Low- and moderate-intensity aerobic exercise acutely reduce blood pressure in adults with high-normal/grade I hypertension

Association of healthy lifestyle score with control of hypertension among treated and untreated hypertensive patients: a large cross-sectional study

Background

Hypertension stands as the leading single contributor to the worldwide burden of mortality and disability. Limited evidence exists regarding the association between the combined healthy lifestyle score (HLS) and hypertension control in both treated and untreated hypertensive individuals. Therefore, we aimed to investigate the association between HLS and hypertension control among adults with treated and untreated hypertension.

Methods

This cross-sectional study, including 311,994 hypertension patients, was conducted in Guangzhou using data from the National Basic Public Health Services Projects in China. The HLS was defined based on five low-risk lifestyle factors: healthy dietary habits, active physical activity, normal body mass index, never smoking, and no alcohol consumption. Controlled blood pressure was defined as systolic blood pressure <140 mmHg and diastolic blood pressure <90 mmHg. A multivariable logistic regression model was used to assess the association between HLS and hypertension control after adjusting for various confounders.

Results

The HLS demonstrated an inverse association with hypertension control among hypertensive patients. In comparison to the low HLS group (scored 0-2), the adjusted odds ratios (95% confidence intervals) for hypertension were 0.76 (0.74, 0.78), 0.59 (0.57, 0.60), and 0.48 (0.46, 0.49) for the HLS groups scoring 3, 4, and 5, respectively (Ptrend < 0.001). Notably, an interaction was observed between HLS and antihypertensive medication in relation to hypertension control (Pinteraction < 0.001). When comparing the highest HLS (scored 5) with the lowest HLS (scored 0-2), adjusted odds ratios (95% confidence intervals) were 0.50 (0.48, 0.52, Ptrend < 0.001) among individuals who self-reported using antihypertensive medication and 0.41 (0.38, 0.44, Ptrend < 0.001) among those not using such medication. Hypertensive patients adhering to a healthy lifestyle without medication exhibited better blood pressure management than those using medication while following a healthy lifestyle.

Conclusion

HLS was associated with a reduced risk of uncontrolled blood pressure.

Intrahospital supervised exercise training improves survival rate among hypertensive patients with COVID-19

Among the people most affected by coronavirus disease 2019 (COVID-19) are those suffering from hypertension (HTN). However, pharmacological therapies for HTN are ineffective against COVID-19 progression and severity. It has been proposed that exercise training (EX) could be used as post-COVID treatment, which does not rule out the possible effects during hospitalization for COVID-19. Therefore, we aimed to determine the impact of supervised EX on HTN patients with COVID-19 during hospitalization. Among a total of 1,508 hospitalized patients with COVID-19 (confirmed by PCR), 439 subjects were classified as having HTN and were divided into two groups: EX (n = 201) and control (n = 238) groups. EX (3-4 times/wk during all hospitalizations) consisted of aerobic exercises (15-45 min; i.e., walking); breathing exercises (10-15 min) (i.e., diaphragmatic breathing, pursed-lip breathing, active abdominal contraction); and musculoskeletal exercises (8-10 sets of 12-15 repetitions/wk; lifting dumbbells, standing up and sitting, lumbar stabilization). Our data revealed that the EX (clinician: patient, 1:1 ratio) intervention was able to improve survival rates among controlled HTN patients with COVID-19 during their hospitalization when compared with the control group (chi-squared: 4.83; hazard ratio: 1.8; 95% CI: 1.117 to 2.899; P = 0.027). Multivariate logistic regression analysis revealed that EX was a prognostic marker (odds ratio: 0.449; 95% CI: 0.230-0.874; P = 0.018) along with sex and invasive and noninvasive mechanical ventilation. Our data showed that an intrahospital supervised EX program reduced the mortality rate among patients with HTN suffering from COVID-19 during their hospitalization.NEW & NOTEWORTHY In the present study, we found that exercise training improves the survival rate in hypertensive patients with COVID-19 during their hospitalization period. Our results provide strong evidence for the therapeutic efficacy of exercise training as a feasible approach to improving the outcomes of patients with COVID-19 who suffer from hypertension during their hospitalization.

HIGH-INTENSITY INTERVAL TRAINING POSES NO RISK TO HYPERTENSIVE WOMEN

ABSTRACT Introduction: The aim of this study was to evaluate whether a single session of high-intensity interval training (HIIT) would promote a hypotensive effect and cardiovascular risk in hypertensive women, in addition to increasing the bioavailability of nitric oxide. Methods: The sample consisted of 10 hypertensive women (63.7 ± 10.34 years; 66 ± 7.67 kg and 153.7 ± 9.08 cm) and the training load was established at 60% of the maximum aerobic speed. Results: We observed a very high hypotensive effect between the interaction moments during the intervention (Int. Pre: 122.40 ± 18.58; Int. Post: 143.00 ± 24.90; Int. Post 60min: 121.40 ± 13.87; p<0.001, η2P = 0.569). No cardiovascular risk was observed during the intervention (DP = Int. Pre: 9138.20 ± 1805.34; Int. Post: 14849.70 ± 3387.94; Int. Post 60min: 9615.90 ± 1124.41, p< 0.001, η2P = 0.739) and there was no increase in the bioavailability of nitric oxide. Conclusion: In conclusion, this work reveals that an HIIT session is capable of generating a hypotensive effect while not posing cardiovascular risk in hypertensive women. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals .

Sources of automatic office blood pressure measurement error: a systematic review

OBJECTIVE

Accurate and reliable blood pressure (BP) measurement is important for the prevention and treatment of hypertension. The oscillometric-based automatic office blood pressure measurement (AOBPM) is widely used in hospitals and clinics, but measurement errors are common in BP measurements. There is a lack of systematic review of the sources of measurement errors.

APPROACH

A systematic review of all existing research on sources of AOBPM errors. A search strategy was designed in six online databases, and all the literature published before October 2021 was selected. Those studies that used the AOBPM device to measure BP from the upper arm of subjects were included.

MAIN RESULTS

A total of 1365 studies were screened, and 224 studies were included in this final review. They investigated 22 common error sources with clinical AOBPM. Regarding the causes of BP errors, this review divided them into the following categories: the activities before measurement, patient's factors, measurement environment, measurement procedure, and device settings. 13 sources caused increased systolic and diastolic BP (SBP and DBP), 2 sources caused the decrease in SBP and DBP, only 1 source had no significant effect on BPs, and the other errors had a non-uniform effect (either increase or decrease in BPs). The error ranges for SBP and DBP were -14 to 33 mmHg and -6 to 19 mmHg, respectively.

SIGNIFICANCE

The measurement accuracy of AOBPM is susceptible to the influence of measurement factors. Interpreting BP readings need to be treated with caution in clinical measurements. This review made comprehensive evidence for the need for standardized BP measurements and provided guidance for clinical practitioners when measuring BP with AOBPM devices.

The Effect of Enalapril, Losartan, or Not Antihypertensive on the Oxidative Status in Renal Transplant Recipients

The clinical and biochemical improvement observed in kidney transplant (RT) recipients is remarkable. The correct functioning of the allograft depends on various factors such as the donor's age, the alloimmune response, the ischemia-reperfusion injury, arterial hypertension, and the interstitial fibrosis of the allograft, among others. Antihypertensive drugs are necessary for arterial hypertension patients to avoid or reduce the probability of affecting graft function in RT recipients. Oxidative stress (OS) is another complex pathophysiological process with the ability to alter posttransplant kidney function. The study's objective was to determine the effect of the administration of Enalapril, Losartan, or not antihypertensive medication on the oxidative state in RT recipients at the beginning of the study and one year of follow-up. All patients included in the study found significant overexpression of the oxidative damage marker to DNA and the antioxidant enzymes superoxide dismutase (SOD) and glutathione peroxidase (GPx). In contrast, it was found that the determination of the total antioxidant capacity decreased significantly in the final determination at one year of follow-up in all the patients who ingested Enalapril and Losartan. We found dysregulation of the oxidative state characterized mainly by oxidative damage to DNA and a significant increase in antioxidant enzymes, which could suggest a compensatory effect against the imbalance of the oxidative state.