Weight change and mortality: Long-term results from the trials of hypertension prevention

To what extent the weight changes impact the risk of hypertension among menopausal women: insights from Tehran lipid and glucose study

BACKGROUND & AIM

The association between weight change and incident hypertension (HTN) in menopausal women has not been well characterized. This study aimed to determine whether weight changes after menopausal years make a difference in incidents of hypertension.

MATERIALS & METHODS

This population-based study was performed using data collected from Tehran Lipid and Glucose Study cohort (1999-2018). Women who had natural and early menopause were followed up every 3 years. Data gathering was performed through the standard protocol of the study. Statistical analysis was performed using multivariable Cox hazard regression analysis. We used the 'survival' package in the R software version 3.6.0 to fit survival models.

RESULTS

A total of 487 menopausal women met the inclusion criteria; 62.6% had natural menopause and remained had early menopause. Among the participants, 65.5% experienced HTN. The highest proportion of participants had > 5% weight gain, while the lowest had 3-5% weight gain. Either losing body weight (lost > 5%: HR: 0.44; CI 95%, 0.32, 0.62; p < 0.001), (lost 3-5%; HR: 0.47; CI 95%, 0.26, 0.84; p = 0.01), and weight gain > 5% (HR: 0.69; CI 95%, 0.51, 0.91; p = 0.01), were associated with decreased risk of HTN after adjustment for confounders. In this study, weight loss and gain have a protective impact on the development of HTN in subjects. For incident HTN, age (HR: 1.04 (1.01, 1.08), p = 0.004), fasting blood glucose (HR: 1.01, CI 95%:1.00, 1.01; p < 0.001), body mass index (1.02 (1.00, 1.05), p = 0.03) and smoking (1.70 (1.11, 2.58), p = 0.01) were positively associated with HTN.

CONCLUSIONS

Our study indicates the significant association of weight change with hypertension risk in later life among menopausal women.

Management of Stage 1 Hypertension in Adults With a Low 10-Year Risk for Cardiovascular Disease: Filling a Guidance Gap: A Scientific Statement From the American Heart Association

High blood pressure (BP) is the leading cause of worldwide cardiovascular disease morbidity and mortality. Patients and clinicians dealing with hypertension have benefited from the evidence of event-based randomized controlled clinical trials. One result from those trials has been the development of evidence-based guidelines. The commitment to using evidence from these event-based randomized trials has been a cornerstone in the development of guideline treatment recommendations. However, in some situations, evidence from event-based trials is not available to guideline writers or clinicians for assistance in treatment decision making. Such is the case for the management of many patients with stage 1 hypertension. The purpose of this scientific statement is to provide information complementary to the 2017 Hypertension Clinical Practice Guidelines for the patient with untreated stage 1 hypertension (systolic BP/diastolic BP, 130-139/80-89 mm Hg) with a 10-year risk for atherosclerotic cardiovascular disease <10% who fails to meet the systolic BP/diastolic goal (<130/80 mm Hg) after 6 months of guideline-recommended lifestyle therapy. This statement provides evidence from sources other than event-based randomized controlled clinical trials and offers therapy options for consideration by clinicians.

[The role of interval training in the physical rehabilitation of strength sports athletes with hypertension: a randomized controlled study]

OBJECTIVE

To evaluate the effect of high-intensity interval aerobic work on blood pressure and body composition in strength sports athletes of heavy weight categories.

MATERIAL AND METHODS

The examination and physical rehabilitation of 55 strength sports athletes of heavy weight categories with arterial hypertension were performed. Athletes were randomized into two groups: the main group (n=35) and the control group (n=20). The main group athletes trained 120 days (3 times a week) on a bicycle ergometer according to the high-intensity interval protocol, and the control group participants trained 120 days (3 times a week) according to their traditional strenght protocol. All athletes underwent a complex examination, including: a survey, examination, three-time measurement of blood pressure, bioelectrical impedance analysis and calculations of body composition indices, Before and after the physical rehabilitation.

RESULTS

After 120 days of physical rehabilitation, there was an improvement in body composition and a significant decrease in blood pressure: systolic blood pressure by 4.7%, diastolic blood pressure by 5.6%.

CONCLUSIONS

High-intensity aerobic interval work, regardless of the athlete's body composition, has a therapeutic and prophylactic effect on the cardiovascular system. The aerobic workout training protocol taking into account metabolic variables, that we developed, will allow athletes to effectively and safely influence the prevention and treatment of hypertension.