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Ramdani S, Haddiya I. Updates in the management of hypertension. Ann Med Surg (Lond) 2024; 86:3514-3521. [PMID: 38846840 PMCID: PMC11152838 DOI: 10.1097/ms9.0000000000002052] [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: 01/23/2024] [Accepted: 03/30/2024] [Indexed: 06/09/2024] Open
Abstract
Hypertension is the leading cause of cardiovascular diseases and nephropathies. Its treatment and management require long-term follow-up which can be facilitated by the emergence of device-based therapies. Novel recommendations have been well described in the latest ESH guidelines as well as new risk factors have been identified. The authors summarized the published evidence on hypertension management. The authors also cited in this review novel treatment approaches in different settings and the intervention of medication adherence in treatment success. Such non-communicable disease requires long-term follow-up and monitoring, which is quite facilitated in the era of digitalization by cuff-less devices based on prediction tools.
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Affiliation(s)
- Sara Ramdani
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, University Mohammed First
| | - Intissar Haddiya
- Laboratory of Epidemiology, Clinical Research and Public Health, Faculty of Medicine and Pharmacy of Oujda, University Mohammed First
- Department of Nephrology, Mohammed VI University Hospital, Oujda, Morocco
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Chen J, Wang Y, Li W, Zhang Y, Cao R, Peng X, Zhang J, Liu K, Han M, Fu L. Physical activity and eating behaviors patterns associated with high blood pressure among Chinese children and adolescents. BMC Public Health 2023; 23:1516. [PMID: 37558994 PMCID: PMC10413547 DOI: 10.1186/s12889-023-16331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 07/18/2023] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Physical activity and eating behavior are associated with hypertension in children and adolescents. Revealing the associations between physical activity patterns, eating behavior patterns and high blood pressure (HBP) could help improve the problem of hypertension from the actual children's physical activities and eating behaviors. METHODS A total of 687 students aged 8-15 years were selected from two nine-year primary and secondary schools using stratified cluster random sampling method. The students' body height, weight, systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured, and their physical activity time and eating behaviors were surveyed by using CLASS questionnaire and self-made eating behavior questionnaire, respectively. Exploratory factor analysis (EFA) was used to extract moderate to vigorous physical activity factor (MVPAF), sedentary activity factor (SAF), healthy eating behavior factor (HEBF), unhealthy eating behavior factor (UHEBF). MVPAF ≥ SAF was defined as moderate to vigorous physical activity pattern (MVPAP), MVPAF < SAF was defined as sedentary activity pattern (SAP). HEBF ≥ UHEBF was defined as healthy eating behavior pattern (HEBP), while the opposite was defined as unhealthy eating behavior pattern (UHEBP). Lifestyles includes physical activity patterns and eating behavior patterns. RESULTS The overall prevalence of hypertension was 5.8% (40/687), and was 5.69% (21/369) in boys and 5.97% (19/318) in girls, respectively. The MVPAF and UHEBF in boys were significantly higher than those in girls (P < 0.01), while the SAF in girls was significantly higher than that in boys (P < 0.05). The SAF was positively correlated with SBP in girls (β(SE) = 0.14 (0.50), P = 0.016), and was positively correlated with SBP (β(SE) = 0.21 (1.22), P = 0.000 and DBP (β(SE) = 0.14 (0.49), P = 0.006) in boys. The MVPAF was negatively correlated with DBP (β(SE)=-0.11 (0.40), P = 0.022) in boys. In boys, the SAP increased the risks of HBP (OR (95% CI):3.34 (1.30-8.63)) and high DBP (OR (95% CI):3.08 (1.02-9.34)) compared with MVPAP. CONCLUSION Compared with the boys with MVPAP, boys with SAP may increase the risks of HBP and high DBP. The SAF may be positively associated with SBP in boys and girls, while the MVPAF may be negatively associated with DBP in boys.
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Affiliation(s)
- Jiaoyan Chen
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Yuanyuan Wang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Wenxiu Li
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Ya Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Ruiyao Cao
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Xingwang Peng
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Juan Zhang
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Keke Liu
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Mei Han
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China
| | - Lianguo Fu
- Department of child and adolescent health, School of public health, Bengbu Medical College, 2600 East Sea Avenue, Bengbu Anhui, Bengbu, Anhui, 233030, PR China.
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di Cagno A, Fiorilli G, Buonsenso A, Di Martino G, Centorbi M, Angiolillo A, Calcagno G, Komici K, Di Costanzo A. Long-Term Physical Activity Effectively Reduces the Consumption of Antihypertensive Drugs: A Randomized Controlled Trial. J Cardiovasc Dev Dis 2023; 10:285. [PMID: 37504541 PMCID: PMC10380464 DOI: 10.3390/jcdd10070285] [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: 06/04/2023] [Revised: 06/28/2023] [Accepted: 07/01/2023] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND Although physical activity (PA) has been shown to enhance hypertension control, the impact of exercise on the potential decrease of the use of antihypertensive medications remains inadequately researched. AIM The aim was to assess the impact of a two-year PA on the medication requirements of individuals with hypertension. METHODS A clinical trial was conducted, involving 130 participants with essential hypertension who took at least one antihypertensive medication. Participants were randomly assigned to either a control group (CG n = 65) or an experimental group (EG n = 65) that underwent a 24-month supervised PA program based on a combination of aerobic and resistance training. The antihypertensive drug load for each participant was determined by adding the ratios of the prescribed daily dose (PDD) to the defined daily dose (DDD) for all antihypertensive medications taken by the participants. The outcome measures were evaluated at 0, 6, 12, 18, and 24 months. RESULTS A total of 76 participants completed the 24-month assessment, and RM-ANOVA revealed a significantly lower antihypertensive drug load in the EG compared to the CG at 18 (p < 0.017) and 24 months (p < 0.003). CONCLUSION A long-term PA program can decrease the antihypertensive drug load in older adults with essential hypertension. The trend of improvement regarding the EG drug load intake and the trend of CG drug load increase, although not significant over time, results in a significant difference between the groups at 18 months and an even greater difference at 24 months. This trend certifies the protective value of PA against the aging process and its related health risk factors.
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Affiliation(s)
- Alessandra di Cagno
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy;
| | - Giovanni Fiorilli
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.D.M.); (M.C.)
| | - Andrea Buonsenso
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.D.M.); (M.C.)
| | - Giulia Di Martino
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.D.M.); (M.C.)
| | - Marco Centorbi
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.D.M.); (M.C.)
| | - Antonella Angiolillo
- Centre for Research and Training in Medicine of Aging, Department of Medicine and Health Science “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.A.); (K.K.); (A.D.C.)
| | - Giuseppe Calcagno
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy; (G.F.); (A.B.); (G.D.M.); (M.C.)
| | - Klara Komici
- Centre for Research and Training in Medicine of Aging, Department of Medicine and Health Science “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.A.); (K.K.); (A.D.C.)
| | - Alfonso Di Costanzo
- Centre for Research and Training in Medicine of Aging, Department of Medicine and Health Science “V. Tiberio”, University of Molise, 86100 Campobasso, Italy; (A.A.); (K.K.); (A.D.C.)
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Alzahrani AA, Alqahtani AS, Vennu V, Bindawas SM. Feasibility and Efficacy of Low-to-Moderate Intensity Aerobic Exercise Training in Reducing Resting Blood Pressure in Sedentary Older Saudis with Hypertension Living in Social Home Care: A Pilot Randomized Controlled Trial. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1171. [PMID: 37374375 DOI: 10.3390/medicina59061171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 05/30/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: The effect of non-pharmacological aerobic exercise training on blood pressure in sedentary older individuals receiving social home care in Saudi Arabia has not been investigated. This study aimed to examine the effects of aerobic exercise on blood pressure in sedentary older Saudis with hypertension residing in these settings. Materials and Methods: A pilot randomized control trial was conducted with 27 sedentary individuals, aged 60-85, diagnosed with hypertension, and living in social home care in Makkah, Saudi Arabia. Recruitment took place between November 2020 and January 2021, and participants were randomly assigned to either the experimental or control group. The experimental group engaged in three 45 min sessions of low-to-moderate intensity aerobic activity per week for eight weeks. This trail was registered with the ISRCTN registry (ISRCTN50726324). Results: Following eight weeks of mild to moderate aerobic exercise training, the primary outcome of resting blood pressure showed a significant reduction in the experimental group (systolic blood pressure: mean difference [MD] = 2.91 mmHg, 95% confidence interval [CI] = 1.61, 4.21, p = 0.001; and diastolic blood pressure: MD = 1.33 mmHg, 95% CI = 1.16, 1.50, p = 0.001) compared to the control group. Within the experimental group, there was also a significant decrease in systolic blood pressure (MD = -2.75 mmHg, 95% CI = -7.73, 2.22, p = 0.005) and diastolic blood pressure (MD = -0.83 mmHg, 95% CI = -5.81, 4.14, p = 0.02). Conclusions: This trial demonstrates the feasibility and potential benefits of low-to-moderate intensity aerobic exercise training in reducing resting blood pressure among sedentary older Saudis with hypertension residing in this aged care setting.
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Affiliation(s)
- Abdulrahman A Alzahrani
- Social Care Center for the Elderly, Mecca 12840, Saudi Arabia
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Abdulfattah S Alqahtani
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
| | - Saad M Bindawas
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia
- King Salman Center for Disability Research, Riyadh 11614, Saudi Arabia
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Tsoi K, Lam A, Tran J, Hao Z, Yiu K, Chia YC, Turana Y, Siddique S, Zhang Y, Cheng HM, Wang JG, Kario K. The Western and Chinese exercise training for blood pressure reduction among hypertensive patients: An overview of systematic reviews. J Clin Hypertens (Greenwich) 2023. [PMID: 36946438 DOI: 10.1111/jch.14610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 09/07/2022] [Accepted: 11/05/2022] [Indexed: 03/23/2023]
Abstract
Hypertension remains the world's leading cause of premature death. Interventions such as exercise, diet modification, and pharmacological therapy remain the mainstay of hypertension treatment. Numerous systematic reviews and meta-analyses demonstrated the effectiveness of western exercises, such as aerobic exercise and resistance exercise, in reducing blood pressure in hypertensive patients. There is recently emerging evidence of blood pressure reduction with Chinese exercises, such as Tai Chi, Baduanjin, and Qigong. The current overview of systematic reviews aims to evaluate the quality and descriptively summarize the evidence for the effectiveness of western and Chinese exercises for hypertension management. Thirty-nine systematic reviews were included in this overview, with 15 of those being on Chinese exercise. Evidence suggests that exercise training, regardless of Western or Chinese exercise, generally reduced both systolic and diastolic blood pressure. High-intensity intermittent training did not further reduce blood pressure when compared to moderate-intensity continuous training. Conflicting results on the effectiveness of blood pressure reduction when comparing Chinese and Western exercise training were observed. This suggests the comparable effectiveness of Chinese exercise training, in particularly Tai Chi, to general or aerobic exercise training in terms of blood pressure reduction. The Chinese exercise modality and intensity may be more suitable for the middle-aged and elderly population.
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Affiliation(s)
- Kelvin Tsoi
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Amy Lam
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Joshua Tran
- Department of Medicine and Therapeutics, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Ziyu Hao
- The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Karen Yiu
- Stanley Ho Big Data Decision Analytics Research Centre, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Medical and Life Sciences, Sunway University, Bandar Sunway, Malaysia
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Yuqing Zhang
- Divisions of Hypertension and Heart Failure, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hao-Min Cheng
- Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Ph.D. Program of Interdisciplinary Medicine (PIM), National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Public Health, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
- Institute of Health and Welfare Policy, National Yang Ming Chiao Tung University College of Medicine, Taipei, Taiwan
| | - Ji-Guang Wang
- Department of Cardiovascular Medicine, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, State Key Laboratory of Medical Genomics, National Research Centre for Translational Medicine, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
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Liu CT, Hung IL, Hsu CY, Hu KC, Chen YH, Tsai MY. Chinese Herbal Medicine Reduces the Risk of Heart Failure in Hypertensive Patients: A Nationwide, Retrospective, Cohort Study. Front Cardiovasc Med 2022; 9:922728. [PMID: 35898268 PMCID: PMC9313033 DOI: 10.3389/fcvm.2022.922728] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 06/22/2022] [Indexed: 11/16/2022] Open
Abstract
Background Hypertension (HTN) is the leading preventable risk factor for cardiovascular disease worldwide. Patients with HTN are at higher risk for heart failure (HF). The currently available therapeutic approaches for HTN do not always optimally control blood pressure or are not suitable for hypertensive patients who have a higher number of comorbidities. This study aimed to determine whether Chinese herbal medicine (CMH)-based interventions could reduce the risk of HF in hypertensive patients. Methods This retrospective study randomly selected 2 million enrollees from the National Health Insurance Research Database and identified 507,608 patients who were newly diagnosed with HTN in 2000–2017. After 1:1 frequency-matching by age, sex, index year, income, urbanization, duration of HTN, comorbidities and antihypertensive medications, we selected 8,912 eligible patients in each group. During 16 years of follow-up, 380 CHM users and 426 CHM non-users developed HF, representing incidence rates of 6.29 and 7.43 per 1,000 person-years, respectively. Results CHM users had significantly lower HF risk compared with CHM non-users (adjusted HR = 0.85, 95% CI 0.74–0.98). The markedly predominant effect was observed in those receiving CHM products for more than 180 days (adjusted HR = 0.65). The frequently prescribed formula, Jia-Wei-Xiao-Yao-San, and the single herbs Ge Gen, Huang Qi, Du Zhong, Huang Qin, and Chuan Xiong were significantly associated with lower risk of HF. Conclusions This population-based study revealed decreased HF risk in hypertensive patients with CHM use. These findings may provide a reference for HF prevention strategies and support the integration of CHM into clinical intervention programs that provide a favorable prognosis for hypertensive patients.
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Affiliation(s)
- Chun-Ting Liu
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Chinese Medicine, Dali Branch, Jen-Ai Hospital, Taichung, Taiwan
| | - I-Ling Hung
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Department of Chinese Medicine, Dali Branch, Jen-Ai Hospital, Taichung, Taiwan
| | - Chung Y. Hsu
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan
| | - Kai-Chieh Hu
- Management Office for Health Data, College of Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yung-Hsiang Chen
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
- *Correspondence: Ming-Yen Tsai ;
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