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Bagherikholenjani F, Shahidi S, Khosravi A, Mansouri A, Ashoorion V, Sarrafzadegan N. Update of the clinical guideline for hypertension diagnosis and treatment in Iran. Clin Hypertens 2024; 30:13. [PMID: 38822442 PMCID: PMC11143619 DOI: 10.1186/s40885-024-00269-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Accepted: 03/12/2024] [Indexed: 06/03/2024] Open
Abstract
BACKGROUND This article introduces the updated version of the Iranian guideline for the diagnosis and treatment of hypertension in adults. The initial version of the national guideline was developed in 2011 and updated in 2014. Among the reasons necessitating the update of this guideline were the passage of time, the incompleteness of the scopes, the limitation of the target group, and more important is the request of the ministry of health in Iran. METHOD The members of the guideline updating group, after reviewing the original version and the new evidence, prepared 10 clinical questions regarding hypertension, and based on the evidence found from the latest scientific documents, provided recommendations or suggestions to answer these questions. RESULT According to the updated guideline, the threshold for office prehypertension diagnosis should be considered the systolic blood pressure (SBP) of 130-139 mmHg and/or the diastolic blood pressure (DBP) of 80-89 mmHg, and in adults under 75 years of age without comorbidities, the threshold for office hypertension diagnosis should be SBP ≥ 140 mmHg and or DBP ≥ 90 mmHg. The goal of treatment in adults who lack comorbidities and risk factors is SBP < 140 mmHg and DBP < 90 mmHg. The first-line treatment recommended in people with prehypertension is lifestyle modification, while for those with hypertension, pharmacotherapy along with lifestyle modification. The threshold to start drug therapy is determined at SBP ≥ 140 mmHg and or DBP ≥ 90 mmHg, and the first-line treatment is considered a drug or a combined pill of antihypertensive drugs, including ACEIs, ARBs, thiazide and thiazide-like agents, or CCBs. At the beginning of the pharmacotherapy, the Guideline Updating Group members suggested studying serum electrolytes, creatinine, lipid profile, fasting sugar, urinalysis, and an electrocardiogram. Regarding the visit intervals, monthly visits are suggested at the beginning of the treatment or in case of any change in the type or dosage of the drug until achieving the treatment goal, followed by every 3-to-6-month visits. Moreover, to reduce further complications, it was suggested that healthcare unit employees use telehealth strategies. CONCLUSIONS In this guideline, specific recommendations and suggestions have been presented for adults and subgroups like older people or those with cardiovascular disease, diabetes mellitus, chronic kidney disease, and COVID-19.
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Affiliation(s)
- Fahimeh Bagherikholenjani
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shahla Shahidi
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Alireza Khosravi
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Iranian Network of Cardiovascular Research, Tehran, Iran
| | - Asieh Mansouri
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
- Iranian Network of Cardiovascular Research, Tehran, Iran.
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Vargas-Molina S, García-Sillero M, Daniel Jiménez-García J, Carbone L, Bonilla DA, Petro JL, Romance R, Benítez-Porres J. Effects of a Nonlinear Program on Different Health Parameters in the Elderly. Sports Health 2024:19417381241253267. [PMID: 38800872 DOI: 10.1177/19417381241253267] [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: 05/29/2024] Open
Abstract
BACKGROUND The aim of this research was to evaluate the impact of a nonlinear training program on visceral adipose tissue (VAT) and systolic (SBP) and diastolic (DBP) blood pressure, as well as the response of biochemical parameters such as fasting plasma glucose (FPG), total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG). HYPOTHESIS The nonlinear periodized program would produce greater improvements in outcomes than the linear periodized training program. STUDY DESIGN Randomized cross-sectional design. LEVEL OF EVIDENCE Level 3. METHODS Older adults with no previous training experience (10 male and 8 female [age, 64 ± 2.1 years; height, 165.12 ± 7.5 cm; body mass, 72.5 ± 11.4 kg; body max index, 26.5 ± 3.2 kg/m2]) were randomized to linear (n = 9, TT) or undulating (n = 9, UT) periodization. After a 3-week familiarization period, all participants performed 3 sessions of resistance training per week; 8 weeks of training were conducted for each group. Dual x-ray absorptiometry was used to measure VAT, and SBP and DBP were measured using an OMRON M3 digital automatic blood pressure monitor. Blood samples were collected between 8:00 a.m. and 9:30 a.m. after 12-hour overnight fasting. RESULTS Both interventions significantly (P < 0.05) decreased FPG, TC, LDL-C, and TG. A significant decrease in SBP and DBP was observed only in the UT group (P < 0.05). No significant between-group differences in outcomes were observed (P > 0.5). However, the effect size was marginally more pronounced for all outcomes in the UT group. CONCLUSION An undulating periodization program was effective in improving VAT, TC, LDL-C, FPG, HDL-C, TG, and blood glucose levels in older adults. CLINICAL RELEVANCE Resistance training can be programmed in an undulating or traditional way in older adults based on improvements in health parameters, considering adherence and individual preferences.
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Affiliation(s)
- Salvador Vargas-Molina
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Manuel García-Sillero
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - José Daniel Jiménez-García
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Leandro Carbone
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Diego A Bonilla
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Jorge L Petro
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Ramón Romance
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
| | - Javier Benítez-Porres
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and EADE-University of Wales Trinity Saint David, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain
- Department of Health Sciences, Faculty of Health Sciences, University of Jaen, Spain
- University of Salvador, Buenos Aires, Argentina
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Research Division, Dynamical Business and Science Society - DBSS International SAS, Bogotá, Colombia, and Research Group in Physical Activity, Sports and Health Sciences (GICAFS), Universidad de Córdoba, Montería, Colombia
- Human Kinetics and Body Composition Laboratory, University of Málaga, Málaga, Spain
- Physical Education and Sport Area, Faculty of Medicine, University of Málaga, Málaga, Spain, and IBIMA Plataforma BIONAND, Málaga, Spain
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Qiu S, Cai X, Liang Y, Chen W, Wang D, Sun Z, Xie B, Wu T. Cumulative muscle strength and risk of diabetes: A prospective cohort study with mediation analysis. Diabetes Res Clin Pract 2023; 197:110562. [PMID: 36738835 DOI: 10.1016/j.diabres.2023.110562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/15/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023]
Abstract
AIMS Previous studies assessing the association of muscle strength with risk of diabetes have seldomly accounted for the cumulative exposure over time. This study examined the association of 4-year cumulative muscle strength with risk of diabetes in middle-aged and older adults. METHODS We included participants without diabetes, who had 3 repeated measurements of muscle strength, which was assessed by grip strength (normalized by body-weight) and chair-rising time, over 4 years. Cumulative muscle strength was calculated based on trapezoid rule. Logistic regression analysis and mediation analysis for cumulative blood pressure were performed. RESULTS We included 3731 and 3799 participants with data on cumulative grip strength and cumulative chair-rising time, respectively. The odds of diabetes were gradually reduced with increments in cumulative grip strength or decrements in cumulative chair-rising time, with the corresponding odds ratio being 0.79 and 0.89 per 1 standard deviation change after multivariable-adjustment. Cumulative systolic blood pressure mediated 10.8% and 14.2% of the associations of diabetes with cumulative grip strength and cumulative chair-rising time, respectively. Cumulative grip strength also correlated inversely with blood pressure, glycemia, and inflammation. CONCLUSIONS Higher cumulative muscle strength was associated with lower risk of diabetes and better cardiometabolic health in middle-aged and older Chinese adults.
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Affiliation(s)
- Shanhu Qiu
- Department of General Practice, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China
| | - Xue Cai
- Department of Nursing Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Yan Liang
- Department of General Practice, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China
| | - Wenji Chen
- Department of General Practice, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China.
| | - Bo Xie
- Department of General Practice, Zhongda Hospital; Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China; Research and Education Centre of General Practice, Zhongda Hospital, Southeast University, Nanjing, China.
| | - Tongzhi Wu
- Adelaide Medical School and Centre of Research Excellence (CRE) in Translating Nutritional Science to Good Health, The University of Adelaide, Adelaide, Australia
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Zheng Y, You T, Du R, Zhang J, Peng T, Liang J, Zhao B, Ou H, Jiang Y, Feng H, Yilifate A, Lin Q. The Effect of Non-immersive Virtual Reality Exergames Versus Band Stretching on Cardiovascular and Cerebral Hemodynamic Response: A Functional Near-Infrared Spectroscopy Study. Front Hum Neurosci 2022; 16:902757. [PMID: 35903784 PMCID: PMC9314640 DOI: 10.3389/fnhum.2022.902757] [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: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
Background Exercise is one of the effective ways to improve cognition. Different forms of exercises, such as aerobic exercise, resistance exercise, and coordination exercise, have different effects on the improvement of cognitive impairment. In recent years, exergames based on Non-Immersive Virtual Reality (NIVR-Exergames) have been widely used in entertainment and have gradually been applied to clinical rehabilitation. However, the mechanism of NIVR-Exergames on improving motor cognition has not been clarified. Therefore, the aim of this study is to find whether NIVR-Exergames result in a better neural response mechanism to improve the area of the cerebral cortex related to motor cognition under functional near-infrared spectroscopy (fNIRS) dynamic monitoring in comparison with resistance exercise (resistance band stretching). Methods A cross-over study design was adopted in this study, and 15 healthy young subjects (18–24 years old) were randomly divided into group A (n = 8) and group B (n = 7) according to a computerized digital table method. Task 1 was an NIVR-Exergame task, and Task 2 was resistance band stretching. Group A first performed Task 1, rested for 30 min (i.e., a washout period), and then performed Task 2. Group B had the reverse order. The fNIRS test was synchronized in real time during exercise tasks, and heart rate measurements, blood pressure measurements, and 2-back task synchronization fNIRS tests were performed at baseline, Post-task 1, and Post-task 2. The primary outcomes were beta values from the general linear model (GLM) in different regions of interest (ROIs), and the secondary outcomes were heart rate, blood pressure, reaction time of 2-back, and accuracy rate of 2-back. Results The activation differences of Task 1 and Task 2 in the right premotor cortex (PMC) (P = 0.025) and the left PMC (P = 0.011) were statistically significant. There were statistically significant differences in the activation of the right supplementary motor area (SMA) (P = 0.007), left dorsolateral prefrontal cortex (DLPFC) (P = 0.031), left and right PMC (P = 0.005; P = 0.002) between baseline and Post-task 1. The differences in systolic pressure (SBP) between the two groups at three time points among women were statistically significant (P1 = 0.009, P2 < 0.001, P3 = 0.044). Conclusion In this study, we found that NIVR-Exergames combined with motor and challenging cognitive tasks can promote the activation of SMA, PMC and DLPFC in healthy young people compared with resistance exercise alone, providing compelling preliminary evidence of the power for the rehabilitation of motor and cognitive function in patients with central nervous system diseases.
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Affiliation(s)
- Yuxin Zheng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Tingting You
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Rongwei Du
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Jiahui Zhang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Tingting Peng
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Junjie Liang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Biyi Zhao
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Haining Ou
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Yongchun Jiang
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
| | - Huiping Feng
- Department of Clinical Nutrition, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Huiping Feng,
| | - Anniwaer Yilifate
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
- Anniwaer Yilifate,
| | - Qiang Lin
- Department of Rehabilitation Medicine, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
- Department of Rehabilitation Medicine, The Fifth College of Guangzhou Medical University, Guangzhou, China
- *Correspondence: Qiang Lin,
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