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Ferreira MJ, Sebastião E, Pelicioni PHS. Feasible and Safe Approaches for Exercise Adherence in Hypertension. Am J Hypertens 2024; 37:394-395. [PMID: 38497804 DOI: 10.1093/ajh/hpae036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Affiliation(s)
- Maycon Junior Ferreira
- Department of Medicine, Universidade Federal de São Paulo (UNIFESP), São Paulo, São Paulo,Brazil
| | - Emerson Sebastião
- Department of Health and Kinesiology, University of Illinois Urbana-Champaign, Urbana, Illinois, United States
| | - Paulo Henrique Silva Pelicioni
- School of Health Sciences, University of New South Wales, Randwick, Australia
- Neuroscience Research Australia, University of New South Wales, Randwick, Australia
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Liang W, Liu C, Yan X, Hou Y, Yang G, Dai J, Wang S. The impact of sprint interval training versus moderate intensity continuous training on blood pressure and cardiorespiratory health in adults: a systematic review and meta-analysis. PeerJ 2024; 12:e17064. [PMID: 38495758 PMCID: PMC10944631 DOI: 10.7717/peerj.17064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 02/15/2024] [Indexed: 03/19/2024] Open
Abstract
Background Although aerobic exercise is the primary modality recommended for the treatment of hypertension, it remains unclear whether high-intensity all-out sprint interval training (SIT) can result in greater reductions of blood pressure (BP) and cardiorespiratory health. This systematic review aims to compare the impact of SIT versus Moderate-intensity continuous training (MICT) on improvements in resting systolic blood pressure (SBP), diastolic blood pressure (DBP) and maximal oxygen uptake (VO2 max) among adults. Methods We conducted a systematic search of three online databases (PubMed, Embase, and Web of Science) from January 2000 to July 2023 to identify randomized controlled trials that compared the chronic effects of SIT versus MICT on BP in participants with high or normal blood pressure. We extracted information on participant characteristics, exercise protocols, BP outcomes, and intervention settings. Furthermore, the changes in VO2 max between the two groups were analyzed using a meta-analysis. The pooled results were presented as weighted means with 95% confidence intervals (CI). Results Out of the 1,874 studies initially were found, eight were included in this review, totaling 169 participants. A significant decrease in SBP (MD = -2.82 mmHg, 95% CI [-4.53 to -1.10], p = 0.08, I2 =45%) was observed in the SIT group compared to before the training, but no significant decrease in DBP (MD = -0.75 mmHg, 95% CI [-1.92 to 0.42], p = 0.16, I2 = 33%) was observed. In contrast, both SBP (MD = -3.00 mmHg, 95% CI [-5.31 to -0.69], p = 0.68, I2 = 0%) and DBP (MD = -2.11 mmHg, 95% CI [-3.63 to -0.60], p = 0.72, I2 = 0%) significantly decreased in the MICT group with low heterogeneity. No significant difference was found in resting SBP and DBP between SIT and MICT after the intervention. Both SIT and MICT significantly increased VO2 peak, with SIT resulting in a mean difference (MD) of 1.75 mL/kg/min (95% CI [0.39-3.10], p = 0.02, I2 = 61%), and MICT resulting in a mean difference of 3.10 mL/kg/min (95% CI [1.03-5.18], p = 0.007, I2 = 69%). MICT was more effective in improving VO2 peak (MD = -1.36 mL/kg/min, 95% CI [-2.31 to 0.40], p = 0.56, I2 = 0%). Subgroup analysis of duration and single sprint time showed that SIT was more effective in reducing SBP when the duration was ≥8 weeks or when the sprint time was <30 s. Conclusion Our meta-analysis showed that SIT is an effective intervention in reducing BP and improving cardiorespiratory fitness among adults. Consequently, SIT can be used in combination with traditional MICT to increase the variety, utility, and time efficiency of exercise prescriptions for different populations.
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Affiliation(s)
- Weibao Liang
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, Guangdong, China
| | - Chuannan Liu
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, Guangdong, China
| | - Xujie Yan
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, Guangdong, China
| | - Yu Hou
- Department of Physical Education, Kunsan National University, Gunsan, South Korea
| | - Guan Yang
- School of Physical Education, South China University of Technology, Guangzhou, Guangdong, China
| | - Jianmin Dai
- College of Sports Science, Kyungnam University, Changwon, South Korea
| | - Songtao Wang
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, Guangdong, China
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Pakhan AA, Jawade S, Boob MA, Somaiya KJ. Impact of Pulsed Electromagnetic Field Therapy and Aerobic Exercise on Patients Suffering With Hypertension: A Systematic Review. Cureus 2024; 16:e56414. [PMID: 38638759 PMCID: PMC11024783 DOI: 10.7759/cureus.56414] [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: 08/14/2023] [Accepted: 03/18/2024] [Indexed: 04/20/2024] Open
Abstract
Hypertension is a major preventable risk factor for cardiovascular disease. This review evaluates the effects of pulsed electromagnetic field (PEMF) therapy and aerobic exercise on blood pressure (BP) levels in hypertensive patients. This study incorporated research conducted between 2012 and 2020 that was found through a systematic literature search. The measures used to estimate the improvement in BP include the BP measurements, quality-of-life (QOL) scale, and plasma nitric oxide (NO) level. The examination of the review comprised eight studies. These encompassed studies involving individuals with a systolic BP (SBP) above 140 mmHg and a diastolic BP (DBP) above 90 mmHg; those falling within the age range of 40 to 60 years, including both genders; and patients on antihypertensive medications. The review of selected articles concluded that PEMF therapy and aerobic exercise positively impact BP among individuals with hypertension. Aerobic exercises of moderate intensity including brisk walking, jogging, and cycling type of aerobic exercises help reduce BP and maintain patients' physical fitness. PEMF therapy is a complementary approach that affects the biological system and potential health, positively impacting BP. Results indicate that PEMF therapy can be a nonpharmacological method to manage BP in clinical populations. More thorough research is necessary to understand the best dosage, long-term effects, and comparison between PEMF therapy and aerobic exercise.
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Affiliation(s)
- Arjavi A Pakhan
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapna Jawade
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Manali A Boob
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Kamya J Somaiya
- Musculoskeletal Physiotherapy, Ravi Nair Physiotherapy College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Brito LC, Azevêdo LM, Amaro-Vicente G, Costa LR, da Silva Junior ND, Halliwill JR, Rondon MUPB, Forjaz CLM. Evening but not morning aerobic training improves sympathetic activity and baroreflex sensitivity in elderly patients with treated hypertension. J Physiol 2024; 602:1049-1063. [PMID: 38377223 DOI: 10.1113/jp285966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/08/2024] [Indexed: 02/22/2024] Open
Abstract
The blood pressure-lowering effect of aerobic training is preceded by improving cardiovascular autonomic control. We previously demonstrated that aerobic training conducted in the evening (ET) induces a greater decrease in blood pressure than morning training (MT). To study whether the greater blood pressure decrease after ET occurs through better cardiovascular autonomic regulation, this study aimed to compare MT versus ET on muscle sympathetic nerve activity (MSNA) and baroreflex sensitivity (BRS) in treated patients with hypertension. Elderly patients treated for hypertension were randomly allocated into MT (n = 12, 07.00-10.00 h) or ET (n = 11, 17.00-20.00 h) groups. Both groups trained for 10 weeks, 3 times/week, cycling for 45 min at moderate intensity. Beat-to-beat blood pressure (finger photoplethysmography), heart rate (electrocardiography) and MSNA (microneurography) were assessed at the initial and final phases of the study at baseline and during sequential bolus infusions of sodium nitroprusside and phenylephrine (modified-Oxford technique) to evaluate cardiac and sympathetic BRS. Mean blood pressure decreased significantly after ET but not after MT (-9 ± 11 vs. -1 ± 8 mmHg, P = 0.042). MSNA decreased significantly only after ET with no change after MT (-12 ± 5 vs. -3 ± 7 bursts/100 heart beats, P = 0.013). Sympathetic BRS improved after ET but not after MT (-0.8 ± 0.7 vs. 0.0 ± 0.8 bursts/100 heart beats/mmHg, P = 0.052). Cardiac BRS improved similarly in both groups (ET: +1.7 ± 1.8 vs. MT: +1.4 ± 1.9 ms/mmHg, Pphase ≤ 0.001). In elderly patients treated for hypertension, only ET decreased mean blood pressure and MSNA and improved sympathetic BRS. These findings revealed that the sympathetic nervous system has a key role in ET's superiority to MT in blood pressure-lowering effect. KEY POINTS: Reducing muscle nerve sympathetic activity and increasing sympathetic baroreflex sensitivity plays a key role in promoting the greater blood pressure reduction observed with evening training. These findings indicated that simply changing the timing of exercise training may offer additional benefits beyond antihypertensive medications, such as protection against sympathetic overdrive and loss of baroreflex sensitivity, independent markers of mortality. Our new findings also suggest new avenues of investigation, such as the possibility that evening aerobic training may be beneficial in other clinical conditions with sympathetic overdrive, such as congestive heart failure and hypertrophic cardiomyopathy.
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Affiliation(s)
- Leandro C Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Luan M Azevêdo
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Graziela Amaro-Vicente
- Laboratory of Autonomic Control of Circulation, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Luis R Costa
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Natan D da Silva Junior
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - John R Halliwill
- Department of Human Physiology, University of Oregon, Eugene, OR, USA
| | - Maria U P B Rondon
- Laboratory of Autonomic Control of Circulation, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
| | - Cláudia L M Forjaz
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, São Paulo, Brazil
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González-Devesa D, Varela S, Diz-Gómez JC, Ayán-Pérez C. The efficacy of Pilates method in patients with hypertension: systematic review and meta-analysis. J Hum Hypertens 2024; 38:200-211. [PMID: 38361026 DOI: 10.1038/s41371-024-00899-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 02/01/2024] [Accepted: 02/05/2024] [Indexed: 02/17/2024]
Abstract
This study aimed to systematically review the available evidence on the effects of Pilates training programs on blood pressure in hypertensive patients. Randomized clinical trials and comparative studies were searched in four electronic databases until September 2023 (updated December 2023). The methodological quality of included studies was assessed using the Physiotherapy Evidence Database and Methodological Index for Non-Randomized Studies scales. A total of 4 randomized clinical trials and 7 comparative studies were included, showing a low (n = 1), hight (n = 6), and good (n = 4) methodological quality. Data synthesis indicated that participants who performed Pilates program obtained significantly reduces on systolic blood pressure and diastolic blood pressure, of -4.76 mmHg (95% CI: -6.55 to -2.97, p < 0.001) and -3.43 mmHg (95% CI: -4.37 to -2.49, p < 0.001), respectively, in comparison with those included in the comparison groups. When the analysis was performed by comparing hypertensive, and normotensive patients, the results remained non-significant for blood pressure (systolic blood pressure: 0.96 mmHg (95% CI: -2.85 to 4.77, P = 0.49); diastolic blood pressure: 1.18 mmHg (95% CI: -1.23 to 3.58, P = 0.34); mean blood pressure: 1.73 mmHg (95% CI: -1.96 to 5.42, P = 0.36). Evidence suggests Pilates is safe for hypertensive patients and can be part of their rehabilitation, but it may not necessarily offer superior results or improve exercise adherence compared to other modalities.
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Affiliation(s)
- Daniel González-Devesa
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain Well-Move Research Group, 36310, Vigo, Spain.
| | - Silvia Varela
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain Well-Move Research Group, 36310, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, 36310, Vigo, Spain
| | - Jose C Diz-Gómez
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain Well-Move Research Group, 36310, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, 36310, Vigo, Spain
| | - Carlos Ayán-Pérez
- Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, Spain Well-Move Research Group, 36310, Vigo, Spain
- Departamento de Didácticas Especiais, Universidade de Vigo, 36310, Vigo, Spain
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Jabbarzadeh Ganjeh B, Zeraattalab-Motlagh S, Jayedi A, Daneshvar M, Gohari Z, Norouziasl R, Ghaemi S, Selk-Ghaffari M, Moghadam N, Kordi R, Shab-Bidar S. Effects of aerobic exercise on blood pressure in patients with hypertension: a systematic review and dose-response meta-analysis of randomized trials. Hypertens Res 2024; 47:385-398. [PMID: 37872373 DOI: 10.1038/s41440-023-01467-9] [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: 02/05/2023] [Revised: 09/19/2023] [Accepted: 09/26/2023] [Indexed: 10/25/2023]
Abstract
We aimed to evaluate the dose-dependent effects of aerobic exercise on systolic (SBP) and diastolic blood pressure (DBP) and haemodynamic factors in adults with hypertension. PubMed, Scopus, and Web of Science were searched to April 2022 for randomized trials of aerobic exercise in adults with hypertension. We conducted a random-effects meta-analysis to estimate mean differences (MDs) and 95%CIs for each 30 min/week increase in aerobic exercise. The certainty of evidence was rated using the GRADE approach. The analysis of 34 trials with 1787 participants indicated that each 30 min/week aerobic exercise reduced SBP by 1.78 mmHg (95%CI: -2.22 to -1.33; n = 34, GRADE=low), DBP by 1.23 mmHg (95%CI: -1.53 to -0.93; n = 34, GRADE=moderate), resting heart rate (MD = -1.08 bpm, 95%CI: -1.46 to -0.71; n = 23, GRADE=low), and mean arterial pressure (MD = -1.37 mmHg, 95%CI: -1.80 to -0.93; n = 9, GRADE = low). A nonlinear dose-dependent decrement was seen on SBP and DBP, with the greatest decrement at 150 min/week (MD150 min/week = -7.23 mmHg, 95%CI: -9.08 to -5.39 for SBP and -5.58 mmHg, 95%CI: -6.90 to -4.27 for DBP). Aerobic exercise can lead to a large and clinically important reduction in blood pressure in a dose-dependent manner, with the greatest reduction at 150 min/week. The dose-dependent effects of aerobic exercise on systolic and diastolic blood pressure and haemodynamic factors in adults with hypertension.
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Affiliation(s)
| | | | - Ahmad Jayedi
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Mojtaba Daneshvar
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Gohari
- Department of Sports Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Norouziasl
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Ghaemi
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Selk-Ghaffari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Navid Moghadam
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Kordi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, Tehran University of Medical Sciences, Tehran, Iran.
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Zaman S, Raj IS, Yang AWH, Lindner R, Denham J. Exercise training reduces arterial stiffness in women with high blood pressure: a systematic review and meta-analysis. J Hypertens 2024; 42:197-204. [PMID: 37851002 DOI: 10.1097/hjh.0000000000003594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2023]
Abstract
The acute and long-term benefits of exercise on cardiovascular health are well established, yet the optimal mode of exercise training that improves arterial stiffness in women with high blood pressure remains unclear. The aim of this systematic review and meta-analysis was to assess the influence of aerobic and resistance training on arterial stiffness in women with high blood pressure. After an extensive search of four online databases, six randomized controlled trials met the inclusion criteria and were included in meta-analyses. Data were extracted from six studies examining the influence of exercise on arterial stiffness assessed by pulse wave velocity (PWV) and were expressed as standardized mean difference (SMD). Whereas aerobic exercise significantly reduced arterial PWV in women with high blood pressure after long-term training [SMD -1.87, 95% confidence interval (CI) -2.34 to -1.40], resistance training had a more modest effect that was borderline statistically significant (SMD -0.31, 95% CI -0.65 to 0.03). These findings suggest regular long-term aerobic exercise training (i.e. 12-20 week interventions) reduces arterial stiffness in women with high blood pressure. Although not statistically significant, the modest number of included trials and lack of publication bias encourages further assessments on the efficacy of resistance exercise for improving arterial stiffness in women with high blood pressure. Given the unique benefits of aerobic and resistance training, particularly for postmenopausal women (e.g. bone health and muscular strength), both modes of training should be encouraged for women with high blood pressure to enhance arterial function and support favorable cardiovascular outcomes.
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Affiliation(s)
- Shadman Zaman
- RMIT University, School of Health and Biomedical Sciences, Melbourne, Victoria
| | - Isaac Selva Raj
- RMIT University, School of Health and Biomedical Sciences, Melbourne, Victoria
- Edith Cowan University, School of Medical and Health Sciences, Joondalup, Western Australia
| | | | - Robert Lindner
- RMIT University, School of Health and Biomedical Sciences, Melbourne, Victoria
| | - Joshua Denham
- RMIT University, School of Health and Biomedical Sciences, Melbourne, Victoria
- University of Southern Queensland, School of Health and Medical Sciences
- Centre for Health Research, Toowoomba, Queensland, Australia
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Luqman A, Hassan A, Ullah M, Naseem S, Ullah M, Zhang L, Din AU, Ullah K, Ahmad W, Wang G. Role of the intestinal microbiome and its therapeutic intervention in cardiovascular disorder. Front Immunol 2024; 15:1321395. [PMID: 38343539 PMCID: PMC10853344 DOI: 10.3389/fimmu.2024.1321395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2023] [Accepted: 01/08/2024] [Indexed: 02/15/2024] Open
Abstract
The gut microbiome is a heterogeneous population of microbes comprising viruses, bacteria, fungi, and protozoa. Such a microbiome is essential for sustaining host equilibrium, and its impact on human health can be altered by a variety of factors such as external variables, social behavior, age, nutrition, and genetics. Gut microbes' imbalances are related to a variety of chronic diseases including cancer, obesity, and digestive disorders. Globally, recent findings show that intestinal microbes have a significant role in the formation of cardiovascular disease (CVD), which is still the primary cause of fatalities. Atherosclerosis, hypertension, diabetes, inflammation, and some inherited variables are all cardiovascular risk variables. However, studies found correlations between metabolism, intestinal flora, and dietary intake. Variations in the diversity of gut microbes and changes in their activity are thought to influence CVD etiology. Furthermore, the gut microbiota acts as an endocrine organ, producing bioactive metabolites such as TMA (trimethylamine)/TMAO (trimethylamine N-oxide), SCFA (short-chain fatty acids), and bile acids, which have a substantial impact on host wellness and disease by multiple mechanisms. The purpose of this overview is to compile current evidence highlighting the intricate links between gut microbiota, metabolites, and the development of CVD. It focuses on how intestinal dysbiosis promotes CVD risk factors such as heart failure, hypertension, and atherosclerosis. This review explores the normal physiology of intestinal microbes and potential techniques for targeting gut bacteria for CVD treatment using various microbial metabolites. It also examines the significance of gut bacteria in disease treatment, including supplements, prebiotics, probiotics, antibiotic therapies, and fecal transplantation, which is an innovative approach to the management of CVD. As a result, gut bacteria and metabolic pathways become increasingly attractive as potential targets for CVD intervention.
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Affiliation(s)
- Ameer Luqman
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
| | - Adil Hassan
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
- Chongqing Key Laboratory of Nano/Micro Composite Materials and Devices, Chongqing University of Science and Technology, Chongqing, China
| | - Mehtab Ullah
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Sahar Naseem
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
| | - Mehraj Ullah
- School of Fermentation Engineering Tianjin University of Science and Technology, Tianjin, China
| | | | - Ahmad Ud Din
- Plants for Human Health Institute, Department of Food, Bioprocessing and Nutrition Sciences, North Carolina State University, Kannapolis, NC, United States
| | - Kamran Ullah
- Department of Biology, The University of Haripur, Haripur, Khyber Pakhtunkhwa, Pakistan
| | - Waqar Ahmad
- Basic Medicine Research Innovation Center for Cardiometabolic Diseases, Ministry of Education, Southwest Medical University, Luzhou, China
| | - Guixue Wang
- Key Laboratory for Biorheological Science and Technology of Ministry of Education, State and Local Joint Engineering Laboratory for Vascular Implants, Bioengineering College of Chongqing University, Chongqing, China
- JinFeng Laboratories, Chongqing, China
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Grannell A, Hallson H, Gunlaugsson B, Jonsson H. Exercise therapy as a digital therapeutic for chronic disease management: consideration for clinical product development. Front Digit Health 2023; 5:1250979. [PMID: 38173910 PMCID: PMC10761443 DOI: 10.3389/fdgth.2023.1250979] [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: 06/30/2023] [Accepted: 12/06/2023] [Indexed: 01/05/2024] Open
Abstract
Digital exercise therapies (DET) have the potential to bridge existing care gaps for people living with chronic conditions. Acting as either a standalone, embedded within multi-modal lifestyle therapy, or adjunct to pharmacotherapy or surgery, evidence-based DETs can favorably impact the health of a rapidly growing population. Given the nascent nature of digital therapeutics, the regulatory landscape has yet to mature. As such, in the absence of clear guidelines clinical digital product developers are responsible for ensuring the DET adheres to fundamental principles such as patient risk management and clinical effectiveness. The purpose of this narrative review paper is to discuss key considerations for clinical digital product developers who are striving to build novel digital therapeutic (DTx) solutions and thus contribute towards standardization of product development. We herein draw upon DET as an example, highlighting the need for adherence to existing clinical guidelines, human-centered design and an intervention approach that leverages the Chronic Care Model. Specific topics and recommendations related to the development of innovative and scalable products are discussed which ultimately allow for differentiation from a basic wellness tool and integration to clinical workflows. By embodying a code of ethics, clinical digital product developers can adequately address patients' needs and optimize their own future digital health technology assessments including appropriate evidence of safety and efficacy.
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Affiliation(s)
- Andrew Grannell
- Sidekick Health, Research & Development Unit, Kópavogur, Iceland
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Azevêdo LM, Brito LCD, Peçanha T, Fecchio RY, Rezende RA, da Silva GV, Pio-Abreu A, Mion Junior D, Halliwill JR, Forjaz CLDM. Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men? J Hum Hypertens 2023; 37:1070-1075. [PMID: 37587259 DOI: 10.1038/s41371-023-00853-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 06/04/2023] [Accepted: 08/08/2023] [Indexed: 08/18/2023]
Abstract
The acute decrease in blood pressure (BP) observed after a session of exercise (called post-exercise hypotension) has been proposed as a tool to predict the chronic reduction in BP induced by aerobic training. Therefore, this study investigated whether post-exercise hypotension observed after a maximal exercise test is associated to the BP-lowering effect of aerobic training in treated hypertensives. Thirty hypertensive men (50 ± 8 years) who were under consistent anti-hypertensive treatment underwent a maximal exercise test (15 watts/min until exhaustion), and post-exercise hypotension was determined by the difference between BP measured before and at 30 min after the test. Subsequently, the patients underwent 10 weeks of aerobic training (3 times/week, 45 min/session at moderate intensity), and the BP-lowering effect of training was assessed by the difference in BP measured before and after the training period. Pearson correlations were employed to evaluate the associations. Post-maximal exercise test hypotension was observed for systolic and mean BPs (-8 ± 6 and -2 ± 4 mmHg, all P < 0.05). Aerobic training reduced clinic systolic/diastolic BPs (-5 ± 6/-2 ± 3 mmHg, both P < 0.05) as well as awake and 24 h mean BPs (-2 ± 6 and -2 ± 5 mmHg, all P < 0.05). No significant correlation was detected between post-exercise hypotension and the BP-lowering effect of training either for clinic or ambulatory BPs (r values ranging from 0.00 to 0.32, all p > 0.05). Post-exercise hypotension assessed 30 min after a maximal exercise test cannot be used to predict the BP-lowering effect of aerobic training in treated hypertensive men.
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Affiliation(s)
- Luan Morais Azevêdo
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Leandro Campos de Brito
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA
| | - Tiago Peçanha
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
- Department of Sport and Exercise Sciences, Manchester Metropolitan University, Institute of Sport, Manchester, United Kingdom
| | - Rafael Yokoyama Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Rafael Andrade Rezende
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Giovânio Vieira da Silva
- Hypertension Unit, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Andrea Pio-Abreu
- Hypertension Unit, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
| | - Décio Mion Junior
- Hypertension Unit, Hospital das Clínicas, Medical School, University of São Paulo, São Paulo, Brazil
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Zou Z, Wang Z, Herold F, Kramer AF, Ng JL, Hossain MM, Chen J, Kuang J. Validity and reliability of the physical activity and social support scale among Chinese established adults. Complement Ther Clin Pract 2023; 53:101793. [PMID: 37579659 DOI: 10.1016/j.ctcp.2023.101793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 08/07/2023] [Accepted: 08/08/2023] [Indexed: 08/16/2023]
Abstract
Social support is a crucial factor that can facilitate regular engagement in physical activity. To assess the influence of social factors on the level of regular physical activity, the Physical Activity and Social Support Scale (PASSS) has been developed. However, the PASSS has yet to be validated in a Chinese sample of established adults. To address this gap in the literature, this study describes the development and psychometric evaluation of a Chinese version of the PASSS (PASSS-C) for established adults. PASSS-C was validated for a Chinese sample of adults aged between 30 and 45 years old (N = 1799). Structural validity was evaluated using confirmatory factor analysis (CFA) with Maximum Likelihood Method (MLM). Spearman's correlations between the PASSS-C and the International Physical Activity Questionnaire - Short Form (IPAQ-SF), the Social Support Rating Scale - Chinses Version (SSRS-C), and the Affective Exercise Experience Scale - Chinese Version (AFFEXX-C) were determined to examine the criterion validity. Cronbach's alpha coefficients and McDonald's omega coefficients were used to assess the internal consistency of the total scale and sub-scales of the PASSS-C. The results of the CFA suggest that the five-factor model had an acceptable fit (CFI = 0.99, GFI = 0.99, SRMR = 0.01, RMSEA = 0.02). Cronbach's alpha and McDonald's omega for the PASSS-C and its sub-scales ranged from 0.81 to 0.96. The results indicate that the PASSS-C has acceptable psychometric properties. Thus, the scale can be used to assess the levels of social support for physical activity in Chinese established adults.
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Affiliation(s)
- Zhenxing Zou
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China
| | - Zihe Wang
- Beijing Chaoyang Hospital, Capital Medical University, Beijing, 100020, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Arthur F Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA, 02115, USA; Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL, 61820, USA
| | - Jonathan Leo Ng
- Department of Health, Physical Education, and Sport, School of Education, College of Design and Social Context, RMIT University, Melbourne, VIC, Australia
| | - M Mahbub Hossain
- Department of Decision and Information Sciences, C.T. Bauer College of Business, University of Houston, TX 77204, USA; Department of Health Systems and Population Health Sciences, Tilman J. Fertitta Family College of Medicine, University of Houston, TX 77204, USA
| | - Jianyu Chen
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
| | - Jin Kuang
- Body-Brain-Mind Laboratory, School of Psychology, Shenzhen University, Shenzhen, 518060, China.
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12
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Shariful Islam M, Fardousi A, Sizear MI, Rabbani MG, Islam R, Saif-Ur-Rahman KM. Effect of leisure-time physical activity on blood pressure in people with hypertension: a systematic review and meta-analysis. Sci Rep 2023; 13:10639. [PMID: 37391436 PMCID: PMC10313796 DOI: 10.1038/s41598-023-37149-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 06/16/2023] [Indexed: 07/02/2023] Open
Abstract
High blood pressure is a major risk factor for premature death. Leisure-time physical activities have been recommended to control hypertension. Studies examining how leisure-time physical activity affects blood pressure have found mixed results. We aimed to conduct a systematic review examining the effect of leisure-time physical activity (LTPA) on lowering blood pressure among adults living with hypertension. We searched studies in Embase, Medline/PubMed, Web of Science, Physical Education Index, Scopus and CENTRAL (the Cochrane Library). The primary outcome variables were systolic blood pressure (SBP) and diastolic blood pressure (DBP). This systematic review is registered on PROSPERO (CRD42021260751). We included 17 studies out of 12,046 screened articles in this review. Moderate-intensity LTPA (all types) reduced SBP compared to the non-intervention control group (MD -5.35 mm Hg, 95% CI -8.06 to -2.65, nine trials, n = 531, low certainty of the evidence). Mean DBP was reduced by -4.76 mm Hg (95% CI -8.35 to -1.17, nine trials, n = 531, low certainty of the evidence) in all types of LTPA (moderate intensity) group compared to the non-intervention control group. Leisure-time walking reduced mean SBP by -8.36 mmHg, 95% CI -13.39 to -3.32, three trials, n = 128, low certainty of the evidence). Walking during leisure time reduced -5.03 mmHg mean DBP, 95% CI -8.23 to -1.84, three trials, n = 128, low certainty of the evidence). Performing physical activity during free time probably reduces SBP and DBP (low certainty of the evidence) among adults with hypertension.
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Affiliation(s)
| | - Ammatul Fardousi
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh
| | - Monaemul Islam Sizear
- Health Systems for Tuberculosis, Dhaka, Bangladesh
- Public Health Foundation, Bangladesh, Dhaka, Bangladesh
| | - Md Golam Rabbani
- Health Economics Unit, Health Services Division, Ministry of Health and Family Welfare, Dhaka, Bangladesh
| | | | - K M Saif-Ur-Rahman
- Health Systems and Population Studies Division, icddr,b, Dhaka, Bangladesh.
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13
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Teixeira JMM, Motta-Santos D, Milanovic Z, Pereira RL, Krustrup P, Póvoas S. Intermittent high-intensity exercise for pre- to established hypertension: A systematic review and meta-analysis. Scand J Med Sci Sports 2023; 33:364-381. [PMID: 36579740 DOI: 10.1111/sms.14299] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/30/2022] [Accepted: 12/12/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To determine the impact of intermittent high-intensity exercise training ([IHIE], including high-intensity interval training [HIIT] and recreational team sports [RTS]) on systolic (SBP) and diastolic blood pressure (DBP) in adults with pre- to established arterial hypertension. DATA SOURCES MEDLINE, Cochrane Library, Embase, and SPORTDiscus. ELIGIBILITY CRITERIA Randomized controlled trials (RCTs) comparing the impact of IHIE on BP versus a non-exercise control. DATA COLLECTION AND ANALYSIS Two authors independently conducted all procedures. Mean differences were calculated using random-effects model. The certainty of the evidence was assessed with GRADE. RESULTS Twenty-seven RCTs (18 HIIT and 9 RTS) were analyzed, with median duration of 12 weeks. Participants' (n = 946) median age was 46 years. Overall, IHIE decreased SBP (-3.29 mmHg; 95% CI: -5.19, -1.39) and DBP (-2.62 mmHg; 95% CI: -3.79, -1.44) compared to the control group. IHIE elicited higher decreases in office SBP and DBP of hypertensive subjects (SBP: -7.13 mmHg, [95% CI: -10.12, -4.15]; DBP: -5.81 mmHg, [95% CI: -7.94, -3.69]) than pre-hypertensive (SBP: -2.14 mmHg, [95% CI: -4.36, -0.08]; DBP: -1.83 mmHg, [95% CI: -2.99, -0.67]). No significant differences were found between HIIT (SBP: -2.12 mmHg, [95% CI: -4.78, -0.54]; DBP: -1.89 mmHg, [95% CI: -3.32, -0.48]) and RTS (SBP: -4.18 mmHg, [95% CI: -7.19, -2.43]; DBP: -4.04 mmHg, [95% CI: -6.00, -2.09]). These findings present low/very low certainty of evidence. No adverse cardiovascular events were reported. CONCLUSIONS IHIE appears to be safe and to promote substantial decreases in BP, particularly in patients with hypertension. However, the certainty of evidence was low/very low. PROTOCOL CRD42020163575.
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Affiliation(s)
- Jorge M M Teixeira
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal
| | - Daisy Motta-Santos
- Sports Department, School of Physical Education, Physiotherapy and Occupational Therapy, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Zoran Milanovic
- Faculty of Sport and Physical Education, University of Niš, Niš, Serbia.,Science and Research Centre Koper, Institute for Kinesiology Research, Koper, Slovenia.,Faculty of Sports Studies, Incubator of Kinanthropological Research, Masaryk University, Brno, Czech Republic
| | - Rita L Pereira
- Laboratory of Metabolism and Exercise, Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal.,University of Maia, Maia, Portugal
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark.,Sport and Health Sciences, College of Life and Environment Sciences, University of Exeter, Exeter, UK.,Department of Physical Education and Sports Training, Shanghai University of Sport (SUS), Shanghai, China.,Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
| | - Susana Póvoas
- Research Center in Sports Sciences, Health Sciences and Human Development (CIDESD), University of Maia, Maia, Portugal.,Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
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14
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Tsoi K, Lam A, Tran J, Hao Z, Yiu K, Chia YC, Turana Y, Siddique S, Zhang Y, Cheng HM, Wang JG, Kario K. The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews. J Clin Hypertens (Greenwich) 2023. [PMID: 36946438 DOI: 10.1111/jch.14610] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 11/05/2022] [Indexed: 03/23/2023]
Abstract
Hypertension remains the world's leading cause of premature death. Interventions such as exercise, diet modification, and pharmacological therapy remain the mainstay of hypertension treatment. Numerous systematic reviews and meta-analyses demonstrated the effectiveness of western exercises, such as aerobic exercise and resistance exercise, in reducing blood pressure in hypertensive patients. There is recently emerging evidence of blood pressure reduction with Chinese exercises, such as Tai Chi, Baduanjin, and Qigong. The current overview of systematic reviews aims to evaluate the quality and descriptively summarize the evidence for the effectiveness of western and Chinese exercises for hypertension management. Thirty-nine systematic reviews were included in this overview, with 15 of those being on Chinese exercise. Evidence suggests that exercise training, regardless of Western or Chinese exercise, generally reduced both systolic and diastolic blood pressure. High-intensity intermittent training did not further reduce blood pressure when compared to moderate-intensity continuous training. Conflicting results on the effectiveness of blood pressure reduction when comparing Chinese and Western exercise training were observed. This suggests the comparable effectiveness of Chinese exercise training, in particularly Tai Chi, to general or aerobic exercise training in terms of blood pressure reduction. The Chinese exercise modality and intensity may be more suitable for the middle-aged and elderly population.
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Affiliation(s)
- Kelvin Tsoi
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Lam
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joshua Tran
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ziyu Hao
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Karen Yiu
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao-Min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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15
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Sarinukul C, Janyacharoen T, Donpunha W, Nakmareong S, Ruksapukdee W, Sawanyawisuth K. The Effects of Stepping Exercise on Blood Pressure, Physical Performance, and Quality of Life in Female Older Adults with Stage 1 Hypertension: a Randomized Controlled Trial. Can Geriatr J 2023; 26:144-149. [PMID: 36865403 PMCID: PMC9953505 DOI: 10.5770/cgj.26.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/04/2023] Open
Abstract
Background Hypertension is a common disease, particularly in older adults. In a previous study, we found that an eight-week course of stepping exercise improved physical performance in healthy older adults as measured using the six-minute walk test (468 vs. 426 m in controls; p = .01). This study aims to further evaluate the effects of stepping exercise on blood pressure, physical performance, and quality of life in older adults with stage 1 hypertension. Methods This was a randomized, controlled trial comparing older adults with stage 1 hypertension who performed stepping exercise with controls. The stepping exercise (SE) was performed at moderate intensity three times/week over an eight-week period. Participants in the control group (CG) received verbal and written (pamphlet) lifestyle modification advice. Blood pressure at Week 8 was the primary outcome, while quality of life score and physical performance on the 6-minute walk test (6MWT), timed up and go test (TUGT), and five times sit to stand test (FTSST) were secondary outcomes. Results There were 17 female patients in each group (total of 34). After eight weeks of training, participants in the SE group showed significant improvements in systolic blood pressure (SBP; 132.0 vs. 145.1 mmHg; p<.01), diastolic blood pressure (DBP; 67.3 vs. 87.6 mmHg; p<.01), 6MWT (465.6 vs. 437.0; p<.01), TUGT (8.1 vs. 9.2 sec; p<.01), and FTSST (7.9 vs. 9.1 sec; p<.01) compared to controls. Regarding within-group comparison, participants in the SE also showed significant improvement in all outcomes from baseline, while any such outcomes in the CG were comparable from baseline (SBP: 144.1 to 145.1 mmHg; p = .23; DBP: 84.3 to 87.6 mmHg; p = .90). Conclusions The stepping exercise examined is an effective non-pharmacological intervention for blood pressure control in female older adults with stage 1 hypertension. This exercise also resulted in improvements in physical performance and quality of life.
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Affiliation(s)
- Chawin Sarinukul
- School of Physiotherapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen
| | - Taweesak Janyacharoen
- School of Physiotherapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen
- Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen
| | - Wanida Donpunha
- School of Physiotherapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen
| | - Saowanee Nakmareong
- School of Physiotherapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen
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16
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Esmailiyan M, Amerizadeh A, Vahdat S, Ghodsi M, Doewes RI, Sundram Y. Effect of Different Types of Aerobic Exercise on Individuals With and Without Hypertension: An Updated Systematic Review. Curr Probl Cardiol 2023; 48:101034. [PMID: 34718034 DOI: 10.1016/j.cpcardiol.2021.101034] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 10/16/2021] [Indexed: 02/01/2023]
Abstract
High blood pressure (BP) is one of the main modifiable risk factors for cardiovascular disease (CVD) and preventing it greatly reduces the vascular consequences of aging and, along with intensive treatment of hypertension, eliminates a large portion of the burden of CVD-related mortality. Many meta-analyses and studies proved that regular aerobic exercise (AE) reduces BP but most of these studies consider only hypertensive populations or only AE but not resistant exercise or their combination. In this review, we aimed to study the effect of different types of physical activity (PA)/AE on various populations including normotensive, prehypertensive, primary hypertensive, and resistant hypertensive with different comorbidities. We searched PubMed, Web of Science, and Google Scholar for English articles with keywords for physical activity, aerobic exercise, and blood pressure from January 2010 until September 2021. Finally, 24 studies were included. Results showed that chronic or acute AE (long-term or short-term), either alone or as combined with different sessions and programs can reduce systolic and diastolic BP in every group including normotensive, prehypertensive, primary hypertensive, resistant hypertensive individuals and diabetic patients and those with kidney problems but not in people with chronic heart failure. Isometric exercise training showed to be useful in reducing BP in all groups either as low intensity or as high intensity but the rate of reduction was different in terms of gender. AE showed to be effective in terms of BP reduction in a different age range. It can be seen that different types and duration of AE independent of the modality and programs and independent of the BP medical situation of individuals have been successful in terms of BP reduction. For those with chronic heart failure, more concern and help might be needed to decrease BP via exercise.
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Affiliation(s)
| | - Atefeh Amerizadeh
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Sahar Vahdat
- Isfahan Kidney Diseases Research Center, Khorshid Hospital, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Ghodsi
- Assistant Prof. of Cardiovascular surgery, Department of Surgery, School of Medicine, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Rumi Iqbal Doewes
- Faculty of Pharmacy, Asia Metropolitan University, Malaysia; Faculty of Sport, Universitas Sebelas Maret, Jl. Ir. Sutami, 36A, Kentingan, Surakarta, Indonesia
| | - Yamuna Sundram
- Faculty of Pharmacy, Asia Metropolitan University, Malaysia
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17
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Effects of exergame and bicycle exercise intervention on blood pressure and executive function in older adults with hypertension: A three-group randomized controlled study. Exp Gerontol 2023; 173:112099. [PMID: 36681131 DOI: 10.1016/j.exger.2023.112099] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 01/21/2023]
Abstract
Management of hypertension and prevention of cognitive decline are challenging public health problems. However, the effects of exergame intervention on blood pressure (BP) remain to be explored, and whether exergame intervention is an effective alternative to traditional physical exercise intervention for older adults with hypertension remains to be demonstrated. This study aimed to explore the effectiveness of moderate-intensity exergame intervention and bicycle exercise training on BP and executive function in older hypertensive patients. A total of 128 participants were randomly assigned to the exergame intervention group (n = 41), bicycle exercise intervention group (n = 44), and control group (n = 43). The intervention groups exercised for 60 min, 3 times per week, for 16 weeks, while the control group maintained their normal lifestyle. The results revealed that there were no significant differences between two intervention groups and control group in systolic BP and diastolic BP changes (ps > 0.05). Both intervention groups demonstrated significant improvements in working memory when compared with control group (exergame intervention group: -461.9 ms, p = 0.025; bicycle exercise intervention group: -470.1 ms, p = 0.021). There were no significant differences in systolic BP, diastolic BP, or working memory between the two intervention groups after 16 weeks of training (ps > 0.05). No difference in inhibition or cognitive flexibility was observed between the intervention and control groups (ps > 0.05). The current results showed that moderate-intensity exergame intervention did not produce significant benefits in reducing BP, but yielded similar beneficial effects in working memory to that of bicycle exercise intervention. More studies are needed on whether exergame intervention has the potential to be a promising supplemental therapeutic tool for older adults with hypertension.
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18
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Bartsch B, Faulkner J, Moore JB, Stoner L. Exercise prescription, intervention, dissemination, and implementation following transient ischemic attack or stroke: advancing the field through interdisciplinary science. Transl Behav Med 2023; 13:309-315. [PMID: 36694928 DOI: 10.1093/tbm/ibac107] [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: 01/26/2023] Open
Abstract
Lay Summary
Research has demonstrated that both exercise, and a reduction in cardiovascular disease (CVD) risk factors (i.e., high blood sugar, blood lipids, and blood pressure), following a stroke or transient ischemic attack (TIA) are beneficial for reducing risk of recurrent stroke or TIA and for improving overall quality of life. Despite this evidence, many stroke and TIA survivors remain inactive and sedentary and present with multiple CVD risk factors. The purpose of this commentary is to highlight gaps in the current literature in regard to exercise and behavior interventions for the stroke and TIA populations, present ideas for intervention design, and discuss the dissemination and implementation of research findings. The future research ideas presented in this commentary are based on current research findings, as well as the professional experience of the article authors. Professional experience spans occupational therapy in neurorehabilitation, clinical exercise physiology in rehabilitation, creation and implementation of stroke rehabilitation clinics, stroke and TIA research, and behavioral and implementation science.
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Affiliation(s)
- Bria Bartsch
- Department of Physical Therapy, Rehabilitation Science, and Athletic Training, University of Kansas Medical Center, Kansas City, KS, USA
| | - James Faulkner
- Department of Sport, Exercise and Health, University of Winchester, Winchester, UK
| | - Justin B Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Lee Stoner
- Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, NC, USA.,Department of Epidemiology, The Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
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19
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Malta DC, Bernal RTI, Ribeiro EG, Moreira AD, Felisbino-Mendes MS, Velásquez-Meléndez JG. Arterial hypertension and associated factors: National Health Survey, 2019. Rev Saude Publica 2023; 56:122. [PMID: 36629713 PMCID: PMC9749662 DOI: 10.11606/s1518-8787.2022056004177] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 03/14/2022] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To analyze the factors associated with self-reported arterial hypertension, as well as its prevalence in the Brazilian adult population. METHODS Data from 88,531 individuals aged 18 years or older who responded to the 2019 National Health Survey were analyzed. The outcome studied was self-reported arterial hypertension. Sociodemographic variables and clinical and lifestyle conditions were considered as exposures. The prevalence ratio (PR), crude and adjusted for sex, age, and schooling was used as a measure of association to verify the factors related to its prevalence, obtained by Poisson regression with robust variance. RESULTS The prevalence of self-reported arterial hypertension was of 23.9% (95%CI: 23.4-24.4). When adjusting for age, sex, and schooling, the adjusted Prevalence Ratios (APR) were higher among: regular health self-assessment (APR = 1.6; 95%CI: 1.5-1.6) and bad health self-assessment (APR = 1.7; 95%CI: 1.6-1.8); self-reference to heart disease (APR = 1.7; 95%CI: 1.6-1.7), diabetes (APR = 1.7; 95%CI: 1.6-1.8), high cholesterol (APR = 1.6; 95%CI: 1.6-1.7), overweight (APR = 1.4; 95%CI: 1.4-1.5), and obesity (APR = 2.0; 95%CI: 1.9-2.1); high salt intake (APR = 1.1; 95%CI: 1.0-1.1); higher among former smokers (APR = 1.1; 95%CI: 1.1-1.2) and lower among smokers (APR = 0.9; 95%CI: 0.8-0.9); and consumption of ultra-processed foods (APR = 0.9; 95%CI: 0.8-0.9). CONCLUSION A quarter of the Brazilian adult population claims to have arterial hypertension, more prevalent among women and associated with older age groups, Black, mixed-race, and others, low schooling, high salt intake, former smoking, presence of comorbidities, and worse health self-assessment.
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Affiliation(s)
- Deborah Carvalho Malta
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Regina Tomie Ivata Bernal
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Edmar Geraldo Ribeiro
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Alexandra Dias Moreira
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Mariana Santos Felisbino-Mendes
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
| | - Jorge Gustavo Velásquez-Meléndez
- Universidade Federal de Minas GeraisEscola de EnfermagemDepartamento de Enfermagem Materno Infantil e Saúde PúblicaBelo HorizonteMGBrasilUniversidade Federal de Minas Gerais. Escola de Enfermagem. Departamento de Enfermagem Materno Infantil e Saúde Pública. Belo Horizonte, MG, Brasil
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20
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Yin Y, Yu Z, Wang J, Sun J. Effects of the different Tai Chi exercise cycles on patients with essential hypertension: A systematic review and meta-analysis. Front Cardiovasc Med 2023; 10:1016629. [PMID: 36937925 PMCID: PMC10020615 DOI: 10.3389/fcvm.2023.1016629] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 02/15/2023] [Indexed: 03/06/2023] Open
Abstract
Objective The main treatment for essential hypertension at this stage is pharmacotherapy. Long-term pharmacotherapy is costly with some side effects. Tai Chi, a bright star in traditional Chinese arts, relaxes both mind and body and has been shown to relax blood vessels and lower blood pressure. This study aimed to systematically review the therapeutic effectiveness of the Tai Chi exercise cycle on blood pressure and cardiovascular risk factors of patients with essential hypertension. Methods Searching CNKI, VIP, CBM, PubMed, EBSCO, Embase, Cochrane Library, and Web of Science to collect randomized controlled trials about Tai Chi exercise in the treatment of patients with essential hypertension according to the inclusion and exclusion criteria. The search time ranged from the date of database construction to December 2022. The Cochrane risk-of-bias tool was used to evaluate the included trials. The meta-analysis was performed with RevMan5.3 and Stata12.0 software. Results According to the meta-analysis, compared with the controls, Tai Chi exercise with a cycle of more than 12 weeks may be better for the reduction of systolic blood pressure (SBP) [MD = -11.72, 95% CI (-15.52, -7.91)] and diastolic blood pressure (DBP) [MD = -4.68, 95% CI (-7.23, -2.12)], as well as increasing the content of nitric oxide (NO) [MD = 0.99, 95% CI (0.69, 1.28)]. The blood lipid metabolism ability may also be improved after more than 12 weeks of Tai Chi exercise, total cholesterol (TC) [SMD = -0.68, 95% CI (-0.89, -0.46), triglyceride (TG) [SMD = -0.84, 95% CI (-1.25, -0.43)], low-density lipoprotein cholesterol (LDL-C) [SMD = -1.58, 95% CI (-2.29, -0.86)]. However, the improvement of high-density lipoprotein cholesterol (HDL-C) [SMD = 0.54, 95% CI (0.28, 0.79)] was better with a less than 12 weeks exercise cycle. A subgroup analysis for exercise frequency and time showed that the exercise frequency should preferably be more than or equal to 5 times per week for patients with hypertension, and for patients with hypertension plus hyperlipidemia, the exercise frequency less than 5 times per week with exercise time less than 60 min each day may be more beneficial. Conclusion The meta-analysis indicated that a more than 12 weeks Tai Chi exercise cycle with less than 60 min each time and more than 5 times per week may be more beneficial in blood pressure reduction, NO level increasing and blood lipid metabolism improving in the comparison with the other exercise cycles. For patients with hypertension plus hyperlipidemia, exercise frequency of less than 5 times per week may be better. Systematic Review Registration [http://www.crd.york.ac.uk/prospero], identifier [CRD42022352035].
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Affiliation(s)
- Yikun Yin
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Zhengze Yu
- College of Physical Education and Health, Guangxi Normal University, Guilin, China
| | - Jialin Wang
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
| | - Junzhi Sun
- Institute of Sports Medicine and Health, Chengdu Sport University, Chengdu, China
- Correspondence: Junzhi Sun
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Hayes P, Ferrara A, Keating A, McKnight K, O'Regan A. Physical Activity and Hypertension. Rev Cardiovasc Med 2022; 23:302. [PMID: 39077709 PMCID: PMC11262345 DOI: 10.31083/j.rcm2309302] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 07/31/2022] [Accepted: 08/09/2022] [Indexed: 07/31/2024] Open
Abstract
Hypertension and physical inactivity are leading causes of premature mortality. While both are modifiable risk factors for cardiovascular disease, their prevalence remains high. As populations grow older, they are more likely to develop hypertension and to become less physically active. Scientific advances have contributed to understanding of how physical activity improves blood pressure and the clinically relevant ambulatory blood pressure, but this is not reflected in hypertension guidelines for clinical management of hypertension. The aim of this paper is to clearly present up to date knowledge from scientific studies that underpin the role of physical activity in hypertension management. Longitudinal studies in this review demonstrate a protective effect of higher physical activity levels as well as higher levels of cardiorespiratory fitness. Interventional studies report improvements in blood pressure associated with aerobic, resistance and concurrent exercise; the improvements in some studies were greatest among participant groups with established hypertensions; the effect was observed for groups with treatment-resistant hypertension also, a clinically important subgroup. The most recent research provides evidence for the synergy between physical activity and pharmacotherapy for the treatment of hypertension, providing an opportunity for clinicians to promote physical activity as an adjunctive treatment for hypertension as well as a preventative strategy. This review critiques the evidence and summarises the most up to date literature in the field of physical activity and hypertension.
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Affiliation(s)
- Peter Hayes
- School of Medicine, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Alexandra Ferrara
- School of Medicine, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Aoife Keating
- School of Medicine, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Kathryn McKnight
- School of Medicine, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
| | - Andrew O'Regan
- School of Medicine, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland
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22
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YANG MINGXUAN, PAN YANXIA, LI KUNHUI, CHEN XIUYUN, LI MINYAN, LIN JIANPING, LI MING, LIN CHENG. Effects of Exercise Training on PPARβ/δ Expression in Skeletal Muscle of Rats with Spontaneous Hypertension. Med Sci Sports Exerc 2022; 54:1309-1316. [PMID: 35389955 PMCID: PMC9301982 DOI: 10.1249/mss.0000000000002925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to identify the relationship and mechanism between skeletal muscle peroxisome proliferator-activated receptor β/δ (PPARβ/δ) and spontaneous hypertension. METHODS Rats were divided into four groups ( n = 10): spontaneous hypertensive rats exercise group (SHR-E), spontaneous hypertensive rats sedentary group (SHR-S), Wistar-Kyoto control rats exercise group (WKY-E), and Wistar-Kyoto control rats sedentary group (WKY-S). Although the sedentary groups were placed on the treadmill without moving during the training sessions, the exercise groups were forced to run on a treadmill for 8 wk, 1 h·d -1 , 5 d·wk -1 . After training, the density and area of gastrocnemius microvessels were observed. PPARβ/δ, vascular endothelial growth factor A (VEGFA), superoxide dismutase 2 (SOD-2), and nitric oxide synthase in gastrocnemius were measured by real-time quantitative polymerase chain reaction (RT-qPCR) and Western blot. RESULTS Except the sixth week of age, the systolic blood pressure of SHR-S was significantly higher than that of WKY-S at all time periods. Exercise significantly reduced systolic blood pressure in SHR rats. Compared with the SHR-S group, the WKY-S group had significantly higher PPARβ/δ protein level and density of skeletal muscle microvessels. Eight weeks of exercise increased the PPARβ/δ, SOD-2, VEGFA, and microvessel density and area in the skeletal muscle of SHR. CONCLUSIONS Exercise training promoted PPARβ/δ mRNA and protein-level expression of PPARβ/δ, SOD-2 and VEGFA in skeletal muscle, thus increasing the density and area of skeletal muscle blood vessels. These regulations contribute to the reduction of peripheral vascular resistance. This may be a potential mechanism of exercise to reduce blood pressure.
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Affiliation(s)
- MINGXUAN YANG
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, CHINA
| | - YANXIA PAN
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - KUNHUI LI
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - XIUYUN CHEN
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - MINYAN LI
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - JIANPING LIN
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - MING LI
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
| | - CHENG LIN
- Department of Rehabilitation Therapy, School of Health, Fujian Medical University, Fuzhou, CHINA
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Meta-Analysis of the Effect of Aerobic Training on Blood Pressure in Hypertensive Patients. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9281661. [PMID: 35664636 PMCID: PMC9159888 DOI: 10.1155/2022/9281661] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 05/05/2022] [Accepted: 05/10/2022] [Indexed: 11/26/2022]
Abstract
Background We aimed to evaluate the effect of different aerobic training methods and exercise duration on blood pressure in hypertensive patients, including systolic blood pressure (SBP) and diastolic blood pressure (DBP). Methods Using the literature review method, the English database PubMed was retrieved to obtain relevant research literature, and the selected studies were analyzed and evaluated. Results 14 clinical studies were included in this study, with a total of 1027 patients, including 681 in the aerobic training group and 409 in the control group. Based on heterogeneity test results, the differences of SBP and DBP before and after the physical intervention were combined using a random effect model. The results indicated that the aerobic training group could significantly reduce SBP compared with the control group, WMD = −9.91, 95% CI (-14.21, -5.61), P < 0.0001. The DBP was reduced significantly in the aerobic training group, WMD = −4.32, 95% CI (- 7.02, -1.62), P < 0.001. The results of subgroup analysis showed that both progressive training and nonprogressive training could reduce blood pressure in patients, and training time less than 12 weeks and more than 12 weeks could reduce blood pressure in patients. Conclusion Implementing aerobic training can effectively reduce blood pressure in hypertensive patients. Progressive training, nonprogressive training, and different training cycles can all benefit hypertensive patients.
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Maiuolo J, Carresi C, Gliozzi M, Mollace R, Scarano F, Scicchitano M, Macrì R, Nucera S, Bosco F, Oppedisano F, Ruga S, Coppoletta AR, Guarnieri L, Cardamone A, Bava I, Musolino V, Paone S, Palma E, Mollace V. The Contribution of Gut Microbiota and Endothelial Dysfunction in the Development of Arterial Hypertension in Animal Models and in Humans. Int J Mol Sci 2022; 23:ijms23073698. [PMID: 35409057 PMCID: PMC8999124 DOI: 10.3390/ijms23073698] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/25/2022] [Accepted: 03/25/2022] [Indexed: 02/06/2023] Open
Abstract
The maintenance of the physiological values of blood pressure is closely related to unchangeable factors (genetic predisposition or pathological alterations) but also to modifiable factors (dietary fat and salt, sedentary lifestyle, overweight, inappropriate combinations of drugs, alcohol abuse, smoking and use of psychogenic substances). Hypertension is usually characterized by the presence of a chronic increase in systemic blood pressure above the threshold value and is an important risk factor for cardiovascular disease, including myocardial infarction, stroke, micro- and macro-vascular diseases. Hypertension is closely related to functional changes in the endothelium, such as an altered production of vasoconstrictive and vasodilator substances, which lead to an increase in vascular resistance. These alterations make the endothelial tissue unresponsive to autocrine and paracrine stimuli, initially determining an adaptive response, which over time lead to an increase in risk or disease. The gut microbiota is composed of a highly diverse bacterial population of approximately 1014 bacteria. A balanced intestinal microbiota preserves the digestive and absorbent functions of the intestine, protecting from pathogens and toxic metabolites in the circulation and reducing the onset of various diseases. The gut microbiota has been shown to produce unique metabolites potentially important in the generation of hypertension and endothelial dysfunction. This review highlights the close connection between hypertension, endothelial dysfunction and gut microbiota.
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Affiliation(s)
- Jessica Maiuolo
- Laboratory of Pharmaceutical Biology, in IRC-FSH Center, Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy;
- Correspondence: (J.M.); (M.G.)
| | - Cristina Carresi
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
| | - Micaela Gliozzi
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Correspondence: (J.M.); (M.G.)
| | - Rocco Mollace
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Federica Scarano
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Miriam Scicchitano
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Roberta Macrì
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Saverio Nucera
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Francesca Bosco
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Francesca Oppedisano
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Stefano Ruga
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
| | - Anna Rita Coppoletta
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
| | - Lorenza Guarnieri
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
| | - Antonio Cardamone
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
| | - Irene Bava
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Vincenzo Musolino
- Laboratory of Pharmaceutical Biology, in IRC-FSH Center, Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy;
| | - Sara Paone
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Ernesto Palma
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- Nutramed S.c.a.r.l, Complesso Ninì Barbieri, Roccelletta di Borgia, 88021 Catanzaro, Italy;
| | - Vincenzo Mollace
- IRC-FSH Department of Health Sciences, University “Magna Græcia” of Catanzaro Italy, 88021 Catanzaro, Italy; (C.C.); (R.M.); (F.S.); (M.S.); (R.M.); (S.N.); (F.B.); (F.O.); (S.R.); (A.R.C.); (L.G.); (A.C.); (I.B.); (E.P.); (V.M.)
- IRCCS San Raffaele, Via di Valcannuta 247, 00133 Rome, Italy
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Viana S, Salvador R, Morouço P, Rebelo-Gonçalves R. The Contribution of Exercise in Telemedicine Monitoring in Reducing the Modifiable Factors of Hypertension—A Multidisciplinary Approach. Eur J Investig Health Psychol Educ 2022; 12:363-386. [PMID: 35447745 PMCID: PMC9028822 DOI: 10.3390/ejihpe12040027] [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: 03/10/2022] [Revised: 03/21/2022] [Accepted: 03/24/2022] [Indexed: 11/16/2022] Open
Abstract
The aim of this review was to explore the contribution of physical activity and exercise in the control and reduction of modifiable factors of arterial hypertension in telemedicine programs, assuming a multidisciplinary perspective. Searches were carried out following the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-analyses), and the research question defined using the PICOS approach (Population, Intervention, Comparator, Outcomes, Study design). The search strategy applied the following terms: blood pressure OR hypertension AND exercise OR physical activity AND telemedicine. The initial search identified 2190 records, but only 19 studies were considered eligible after checking for the inclusion and exclusion criteria. The following training variables were generally included: heart rate and heart rate reserve, respiratory rate, rate of perceived exertion and oxygen consumption, but no resistance training variables were found. The significant improvements on blood pressure parameters of participants diagnosed with hypertension tended to be transient. The exercise prescription was commonly based on general instructions and recommendations for exercise and hypertension. On the other hand, most of the studies including patients in cardiac rehabilitation programs used a personalized training program based on a baseline assessment, particularly following a cardiopulmonary exercise test. The inclusion of exercise professionals in multidisciplinary teams could provide a more person-oriented approach and the long-term maintenance of a healthy lifestyle.
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Affiliation(s)
- Silvane Viana
- School of Education and Social Sciences, Polytechnic of Leiria, 2411 Leiria, Portugal; (S.V.); (R.S.); (P.M.)
| | - Rogério Salvador
- School of Education and Social Sciences, Polytechnic of Leiria, 2411 Leiria, Portugal; (S.V.); (R.S.); (P.M.)
- Life Quality Research Centre (CIEQV), 2411 Leiria, Portugal
| | - Pedro Morouço
- School of Education and Social Sciences, Polytechnic of Leiria, 2411 Leiria, Portugal; (S.V.); (R.S.); (P.M.)
- Center for Innovative Care and Health Technology (ciTechCare), Polytechnic of Leiria, 2411 Leiria, Portugal
| | - Ricardo Rebelo-Gonçalves
- School of Education and Social Sciences, Polytechnic of Leiria, 2411 Leiria, Portugal; (S.V.); (R.S.); (P.M.)
- Life Quality Research Centre (CIEQV), 2411 Leiria, Portugal
- Research Unit for Sport and Physical Activity (CIDAF—uid/dtp04213/2020), University of Coimbra, 3040 Coimbra, Portugal
- Correspondence: or ; Tel.: +35-1244829400
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de Barcelos GT, Heberle I, Coneglian JC, Vieira BA, Delevatti RS, Gerage AM. Effects of Aerobic Training Progression on Blood Pressure in Individuals With Hypertension: A Systematic Review With Meta-Analysis and Meta-Regression. Front Sports Act Living 2022; 4:719063. [PMID: 35252853 PMCID: PMC8891157 DOI: 10.3389/fspor.2022.719063] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 01/05/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Aerobic training of moderate intensity is the primary modality recommended in the management of hypertension. The manipulation of training variables can be an important strategy for the continuity of health benefits; however, little is known about the effects of the progression of aerobic training variables in the adaptations of blood pressure in hypertensive adults. OBJECTIVE To analyze, through a systematic review with meta-analysis, the effects of aerobic training with and without progression on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in hypertensive adults. METHOD The search for the studies was carried out in the PubMed, Cochrane Central, SPORTDiscus and LILACS databases. Clinical trials that analyzed the effect of aerobic training, lasting at least six weeks, on blood pressure in hypertensive individuals comparing with a control group without intervention were selected. The selection of studies and data extraction were carried out independently by two pairs of researchers. The results are presented as mean difference and 95% confidence interval. Statistical significance was considered with p < 0.05. RESULTS Of the 13,028 studies found, 24 were selected and included in this review, 12 with progression of training variables and 12 without progression, with a total of 1,207 participants analyzed. There was a reduction in SBP after aerobic training with progression (-10.67 mmHg; 95% CI -15.421, -5.926; p < 0.001) and without progression (-10.17 mmHg; CI -12.213, -8.120; p < 0.001). DBP also decreased after aerobic training with progression (-5.49 mmHg; 95% CI -8.663, -2.310; p < 0.001) and without progression (-6.51 mmHg; 95% CI -9.147, -3.868; p < 0.001). According to the results of the meta-regression analyses, only age showed an association with the reduction of SBP (β: -0.323; CI -0.339, -0.307; p < 0.001). CONCLUSION Aerobic training promotes a reduction in the SBP and DBP levels of adults with hypertension, regardless of whether or not the training variables progression.
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Affiliation(s)
- Guilherme Tadeu de Barcelos
- Department of Physical Education, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil
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Aerobic Exercise Attenuates Pressure Overload-Induced Cardiac Dysfunction through Promoting Skeletal Muscle Microcirculation and Increasing Muscle Mass. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:8279369. [PMID: 34819985 PMCID: PMC8608514 DOI: 10.1155/2021/8279369] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 09/27/2021] [Accepted: 10/15/2021] [Indexed: 12/05/2022]
Abstract
Background Aerobic exercise has been proven to have a positive effect on cardiac function after hypertension; however, the mechanism is not entirely clarified. Skeletal muscle mass and microcirculation are closely associated with blood pressure and cardiac function. Objective This study was designed to investigate the effects of aerobic exercise on the skeletal muscle capillary and muscle mass, to explore the possible mechanisms involved in exercise-induced mitigation of cardiac dysfunction in pressure overload mice. Methods In this study, 60 BALB/C mice aged 8 weeks were randomly divided into 3 groups: control (CON), TAC, and TAC plus exercise (TAE) group and utilized transverse aortic constriction (TAC) to establish hypertensive model; meanwhile, treadmill training is used for aerobic exercise. After 5 days of recovery, mice in the TAE group were subjected to 10-week aerobic exercise. Carotid pressure and cardiac function were examined before mice were executed by Millar catheter and ultrasound, respectively. Muscle mass of gastrocnemius was weighed; cross-sectional area and the number of capillaries of gastrocnemius were detected by HE and immunohistochemistry, respectively. The mRNA and protein levels of VEGF in skeletal muscle were determined by RT-PCR and western blot, respectively. Results We found that ① 10-week aerobic exercise counteracted hypertension and attenuated cardiac dysfunction in TAC-induced hypertensive mice; ② TAC decreased muscle mass of gastrocnemius and resulted in muscle atrophy, while 10-week aerobic exercise could reserve transverse aortic constriction-induced the decline of muscle mass and muscle atrophy; and ③ TAC reduced the number of capillaries and the protein level of VEGF in gastrocnemius, whereas 10-week aerobic exercise augmented the number of capillaries, the mRNA and protein levels of VEGF in mice were subjected to TAC surgery. Conclusions This study indicates that 10-week aerobic exercise might fulfill its blood pressure-lowering effect via improving skeletal muscle microcirculation and increasing muscle mass.
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D'Amuri A, Sanz JM, Capatti E, Di Vece F, Vaccari F, Lazzer S, Zuliani G, Dalla Nora E, Passaro A. Effectiveness of high-intensity interval training for weight loss in adults with obesity: a randomised controlled non-inferiority trial. BMJ Open Sport Exerc Med 2021; 7:e001021. [PMID: 34367654 PMCID: PMC8292807 DOI: 10.1136/bmjsem-2020-001021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Obesity treatment guidelines suggest moderate-intensity continuous training (MICT), but the patient's compliance to this indication remains low. High-intensity interval training (HIIT) is a time sparing training mode whose metabolic effects are not clear. This study aimed to determine whether a 12-week HIIT was more effective than MICT for weight loss in obese adults. METHODS 44 obese subjects were randomised and trained with isoenergetic treadmill exercises for 12 weeks: MICT (60% of maximal oxygen peak, VO2peak) or HIIT (3-7 repetition of 3 min 100% of VO2peak interspersed by 1.5 min 50% of VO2peak). The primary outcome was a change in body weight; the secondary outcomes were changes in body composition, blood pressure, lipid profile, glycaemia, insulin and VO2peak. RESULTS 32 subjects (53% male, mean age: 38.5 years, mean body mass index: 35.5 kg/m2) completed the trial. MICT and HIIT showed comparable effect within groups in weight loss (-6.0 kg (-9.0 kg to -3.0 kg) vs -5.7 kg (-8.3 kg to -3.1 kg)), changes in fat mass (-2.9% (-4.4% to -1.4%) vs -3.6% (-5.9% to -1.2%)), fat free mass (-5.3% (-7.8% to -2.8%) vs -5.5% (-8.3% to -2.6%)), diastolic blood pressure (-5.5 mm Hg (-10.6 mm Hg to -0.3 mm Hg) vs -5.8 mm Hg (-11.3 mm Hg to -0.3 mm Hg)) and low-density lipoprotein cholesterol (-16.4 mg/dL (-30.8 mg/dL to -2.0 mg/dL) vs -14.7 mg/dL (-25.6 mg/dL to -3.8 mg/dL)). There was a significant change between groups in VO2peak (HIIT: +461.6 mL (329.3‒593.8 mL); MICT: +170.5 mL (86.7-254.4 mL); p<0001) and duration of sessions (HIIT: 35.0 min (31.7 ‒35.6 min); MICT: 46.5 min (40.2‒48.3 min); p<0.001). No significant changes in systolic blood pressure, high-density lipoprotein cholesterol, triglycerides, glycaemia or plasma insulin were observed. CONCLUSIONS In healthy adults with obesity, HIIT compared with MICT induced similar weight loss and cardiovascular risk factors improvement but resulted in a larger increase in cardiorespiratory fitness over a shorter period.
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Affiliation(s)
- Andrea D'Amuri
- Department of Translational Medicine, University of Ferrara, Ferrara, Emilia Romagna, Italy
| | - Juana Maria Sanz
- Department of Chemical and Pharmaceutical Sciences, University of Ferrara, Ferrara, Emilia Romagna, Italy
| | - Eleonora Capatti
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy
| | - Francesca Di Vece
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy
| | - Filippo Vaccari
- Department of Medical Sciences, University of Udine, Udine, Friuli Venezia Giulia, Italy
| | - Stefano Lazzer
- Department of Medical Sciences, University of Udine, Udine, Friuli Venezia Giulia, Italy
| | - Giovanni Zuliani
- Department of Translational Medicine, University of Ferrara, Ferrara, Emilia Romagna, Italy
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy
| | - Edoardo Dalla Nora
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy
| | - Angelina Passaro
- Department of Translational Medicine, University of Ferrara, Ferrara, Emilia Romagna, Italy
- Medical Department, University Hospital of Ferrara Arcispedale Sant'Anna, Ferrara, Emilia Romagna, Italy
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Huang F, Leng X, Kasukurthi MV, Huang Y, Li D, Tan S, Lu G, Lu J, Benton RG, Borchert GM, Huang J. Utilizing Machine Learning Techniques to Predict the Efficacy of Aerobic Exercise Intervention on Young Hypertensive Patients Based on Cardiopulmonary Exercise Testing. JOURNAL OF HEALTHCARE ENGINEERING 2021; 2021:6633832. [PMID: 33968353 PMCID: PMC8084649 DOI: 10.1155/2021/6633832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Revised: 03/08/2021] [Accepted: 04/05/2021] [Indexed: 11/17/2022]
Abstract
Recently, the incidence of hypertension has significantly increased among young adults. While aerobic exercise intervention (AEI) has long been recognized as an effective treatment, individual differences in response to AEI can seriously influence clinicians' decisions. In particular, only a few studies have been conducted to predict the efficacy of AEI on lowering blood pressure (BP) in young hypertensive patients. As such, this paper aims to explore the implications of various cardiopulmonary metabolic indicators in the field by mining patients' cardiopulmonary exercise testing (CPET) data before making treatment plans. CPET data are collected "breath by breath" by using an oxygenation analyzer attached to a mask and then divided into four phases: resting, warm-up, exercise, and recovery. To mitigate the effects of redundant information and noise in the CPET data, a sparse representation classifier based on analytic dictionary learning was designed to accurately predict the individual responsiveness to AEI. Importantly, the experimental results showed that the model presented herein performed better than the baseline method based on BP change and traditional machine learning models. Furthermore, the data from the exercise phase were found to produce the best predictions compared with the data from other phases. This study paves the way towards the customization of personalized aerobic exercise programs for young hypertensive patients.
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Affiliation(s)
- Fangwan Huang
- College of Mathematics and Computer Science, Fuzhou University, Fuzhou 350108, China
| | - Xiuyu Leng
- Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | | | - Yulong Huang
- College of Allied Health Professions, University of South Alabama, Mobile, AL 36688, USA
| | - Dongqi Li
- School of Computing, University of South Alabama, Mobile, AL 36688, USA
| | - Shaobo Tan
- School of Computing, University of South Alabama, Mobile, AL 36688, USA
| | - Guiying Lu
- Department of Cardiology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou 510080, China
| | - Juhong Lu
- College of Mathematics and Computer Science, Fuzhou University, Fuzhou 350108, China
| | - Ryan G. Benton
- School of Computing, University of South Alabama, Mobile, AL 36688, USA
| | - Glen M. Borchert
- Department of Pharmacology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA
| | - Jingshan Huang
- School of Computing, University of South Alabama, Mobile, AL 36688, USA
- Department of Pharmacology, College of Medicine, University of South Alabama, Mobile, AL 36688, USA
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Wondmieneh A, Gedefaw G, Getie A, Demis A. Self-Care Practice and Associated Factors among Hypertensive Patients in Ethiopia: A Systematic Review and Meta-Analysis. Int J Hypertens 2021; 2021:5582547. [PMID: 33898063 PMCID: PMC8052173 DOI: 10.1155/2021/5582547] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Accepted: 03/31/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Hypertension is one of the leading causes of morbidity and mortality in developing countries including Ethiopia. Self-care practice has been provided as one of the most important preventive mechanisms of hypertension and is considered as a basic treatment for hypertension. There is no national-level study that assesses hypertensive self-care practice in Ethiopia. Therefore, this study aimed to assess the pooled level of hypertensive self-care practices and associated factors in Ethiopia. METHODS This study was carried out using published and unpublished articles accessed from databases: PubMed/MEDLINE, HENARI, Google Scholar, Web of Science, Scopus, African Journals, and university repositories. Data were extracted using a standard data extraction format. Data analysis was carried out using STATA version 11. Heterogeneity across the included studies was assessed using Cochrane's Q statistics and I 2 test with its corresponding p values. Publication bias was determined using Egger's test and presented with a funnel plot. The pooled level of hypertensive self-care practice was estimated using a random-effects meta-analysis model. RESULTS This systematic review included 17 cross-sectional studies with 5,248 study participants. The overall pooled level of self-care practice among hypertensive patients in Ethiopia was 41.55% (95% CI 33.06, 50.05). Participant formal education (AOR = 2.82; 95% CI 2.18, 3.64) and good knowledge of hypertension (AOR = 4.04; 95% CI 2.19, 7.44) were significantly associated with self-care practice among hypertensive patients in Ethiopia. CONCLUSION In this study, more than half of hypertensive patients had poor hypertensive self-care practice in Ethiopia. Participant's formal education and good knowledge of hypertension were significantly associated with self-care practice among people living with hypertension in Ethiopia. Therefore, based on the evidence of this study, we recommended that programmers and policymakers should enhance the awareness of hypertensive patients on self-care practice domains and strengthen local programs working on noncommunicable diseases.
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Affiliation(s)
- Adam Wondmieneh
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Getnet Gedefaw
- Department of Midwifery, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Addisu Getie
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
| | - Asmamaw Demis
- Department of Nursing, College of Health Sciences, Woldia University, P.O. Box 400, Woldia, Ethiopia
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Barroso WKS, Rodrigues CIS, Bortolotto LA, Mota-Gomes MA, Brandão AA, Feitosa ADDM, Machado CA, Poli-de-Figueiredo CE, Amodeo C, Mion Júnior D, Barbosa ECD, Nobre F, Guimarães ICB, Vilela-Martin JF, Yugar-Toledo JC, Magalhães MEC, Neves MFT, Jardim PCBV, Miranda RD, Póvoa RMDS, Fuchs SC, Alessi A, Lucena AJGD, Avezum A, Sousa ALL, Pio-Abreu A, Sposito AC, Pierin AMG, Paiva AMGD, Spinelli ACDS, Nogueira ADR, Dinamarco N, Eibel B, Forjaz CLDM, Zanini CRDO, Souza CBD, Souza DDSMD, Nilson EAF, Costa EFDA, Freitas EVD, Duarte EDR, Muxfeldt ES, Lima Júnior E, Campana EMG, Cesarino EJ, Marques F, Argenta F, Consolim-Colombo FM, Baptista FS, Almeida FAD, Borelli FADO, Fuchs FD, Plavnik FL, Salles GF, Feitosa GS, Silva GVD, Guerra GM, Moreno Júnior H, Finimundi HC, Back IDC, Oliveira Filho JBD, Gemelli JR, Mill JG, Ribeiro JM, Lotaif LAD, Costa LSD, Magalhães LBNC, Drager LF, Martin LC, Scala LCN, Almeida MQ, Gowdak MMG, Klein MRST, Malachias MVB, Kuschnir MCC, Pinheiro ME, Borba MHED, Moreira Filho O, Passarelli Júnior O, Coelho OR, Vitorino PVDO, Ribeiro Junior RM, Esporcatte R, Franco R, Pedrosa R, Mulinari RA, Paula RBD, Okawa RTP, Rosa RF, Amaral SLD, Ferreira-Filho SR, Kaiser SE, Jardim TDSV, Guimarães V, Koch VH, Oigman W, Nadruz W. Brazilian Guidelines of Hypertension - 2020. Arq Bras Cardiol 2021; 116:516-658. [PMID: 33909761 PMCID: PMC9949730 DOI: 10.36660/abc.20201238] [Citation(s) in RCA: 297] [Impact Index Per Article: 99.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Weimar Kunz Sebba Barroso
- Universidade Federal de Goiás , Goiânia , GO - Brasil
- Liga de Hipertensão Arterial , Goiânia , GO - Brasil
| | - Cibele Isaac Saad Rodrigues
- Pontifícia Universidade Católica de São Paulo , Faculdade de Ciências Médicas e da Saúde , Sorocaba , SP - Brasil
| | | | | | - Andréa Araujo Brandão
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
| | | | | | | | - Celso Amodeo
- Universidade Federal de São Paulo (UNIFESP), São Paulo , SP - Brasil
| | - Décio Mion Júnior
- Hospital das Clínicas da Faculdade de Medicina da USP , São Paulo , SP - Brasil
| | | | - Fernando Nobre
- Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo , Ribeirão Preto , SP - Brasil
- Hospital São Francisco , Ribeirão Preto , SP - Brasil
| | | | | | | | - Maria Eliane Campos Magalhães
- Hospital Universitário Pedro Ernesto da Universidade do Estado do Rio de Janeiro (UERJ), Rio de Janeiro , RJ - Brasil
| | - Mário Fritsch Toros Neves
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
| | | | | | | | - Sandra C Fuchs
- Faculdade de Medicina da Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre , RS - Brasil
| | | | | | - Alvaro Avezum
- Hospital Alemão Oswaldo Cruz , São Paulo , SP - Brasil
| | - Ana Luiza Lima Sousa
- Universidade Federal de Goiás , Goiânia , GO - Brasil
- Liga de Hipertensão Arterial , Goiânia , GO - Brasil
| | | | | | | | | | | | | | | | - Bruna Eibel
- Instituto de Cardiologia , Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre , RS - Brasil
- Centro Universitário da Serra Gaúcha (FSG), Caxias do Sul , RS - Brasil
| | | | | | | | | | | | | | - Elizabete Viana de Freitas
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
- Departamento de Cardiogeriatria da Sociedade Brazileira de Cardiologia , Rio de Janeiro , RJ - Brasil
| | | | | | - Emilton Lima Júnior
- Hospital de Clínicas da Universidade Federal do Paraná (HC/UFPR), Curitiba , PR - Brasil
| | - Erika Maria Gonçalves Campana
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
- Universidade Iguaçu (UNIG), Rio de Janeiro , RJ - Brasil
| | - Evandro José Cesarino
- Faculdade de Ciências Farmacêuticas de Ribeirão Preto da Universidade de São Paulo , Ribeirão Preto , SP - Brasil
- Associação Ribeirãopretana de Ensino, Pesquisa e Assistência ao Hipertenso (AREPAH), Ribeirão Preto , SP - Brasil
| | - Fabiana Marques
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo , Ribeirão Preto , SP - Brasil
| | | | | | | | - Fernando Antonio de Almeida
- Pontifícia Universidade Católica de São Paulo , Faculdade de Ciências Médicas e da Saúde , Sorocaba , SP - Brasil
| | | | | | - Frida Liane Plavnik
- Instituto do Coração (InCor), São Paulo , SP - Brasil
- Hospital Alemão Oswaldo Cruz , São Paulo , SP - Brasil
| | | | | | | | - Grazia Maria Guerra
- Instituto do Coração (InCor), São Paulo , SP - Brasil
- Universidade Santo Amaro (UNISA), São Paulo , SP - Brasil
| | | | | | | | | | | | - José Geraldo Mill
- Centro de Ciências da Saúde , Universidade Federal do Espírito Santo , Vitória , ES - Brasil
| | - José Marcio Ribeiro
- Faculdade Ciências Médicas de Minas Gerais , Belo Horizonte , MG - Brasil
- Hospital Felício Rocho , Belo Horizonte , MG - Brasil
| | - Leda A Daud Lotaif
- Instituto Dante Pazzanese de Cardiologia , São Paulo , SP - Brasil
- Hospital do Coração (HCor), São Paulo , SP - Brasil
| | | | | | | | | | | | - Madson Q Almeida
- Hospital das Clínicas da Faculdade de Medicina da USP , São Paulo , SP - Brasil
| | | | | | | | | | | | | | | | | | | | | | | | - Roberto Esporcatte
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
- Hospital Pró-Cradíaco , Rio de Janeiro , RJ - Brasil
| | - Roberto Franco
- Universidade Estadual Paulista (UNESP), Bauru , SP - Brasil
| | - Rodrigo Pedrosa
- Pronto Socorro Cardiológico de Pernambuco (PROCAPE), Recife , PE - Brasil
| | | | | | | | | | | | | | - Sergio Emanuel Kaiser
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
| | | | | | - Vera H Koch
- Universidade de São Paulo (USP), São Paulo , SP - Brasil
| | - Wille Oigman
- Faculdade de Ciências Médicas da Universidade do Estado do Rio de Janeiro (FCM-UERJ), Rio de Janeiro , RJ - Brasil
| | - Wilson Nadruz
- Universidade Estadual de Campinas (UNICAMP), Campinas , SP - Brasil
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Lee SH, Chae YR. Characteristics of Aerobic Exercise as Determinants of Blood Pressure Control in Hypertensive Patients: A Systematic Review and Meta-Analysis. J Korean Acad Nurs 2021; 50:740-756. [PMID: 33441523 DOI: 10.4040/jkan.20169] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 09/21/2020] [Accepted: 10/27/2020] [Indexed: 11/09/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the effect on blood pressure (BP) and heart rate (HR) according to aerobic exercise characteristics in adults with hypertension using a systematic review and meta-analysis. METHODS The related researches were selected from PubMed, EMBASE, Cochrane library, CINAHL, PsycINFO, SPORTDiscus and 5 domestic databases up to September 4, 2019. To estimate the effect size, random effect models were used to derive weighted mean differences (WMD) and their 95% confidence intervals (CI) of aerobic exercise on BP and HR. RESULTS A total of 37 RCTs with 1,813 samples were included. Aerobic exercise was found to significantly reduce systolic BP (WMD, - 8.29 mmHg; 95% CI, - 10.12 to - 6.46), diastolic BP (WMD, - 5.19 mmHg; 95% CI, - 6.24 to - 4.14) and HR (WMD, - 4.22 beats/min; 95% CI, - 5.36 to -3.09). In detail, systolic BP and diastolic BP were significantly decreased in all groups of exercise types, frequency and duration. Systolic BP and diastolic BP were significantly decreased in the moderate and vigorous-intensity group. Exercise characteristics with the most dramatical change in systolic BP were water-based training, moderate-intensity, 3 times a week and 8 to 11 weeks of duration. In diastolic BP, the greatest effect size was over 24 weeks of exercise. CONCLUSION Moderate aerobic exercise, especially water-based exercise can be an important part of lifestyle modification for hypertensive patients. Also, it can be recommended in a variety of clinical settings for lowering BP and HR. However, there is insufficient evidence that low-intensity exercise is effective in lowering BP.
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Affiliation(s)
- Sun Hee Lee
- Department of Nursing, Saekyung University, Yeongwol, Korea
| | - Young Ran Chae
- College of Nursing, Kangwon National University, Chuncheon, Korea.
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Saco-Ledo G, Valenzuela PL, Ruiz-Hurtado G, Ruilope LM, Lucia A. Exercise Reduces Ambulatory Blood Pressure in Patients With Hypertension: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Am Heart Assoc 2020; 9:e018487. [PMID: 33280503 PMCID: PMC7955398 DOI: 10.1161/jaha.120.018487] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Although exercise training reduces office blood pressure (BP), scarcer evidence is available on whether these benefits also apply to ambulatory blood pressure (ABP), which is a stronger predictor of cardiovascular disease and mortality. The present study aims to assess the effects of exercise training on ABP in patients with hypertension based on evidence from randomized controlled trials. Methods and Results A systematic search of randomized controlled trials on the aforementioned topic was conducted in PubMed and Scopus (since inception to April 1, 2020). The mean difference between interventions (along with 95% CI) for systolic BP and diastolic BP was assessed using a random-effects model. Sub-analyses were performed attending to (1) whether participants were taking antihypertensive drugs and (2) exercise modalities. Fifteen studies (including 910 participants with hypertension) met the inclusion criteria. Interventions lasted 8 to 24 weeks (3-5 sessions/week). Exercise significantly reduced 24-hour (systolic BP, -5.4 mm Hg; [95% CI, -9.2 to -1.6]; diastolic BP, -3.0 mm Hg [-5.4 to -0.6]), daytime (systolic BP, -4.5 mm Hg [-6.6 to -2.3]; diastolic BP, -3.2 mm Hg [-4.8 to -1.5]), and nighttime ABP (systolic BP, -4.7 mm Hg [-8.4 to -1.0]; diastolic BP, -3.1 mm Hg [-5.3 to -0.9]). In separate analyses, exercise benefits on all ABP measures were significant for patients taking medication (all P<0.05) but not for untreated patients (although differences between medicated and non-medicated patients were not significant), and only aerobic exercise provided significant benefits (P<0.05). Conclusions Aerobic exercise is an effective coadjuvant treatment for reducing ABP in medicated patients with hypertension.
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Affiliation(s)
- Gonzalo Saco-Ledo
- Bioenergy and Motion Analysis Laboratory National Research Center on Human Evolution (CENIEH) Burgos Spain
| | | | - Gema Ruiz-Hurtado
- Hypertension Unit and Cardiorenal Translational Laboratory Hospital 12 de Octubre Madrid Spain.,Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain
| | - Luis M Ruilope
- Hypertension Unit and Cardiorenal Translational Laboratory Hospital 12 de Octubre Madrid Spain.,Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain
| | - Alejandro Lucia
- Research Institute of the Hospital Universitario 12 de Octubre ('imas12') Madrid Spain.,Faculty of Sport Sciences European University of Madrid Spain
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Kemi Y, Hoshide S, Yamashita E, Kario K. The possibility that long-term isometric handgrip exercise contributes to left atrial enlargement in patients with hypertension. J Clin Hypertens (Greenwich) 2020; 22:2137-2140. [PMID: 33164318 DOI: 10.1111/jch.14036] [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: 04/15/2020] [Revised: 08/20/2020] [Accepted: 08/27/2020] [Indexed: 10/23/2022]
Abstract
Hypertension guidelines recommend isometric handgrip exercise (IHG) as a non-pharmacological treatment. The aim of this study was to investigate whether IHG is safe for hypertensive patients. The participants were mostly middle-aged to elderly patients with hypertension. Participants wore a pedometer for 4 weeks and were then divided into two groups: Those who had taken at least 7000 steps per day were placed in an IHG-only group (n = 11), and those who took fewer steps were placed in an IHG + walking group (n = 4). Both groups then performed IHG for 12 weeks. No significant blood pressure reduction occurred from before to after intervention in either group. In the IHG-only group, brain natriuretic peptide (BNP) was significantly higher and left atrial (LA) volume (24.6 ± 9.1 to 36.4 ± 17.9 mL, P = .007) was significantly larger after intervention than before. Long-term IHG may induce both LA enlargement and increased BNP in hypertensive patients.
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Affiliation(s)
- Yuta Kemi
- Ueno-mura Clinic, Ueno, Japan.,Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.,Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan
| | - Satoshi Hoshide
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
| | - Eiji Yamashita
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan.,Division of Cardiology, Gunma Prefectural Cardiovascular Center, Maebashi, Japan
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University, Shimotsuke, Japan
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Wood TR, Jóhannsson GF. Metabolic health and lifestyle medicine should be a cornerstone of future pandemic preparedness. LIFESTYLE MEDICINE 2020. [DOI: 10.1002/lim2.2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Affiliation(s)
- Thomas R. Wood
- Department of Pediatrics University of Washington Seattle Washington
- Institute for Human and Machine Cognition Pensacola Florida
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36
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Somprasong K, Apidechkul T, Kullawong N, Upala P, Tamornpark R, Chomchoei C, Yeemard F, Khunthason S, Keawdounglek V, Wongfu C. Prevalence of and factors associated with hypertension among the hill tribe population aged 35 years and over in northern Thailand: a cross-sectional study. AMERICAN JOURNAL OF CARDIOVASCULAR DISEASE 2020; 10:6-16. [PMID: 32411501 PMCID: PMC7218683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/11/2020] [Accepted: 02/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Hypertension (HT) is a serious noncommunicable disease that can lead to several health problems when it is not detected or is not properly diagnosed and treated in a timely manner, particularly in individuals living in poor economic and education conditions. The hill tribe population in northern Thailand is a vulnerable population with limited information available regarding HT. METHODS The study aimed to estimate the prevalence of HT and to determine the factors associated with HT among individuals from hill tribes aged 35 years and over and living in northern Thailand. A cross-sectional study was conducted to gather essential information from six main hill tribe groups: the Akha, Lahu, Karen, Hmong, Yao and Lisu tribes in Chiang Rai Province. A simple random method was used to select 30 hill tribe villages (5 villages for each tribe). People aged 35 years and over who lived in the selected villages were invited to participate in the study. A validated questionnaire and a 5-mL blood specimen were used as research instruments. A face-to-face interview was conducted to collect data after informed consent was obtained, and 5-mL blood specimens were drawn to determine the lipid profiles of the participants. Logistic regression was performed to determine the factors associated with HT at the significance level of α = 0.05. RESULTS A total of 1,287 participants were recruited into the study: 60.5% were females, 30.4% were aged 35-44 years, 65.4% were illiterate, and 83.1% were married. The overall prevalence of HT was 24.3%, and the Yao tribe had the highest prevalence at 18.5%. In the multivariable analysis, three variables were found to be associated with HT: marital status, ability to read Thai, and exercise behavior. Those who were single and divorced had a 2.55 (95% CI = 1.23-5.06) and 2.69 times greater chance (95% CI = 1.10-6.59), respectively, of developing HT than those who were married. Those who could not read Thai had a 2.13 times greater chance (95% CI = 1.50-3.01) of developing HT than those who could read, and those who did not exercise and who exercised sometimes had a 1.96 (95% CI = 1.07-3.58) and 2.24 times greater chance (95% CI = 1.21-4.13), respectively, of developing HT than those who regularly exercised. CONCLUSION A health screening program for the identification of new HT among the hill tribe population urgently needs to be implemented, followed by the introduction of a proper exercise program to reduce the risk of HT, particularly for those who are illiterate and for single or divorced people.
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Affiliation(s)
- Kanya Somprasong
- Chiang Rai Prachanukroh HospitalChiang Rai, Thailand
- School of Health Science, Mae Fah Luang UniversityThailand
| | - Tawatchai Apidechkul
- School of Health Science, Mae Fah Luang UniversityThailand
- Center of Excellence for Hill Tribe Health Research, Mae Fah Luang UniversityThailand
| | | | - Panupong Upala
- Center of Excellence for Hill Tribe Health Research, Mae Fah Luang UniversityThailand
| | - Ratipark Tamornpark
- Center of Excellence for Hill Tribe Health Research, Mae Fah Luang UniversityThailand
| | | | - Fartima Yeemard
- Center of Excellence for Hill Tribe Health Research, Mae Fah Luang UniversityThailand
| | - Siriyaporn Khunthason
- School of Health Science, Mae Fah Luang UniversityThailand
- Center of Excellence for Hill Tribe Health Research, Mae Fah Luang UniversityThailand
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Unda Villafuerte F, Llobera Cànaves J, Lorente Montalvo P, Moreno Sancho ML, Oliver Oliver B, Bassante Flores P, Estela Mantolan A, Pou Bordoy J, Rodríguez Ruiz T, Requena Hernández A, Leiva A, Torrent Quetglas M, Coll Benejam JM, D’Agosto Forteza P, Rigo Carratalà F. Effectiveness of a multifactorial intervention, consisting of self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise, in patients with uncontrolled hypertension taking 2 or more antihypertensive drugs: The MEDICHY study. Medicine (Baltimore) 2020; 99:e19769. [PMID: 32332617 PMCID: PMC7220514 DOI: 10.1097/md.0000000000019769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION High blood pressure is the leading modifiable risk factor for cardiovascular disease, and is associated with high morbidity and mortality and with significant health care costs for individuals and society. However, fewer than half of the patients with hypertension receiving pharmacological treatment have adequate blood pressure control. The main reasons for this are therapeutic inertia, lack of adherence to treatment, and unhealthy lifestyle (i.e., excess dietary fat and salt, sedentary lifestyle, and overweight). Cardiovascular risk and mortality are greater in hypertensive patients who are receiving treatment but have suboptimal control of blood pressure. METHODS/DESIGN This is a multicentre, parallel, 2-arm, single-blind (outcome assessor), controled, cluster-randomized clinical trial. General practitioners and nurses will be randomly allocated to the intervention group (self-management of antihypertensive medication, self-measurement of blood pressure, hypocaloric and low sodium diet, and physical exercise) or the control group (regular clinical practice). A total of 424 patients in primary care centers who use 2 or more antihypertensive drugs and blood pressure of at least 130/80 during 24-hambulatory blood pressure monitoring will be recruited. The primary outcome is systolic blood pressure at 12 months. The secondary outcomes are blood pressure control (<140/90 mm Hg); quality of life (EuroQol 5D); direct health care costs; adherence to use of antihypertensive medication; and cardiovascular risk (REGICOR and SCORE scales). DISCUSSION This trial will be conducted in the primary care setting and will evaluate the impact of a multifactorial intervention consisting of self-management of blood pressure, antihypertensive medications, and lifestyle modifications (hypocaloric and low sodium diet and physical exercise).
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Affiliation(s)
| | - Joan Llobera Cànaves
- Primary Care Research Unit of Mallorca, Balearic Health Services (IB-Salut)
- Institut d’investigació Sanitària Illes Balears
| | | | | | | | | | | | | | - Tomás Rodríguez Ruiz
- Primary Care Research Unit of Menorca, Balearic Health Services (IB-Salut), Menorca, Balearic Islands, Spain
| | | | - Alfonso Leiva
- Primary Care Research Unit of Mallorca, Balearic Health Services (IB-Salut)
- Institut d’investigació Sanitària Illes Balears
| | - Matíes Torrent Quetglas
- Institut d’investigació Sanitària Illes Balears
- Primary Care Research Unit of Menorca, Balearic Health Services (IB-Salut), Menorca, Balearic Islands, Spain
| | - José María Coll Benejam
- Institut d’investigació Sanitària Illes Balears
- Menorca Primary care management, Menorca, Balearic Health Services (IB-Salut)
| | | | - Fernando Rigo Carratalà
- Institut d’investigació Sanitària Illes Balears
- San Agustín Healthcare Centre, Institut d’investigació Sanitària Illes Balears
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Dassanayake S, Sole G, Wilkins G, Skinner M. Exercise: a therapeutic modality to treat blood pressure in resistant hypertension. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1733781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Suranga Dassanayake
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Gisela Sole
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Gerard Wilkins
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Margot Skinner
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Dassanayake S, Sole G, Wilkins G, Skinner M. Effect of exercise and physical activity on blood pressure in adults with resistant hypertension: a protocol for a systematic review. PHYSICAL THERAPY REVIEWS 2020. [DOI: 10.1080/10833196.2020.1728986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Suranga Dassanayake
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Gisela Sole
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
| | - Gerard Wilkins
- Department of Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Margot Skinner
- Center for Health Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand
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Fan WG, Xie F, Wan YR, Campbell NRC, Su H. The impact of changes in population blood pressure on hypertension prevalence and control in China. J Clin Hypertens (Greenwich) 2020; 22:150-156. [PMID: 32003937 DOI: 10.1111/jch.13820] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/27/2019] [Accepted: 12/10/2019] [Indexed: 01/20/2023]
Abstract
In China, there are approximately 250 million adults who have hypertension with low rates of awareness, treatment and control. Changes in lifestyles at a population level have the potential to enhance or deteriorate the prevention and control of hypertension. We used data from a regional hypertension survey to examine the impact of 2/1 mm Hg decreases or increases in population blood pressure on hypertension prevalence, and rates of unawareness of the hypertension diagnosis, treatment, and control. The primary analysis was based on the average blood pressure of respondents from three visits and a diagnostic threshold of 140/90 mm Hg for hypertension. Secondary analyses examined average blood pressure from the first survey visit and also a diagnostic threshold of 130/80 mm Hg for hypertension. The baseline hypertension prevalence was 33.4%, and rates of unawareness of the hypertension diagnosis, treatment, and control were 74.2%, 25.8%, and 9.7%, respectively. Decreases or increases in blood pressure by 10/5 mm Hg resulted in changes in hypertension prevalence (22.1% vs 53.4%) and rates of unawareness of the diagnosis (60.9% vs 83.8%), treatment (39.1% vs 16.2%), and control (21.2% vs 3.6%), respectively. Similar trends were seen in the secondary analyses. Population changes in lifestyle could have a very large impact on the prevalence and control of hypertension in China. The results support implementation of programs to improve population lifestyles while implementing health services policies to enhance the clinical management of hypertension.
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Affiliation(s)
- Wei-Guo Fan
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Xie
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Yi-Rong Wan
- Dutou Hospital of Nanchang County, Jiangxi, China
| | - Norm R C Campbell
- Libin Cardiovascular Institute of Alberta, University of Calgary, Calgary, AB, Canada
| | - Hai Su
- Department of Cardiovascular Medicine, The Second Affiliated Hospital of Nanchang University, Nanchang, China
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Okechukwu C. Effectiveness of physical activity in the prevention and treatment of hypertension: A mini review. CHRISMED JOURNAL OF HEALTH AND RESEARCH 2020. [DOI: 10.4103/cjhr.cjhr_99_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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