, however statistics are generally derived from cross sectional surveys that utilize different methodologies and population samples. We investigated blood pressure (BP) changes over 11-12 years in a large cohort of adults aged 50 years and older (n = 820) included in the World Health Organization's Study on global AGEing and adult health (WHO-SAGE Ghana) Wave 1 (2007/8) with follow up in Wave 3 (2019). Participants' BP were measured in triplicate and a survey completed at both time points. Survey instruments collected information on sociodemographic characteristics, lifestyle, health behaviors and chronic conditions. While no significant difference was found in systolic BP between Waves 1 and 3, diastolic BP decreased by 9.7mmHg (mean = 88.6, 15.4 to 78.9, 13.6 respectively) and pulse pressure increased by 9.5mmHg (44.8, 13.7 to 54.3, 14.1). Awareness of hypertension increased by 37%, from (20% to 57%), but no differences were found for the proportion of hypertensives receiving treatment nor those that had controlled BP. Mixed effects modelling showed a decrease in diastolic BP was associated with increasing age, living in rural areas and having health insurance. Factors associated with an increased awareness of hypertension were residing in urban areas, having health insurance and increasing body mass index. While diagnosis of hypertension has improved over time in Ghana, there is an ongoing need to improve its treatment in older adults.
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Affiliation(s)
- Elias K. Menyanu
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Barbara Corso
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Nadia Minicuci
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Ilaria Rocco
- Neuroscience Institute, National Research Council, Padova, Italy
| | - Joanna C. Russell
- School of Health and Society, Faculty of Social Sciences, University of Wollongong, Wollongong, New South Wales, Australia
| | - Lisa J. Ware
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Glory Chidumwa
- SAMRC/Wits Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
- Department of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Nirmala N. Naidoo
- World Health Organization Data, Analytics and Delivery for Impact Division, Geneva, Switzerland
| | | | - Paul R. Kowal
- Chiang Mai University Research Institute for Health Sciences, Chiang Mai, Thailand
- World Health Organization SAGE, Geneva, Switzerland
| | - Aletta E. Schutte
- School of Public Health and Community Medicine, The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Karen E. Charlton
- School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
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25
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Trends in cardiorespiratory fitness among apparently healthy adults from the Ball State Adult Fitness Longitudinal Lifestyle STudy (BALL ST) cohort from 1970-2019. PLoS One 2020; 15:e0242995. [PMID: 33259526 PMCID: PMC7707578 DOI: 10.1371/journal.pone.0242995] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 11/12/2020] [Indexed: 12/19/2022] Open
Abstract
Introduction Cardiorespiratory fitness (CRF) is a strong independent predictor of cardiovascular disease (CVD) and CVD mortality. However, little is known in regards to how CRF has trended in apparently healthy adults over the past several decades. Purpose To analyze trends in CRF and CVD risk factors over the last 50 years in a population of apparently healthy adult men and women. Methods Participants were 4,214 apparently healthy adults (2,390 men and 1,824 women) from the Ball State Adult Fitness Longitudinal Lifestyle STudy (BALL ST) that performed maximal cardiopulmonary exercise testing between 1970–2019 for the assessment of CRF defined as VO2max (ml/kg/min). Participants were self-referred either to a community-based exercise program, fitness testing, or were research subjects in exercise related studies and were placed into groups by decade based on testing date. Results CRF showed a general trend to decline (P<0.05) from the 1970s to the 2000s with an increase (P<0.05) from the 2000s to the 2010s for both men and women. This pattern persisted for age and sex-adjusted CRF level, determined by Fitness Registry and the Importance of Exercise: A National Data Base (FRIEND). For both women and men, CRF across the decades was associated (P<0.05) with the prevalence of physical inactivity, smoking, obesity, dyslipidemia and hypertension, and with diabetes in men only. Conclusion CRF declined from 1970 through the 2000s in a cohort of apparently healthy men and women which was associated with worsening CVD risk profiles. However, the decline in CRF was attenuated over the past decade which may have a positive impact on future CVD in the population. Promoting physical activity to increase CRF should be a primary aspect of CVD prevention programs.
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26
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Fardman A, Banschick GD, Rabia R, Percik R, Fourey D, Segev S, Klempfner R, Grossman E, Maor E. Cardiorespiratory fitness and survival following cancer diagnosis. Eur J Prev Cardiol 2020; 28:1242-1249. [PMID: 34551084 DOI: 10.1177/2047487320930873] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 05/11/2020] [Indexed: 12/20/2022]
Abstract
Abstract
Aims
Data on the association of cardiorespiratory fitness with survival of cancer patients are limited. This study aimed to evaluate the association between midlife cardiorespiratory fitness and survival after a subsequent cancer diagnosis.
Methods
We evaluated 19,134 asymptomatic self-referred adults who were screened in preventive healthcare settings. All subjects were free of cardiovascular disease and cancer at baseline and completed a maximal exercise stress test. Fitness was categorised into age-specific and sex-specific quintiles according to the treadmill time and dichotomised to low (quintiles 1–2) and high fitness groups.
Results
The mean age was 50 ± 8 years and 72% were men. During a median follow-up of 13 years (interquartile range 7–16) 517 (3%) died. Overall, 1455 (7.6%) subjects developed cancer with a median time to cancer diagnosis of 6.4 years (interquartile range 3–10). Death from the time of cancer diagnosis was significantly lower among the high fitness group (Plog rank = 0.03). Time-dependent analysis showed that subjects who developed cancer during follow-up were more likely to die (P < 0.001). The association of cancer with survival was fitness dependent such that in the lower fitness group cancer was associated with a higher risk of death, whereas among the high fitness group the risk of death was lower (hazard ratio 20 vs. 15; Pfor interaction = 0.047). The effect modification persisted after applying a 4-year blanking period between fitness assessment and cancer diagnosis (Pfor interaction = 0.003).
Conclusion
Higher midlife cardiorespiratory fitness is associated with better survival among cancer patients. Our findings support fitness assessment in preventive healthcare settings.
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Affiliation(s)
| | | | - Razi Rabia
- Sackler School of Medicine, Tel-Aviv University, Israel
| | - Ruth Percik
- Sackler School of Medicine, Tel-Aviv University, Israel
- Institute of Endocrinology, Chaim Sheba Medical Center, Israel, Leviev Heart Center, Chaim Sheba Medical Center, Israel
| | - Dana Fourey
- Sackler School of Medicine, Tel-Aviv University, Israel
- Institute of Endocrinology, Chaim Sheba Medical Center, Israel, Leviev Heart Center, Chaim Sheba Medical Center, Israel
| | - Shlomo Segev
- Sackler School of Medicine, Tel-Aviv University, Israel
- Institute for Medical Screening, Chaim Sheba Medical Center, Israel
| | - Robert Klempfner
- Sackler School of Medicine, Tel-Aviv University, Israel
- Institute of Endocrinology, Chaim Sheba Medical Center, Israel, Leviev Heart Center, Chaim Sheba Medical Center, Israel
| | - Ehud Grossman
- Sackler School of Medicine, Tel-Aviv University, Israel
| | - Elad Maor
- Sackler School of Medicine, Tel-Aviv University, Israel
- Institute of Endocrinology, Chaim Sheba Medical Center, Israel, Leviev Heart Center, Chaim Sheba Medical Center, Israel
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27
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Fardman A, Banschick GD, Rabia R, Percik R, Segev S, Klempfner R, Grossman E, Maor E. Cardiorespiratory Fitness Is an Independent Predictor of Cardiovascular Morbidity and Mortality and Improves Accuracy of Prediction Models. Can J Cardiol 2020; 37:241-250. [PMID: 32428619 DOI: 10.1016/j.cjca.2020.05.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/06/2020] [Accepted: 05/06/2020] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Although cardiorespiratory fitness (CRF) is a strong independent predictor of adverse cardiovascular outcomes, it is not considered as a risk enhancer by current guidelines. METHODS We evaluated asymptomatic self-referred adults aged 40 to 79 years of age, free of cardiovascular disease at baseline, who were screened annually and completed baseline exercise stress test. Baseline CRF was dichotomized into 2 groups: low (metabolic equivalents < 8) and high. The primary endpoint was the composite of death, nonfatal acute coronary syndrome, and stroke after excluding subjects diagnosed with metastatic cancer during follow-up. RESULTS Study population included 15,445 subjects with median age of 49 years (interquartile range: 44-55). During median follow-up of 8 years 1362 (9%) subjects developed the study endpoint. Kaplan-Meier survival analysis showed that both fitness and atherosclerotic cardiovascular disease (ASCVD) were associated with developing of the study endpoint (P < 0.001 for both). Cox regression model with adjustment for ASCVD risk consistently showed that lower fitness was associated with a significant 23% higher risk to develop the study endpoint (P = 0.001). Continuous net reclassification improvement analysis showed an overall improvement of 11.4% (95% confidence interval, 8%-14.6%; P value < 0.001) in the accuracy of classification when fitness was added to the ASCVD model. CONCLUSIONS Low CRF is a strong independent predictor of the cardiovascular morbidity and mortality in asymptomatic adults. Addition of fitness to the pooled cohort ASCVD risk significantly improves the accuracy of the model.
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Affiliation(s)
- Alexander Fardman
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Razi Rabia
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Ruth Percik
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Institute of Endocrinology, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Shlomo Segev
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel; Institute for Medical Screening, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Robert Klempfner
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Institute for Medical Screening, Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Ehud Grossman
- Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elad Maor
- Leviev Heart Center, Chaim Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
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28
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Physical Exercise as an Immunomodulator of Chronic Diseases in Aging. J Phys Act Health 2020; 17:662-672. [PMID: 32396868 DOI: 10.1123/jpah.2019-0237] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 02/24/2020] [Accepted: 03/20/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND The progressive dysfunction of the immune system during aging appears to be involved in the pathogenesis of several age-related disorders. However, regular physical exercise can present "antiaging" effects on several physiological systems. METHODS A narrative review of studies investigating the chronic effects of exercise and physical activity on the immune system and its association with age-related chronic diseases was carried out according to the guidelines for writing a narrative review. RESULTS There is compelling evidence suggesting that age-related immune system alterations play a key role on the pathophysiology of atherosclerosis, hypertension, chronic heart failure, type 2 diabetes, obesity, arthritis, and chronic obstructive pulmonary disease. On the other hand, the regular practice of physical activity appears to improve most of the inflammatory/immunological processes involved in these diseases. CONCLUSION Epidemiological, experimental, and clinical studies permit us to affirm that regular physical activity improves immunomodulation and may play a key role in the prevention and treatment of several age-related chronic diseases. However, further studies are needed to better describe the prophylactic and therapeutic effects of physical exercise in specific organs of older individuals, as well as the mechanisms involved in such response.
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Andersen K, Hållmarker U, James S, Sundström J. Long-Distance Skiing and Incidence of Hypertension: A Cohort Study of 206 889 Participants in a Long-Distance Cross-Country Skiing Event. Circulation 2020; 141:743-750. [PMID: 31902224 DOI: 10.1161/circulationaha.119.042208] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Hypertension is the leading risk factor for death worldwide, and high levels of physical activity are associated with a lower incidence of hypertension. The associations of excessive levels of exercise and incidence of hypertension are less well known. We aim to compare the incidence of hypertension among 206 889 participants in a long-distance cross-country skiing event and 505 542 people randomly sampled from the general population (matched to the skiers on age, sex, and place of residence). METHODS Skiers' best performance (in percent of winning time) and number of completed races during the study period were associated with incidence of hypertension after participation in Vasaloppet. Hypertension was defined as prescription of blood pressure-lowering drugs as obtained from the national drug registry. Models were adjusted for sex, age, education, and income (total effect). RESULTS During a median time of risk of 8.3 years, skiers had a lower incidence of hypertension compared with nonskiers (hazard ratio [HR], 0.59 [95% CI, 0.58-0.60]). Among the skiers, better performance (in percent of winning time) in Vasaloppet was strongly associated with a lower incidence of hypertension (fastest fifth: HR, 0.41 [95% CI, 0.39-0.42]; slowest fifth: HR, 0.78 [95% CI, 0.75-0.81]). The association was nearly linear and did not differ between sexes. Among the skiers, a weaker association was seen between the number of completed races during the study period and the incidence of hypertension (1 race: HR, 0.63 [95% CI, 0.62-0.65]; >5 races: HR, 0.51 [95% CI, 0.50-0.53]). A subanalysis of 10 804 participants including adjustment for lifestyle factors showed similar results. CONCLUSIONS Participation in a long-distance skiing event was associated with a 41% lower incidence of hypertension over the next 8 years compared with nonparticipation. A near linear association between performance and incidence of hypertension was observed. This adds to the list of beneficial effects of intensive training, because hypertension is the leading risk factor of premature death globally.
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Affiliation(s)
- Kasper Andersen
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (K.A., U.H., S.J., J.S.)
| | - Ulf Hållmarker
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (K.A., U.H., S.J., J.S.).,Department of Internal Medicine, Mora Hospital, Sweden (U.H.)
| | - Stefan James
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (K.A., U.H., S.J., J.S.)
| | - Johan Sundström
- Department of Medical Sciences and Uppsala Clinical Research Center, Uppsala University, Sweden (K.A., U.H., S.J., J.S.)
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30
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Analysis of Association of Occupational Physical Activity, Leisure-Time Physical Activity, and Sedentary Lifestyle with Hypertension according to the Adherence with Aerobic Activity in Women Using Korea National Health and Nutrition Examination Survey 2016-2017 Data. Int J Hypertens 2020; 2020:8943492. [PMID: 32110448 PMCID: PMC7042501 DOI: 10.1155/2020/8943492] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 11/07/2019] [Accepted: 01/10/2020] [Indexed: 01/02/2023] Open
Abstract
Purpose We investigated the association between occupational physical activity, leisure-time physical activity, and sedentary lifestyle with hypertension by adherence with aerobic exercise in middle-aged and elderly women. Methods A cross-sectional analysis was performed using Korea National Health and Nutrition Examination Survey (KNHANES), a nationally representative data between 2016 and 2017. A total of 4,241 women aged 40 years or older were included. Hypertension diagnosed by physician and exercise status was asked by questionnaires. Results Mean age of the participants was 58.4 (±11.4, range: 40∼80 years). There were 1,681 (39.6%) women in the aerobic activity adherence group. In the logistic regression analysis with adjustment for confounding factors, frequency of occupational physical activity (OPA) level (OR 1.931; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; p=0.048, in ≤4 per week group), walking frequency (OR 0.436; Conclusions In the aerobic activity adherence group, further research is needed to identify the influence of occupational physical activity. In the aerobic activity nonadherence group, decreasing sitting hours and increasing endurance exercise may be helpful.
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Abstract
Hypertension is a fatal yet preventable risk factor for cardiovascular disease and is responsible for majority of cardiovascular mortality. Hypertension is closely associated with inactive lifestyle. Physical activity and/or exercise are shown to delay development of hypertension. Both aerobic and resistance exercise have been proven to reduce blood pressure (BP) effectively. Since brisk walking is an easy, inexpensive, simple, and effective way of exercise, this type of an aerobic workout can be recommended to society. All professional organizations and government bodies recommend moderate-intensity aerobic exercise for at least 30 min on at least 3 days of the week or resistance exercise on 2-3 days of the week. Exercise sessions can either be continuous for 30 min or be composed of at least 10 min of short exercise duration to a daily total of 30 min. After an exercise session, BP decreases, and this decline continues for up to 24 h; which is called post-exercise hypotension. Overall 5 mmHg decrease in BP with regular exercise may be ensured. With a decrease of 5 mmHg in systolic BP, mortality due to coronary heart disease decreases by 9%, mortality due to stroke decreases by 14% and all-cause mortality decreases by 7%. Regular exercise should therefore be recommended for all individuals including normotensives, prehypertensives, and hypertensives.
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Affiliation(s)
- Şeref Alpsoy
- Faculty of Medicine, Department of Cardiology, Namık Kemal University, Tekirdag, Turkey.
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Knappe F, Colledge F, Gerber M. Impact of an 8-Week Exercise and Sport Intervention on Post-Traumatic Stress Disorder Symptoms, Mental Health, and Physical Fitness among Male Refugees Living in a Greek Refugee Camp. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16203904. [PMID: 31618825 PMCID: PMC6843378 DOI: 10.3390/ijerph16203904] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 10/11/2019] [Accepted: 10/13/2019] [Indexed: 02/07/2023]
Abstract
Objective: To explore the potential impact of exercise and sport training on symptoms of post-traumatic stress disorder (PTSD), depression, anxiety, quality of life, pain, and fitness in male refugees living in a Greek refugee camp. Methods: This investigation was designed as a one group pre-test/post-test study. A total of 45 refugees (Mage = 25.6) participated in the data assessment. All participants were invited to engage in an 8-week exercise and sport intervention. Data were analysed with hierarchical regression analyses. Results: Baseline scores significantly predicted post-intervention scores across all study variables. Regression analyses showed that a higher participation rate predicted fewer anxiety symptoms, better health-related quality of life, higher self-perceived fitness, higher handgrip strength, and better cardiovascular fitness at post-intervention. A non-significant trend was also found for PTSD and depressive symptoms, showing that a higher participation rate was associated with fewer complaints at post-intervention. Conclusions: Among male refugees living in precarious conditions in a Greek refugee camp, frequency of participation in an 8-week exercise and sport training program seemed to have the potential to positively impact refugees’ health. Due to the pre-experimental study design, our results must be interpreted with caution.
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Affiliation(s)
- Florian Knappe
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, 4052 Basel, Switzerland.
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Jiménez-Pavón D, Carbonell-Baeza A, Lavie CJ. Promoting the Assessment of Physical Activity and Cardiorespiratory Fitness in Assessing the Role of Vascular Risk on Cognitive Decline in Older Adults. Front Physiol 2019; 10:670. [PMID: 31214046 PMCID: PMC6554421 DOI: 10.3389/fphys.2019.00670] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2018] [Accepted: 05/13/2019] [Indexed: 01/09/2023] Open
Affiliation(s)
- David Jiménez-Pavón
- MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Ana Carbonell-Baeza
- MOVE-IT Research Group and Department of Physical Education, Faculty of Education Sciences, University of Cádiz, Cádiz, Spain.,Biomedical Research and Innovation Institute of Cádiz (INiBICA) Research Unit, Puerta del Mar University Hospital, University of Cádiz, Cádiz, Spain
| | - Carl J Lavie
- Department of Cardiovascular Diseases, John Ochsner Heart and Vascular Institute, Ochsner Clinical School - The University of Queensland's School of Medicine, New Orleans, LA, United States
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Díaz-Gutiérrez J, Ruiz-Estigarribia L, Bes-Rastrollo M, Ruiz-Canela M, Martin-Moreno JM, Martínez-González MA. The role of lifestyle behaviour on the risk of hypertension in the SUN cohort: The hypertension preventive score. Prev Med 2019; 123:171-178. [PMID: 30902699 DOI: 10.1016/j.ypmed.2019.03.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 02/05/2019] [Accepted: 03/16/2019] [Indexed: 11/29/2022]
Abstract
Lifestyles may influence the risk of hypertension. Our objective was to assess the association between a healthy-lifestyle score and the incidence of hypertension. The SUN Project is a dynamic, prospective cohort of Spanish university graduates (1999-2014). Among 14,057 participants initially free of hypertension, we assessed the influence of lifestyle-related factors based on a 10-item score that we previously reported to be associated with lower risk of major cardiovascular events. However, we focused on factors related to hypertension risk according to previous scientific evidence and international clinical guidelines and constructed a 6-item score including: no smoking, moderate-to-high physical activity, Mediterranean diet adherence, healthy body mass index, moderate alcohol intake and no binge drinking. We fitted Cox regression models to adjust for potential confounders. During a median follow-up of 10.2 years, we identified 1406 incident cases of medically diagnosed hypertension. The risk of developing hypertension was linearly reduced as participants better adhered to a healthy lifestyle pattern built by summing up these 6 factors (p for trend<0.001). The highest category (5-6 factors) exhibited a significant 46% relative reduction in the risk of developing hypertension compared to the lowest category (0-1 factors) (multivariable-adjusted hazard ratio = 0.54; 95% CI: 0.42-0.68). Among the components of the score, BMI was apparently the main factor driving the association between the HLS and lower risk of hypertension. A healthy-lifestyle score including six simple healthy habits was longitudinally and linearly associated with a substantially reduced risk of hypertension. This index may be a useful tool for hypertension prevention.
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Affiliation(s)
- Jesús Díaz-Gutiérrez
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain.
| | - Liz Ruiz-Estigarribia
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain.
| | - Maira Bes-Rastrollo
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain.
| | - Miguel Ruiz-Canela
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain.
| | - José M Martin-Moreno
- University of Valencia, Department of Preventive Medicine and Public Health, University Clinical Hospital-INCLIVA, Valencia, Spain.
| | - Miguel A Martínez-González
- University of Navarra, Department of Preventive Medicine and Public Health, School of Medicine, Pamplona, Spain; CIBER Pathophysiology of Obesity and Nutrition, Institute of Health Carlos III, Madrid, Spain; IDISNA Navarra's Health Research Institute, Pamplona, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States.
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Carey RM, Calhoun DA, Bakris GL, Brook RD, Daugherty SL, Dennison-Himmelfarb CR, Egan BM, Flack JM, Gidding SS, Judd E, Lackland DT, Laffer CL, Newton-Cheh C, Smith SM, Taler SJ, Textor SC, Turan TN, White WB. Resistant Hypertension: Detection, Evaluation, and Management: A Scientific Statement From the American Heart Association. Hypertension 2019; 72:e53-e90. [PMID: 30354828 DOI: 10.1161/hyp.0000000000000084] [Citation(s) in RCA: 572] [Impact Index Per Article: 114.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Resistant hypertension (RH) is defined as above-goal elevated blood pressure (BP) in a patient despite the concurrent use of 3 antihypertensive drug classes, commonly including a long-acting calcium channel blocker, a blocker of the renin-angiotensin system (angiotensin-converting enzyme inhibitor or angiotensin receptor blocker), and a diuretic. The antihypertensive drugs should be administered at maximum or maximally tolerated daily doses. RH also includes patients whose BP achieves target values on ≥4 antihypertensive medications. The diagnosis of RH requires assurance of antihypertensive medication adherence and exclusion of the "white-coat effect" (office BP above goal but out-of-office BP at or below target). The importance of RH is underscored by the associated risk of adverse outcomes compared with non-RH. This article is an updated American Heart Association scientific statement on the detection, evaluation, and management of RH. Once antihypertensive medication adherence is confirmed and out-of-office BP recordings exclude a white-coat effect, evaluation includes identification of contributing lifestyle issues, detection of drugs interfering with antihypertensive medication effectiveness, screening for secondary hypertension, and assessment of target organ damage. Management of RH includes maximization of lifestyle interventions, use of long-acting thiazide-like diuretics (chlorthalidone or indapamide), addition of a mineralocorticoid receptor antagonist (spironolactone or eplerenone), and, if BP remains elevated, stepwise addition of antihypertensive drugs with complementary mechanisms of action to lower BP. If BP remains uncontrolled, referral to a hypertension specialist is advised.
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Cardiorespiratory Fitness and Risk of All-Cause, Cardiovascular Disease, and Cancer Mortality in Men With Musculoskeletal Conditions. J Phys Act Health 2019; 16:134-140. [DOI: 10.1123/jpah.2017-0644] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ortega R, Grandes G, Sanchez A, Montoya I, Torcal J. Cardiorespiratory fitness and development of abdominal obesity. Prev Med 2019; 118:232-237. [PMID: 30414943 DOI: 10.1016/j.ypmed.2018.10.020] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 07/30/2018] [Accepted: 10/20/2018] [Indexed: 01/20/2023]
Abstract
Both, cardiorespiratory fitness and abdominal obesity are independently associated with developing cardiovascular disease and its risk factors. However, the relationship between both attributes is unclear. We examine the relationship between cardiorespiratory fitness and the risk of developing abdominal obesity, and secondarily, other adiposity measures. Retrospective observational study of a cohort of 1284 sedentary patients, who had participated in a clinical trial of physical activity promotion carried out in Spain (2003-2007). At baseline, they were free of cardiovascular disease, hypertension, diabetes, dyslipidemia and/or abdominal obesity, with an indirect VO2max measurement, were 19-80 years old, 62% women, and had completed the two year follow-up. The exposure factor was cardiorespiratory fitness categorized as high, moderate or low, according to tertiles of VO2max values. The main outcome measure was the risk of developing abdominal obesity, as defined by waist circumference >102 (men) and >88 (women) cm. Secondary outcomes were the risk of developing: general obesity, excess body fat, and their combination ("defined" obesity). At two years, 10.5% of the participants had developed abdominal obesity: 6.1% in the high cardiorespiratory fitness tertile, 9.7% in the moderate tertile (adjusted odds ratio, 1.20; 95% confidence interval 0.68-2.10), and 15.7% in the low tertile (adjusted odds ratio, 2.29; 95% confidence interval 1.34-3.91). Moreover, 2.2% of participants in the high cardiorespiratory fitness tertile developed "defined" obesity as did 5.4% in the low tertile (adjusted odds ratio, 2.90; 95% confidence interval 1.15-7.29). Low cardiorespiratory fitness levels are associated with a higher risk of developing abdominal and "defined" obesity.
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Affiliation(s)
- Ricardo Ortega
- Santa Barbara Primary Care Centre, Castilla-La Mancha Health Service, Esparteros 6, E-45006 Toledo, Spain.
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Alvaro Sanchez
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Imanol Montoya
- Primary Care Research Unit of Bizkaia, Basque Health Service (BHS), Luis Power 18, E-48014 Bilbao, Spain
| | - Jesús Torcal
- Basauri-Ariz Primary Care Centre, BHS, Nagusia, E-48970 Basauri, Spain
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de Carvalho Souza Vieira M, Boing L, Leitão AE, Vieira G, Coutinho de Azevedo Guimarães A. Effect of physical exercise on the cardiorespiratory fitness of men—A systematic review and meta-analysis. Maturitas 2018; 115:23-30. [DOI: 10.1016/j.maturitas.2018.06.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 05/30/2018] [Accepted: 06/10/2018] [Indexed: 12/28/2022]
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Physical activity prevents blood pressure increases in individuals under treatment for knee osteoarthritis. Blood Press Monit 2018; 23:297-300. [PMID: 30157058 DOI: 10.1097/mbp.0000000000000346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The aim of this study was to assess the role of physical activity in blood pressure (BP) in individuals with knee osteoarthritis. We compared 136 participants under treatment for primary knee osteoarthritis (age=67.6±9.6 years) allocated to the sedentary-sedentary, active-sedentary, sedentary-active, and active-active groups depending on their levels of daily physical activity before and after follow-up. Their BP, BMI, and endurance performance (6-min walking test) were compared during 12 months of follow-up. The sedentary-sedentary group had increased systolic BP (11±3 mmHg), and the active-sedentary group had increased systolic (12±4 mmHg) and diastolic BP (5±1 mmHg) during follow-up. By contrast, the sedentary-active group maintained systolic BP and showed reduced diastolic BP (5±2 mmHg), and the active-active group maintained both systolic and diastolic BP. Positive effects on BP were accompanied by improvements in endurance performance and BMI in the sedentary-active group (endurance performance=8.5±2.7%; BMI=9.3±3.6%) and the active-active group (endurance performance=2.9±0.9%; BMI=3.8±2.0%), which did not occur in the sedentary-sedentary and active-sedentary groups. These results suggest a positive role of high levels of daily living physical activity in the prevention/management of hypertension in individuals with knee osteoarthritis.
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Whitaker KM, Ingram KH, Appiah D, Nicholson WK, Bennett WL, Lewis CE, Reis JP, Schreiner PJ, Gunderson EP. Prepregnancy Fitness and Risk of Gestational Diabetes: A Longitudinal Analysis. Med Sci Sports Exerc 2018; 50:1613-1619. [PMID: 29521721 PMCID: PMC6047908 DOI: 10.1249/mss.0000000000001600] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE This study aimed to assess the associations of prepregnancy cardiorespiratory fitness, moderate- to vigorous-intensity physical activity (MVPA), and time spent watching television with subsequent development of gestational diabetes mellitus (GDM). METHODS Participants were 1333 women enrolled in the Coronary Artery Risk Development in Young Adults study who did not have diabetes either at baseline (1985-86) or before births occurring after baseline. Baseline fitness was estimated using a graded symptom-limited maximal exercise treadmill test and expressed in MET units. Baseline MVPA (exercise units per day) was measured using the Coronary Artery Risk Development in Young Adults physical activity history questionnaire, and television viewing (h·d) was assessed by self-report in 1990-1991. Logistic regression analysis was used to derive odds ratios and 95% confidence intervals, adjusting for time from baseline to delivery and baseline study center, age, race, education, parity, family history of diabetes, smoking, alcohol, saturated fat intake, waist circumference, homeostasis model assessment of insulin resistance, and HDL cholesterol. RESULTS Over 25 yr of follow-up, 164 women developed GDM. The odds of developing GDM were 21% lower for each 1 SD increment in baseline level of fitness (2.3 METs, odds ratio = 0.79, 95% confidence interval = 0.65-0.96). Prepregnancy MVPA and television viewing were not statistically associated with the development of GDM. CONCLUSION Study findings indicate that objectively assessed prepregnancy fitness, but not self-reported MVPA or television time, is associated with GDM. Clinicians should counsel women on the benefits of improving fitness in the preconception period, particularly among women at greater risk for GDM.
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Affiliation(s)
- Kara M. Whitaker
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
| | - Katherine H. Ingram
- Department of Exercise Science and Sport Management, Kennesaw State University, Kennesaw, GA
| | - Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Abilene, TX
| | - Wanda K. Nicholson
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC
| | - Wendy L. Bennett
- Division of General Internal Medicine, John Hopkins University School of Medicine, Baltimore, MD
| | - Cora E. Lewis
- Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Jared P. Reis
- Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, Bethesda, MD
| | - Pamela J. Schreiner
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Erica P. Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
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Interaction between physical activity and television time on blood pressure level: cross-sectional data from 45 000 individuals. J Hypertens 2018; 36:1041-1050. [PMID: 29369146 DOI: 10.1097/hjh.0000000000001675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES The aim was to investigate if there is an interaction between sitting time and leisure time physical activity on blood pressure and if there are age differences and sex differences in this respect. METHODS Linear regression analysis on cross-sectional data was performed in more than 45 000 men and women from two Swedish cohort studies, EpiHealth (45-75 years) and LifeGene (18-45 years). Self-reported leisure time physical activity was given in five levels from low (level 1) to vigorous physical activity (level 5) and television time was used as a proxy measure of sitting time. RESULTS High physical activity was associated with lower DBP (P = 0.001), but not SBP. Active middle-aged men had lower DBP (-1.1 mmHg; 95% CI -1.7 to -0.4) compared with inactive participants. Prolonged television time was associated with higher SBP (P < 0.001) and DBP (P = 0.011) in both sexes and in most age groups. Watching 3 h instead of 1 h television per day was associated with higher SBP in middle-aged women (SBP: 1.1 mmHg; 95% CI 0.7-1.4) and men (SBP: 1.2 mmHg; 95% CI 0.8-1.6). Only in young men, a high physical activity (level 4 instead of level 1) could compensate for a prolonged television time (3 h per day) in terms of DBP. CONCLUSION Prolonged television time was associated with higher SBP and DBP in both sexes and at most ages, whereas an increased physical activity was mainly associated with a lower DBP. Only in young men, a high physical activity could compensate for prolonged television time regarding DBP.
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High-intensity interval training lowers blood pressure and improves apelin and NOx plasma levels in older treated hypertensive individuals. J Physiol Biochem 2017; 74:47-55. [PMID: 29214526 DOI: 10.1007/s13105-017-0602-0] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 11/28/2017] [Indexed: 01/11/2023]
Abstract
Hypertension is the major risk factor for cardiovascular diseases and is one of the primary causes of morbidity and mortality worldwide. Apelin levels and NO bioavailability are impaired in older hypertensive patients. Exercise is an effective intervention for treating hypertension. Our purpose was to evaluate the effect of high-intensity interval training on blood pressure, apelin, and NOx plasma levels in older treated hypertensive individuals. Thirty treated hypertensive subjects (61.70 ± 5.78 years, 17 males, 13 females) were randomly divided into 6 weeks of high-intensity interval training (n = 15) and control (n = 15). The exercise training was conducted for three 35-min sessions a week (1.5-min interval at 85-90% of heart rate reserve [HRR] and 2 min active phase at 50-55% of HRR). Assessment of plasma apelin, nitrite/nitrate (NOx), and endothelin-1 (ET-1) was performed before and after the intervention. At the end of the study, apelin, and NOx plasma levels increased significantly in the high-intensity interval training (HIIT) group (P = 0.021, P = 0.003, respectively). Conversely, ET-1 plasma levels significantly decreased in the training group after the intervention (P = 0.015). Moreover, there was a positive correlation between the change of plasma apelin and change of plasma NOx (r = 0. 771, P = 0.0008). In addition, there was a negative correlation between the change of plasma ET-1, change of plasma apelin (r = - 0.595, P = 0.019), and variation of NOx (r = - 0.572, P = 0.025). This study indicates that, by increasing of apelin and NOx plasma levels, HIIT may be effective in reducing blood pressure.
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Impact of Changes in Cardiorespiratory Fitness on Hypertension, Dyslipidemia and Survival: An Overview of the Epidemiological Evidence. Prog Cardiovasc Dis 2017; 60:56-66. [DOI: 10.1016/j.pcad.2017.02.006] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 02/28/2017] [Indexed: 02/07/2023]
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Sui X, Sarzynski MA, Lee DC, Lavie CJ, Zhang J, Kokkinos PF, Payne J, Blair SN. Longitudinal Patterns of Cardiorespiratory Fitness Predict the Development of Hypertension Among Men and Women. Am J Med 2017; 130:469-476.e2. [PMID: 27986522 PMCID: PMC5362290 DOI: 10.1016/j.amjmed.2016.11.017] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Revised: 11/02/2016] [Accepted: 11/04/2016] [Indexed: 11/27/2022]
Abstract
BACKGROUND Most of the existing literature has linked a baseline cardiorespiratory fitness or change between baseline and one follow-up measurement of cardiorespiratory fitness to hypertension. The purpose of the study is to assess the association between longitudinal patterns of cardiorespiratory fitness changes with time and incident hypertension in adult men and women. METHODS Participants were aged 20 to 82 years, were free of hypertension during the first 3 examinations, and received at least 4 preventive medical examinations at the Cooper Clinic in Dallas, Texas, from 1971 to 2006. They were classified into 1 of 5 groups based on all of the measured cardiorespiratory fitness values (in metabolic equivalents) during maximal treadmill tests. Logistic regression was used to compute odds ratios and 95% confidence intervals. RESULTS Among 4932 participants (13% women), 1954 developed hypertension. After controlling for baseline potential confounders, follow-up duration, and number of follow-up visits, odds ratios (95% confidence intervals) for hypertension were 1.00 for the decreasing group (referent), 0.64 (0.52-0.80) for the increasing group, 0.89 (0.70-1.12) for the bell-shape group, 0.78 (0.62-0.98) for the U-shape group, and 0.83 (0.69-1.00) for the inconsistent group. The general pattern of the association was consistent regardless of participants' baseline cardiorespiratory fitness or body mass index levels. CONCLUSIONS An increasing pattern of cardiorespiratory fitness provides the lowest risk of hypertension in this middle-aged relatively healthy population. Identifying specific pattern(s) of cardiorespiratory fitness change may be important for determining associations with comorbidity, such as hypertension.
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Affiliation(s)
- Xuemei Sui
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia.
| | - Mark A Sarzynski
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Duck-Chul Lee
- Department of Kinesiology, College of Human Sciences, Iowa State University, Ames
| | - Carl J Lavie
- Department of Cardiovascular Diseases, Ochsner Clinical School, The University of Queensland School of Medicine, New Orleans, La
| | - Jiajia Zhang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
| | - Peter F Kokkinos
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Cardiology Division, Veterans Affairs Medical Center; Georgetown University, School of Medicine, Washington, DC
| | - Jonathan Payne
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia
| | - Steven N Blair
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, Columbia; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia
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Diaz KM, Booth JN, Seals SR, Abdalla M, Dubbert PM, Sims M, Ladapo JA, Redmond N, Muntner P, Shimbo D. Physical Activity and Incident Hypertension in African Americans: The Jackson Heart Study. Hypertension 2017; 69:421-427. [PMID: 28137988 DOI: 10.1161/hypertensionaha.116.08398] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 09/18/2016] [Accepted: 11/28/2016] [Indexed: 11/16/2022]
Abstract
There is limited empirical evidence to support the protective effects of physical activity in the prevention of hypertension among African Americans. The purpose of this study was to examine the association of physical activity with incident hypertension among African Americans. We studied 1311 participants without hypertension at baseline enrolled in the Jackson Heart Study, a community-based study of African Americans residing in Jackson, Mississippi. Overall physical activity, moderate-vigorous physical activity, and domain-specific physical activity (work, active living, household, and sport/exercise) were assessed by self-report during the baseline examination (2000-2004). Incident hypertension, assessed at examination 2 (2005-2008) and examination 3 (2009-2013), was defined as the first visit with systolic/diastolic blood pressure ≥140/90 mm Hg or self-reported antihypertensive medication use. Over a median follow-up of 8.0 years, there were 650 (49.6%) incident hypertension cases. The multivariable-adjusted hazard ratios (95% confidence interval) for incident hypertension comparing participants with intermediate and ideal versus poor levels of moderate-vigorous physical activity were 0.84 (0.67-1.05) and 0.76 (0.58-0.99), respectively (P trend=0.038). A graded, dose-response association was also present for sport/exercise-related physical activity (Quartiles 2, 3, and 4 versus Quartile 1: 0.92 [0.68-1.25], 0.87 [0.67-1.13], 0.75 [0.58-0.97], respectively; P trend=0.032). There were no statistically significant associations observed for overall physical activity, or work, active living, and household-related physical activities. In conclusion, the results of the current study suggest that regular moderate-vigorous physical activity or sport/exercise-related physical activity may reduce the risk of developing hypertension in African Americans.
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Affiliation(s)
- Keith M Diaz
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.).
| | - John N Booth
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Samantha R Seals
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Marwah Abdalla
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Patricia M Dubbert
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Mario Sims
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Joseph A Ladapo
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Nicole Redmond
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Paul Muntner
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
| | - Daichi Shimbo
- From the Department of Medicine, Columbia University Medical Center, New York, NY (K.M.D., M.A., D.S.); Department of Epidemiology, University of Alabama at Birmingham (J.N.B., P.M.); Center of Biostatistics and Bioinformatics (S.R.S.) and Department of Medicine (M.S.), University of Mississippi Medical Center, Jackson; South Central Mental Illness, Research, and Clinical Center and Little Rock Geriatric Research, Education, and Clinical Center, AR (P.M.D.); Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, Los Angeles, CA (J.A.L.); and Clinical Applications and Prevention Branch, National Heart Lung and Blood Institute, Bethesda, MD (N.R.)
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High-Intensity Interval Training Versus Moderate-Intensity Continuous Training in the Prevention/Management of Cardiovascular Disease. Cardiol Rev 2016; 24:273-281. [DOI: 10.1097/crd.0000000000000124] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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48
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Seyedmehdi SM, Attarchi M, Cherati AS, Hajsadeghi S, Tofighi R, Jamaati H. Relationship of aerobic fitness with cardiovascular risk factors in firefighters. Work 2016; 55:155-161. [PMID: 27612056 DOI: 10.3233/wor-162375] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Epidemiological studies on the general population have shown that increased physical activity and aerobic fitness (AF) significantly decrease the risk of coronary artery disease. Finding ways to decrease such risk factors can promote the health of firefighters. METHODS This study was conducted in a large industrial facility in Tehran. AF assessment and submaximal aerobic fitness testing of participants were performed according to the guidelines of the American College of Sports Medicine (ACSM). AF was determined using a bicycle ergometer. Other information was collected using a specifically designed questionnaire, physical examination and blood test. Data were analyzed using SPSS. Level of significance was set at P < 0.05. RESULTS A total of 157 male firefighters were evaluated in an industrial facility. The results of logistic regression analysis revealed that AF was significantly correlated with age, body mass index (BMI), cigarette smoking, physical activity, hemoglobin level, low-density lipoprotein (LDL) level, high-density lipoprotein (HDL) level, resting systolic blood pressure (RSBP), diastolic blood pressure (RDBP) and heart rate (RHR) (P < 0.05). CONCLUSIONS Firefighters with greater AF had lower cardiovascular disease (CVD) risk factors. Longitudinal studies are required to further confirm this finding. Increasing the AF may decrease CVD risk factors in firefighters.
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Affiliation(s)
- Seyed Mohammad Seyedmehdi
- Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mirsaeed Attarchi
- Department of Forensic Medicine, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran.,Department of Occupational Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | - Shokoufeh Hajsadeghi
- Department of Cardiology, Rasoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hamidreza Jamaati
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran
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49
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Israel A, Kivity S, Sidi Y, Segev S, Berkovitch A, Klempfner R, Lavi B, Goldenberg I, Maor E. Use of exercise capacity to improve SCORE risk prediction model in asymptomatic adults. Eur Heart J 2016; 37:2300-6. [PMID: 26916798 DOI: 10.1093/eurheartj/ehw053] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 12/08/2015] [Indexed: 11/14/2022] Open
Abstract
AIMS The SCORE risk estimation system is used for cardiovascular risk stratification in apparently healthy adults and is based on known cardiovascular risk factors. The purpose of the current study was to evaluate whether exercise capacity can improve the accuracy of the SCORE overall survival risk estimation. METHODS AND RESULTS We investigated 22 878 asymptomatic men and women who were annually screened in a tertiary medical centre. All subjects were free of known ischaemic heart disease, and had completed maximal exercise stress test according to the Bruce protocol. The SCORE risk estimation system was used to evaluate individual cardiovascular risk for all subjects. The primary endpoint was mortality, after exclusion of patients with metastatic cancer during follow-up. The incremental contribution of exercise capacity in predicting the risk of death was evaluated by net reclassification improvement (NRI) and area under the receiver operating curve (AUROC). Mean age of the study population was 47.4 ± 10.3, and 71.6% were men. There were 505 (2.21%) deaths during a mean follow-up of 9.2 ± 4.1 years. Kaplan-Meier survival analysis showed that both SCORE and low exercise capacity were associated with reduced survival. When added to the SCORE risk prediction, exercise capacity allowed more accurate risk stratification: NRI analysis showed an overall improvement of 56.8% in the accuracy of classification and the AUROC increased (0.782 vs. 0.766). CONCLUSION Both SCORE and exercise capacity are strong independent predictors of all-cause mortality. The addition of exercise capacity to the SCORE risk model can improve the accuracy of the model.
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Affiliation(s)
- Ariel Israel
- Leviev Heart Centre, Chaim Sheba Medical Centre, Tel-Hashomer 52621, Israel Clalit Health Services, Jerusalem, Israel
| | - Shaye Kivity
- Department of Internal Medicine C, Chaim Sheba Medical Centre, Tel-Hashomer, Israel Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Centre, Tel-Hashomer, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Yechezkel Sidi
- Department of Internal Medicine C, Chaim Sheba Medical Centre, Tel-Hashomer, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Shlomo Segev
- Institute for Medical Screening, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - Anat Berkovitch
- Leviev Heart Centre, Chaim Sheba Medical Centre, Tel-Hashomer 52621, Israel
| | - Robert Klempfner
- Leviev Heart Centre, Chaim Sheba Medical Centre, Tel-Hashomer 52621, Israel
| | - Bruno Lavi
- Medical Center Management, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
| | - Ilan Goldenberg
- Leviev Heart Centre, Chaim Sheba Medical Centre, Tel-Hashomer 52621, Israel Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Elad Maor
- Leviev Heart Centre, Chaim Sheba Medical Centre, Tel-Hashomer 52621, Israel Pinchas Borenstein Talpiot Medical Leadership Program, Chaim Sheba Medical Centre, Tel-Hashomer, Israel
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50
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Carter SJ, Goldsby TU, Fisher G, Plaisance EP, Gower BA, Glasser SP, Hunter GR. Systolic blood pressure response after high-intensity interval exercise is independently related to decreased small arterial elasticity in normotensive African American women. Appl Physiol Nutr Metab 2016; 41:484-90. [PMID: 26953821 DOI: 10.1139/apnm-2015-0512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Aerobic exercise transiently lowers blood pressure. However, limited research has concurrently evaluated blood pressure and small arterial elasticity (SAE), an index of endothelial function, among African American (AA) and European American (EA) women the morning after (i.e., ≈22 h later) acute bouts of moderate-intensity continuous (MIC) and high-intensity interval (HII) exercise matched for total work. Because of greater gradients of shear stress, it was hypothesized that HII exercise would elicit a greater reduction in systolic blood pressure (SBP) compared to MIC exercise. After baseline, 22 AA and EA women initiated aerobic exercise training 3 times/week. Beginning at week 8, three follow-up assessments were conducted over the next 8 weeks at random to measure resting blood pressure and SAE. In total all participants completed 16 weeks of training. Follow-up evaluations were made: (i) in the trained state (TS; 8-16 weeks of aerobic training); (ii) ≈22 h after an acute bout of MIC exercise; and (iii) ≈22 h after an acute bout of HII exercise. Among AAs, the acute bout of HII exercise incited a significant increase in SBP (mm Hg) (TS, 121 ± 14 versus HII, 128 ± 14; p = 0.01) whereas responses (TS, 116 ± 12 versus HII, 113 ± 9; p = 0.34) did not differ in EAs. After adjusting for race, changes in SAE were associated (partial r = -0.533; p = 0.01) with changes in SBP following HII exercise. These data demonstrate an acute, unaccustomed bout of HII exercise produces physiological perturbations resulting in a significant increase in SBP that are independently associated with decreased SAE among AA women, but not EA women.
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Affiliation(s)
- Stephen J Carter
- a Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233, USA.,c Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - TaShauna U Goldsby
- c Nutrition Obesity Research Center, University of Alabama at Birmingham, Birmingham, AL 35233, USA.,d Office of Energetics, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Gordon Fisher
- a Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233, USA.,b Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Eric P Plaisance
- a Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Barbara A Gower
- b Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Stephen P Glasser
- e Department of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL 35233, USA
| | - Gary R Hunter
- a Department of Human Studies, University of Alabama at Birmingham, Birmingham, AL 35233, USA.,b Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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