Effect of Strength Training on Oxidative Stress and the Correlation of the Same with Forearm Vasodilatation and Blood Pressure of Hypertensive Elderly Women: A Randomized Clinical Trial

Blood pressure responsiveness to resistance training in the hypertensive older adult: a randomized controlled study

Different lifestyle changes have been employed to improve clinical hypertension. However, there is scarce evidence on the blood pressure responsiveness to resistance training (RT) in hypertensive older adults. Consequently, little is known about some participants clinically reducing blood pressure and others not. Thus, we investigate the effects and responsiveness of RT on blood pressure in hypertensive older adults. We secondarily evaluated the biochemical risk factors for cardiovascular disease and functional performance. Older participants with hypertension were randomly assigned into RT (n = 27) and control group (n = 25). Blood pressure, functional performance (timed up and go, handgrip strength, biceps curl and sit-to-stand), fasting glucose, and lipid profiles were evaluated preintervention and postintervention. The statistic was performed in a single-blind manner, the statistician did not know who was the control and RT. RT was effective in reducing systolic blood pressure (SBP) (pre 135.7 ± 14.7; post 124.7 ± 11.0; P  < 0.001) and the responses to RT stimuli varied noticeably between hypertensive older adults after 12 weeks. For example, 13 and 1 responders displayed a minimal clinical important difference for SBP attenuation (10.9 mmHg) in the RT and control groups, respectively. RT improved the functional performance of older people with hypertension, while no differences were found in biochemical parameters (triglycerides, HDL, LDL, fasting glucose) after 12 weeks. In conclusion, responses to RT stimuli varied noticeably between hypertensive individuals and RT was effective in reducing SBP.

Effect of exercise and antioxidant supplementation on cellular lipid peroxidation in elderly individuals: Systematic review and network meta-analysis

Background: The viewpoints of previous studies on the correlation between exercise and cellular lipid peroxidation are contradictory from many perspectives and lack evidence for elder individuals. A new systematic review with network meta-analysis is necessary and will have significant practical value to provide high-quality evidence in the development of exercise protocols and an evidence-based guide for antioxidant supplementation for the elderly. Aims: To identify the cellular lipid peroxidation induced by different types of exercise, with or without antioxidant supplementation, in elderly individuals. Methods: Randomized controlled trials that recruited elderly participants and reported cellular lipid peroxidation indicators and were published in peer-reviewed journals in English were searched by a Boolean logic search strategy and screened in the databases PubMed, Medline, Embase, and Web of Science. The outcome measures were the biomarkers of oxidative stress in cell lipids in urine and blood, namely F2-isoprostanes, hydrogen peroxide (LOOH, PEROX, or LIPOX), malondialdehyde (MDA), and thiobarbituric acid reactive substances (TBARS). Result: 7 trials were included. A combination program of aerobic exercise (AE), low-intensity resistance training (LIRT), and a placebo intake (Placebo) and a combination program of aerobic exercise, low-intensity resistance training, and antioxidant supplementation (S) had the most and sub-most potential to dampen cellular lipid peroxidation (AE + LIRT + Placebo: 0.31 in Rank 1 and 0.2 in Rank 2; AE + LIRT + S: 0.19 in Rank 1 and 0.20 in Rank 2); A placebo intake (Placebo) and a blank intervention without exercise (NE) had the most and sub-most potential to induce an enhancement of cellular lipid peroxidation (Placebo: 0.51 in Rank 9 and 0.16 in Rank 8; NE: 0.16 in Rank 9 and 0.28 in Rank 8). All included studies had an unclear risk of selecting reporting. There were no high confidence ratings in all the direct and indirect comparisons, 4 comparisons in the direct evidence structure and 7 comparisons in the indirect evidence structure had moderate confidence. Conclusion: A combined protocol consisting of aerobic exercise and low-intensity resistance training is recommended to dampen cellular lipid peroxidation. Extra antioxidant supplementation might be unnecessary if an elderly individual has enough aerobic and resistance exercise. Systematic Review Registration: CRD42022367430.

Nutritional status, health risk behaviors, and eating habits are correlated with physical activity and exercise of brazilian older hypertensive adults: a cross-sectional study

BACKGROUND

Nutritional status, health risk behaviors, eating habits, and other comorbidities (such as diabetes) may be associated with recommended amounts of physical activity (PA) and exercise (EX) in healthy older adults. However, these associations are still unclear for older hypertensive adults, who require greater care from health professionals. The purpose of this study was to associate the nutritional status, health risk behaviors, eating habits, and the presence of diabetes with recommended amounts of physical activity and exercise practice of older hypertensive adults.

METHODS

Ten thousand seven hundred eighty-nine older hypertensive adults (70.9 ± 7.4 years) from the VIGITEL telephone survey were classified according to PA levels (insufficiently active/sufficiently active) and EX practice (non-practitioners/practitioners). Binary logistic regression was used to observe the odds ratio (OR) between independent variables (nutritional status [body mass index], sociodemographic characteristics [age/sex/years of study], risk behaviors [screen time/alcohol/tobacco consumption], eating habits [minimally/ultra-processed foods consumption score], and the presence of diabetes) with recommended amounts of PA/EX (dependent variable).

RESULTS

Highest nutritional status (OR_PA = 0.975 [95%-CI: 0.965 - 0.985]; OR_EX = 0.981[95%-CI: 0.972 - 0.991]), age (OR_PA = 0.955 [95%-CI: 0.949 - 0.961]; OR_EX = 0.980[95%-CI: 0.975 - 0.986]), screen time (OR_PA = 0.909[95%-CI: 0.835 - 0.990]), alcohol consumption (OR_PA = 0.683[95%-CI: 0.621 - 0.758]; OR_EX = 0.702[95%-CI: 0.637 - 0.779]), tobacco (OR_PA = 0.601 [95%-CI: 0.492 - 0.736]; OR_EX = 0.464[95%-CI: 0.384 - 0.562]) ultra-processed foods consumption score (OR_PA = 0.896[95%-CI: 0.871 - 0.921]; OR_EX = 0.886[95%-CI: 0.863 - 0.909]) and having diabetes (OR_PA = 0.780[95%-CI: 0.708 - 0.859]; OR_EX = 0.831[95%-CI: 0.759 - 0.909]) reduced the odds of being sufficiently active/practicing exercise (p < 0.05). Male sex (OR_PA = 1.633[95%-CI: 1.491 - 1.789]; OR_EX = 1.247[95%-CI: 1.140 - 1.363]), years of study (OR_PA = 1.026[95%-CI: 1.018 - 1.035]; OR_EX = 1.050[95%-CI: 1.041 - 1.058]), and minimally processed foods consumption score increased the odds of being sufficiently active/practicing exercise (OR_PA = 1.132[95%-CI: 1.109 - 1.155]; OR_EX = 1.167[95%-CI: 1.145 - 1.191], respectively; p < 0.05).

CONCLUSION

Nutritional status, health risk behaviors, eating habits, and the presence of diabetes were associated with the odds of older hypertensive adults complying with PA and EX recommendations. The results may help health professionals understand how these factors are associated with the changes of older hypertensive adults participating in physical activity and exercise.

Moderate Endurance Training and MitoQ Improve Cardiovascular Function, Oxidative Stress, and Inflammation in Hypertensive Individuals: The Role of miR-21 and miR-222: A Randomized, Double-Blind, Clinical Trial

OBJECTIVE

Hypertension (HTN) is among the leading causes of myocardial infarction, stroke, and kidney disease. The MitoQ supplement is a mitochondrial-targeted antioxidant that attenuates the generation of reactive oxygen species (ROS). miRNAs play an essential role in the pathophysiology of HTN. Regular aerobic exercise is recommended to decrease the risk of cardiovascular disease. We aimed to evaluate the effects of MitoQ supplementation and moderate endurance training (ET), alone and in combination, on cardiac function, blood pressure, the circulatory levels of miRNA-21 and miRNA-222, and oxidative status in individuals with HTN.

MATERIALS AND METHODS

In a double-blind, randomized clinical trial (except for ET group), 52 male hypertensive subjects (40-55 years old) were randomly divided into four groups (n=13): Placebo, MitoQ (20 mg/day, oral), ET (Cycle ergometer, moderate intensity, 40-60% VO2 peak, three sessions/week for six weeks), and MitoQ+ET. Cardiac echocardiography indices, serum oxidative and inflammation status, and miRNAs 21 and 222 were assessed before and after interventions.

RESULTS

Left ventricular mass [effect size (ES): -6.3, 95% confidence interval (CI): -11.2 to -1.4] and end-systolic/ diastolic diameters significantly improved in the intervention groups (ES: -0.05, 95% CI: -0.11 to 0.00 and -0.09, 95% CI: -0.16 to -0.02). Total serum antioxidant capacity (TAC) increased (ES: 36.0, 95% CI: 26.1 to 45.8), and malondialdehyde (MDA) (ES: -0.43, 95% CI: -0.53 to -0.32), IL-6 (ES: -1.6, 95% CI: -1.98 to -1.25), miR-21 (ES: -0.48, 95% CI: -0.61 to -0.35), and miR-222 (ES: -0.31, 95% CI: -0.44 to -0.18) significantly decreased in response to ET, MitoQ, and their combination.

CONCLUSION

MitoQ and ET, individually and more pronouncedly in combination, can improve cardiovascular health in people with high blood pressure (BP) by reducing inflammation and increasing antioxidant defense, in association with reduction in circulatory miR-21 and miR-222 levels (registration number: IRCT20190228042870N1).

Non-pharmacological interventions for older patients with hypertension: A systematic review and network meta-analysis

OBJECTIVE

To determine the most effective non-pharmacological interventions to control the blood pressure variation in older hypertensive patients.

METHODS

Primary endpoints were office systolic blood pressure (SBP) and diastolic blood pressure (DBP). The quality of evidence was assessed using the "risk of bias 2″ tool and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. We performed a Bayesian network meta-analysis using R-4.0.2 software to compare the efficacy of interventions.

RESULTS

36 eligible studies (3,531 patients) with a median follow-up of 12 weeks, assessing 18 non-pharmacological interventions, were included. The percentages of high, moderate, low, and very low certainty evidence were 16.7%, 38.9%, 33.3%, and 11.1%, respectively.

CONCLUSION

High certainty evidence suggests that self-management education is most effective in lowering SBP and DBP in older patients with hypertension, followed by moderate-intensity aerobic exercise. Moderate-intensity resistance training is the most effective exercise for lowering SBP.

REGISTRATION

PROSPERO, #CRD42020209850.

The effects of exercise training on hypertensive older adults: an umbrella meta-analysis

Exercise training has been shown to blunt many of the physiological declines and common diseases of the aging process. One such beneficial effect is the reduction of blood pressure (BP) in hypertensive older adults. However, there is no consensus about which benefits of aerobic (AT) or resistance training (RT) may be lost by the use of combined training (CT) or even what benefits could be acquired only by performing CT, considering the extensive health needs of older adults with hypertension. Thus, we performed an umbrella meta-analysis. The benefits conferred by CT are extensive and encompass cardiorespiratory fitness, muscular fitness, and blood lipid profile improvements. CT may be recommended to improve the extensive health needs of hypertensive older adults that go beyond blood pressure reduction.

Effects of low-to-moderate physical activities on older adults with chronic diseases: A systematic review and meta-analysis

AIM

Examined the evidence of low-to-moderate-intensity physical activities to assess the effect in managing hypertension, diabetes mellitus and hyperlipidaemia conditions among community-dwelling older adult.

BACKGROUND

Physical activity is recommended for the maintenance and improvement of health. However, high-intensity physical activity may adversely impact exercise adherence by older adults.

DESIGN

This review was conducted with reference to methods set out in the Cochrane Handbook for Systematic Reviews of Interventions. The PRISMA statement was employed to guide the reporting of the systematic review and meta-analyses.

DATA SOURCES

Seven electronic databases were searched to identify relevant articles that were published in English from 1 January 2000 to 31 December 2020.

REVIEW METHOD

This review included randomised controlled trials and cluster-randomised controlled trials on interventions of physical activities with low-to-moderate intensities compared against usual care without physical activities. Two reviewers independently extracted data and assessed the risk of bias using the Cochrane Risk of Bias Tool. Meta-analysis was performed using RevMan, with Cochran Q and I² used for determining heterogeneity. The overall effect was reviewed with z scores.

RESULTS

Fifteen randomised controlled trials with 940 total participants were evaluated. Low-to-moderate-intensity physical activity significantly improved systolic blood pressure [Z = 3.59, p = .0003], HbA1C [Z = 2.10, p = .04] and high-density lipoprotein (HDL) levels [Z = 3.83, p = .0001], compared to usual care. A further subgroup analysis found no significant difference in systolic blood pressure level after three sessions a week as well as after three months. There were insufficient papers to evaluate for both HbA1C and HDL levels.

CONCLUSION

Regular physical activity ranging from low-to-moderate intensity should be encouraged among older adults with chronic diseases.

RELEVANCE FOR CLINICAL PRACTICE

This review suggested that low-to-moderate levels of physical activity could be encouraged among community-dwelling older adults to improve their physical health.

Is resistance training alone an antihypertensive therapy? A meta-analysis

Evidence concerning the prescription of isolated resistance training (RT) to hypertensive individuals is limited. Guidelines are divergent concerning RT inclusion for prehypertensive and hypertensive persons. A meta-analysis investigating data with larger sample sizes provides more robust effect size estimates and allows for inferences on clinical choices concerning the effectiveness of RT alone. In this context, the aim of this meta-analysis was to assess the effects of RT alone on the systolic (SBP) and diastolic (DBP) blood pressures in prehypertensive and hypertensive individuals. Data from 13 studies involving 417 participants (207 assigned to RT and 210 controls) were obtained. The results indicate significant reductions in SBP (-6.16 mmHg CI -8.27 to -4.04; I²: 31.0% P value for heterogeneity = 0.136 and effect size = -0.59) and DBP (-3.70 mmHg CI -5.19 to -2.21; I²: 18.3% P value for heterogeneity = 0.106 and effect size = -0.55) when compared to control groups. In conclusion, RT alone is able to reduce SBP and DBP in prehypertensive and hypertensive subjects, especially in elderly individuals.

Potential Mechanisms Behind the Blood Pressure-Lowering Effect of Dynamic Resistance Training

PURPOSE OF REVIEW

To elucidate the hemodynamic, autonomic, vascular, hormonal, and local mechanisms involved in the blood pressure (BP)-lowering effect of dynamic resistance training (DRT) in prehypertensive and hypertensive populations.

RECENT FINDINGS

The systematic search identified 16 studies involving 17 experimental groups that assessed the DRT effects on BP mechanisms in prehypertensive and/or hypertensive populations. These studies mainly enrolled women and middle-aged/older individuals. Vascular effects of DRT were consistently reported, with vascular conductance, flow-mediated dilation, and vasodilatory capacity increases found in all studies. On the other hand, evidence regarding the effects of DRT on systemic hemodynamics, autonomic regulation, hormones, and vasoactive substances are still scarce and controversial, not allowing for any conclusion. The current literature synthesis shows that DRT may promote vascular adaptations, improving vascular conductance and endothelial function, which may have a role in the BP-lowering effect of this type of training in prehypertensive and hypertensive individuals. More studies are needed to explore the role of other mechanisms in the BP-lowering effect of DRT.

Resistance training to reduce resting blood pressure and increase muscle strength in users and non-users of anti-hypertensive medication: A meta-analysis

Objective: The aim of this study was to conduct a systematic review with meta-analysis to analyze the effect of resistance training variables prescription on resting systolic (SBP) and diastolic blood pressure (DBP) and muscle strength changes. Methods: The search was conducted in the PubMed, Web of Science, and SPORTDiscus databases until August 2020 for randomized controlled trials with non-exercising control group. Results: In total, 36 studies qualified for inclusion in this meta-analysis. Eleven studies included users of antihypertensive medication, while the remaining 25 studies were conducted with non-users of antihypertensive medication. Resistance training only reduced SBP (-0.56 [-0.77 to -0.35]; P < .001) and DBP (-0.46 [-0.68 to -0.24]; P < .001) in anti-hypertensive medication users, with changes ranging from -6.1 to -2.8 mmHg for SBP and -4.6 to -1.6 mmHg for DBP. Muscle strength increased significantly in both users (0.76 [0.49 to 1.02]; P < .001) and non-users of antihypertensive medication (0.94 [0.71 to 1.16]; P < .001). Resistance training should be performed by users and non-users of antihypertensive medication for 8 to 16 weeks (2 to 3 days a week) and 8 to 12 non-failure repetitions. However, users should train with less load (60-80 vs 70-85% 1RM) and exercise sets (1-3 vs 2-4) than non-users of antihypertensive medication. Conclusion: Resistance training increases muscle strength and reduces resting SBP and DBP in individuals under BP pharmacological therapy, while in individuals who do not use antihypertensive drugs, resistance training only increases strength.

Characteristics of Physical Exercise Programs for Older Adults in Latin America: A Systematic Review of Randomized Controlled Trials

AIM

To characterize physical exercise programs for older adults in Latin America.

METHODS

This review was conducted in accordance with the PRISMA statement. A search for randomized controlled trials (RCTs) published between the years 2015 and 2020 was performed in the Scopus, MedLine and SciELO databases.

RESULTS

A total of 101 RCTs were included. A large percentage of the studies had an unclear risk of bias in the items: selection, performance, detection and attribution. Furthermore, a heterogeneous level of compliance was observed in the CERT items. A total sample of 5013 older adults (79% women) was included. 97% of the studies included older adults between 60-70 years, presenting an adherence to the interventions of 86%. The studies were mainly carried out in older adults with cardiometabolic diseases. Only 44% of the studies detailed information regarding the place of intervention; of these studies, 61% developed their interventions in university facilities. The interventions were mainly based on therapeutic physical exercise (89% of the articles), with a duration of 2-6 months (95% of the articles) and a frequency of 2-3 times a week (95% of the articles) with sessions of 30-60 min (94% of the articles) led by sports science professionals (51% of the articles). The components of physical fitness that were exercised the most were muscular strength (77% of the articles) and cardiorespiratory fitness (47% of the articles). Furthermore, only 48% of the studies included a warm-up stage and 34% of the studies included a cool-down stage.

CONCLUSIONS

This systematic review characterized the physical exercise programs in older adults in Latin America, as well the most frequently used outcome measures and instruments, by summarizing available evidence derived from RCTs. The results will be useful for prescribing future physical exercise programs in older adults.

The Role of Antioxidants Supplementation in Clinical Practice: Focus on Cardiovascular Risk Factors

Oxidative stress may be defined as an imbalance between reactive oxygen species (ROS) and the antioxidant system to counteract or detoxify these potentially damaging molecules. This phenomenon is a common feature of many human disorders, such as cardiovascular disease. Many of the risk factors, including smoking, hypertension, hypercholesterolemia, diabetes, and obesity, are associated with an increased risk of developing cardiovascular disease, involving an elevated oxidative stress burden (either due to enhanced ROS production or decreased antioxidant protection). There are many therapeutic options to treat oxidative stress-associated cardiovascular diseases. Numerous studies have focused on the utility of antioxidant supplementation. However, whether antioxidant supplementation has any preventive and/or therapeutic value in cardiovascular pathology is still a matter of debate. In this review, we provide a detailed description of oxidative stress biomarkers in several cardiovascular risk factors. We also discuss the clinical implications of the supplementation with several classes of antioxidants, and their potential role for protecting against cardiovascular risk factors.

Aerobic or resistance training improves autonomic control of circulation in oophorectomized rats with cardiometabolic dysfunctions: Impact on renal oxidative stress

Cardiovascular autonomic dysfunction is associated with end organ damage and increased risk of mortality. Menopause and metabolic syndrome increase the risk for cardiorenal complications. In this study, we investigated the effects of aerobic or resistance exercise training on autonomic control of circulation and renal oxidative stress in a model of menopause and metabolic syndrome. Female Wistar rats and spontaneously hypertensive rats (SHR) were divided into 5 groups (n = 8): control (C), hypertensive (H), and sedentary (FHO), aerobic trained (FHOTa) and resistance trained (FHOTr) oophorectomized hypertensive treated with fructose (100 mg/mL drink water for 19 weeks). The FHO group presented increased vascular sympathetic modulation (LF-SBP), impaired baroreflex sensitivity (BRS) associated with increased blood pressure (BP) when compared to the H group. Aerobic exercise training enhanced tachycardic responses, while resistance training improved bradycardic responses to BP changes, thus ameliorating BRS. Moreover, despite unchanged BP, both exercise training protocols were effective in preventing increase in LF-SBP, reduction in systemic nitric oxide bioavailability (NOx), and increase in oxidative stress in the renal tissue, by decreasing lipid and protein oxidation in renal tissue. Positive correlation between LF-SBP and renal lipoperoxidation (r = 0.63, p < 0.05), as well as a negative correlation between NOx and renal lipoperoxidation (r = -0.66, p < 0.05) were observed. In conclusion, both aerobic and resistance exercise training were effective in improving autonomic control of circulation and reducing renal oxidative stress, thus attenuating the deleterious effects induced by arterial hypertension and fructose overload in female rats after ovarian hormone deprivation.

Lifestyle interventions for the prevention and treatment of hypertension

Hypertension affects approximately one third of the world's adult population and is a major cause of premature death despite considerable advances in pharmacological treatments. Growing evidence supports the use of lifestyle interventions for the prevention and adjuvant treatment of hypertension. In this Review, we provide a summary of the epidemiological research supporting the preventive and antihypertensive effects of major lifestyle interventions (regular physical exercise, body weight management and healthy dietary patterns), as well as other less traditional recommendations such as stress management and the promotion of adequate sleep patterns coupled with circadian entrainment. We also discuss the physiological mechanisms underlying the beneficial effects of these lifestyle interventions on hypertension, which include not only the prevention of traditional risk factors (such as obesity and insulin resistance) and improvements in vascular health through an improved redox and inflammatory status, but also reduced sympathetic overactivation and non-traditional mechanisms such as increased secretion of myokines.

Effects of resistance exercise training on redox homeostasis in older adults. A systematic review and meta-analysis

BACKGROUND

Resistance exercise training (RET) has proven effective at reducing the risk of chronic disease in older populations, and it appears to regulate redox homeostasis.

AIMS

To determine the effects of RET on redox homeostasis in older people.

STUDY DESIGN

A systematic review and meta-analysis of randomized clinical trials identified by searching MEDLINE, Web of Science, EMBASE, Sportdiscus, LILACS, CENTRAL and CINAHL. We included studies of subjects aged 65 years or older, with or without pathologies, and including RET metrics with quantified molecular oxidation and antioxidant capacity outcomes.

RESULTS

Fifteen studies were included in this review. Agreement between reviewers reached a kappa value of 0.725. There were a total of 614 participants, with an average age of 68.1 years. Five (for molecular oxidation markers) and three (for antioxidant capacity markers) studies included data that quantified the effects of RET on homeostasis redox. The results of the meta-analysis showed that there were no differences in the molecular oxidation markers (SMD = -0.26; 95% CI = -0.57 to 0.05; P = 0.10; I2 = 0%) and antioxidant capacity markers (SMD = 0.53; 95% CI = -0.20 to 1.26; P = 0.16; I2 = 71.5%) in healthy older people after a RET of 8-24 weeks compared to non-intervention.

CONCLUSIONS

Based on a small number of studies of low methodological quality, this systematic review with meta-analysis suggests that RET is not effective at reducing molecular oxidation markers in healthy older people. More research is needed on the effects of RET on redox homeostasis in older people.

PROSPERO REGISTRATION NUMBER

CRD42019121529.

Research Progress of Oxidative Stress and MicroRNAs in the Prevention of Catheter-Related Thrombus Under Resistance Exercise

Central venous access devices (CVADs) have completely changed the care for patients who require long-term venous access. With the widespread use of CVADs, the incidence of catheter-related thrombus (CRT) has increased. Catheter-related thrombus is a common complication in patients who use CVADs and is mainly caused by endothelial injury, blood stasis, and hypercoagulability. In recent years, the correlations between oxidative stress (OS) and microRNA (miRNA) and CRT have become a hot topic in clinical research. When a catheter punctures the vessel wall, it causes OS damage to the vascular endothelial cells, leading to a series of CRT diseases. MicroRNAs can regulate the mechanism of thrombus and play an important role in the formation of anti-thrombus. Numerous studies have shown that resistance exercise can reduce the level of OS in vascular endothelial cells, inhibit vascular endothelial cell dysfunction, and maintain the stability of hemodynamics and biochemical state. In the current work, the recent studies on the effects of resistance exercise on OS and miRNA in vascular endothelial cells were reviewed.

Short-Term Resistance Training Improves Cardiac Autonomic Modulation and Blood Pressure in Hypertensive Older Women: A Randomized Controlled Trial

Oliveira-Dantas, FF, Brasileiro-Santos, MdS, Thomas, SG, Silva, AS, Silva, DC, Browne, RAV, Farias-Junior, LF, Costa, EC, and Santos, AdC. Short-term resistance training improves cardiac autonomic modulation and blood pressure in hypertensive older women: a randomized controlled trial. J Strength Cond Res 34(1): 37-45, 2020-This randomized controlled trial investigated the efficacy of short-term resistance training (RT) on cardiac autonomic modulation and peripheral hemodynamic parameters in hypertensive older women. Twenty-five hypertensive older women who were insufficiently active (64.7 ± 4.7 years) participated in this study. Subjects were randomly allocated to a 10-week RT program (2 d·wk in the first 5 weeks; 3 d·wk in the last 5 weeks) or a nonexercise control group. Linear reverse periodization was used for the RT program. Cardiac autonomic modulation, mean blood pressure (MBP), peripheral vascular resistance (PVR), and resting heart rate (RHR) were measured before and after 10 weeks. The RT group reduced cardiac sympathetic modulation (0V%; B = -6.6; 95% confidence interval [CI]: -12.9 to -0.2; p = 0.045; Cohen's d = 0.88) and showed a trend for increased parasympathetic modulation (2V%; B = 12.5; 95% CI: 0-25; p = 0.050; Cohen's d = 0.87) compared with the control group. The RT group reduced MBP (B = -8.5 mm Hg; 95% CI: -13.6 to -3.4; p = 0.001; Cohen's d = 1.27), PVR (B = -14.1 units; 95% CI: -19.9 to -8.4; p < 0.001; Cohen's d = 1.86), and RHR (B = -8.8 b·min; 95% CI: -14.3 to -3.3; p = 0.002; Cohen's d = 1.20) compared with the control group. In the RT group, the changes in 2V% patterns and low-frequency components showed a correlation with changes in MBP (r = -0.60; p = 0.032) and RHR (r = 0.75; p = 0.0003). In conclusion, 10 weeks of RT improved cardiac autonomic modulation and reduced MBP and PVR in hypertensive older women. These results reinforce the importance of RT for this population.

Lifestyle Modification for Enhancing Autonomic Cardiac Regulation in Children: The Role of Exercise

Decreased physical activity (PA) is a global concern contributing to the rise in cardiometabolic diseases. One potential mechanism linking insufficient PA and poor health is dysregulated autonomic nervous system (ANS) activity. This relationship is established in adults and PA recommendations, with specific exercise prescription guidelines, have been proposed to overcome this societal health burden. However, research on the benefits and underlying mechanisms of exercise on ANS activity in children <18 years old is limited. This review aimed to describe the optimal exercise “dose” and potential mechanisms of action that exercise may pose on enhancing child ANS activity, represented by heart rate variability (HRV). PubMed, Web of Science and Google Scholar were searched for articles examining the influence of exercise on child HRV. Various exercise duration and frequency combinations appear to improve HRV indices, primarily those representing parasympathetic influence. Furthermore, both aerobic and resistance training benefit HRV through potentially different mechanisms with intensity proposed to be important for exercise prescription. Findings indicate that exercise is a crucial lifestyle modification with protective and therapeutic effects on cardiometabolic health associated with improvements in child ANS activity. Exercise programming must consider the various components including mode, intensity and population characteristics to optimize ANS health.

Combined exercise training improves blood pressure and antioxidant capacity in elderly individuals with hypertension

Background/objective

Although regular exercise plays a role in achieving healthy aging, a specific mode of exercise may be required for elderly individuals with hypertension (HT). Therefore, this study aimed to assess the effects of combined endurance and strength training (CBT) on blood pressure (BP) and antioxidant capacity in elderly individuals with HT.

Methods

In a single-blinded, randomized controlled trial, 54 older men and women aged 67 ± 5.8 years completed endurance training (ET, n = 13), strength training (ST, n = 13), combined endurance and strength training (CBT, n = 16) or served as controls (CON, n = 12). The intervention was a supervised exercise training (1-h sessions, three per week for 12 weeks), followed by a self-supervised exercise training for 12 weeks. Measurements of BP, glutathione peroxidase (GPx), total nitrite/nitrate (NOx-), malondialdehyde (MDA), and high-sensitive C-reactive protein (hs-CRP) were obtained before and after the supervised and the self-supervised periods.

Results

After the supervised period, systolic BP (SBP) decreased by 7.9% in the ET (p < 0.05) and 8.2% in the CBT (p < 0.01); GPx activity increased by 41.3% in the ET (p < 0.01), 19.1% in the ST (p < 0.05), and 49.2% in the CBT (p < 0.01); NOx-concentrations increased by 66.2% in the ET and 71.9% in the CBT (both p < 0.01), MDA concentrations decreased by 65.1% in the ST (p < 0.05) and 61% in the CBT (p < 0.01); hs-CRP concentrations decreased by 49.2% in only the CBT (p < 0.05). After the self-supervised period, SBP decreases by 7.5% in only the CBT (p < 0.01); NOx-concentrations increased by 68.5% in the ET and 92.4% in the CBT (both p < 0.01). However, there was no significant difference in SBP, GPx activity, NOx-, MDA and hs-CRP concentrations between the training groups.

Conclusion

The hypotensive and antioxidant effects of the CBT seem to be similar to the ET after the supervised training period. However, after the self-supervised training period, the CBT program might affect better due to greater exercise adherence and attendance in elderly individuals with HT.

Cardiovascular function is related to neuromuscular performance in Parkinson's disease

Aim: The current study examined the relationship of handgrip, leg and arm neuromuscular performance with cardiovascular function in patients with Parkinson's disease (PD). Materials & methods: Blood pressure, vascular measures and handgrip, shoulder and leg neuromuscular performance were obtained in PD persons and healthy controls. Results: The data reveal that muscular and cardiovascular functions are altered (p < 0.05) in PD. Most importantly, regression indicates that altered central and peripheral cardiovascular function measures demonstrate a moderately strong relationship (p < 0.05) with deteriorated handgrip (R2-range = 0.196–0.257), shoulder (R2-range = 0.146–0.289) and leg (R2-range = 0.19–0.35) neuromuscular performance in PD. Conclusion: These results suggest that deteriorated neuromuscular performance and cardiovascular function are related in PD. Future studies are needed to determine that developing muscular strength might contribute to improving cardiovascular function in PD.

The Janus Head of Oxidative Stress in Metabolic Diseases and During Physical Exercise

PURPOSE OF REVIEW

Oxidative stress describes an imbalance between production and degradation of reactive oxygen species (ROS), which can damage macromolecules. However, ROS may also serve as signaling molecules activating cellular pathways involved in cell proliferation and adaptation. This review describes alterations in metabolic diseases including obesity, insulin resistance, and/or diabetes mellitus as well as responses to acute and chronic physical exercise.

RECENT FINDINGS

Chronic upregulation of oxidative stress associates with the development of insulin resistance and type 2 diabetes (T2D). While single bouts of exercise can transiently induce oxidative stress, chronic exercise promotes favorable oxidative adaptations with improvements in muscle mitochondrial biogenesis and glucose uptake. Although impaired antioxidant defense fails to scavenge ROS in metabolic diseases, chronic exercising can restore this abnormality. The different metabolic effects are likely due to variability of reactive species and discrepancies in temporal (acute vs. chronic) and local (subcellular distribution) patterns of production.

Improved skeletal muscle mass and strength after heavy strength training in very old individuals

Age-related loss of muscle mass and function represents personal and socioeconomic challenges. The purpose of this study was to determine the adaptation of skeletal musculature in very old individuals (83+ years) performing 12weeks of heavy resistance training (3×/week) (HRT) compared to a non-training control group (CON). Both groups received similar protein supplementations. We studied 26 participants (86.9±3.2 (SD) (83-94, range) years old) per-protocol. Quadriceps cross-sectional area (CSA) differed between groups at post-test (P<0.05) and increased 1.5±0.7cm² (3.4%) (P<0.05) in HRT only. The increase in CSA is correlated inversely with the baseline level of CSA (R²=0.43, P<0.02). Thigh muscle isometric strength, isokinetic peak torque and power increased significantly only in HRT by 10-15%, whereas knee extension one-repetition maximum (1 RM) improved by 91%. Physical functional tests, muscle fiber type distribution and size did not differ significantly between groups. We conclude that in protein supplemented very old individuals, heavy resistance training can increase muscle mass and strength, and that the relative improvement in mass is more pronounced when initial muscle mass is low.