1
|
McLellan HL, Dawson EA, Eijsvogels TMH, Thijssen DHJ, Bakker EA. Impact of Hypertension on the Dose-Response Association Between Physical Activity and Stroke: A Cohort Study. Stroke 2024; 55:2231-2239. [PMID: 39114902 DOI: 10.1161/strokeaha.123.045870] [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: 11/15/2023] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Regular physical activity is associated with a reduced stroke risk. However, this relationship might be attenuated in the presence of hypertension and antihypertensive medication use. We examined the dose-response relationship between physical activity and stroke in normotensive and hypertensive individuals. METHODS A Dutch population-based cohort including 139 930 individuals (41% men; mean age, 44±13) was performed (median follow-up, 6.75 years). Participants were stratified at baseline as hypertensive (44%) or normotensive (56%) and categorized into quartiles of the lowest (Q1) to the highest (Q4) moderate-to-vigorous, self-reported physical activity. The primary outcome was incident stroke (fatal and nonfatal). Cox regression estimated hazard ratios and 95% CIs. The main analyses were stratified on baseline blood pressure and adjusted for confounders. Hypertensives were stratified into medicated (21%) or non-medicated (79%). RESULTS Compared with Q1, adjusted hazard ratios were 0.87 (0.69-1.10; P=0.23), 0.75 (0.59-0.95; P=0.02), and 0.94 (0.74-1.20; P=0.64) for Q2 to Q4, respectively in the total population. Hazard ratios for normotensives were 0.79 (0.50-1.25; P=0.32), 0.75 (0.48-1.18; P=0.22), 0.97 (0.62-1.51; P=0.90) for Q2 to Q4, respectively. In hypertensives, hazard ratios were 0.89 (0.68-1.17; P=0.41), 0.74 (0.56-0.98; P=0.03), 0.92 (0.69-1.23; P=0.56) for Q2 to Q4, respectively. There was no significant interaction between hypertension status for the relation between physical activity and stroke risk. The stratified analysis revealed a smaller benefit of moderate-to-vigorous physical activity in medicated hypertensives compared with nonmedicated hypertensives, but no significant interaction effect was found. CONCLUSIONS Regular moderate-to-vigorous physical activity is beneficial for stroke risk reduction (Q3 compared with Q1), which is not affected by hypertension. Antihypertensive medication may be associated with a smaller benefit of moderate-to-vigorous physical activity on the risk of stroke, but further research is warranted.
Collapse
Affiliation(s)
- Hannah L McLellan
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore's University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
| | - Ellen A Dawson
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore's University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
| | - Thijs M H Eijsvogels
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
| | - Dick H J Thijssen
- Liverpool Centre for Cardiovascular Science, Research Institute for Sport and Exercise Science, Liverpool John Moore's University, United Kingdom (H.L.M.L., E.A.D., D.H.J.T.)
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
| | - Esmée A Bakker
- Department of Medical BioSciences, Radboud University Medical Center, Nijmegen, the Netherlands (T.M.H.E., D.H.J.T., E.A.B.)
- Department of Physical Education and Sports, Sport and Health University Research Institute (iMUDS), University of Granada, Spain (E.A.B.)
| |
Collapse
|
2
|
Narita K, Shimbo D, Kario K. Assessment of blood pressure variability: characteristics and comparison of blood pressure measurement methods. Hypertens Res 2024:10.1038/s41440-024-01844-y. [PMID: 39152254 DOI: 10.1038/s41440-024-01844-y] [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: 06/10/2024] [Revised: 07/10/2024] [Accepted: 07/16/2024] [Indexed: 08/19/2024]
Abstract
Previous studies have reported that blood pressure variability (BPV) is associated with the risk of cardiovascular events independent of blood pressure (BP) levels. While there is little evidence from intervention trials examining whether suppressing BPV is useful in preventing cardiovascular disease, it is suggested that detection of abnormally elevated BPV may be useful in reducing cardiovascular events adding by complementing management of appropriate BP levels. Cuffless BP devices can assess beat-to-beat BPV. Although cuffless BP monitoring devices have measurement accuracy issues that need to be resolved, this is an area of research where the evidence is accumulating rapidly, with many publications on beat-to-beat BPV over several decades. Ambulatory BP monitoring (ABPM) can assess 24-hour BPV and nocturnal dipping patterns. Day-to-day BPV and visit-to-visit BPV are assessed by self-measured BP monitoring at home and office BP measurement, respectively. 24 h, day-to-day, and visit-to-visit BPV have been reported to be associated with cardiovascular prognosis. Although there have been several studies comparing whether ABPM and self-measured BP monitoring at home is the superior measurement method of BPV, no strong evidence has been accumulated that indicates whether ABPM or self-measured home BP is superior. ABPM and self-measured BP monitoring have their own advantages and complement each other in the assessment of BPV.
Collapse
Affiliation(s)
- Keisuke Narita
- Columbia Hypertension Laboratory, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA.
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan.
| | - Daichi Shimbo
- Columbia Hypertension Laboratory, Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| |
Collapse
|
3
|
Choi Y, Lee DC, Han Y, Sung H, Yoon J, Kim YS. Combined association of aerobic and muscle strengthening activity with mortality in individuals with hypertension. Hypertens Res 2024:10.1038/s41440-024-01788-3. [PMID: 39138362 DOI: 10.1038/s41440-024-01788-3] [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: 04/23/2024] [Revised: 06/05/2024] [Accepted: 06/17/2024] [Indexed: 08/15/2024]
Abstract
Evidence on the association between meeting both aerobic physical activity (PA) and muscle-strengthening activity (MSA) guidelines with mortality in individuals with hypertension is scarce. We included 34,990 adults from the 2007 to 2013 Korea National Health and Nutrition Examination Survey, linking mortality follow-up data until 2019. Adherence to PA guidelines was assessed based on the current PA guidelines using a self-reported questionnaire and categorized as follows: meeting MSA only, aerobic PA only, both MSA and aerobic PA, or neither. Associations of hypertension and adherence to PA guidelines with all-cause and cardiovascular disease (CVD) mortality were examined using Cox proportional hazard models. Over 9.2 years, 1948 participants died from any cause and 419 from CVD. Meeting both PA guidelines was associated with the lowest risk of all-cause and CVD mortalities in the total sample regardless of hypertension status. In individuals with hypertension, meeting aerobic PA guidelines only had a 24% lower risk of both all-cause and CVD mortality, and meeting both PA guidelines further reduced risks by 40% and 43%, respectively; however, meeting MSA guidelines only was not associated with either all-cause or CVD mortality. In individuals without hypertension, only meeting both MSA and aerobic PA guidelines, but not meeting either MSA or aerobic PA guidelines, showed reduced risk of CVD mortality. In Korean population, non-hypertensive individuals who met both guidelines had a lower risk of CVD mortality. However, hypertensive individuals showed a reduced risk of both all-cause and CVD mortality when meeting aerobic PA or both guidelines, but not MSA alone.
Collapse
Affiliation(s)
- Younghwan Choi
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Duck-Chul Lee
- School of Education, University of Pittsburgh, Pittsburgh, PA, USA
| | - Yunmin Han
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea
| | - Hoyong Sung
- Department of Physical Education, Korea Military Academy, Seoul, South Korea
| | - Jiyeon Yoon
- Department of Kinesiology, Iowa State University, Ames, IA, USA
| | - Yeon Soo Kim
- Department of Physical Education, College of Education, Seoul National University, Seoul, South Korea.
- Institute of Sport Science, Seoul National University, Seoul, South Korea.
| |
Collapse
|
4
|
Jones R, Robinson AT, Beach LB, Lindsey ML, Kirabo A, Hinton A, Erlandson KM, Jenkins ND. Exercise to Prevent Accelerated Vascular Aging in People Living With HIV. Circ Res 2024; 134:1607-1635. [PMID: 38781293 PMCID: PMC11126195 DOI: 10.1161/circresaha.124.323975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/25/2024]
Abstract
Given advances in antiretroviral therapy, the mortality rate for HIV infection has dropped considerably over recent decades. However, people living with HIV (PLWH) experience longer life spans coupled with persistent immune activation despite viral suppression and potential toxicity from long-term antiretroviral therapy use. Consequently, PLWH face a cardiovascular disease (CVD) risk more than twice that of the general population, making it the leading cause of death among this group. Here, we briefly review the epidemiology of CVD in PLWH highlighting disparities at the intersections of sex and gender, age, race/ethnicity, and the contributions of social determinants of health and psychosocial stress to increased CVD risk among individuals with marginalized identities. We then overview the pathophysiology of HIV and discuss the primary factors implicated as contributors to CVD risk among PLWH on antiretroviral therapy. Subsequently, we highlight the functional evidence of premature vascular dysfunction as an early pathophysiological determinant of CVD risk among PLWH, discuss several mechanisms underlying premature vascular dysfunction in PLWH, and synthesize current research on the pathophysiological mechanisms underlying accelerated vascular aging in PLWH, focusing on immune activation, chronic inflammation, and oxidative stress. We consider understudied aspects such as HIV-related changes to the gut microbiome and psychosocial stress, which may serve as mechanisms through which exercise can abrogate accelerated vascular aging. Emphasizing the significance of exercise, we review various modalities and their impacts on vascular health, proposing a holistic approach to managing CVD risks in PLWH. The discussion extends to critical future study areas related to vascular aging, CVD, and the efficacy of exercise interventions, with a call for more inclusive research that considers the diversity of the PLWH population.
Collapse
Affiliation(s)
- Raymond Jones
- Heersink School of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | | | - Lauren B. Beach
- Department of Medical Social Sciences, Northwestern, Chicago, IL
- Department of Preventive Medicine, Northwestern, Chicago, IL
| | - Merry L. Lindsey
- School of Graduate Studies, Meharry Medical College, Nashville, TN
- Research Service, Nashville VA Medical Center, Nashville, TN
| | - Annet Kirabo
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN
- Vanderbilt Center for Immunobiology, Nashville, TN
- Vanderbilt Institute for Infection, Immunology and Inflammation, Nashville, TN
- Vanderbilt Institute for Global Health, Nashville, TN
| | - Antentor Hinton
- Department of Molecular Physiology and Biophysics, Vanderbilt University, Nashville, TN
| | | | - Nathaniel D.M. Jenkins
- Department of Health and Human Physiology, University of Iowa, Iowa City, IA
- Abboud Cardiovascular Research Center, University of Iowa, Iowa City, IA
- Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, IA
| |
Collapse
|
5
|
Hou Y, Yang S. Association of risk factors for high blood pressure across 46 low- and middle-income countries: A multi-country cross-sectional analysis. J Glob Health 2024; 14:04087. [PMID: 38784988 PMCID: PMC11117091 DOI: 10.7189/jogh.14.04087] [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: 05/25/2024] Open
Abstract
Background Despite acknowledging the influence of various lifestyle and metabolic risk factors on hypertension, it remains uncertain to identify the primary contributors and differentiate which modifiable risk factors mediate the causal effects of hypertension. We aimed to examine the hierarchical association of eight prominent lifestyle and metabolic risk factors, along with demographic variables, with hypertension in adults and to explore the mediating effects of modifiable metabolic risk factors on hypertension. Methods A cross-sectional study was conducted in 46 low- and middle-income countries using the World Health Organization (WHO) STEPwise approach to noncommunicable disease risk factor surveillance from 2002 to 2020. In a sample of 179 535 non-pregnant adults, we assessed the weighted population-attributable risk percentages (PAR%) for hypertension associated with eight risk factors. Additionally, we investigated the mediating role of metabolic risk factors on the effects of lifestyle risk factors on hypertension. Results After adjusting for the sample weight in each country, 26.7% of participants had hypertension. The prevalence of hypertension was highest in those aged ≥65 years, with obesity-associated hypertension (45.7%) exceeding the rates for overweight (32.2%) and non-overweight individuals (18.2%). These eight risk factors collectively explain 83.7% of the PAR% associated with hypertension adjusted for the communal variance. Among the modifiable factors, obesity contributed to a weighted PAR% of 38.2%, while sedentary behaviour and low physical activity combined accounted for a weighted PAR% of 3.1%. Overweight/obesity played a predominant mediating role in the correlation between lifestyle risk factors and systolic and diastolic blood pressure, with the indirect effect accounting for approximately 25-64% and 13-80% of the total effect, respectively. Conclusions These findings offer new insights into the modified risk factors associated with hypertension in adults in low- and middle-income countries, highlighting the crucial role of maintaining a normal body weight for the effective prevention and management of hypertension.
Collapse
Affiliation(s)
- Yaping Hou
- Department of Emergency Medicine, Qilu Hospital of Shandong University, Jinan, Shandong, China
| | - Shengan Yang
- Department of Logistics and Support Services, Qilu Hospital of Shandong University, Jinan, Shandong, China
| |
Collapse
|
6
|
Li L, Zhang W, Liu S, Wang W, Ji X, Zhao Y, Shima M, Yoda Y, Yang D, Huang J, Guo X, Deng F. Cardiorespiratory effects of indoor ozone exposure during sleep and the influencing factors: A prospective study among adults in China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 924:171561. [PMID: 38458472 DOI: 10.1016/j.scitotenv.2024.171561] [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: 12/26/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Ambient ozone (O3) is recognized as a significant air pollutant with implications for cardiorespiratory health, yet the effects of indoor O3 exposure have received less consideration. Furthermore, while sleep occupies one-third of life, research on the health consequences of O3 exposure during this crucial period is scarce. This study aimed to investigate associations of indoor O3 during sleep with cardiorespiratory function and potential predisposing factors. A prospective study among 81 adults was conducted in Beijing, China. Repeated measurements of cardiorespiratory indices reflecting lung function, airway inflammation, cardiac autonomic function, blood pressure, systemic inflammation, platelet and glucose were performed on each subject. Real-time concentrations of indoor O3 during sleep were monitored. Associations of O3 with cardiorespiratory indices were evaluated using linear mixed-effect model. Effect modification by baseline lifestyles (diet, physical activity, sleep-related factors) and psychological status (stress and depression) were investigated through interaction analysis. The average indoor O3 concentration during sleep was 20.3 μg/m3, which was well below current Chinese indoor air quality standard of 160 μg/m3. O3 was associated with most respiratory indicators of decreased airway function except airway inflammation; whereas the cardiovascular effects were only manifested in autonomic dysfunction and not in others. An interquartile range increases in O3 at 6-h average was associated with changes of -3.60 % (95 % CI: -6.19 %, -0.93 %) and -9.60 % (95 % CI: -14.53 %, -4.39 %) in FVC and FEF25-75, respectively. Further, stronger effects were noted among participants with specific dietary patterns, poorer sleep and higher level of depression. This study provides the first general population-based evidence that low-level exposure to indoor O3 during sleep has greater effects on the respiratory system than on the cardiovascular system. Our findings identify the respiratory system as an important target for indoor O3 exposure, and particularly highlight the need for greater awareness of indoor air quality, especially during sleep.
Collapse
Affiliation(s)
- Luyi Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wenlou Zhang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Shan Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xuezhao Ji
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Yetong Zhao
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Masayuki Shima
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Yoshiko Yoda
- Department of Public Health, School of Medicine, Hyogo Medical University, Nishinomiya, Hyogo 663-8501, Japan
| | - Di Yang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Jing Huang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing 100191, China; Center for Environment and Health, Academy for Advanced Interdisciplinary Studies, Peking University, Beijing 100871, China.
| |
Collapse
|
7
|
Thomas RJ. Cardiac Rehabilitation - Challenges, Advances, and the Road Ahead. N Engl J Med 2024; 390:830-841. [PMID: 38416431 DOI: 10.1056/nejmra2302291] [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] [Indexed: 02/29/2024]
Affiliation(s)
- Randal J Thomas
- From the Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN
| |
Collapse
|
8
|
Saladini F. Effects of Different Kinds of Physical Activity on Vascular Function. J Clin Med 2023; 13:152. [PMID: 38202161 PMCID: PMC10780227 DOI: 10.3390/jcm13010152] [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: 09/29/2023] [Revised: 11/26/2023] [Accepted: 12/09/2023] [Indexed: 01/12/2024] Open
Abstract
Regular exercise is one of the main non-pharmacological measures suggested by several guidelines to prevent and treat the development of hypertension and cardiovascular disease through its impact on the vascular system. Routine aerobic training exerts its beneficial effects by means of several mechanisms: decreasing the heart rate and arterial pressure as well as reducing the activation of the sympathetic system and inflammation process without ignoring the important role that it plays in the metabolic profile. Through all these actions, physical training counteracts the arterial stiffening and aging that underlie the development of future cardiovascular events. While the role of aerobic training is undoubted, the effects of resistance training or combined-training exercise on arterial distensibility are still questioned. Moreover, whether different levels of physical activity have a different impact on normotensive and hypertensive subjects is still debated.
Collapse
Affiliation(s)
- Francesca Saladini
- Cardiology Unit, Cittadella Town Hospital, via Casa di Ricovero 40, 35013 Cittadella, Padova, Italy
| |
Collapse
|
9
|
Hart PD, Asiamah N, Teferi G, Uher I. Relationships between physical activity and other health-related measures using state-based prevalence estimates. Health Promot Perspect 2023; 13:308-315. [PMID: 38235011 PMCID: PMC10790124 DOI: 10.34172/hpp.2023.36] [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: 07/18/2023] [Accepted: 08/14/2023] [Indexed: 01/19/2024] Open
Abstract
Background Both physical activity and muscle-strengthening activity have known relationships with other health-related variables such as alcohol and tobacco use, diet, and health-related quality of life (HRQOL). The purpose of this study was to explore and quantify the associations between physical activity measures and health-related variables at the higher state level. Methods This cross-sectional study used data from the 2017 and 2019 Behavioral Risk Factor Surveillance System surveys. State-based prevalence (%) estimates were computed for meeting physical activity guidelines (PA), meeting muscle-strengthening activity guidelines (MS), both PA and MS (MB), drinking alcohol (D1), heavy alcohol drinking (HD), fruit consumption (F1), vegetable consumption (V1), good self-rated health (GH), overweight (OW), obesity (OB), current smoking (SN), and smokeless tobacco use (SL). Descriptive statistics, correlation coefficients, and data visualization methods were employed. Results Strongest associations were seen between PA and F1 (2017: r=0.717 & 2019: r=0.695), MS and OB (2017: r=-0.781 & 2019: r=-0.599), PA and GH (2017: r=0.631 & 2019: r=0.649), PA and OB (2017: r=-0.645 & 2019: r=-0.763), and MB and SN (2017: r=-0.713 & 2019: r=-0.645). V1 was associated only with PA (2017: r=0.335 & 2019: r=0.357) whereas OW was not associated only with PA. Canonical correlation analysis showed the physical activity variables were directly related (r c=0.884, P<0.001) to the health variables. Conclusion This study used high-level data to support the many known relationships between PA measures and health-related variables.
Collapse
Affiliation(s)
- Peter D. Hart
- Glenville State University, Glenville, WV 26351, USA
- Health Promotion Research, Havre, Montana, USA
- Kinesmetrics Lab, Tallahassee, Florida, USA
| | - Nestor Asiamah
- School of Health and Social Care, University of Essex, Colchester, UK
| | - Getu Teferi
- Department of Sports Science, Debremarkos University, Debremarkos, Ethiopia
| | - Ivan Uher
- Institute of Physical Education and Sport, Pavol Jozef Šafárik University, 040 01 Košice, Slovakia
| |
Collapse
|
10
|
Kazibwe R, Singleton MJ, Chevli PA, Kaze AD, Namutebi JH, Shapiro MD, Yeboah J. Association between physical activity and clinical outcomes in high-risk hypertension: Post-hoc analysis of SPRINT. Am J Prev Cardiol 2023; 16:100524. [PMID: 37576387 PMCID: PMC10415631 DOI: 10.1016/j.ajpc.2023.100524] [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: 03/08/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 08/15/2023] Open
Abstract
Objective Engaging in physical activity (PA) is recommended to reduce the risk of morbidity and mortality in patients with hypertension. However, the association between PA and clinical outcomes in individuals with high-risk hypertension is understudied. We examined the relationship between PA and clinical outcomes in the Systolic Blood Pressure Intervention Trial (SPRINT). SPRINT investigated the benefit of intensive (vs. standard) blood pressure treatment in patients with high-risk hypertension. Methods Baseline data on PA was self-reported. Vigorous-intensity PA (VPA) was categorized into 2 groups based on frequency of "Rarely or Never" and 1 or more sessions/month. Moderate-intensity PA (MPA) was also categorized into 2 groups based on average duration/day of <15 min and 15 or more minutes. Using multivariable Cox regression, we estimated the associations between PA the primary outcome which was a composite of cardiovascular events, and all-cause mortality. Results A total of 8,320 (age 67.8 ± 9.3, 34.9% women) of SPRINT participants with data on PA were included. During a median follow-up of 3.8 years, 619 primary outcome, and 419 all-cause mortality events occurred. Compared to not engaging in VPA, the risk of the primary outcome, myocardial infarction, and all-cause mortality (HR 95% CIs) associated with VPA of ≥1sessions/month was 0.79(0.65-0.94; p=0.009), 0.70(0.52-0.93; p=0.014) and 0.75(0.60-0.94; p=0.011), respectively. Similarly, the risk of the primary outcome and all-cause mortality (HR 95% CI) associated with engaging in MPA for ≥15 min/day, relative to <15 min/day was 0.76(0.63-0.93; p=0.008) and 0.80(0.62-1.02; p=0.066), respectively. Conclusion Among individuals with hypertension from the SPRINT study, VPA and MPA at a threshold of ≥1sessions/month and MPA of ≥15 min/day respectively, were both associated with a lower risk for cardiovascular events, and VPA was also associated with a reduced risk for all-cause mortality. Further studies are required to identify the optimal volume and intensity of PA in high-risk hypertension.
Collapse
Affiliation(s)
- Richard Kazibwe
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Matthew J. Singleton
- Department of Medicine, Section on Cardiovascular Medicine, WellSpan Health, York, PA, USA
| | - Parag A. Chevli
- Department of Medicine, Section on Hospital Medicine, Wake Forest University School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | | | | | - Michael D. Shapiro
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Joseph Yeboah
- Center for the Prevention of Cardiovascular Disease Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| |
Collapse
|
11
|
Carneiro I, Krustrup P, Castagna C, Mohr M, Magalhães J, Pereira R, Santos R, Martins S, Guimarães JT, Coelho E, Póvoas S. Dose-response effect of a recreational team handball-based exercise programme on cardiometabolic health and physical fitness in inactive middle-aged-to-elderly males - a randomised controlled trial. Eur J Sport Sci 2023; 23:2178-2190. [PMID: 37162301 DOI: 10.1080/17461391.2023.2213195] [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] [Indexed: 05/11/2023]
Abstract
This study aimed at examining the dose-response of a recreational team handball (TH) exercise-based programme on cardiometabolic health and physical fitness in inactive middle-aged-to-elderly males without TH experience. Fifty-four inactive middle-aged-to-elderly men (67.5 ± 4.2 years; stature 168.8 ± 6.2 cm; body mass 78.4 ± 10.7 kg; fat mass 27.1 ± 5.3%; BMI 27.4 ± 2.9 kg/m2; VO2peak 27.3 ± 4.8 mL/min/kg) were randomised into three intervention groups performing 1 (TH1, n = 13), 2 (TH2, n = 15), or 3 (TH3, n = 12) 60-min weekly recreational TH-based training sessions, for 16 weeks, and a control group (CG, n = 14). A time x group interaction was observed for VO2peak, aerobic performance, fasting plasma insulin and body and fat mass (p ≤ 0.043) with TH3 showing the greatest overall effects. Post-intervention differences were observed in aerobic performance (TH3>CG, TH1 and TH2; TH2>CG), body mass (TH3>CG and TH1), fat mass (TH3>CG), VO2peak (TH3>CG) and plasma insulin (TH3>CG) (p ≤ 0.040). In conclusion, recreational TH performed for 60-min thrice and twice per week results in improved aerobic performance for middle-aged-to-elderly men. Moreover, it was observed that three weekly sessions were more effective in providing overall cardiometabolic benefits compared to training with a lower weekly frequency. ClinicalTrials.gov ID: NCT05295511.Trial registration: ClinicalTrials.gov identifier: NCT05295511.Highlights: We observed high intensities and fun levels during recreational TH, organised as formal and small-sided games, for middle-aged-to-elderly men during a 16-week period, independently of the number of weekly training sessions.Marked positive effects on aerobic performance and cardiometabolic health were observed in the intervention group that performed 3 weekly sessions.The study results indicate that recreational TH training with low frequency and volume results in some beneficial effects on cardiometabolic fitness and health for middle-aged-to-elderly men, but future studies with more participants or longer intervention periods are warranted to explore this possibility.
Collapse
Affiliation(s)
- Ivone Carneiro
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, 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
- Danish Institute for Advanced Study (DIAS), University of Southern Denmark, Odense, Denmark
- Sport and Health Sciences, University of Exeter, Exeter, United Kingdom
- Shanghai University of Sport (SUS), Shanghai, People's Republic of China
| | - Carlo Castagna
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Department of Biomolecular Sciences, School of Exercise and Health Sciences, Carlo Bo Urbino University, Urbino, Italy
| | - Magni Mohr
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), University of Southern Denmark, Odense, Denmark
- Centre of Health Sciences, Faculty of Health, University of the Faroe Islands, Tórshavn, Faroe Islands
| | - José Magalhães
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- LaMetEx, Research Centre in Physical Activity, Health and Leisure, CIAFEL, Department Sports Biology, Faculty of Sport, University of Porto, Porto, Portugal
| | - Rita Pereira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
- University of Maia, Maia, Portugal
| | - Rute Santos
- Institute of Education, University of Minho, Braga, Portugal
- Research Centre on Child Studies, University of Minho, Braga, Portugal
| | - Sandra Martins
- Department of Clinical Pathology, São João Hospital University Centre and EPIUnit, Public Health Institute, University of Porto, Porto, Portugal
| | - João Tiago Guimarães
- Department of Clinical Pathology, São João Hospital University Centre and EPIUnit, Public Health Institute, University of Porto, Porto, Portugal
- Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Eduardo Coelho
- Porto Sports Medicine Center (IPDJ, IP), Porto, Portugal
| | - 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
| |
Collapse
|
12
|
Xiang B, Zhou Y, Wu X, Zhou X. Association of Device-Measured Physical Activity With Cardiovascular Outcomes in Individuals With Hypertension. Hypertension 2023; 80:2455-2463. [PMID: 37667966 DOI: 10.1161/hypertensionaha.123.21663] [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: 06/15/2023] [Accepted: 08/14/2023] [Indexed: 09/06/2023]
Abstract
BACKGROUND There is insufficient evidence to show that the guidelines' recommendations of physical activity (PA) are associated with long-term benefits in individuals with hypertension. METHODS This prospective cohort study included UK Biobank participants with hypertension. Time spent on vigorous-intensity PA (VPA), moderate-intensity PA (MPA), and light-intensity PA (LPA) measured by wrist-worn accelerometer were extracted. The primary outcomes were major adverse cardiovascular events (including cardiovascular death, stroke, and myocardial infarction) and all-cause mortality. The secondary outcomes were cardiovascular death, myocardial infarction, and stroke, respectively. The relationships of PA with outcomes were analyzed using Cox regression models. RESULTS This study included 49 060 eligible participants with a median follow-up of 7.0 years. MPA was inversely associated with risks of major adverse cardiovascular events and all-cause mortality. Modest amounts of LPA or VPA were likely to be more beneficial than higher amounts of either in all-cause death or cardiovascular outcomes. Compared with the least active group, 150 to 300 min/wk of MPA or more was significantly associated with decreased risk of all-cause death (by 34%-54%) and major adverse cardiovascular events (by 23%-41%), but 75 to 150 min/wk of VPA or more was associated with few further benefits, even weakening the cardiovascular benefits. CONCLUSIONS MPA had an inverse dose-response association with the risk of all-cause mortality and cardiovascular outcomes in individuals with hypertension. Modest amounts of LPA or VPA are also beneficial, but higher amounts may be not. MPA may be the optimal PA intensity for individuals with hypertension. Further researches are required to determine whether high levels of VPA should be recommended.
Collapse
Affiliation(s)
- Boyang Xiang
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Yujia Zhou
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiaoguang Wu
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| | - Xiang Zhou
- Department of Cardiology, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
13
|
Sharma C, Ahuja KDK, Kulkarni B, Byrne NM, Hills AP. Life course research in physical activity: Pathway to Global Action Plan 2030. Obes Rev 2023; 24:e13554. [PMID: 36815214 DOI: 10.1111/obr.13554] [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: 05/26/2022] [Revised: 11/13/2022] [Accepted: 01/13/2023] [Indexed: 02/24/2023]
Abstract
Current global trends in physical activity levels demonstrate that the world is not on track to achieve the 2030 target set by the Global Action Plan. The Action Plan posited that physical activity should be an integral component of "daily lives" of all individuals "across the life course." Potential contributions to achieve global physical activity goals include the utilization of compositional data analysis and life course epidemiology to provide a framework for the composite nature of physical activity and complex life course relationships. Combining these two traditionally disconnected fields represents a paradigm shift in physical activity research. Here, we discuss how these combined fields enable a reinterpretation of previous research findings and explore their impact on policy and potential advantages and challenges. Careful consideration needs to be given to the implications of both fields remaining disconnected and the alternate option of consolidation to realize ambitions.
Collapse
Affiliation(s)
- Chitra Sharma
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Kiran D K Ahuja
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| | - Bharati Kulkarni
- Division of Reproductive Biology Maternal and Child Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Nuala M Byrne
- Division of Reproductive Biology Maternal and Child Health and Nutrition, Indian Council of Medical Research, Ansari Nagar, New Delhi, India
| | - Andrew P Hills
- School of Health Sciences, College of Health and Medicine, University of Tasmania, Launceston, Tasmania, Australia
| |
Collapse
|
14
|
Sun J, Wu H, Zhao M, Magnussen CG, Xi B. Dose-response association of leisure time physical activity with mortality in adults with major chronic diseases. Front Nutr 2022; 9:1048238. [PMID: 36618699 PMCID: PMC9811256 DOI: 10.3389/fnut.2022.1048238] [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: 09/19/2022] [Accepted: 11/22/2022] [Indexed: 12/24/2022] Open
Abstract
We aimed to evaluate the association between leisure-time physical activity (PA) and mortality risk in adults with major chronic diseases. A total of 170,579 adults with major chronic diseases aged 30-84 years from the U.S. National Health Interview Surveys (1997-2014) with linkage to the National Death Index (NDI) through December 31, 2015 were included in this study. During a median follow-up of 7.25 years, 36,914 adults with chronic diseases died from all causes, 8,767 died from cardiovascular disease (CVD), and 9,090 died from cancer. Compared with participants with no leisure-time PA, those with a low level (10-59 min/week) of total leisure-time PA had a 23% [hazard ratio (HR) 0.77, 95% confidence interval (CI) 0.73-0.82] reduced risk of all-cause mortality. Adults with higher levels of leisure time had more reduced risk of all-cause mortality, as well as CVD-specific and cancer-specific mortality. Adults with leisure-time PA ≥ 1,500 min/week had more reduced risk of CVD-specific mortality (61%) but less reduced risk of cancer-specific mortality (29%) compared with the reduced risk of all-cause mortality (43%). There was an inversely non-linear dose-response relationship between leisure-time PA and all-cause and cause-specific mortality. Reduced risk of all-cause and cancer-specific mortality between leisure-time light-to-moderate PA and vigorous-intensity PA time were largely comparable. Low and high levels of leisure-time PA showed substantial survival benefits compared with no leisure-time PA in adults with major chronic diseases. The light-to-moderate-intensity leisure-time PA is largely comparable with vigorous PA to provide survival benefits for all-cause and cancer-specific mortality.
Collapse
Affiliation(s)
- Jiahong Sun
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Han Wu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China
| | - Min Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Costan G. Magnussen
- Baker Heart and Diabetes Institute, Melbourne, VIC, Australia,Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland,Centre for Population Health Research, University of Turku, Turku University Hospital, Turku, Finland
| | - Bo Xi
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Qilu Hospital, Shandong University, Jinan, Shandong, China,*Correspondence: Bo Xi,
| |
Collapse
|
15
|
Xu YX, Zhou Y, Huang Y, Yu Y, Li JY, Huang WJ, Wan YH, Tao FB, Sun Y. Physical activity alleviates negative effects of bedroom light pollution on blood pressure and hypertension in Chinese young adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 313:120117. [PMID: 36087897 DOI: 10.1016/j.envpol.2022.120117] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/08/2022] [Accepted: 09/02/2022] [Indexed: 06/15/2023]
Abstract
Excessive exposure to light at night (LAN) has become a serious public health concern. However, little is known about the impact of indoor LAN exposure on blood pressure, particularly among young adults. We aimed to investigate the effects of bedroom individual-level LAN exposure in real-world environment on blood pressure and hypertension among vulnerable young adults, and to evaluate the possible buffering effect of physical activity. In this cross-sectional study, a total of 400 healthy young adults aged 16-22 years were included. Bedroom LAN exposure was recorded at 1-min intervals for two consecutive nights using a TES-1339 R illuminance meter. Blood pressure was measured three times (8-11 a.m. in the physical examination day) in the seated position using an Omron HEM-7121 digital sphygmomanometer. A wrist-worn triaxial accelerometer (ActiGraph GT3X-BT) was used to assess physical activity for seven consecutive days. Each 1 lx increase of bedroom LAN intensity was associated with 0.55 mmHg-increase in SBP (95% CI: 0.15, 0.95), 0.30 mmHg-increase in DBP (95% CI: 0.06, 0.54), and 0.38 mmHg-increase in MAP (95% CI: 0.12, 0.65). Higher levels of LAN exposure were associated with increased risk of hypertension (LAN ≥ 3lx vs. LAN < 3lx: OR = 3.30, 95%CI = 1.19-9.19; LAN ≥ 5lx vs. LAN < 5lx: OR = 3.87, 95%CI = 1.37-10.98). However, these detrimental effects of bedroom LAN exposure on blood pressure and hypertension were not observed among young adults with high MVPA (≥2 h/day) level. MVPA can alleviate negative effects of bedroom LAN exposure on blood pressure and hypertension. Maintaining bedroom settings darkness at night may be an important strategy for reducing the risk of hypertension. Furthermore, for individuals living with high levels of indoor LAN exposure, regular physical activity may be a good option for preventing cardiovascular disease and hypertension.
Collapse
Affiliation(s)
- Yu-Xiang Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yi Zhou
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yan Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yang Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Jing-Ya Li
- School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Wen-Juan Huang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China
| | - Yu-Hui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Fang-Biao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Ying Sun
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, Anhui, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China; Anhui Provincial Key Laboratory of Population Health and Aristogenics, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
| |
Collapse
|
16
|
Yang Y, Xu H, Liu X, Li J, Liew Z, Liu X, Huang C, Zhu J, Zhang J, Chen L, Hao Y, Qin G, Yu Y. Joint association of smoking and physical activity with mortality in elderly hypertensive patients: A Chinese population-based cohort study in 2007-2018. Front Public Health 2022; 10:1005260. [PMID: 36249230 PMCID: PMC9558130 DOI: 10.3389/fpubh.2022.1005260] [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: 07/28/2022] [Accepted: 08/31/2022] [Indexed: 01/27/2023] Open
Abstract
Background Although associations of physical activity and smoking with mortality have been well-established, the joint impact of physical activity and smoking on premature mortality among elderly hypertensive population was still unclear. This study aimed to assess association of physical activity, smoking, and their interaction with all-cause and cardiovascular disease (CVD) mortality risk in elderly hypertensive patients. Methods We included 125,978 Chinese hypertensive patients aged 60-85 years [mean (SD) age, 70.5 (6.9) years] who had records in electronic health information system of Minhang District of Shanghai, China in 2007-2015. Cox regression was used to estimate individual and joint association of smoking and physical activity on all-cause and CVD mortality. Interactions were measured both additively and multiplicatively. Additive interaction was evaluated by relative excess risk due to interaction (RERI), attributable proportion due to interaction (AP) and synergy index (S). Results Among 125,978 elderly hypertensive patients (median age 70.1), 28,250 deaths from all causes and 13,164 deaths from CVD were observed during the follow-up up to 11 years. There was an additive interaction between smoking and physical inactivity [RERI: all-cause 0.19 (95% CI: 0.04-0.34), CVD 0.28 (0.06-0.50); AP: all-cause 0.09 (0.02-0.16), CVD 0.14 (0.04-0.23); S: all-cause 1.21 (1.04-1.42), CVD 1.36 (1.06-1.75)], while the concurrence of both risk factors was associated with more than 2-fold risk of death [hazard ratio (HR): all-cause 2.10 (1.99-2.21), CVD 2.19 (2.02-2.38)]. Conclusion Our study suggested that smoking and physical inactivity together may have amplified association on premature death compared to the sum of their individual associations, highlighting the importance of improving behavioral factors in combination and promoting a comprehensive healthy lifestyle in hypertensive elderly.
Collapse
Affiliation(s)
- Yating Yang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Huilin Xu
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Xiaoqin Liu
- NCRR-National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - Jiong Li
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark,Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark
| | - Zeyan Liew
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, United States
| | - Xing Liu
- Department of Epidemiology, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Chen Huang
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jingjing Zhu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Jinling Zhang
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Linli Chen
- Shanghai Minhang Center for Disease Control and Prevention, Shanghai, China
| | - Yuantao Hao
- Department of Medical Statistics and Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China,*Correspondence: Yuantao Hao
| | - Guoyou Qin
- Shanghai Institute of Infectious Disease and Biosecurity, Shanghai, China,Guoyou Qin
| | - Yongfu Yu
- Department of Biostatistics, School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China,Yongfu Yu
| |
Collapse
|
17
|
Leisure-Time Physical Activity Has a More Favourable Impact on Carotid Artery Stiffness Than Vigorous Physical Activity in Hypertensive Human Beings. J Clin Med 2022; 11:jcm11185303. [PMID: 36142949 PMCID: PMC9506238 DOI: 10.3390/jcm11185303] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/05/2022] [Accepted: 09/07/2022] [Indexed: 11/23/2022] Open
Abstract
Aim. To assess the effect of leisure time versus vigorous long-term dynamic physical activity (PA) on carotid stiffness in normotensive versus hypertensive subjects. Methods. The study was conducted on 120 leisure-time exercisers and 120 competitive athletes. One hundred and twenty sedentary subjects served as controls. In addition, participants were classified according to whether their systolic blood pressure was ≥130 mmHg (hypertensives, n = 120) or normal (normotensives, n = 240) according to the ACC/AHA 2017 definition. Carotid artery stiffness was assessed with an echo-tracking ultrasound system, using the pressure-strain elastic modulus (EP) and one-point pulse wave velocity (PWVβ) as parameters of stiffness. Results. The effect of the two levels of PA differed in the normotensives and the hypertensives. Among the normotensives, there was an ongoing, graded reduction in EP and PWVβ from the sedentary subjects to the athletes. By contrast, among the hypertensives, the lowest levels of EP and PWVβ were found among the leisure-time PA participants. EP and PWVβ did not differ between the hypertensive sedentary subjects and the athletes. A significant interaction was found between PA and BP status on EP (p = 0.03) and a borderline interaction on PWVβ (p = 0.06). In multiple regression analyses, PA was a negative predictor of EP (p = 0.001) and PWVβ (p = 0.0001). The strength of the association was weakened after the inclusion of heart rate in the models (p = 0.04 and 0.007, respectively). Conclusions. These data indicate that in people with hypertension, leisure-time PA has beneficial effects on carotid artery stiffness, whereas high-intensity chronic PA provides no benefit to vascular functions.
Collapse
|
18
|
Pei H, Kang N, Yang F, Song X, Chen G, Wang D. The Distribution and Potential Exposure Factors of Physical Activity Level Among Middle-Aged and Elderly Population - Six Communities, Beijing, China, October 2020 to January 2021. China CDC Wkly 2022; 4:593-600. [PMID: 35919298 PMCID: PMC9339360 DOI: 10.46234/ccdcw2022.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/16/2021] [Indexed: 11/23/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS TOPIC? Available evidence suggested that 31% of the world's population do not meet the minimum recommendations for physical activity. WHAT IS ADDED BY THIS REPORT? The latest findings showed that physical activity level (PAL), metabolic equivalents (MET) in min/week with <4,500 (low), 4,500-6,000 (moderate) and ≥6,000 (high) accounted for 45.72%, 25.62%, and 28.66% of middle-aged and elderly population in Changchunyuan Community, Weixiuyuan Community, Zhongguanyuan Community, Yanbeiyuan Community, Kangzeyuan Community, and Xima Community, respectively. The moderate and high PAL was associated with a decreased risk of hypertension, cardiovascular disease, dyslipidemia, and poor sleep. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE? More attention should be given to the middle-aged population who may be at high risk of insufficient physical activity in urban environments as it is of public health significance for improving the community population health.
Collapse
Affiliation(s)
- Heming Pei
- Institute of Population Research/Institute on Aging, Peking University, Beijing, China
| | - Ning Kang
- Institute of Population Research/Institute on Aging, Peking University, Beijing, China
| | - Fan Yang
- Institute of Population Research/Institute on Aging, Peking University, Beijing, China
| | - Xinming Song
- Institute of Population Research/Institute on Aging, Peking University, Beijing, China
| | - Gong Chen
- Institute of Population Research/Institute on Aging, Peking University, Beijing, China,Gong Chen,
| | - Dongmin Wang
- Department of Physical Education, Peking University, Beijing, China,Dongmin Wang,
| |
Collapse
|
19
|
Wang W, Guo T, Guo H, Chen X, Ma Y, Deng H, Yu H, Chen Q, Li H, Liu Q, Shan A, Li Y, Pang B, Shi J, Wang X, Chen J, Deng F, Sun Z, Guo X, Wang Y, Tang N, Wu S. Ambient particulate air pollution, blood cell parameters, and effect modification by psychosocial stress: Findings from two studies in three major Chinese cities. ENVIRONMENTAL RESEARCH 2022; 210:112932. [PMID: 35176316 DOI: 10.1016/j.envres.2022.112932] [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: 10/17/2021] [Revised: 01/04/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
The associations between particulate matter (PM) exposure, psychosocial stress and blood cell parameters are bringing novel insights to characterize the early damage of multiple diseases. Based on two studies conducted in three Chinses cities using cross-sectional (Beijing, 425 participants) and panel study (Tianjin and Shanghai, 92 participants with 361 repeated measurements) designs, this study explored the associations between short-term exposure to ambient PM and blood cell parameters, and the effect modification by psychosocial stress. Increasing PM2.5 exposure was significantly associated with decreases in red blood cell (RBC) count and mean corpuscular hemoglobin concentration (MCHC), and increases in mean corpuscular volume (MCV), platelets count (PLT) and platelet hematocrit (PCT) in both studies. For instance, a 10 μg/m3 increment in PM2.5 concentration was associated with a 1.04% (95%CI: 0.16%, 1.92%) increase in PLT (4-d) and a 1.09% (95%CI: 0.31%, 1.87%) increase in PCT (4-d) in the cross-sectional study, and a 0.64% (95%CI: 0.06%, 1.22%) increase in PLT (1-d) and a 0.72% (95%CI: 0.33%, 1.11%) increase in PCT (1-d) in the panel study, respectively. In addition, stronger increases in MCV, PLT, and PCT associated with PM2.5 exposure were found in higher psychosocial stress group compared to lower psychosocial stress group (p for interaction <0.10), indicating that blood cell parameters of individuals with higher psychosocial stress might be more susceptible to the early damages of PM2.5 exposure.
Collapse
Affiliation(s)
- Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Tongjun Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Huaqi Guo
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xi Chen
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yating Ma
- Institute of Social Psychology, School of Humanities and Social Sciences, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hongyan Deng
- Qinglongqiao Community Health Service Center, Haidian District, Beijing, China
| | - Hengyi Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qiao Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Anqi Shan
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yaoyan Li
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Bo Pang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Jiazhang Shi
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Xinmei Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Juan Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, China
| | - Yan Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; The Ninth People's Hospital of Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Naijun Tang
- Department of Occupational and Environmental Health, Tianjin Key Laboratory of Environment, Nutrition and Public Health, School of Public Health, Tianjin Medical University, Tianjin, China.
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China.
| |
Collapse
|
20
|
Del Pozo Cruz B, Ahmadi M, Inan-Eroglu E, Huang BH, Stamatakis E. Prospective Associations of Accelerometer-Assessed Physical Activity With Mortality and Incidence of Cardiovascular Disease Among Adults With Hypertension: The UK Biobank Study. J Am Heart Assoc 2022; 11:e023290. [PMID: 35253444 PMCID: PMC9075331 DOI: 10.1161/jaha.121.023290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Despite the well-established capacity of physical activity to reduce blood pressure, the associations between physical activity with cardiovascular disease (CVD) incidence and mortality in people living with hypertension are not well understood. We examine the dose-response associations of device-assessed physical activity with all-cause and CVD mortality and CVD incidence (total, stroke, and coronary heart disease) in adults with hypertension. Methods and Results This prospective study included data from 39 294 participants with hypertension in the UK Biobank study who had valid accelerometry data and for whom mortality and CVD followed-up data were available. We categorized moderate-to-vigorous physical activity and total physical activity volume into 4 categories based on the 10th, 50th, and 90th percentiles and used Cox regressions to estimate their associations with CVD mortality and incidence outcomes. Splines were used to assess the dose-response associations. During a median follow-up of 6.25 years (241 418 person-years), 1518 deaths (549 attributable to CVD) and 4933 CVD (fatal and nonfatal) incident events were registered. Compared with the lowest category of moderate-to-vigorous physical activity, the relative risks (hazard ratios and 95% CIs) of all-cause mortality for increasing categories were 0.53 (0.46-0.61), 0.41 (0.34-0.49), and 0.36 (0.26-0.49). We found associations of similar magnitude for total CVD incidence, stroke, and coronary heart disease; and for total physical activity volume across all outcomes. For all outcomes, there were linear or nearly linear inverse dose-response relationships with no evidence of harms with high levels of physical activity. Results were robust to removing participants who died within the first 2 years. Conclusions Our findings underscore the importance of physical activity for people living with hypertension and provide novel insights to support the development of physical activity guideline recommendations for this high-risk group.
Collapse
Affiliation(s)
- Borja Del Pozo Cruz
- Department of Sports Science and Clinical Biomechanics Centre for Active and Healthy Ageing University of Southern Denmark Odense Denmark
| | - Matthew Ahmadi
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Elif Inan-Eroglu
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Bo-Huei Huang
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| | - Emmanuel Stamatakis
- Charles Perkins Centre, School of Health Sciences, Faculty of Medicine and Health The University of Sydney Camperdown New South Wales Australia
| |
Collapse
|
21
|
Li X, Chen K, Hua W, Su Y, Yang J, Liang Z, Xu W, Zhao S, Li Z, Zhang S. Implantable device measured objective daily physical activity as a predictor of long-term all-cause mortality and cardiac death in patients with age > 75 years and high risk of sudden cardiac death: a cohort study : Physical activity and patients over 75 years old. BMC Geriatr 2022; 22:130. [PMID: 35172757 PMCID: PMC8848899 DOI: 10.1186/s12877-022-02813-1] [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: 08/17/2020] [Accepted: 02/03/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To study the relationship between objective daily physical activity (PA), as measured by implantable cardioverter defibrillators (ICDs)/cardiac resynchronization therapy defibrillators (CRTDs), and long-term prognoses in patients with age > 75 years at high risk of sudden cardiac death (SCD). METHODS In total, 133 patients with age > 75 years old (age 79.52 ± 3.68 years) in the SUMMIT study were retrospectively analysed. The major endpoint was all-cause mortality, and the minor endpoint was cardiac death. RESULTS The mean follow-up time was 57.1 ± 24.2 months (range: from 4 to 96 months). In total, 46 all-cause mortality and 23 cardiac death events occurred. The receiver operating characteristic curve indicated a baseline PA cut-off value of 6.47% (93 min/day) can predict all-cause mortality in patients with age > 75 years, with an area under the curve of 0.670 (95% confidence interval (CI): 0.573-0.767, P = 0.001). The sensitivity was 67.4%, and the specificity was 66.7%. Patients with baseline PA ≤ 6.47% had higher rates of all-cause mortality (51.7% vs 20.5%, P < 0.001) and cardiac death (25.0% vs 11.0%, P = 0.040). The estimated Kaplan-Meier survival curves showed that patients with PA ≤ 6.47% had an increased cumulative incidence of all-cause mortality (Log-rank P < 0.0001) and cardiac death (Log-rank P = 0.0067). Multivariate Cox regression analysis showed that PA ≤ 6.47% was an independent predictor of all-cause mortality (hazard ratio (HR) 3.137, 95% CI: 1.667-5.904, P < 0.001) and cardiac death (HR value 3.345, 95% CI: 1.394-8.028, P = 0.007). CONCLUSIONS Daily PA of about 1.5 h was associated with lower all-cause mortality and cardiac death risk in patients with age > 75 years and high risk of SCD with ICDs/CRTDs. PA monitoring may aid in long-term management of older patients at high risk of SCD.
Collapse
Affiliation(s)
- Xiaoyao Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Keping Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Wei Hua
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Yangang Su
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, Beijing, China
| | - Zhaoguang Liang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Shuang Zhao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Zeyi Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China.
| |
Collapse
|
22
|
Carpes L, Costa R, Schaarschmidt B, Reichert T, Ferrari R. High-intensity interval training reduces blood pressure in older adults: A systematic review and meta-analysis. Exp Gerontol 2021; 158:111657. [PMID: 34921916 DOI: 10.1016/j.exger.2021.111657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/29/2021] [Accepted: 12/07/2021] [Indexed: 12/25/2022]
Abstract
BACKGROUND/OBJECTIVES The current systematic review and meta-analysis evaluated the effects of High-Intensity Interval Training (HIIT) on blood pressure (BP) in older adults and compared the efficacy of HIIT versus moderate-intensity continuous training (MICT). METHODS Search was conducted using the databases at PubMed, Scopus, Cochrane Library and EMBASE, for randomized trials comparing the chronic effects (≥4 weeks) of HIIT versus MICT or control group (non-exercise) on BP in older adults (≥60 years) with or without hypertension. RESULTS A total of 10 articles (n = 266 participants) were included in this meta-analysis. HIIT were associated with reductions in systolic BP (MD -7.36; 95%CI -11.80 to -2.92; P < 0.01; I2 = 24%) and diastolic BP (MD -5.48; 95%CI -8.71 to -2.25; P < 0.01; I2 = 40%) versus control group. No differences were found between HIIT and MICT in systolic BP (MD -2.09; 95%CI -9.76 to 5.58; P = 0.59; I2 = 0%) and diastolic BP (MD -1.00; 95%CI -6.01 to 4.01; P = 0.69; I2 = 0%). CONCLUSION HIIT reduces BP in older adults. Additionally, HIIT and MICT provided comparable reductions on BP in this population.
Collapse
Affiliation(s)
- Leandro Carpes
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil
| | - Rochelle Costa
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Bruna Schaarschmidt
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil
| | - Thaís Reichert
- Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil; Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, RS, Brazil.
| |
Collapse
|
23
|
Schrader B, Schrader J, Vaske B, Elsässer A, Haller H, Del Vecchio A, Koziolek M, Gehlenborg E, Lüders S. Football beats hypertension: results of the 3F (Fit&Fun with Football) study. J Hypertens 2021; 39:2290-2296. [PMID: 34261954 DOI: 10.1097/hjh.0000000000002935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Football as the most popular sport could improve insufficient physical activity in patients with cardiovascular risk factors. A modified 'healthy' football training format could motivate hypertensive patients to return to sport and improve risk factors. METHODS The 3F study: 'Fit and Fun with Football' a prospective interventional study with 1 year follow-up. Football group: n = 103, structured 'health'-football training (1×/week, 90 min) led by Deutscher Fußball Bund-licensed football coaches. Hypertensive patients at least 45 years who have not exercised for several years were compared with a control group (n = 105). PRIMARY STUDY OBJECTIVE Reduction of office (OBP) and/or 24-h ambulatory blood pressure (BP) monitoring (ABPM) and/or reduction of number or dosage of antihypertensive medication. MAIN RESULTS OBP values decreased significantly in the football group from 142.6/87.9 to 130.8/81.8 mmHg (P < 0.001), in the control group the values increased slightly (NS). ABPM values decreased significantly in the football group, while a slight increase was found in the control group. At the end of the study, the mean values in the football group of both OPB (P < 0.001) and ABPM (systolic P < 0.001, diastolic P = 0.017) were significantly lower than in the control group. Significantly more people in the football group were able to reduce antihypertensive patients than in the control group (football group:16, control group:6), while more participants in the control group intensified antihypertensive therapy (football group:3, control group:14) (P < 0.001). Among the secondary endpoints, there was a weight loss of 3 kg in the football group and an increase of 1.7 kg in the control group (P < 0.001). CONCLUSION Offering modified 'healthy' football-training to middle-aged hypertensive patients can lead to better BP control and a reduction of antihypertensive medication. Therefore, the offer of 'health football' should be established and supported by clubs, insurances and authorities.
Collapse
Affiliation(s)
| | | | - Bernhard Vaske
- Dipl.-Math. in Institute for Hypertension and Cardiovascular Research (INFO), Cloppenburg
| | | | - Hermann Haller
- Clinic for Renal and Hypertensive Diseases, Hannover Medical School, Hanover
| | - Alessandro Del Vecchio
- Department of Artificial Intelligence in Biomedical Engineering, Friedrich-Alexander-University Erlangen-Nürnberg, Erlangen
| | - Michael Koziolek
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen
| | | | - Stephan Lüders
- Department of Nephrology, Internal Medicine, St.-Josefs-Hospital, Cloppenburg, Germany
| |
Collapse
|
24
|
Yang Y, Dixon-Suen SC, Dugué PA, Hodge AM, Lynch BM, English DR. Physical activity and sedentary behaviour over adulthood in relation to all-cause and cause-specific mortality: a systematic review of analytic strategies and study findings. Int J Epidemiol 2021; 51:641-667. [PMID: 34480556 DOI: 10.1093/ije/dyab181] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Questions remain about the effect on mortality of physical activity and sedentary behaviour over time. We summarized the evidence from studies that assessed exposure from multiple time points and critiqued the analytic approaches used. METHODS A search was performed on MEDLINE, Embase, Emcare, Scopus and Web of Science up to January 2021 for studies of repeatedly assessed physical activity or sedentary behaviour in relation to all-cause or cause-specific mortality. Relative risks from individual studies were extracted. Each study was assessed for risk of bias from multiple domains. RESULTS We identified 64 eligible studies (57 on physical activity, 6 on sedentary behaviour, 1 on both). Cox regression with a time-fixed exposure history (n = 45) or time-varying covariates (n = 13) were the most frequently used methods. Only four studies used g-methods, which are designed to adjust for time-varying confounding. Risk of bias arose primarily from inadequate adjustment for time-varying confounders, participant selection, exposure classification and changes from measured exposure. Despite heterogeneity in methods, most studies found that being consistently or increasingly active over adulthood was associated with lower all-cause and cardiovascular-disease mortality compared with being always inactive. Few studies examined physical-activity changes and cancer mortality or effects of sedentary-behaviour changes on mortality outcomes. CONCLUSIONS Accumulating more evidence using longitudinal data while addressing the methodological challenges would provide greater insight into the health effects of initiating or maintaining a more active and less sedentary lifestyle.
Collapse
Affiliation(s)
- Yi Yang
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Suzanne C Dixon-Suen
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Institute for Physical Activity and Nutrition, Deakin University, Geelong, VIC, Australia
| | - Pierre-Antoine Dugué
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, VIC, Australia
| | - Allison M Hodge
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| | - Brigid M Lynch
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia.,Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia
| | - Dallas R English
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, VIC, Australia.,Centre for Epidemiology and Biostatistics, University of Melbourne, Melbourne, VIC, Australia
| |
Collapse
|
25
|
Association of Primary Hypertension and Risk of Cerebrovascular Diseases with Overweight and Physical Activity in Korean Women: A Longitudinal Study. Healthcare (Basel) 2021; 9:healthcare9091093. [PMID: 34574867 PMCID: PMC8465631 DOI: 10.3390/healthcare9091093] [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: 06/19/2021] [Revised: 08/19/2021] [Accepted: 08/23/2021] [Indexed: 02/05/2023] Open
Abstract
Cerebrovascular diseases include stroke, intracranial stenosis, aneurysms, and vascular malformations; primary hypertension is typically associated with cerebrovascular disease. The incidence of these diseases is higher in men than in women, and low physical activity and obesity are known to increase the risk of cerebrovascular disease. This study aimed to longitudinally analyze the adjusted relative risk (ARR) of primary hypertension and cerebrovascular diseases, in relation to body mass index (BMI) and physical activity (PA), in Korean women. The study retrieved the data of 1,464,377 adult Korean women (aged 50–79 years), who participated in the national health screening program from 2002 to 2003. The participants had no history of primary hypertension or cerebrovascular diseases, and were followed up by the International Statistical Classification of Diseases and Related Health Problems (ICD) until 2013. The participants were divided into the following groups: normal weight (18.5–24.9), overweight (25.0–29.9), and obese (≥30.0) kg/m2, based on the World Health Organization (WHO) classification. The frequency of PA (days) was determined using a physical activity questionnaire, and defined as low (0–2), medium (3–4), and high (5–7) days. The RR was calculated using Cox regression. Three models were created based on the adjusted variables. The ARR for hypertension was 0.933 (95% CI; 0.920–0.955, p < 0.001) in obese patients with medium PA. Primary hypertension was lower (ARR: 0.943; 95% CI; 0.928–0.961, p < 0.001) in overweight participants with medium PA, than in those with low PA. The incidence of cerebrovascular disease was lower in overweight individuals with medium PA (ARR: 0.945, 95% CI; 0.925–0.976, p < 0.001), than in those with low PA. The risk of cerebrovascular disease was reduced in normal-weight participants with medium PA (ARR: 0.889; 95% CI: 0.854–0.919; p < 0.001), than in those with high PA (ARR 0.913; 95% CI; 0.889–0.953, p < 0.001). In the obese group, there was no significant difference in the risk of cerebrovascular disease, based on the frequency of PA. In conclusion, the relative risk of primary hypertension in women was lower with moderate activity than with low activity, in the normal-weight and overweight groups. The relative risk of cerebrovascular disease was lower in the participants with moderate and high activity than in those with low activity, even at normal weight. In obese individuals, moderate and high activity reduced cerebrovascular disease compared to low activity. Therefore, regardless of obesity, PA may contribute to the prevention of primary hypertension and cerebrovascular disease in adult women.
Collapse
|
26
|
Oppezzo M, Tremmel J, Kapphahn K, Desai M, Baiocchi M, Sanders M, Prochaska J. Feasibility, preliminary efficacy, and accessibility of a twitter-based social support group vs Fitbit only to decrease sedentary behavior in women. Internet Interv 2021; 25:100426. [PMID: 34401385 PMCID: PMC8350596 DOI: 10.1016/j.invent.2021.100426] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/23/2021] [Accepted: 07/04/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Health behavior change interventions delivered by social media allow for real-time, dynamic interaction, peer social support, and experimenter-provided content. AIMS We tested the feasibility, acceptability, and preliminary efficacy of a novel Twitter-based walking break intervention with daily behavior change strategies and prompts for social support, combined with a Fitbit, vs. Fitbit alone. METHODS In a 2-group pilot, 45 sedentary women from a heart clinic were randomized to Twitter + Fitbit activity tracker (Tweet4Wellness, n = 23) or Fitbit-only (control, n = 22). All received a Fitbit and 13 weeks of tailored weekly step goals. Tweet4Wellness consisted of a private Twitter support group, with daily automated behavior change "tweets" informed by behavior change theory, and encouragement to communicate within the group. Feasibility outcomes included recruitment and enrollment numbers, implementation challenges, and number and type of help requests from participants throughout the study period. Preliminary efficacy outcomes provided by Fitbit data were sedentary minutes, number of hours with >250 steps, maximum sitting bout, weighted sedentary median bout length, total steps, intensity minutes (>3.0 METS), and ratio of time spent sitting-to-moving. Acceptability outcomes included level of Twitter participation within Tweet4Wellness, and Likert scale plus open-ended survey questions on enjoyment and perceived effectiveness of intervention components. Survey data on acceptability of the features of the intervention were collected at 13 weeks (end-of-treatment [EOT]) and 22 weeks (follow-up). RESULTS The study was feasible, with addressable implementation challenges. Tweet4Wellness participants changed significantly from baseline to EOT relative to control participants on number of active hours p = .018, total steps p = .028, and ratio of sitting-to-moving, p = .014. Only sitting-to-moving was significant at follow-up (p = .047). Among Tweet4Wellness participants, each tweet sent during treatment was associated with a 0.11 increase in active hours per day (p = .04) and a 292-step increase per day (p < .001). Tweet4Wellness participants averaged 54.8 (SD = 35.4) tweets, totaling 1304 tweets, and reported liking the accountability and peer support provided by the intervention. CONCLUSION A Twitter-delivered intervention for promoting physical activity among inactive women from a heart clinic was feasible, acceptable, and demonstrated preliminary efficacy in increasing daily active hours, daily total steps, and the ratio of sitting-to-moving from pre to post for the intervention compared with the control. Lessons learned from this pilot suggest that the next study should expand the recruitment pool, refine the intervention to increase group engagement, and select active hours, total steps, and ratio of sitting-to-movement as primary sedentary behavior measures.
Collapse
Affiliation(s)
- M.A. Oppezzo
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States of America,Corresponding author at: Department of Medicine, Stanford Prevention Research Center, Stanford University, Stanford, CA, United States of America.
| | - J.A. Tremmel
- Interventional Cardiology, Women's Heart Health at Stanford, Stanford, CA, United States of America
| | - K. Kapphahn
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, CA, United States of America
| | - M. Desai
- Quantitative Science Unit, Stanford University School of Medicine, Stanford, CA, United States of America
| | - M. Baiocchi
- Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, United States of America
| | - M. Sanders
- Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, United States of America
| | - J.J. Prochaska
- Department of Medicine, Stanford Prevention Research Center, Stanford University School of Medicine, Stanford, CA, United States of America
| |
Collapse
|
27
|
Koyama T, Ozaki E, Kuriyama N, Tomida S, Yoshida T, Uehara R, Tanaka K, Hara M, Hishida A, Okada R, Kubo Y, Oze I, Koyanagi YN, Mikami H, Nakamura Y, Shimoshikiryo I, Takezaki T, Suzuki S, Otani T, Kuriki K, Takashima N, Kadota A, Arisawa K, Katsuura-Kamano S, Ikezaki H, Murata M, Takeuchi K, Wakai K. Effect of Underlying Cardiometabolic Diseases on the Association Between Sedentary Time and All-Cause Mortality in a Large Japanese Population: A Cohort Analysis Based on the J-MICC Study. J Am Heart Assoc 2021; 10:e018293. [PMID: 34121417 PMCID: PMC8403304 DOI: 10.1161/jaha.120.018293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Background This study aimed to determine the association between sedentary time and mortality with regard to leisure-time physical activity with or without cardiometabolic diseases such as hypertension, dyslipidemia, and diabetes mellitus. Methods and Results Using data from the J-MICC (Japan Multi-Institutional Collaborative Cohort) Study, 64 456 participants (29 022 men, 35 434 women) were analyzed. Hazard ratios (HRs) and 95% CIs were used to characterize the relative risk of all-cause mortality to evaluate its association with sedentary time (categorical variables: <5, 5 to <7, 7 to <9, ≥9 h/d and 2-hour increments in exposure) according to the self-reported hypertension, dyslipidemia, and diabetes mellitus using a Cox proportional hazards model. A total of 2257 participants died during 7.7 years of follow-up. The corresponding HRs for each 2-hour increment in sedentary time among participants with all factors, no factors, hypertension, dyslipidemia, and diabetes mellitus were 1.153 (95% CI, 1.114-1.194), 1.125 (95% CI, 1.074-1.179), 1.202 (95% CI, 1.129-1.279), 1.176 (95% CI, 1.087-1.273), and 1.272 (95% CI, 1.159-1.396), respectively. Furthermore, when analyzed according to the combined different factors (hypertension, dyslipidemia, and diabetes mellitus), HRs increased with each additional factor, and participants reporting all 3 conditions had the highest HR of 1.417 (95% CI, 1.162-1.728) independently of leisure-time metabolic equivalents. Conclusions The association between sedentary time and increased mortality is stronger among patients with hypertension, dyslipidemia, and diabetes mellitus regardless of leisure-time physical activity in a large Japanese population.
Collapse
Affiliation(s)
- Teruhide Koyama
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan
| | - Etsuko Ozaki
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan
| | - Nagato Kuriyama
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan.,Shizuoka Graduate University of Public Health Shizuoka Japan
| | - Satomi Tomida
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan.,Department of Endocrine and Breast Surgery Kyoto Prefectural University of Medicine Kyoto Japan
| | - Tamami Yoshida
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan
| | - Ritei Uehara
- Department of Epidemiology for Community Health and Medicine Kyoto Prefectural University of Medicine Kyoto Japan
| | - Keitaro Tanaka
- Department of Preventive Medicine Faculty of Medicine Saga University Saga Japan
| | - Megumi Hara
- Department of Preventive Medicine Faculty of Medicine Saga University Saga Japan
| | - Asahi Hishida
- Department of Preventive Medicine Nagoya University Graduate School of Medicine Aichi Japan
| | - Rieko Okada
- Department of Preventive Medicine Nagoya University Graduate School of Medicine Aichi Japan
| | - Yoko Kubo
- Department of Preventive Medicine Nagoya University Graduate School of Medicine Aichi Japan
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention Aichi Cancer Center Research Institute Aichi Japan
| | - Yuriko N Koyanagi
- Division of Cancer Information and Control Aichi Cancer Center Research Institute Aichi Japan
| | - Haruo Mikami
- Cancer Prevention Center Chiba Cancer Center Research Institute Chiba Japan
| | - Yohko Nakamura
- Cancer Prevention Center Chiba Cancer Center Research Institute Chiba Japan
| | - Ippei Shimoshikiryo
- Department of International Island and Community Medicine Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan
| | - Toshiro Takezaki
- Department of International Island and Community Medicine Kagoshima University Graduate School of Medical and Dental Sciences Kagoshima Japan
| | - Sadao Suzuki
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Aichi Japan
| | - Takahiro Otani
- Department of Public Health Nagoya City University Graduate School of Medical Sciences Aichi Japan
| | - Kiyonori Kuriki
- Laboratory of Public Health School of Food and Nutritional Sciences University of Shizuoka Japan
| | - Naoyuki Takashima
- Department of Public Health Faculty of Medicine Kindai University Osaka Japan.,Department of Public Health Shiga University of Medical Science Shiga Japan
| | - Aya Kadota
- Department of Public Health Shiga University of Medical Science Shiga Japan
| | - Kokichi Arisawa
- Department of Preventive Medicine Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Sakurako Katsuura-Kamano
- Department of Preventive Medicine Tokushima University Graduate School of Biomedical Sciences Tokushima Japan
| | - Hiroaki Ikezaki
- Department of General Internal Medicine Kyushu University Hospital Fukuoka Japan.,Department of Comprehensive General Internal Medicine Faculty of Medical Sciences Kyushu University Fukuoka Japan
| | - Masayuki Murata
- Department of General Internal Medicine Kyushu University Hospital Fukuoka Japan
| | - Kenji Takeuchi
- Department of Preventive Medicine Nagoya University Graduate School of Medicine Aichi Japan
| | - Kenji Wakai
- Department of Preventive Medicine Nagoya University Graduate School of Medicine Aichi Japan
| | | |
Collapse
|
28
|
Synergistic harmful interaction between sustained physical inactivity and hypertension/diabetes mellitus on the risk of all-cause mortality: a retrospective observational cohort study. J Hypertens 2021; 39:2058-2066. [PMID: 34102662 DOI: 10.1097/hjh.0000000000002905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
OBJECTIVE Hypertension, diabetes mellitus and physical inactivity can cause cardiovascular complications or premature death. However, it has not been clarified whether those major comorbidities and physical activity interact in affecting health outcomes. The aim of this study is to evaluate the potential interaction between temporal physical activity profiles and hypertension or diabetes mellitus on the risk for all-cause mortality. METHODS This study used Korea National Health Insurance Service (KNHIS) database and included about 6.5 million participants who underwent health screening in 2009 and 2011. Physical activity was evaluated as 2-year change based on self-reported survey using 7-day recall method, and grouped as remained active, inactive-to-active, active-to-inactive, or remained inactive. Participants were categorized into groups according to the presence of hypertension/diabetes mellitus. Outcome included all-cause mortality. RESULTS In total, 6 554 082 participants (48.4 ± 13.3 years; 56.7% men) were included. During a median 6.4-year follow-up, 83 241 deaths occurred. Compared with the 'remained active' group, other groups had a higher mortality risk after adjustment for covariates [adjusted hazard ratio (aHR) 1.17, 95% CI 1.13-1.21 in the 'inactive-to-active' group, aHR 1.28, 95% CI 1.24-1.32 in the 'active-to-inactive' group, aHR 1.52, 95% CI 1.48-1.57 in the 'remained inactive' group). Hypertension and diabetes mellitus were significant effect modifiers in the association between physical activity and the risk of all-cause mortality (P for interaction <0.001). The harmful effects of persistent physical inactivity on all-cause mortality were the most obvious in those with both hypertension and diabetes mellitus among groups. CONCLUSION Sustained physical inactivity was associated with increased risk of all-cause mortality in those with hypertension or diabetes mellitus more strongly than in those without. Physicians should emphasize sustained physical activity even more in patients with hypertension or diabetes mellitus.
Collapse
|
29
|
Wang F, Wang X. Associations between PM2.5 exposure duration and physical activity intensity on the health of hypertension in urban residents of Beijing. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:29742-29754. [PMID: 33569688 DOI: 10.1007/s11356-021-12698-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 01/25/2021] [Indexed: 06/12/2023]
Abstract
Hypertension is reported to be associated with air pollution and physical activity (PA), and they have different or even conflicting effects on blood pressure (BP). The study evaluated the combined effects of PM2.5 exposure duration and physical activity intensity on systolic blood pressure (SBP) and diastolic blood pressure (DBP) of hypertension. A total of 2613 patients (≥18-year-olds) at baseline who attended surveys from the China Health and Nutrition Survey (2011-2015) in Beijing were selected, as well as the PM2.5 data collected in the same period. The mixed linear effects model and multivariate analysis of variance (MANOVA) were used to explore the multiple effects of PM2.5 exposure duration and PA intensity on SBP and DBP, respectively. The correlation results indicated PM2.5 exposure duration (>15 days) occurred more significant correlations with DBP and longer PM2.5 exposures duration (>60 day) with SBP. The mixed linear effects model showed the important random terms of gender, PA levels, and BMI classification for both SBP and DBP. It also indicated the significant fixed effect from age for both SBP and DBP, and the significant fixed effects from PM2.5 and weight, as well as the interaction in DBP. The random effects of PA levels put effects on different weight people for SBP and on different age people for DBP, while the person of SBP exposed to PM2.5 environments may tend to be affected by BMI classification. The model's main effects showed PA and the interaction with gender could put significant effects on BP. The gender effects and the PA level effects were also improved by the MANOVA results. We concluded that the more PM2.5 exposure duration may lead to more significant correlation with higher BP values. The PA levels could lead to the different effects on the health showing the variations in age, gender, and BMI classification. For SBP of people who are exposed to PM2.5 environments, it may tend to be affected by BMI classification, which also may influence the DBP through weight adjusting first and then cause hypertension. The gender difference of BP may be affected by PA showing the higher PA level and the more gender difference.
Collapse
Affiliation(s)
- Fei Wang
- Sports Science Institute, Shanxi University, Taiyuan, 030006, Shanxi, China.
- School of Physical Education, Shanxi University, No. 92 Wucheng Road, Taiyuan, 030006, Shanxi, China.
| | - Xinyu Wang
- School of Physical Education, Shanxi University, No. 92 Wucheng Road, Taiyuan, 030006, Shanxi, China
| |
Collapse
|
30
|
Chen Q, Li H, Liu Q, Wang W, Deng F, Sun Z, Guo X, Wu S. Does psychosocial stress modify the association of fine particulate matter and ozone with cardiovascular health indicators? ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 277:116726. [PMID: 33639598 DOI: 10.1016/j.envpol.2021.116726] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/12/2021] [Accepted: 02/08/2021] [Indexed: 06/12/2023]
Abstract
Fine particulate matter (PM2.5) and ozone (O3) air pollution can cause abnormal changes in blood pressure (BP), blood glucose and lipids, which are important indicators for cardiovascular health. Psychosocial stress could be a potential effect modifier for adverse health effects of air pollution, but research evidence is scarce. A cross-sectional study with 373 elderly subjects was conducted in Beijing during 2018-2019. We collected psychosocial stress information on anxiety, perceived stress and depression, obtained daily environmental data, measured resting BP, blood glucose and lipids in study participants, and analyzed the associations of PM2.5 or O3 with cardiovascular health indicators and the modification effect by psychosocial stress. Results showed that PM2.5 was significantly associated with increased systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) ; and O3 was significantly associated with elevated DBP, glycated hemoglobin (HbA1c) and total triglyceride (TG). In addition, the associations of PM2.5 with TG, and O3 with SBP and TG were higher in participants with high psychosocial stress, whereas the associations of O3 with high-density lipoprotein cholesterol (HDL-C) were higher in participants with low psychosocial stress. For an interquartile range (IQR) (56.8 μg/m³) increase in PM2.5 at 4-d moving average, TG increased by 21.43% (95% CI: 2.90, 43.29) in high perceived-stress group, and decreased by 20.05% (95% CI: -30.31, -8.28) in low perceived-stress group (p for interaction = 0.04). For an IQR (63.0 μg/m³) increase in O3 at 2-d moving average, TG increased by 32.01% (95% CI: 7.65, 61.89) in high perceived-stress group, and increased by 7.95% (95% CI: -9.80, 29.20) only in low perceived-stress group (p for interaction = 0.04). For an IQR (64.0 μg/m³) increase in O3 at 3-d moving average, HDL-C decreased by 4.55% (95% CI: -12.15, 3.72) in high perceived-stress group, and increased by 0.57% (95% CI: -6.99, 8.75) in low perceived-stress group (p for interaction=0.002). In conclusion, our results indicated that short-term exposures to PM2.5 and O3 were associated with significant changes in BP, blood glucose and lipids, and psychosocial stress may increase the susceptibility of the participants to the adverse cardiovascular effects of PM2.5 and O3.
Collapse
Affiliation(s)
- Qiao Chen
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Hongyu Li
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Qisijing Liu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Wanzhou Wang
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Furong Deng
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Zhiwei Sun
- Department of Toxicology and Sanitary Chemistry, School of Public Health, Capital Medical University, Beijing, 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Xinbiao Guo
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health Sciences, School of Public Health, Peking University, Beijing, 100191, China.
| |
Collapse
|
31
|
Factors Related to Blood Pressure Response after Community-Based Exercise Program in the Elderly Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063149. [PMID: 33803874 PMCID: PMC8003188 DOI: 10.3390/ijerph18063149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/14/2021] [Accepted: 03/16/2021] [Indexed: 11/16/2022]
Abstract
Exercise has been recommended for blood pressure (BP) control, but not every individual can improve BP and reduce the risk of cardiovascular disease effectively by exercise. This study aimed to evaluate the BP response after 12-week exercise intervention and then identify the potential factors of responders on BP (R-BP) control. This was a retrospective cohort study from a project of Taipei City Government. Subjects completed the original program were included for further analysis. Sociodemographic factors, health-related behaviors, and cardiovascular risks were extracted as potential factors. The results were categorized into R-BP control, i.e., BP under optimal level (systolic BP (SBP) < 140 mmHg; and diastolic BP (DBP) < 90 mmHg) or a significant BP reduction (SBP ↓10 mmHg or DBP ↓5 mmHg) after intervention, or non-responder on BP control, i.e., subjects who failed to achieve the targets. There were 81.62% R-BP subjects. R-BP showed lower SBP and lower risk of hypertension at baseline. Active lifestyle could quadruple the number of R-BP. Higher educational level or more prescription medications were likely to be R-BP in subjects with diagnosed hypertension. Active lifestyle combined with exercise could benefit R-BP in the elderly population. Health-related factors also need to be considered for BP control.
Collapse
|
32
|
Zhou T, Su J, Tao R, Qin Y, Zhou J, Lu Y, Hua Y, Jin J, Guo Y, Chen Z, Li L, Wu M. The association between daily total physical activity and risk of cardiovascular disease among hypertensive patients: a 10-year prospective cohort study in China. BMC Public Health 2021; 21:517. [PMID: 33726720 PMCID: PMC7968198 DOI: 10.1186/s12889-021-10551-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/01/2021] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND The effect of high levels of physical activity and relationship between daily total physical activity and the risk of cardiovascular disease (CVD) among hypertensive people were not clear. This study aimed to explore the optimum level of physical activity for CVD prevention. METHODS Data used in the present study was derived from the sub-study of China Kadoorie Biobank study (CKB) in Jiangsu province of China. The CKB was a prospective cohort study established during 2004-2008. At baseline, 53,259 participants aged 35-74 years were recruited for the CKB Jiangsu sub-study conducted in Wuzhong district of Suzhou City. Among those 53,259 participants, the 20,179 hypertensive individuals were our study population. The outcome events were cardiovascular diseases (CVDs), while the independent variable was total daily physical activity. The Cox proportional hazard models were introduced to investigate the association between total physical activity and CVDs, reporting as hazard ratios (HR) and 95% confidence intervals (CIs). RESULTS During a 10.1-year follow-up, 2419 CVD cases were identified. After adjustment for potential confounding factors, compared with participants at the lowest level of daily total physical activity, the hazard ratios for CVDs were 0.87 (95%CI: 0.79-0.97), 0.73 (95%CI: 0.65-0.83) and 0.75 (95%CI: 0.65-0.85) for participants within 2, 3 and 4 quartiles of physical activity. Such a negative association between total physical activity and CVDs were also observed among participants by gender and age-group, but within patients with stage 1 hypertension only. Moreover, the association of physical activity with CVDs was U-shape and the lowest HR (0.63, 95%CI: 0.54-0.74) was observed at 35.4 MET-h/d of total physical activity. CONCLUSIONS Total daily physical activity was negatively associated with CVDs among hypertensive adults in China, and this association was U-shape. It has some public health implications that community-based total physical activity intervention campaigns can be of help for CVDs prevention among hypertensive people in China.
Collapse
Affiliation(s)
- Tingyu Zhou
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jian Su
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Ran Tao
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yu Qin
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Jinyi Zhou
- Department of Non-communicable Chronic Disease Control and Prevention, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China
| | - Yan Lu
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou City Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Yujie Hua
- Department of Non-communicable Chronic Disease Control and Prevention, Suzhou City Center for Disease Control and Prevention, Suzhou, 215004, China
| | - Jianrong Jin
- Wuzhong District of Suzhou City Center for Disease Control and Prevention, Suzhou, 215100, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, 102308, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Ming Wu
- Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
| |
Collapse
|
33
|
Pescatello LS, Wu Y, Gao S, Livingston J, Sheppard BB, Chen MH. Do the combined blood pressure effects of exercise and antihypertensive medications add up to the sum of their parts? A systematic meta-review. BMJ Open Sport Exerc Med 2021; 7:e000895. [PMID: 34192008 PMCID: PMC7818845 DOI: 10.1136/bmjsem-2020-000895] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/30/2020] [Indexed: 01/08/2023] Open
Abstract
Objective To compare the blood pressure (BP) effects of exercise alone (EXalone), medication alone (MEDSalone) and combined (EX+MEDScombined) among adults with hypertension. Data sources PubMed, Scopus, Cumulative Index to Nursing and Allied Health Literature, SPORTDiscus and the Cochrane Library. Eligibility criteria Randomised controlled trails (RCTs) or meta-analyses (MAs) of controlled trials that: (1) involved healthy adults>18 year with hypertension; (2) investigated exercise and BP; (3) reported preintervention and postintervention BP and (4) were published in English. RCTs had an EX+MEDScombined arm; and an EXalone arm and/or an MEDSalone arm; and MAs performed moderator analyses. Design A systematic network MA and meta-review with the evidence graded using the Physical Activity Guidelines for Americans Advisory Committee system. Outcome The BP response for EXalone, MEDSalone and EX+MEDScombined and compared with each other. Results Twelve RCTs qualified with 342 subjects (60% women) who were mostly physically inactive, middle-aged to older adults. There were 13 qualifying MAs with 28 468 participants (~50% women) who were mostly Caucasian or Asian. Most RCTs were aerobic (83.3%), while the MAs involved traditional (46%) and alternative (54%) exercise types. Strong evidence demonstrates EXalone, MEDSalone and EX+MEDScombined reduce BP and EX+MEDScombined elicit BP reductions less than the sum of their parts. Strong evidence indicates EX+MEDScombined potentiate the BP effects of MEDSalone. Although the evidence is stronger for alternative than traditional types of exercise, EXaloneelicits greater BP reductions than MEDSalone. Conclusions The combined BP effects of exercise and medications are not additive or synergistic, but when combined they bolster the antihypertensive effects of MEDSalone. PROSPERO registration number The protocol is registered at PROSPERO CRD42020181754.
Collapse
Affiliation(s)
- Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Simiao Gao
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| | | | | | - Ming-Hui Chen
- Department of Statistics, University of Connecticut, Storrs, Connecticut, USA
| |
Collapse
|
34
|
Park S, Han K, Lee S, Kim Y, Lee Y, Kang MW, Park S, Kim YC, Han SS, Lee H, Lee JP, Joo KW, Lim CS, Kim YS, Kim DK. Cardiovascular or mortality risk of controlled hypertension and importance of physical activity. Heart 2021; 107:1472-1479. [PMID: 33402363 DOI: 10.1136/heartjnl-2020-318193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/04/2020] [Accepted: 11/09/2020] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVE To investigate the risk of major adverse cardiac and cerebrovascular events (MACCEs) and all-cause death of patients with controlled hypertension and suggest the benefits of physical activity in their prognosis. METHODS People aged 40-69 years from the prospective UK Biobank cohort (UKB, n=220 026) and the retrospective Korean National Health Insurance Service cohort (KNHIS, n=3 593 202) were included in this observational cohort study, excluding those with previous cerebrocardiovascular diseases or hypertension without treatment. The study groups were stratified into normotension, controlled hypertension (patients with hypertension with systolic blood pressure <140 mm Hg and diastolic blood pressure <90 mm Hg) and uncontrolled hypertension groups. The outcomes were MACCEs and all-cause mortality, analysed by Cox regression analysis. RESULTS We included 161 405/18 844/39 777 and 3 122 890/383 828/86 484 individuals with normotension/controlled hypertension/uncontrolled hypertension state from the UKB and KNHIS cohorts, respectively. The controlled hypertension group showed significantly higher risk of MACCEs (UKB: adjusted HR 1.73 (95% CI 1.55 to 1.92); KNHIS: 1.46 (95% CI 1.43 to 1.49)) and all-cause mortality (UKB: adjusted HR 1.28 (95% CI 1.18 to 1.39); KNHIS: 1.29 (95% CI 1.26 to 1.32)) than individuals with normotension. The controlled hypertension group not involved in any moderate or moderate-to-vigorous physical activity showed high risk of adverse outcomes, which was comparable with or even higher than the risk of patients with uncontrolled hypertension who were engaged in physical activity. CONCLUSIONS Controlled hypertension is associated with residual risks of adverse outcomes. Clinicians may encourage physical activity for patients with controlled hypertension, not being reassured by their achieved target blood pressure values.
Collapse
Affiliation(s)
- Sehoon Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Internal Medicine, Armed Forces Capital Hospital, Gyeonggi-do, Korea (the Republic of)
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea (the Republic of)
| | - Soojin Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Yaerim Kim
- Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Korea (the Republic of)
| | - Yeonhee Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Min Woo Kang
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Sanghyun Park
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Korea (the Republic of)
| | - Yong Chul Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Seung Seok Han
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Hajeong Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
| | - Jung Pyo Lee
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
| | - Kwon Wook Joo
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
| | - Chun Soo Lim
- Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul, Korea (the Republic of).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
| | - Yon Su Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of).,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
| | - Dong Ki Kim
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of) .,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea (the Republic of).,Kidney Research Institute, Seoul National University, Seoul, Korea (the Republic of)
| |
Collapse
|
35
|
Li X, Chen K, Hua W, Su Y, Yang J, Liang Z, Xu W, Xue X, Zhang S, Zhao S. Association of the Obesity Paradox With Objective Physical Activity in Patients at High Risk of Sudden Cardiac Death. J Clin Endocrinol Metab 2020; 105:5907988. [PMID: 32942298 DOI: 10.1210/clinem/dgaa659] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 09/16/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To investigate the obesity paradox and its interrelationship with objective physical activity (PA) in patients at high risk of sudden cardiac death. METHODS A total of 782 patients with implantable cardioverter-defibrillators/cardiac resynchronization therapy defibrillators in the Study of Home Monitoring System Safety and Efficacy in Cardiac Implantable Electronic Device-Implantable Patients registry were retrospectively analyzed and grouped by body mass index (BMI) (kg/m2): normal weight (18.5 ≤ BMI < 25) and overweight or class I obesity (25 ≤ BMI < 35). PA was measured with home monitoring and categorized into 4 groups (Q1-Q4) by the baseline quartiles. The main endpoint was all-cause mortality. RESULTS During a mean follow-up period of 59.9 ± 21.9 months, 182 all-cause mortality events occurred. Mortality tended to be lower in overweight and obesity patients (18.9% vs 25.1%, P = 0.061) and decreased by PA quartiles (44.1% vs 22.6% vs 15.3% vs 11.2%, Q1-Q4, P < 0.001). Multivariate Cox analysis indicated BMI (hazard ratio, 0.918; 95% confidence interval, 0.866-0.974; P = 0.004) and PA (0.436, 0.301-0.631, Q2 vs Q1; 0.280, 0.181-0.431, Q3 vs Q1; 0.257, 0.158-0.419, Q4 vs Q1; P < 0.001 for all) were associated with reduced risk. The obesity paradox was significant in the total cohort (log rank P = 0.049) and low PA group (log rank P = 0.010), but disappeared in the high PA group (log rank P = 0.692). Dose-response curves showed a significant reduction in risk with low-moderate PA, and the pattern varied between different BMI groups. CONCLUSIONS The obesity paradox only persisted in physically inactive patients. PA might be related to the development of the obesity paradox.
Collapse
Affiliation(s)
- Xiaoyao Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keping Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wei Hua
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yangang Su
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, Beijing, China
| | - Zhaoguang Liang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Xiaodi Xue
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Shuang Zhao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
36
|
Li X, Zhao S, Chen K, Hua W, Su Y, Yang J, Liang Z, Xu W, Zhang S. Dose-response association of implantable device-measured physical activity with long-term cardiac death and all-cause mortality in patients at high risk of sudden cardiac death: a cohort study. Int J Behav Nutr Phys Act 2020; 17:119. [PMID: 32957993 PMCID: PMC7507242 DOI: 10.1186/s12966-020-01026-2] [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: 05/16/2020] [Accepted: 09/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Cardiovascular implantable electronic devices (CIEDs) with physical activity (PA) recording function can continuously and automatically collect patients’ long-term PA data. The dose-response association of implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy defibrillator (CRTD)-measured PA with cardiovascular outcomes in patients at high risk of sudden cardiac death (SCD) was investigated. Methods In total, 822 patients fulfilling the inclusion criteria were included and divided into three groups according to baseline PA tertiles: tertile 1 (< 8.04%, n = 274), tertile 2 (8.04–13.24%, n = 274), and tertile 3 (> 13.24%, n = 274). The primary endpoint was cardiac death, the secondary endpoint was all-cause mortality. Results During a mean follow-up of 59.7 ± 22.4 months, cardiac death (18.6% vs 8.8% vs 5.5%, tertiles 1–3, P < 0.001) and all-cause mortality (39.4% vs 20.4% vs 9.9%, tertiles 1–3, P < 0.001) events decreased according to PA tertiles. Compared with patients younger than 60 years old, older patients had a lower average PA level (9.6% vs 12.8%, P < 0.001) but higher rates of cardiac death (13.2% vs 8.1%, P = 0.024) and all-cause mortality (28.4% vs 16.7%, P < 0.001) events. Adjusted multivariate Cox regression analyses showed that a higher tertile of PA was associated with a lower risk of cardiac death (hazard ratio (HR) 0.41, 95% confidence interval (CI): 0.25–0.68, tertile 2 vs tertile 1; HR 0.28, 95% CI: 0.15–0.51, tertile 3 vs tertile 1, Ptrend < 0.001). Similar results were observed for all-cause mortality. The dose-response curve showed an inverse non-linear pattern, and a significant reduction in endpoint risk was observed at the low-moderate PA level. The HR for cardiac death was reduced by half with 12.32% PA (177 min), and the HR for all-cause mortality was reduced by half with 11.92% PA (172 min). Subgroup analysis results indicated that older adults could benefit from PA and the range for achieving optimal benefits might be lower. Conclusions PA monitoring may aid in long-term management of patients at high risk of SCD. More PA will generate better survival benefits, but even low-moderate PA is already good especially for older adults, which is relatively easy to achieve.
Collapse
Affiliation(s)
- Xiaoyao Li
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Shuang Zhao
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Keping Chen
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Wei Hua
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China
| | - Yangang Su
- Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Jiefu Yang
- Department of Cardiology, Beijing Hospital, Beijing, China
| | - Zhaoguang Liang
- Department of Cardiology, First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Wei Xu
- Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing, China
| | - Shu Zhang
- Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Bei Li Shi Road, Xicheng District, Beijing, 100037, China.
| |
Collapse
|
37
|
Saroj C, Juthika M, Tao Y, Xi C, Ji-Youn Y, Cameron MG, Camilla WF, Lauren KG, Jennifer HW, Matam VK, Bina J. Metabolites and Hypertension: Insights into Hypertension as a Metabolic Disorder: 2019 Harriet Dustan Award. Hypertension 2020; 75:1386-1396. [PMID: 32336227 PMCID: PMC7225070 DOI: 10.1161/hypertensionaha.120.13896] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
For over 100 years, essential hypertension has been researched from different perspectives ranging from genetics, physiology, and immunology to more recent ones encompassing microbiology (microbiota) as a previously underappreciated field of study contributing to the cause of hypertension. Each field of study in isolation has uniquely contributed to a variety of underlying mechanisms of blood pressure regulation. Even so, clinical management of essential hypertension has remained somewhat static. We, therefore, asked if there are any converging lines of evidence from these individual fields that could be amenable for a better clinical prognosis. Accordingly, here we present converging evidence which support the view that metabolic dysfunction underlies essential hypertension.
Collapse
Affiliation(s)
- Chakraborty Saroj
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Mandal Juthika
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Yang Tao
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Cheng Xi
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Yeo Ji-Youn
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - McCarthy G. Cameron
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Wenceslau F. Camilla
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Koch G. Lauren
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Hill W. Jennifer
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Vijay-Kumar Matam
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| | - Joe Bina
- Center for Hypertension and Precision Medicine and Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, Ohio
| |
Collapse
|
38
|
Joseph G, Marott JL, Biering-Sørensen T, Johansen MN, Saevereid HA, Nielsen G, Schnohr P, Prescott E, Søgaard P, Mogelvang R. Level of Physical Activity, Left Ventricular Mass, Hypertension, and Prognosis. Hypertension 2020; 75:693-701. [DOI: 10.1161/hypertensionaha.119.14287] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Left ventricular hypertrophy is a strong predictor of prognosis in hypertension. Physical activity is associated with higher left ventricular mass but also reduced risk of cardiovascular outcomes. The aims were to explore whether (1) presence of hypertension modifies the association between physical activity and left ventricular mass; (2) the beneficial association between physical activity and prognostic outcome is modified by left ventricular hypertrophy. Randomly selected number of 3078 persons from the general population underwent echocardiogram. Left ventricular mass was indexed to body surface area. Level of physical activity was self-reported: inactivity, light activity, and moderate/high activity. Blood pressure was measured in rest: normal BP (<140/90 mm Hg) and hypertension (≥140/90 mm Hg or in pharmacological treatment for hypertension). Presence of hypertension modified the association between physical activity and left ventricular mass index significantly (test for interaction:
P
=0.01): in normal BP, higher levels of physical activity were associated with significantly higher left ventricular mass index (
P
<0.001), but this was not present in hypertension (
P
=0.90). Level of physical activity was associated with reduction in mortality and cardiovascular outcome independent of the presence of LVH (Persons with LVH: light activity HR, 0.77 [0.52–1.15], moderate/high activity HR, 0.61 [0.38–0.97]; test for interaction between LVH and level of physical activity
P
=0.71). In conclusion, persons with normal BP had higher left ventricular mass index at increased levels of physical activity, whereas this association was not present among persons with hypertension. Level of physical activity was associated with better prognosis independent of whether left ventricular hypertrophy was present or not.
Collapse
Affiliation(s)
- Gowsini Joseph
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
- Department of Clinical Medicine, Aalborg University, Denmark (G.J., P. Søgaard)
- Department of Cardiology and Centre for Clinical Research, North Denmark Regional Hospital, Hjorring, Denmark (G.J., G.N.)
- Department of Cardiology, Rigshospitalet (G.J., R.M.), University of Copenhagen, Denmark
| | - Jacob Louis Marott
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
| | - Tor Biering-Sørensen
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences (T.B.-S.), University of Copenhagen, Denmark
- Department of Cardiology, Herlev-Gentofte Hospital, University of Copenhagen, Hellerup, Denmark (T.B.-S.)
| | | | - Hans A. Saevereid
- Department of Cardiology, Bispebjerg-Frederiksberg Hospital (H.A.S., E.P.), University of Copenhagen, Denmark
| | - Gitte Nielsen
- Department of Cardiology and Centre for Clinical Research, North Denmark Regional Hospital, Hjorring, Denmark (G.J., G.N.)
| | - Peter Schnohr
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
- Department of Cardiology, Aalborg University Hospital, Denmark (M.N.J, P.S.)
| | - Eva Prescott
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
- Department of Cardiology, Bispebjerg-Frederiksberg Hospital (H.A.S., E.P.), University of Copenhagen, Denmark
| | - Peter Søgaard
- Department of Clinical Medicine, Aalborg University, Denmark (G.J., P. Søgaard)
| | - Rasmus Mogelvang
- From the The Copenhagen City Heart Study, Bispebjerg-Frederiksberg Hospital, University of Copenhagen, Denmark (G.J., J.L.M., T.B.-S., P. Schnohr, E.P., R.M.)
- Department of Cardiology, Rigshospitalet (G.J., R.M.), University of Copenhagen, Denmark
- Department of Clinical Research, University of Southern Denmark, Svendborg, Denmark (R.M.)
| |
Collapse
|