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Tsuda T, Robinson BW. Beneficial Effects of Exercise on Hypertension-Induced Cardiac Hypertrophy in Adolescents and Young Adults. Curr Hypertens Rep 2024:10.1007/s11906-024-01313-4. [PMID: 38888690 DOI: 10.1007/s11906-024-01313-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/30/2024] [Indexed: 06/20/2024]
Abstract
PURPOSE OF REVIEW Hypertension-induced cardiac hypertrophy is widely known as a major risk factor for increased cardiovascular morbidity and mortality. Although exercise is proven to exert overall beneficial effects on hypertension and hypertension-induced cardiac hypertrophy, there are some concerns among providers about potential adverse effects induced by intense exercise, especially in hypertensive athletes. We will overview the underlying mechanisms of physiological and pathological hypertrophy and delineate the beneficial effects of exercise in young people with hypertension and consequent hypertrophy. RECENT FINDINGS Multiple studies have demonstrated that exercise training, both endurance and resistance types, reduces blood pressure and ameliorates hypertrophy in hypertensives, but certain precautions are required for hypertensive athletes when allowing competitive sports: Elevated blood pressure should be controlled before allowing them to participate in high-intensity exercise. Non-vigorous and recreational exercise are always recommended to promote cardiovascular health. Exercise-induced cardiac adaptation is a benign and favorable response that reverses or attenuates pathological cardiovascular remodeling induced by persistent hypertension. Exercise is the most effective nonpharmacological treatment for hypertensive individuals. Distinction between recreational-level exercise and competitive sports should be recognized by medical providers when allowing sports participation for adolescents and young adults.
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Affiliation(s)
- Takeshi Tsuda
- Nemours Cardiac Center, Nemours Children's Health, 1600 Rockland Rd, Wilmington, DE, 19803, USA.
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadephia, PA, 19107, USA.
| | - Bradley W Robinson
- Nemours Cardiac Center, Nemours Children's Health, 1600 Rockland Rd, Wilmington, DE, 19803, USA
- Department of Pediatrics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadephia, PA, 19107, USA
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Hoseini R, Raed Hamid R. Lowering blood pressure by exercise: investigating the effect of sweating. Blood Press Monit 2024; 29:109-118. [PMID: 38299995 DOI: 10.1097/mbp.0000000000000691] [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: 02/02/2024]
Abstract
High blood pressure (hypertension), is a common medical condition, affecting millions of people and is associated with significant health risks. Exercise has been suggested to manage hypertension by inducing sweating and the corresponding loss of sodium and water from the body.Thus, a variety of epidemiological and clinical studies have been conducted to investigate the relationship between sweating and exercise-induced blood pressure reduction and its impacts on hypertension. The mechanisms underlying exercise-induced blood pressure reduction are complex and still not fully understood. However, several pathways have been suggested, including the loss of sodium and water through sweat, a decrease in peripheral resistance, and an improvement in endothelial function in the blood vessels. The decrease in sodium and water content in the body associated with sweating may result in a reduction in blood volume and thus a decrease in blood pressure. Moreover, the reduction in peripheral resistance is thought to be mediated by the activation of the nitric oxide synthase pathway and the release of vasodilators such as prostacyclin and bradykinin, which lead to vasodilation and, thus, a reduction in blood pressure. In conclusion, exercise-induced sweating and consequent sodium and water loss appear to be a reliable biological link to the blood pressure-reducing effects of exercise in hypertensive individuals. Additionally, the mechanisms underlying exercise-induced blood pressure reduction are complex and involve several biological pathways in the cardiovascular system. Therefore, understanding the role of sweat production in blood pressure management is important for developing effective exercise interventions to prevent and manage hypertension.
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Affiliation(s)
- Rastegar Hoseini
- Department of Exercise Physiology, Faculty of Sport Sciences, Razi University, Kermanshah
| | - Rasha Raed Hamid
- Physical Education and Sport Sciences Department, University of Garmian, Kurdistan Region, Iraq
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Woramontri C, Chaunchaiyakul R, Yang AL, Lin YY, Masodsai K. Effect of Mat Pilates Training on Blood Pressure, Inflammatory, and Oxidative Profiles in Hypertensive Elderly. Sports (Basel) 2024; 12:120. [PMID: 38786989 PMCID: PMC11125445 DOI: 10.3390/sports12050120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 04/20/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
To determine the effects of mat Pilates training on blood pressure, inflammatory, and antioxidative markers in hypertensive elderly people, 34 hypertensive subjects aged 60-75 years were randomly divided into a control group (CON; n = 17) and a mat Pilates training group (MP; n = 17). The CON participants conducted normal daily activities and participated in neither organized exercises nor sports training, while those in the MP group received mat Pilates training for 60 min three times/week for 12 weeks. Parameters including blood pressure, cardiovascular function, nitric oxide (NO), tumor necrotic factor-alpha (TNF-α), superoxide dismutase (SOD), and malonaldehyde (MDA) were collected at baseline and the end of 12 weeks. The MP group had significantly decreased blood pressure, improved cardiovascular variables, decreased MDA and TNF-α, and increased NO and SOD compared with the CON group and the pre-training period (p < 0.05). In conclusion, these findings demonstrate the positive effects of 12 weeks of mat Pilates training in terms of reducing blood pressure and increasing blood flow related to improvements in anti-inflammatory and antioxidative markers in hypertensive elderly people. Mat Pilates training might be integrated as an alternative therapeutic exercise modality in clinical practice for hypertensive elderly individuals.
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Affiliation(s)
- Chutima Woramontri
- Exercise Physiology in Special Population Research Unit, Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand;
| | | | - Ai-Lun Yang
- Institute of Sports Sciences, University of Taipei, Taipei 11153, Taiwan;
| | - Yi-Yuan Lin
- Department of Exercise and Health Science, National Taipei University of Nursing and Health Sciences, Taipei 11219, Taiwan;
| | - Kunanya Masodsai
- Exercise Physiology in Special Population Research Unit, Faculty of Sports Science, Chulalongkorn University, Bangkok 10330, Thailand;
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Ahn SY, Lee SW, Shin HJ, Lee WJ, Kim JH, Kim HJ, Song W. Effects of a 2-Week Kinect-Based Mixed-Reality Exercise Program on Prediabetes: A Pilot Trial during COVID-19. J Obes Metab Syndr 2024; 33:54-63. [PMID: 38204191 PMCID: PMC11000517 DOI: 10.7570/jomes23040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 11/07/2023] [Accepted: 11/29/2023] [Indexed: 01/12/2024] Open
Abstract
Background Pre-diabetes can develop into type 2 diabetes mellitus, but can prevented by regular exercise. However, the outcomes when combining unsupervised Kinect-based mixed-reality (KMR) exercise with continuous glucose monitoring (CGM) remain unclear. Therefore, this single-arm pilot trial examined changes in blood glucose (BG) concentrations over 672 hours (4 weeks), including a 2-week period of KMR exercise and CGM in individuals with pre-diabetes. Methods This was a pre-and post-treatment case-control study with nine participants. General questionnaires were administered and body composition, fasting BG concentrations, and 2-hour oral glucose tolerance test (2-OGTT) results were measured pre-and post-treatment. Weekly average glucose concentrations, hyperglycemia rate, hypoglycemia rate, average glucose concentration over time, amount of physical activity, amount of food intake, and pre- and postprandial BG (immediately and 30, 60, 90, and 120 minutes after lunch) were measured over 4 weeks (pre-test, exercise, and post -test weeks). Glucose concentrations were measured before exercising, between sets, and 30 and 60 minutes after exercise during the 2 weeks of unsupervised exercise (3 days/week). Results In all participants, body mass index (27.16±2.92 kg/m2), fasting BG (108.00±7.19 mg/dL), 2-OGTT (162.56±18.12 mg/dL), hyperglycemia rate (P=0.040), and 90-minute postprandial BG (P=0.035) were significantly reduced during the 2 exercise weeks, and the 2-OGTT result (P=0.044) and diastolic blood pressure (DBP) (P=0.046) were significantly reduced at the post -test as compared with the pre-test. Conclusion This study found that 2 weeks of unsupervised KMR exercise reduced 2-OGTT, DBP, hyperglycemia rate, and 90-minute postprandial BG concentration. We believed this effect could be identified more clearly in studies involving a larger number of participants and longer durations of exercise.
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Affiliation(s)
- So Young Ahn
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
| | - Si Woo Lee
- Research Institute, Dr.EXSol Inc., Seoul, Korea
| | - Hye Jung Shin
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
- Research Institute, Dr.EXSol Inc., Seoul, Korea
| | - Won Jae Lee
- Department of Physical Education, Kyungnam University, Changwon, Korea
| | | | | | - Wook Song
- Institute of Sports Science, Department of Physical Education, Seoul National University, Seoul, Korea
- Research Institute, Dr.EXSol Inc., Seoul, Korea
- Institute on Aging, Seoul National University, Seoul, Korea
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Talavera-Rodríguez I, Banegas JR, de la Cruz JJ, Martínez-Gómez D, Ruiz-Canela M, Ortolá R, Hershey MS, Artalejo FR, Sotos-Prieto M. Mediterranean lifestyle index and 24-h systolic blood pressure and heart rate in community-dwelling older adults. GeroScience 2024; 46:1357-1369. [PMID: 37561386 PMCID: PMC10828285 DOI: 10.1007/s11357-023-00898-z] [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: 04/03/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023] Open
Abstract
Specific foods, nutrients, dietary patterns, and physical activity are associated with lower blood pressure (BP) and heart rate (HR), but little is known about the joint effect of lifestyle factors captured in a multidimensional score. We assessed the association of a validated Mediterranean-lifestyle (MEDLIFE) index with 24-h-ambulatory BP and HR in everyday life among community-living older adults. Data were taken from 2,184 individuals (51% females, mean age: 71.4 years) from the Seniors-ENRICA-2 cohort. The MEDLIFE index consisted of 29 items arranged in three blocks: 1) Food consumption; 2) Dietary habits; and 3) Physical activity, rest, and conviviality. A higher MEDLIFE score (0-29 points) represented a better Mediterranean lifestyle adherence. 24-h-ambulatory BP and HR were obtained with validated oscillometric devices. Analyses were performed with linear regression adjusted for the main confounders. The MEDLIFE-highest quintile (vs Q1) was associated with lower nighttime systolic BP (SBP) (-3.17 mmHg [95% CI: -5.25, -1.08]; p-trend = 0.011), greater nocturnal-SBP fall (1.67% [0.51, 2.83]; p-trend = 0.052), and lower HR (-2.04 bpm [daytime], -2.33 bpm [nighttime], and -1.93 bpm [24-h]; all p-trend < 0.001). Results were similar for each of the three blocks of MEDLIFE and by hypertension status (yes/no). Among older adults, higher adherence to MEDLIFE was associated with lower nighttime SBP, greater nocturnal-SBP fall, and lower HR in their everyday life. These results suggest a synergistic BP-related protection from the components of the Mediterranean lifestyle. Future studies should determine whether these results replicate in older adults from other Mediterranean and non-Mediterranean countries.
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Affiliation(s)
- Irene Talavera-Rodríguez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
| | - José R Banegas
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Juan J de la Cruz
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - David Martínez-Gómez
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
| | - Rosario Ortolá
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain
| | - Maria S Hershey
- Department of Preventive Medicine and Public Health, Navarra Institute for Health Research (IdisNa), University of Navarra, 31008, Pamplona, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Fernando Rodríguez Artalejo
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain
- CIBEROBN (CIBER of Pathophysiology of Obesity and Nutrition), Madrid, Spain
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA
| | - Mercedes Sotos-Prieto
- Department of Preventive Medicine and Public Health, School of Medicine, Universidad Autónoma de Madrid, 28049, Madrid, Spain.
- CIBERESP (CIBER of Epidemiology and Public Health), Madrid, Spain.
- IMDEA-Food Institute, CEI UAM + CSIC, Madrid, Spain.
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
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Mone P, Tesorio T, De Donato A, Cioppa A, Jankauskas SS, Salemme L, Santulli G. A novel urinary proteomic classifier predicts the risk of coronary artery disease. Eur J Prev Cardiol 2023; 30:1535-1536. [PMID: 37075225 PMCID: PMC10562135 DOI: 10.1093/eurjpc/zwad123] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 04/17/2023] [Indexed: 04/21/2023]
Affiliation(s)
- Pasquale Mone
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461 New York City, NY 10461, USA
- University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | | | | | - Angelo Cioppa
- ‘Montevergine’ Clinic, Mercogliano (Avellino), Italy
| | - Stanislovas S Jankauskas
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461 New York City, NY 10461, USA
- University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Luigi Salemme
- ‘Montevergine’ Clinic, Mercogliano (Avellino), Italy
| | - Gaetano Santulli
- Department of Medicine, Division of Cardiology, Wilf Family Cardiovascular Research Institute, Einstein Institute for Neuroimmunology and Inflammation (INI), Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461 New York City, NY 10461, USA
- Department of Molecular Pharmacology, Einstein-Mount Sinai Diabetes Research Center (ES-DRC), Fleischer Institute for Diabetes and Metabolism (FIDAM), Einstein Institute for Aging Research, Albert Einstein College of Medicine, 1300 Morris Park Avenue, 10461 New York City, NY 10461, USA
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Koh YS, Asharani PV, Devi F, Roystonn K, Wang P, Abdin E, Sum CF, Lee ES, Chong SA, Subramaniam M. Benefits of leisure-related physical activity and association between sedentary time and risk for hypertension and type 2 diabetes. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2023; 52:172-181. [PMID: 38904530 DOI: 10.47102/annals-acadmedsg.2022399] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/22/2024]
Abstract
Introduction Lifestyle modifications can reduce the risk of type 2 diabetes mellitus (T2DM) and hypertension. Our study investigated whether domain-specific physical activity (such as work, transport and leisure) and sedentary behaviour were associated with T2DM and hypertension, and whether these associations were moderated by sex and age. Method For this cross-sectional study, data were obtained from a population survey in Singapore (n=2,867) conducted from February 2019 to March 2020. T2DM and hypertension were self-reported. Global physical activity questionnaire was used to assess domain-specific physical activity (in metabolic equivalent of task [MET]-minutes) and sedentary time (in hours). Logistic regression models were generated to examine the abovementioned associations, and adjusted for age, sex, education, ethnicity, personal income, body mass index, diet and hypertension/diabetes. Interaction terms were included individually to investigate whether age and sex moderated the associations. Results Individuals with >826 MET-minutes of leisure-related physical activity per week had lower odds of having T2DM (odds ratio [OR] 0.46, 95% confidence interval [CI] 0.24-0.86) and hypertension (OR 0.59, 95% CI 0.37-0.94) than those with no leisure-related physical activity. Individuals with >8 hours of sedentary time daily had higher odds of having hypertension (OR 1.69, 95% CI 1.06-2.69) than those with 0-5 hours of sedentary time. Logistic regression models including interaction terms showed that the association between leisure-related physical activity and hypertension was significant for those aged 18-34 (OR 0.15, 95% CI 0.03-0.66) and 50-64 years (OR 0.44, 95% CI 0.21-0.91). The association between sedentary time and hypertension was significant for those aged 18-34 years (OR 15.07, 95% CI 1.69-133.92). Conclusion Our results support the widespread promotion of an active lifestyle to lower the prevalence of diabetes and hypertension in Singapore.
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Affiliation(s)
- Yen Sin Koh
- Research Division, Institute of Mental Health, Singapore
| | - P V Asharani
- Research Division, Institute of Mental Health, Singapore
| | - Fiona Devi
- Research Division, Institute of Mental Health, Singapore
| | | | - Peizhi Wang
- Research Division, Institute of Mental Health, Singapore
| | | | - Chee Fang Sum
- Admiralty Medical Centre, Khoo Teck Puat Hospital, Singapore
| | - Eng Sing Lee
- Clinical Research Unit, National Healthcare Group Polyclinics, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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Maniero C, Lopuszko A, Papalois KB, Gupta A, Kapil V, Khanji MY. Non-pharmacological factors for hypertension management: a systematic review of international guidelines. Eur J Prev Cardiol 2023; 30:17-33. [PMID: 35947982 DOI: 10.1093/eurjpc/zwac163] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 01/19/2023]
Abstract
Lifestyle modifications are one of the cornerstones of hypertension prevention and treatment. We aimed to systematically review hypertension guidelines on their recommendations on non-pharmacological factors including lifestyle interventions, to highlight strength of evidence, similarities, and differences. This systematic review was registered with the international Prospective Register of Systematic Reviews (CRD42021288815). Publications in MEDLINE and EMBASE databases over 10 years since January 2010 to June 2020 were identified. We also included the search from websites of organizations responsible for guidelines development. Two reviewers screened the titles and abstracts to identify relevant guidelines. Two reviewers independently assessed rigour of guideline development using the AGREE II instrument, and one reviewer extracted recommendations. Of the identified guidelines, 10 showed good rigour of development (AGREE II ≥ 60%) and were included in the systematic review. The guidelines were consistent in most recommendations (reduced salt intake, weight, dietary patterns, increased physical activity and smoking cessation, and limiting alcohol intake). Some areas of disagreement were identified, regarding recommendations on novel psychological and environmental factors such as stress or air pollution, alcohol intake thresholds, meat, coffee and tea consumption and refined sugars. Current guidelines agree on the importance of lifestyle in the treatment and prevention of hypertension. Consensus on smoking cessation, limited salt intake, increased physical activity support their integration in management of hypertensive patients and in public health measurements in general population as preventative measurements. Further research into the role of environmental and psychological factors may help clarify future recommendations.
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Affiliation(s)
- Carmela Maniero
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Aleksandra Lopuszko
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Kyriaki-Barbara Papalois
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Ajay Gupta
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Vikas Kapil
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
| | - Mohammed Y Khanji
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London EC1A 7BE, UK.,NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK.,Newham University Hospital, Barts Health NHS Trust, London E13 8SL, UK
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Chuang HH, Cherng WJ, Lin CH, Lee LA, Hsu KH, Lin RH. Physical fitness mediates and predicts for high blood pressure among children in relation to weight status. Front Public Health 2023; 11:1157351. [PMID: 37143976 PMCID: PMC10151579 DOI: 10.3389/fpubh.2023.1157351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/16/2023] [Indexed: 05/06/2023] Open
Abstract
Background Pediatric hypertension contributes to adulthood hypertension and target organ damage. Obesity is a well-known predictor for pediatric hypertension; however, the relationship between physical fitness and blood pressure (BP) is unclear among children. This study aimed to compare the differences in demographics, anthropometrics, and physical fitness across BP subgroups and investigate whether physical fitness was related to pediatric hypertension independent of weight status. Methods This quantitative, cross-sectional study investigated demographic, anthropometric, physical fitness, and BP measures among 360 healthy school-aged children. Continuous variables were compared across BP subgroups with the one-way analysis of variance. Mediation and moderation analyses were used to explore the mechanism. Multivariable regression models were used to assess independent associations for hypertension. Results There were 177 (49.2%), 37 (10.3%), and 146 (40.6%) children in the normotensive, elevated BP, and hypertensive subgroups, respectively. The hypertensive subgroup had higher body mass index (BMI) and waist/height ratio percentiles and performed worse in 800-m run, standing long jump (SLJ), and 1-min sit-ups than the normotensive subgroup. Furthermore, the 800-m run percentile (total effect: β = 0.308, standard error = 0.044, p < 0.001) and sit and reach percentile (total effect: β = 0.308, standard error = 0.044, p < 0.001) mediated the relationship between the BMI percentile and systolic BP percentile; the SLJ percentile was directly associated with the diastolic BP percentile (β,-0.197, 95% confidence interval,-0.298-0.097; p < 0.001). The parsimonious model of multivariable regression models revealed that the SLJ percentile (adjusted exp (β), 0.992, 95% confidence interval, 0.985-0.999; p = 0.042) and BMI percentile (adjusted exp (β), 1.024, 95% confidence interval, 1.016-1.032; p < 0.001) were two independent predictors for pediatric hypertension. Conclusion Physical fitness mediates the relationship between anthropometric and BP measures. The SLJ percentile is associated with pediatric hypertension independent of the BMI percentile. Proactive screening and health promotion for not only healthy weight status but also good physical fitness may be beneficial for BP control among school-aged students.
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Affiliation(s)
- Hai-Hua Chuang
- Department of Family Medicine, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Wen-Jin Cherng
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Division of Cardiology, Department of Internal Medicine, Chang-Gung Memorial Hospital, Linkou Main Branch, Taoyuan, Taiwan
| | - Chih-Hung Lin
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Plastic and Reconstructive Surgery, Linkou Main Branch, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Ang Lee
- Metabolism and Obesity Institute, Taipei and Linkou Main Branches, Chang Gung Memorial Hospital, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
- Departments of Otorhinolaryngology-Head and Neck Surgery, Linkou Main Branch, Chang-Gung Memorial Hospital, Taoyuan, Taiwan
| | - Kuang-Hung Hsu
- Healthy Aging Research Center, Chang Gung University, Taoyuan, Taiwan
- Laboratory for Epidemiology, Department of Health Care Management, Chang Gung University, Taoyuan, Taiwan
- Department of Emergency Medicine, Chang Gung Memorial Hospital at Linkou, Taoyuan, Taiwan
| | - Rong-Ho Lin
- Department of Industrial Engineering and Management, National Taipei University of Technology, Taipei, Taiwan
- *Correspondence: Rong-Ho Lin
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Feter N, Mielke GI, Cunha L, Leite JS, Dumith SC, Rombaldi AJ. Can physical activity attenuate the impact of cardiovascular risk factors in the incidence of dementia? Findings from a population-based cohort study. Psychiatry Res 2022; 317:114865. [PMID: 36179594 DOI: 10.1016/j.psychres.2022.114865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 09/18/2022] [Accepted: 09/24/2022] [Indexed: 01/04/2023]
Affiliation(s)
- Natan Feter
- Postgraduate Program of Epidemiology, Universidade Federal do Rio Grande do Sul, Rua Dr Miguel Barcelos, 547, Pelotas, Porto Alegre, Rio Grande do Sul 96015-150, Brazil.
| | - Gregore I Mielke
- School of Public Health, The University of Queensland, Brisbane, Australia
| | - Larissa Cunha
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
| | - Jayne S Leite
- Postgraduate Program in Health Sciences, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Samuel C Dumith
- Postgraduate Program in Health Sciences, Federal University of Rio Grande, Rio Grande, Brazil
| | - Airton J Rombaldi
- Postgraduate Program in Physical Education, Federal University of Pelotas, Pelotas, Brazil
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Lee GY, Kim KO, Ryu JH, Park SH, Chung HR, Butler M. Exploring Perceived Barriers to Physical Activity in Korean Older Patients with Hypertension: Photovoice Inquiry. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14020. [PMID: 36360900 PMCID: PMC9655165 DOI: 10.3390/ijerph192114020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
This study attempted to explore the barriers to physical activity of older patients with Hypertension. It aimed to provide robust evidence produced through their eyes. First, through the data analysis of the accelerometer and the decision of the research team, 10 out of the 30 applicants were invited to participate in a photovoice study. Photovoice is one example of participatory action research. Photovoice participants can communicate their unique experiences through photographs, providing a highly realistic and authentic perspective that is not possible to be understood with traditional qualitative research. This study inductively identified four main themes; health illiteracy, distortion of health information, fear of physical activity, and rejection of any life changes. Based on a specific understanding of the population's perception of physical activity, this study attempted to provide evidence of why many elderly Korean patients with Hypertension stay inactive.
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Affiliation(s)
- Gun-Young Lee
- Department of Gerokinesiology, Kyungil University, Kyungsan 38428, Korea
| | - Kyung-O Kim
- Department of Gerokinesiology, Kyungil University, Kyungsan 38428, Korea
| | - Jae-Hyeong Ryu
- Chungbuk Boeun Naebuk Public Health Center, Boen 28917, Korea
| | | | - Hae-Ryong Chung
- Health and Fitness Management, College of Health, Clayton State University, Morrow, GA 30260, USA
| | - Marcia Butler
- Health Care Management, College of Health, Clayton State University, Morrow, GA 30260, USA
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12
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Dietrich E, Jomard A, Osto E. Crosstalk between high-density lipoproteins and endothelial cells in health and disease: Insights into sex-dependent modulation. Front Cardiovasc Med 2022; 9:989428. [PMID: 36304545 PMCID: PMC9594152 DOI: 10.3389/fcvm.2022.989428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 09/16/2022] [Indexed: 11/19/2022] Open
Abstract
Atherosclerotic cardiovascular disease is the leading cause of death worldwide. Intense research in vascular biology has advanced our knowledge of molecular mechanisms of its onset and progression until complications; however, several aspects of the patho-physiology of atherosclerosis remain to be further elucidated. Endothelial cell homeostasis is fundamental to prevent atherosclerosis as the appearance of endothelial cell dysfunction is considered the first pro-atherosclerotic vascular modification. Physiologically, high density lipoproteins (HDLs) exert protective actions for vessels and in particular for ECs. Indeed, HDLs promote endothelial-dependent vasorelaxation, contribute to the regulation of vascular lipid metabolism, and have immune-modulatory, anti-inflammatory and anti-oxidative properties. Sex- and gender-dependent differences are increasingly recognized as important, although not fully elucidated, factors in cardiovascular health and disease patho-physiology. In this review, we highlight the importance of sex hormones and sex-specific gene expression in the regulation of HDL and EC cross-talk and their contribution to cardiovascular disease.
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Affiliation(s)
- Elisa Dietrich
- Institute for Clinical Chemistry, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Anne Jomard
- Institute for Clinical Chemistry, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Elena Osto
- Institute for Clinical Chemistry, University of Zurich and University Hospital Zurich, Zurich, Switzerland
- Department of Cardiology, Heart Center, University Hospital Zurich, Zurich, Switzerland
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13
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Zhou L, Feng W, Xiang N, Cheng Y, Ya X, Wang M, Wang X, Liu Y. Association between physical activity dimensions and the risk of hypertension among middle and older adults: A cross-sectional study in China. Front Public Health 2022; 10:995755. [PMID: 36217539 PMCID: PMC9547049 DOI: 10.3389/fpubh.2022.995755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Accepted: 09/09/2022] [Indexed: 01/26/2023] Open
Abstract
Background It is known that insufficient physical activity is associated with the risk of hypertension, but the relationship to different physical activity dimensions within hypertension risk remains to be elucidated. Objective The objective of this study is to identify the association between physical activity intensity, frequency, duration, and volume with hypertension risk. Meanwhile, a dose-response experiment is conducted to determine the relationship between physical activity level and hypertension risk. Methods Data came from the 2018 China Health and Retirement Longitudinal Study (CHARLS, 2018), which included 14266 participants over the age of 45. Binary logistic regression models were established to assess the associations between different dimensions of physical activity and the risk of hypertension. Restricted cubic spline analysis was used to examine possible non-linear associations between physical activity volume and hypertension risk. Results For frequency, lower hypertension risk was associated with performing vigorous physical activity 6-7d/w (OR 0.82, 95%CI 0.73-0.93) and moderate physical activity 6-7d/w (OR 0.89, 95%CI 0.80-0.99). No significant association between any light physical activity frequency and hypertension was observed before and after being adjusted. For the duration, lower hypertension risk was observed in performing vigorous physical activity ≥240 min/d (OR 0.85, 95%CI 0.75-0.97) and moderate physical activity ≥240 min/d (OR 0.83, 95%CI 0.71-0.97). For volume, the risks of hypertension in the participants who reported TPA in the 3th and 4th of quantiles were reduced by 18% (OR 0.82, 95%CI 0.72-0.95) and 22% (OR 0.78, 95%CI 0.68-0.91). A non-linear dose-response association between total physical activity and the risk of hypertension was shown among all of the participants (P non-linearity < 0.05). Conclusion Higher frequency and longer duration of vigorous physical activity or moderate physical activity were significantly associated with a lower risk of hypertension. Higher physical activity levels were associated with a lower risk of hypertension and there was an inverse non-linear dose-response relationship between weekly total physical activity and the risk of hypertension. These findings provide further proof that hypertension could be prevented through increased physical activity.
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Affiliation(s)
- Linlin Zhou
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Wei Feng
- Department of Physical Education, Suzhou University, Suzhou, China
| | - Na Xiang
- Caoxian People's Hospital, Heze, China
| | - Yue Cheng
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xudong Ya
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Mingxia Wang
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China
| | - Xingqi Wang
- School of Life Science, Biomedical R&D Center, Jiangsu Normal University, Xuzhou, China,*Correspondence: Xingqi Wang
| | - Yujia Liu
- Institute of Physical Education, Jiangsu Normal University, Xuzhou, China,Yujia Liu
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14
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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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15
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Pan Q, Zha S, Li J, Guan H, Xia J, Yu J, Cui C, Liu Y, Xu J, Liu J, Chen G, Jiang M, Zhang J, Ding X, Zhao X. Identification of the susceptible subpopulations for wide pulse pressure under long-term exposure to ambient particulate matters. THE SCIENCE OF THE TOTAL ENVIRONMENT 2022; 834:155311. [PMID: 35439510 DOI: 10.1016/j.scitotenv.2022.155311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 04/11/2022] [Accepted: 04/12/2022] [Indexed: 06/14/2023]
Abstract
Wide pulse pressure (WPP) is a preclinical indicator for arterial stiffness and cardiovascular diseases. Long-term exposure to ambient particulate matters (PMs) would increase the risk of WPP. Although reducing pollutants emissions and avoiding outdoor activity during a polluted period are effective ways to blunt the adverse effects. Identifying and protecting the susceptible subpopulation is another crucial way to reduce the disease burdens. Therefore, we aimed to identify the susceptible subpopulations of WPP under long-term exposure to PMs. The WPP was defined as pulse pressure over 60 mmHg. Three-year averages of PMs were estimated using random forest approaches. Associations between WPP and PMs exposure were estimated using generalized propensity score weighted logistic regressions. Demographic, socioeconomic characteristics, health-related behaviors, and hematological biomarkers were collected to detect the modification effects on the WPP-PMs associations. Susceptible subpopulations were defined as those with significantly higher risks of WPP under PMs exposures. The PMs-WPP associations were significant with ORs (95%CI) of 1.126 (1.094, 1.159) for PM1, 1.174 (1.140, 1.210) for PM2.5, and 1.111 (1.088, 1.135) for PM10. There were 17 subpopulations more sensitive to WPP under long-term exposure to PMs. The susceptibility was higher in subpopulations with high BMI (Q3-Q4 quartiles), high-intensive physical activity (Q3 or Q4 quartile), insufficient or excessive fruit intake (Q1 or Q5 quartile), insufficient or too long sleep length (<7 or >8 h). Subpopulations with elevated inflammation markers (WBC, LYM, BAS, EOS: Q3-Q4 quartiles) and glucose metabolism indicators (HbA1c, GLU: Q3-Q4 quartiles) were more susceptible. Besides, elder, urban living, low socioeconomic level, and excessive red meat and sodium salt intake were also related to higher susceptibility. Our findings on the susceptibility characteristics would help to develop more targeted disease prevention and therapy strategies. Health resources can be allocated more effectively by putting more consideration to subpopulations with higher susceptibility.
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Affiliation(s)
- Qing Pan
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Shun Zha
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Jingzhong Li
- Tibet Center for Disease Control and Prevention, Tibet, China
| | - Han Guan
- School of Public Health, the Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guiyang, China
| | - Jingjie Xia
- Chengdu Center for Disease Control and Prevention, Chengdu, China
| | - Jianhong Yu
- Pidu District Center for Disease Control and Prevention, Chengdu, China
| | | | - Yuanyuan Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jiayue Xu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jin Liu
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangdong, China
| | - Min Jiang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Juying Zhang
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.
| | - Xianbin Ding
- Chongqing Municipal Center for Disease Control and Prevention, Chongqing, China
| | - Xing Zhao
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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16
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Maroofi A, Moro T, Agrimi J, Safari F. Cognitive decline in heart failure: Biomolecular mechanisms and benefits of exercise. Biochim Biophys Acta Mol Basis Dis 2022; 1868:166511. [PMID: 35932891 DOI: 10.1016/j.bbadis.2022.166511] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022]
Abstract
By definition, heart failure (HF) is a human pathological condition affecting the structure and function of all organs in the body, and the brain is not an exception to that. Failure of the heart to pump enough blood centrally and peripherally is at the foundation of HF patients' inability to attend even the most ordinary daily activities and progressive deterioration of their cognitive capacity. What is more, between heart and brain exists a bidirectional relationship that goes well beyond hemodynamics and concerns bioelectric and endocrine signaling. This increasingly consolidated evidence makes the scenario even more complex. Studies have mainly chased how HF impairs cognition without focusing much on preventive measures, notably cardio-cerebral health proxies. Here, we aim to provide a brief account of known and hypothetical factors that may explain how exercise can help obviate cognitive dysfunction associated with HF in its different forms. As we shall see, there is a stringent need for a deeper grasp of such mechanisms. Indeed, gaining this new knowledge will automatically shed new light on the inner workings of HF itself, thus resulting in more effective prevention and treatment of this escalating syndrome.
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Affiliation(s)
- Abdulbaset Maroofi
- Department of Exercise Physiology, Faculty of Physical Education & Sport Sciences, University of Guilan, Rasht, Iran
| | - Tatiana Moro
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy
| | - Jacopo Agrimi
- Department of Biomedical Sciences, University of Padua, 35131 Padua, Italy.
| | - Fatemeh Safari
- Department of Physiology, Faculty of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
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17
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Madsen TE, Samaei M, Pikula A, Yu AYX, Carcel C, Millsaps E, Yalamanchili RS, Bencie N, Dula AN, Leppert M, Rundek T, Dreyer RP, Bushnell C. Sex Differences in Physical Activity and Incident Stroke: A Systematic Review. Clin Ther 2022; 44:586-611. [PMID: 35418311 PMCID: PMC9195871 DOI: 10.1016/j.clinthera.2022.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/03/2022] [Accepted: 02/12/2022] [Indexed: 12/25/2022]
Abstract
PURPOSE Physical inactivity, a modifiable risk factor for cardiovascular disease, is independently associated with stroke. Though some prior data have suggested sex differences in levels of physical activity, whether there are sex differences in the role of physical activity in primary stroke prevention is largely unknown. This systematic review identifies and describes recent findings on sex differences in the association between physical activity and incident (first-ever) stroke. This review also describes the current evidence on the strength of the association between physical activity and a reduced stroke risk in women in particular. METHODS Using a prespecified strategy, PubMed/MEDLINE and Cochrane Central were searched to identify observational studies or trials published from 2000 to 2020 and reporting sex differences in physical activity and incident stroke. To be included, among other criteria, studies had to include sex-specific effect estimates from women, men, or both. Titles, abstracts, and full-text articles were screened to identify studies meeting the inclusion criteria, and adjusted sex-specific estimates of the association between physical activity and incident stroke for total stroke (ischemic plus hemorrhagic) or ischemic stroke were abstracted. FINDINGS Thirty-seven studies met the inclusion criteria. Of 17 studies that included data on total incident stroke (ischemic and hemorrhagic combined) in both women and men, 7 (41%) showed similar associations between physical activity and incident stroke between women and men, 6 (35%) suggested a significant effect in women but not in men, and 3 (18%) showed a significant effect in men but not in women. Of 10 studies that included data on ischemic stroke in women and men, 5 (50%) suggested similar effects in women and men, 4 (40%) suggested a significant effect in women but not in men, and 1 (10%) showed an effect in men but not women. In women specifically, the majority of included studies demonstrated a reduced risk for incident stroke with physical activity, with relative risk reductions ranging from 11% to 72%, though most estimates fell between 20% and 40%. IMPLICATIONS The majority of studies indicated a clear association between physical activity and a reduction in stroke risk. Studies were split as to the potential for sex differences in this association. Future prospective investigations should identify strategies for the use of increased physical activity for primary stroke prevention, with sex-specific considerations as warranted. The data on sex-specific dose-response relationship between physical activity and stroke risk are inconclusive and warrant more research.
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Affiliation(s)
- Tracy E Madsen
- Department of Emergency Medicine, Warren Alpert Medical School, and the Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island.
| | - Mehrnoosh Samaei
- Department of Emergency Medicine, Division of Sex and Gender in Emergency Medicine, Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Aleksandra Pikula
- Department of Medicine (Neurology), University of Toronto, University Health Networks, Toronto, Ontario, Canada
| | - Amy Y X Yu
- Department of Medicine (Neurology), University of Toronto, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | - Nicole Bencie
- Warren Alpert Medical School, Brown University, Providence, Rhode Island
| | - Adrienne N Dula
- Departments of Neurology and Diagnostic Medicine, Dell Medical School, University of Texas, Austin, Texas
| | - Michelle Leppert
- Department of Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Tatjana Rundek
- Department of Neurology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Rachel P Dreyer
- Center for Outcomes Research and Evaluation, Department of Emergency Medicine, Yale School of Medicine, New Haven, Connecticut
| | - Cheryl Bushnell
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina
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18
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Mone P, Izzo R, Marazzi G, Manzi MV, Gallo P, Campolongo G, Cacciotti L, Tartaglia D, Caminiti G, Varzideh F, Santulli G, Trimarco V. L-Arginine Enhances the Effects of Cardiac Rehabilitation on Physical Performance: New Insights for Managing Cardiovascular Patients During the COVID-19 Pandemic. J Pharmacol Exp Ther 2022; 381:197-203. [PMID: 35339987 DOI: 10.1124/jpet.122.001149] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 03/21/2022] [Indexed: 11/22/2022] Open
Abstract
Cardiac rehabilitation (CR) following acute myocardial infarction (AMI) improves physical capacities and decreases hospitalizations and cardiovascular mortality. L-Arginine is the substrate used by nitric oxide (NO) synthase (NOS) to generate NO and it has been shown to exert its beneficial effects on endothelium driving vasodilatation, reducing inflammation, and ameliorating physical function. We hypothesized that L-Arginine could enhance physical capacities in patients who underwent CR after AMI. We designed a study aimed to assess the effects of L-arginine administration on the physical capacity of patients who underwent coronary revascularization after AMI. The trial was carried out amid the COVID-19 pandemic. Patients were assigned, with a 2:1 ratio, to add to their standard therapy 1 bottle containing 1.66 g of L-arginine or 1 bottle of identical aspect apart from not containing L-arginine, twice a day orally for 3 weeks. Patients performed a 6-minute walking test (6MWT) and were assessed their Borg modified 0-10 rating of perceived exertion (BRPE) before starting and at the end of the treatment. Seventy-five patients receiving L-Arginine, and thirty-five receiving placebo successfully completed the study. The 6MWT distance increased significantly in the L-Arginine group compared to both baseline and placebo (p<0.0001). Additionally, we observed a significant improvement in the BRPE in patients treated with L-arginine but not in the placebo group. Taken together, our data indicate that L-arginine potentiates the response to CR, independently of age, sex, baseline functional capacity, and comorbid conditions. Significance Statement This study shows for the first time that oral supplementation of L-arginine potentiates the response to cardiac rehabilitation after myocardial infarction and cardiac revascularization. Indeed, we observed a significant improvement in two fundamental parameters, namely, the 6-minute walking test and the Borg modified 0-10 rating of perceived exertion. Strikingly, the beneficial effects of L-arginine were independent from age, sex, comorbid conditions, and baseline functional capacity.
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19
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Vitamin C and Cardiovascular Disease: An Update. Antioxidants (Basel) 2020; 9:antiox9121227. [PMID: 33287462 PMCID: PMC7761826 DOI: 10.3390/antiox9121227] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 02/07/2023] Open
Abstract
The potential beneficial effects of the antioxidant properties of vitamin C have been investigated in a number of pathological conditions. In this review, we assess both clinical and preclinical studies evaluating the role of vitamin C in cardiac and vascular disorders, including coronary heart disease, heart failure, hypertension, and cerebrovascular diseases. Pitfalls and controversies in investigations on vitamin C and cardiovascular disorders are also discussed.
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20
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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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21
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Gulsin GS, Swarbrick DJ, Athithan L, Brady EM, Henson J, Baldry E, Argyridou S, Jaicim NB, Squire G, Walters Y, Marsh AM, McAdam J, Parke KS, Biglands JD, Yates T, Khunti K, Davies MJ, McCann GP. Effects of Low-Energy Diet or Exercise on Cardiovascular Function in Working-Age Adults With Type 2 Diabetes: A Prospective, Randomized, Open-Label, Blinded End Point Trial. Diabetes Care 2020; 43:1300-1310. [PMID: 32220917 DOI: 10.2337/dc20-0129] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2020] [Accepted: 03/02/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To confirm the presence of subclinical cardiovascular dysfunction in working-age adults with type 2 diabetes (T2D) and determine whether this is improved by a low-energy meal replacement diet (MRP) or exercise training. RESEARCH DESIGN AND METHODS This article reports on a prospective, randomized, open-label, blinded end point trial with nested case-control study. Asymptomatic younger adults with T2D were randomized 1:1:1 to a 12-week intervention of 1) routine care, 2) supervised aerobic exercise training, or 3) a low-energy (∼810 kcal/day) MRP. Participants underwent echocardiography, cardiopulmonary exercise testing, and cardiac magnetic resonance (CMR) at baseline and 12 weeks. The primary outcome was change in left ventricular (LV) peak early diastolic strain rate (PEDSR) as measured by CMR. Healthy volunteers were enrolled for baseline case-control comparison. RESULTS Eighty-seven participants with T2D (age 51 ± 7 years, HbA1c 7.3 ± 1.1%) and 36 matched control participants were included. At baseline, those with T2D had evidence of diastolic dysfunction (PEDSR 1.01 ± 0.19 vs. 1.10 ± 0.16 s-1, P = 0.02) compared with control participants. Seventy-six participants with T2D completed the trial (30 routine care, 22 exercise, and 24 MRP). The MRP arm lost 13 kg in weight and had improved blood pressure, glycemia, LV mass/volume, and aortic stiffness. The exercise arm had negligible weight loss but increased exercise capacity. PEDSR increased in the exercise arm versus routine care (β = 0.132, P = 0.002) but did not improve with the MRP (β = 0.016, P = 0.731). CONCLUSIONS In asymptomatic working-age adults with T2D, exercise training improved diastolic function. Despite beneficial effects of weight loss on glycemic control, concentric LV remodeling, and aortic stiffness, a low-energy MRP did not improve diastolic function.
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Affiliation(s)
- Gaurav S Gulsin
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Daniel J Swarbrick
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Lavanya Athithan
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Emer M Brady
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Joseph Henson
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Emma Baldry
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Stavroula Argyridou
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Nishal B Jaicim
- Leicester Clinical Trials Unit, University of Leicester, Leicester, U.K
| | - Gareth Squire
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Yvette Walters
- Leicester Clinical Trials Unit, University of Leicester, Leicester, U.K
| | - Anna-Marie Marsh
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - John McAdam
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | - Kelly S Parke
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K
| | | | - Thomas Yates
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Kamlesh Khunti
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Melanie J Davies
- Diabetes Research Centre, University of Leicester and the NIHR Leicester Biomedical Research Centre, Leicester, U.K
| | - Gerry P McCann
- Department of Cardiovascular Sciences, University of Leicester and the National Institute for Health Research (NIHR) Leicester Biomedical Research Centre, Leicester, U.K.
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Effects of Caloric Intake and Aerobic Activity in Individuals with Prehypertension and Hypertension on Levels of Inflammatory, Adhesion and Prothrombotic Biomarkers-Secondary Analysis of a Randomized Controlled Trial. J Clin Med 2020; 9:jcm9030655. [PMID: 32121255 PMCID: PMC7141349 DOI: 10.3390/jcm9030655] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Revised: 02/25/2020] [Accepted: 02/26/2020] [Indexed: 12/17/2022] Open
Abstract
Background: Cardiopulmonary fitness and low calorie diets have been shown to reduce inflammation but few studies have been conducted in individuals with elevated blood pressure (BP) in a randomized intervention setting. Thereby, adhesion biomarkers, e.g., soluble intercellular adhesion molecule (sICAM)-3, have not been examined so far. Methods: Sixty-eight sedentary prehypertensive and mildly hypertensive individuals (mean age ± SEM: 45 ± 1 years; mean BP: 141/84 ± 1/1 mmHg) were randomized to one of three 12-week intervention groups: cardio training and caloric reduction, cardio training alone, or wait-list control group. Plasma levels of inflammatory, adhesion and prothrombotic biomarkers were assessed. In a second step, intervention groups were combined to one sample and multivariate regression analyses were applied in order to account for exercise and diet behavior changes. Results: There were no significant differences among the intervention groups. In the combined sample, greater caloric reduction was associated with a larger increase of sICAM-3 (p = 0.026) and decrease of C-reactive protein (p = 0.018) as a result of the interventions. More cardio training was associated with increases of sICAM-3 (p = 0.046) as well as interleukin-6 (p = 0.004) and a decrease of tumor necrosis factor-α (p = 0.017) levels. Higher BP predicted higher plasminogen activator inhibitor (PAI)-1 (p = 0.001), and greater fitness predicted lower PAI-1 levels (p = 0.006) after the intervention. Conclusions: In prehypertensive and hypertensive patients, plasma levels of the adhesion molecule sICAM-3 and inflammatory biomarkers have different response patterns to cardio training with and without caloric reduction. Such anti-inflammatory and anti-thrombotic effects may have implications for the prevention of atherothrombotic cardiovascular disease among individuals at increased risk.
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