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Brasil IA, Silva JCPL, Pescatello LS, Farinatti P. Central and peripheral mechanisms underlying postexercise hypotension: a scoping review. J Hypertens 2024; 42:751-763. [PMID: 38525904 DOI: 10.1097/hjh.0000000000003702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/26/2024]
Abstract
Blood pressure (BP) reduction occurs after a single bout of exercise, referred to as postexercise hypotension (PEH). The clinical importance of PEH has been advocated owing to its potential contribution to chronic BP lowering, and as a predictor of responders to exercise training as an antihypertensive therapy. However, the mechanisms underlying PEH have not been well defined. This study undertook a scoping review of research on PEH mechanisms, as disclosed in literature reviews. We searched the PubMed, Web of Science, Scopus, Cumulated Index to Nursing and Allied Health Literature (CINAHL), Cochrane Library, and Sport Discus databases until January 2023 to locate 21 reviews - 13 narrative, four systematic with 102 primary trials, and four meta-analyses with 75 primary trials involving 1566 participants. We classified PEH mechanisms according to major physiological systems, as central (autonomic nervous system, baroreflex, cardiac) or peripheral (vascular, hemodynamic, humoral, and renal). In general, PEH has been related to changes in autonomic control leading to reduced cardiac output and/or sustained vasodilation. However, the role of autonomic control in eliciting PEH has been challenged in favor of local vasodilator factors. The contribution of secondary physiological outcomes to changes in cardiac output and/or vascular resistance during PEH remains unclear, especially by exercise modality and population (normal vs. elevated BP, young vs. older adults). Further research adopting integrated approaches to investigate the potential mechanisms of PEH is warranted, particularly when the magnitude and duration of BP reductions are clinically relevant. (PROSPERO CRD42021256569).
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Affiliation(s)
- Iedda A Brasil
- Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
| | - José Cristiano P L Silva
- Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
- Faculty of Physical Education, University Center of Volta Redonda, Volta Redonda, Brazil
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Paulo Farinatti
- Graduate Program in Exercise and Sport Sciences, University of Rio de Janeiro State, Rio de Janeiro, Brazil
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2
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Mangone LA, Kwon OS, Johnson BT, Wu Y, Pescatello LS. The Role of Exercise in Statin-Associated Muscle Symptoms Outcomes: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Mayo Clin Proc Innov Qual Outcomes 2024; 8:131-142. [PMID: 38384718 PMCID: PMC10878792 DOI: 10.1016/j.mayocpiqo.2024.01.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2024] Open
Abstract
Objective To provide a synthesis of randomized controlled trials (RCTs) investigating statin-associated muscle symptoms (SAMS) in adults who underwent exercise training intervention. Patients and Methods We systematically searched 5 electronic databases for placebo-controlled RCTs through January 31, 2023. We included short-term and long-term exercise interventions that compared the efficacy and safety of exercise+statin vs exercise+placebo in healthy adults and reported SAMS preintervention and postintervention. Publication bias and methodological study quality assessments were performed. Results Five of 454 potentially qualifying RCTs met the inclusion criteria, all short-term exercise RCTs. Participants were predominantly physically inactive young to middle-aged (M=37.2 y) men (57%), 252 (49%) who were on statin therapy, and 271 (53%) on placebo. Of the 3 RCTs providing qualitative SAMS results, 19 (9%) out of 220 participants reported SAMS on exercise+statin and 10 (4%) out of 234 reported SAMS on exercise+placebo. There was no difference between exercise+statin vs exercise+placebo for maximal oxygen consumption (d=-0.18; 95% CI, -0.37 to 0.00; P=.06) or creatine kinase after short-term exercise (d=0.59; 95% CI, -0.06 to 1.25; P=.08). Participants in the exercise+statin group reduced low-density lipoprotein cholesterol vs exercise+placebo (d=-1.84; 95% CI, -2.28 to -1.39; P<.001). Most of the RCTs exhibited low levels of risk of bias (k=4, 80%) and achieved moderate methodological study quality (75.0%±5.2%). Conclusion Self-reported SAMs tended to be 5% greater after short-term exercise in statin users compared with placebo, although this difference did not achieve statistical significance. There remains an important need for placebo-controlled RCTs investigating the prevalence of statin-induced SAMS during exercise training.
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Affiliation(s)
- Laura A. Mangone
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Oh Sung Kwon
- Department of Kinesiology, University of Connecticut, Storrs, CT
- UConn Center on Aging and Department of Orthopedic Surgery, University of Connecticut, School of Medicine, Farmington, CT
| | - Blair T. Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT
| | - Yin Wu
- Department of Research, Hartford Hospital/HealthCare, Hartford, CT
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Hanssen H, Pescatello LS. Is isometric exercise training the best FIT for exercise prescription in the prevention and treatment of arterial hypertension? Br J Sports Med 2024; 58:231-232. [PMID: 38123947 DOI: 10.1136/bjsports-2023-107743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Affiliation(s)
- Henner Hanssen
- Department of Sport, Exercise and Health, University of Basel, Basel, Basel-Stadt, Switzerland
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
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Kiernan PA, Day CA, Berkowsky RS, Zaleski AL, Gao S, Taylor BA, Santos LP, Panza G, Kramarz M, McCormick K, Thompson PD, Fernandez AB, Chen MH, Pescatello LS. Reliability and Time Course of Postexercise Hypotension during Exercise Training among Adults with Hypertension. J Cardiovasc Dev Dis 2024; 11:42. [PMID: 38392256 PMCID: PMC10889392 DOI: 10.3390/jcdd11020042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/25/2024] [Accepted: 01/25/2024] [Indexed: 02/24/2024] Open
Abstract
Postexercise hypotension (PEH), or the immediate decrease in blood pressure (BP) lasting for 24 h following an exercise bout, is well-established; however, the influence of exercise training on PEH dynamics is unknown. This study investigated the reliability and time course of change of PEH during exercise training among adults with hypertension. PEH responders (n = 10) underwent 12 weeks of aerobic exercise training, 40 min/session at moderate-to-vigorous intensity for 3 d/weeks. Self-measured BP was used to calculate PEH before and for 10 min after each session. The intraclass correlation coefficient (ICC) and Akaike Information Criterion (AIC) determined PEH reliability and goodness-of-fit for each week, respectively. Participants were obese (30.6 ± 4.3 kg∙m-2), middle-aged (57.2 ± 10.5 years), and mostly men (60%) with stage I hypertension (136.5 ± 12.1/83.4 ± 6.7 mmHg). Exercise training adherence was 90.6 ± 11.8% with 32.6 ± 4.2 sessions completed. PEH occurred in 89.7 ± 8.3% of these sessions with BP reductions of 9.3 ± 13.1/3.2 ± 6.8 mmHg. PEH reliability was moderate (ICC ~0.6). AIC analysis revealed a stabilization of maximal systolic and diastolic BP reductions at 3 weeks and 10 weeks, respectively. PEH persisted throughout exercise training at clinically meaningful levels, suggesting that the antihypertensive effects of exercise training may be largely due to PEH. Further studies in larger samples and under ambulatory conditions are needed to confirm these novel findings.
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Affiliation(s)
- Peter A Kiernan
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Christina A Day
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Rachel S Berkowsky
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Simiao Gao
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Lucas P Santos
- Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-903, Brazil
| | | | - Melody Kramarz
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Kyle McCormick
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | | | - Ming-Hui Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
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Zaleski AL, Berkowsky R, Craig KJT, Pescatello LS. Comprehensiveness, Accuracy, and Readability of Exercise Recommendations Provided by an AI-Based Chatbot: Mixed Methods Study. JMIR Med Educ 2024; 10:e51308. [PMID: 38206661 PMCID: PMC10811574 DOI: 10.2196/51308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/05/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Regular physical activity is critical for health and disease prevention. Yet, health care providers and patients face barriers to implement evidence-based lifestyle recommendations. The potential to augment care with the increased availability of artificial intelligence (AI) technologies is limitless; however, the suitability of AI-generated exercise recommendations has yet to be explored. OBJECTIVE The purpose of this study was to assess the comprehensiveness, accuracy, and readability of individualized exercise recommendations generated by a novel AI chatbot. METHODS A coding scheme was developed to score AI-generated exercise recommendations across ten categories informed by gold-standard exercise recommendations, including (1) health condition-specific benefits of exercise, (2) exercise preparticipation health screening, (3) frequency, (4) intensity, (5) time, (6) type, (7) volume, (8) progression, (9) special considerations, and (10) references to the primary literature. The AI chatbot was prompted to provide individualized exercise recommendations for 26 clinical populations using an open-source application programming interface. Two independent reviewers coded AI-generated content for each category and calculated comprehensiveness (%) and factual accuracy (%) on a scale of 0%-100%. Readability was assessed using the Flesch-Kincaid formula. Qualitative analysis identified and categorized themes from AI-generated output. RESULTS AI-generated exercise recommendations were 41.2% (107/260) comprehensive and 90.7% (146/161) accurate, with the majority (8/15, 53%) of inaccuracy related to the need for exercise preparticipation medical clearance. Average readability level of AI-generated exercise recommendations was at the college level (mean 13.7, SD 1.7), with an average Flesch reading ease score of 31.1 (SD 7.7). Several recurring themes and observations of AI-generated output included concern for liability and safety, preference for aerobic exercise, and potential bias and direct discrimination against certain age-based populations and individuals with disabilities. CONCLUSIONS There were notable gaps in the comprehensiveness, accuracy, and readability of AI-generated exercise recommendations. Exercise and health care professionals should be aware of these limitations when using and endorsing AI-based technologies as a tool to support lifestyle change involving exercise.
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Affiliation(s)
- Amanda L Zaleski
- Clinical Evidence Development, Aetna Medical Affairs, CVS Health Corporation, Hartford, CT, United States
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT, United States
| | - Rachel Berkowsky
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
| | - Kelly Jean Thomas Craig
- Clinical Evidence Development, Aetna Medical Affairs, CVS Health Corporation, Hartford, CT, United States
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
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Chen S, Wu Y, Bushey EL, Pescatello LS. Evaluation of Exercise Mobile Applications for Adults with Cardiovascular Disease Risk Factors. J Cardiovasc Dev Dis 2023; 10:477. [PMID: 38132645 PMCID: PMC10743387 DOI: 10.3390/jcdd10120477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 11/27/2023] [Indexed: 12/23/2023] Open
Abstract
OBJECTIVE To conduct a systematic review to determine if there are exercise mobile applications (apps) that can produce evidence-based, individualized exercise plans. MATERIALS AND METHODS We searched the Apple Store and Google Play for exercise apps with terms related to exercise and health. Exercise apps were eligible if they: (1) had a ≥4 out of 5 overall rating with ≥1000 reviews; (2) were free to download; and (3) were not gender specific. Exercise apps were evaluated via the evidence-based exercise prescription (ExRx) standards of the American College of Sports Medicine (ACSM) and American Heart Association. For the exercise app evaluation criteria, an app was included if it (1) was evidence-based; (2) contained a preparticipation health screening protocol; (3) built a cardiovascular disease (CVD) risk factor profile; (4) prioritized one chronic disease or health condition to focus on; (5) framed the exercise plan by the frequency, intensity, time, and type principle (FITT) of ExRx; and (6) specified special considerations. RESULTS Of the 531 potentially qualifying apps, 219 qualified. The qualifying apps were rarely evidenced-based (0.5%) or had a preparticipation screening protocol (3.7%). Only 27.7% built CVD risk factor profiles. Most apps (64.8%) focused on body image and/or athletic performance. Only 4.3% focused on chronic diseases or health conditions, while the remainder (34.5%) did not disclose a focus. No app framed the exercise plans by the FITT of ExRx. Only 1.4% of the apps specified special considerations. CONCLUSION There are no commercially available exercise apps that generate an evidence-based, individualized exercise plan for adults with CVD risk factors.
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Affiliation(s)
- Shiqi Chen
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
- Department of Research, Hartford Hospital, Hartford, CT 06102, USA
| | - Erica L. Bushey
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; (Y.W.); (E.L.B.); (L.S.P.)
- Institute for Collaboration on Health Intervention and Policy, University of Connecticut, Storrs, CT 06269, USA
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Contillo AT, Rodriguez NR, Pescatello LS. Exercise and Protein Supplementation Recommendations for Older Adults With Sarcopenic Obesity: A Meta-Review. J Aging Phys Act 2023; 31:878-886. [PMID: 37105550 DOI: 10.1123/japa.2022-0245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 12/23/2022] [Accepted: 02/08/2023] [Indexed: 04/29/2023]
Abstract
This systematic meta-review evaluated the effects of exercise with and without protein interventions on muscle strength and function in older adults with sarcopenic obesity. PubMed, Cochrane Database of Systematic Reviews, Cumulative Index to Nursing and Allied Health Literature, Scopus, and SPORTDiscus databases were searched through February 2021 for relevant systematic reviews and meta-analyses with aerobic, resistance, and/or combined training interventions with and without protein supplementation in older adults ≥ 65 years with sarcopenic obesity. This meta-review showed that exercise with and without protein supplementation improved body composition (i.e., decreased percentage body fat) and functional outcomes (i.e., gait speed and grip strength). Because the current literature is limited, determining the effects of exercise and combined protein supplementation in this population requires further investigation. In the meantime, protein recommendations should align with general sarcopenia recommendations. Based upon available findings, tentative exercise recommendations to optimize health outcomes in this population are proposed.
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Affiliation(s)
- Allison T Contillo
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT,USA
| | - Nancy R Rodriguez
- Department of Nutritional Sciences, University of Connecticut, Storrs, CT,USA
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Lefferts EC, Saavedra JM, Song BK, Brellenthin AG, Pescatello LS, Lee DC. Increasing Lifestyle Walking by 3000 Steps per Day Reduces Blood Pressure in Sedentary Older Adults with Hypertension: Results from an e-Health Pilot Study. J Cardiovasc Dev Dis 2023; 10:317. [PMID: 37623330 PMCID: PMC10455876 DOI: 10.3390/jcdd10080317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 07/19/2023] [Accepted: 07/25/2023] [Indexed: 08/26/2023] Open
Abstract
Increasing daily steps by an additional 3000 steps/day on 5 days/week equates to ~150 min/week of aerobic physical activity to meet the physical activity guidelines; however, its effectiveness for blood pressure control in older adults with hypertension is unknown. A 20-week, single-arm, pilot e-health lifestyle walking intervention was conducted in 21 sedentary older adults (73 ± 5 years old) with hypertension (13 female, 8 male) to investigate the effectiveness of increasing daily steps by an additional 3000 steps/day for blood pressure control. The intervention consisted of two phases, with behavior change assistance provided during the first active phase (weeks 1-10) to help reach step goals and minimal assistance provided during the second self-maintenance phase (weeks 11-20). Nineteen participants (91%) completed both the 10- and 20-week assessments. The participants wore the pedometer for ≥10 h on 97% of the days over 20 weeks. They significantly increased average steps/day from 3899 ± 2198 at baseline to 6512 ± 2633 at 10 weeks and 5567 ± 2587 at 20 weeks. After 20 weeks, both systolic (137 ± 10 to 130 ± 11 mm Hg, p < 0.001) and diastolic (81 ± 6 to 77 ± 6 mm Hg, p = 0.01) blood pressure improved. The response was consistent in participants with (n = 8) and without (n = 13) anti-hypertensive medication. The results of our lifestyle walking intervention are encouraging for reducing blood pressure in older adults with hypertension; however, larger randomized, controlled trials need to be performed to confirm these findings.
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Affiliation(s)
- Elizabeth C. Lefferts
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Joseph M. Saavedra
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Bong Kil Song
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | - Angelique G. Brellenthin
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
| | | | - Duck-chul Lee
- Department of Kinesiology, Iowa State University, Ames, IA 50011, USA; (E.C.L.); (J.M.S.); (A.G.B.)
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Monteiro ER, Vingren JL, Pescatello LS, Corrêa Neto VG, Brown AF, Kingsley JD, Silva JG, Vianna JM, Novaes JDS. Effects of foam rolling and strength training on post exercise hypotension in normotensive women: A cross-over study. J Bodyw Mov Ther 2023; 34:81-86. [PMID: 37301562 DOI: 10.1016/j.jbmt.2023.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/17/2022] [Accepted: 04/11/2023] [Indexed: 06/12/2023]
Abstract
Foam rolling (FR) has recently become very popular among athletes and recreational exercisers and is often used during warm up prior to strength training (ST) to induce self-myofascial release. The purpose was to examine the acute effects of ST and FR performed in isolation or in combination on blood pressure (BP) responses during recovery in normotensive women. Sixteen normotensive and strength trained women completed four interventions: 1) rest control (CON), 2) ST only, 3) FR only, and 4) ST immediately followed by FR (ST + FR). ST consisted of three sets of bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. FR was applied unilaterally in two sets of 120 s to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic (DBP) BP were measured before (rest) and every 10 min, for 60 min, following (Post 10-60) each intervention. Cohen's d effect sizes were calculated to indicate the magnitude effect by the formula d = Md/Sd, where Md is the mean difference and Sd is the standard deviation of differences. Cohen's d effect-sizes were defined as small (≥0.2), medium (≥0.5), and large (≥0.8). There were significant reductions in SBP for ST at Post-50 (p < 0.001; d = -2.14) and Post-60 (p < 0.001; d = -4.43), for FR at Post-60 (p = 0.020; d = -2.14), and for ST + FR at Post-50 (p = 0.001; d = -2.03) and Post-60 (p < 0.001; d = -2.38). No change in DBP was observed. The current findings suggest that ST and FR performed in isolation can acutely reduce SBP but without an additive effect. Thus, ST and FR can both be used to acutely reduce SBP and, importantly, FR can be added to a ST regimen without furthering the SBP reduction during recovery.
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Affiliation(s)
- Estêvão Rios Monteiro
- Postgraduate Program in Physical Education, Universidade Federal do Rio De Janeiro (UFRJ), Rio de Janeiro, Brazil; Postgraduate Program in Rehabilitation Sciences, Centro Universitário Augusto Motta (UNISUAM), Rio de Janeiro, Brazil; Undergraduate Program in Physical Education, Centro Universitário IBMR, Rio de Janeiro, Brazil.
| | - Jakob L Vingren
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, Texas, United States.
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States.
| | - Victor Gonçalves Corrêa Neto
- Undergraduate Program in Physical Education, Estácio de Sá University (UNESA), Rio de Janeiro, Brazil; Undergraduate Program in Physical Education, Gama e Souza University Center (UNIGAMA), Rio de Janeiro, Brazil.
| | - Amanda Fernandes Brown
- Federal Institute of Minas Gerais Southeast, Barbacena, Minas Gerais, Brazil; Postgraduate Program in Medicine, Federal University of Rio de Janeiro (UFRJ), Rio de Janeiro, Brazil.
| | - J Derek Kingsley
- Cardiovascular Dynamics Laboratory, Kent State University, Kent, OH, USA.
| | - Julio Guilherme Silva
- Postgraduate Program in Physical Education, Universidade Federal do Rio De Janeiro (UFRJ), Rio de Janeiro, Brazil.
| | - Jeferson Macedo Vianna
- Postgraduate Program in Physical Education, College of Physical Education and Sports, Federal University of Juiz de Fora, Minas Gerais, Brazil.
| | - Jefferson da Silva Novaes
- Postgraduate Program in Physical Education, Universidade Federal do Rio De Janeiro (UFRJ), Rio de Janeiro, Brazil.
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Cilhoroz BT, Zaleski A, Taylor B, Fernandez AB, Santos LP, Vonk T, Thompson PD, Pescatello LS. The Relationship between Postexercise Hypotension and Heart Rate Variability before and after Exercise Training. J Cardiovasc Dev Dis 2023; 10:jcdd10020064. [PMID: 36826560 PMCID: PMC9958830 DOI: 10.3390/jcdd10020064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/16/2023] [Accepted: 01/22/2023] [Indexed: 02/05/2023] Open
Abstract
Because data are scarce, we examined the relationship between postexercise hypotension (PEH) and heart rate variability (HRV) before and after aerobic exercise training among adults with hypertension. Participants completed a 12 w aerobic training program. Before and after training, they performed a peak graded exercise stress test (GEST) and nonexercise control (CONTROL) and were left attached to an ambulatory BP monitor. Prior to CONTROL, HRV was measured supine for 5 min using a 12-lead electrocardiogram (ECG). The participants (n = 18) were middle-aged (52.1 ± 11.7 y) and 50% men with hypertension (131.7 ± 9.8/85.9 ± 8.5 mmHg) and obesity (30.0 ± 3.7 kg·m-2). Before training, ambulatory systolic BP (ASBP) and diastolic ABP (ADBP) decreased by 3.2 ± 2.1 mmHg and 2.5 ± 1.5 mmHg, respectively, from baseline after the GEST versus CONTROL (p < 0.05). After training, ASBP tended to decrease by 3.5 ± 2.2 mmHg (p = 0.055) and ADBP decreased by 1.7 ± 2.5 mmHg (p = 0.001) from baseline after the GEST versus CONTROL. Before training, HRV high frequency (HFms2) (β = -0.441), age (β = 0.568), and resting SBP (β = 0.504) accounted for 66.8% of the ASBP response (p = 0.001), whereas the low frequency (LF)/HF ratio (β = 0.516) and resting DBP (β = 0.277) accounted for 35.7% of the ADBP response (p = 0.037). After training, the standard deviation of NN intervals (SDNN) (β = -0.556), age (β = 0.506), and resting SBP (β = 0.259) accounted for 60.7% of the ASBP response (p = 0.004), whereas SDNN (β = -0.236) and resting DBP (β = 0.785) accounted for 58.5% of the ADBP response (p = 0.001). Our preliminary findings show that adults with hypertension and parasympathetic suppression (i.e., lower SDNN and HFms2 and higher LF/HF) may elicit PEH to the greatest degree independent of training status versus adults with parasympathetic predominance, suggesting that resting HRV may be an important determinant of PEH.
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Affiliation(s)
- Burak T. Cilhoroz
- Department of Exercise Science, Falk College of Sports and Human Dynamics, Syracuse University, Syracuse, NY 13244, USA
- Correspondence: ; Tel.: +1-516-725-6889; Fax: +1-315-443-2562
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06106, USA
| | - Beth Taylor
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | | | - Lucas P. Santos
- Exercise Pathophysiology Laboratory, Clinical Research Center, Hospital de Clínicas de Porto Alegre, Porto Alegre 90035-003, Brazil
| | - Thijs Vonk
- Department of Physiology, Radboud University Medical Center, 6500 HB Nijmegen, The Netherlands
| | - Paul D. Thompson
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT 06106, USA
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Bond DS, Manuel KM, Wu Y, Livingston J, Papasavas PK, Baillot A, Pescatello LS. Exercise for counteracting weight recurrence after bariatric surgery: a systematic review and meta-analysis of randomized controlled trials. Surg Obes Relat Dis 2022; 19:641-650. [PMID: 36624025 DOI: 10.1016/j.soard.2022.12.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 11/14/2022] [Accepted: 12/10/2022] [Indexed: 12/23/2022]
Abstract
Exercise is recommended to prevent post-surgical weight recurrence. Yet, whether exercise interventions are efficacious in this regard has not been systematically evaluated. Moreover, clinicians lack evidence-based information to advise patients on appropriate exercise frequency, intensity, time, and type (FITT) for preventing weight recurrence. Thus, we conducted a meta-analysis of randomized controlled trials (RCTs) involving exercise interventions specifying FITT and weight measurement ≥12 months post-surgery. We reviewed scientific databases up through February 2022 for RCTs comparing exercise interventions reporting FITT and a nonexercise control group on weight ≥12 months post-surgery. Procedures following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses were registered at the international prospective register of systematic reviews (PROSPERO: CRD42022342337). Of 1368 studies reviewed, 5 met inclusion criteria (n = 189; 47.8 ± 4.2 yr, 36.1 6 ± 3.8 kg·m2, 83.2 ± 9.5% female; 61.7% underwent Roux-en-Y gastric bypass). Exercise interventions were largely supervised, lasted 12-26 weeks, and prescribed 80-210 minutes/week of moderate-to-vigorous intensity combined aerobic and resistance exercise over ≤5 days. Within-group effects showed non-statistically significant weight loss for exercise (d = - .15, 95% confidence interval [CI]: -1.96, 1.65; -1.4 kg; P = .87) and weight gain for control (d = .11, 95% CI: -1.70,1.92; +1.0 kg; P = .90), with no difference between these groups (d = -2.26, 95% CI: -2.07, 1.55; -2.4 kg; P = .78). Exercise elicited an additional 2.4 kg weight loss versus control, although this effect was small and statistically non-significant. Ability to draw definitive conclusions regarding efficacy of exercise interventions for counteracting post-surgical weight recurrence was limited by the small number of trials and methodological issues. Findings highlight the need for more rigorous RCTs of exercise interventions specifically designed to reduce post-surgical weight recurrence.
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Affiliation(s)
- Dale S Bond
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, Connecticut; Department of Research, Hartford Hospital/HealthCare, Hartford, Connecticut.
| | - Katherine M Manuel
- Department of Nutritional Sciences, Howard University, Washington, District of Columbia
| | - Yin Wu
- Department of Research, Hartford Hospital/HealthCare, Hartford, Connecticut; Department of Kinesiology, University of Connecticut, Storrs, Connecticut; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut
| | - Jill Livingston
- Wesleyan Library, Wesleyan University, Middletown, Connecticut
| | - Pavlos K Papasavas
- Department of Surgery, Hartford Hospital/HealthCare, Hartford, Connecticut
| | - Aurélie Baillot
- Department of Nursing, University of Québec en Outaouais, Gatineau, Quebec, Canada; Institut du Savoir Montfort-Recherche, Ottawa, Ontario, Canada
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut
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Lee SY, Park CL, Cilhoroz BT, Pescatello LS. PTSD symptom clusters and cardiovascular responses to stress: Reactivity and recovery. J Psychosom Res 2022; 161:110996. [PMID: 35933739 PMCID: PMC9588198 DOI: 10.1016/j.jpsychores.2022.110996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/29/2022] [Accepted: 07/23/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Posttraumatic stress disorder (PTSD) symptoms are associated with high blood pressure (BP) and decreased heart rate variability (HRV) at rest and in response to acute stress. Unique contributions of PTSD symptom clusters to cardiovascular responses to stress are rarely investigated. This study tested whether PTSD-related arousal/reactivity drives relationships of higher PTSD symptoms with higher BP and lower HRV during rest, reactivity (stressor-induced change from baseline), and recovery. METHODS Using a cross-sectional observational design, we enrolled 84 trauma-exposed community adults (83% female; 68% White; Mage = 35) who endorsed at least one core PTSD symptom. Participants completed a physical exam, self-reports of trauma history and PTSD symptoms, and BP and HRV frequency domain measurements during rest, stressor (mental arithmetic task), and recovery. RESULTS Arousal/reactivity was not associated with BP or HRV reactivity but associated with a higher low (LF) to high (HF) frequency (HF) ratio (LF/HF) during recovery reflecting sympathetic predominance. During the stressor, more avoidance and intrusion were associated with increased diastolic blood pressure (DBP) from baseline; more avoidance was associated with parasympathetic predominance (lower LF/HF); and more negative cognitions/mood was associated with decreased systolic blood pressure (SBP), DBP, and LF from baseline. During recovery, more intrusion and negative cognitions/mood were associated with increased SBP from baseline; less negative cognitions/mood was associated with sympathetic predominance (higher LF/HF). CONCLUSIONS PTSD symptom clusters demonstrated differential relationships with SBP, DBP, and HRV during reactivity and recovery. Findings may inform targeted PTSD symptom reduction interventions for disrupting links between PTSD and CVD risk.
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Affiliation(s)
- Sharon Y Lee
- Brown University, Warren Alpert Medical School, Department of Psychiatry and Human Behavior, USA.
| | - Crystal L Park
- University of Connecticut, Department of Psychological Sciences, USA.
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Day C, Berkowsky RS, Zaleski AL, Chen MH, Taylor BA, Parducci PM, Wu Y, Fernhall B, Thompson PD, Fernandez AB, Pescatello LS. THE INFLUENCE OF SUDDEN VIGOROUS PHYSICAL EXERTION ON CARDIAC DEMAND UNDER AMBULATORY CONDITIONS AMONG FIREFIGHTERS. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880696.68519.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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14
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Kiernan PA, Day CA, Berkowsky RS, Zaleski AL, Taylor BA, Santos LP, Panza G, Kramarz M, McCormick K, Thompson PD, Fernandez AB, Chen MH, Pescatello LS. The Reproducibility Of Postexercise Hypotension Over A 12-week Exercise Training Program Among Adults With Hypertension. Med Sci Sports Exerc 2022. [DOI: 10.1249/01.mss.0000880672.02200.81] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Abstract
ABSTRACT Hypertension is the leading risk factor for cardiovascular disease and an independent predictor of mortality. The prevalence of hypertension has doubled in the last two decades and evidence suggests that almost half the individuals are unaware of their condition. The antihypertensive effects of exercise are now undisputable, and exercise training is recommended by the major professional and scientific societies, including the American College of Sports Medicine (ACSM), as first-line treatment to prevent, treat, and control hypertension. This review aims to overview the evidence supporting the current ACSM Frequency, Intensity, Time, and Type exercise recommendations for hypertension, discuss new and emerging evidence on exercise in the treatment of hypertension from our laboratories; and propose future directions of research integrating this new and emerging evidence.
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Affiliation(s)
- Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University of Maia, Maia, Porto, PORTUGAL
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Susana Lopes
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
| | - Fernando Ribeiro
- Institute of Biomedicine, (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Porto, PORTUGAL
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Pinto D, Rato ND, Garcia C, Teixeira M, Marques MJ, Amaral T, Amaral L, Ruivo P, Abreu R, Oliveira AP, Carneiro C, Figueiredo D, Polónia J, Mesquita-Bastos J, Viana JL, Pescatello LS, Ribeiro F, Alves AJ. EFFECTS OF HOME-BASED ISOMETRIC HANDGRIP OR AEROBIC EXERCISE TRAINING IN OLDER ADULTS WITH PRE-HYPERTENSION AND HYPERTENSION. J Hypertens 2022. [DOI: 10.1097/01.hjh.0000838220.85703.0f] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Farinatti P, Pescatello LS, Crisafulli A, Taiar R, Fernandez AB. Editorial: Post-Exercise Hypotension: Clinical Applications and Potential Mechanisms. Front Physiol 2022; 13:899497. [PMID: 35492589 PMCID: PMC9039323 DOI: 10.3389/fphys.2022.899497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 03/29/2022] [Indexed: 12/02/2022] Open
Affiliation(s)
- Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
- *Correspondence: Paulo Farinatti,
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Mansfield, CT, United States
| | - Antonio Crisafulli
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - Redha Taiar
- Department of Sport Science, Reims University, Reims, France
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Monteiro ER, Pescatello LS, Winchester JB, Corrêa Neto VG, Brown AF, Budde H, Marchetti PH, Silva JG, Vianna JM, Novaes JDS. Effects of Manual Therapies and Resistance Exercise on Postexercise Hypotension in Women With Normal Blood Pressure. J Strength Cond Res 2022; 36:948-954. [PMID: 34533487 DOI: 10.1519/jsc.0000000000004137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Monteiro, ER, Pescatello, LS, Winchester, JB, Corrêa Neto, VG, Brown, AF, Budde, H, Marchetti, PH, Silva, JG, Vianna, JM, and Novaes, JdS. Effects of manual therapies and resistance exercise on postexercise hypotension in women with normal blood pressure. J Strength Cond Res 36(4): 948-954, 2022-The purpose of this investigation was to examine the acute effects of resistance exercise (RE) and different manual therapies (static stretching and manual massage [MM]) performed separately or combined on blood pressure (BP) responses during recovery in women with normal BP. Sixteen recreationally strength-trained women (age: 25.1 ± 2.9 years; height: 158.9 ± 4.1 cm; body mass: 59.5 ± 4.9 kg; body mass index: 23.5 ± 1.9 kg·m-2; baseline systolic BP median: 128 mm Hg; and baseline diastolic BP median: 78 mm Hg) were recruited. All subjects performed 6 experiments in a randomized order: (a) rest control (CON), (b) RE only (RE), (c) static-stretching exercise only (SS), (d) MM only, (e) RE immediately followed by SS (RE + SS), and (f) RE immediately followed by MM (RE + MM). RE consisted of 3 sets of bilateral bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. Static stretching and MM were applied unilaterally in 2 sets of 120 seconds to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic BP were measured before (rest) and every 10 minutes for 60 minutes following (Post 10-60) each intervention. There were significant intragroup differences for RE in Post-50 (p = 0.038; d = -2.24; ∆ = -4.0 mm Hg). Similarly, SBP intragroup differences were found for the SS protocol in Post-50 (p = 0.021; d = -2.67; ∆ = -5.0 mm Hg) and Post-60 (p = 0.008; d = -2.88; ∆ = -5.0 mm Hg). Still, SBP intragroup differences were found for the MM protocol in Post-50 (p = 0.011; d = -2.61; ∆ = -4.0 mm Hg) and Post-60 (p = 0.011; d = -2.74; ∆ = -4.0 mm Hg). Finally, a single SBP intragroup difference was found for the RE + SS protocol in Post-60 (p = 0.024; d = -3.12; ∆ = -5.0 mm Hg). Practitioners should be aware that SS and MM have the potential to influence BP responses in addition to RE or by themselves and therefore should be taken into consideration for persons who are hypertensive or hypotensive.
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Affiliation(s)
- Estêvão R Monteiro
- Postgraduate Program in Physical Education, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
- Undergraduate Program in Physical Education, Augusto Motta University Center, Rio de Janeiro, Brazil
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut
| | - Jason B Winchester
- Division of Health Science and Human Performance, Concordia University Chicago, River Forest, Illinois
| | - Victor G Corrêa Neto
- Estacio de Sa University, Rio de Janeiro, Brazil
- Gama e Souza University Center, Rio de Janeiro, Brazil
| | - Amanda F Brown
- Department of Physical Education, Federal Institute of Education, Science and Technology of Southeast of Minas Gerais-Campus Barbacena, Barbacena, Minas Gerais, Brazil
- Postgraduate Program in Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Henning Budde
- Faculty of Human Sciences, MSH Medical School Hamburg, Germany
| | - Paulo H Marchetti
- Department of Kinesiology, California State University, Northridge, California; and
| | - Julio G Silva
- Postgraduate Program in Physical Education, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Jeferson M Vianna
- Postgraduate Program in Physical Education, College of Physical Education and Sports, Federal University of Juiz de Fora, Minas Gerais, Brazil
| | - Jefferson da Silva Novaes
- Postgraduate Program in Physical Education, School of Physical Education and Sports, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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Day C, Wu Y, Pescatello LS. Evaluating the Methodological Quality of Postexercise Hypotension Aerobic Exercise Interventions. Front Physiol 2022; 13:851950. [PMID: 35360233 PMCID: PMC8960741 DOI: 10.3389/fphys.2022.851950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundPostexercise hypotension (PEH) is the immediate reduction in blood pressure (BP) of 5–8 mmHg that occurs after a single bout of aerobic exercise among adults with hypertension. Across PEH studies, there are variations in the level of rigor of the study designs and methods that limit the conclusions that can be made about PEH.ObjectiveTo develop and then apply a methodological study quality evaluation checklist to aerobic exercise PEH studies to provide methodological guidance.MethodsWe developed a PEH checklist (PEH√list) based upon contemporary methodological study quality standards. The PEH√list contains 38 items divided into three categories: sample (n = 10 items), study (n = 23 items), and intervention characteristics (n = 5 items). We then systematically searched six databases to January 2019 to identify and then evaluate studies that: (1) enrolled adults ≥18 years with hypertension and without other chronic diseases or conditions; (2) included a bout of aerobic exercise and a non-exercise control session; and (3) were published in English.ResultsOf 17,149 potential studies, 64 qualified. Participants (N = 1,489) were middle-aged (38.6 ± 15.6 year), overweight (26.1 ± 2.5 kg/m2) mostly men (64.4%) with elevated BP (systolic BP 129.5 ± 15.2/diastolic BP 81.0 ± 10.1 mmHg). Overall, the qualifying studies satisfactorily reported 53.9 ± 13.3% (24.2–82.8%) of the relevant items on the PEH√list. Of note, only 20.3% of the studies disclosed BP was measured following professional guidelines, 18.8% reported BP was taken by the same assessor pre- and post-intervention, and 35.5% stated participants abstained from caffeine, alcohol, and physical activity prior to testing. Half (51.5%) indicated they statistically controlled for pre-exercise/baseline BP. Meanwhile, 100% of the studies reported the setting in which the BP measurements were taken, time from the end of the exercise to the start of the BP measurements, and if relevant, the length of the ambulatory BP monitoring period.ConclusionOverall, the PEH√list items were not well satisfied; especially items with potential confounding effects on PEH. We contend the PEH√list provides guidance to investigators on the important methodological study considerations in PEH aerobic exercise studies that should be attended to in the future.Systematic Review Registration[https://www.crd.york.ac.uk/PROSPERO/], identifier [#CRD42020221996].
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Affiliation(s)
- Christina Day
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- *Correspondence: Christina Day,
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT, United States
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT, United States
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Affiliation(s)
- Fernando Ribeiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Linda S Pescatello
- College of Agriculture, Health and Natural Resources, Department of Kinesiology, University of Connecticut, Storrs
| | - Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia, Maia, Portugal
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21
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Pinto D, Dias N, Garcia C, Teixeira M, Marques EA, Marques MJ, Amaral T, Amaral L, Ruivo P, Abreu R, Carneiro C, Oliveira AP, Figueiredo D, Polónia J, Mesquita-Bastos J, Viana JL, Pescatello LS, Ribeiro F, Alves AJ. EFFECTS OF HOME-BASED ISOMETRIC HANDGRIP TRAINING OR AEROBIC TRAINING ON OFFICE BLOOD PRESSURE AMONG OLDER ADULTS WITH HIGH NORMAL BP TO ESTABLISHED HYPERTENSION -PRELIMINARY RESULTS OF THE HOLDAGE TRIAL. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)02560-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Piralaiy E, Siahkuhian M, Nikookheslat SD, Pescatello LS, Sheikhalizadeh M, Khani M. Cardiac Autonomic Modulation in Response to Three Types of Exercise in Patients with Type 2 Diabetic Neuropathy. J Diabetes Metab Disord 2021; 20:1469-1478. [PMID: 34900798 DOI: 10.1007/s40200-021-00889-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 08/20/2021] [Indexed: 11/28/2022]
Abstract
Purpose Physical exercise is necessary in the handling DM, but it is not distinct which kind of physical exercise can improve cardiac autonomic modulation in T2DM. The purpose of this study was to compare the effects of three different modalities of exercise (aerobic, resistant, and combined) on cardiac autonomic modulation as measured by HRV in patients with type 2 diabetic neuropathy. Methods The participants were 45 men (age: 55.24 ± 8.11 years, weight: 89.5 ± 13.4 kg, height: 171.85 ± 6.98 cm, duration of diabetes: 12.51 ± 6.46 years) with type 2 diabetic neuropathy who were clinically free from signs and symptoms of cardiovascular disease. Participants were randomly assigned to one of four groups: aerobic-training (n = 11), dynamic resistant-training (n = 11), Combined-training (n = 11), or a non-exercise control group (n = 12). The exercise groups performed aerobic and resistant exercise for 25-45 min per day, 3-5 times per week for 12 weeks. Anthropometrics, biochemical markers (FBS, HbA1c, Lipid Profile, and Insulin), and heart rate variability in the exercise laboratory and under ambulatory conditions by 3-channel ECG digital Holter recorder were examined. Results All time and frequency-domain HRV parameters (except LF power) were significantly improved in the exercise groups, compared with the control group (p < 0.05). SDNN, rMSSD, and HF power were boosted, LF power was not different, and the LF/HF ratio decreased after versus before exercise training, independent of exercise modality. HbA1c in aerobic and resistant-training groups, and insulin and LDL in the resistant-training group were decreased after exercise training (p < 0.05). Conclusions Exercise training, independent of modality, in patients with type 2 diabetic neuropathy who were clinically free of the cardiovascular disease cause to significant progress in cardiovascular autonomic function assessed by HRV via enhancing cardio-vagal and reducing cardio-sympathetic tone.
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Affiliation(s)
- Elaheh Piralaiy
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 29 Bahman Blvd, 5166616471 Tabriz, Iran
| | - Marefat Siahkuhian
- Department of Physical Education and Sport Sciences, Faculty of Education and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Saeed Dabbagh Nikookheslat
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 29 Bahman Blvd, 5166616471 Tabriz, Iran
| | | | - Mahboub Sheikhalizadeh
- Department of Physical Education and Sport Sciences, Ahar Branch, Islamic Azad University, Ahar, Iran
| | - Mostafa Khani
- Department of Exercise Physiology, Faculty of Physical Education and Sport Sciences, University of Tabriz, 29 Bahman Blvd, 5166616471 Tabriz, Iran
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Rudin LR, Dunn L, Lyons K, Livingston J, Waring ME, Pescatello LS. Professional Exercise Recommendations for Healthy Women Who Are Pregnant: A Systematic Review. Womens Health Rep (New Rochelle) 2021; 2:400-412. [PMID: 34671761 PMCID: PMC8524738 DOI: 10.1089/whr.2021.0077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 06/13/2023]
Abstract
Background: Exercise in pregnancy favorably affects maternal and fetal outcomes, yet only 50% of women receive exercise guidance during prenatal care and 15% are told to stop exercising. Reasons for clinician reluctance to recommend exercise include safety concerns and ambiguity of recommendations. To better inform clinicians, this systematic review assembled a consensus exercise prescription (ExRx) for healthy pregnant women framed by the Frequency, Intensity, Time, and Type (FITT) principle. Methods: In April 2021, PubMed, Scopus, SPORTDiscus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), and Cochrane databases were searched. Reports were eligible if: (1) targeted healthy pregnant women, (2) framed the ExRx by the FITT, and (3) published by a professional society from 2000 to 2021 in English. The Appraisal of Guidelines for Research and Evaluation II tool assessed risk of bias. Results: Twelve reports of poor to good quality were included. Nine societies conducted systematic reviews, but only three provided a detailed, transparent description of the review conducted. Although the FITT varied, the most common was most days of the week, moderate intensity, 30 minutes/session to accumulate 150 minutes/week, and aerobic, resistance, and flexibility exercise with three societies advising neuromotor exercise. All professional societies specified activities to avoid and eight societies included contraindications to exercise. Conclusions: This systematic review produced a consensus ExRx for healthy pregnant women to better inform clinicians about advising their patients to exercise during pregnancy. Future research is needed to determine the upper limits of exercise while pregnant and provide better informed guidance relating to safety concerns for women who are pregnant.
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Affiliation(s)
- Lauren R. Rudin
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Leslie Dunn
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
| | - Kaitlyn Lyons
- Central Connecticut State University, New Britain, Connecticut, USA
| | - Jill Livingston
- Wesleyan Library, Wesleyan University, Middletown, Connecticut, USA
| | - Molly E. Waring
- Department of Allied Health Sciences, University of Connecticut, Storrs, Connecticut, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
| | - Linda S. Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, Connecticut, USA
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, Connecticut, USA
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Lopes S, Mesquita-Bastos J, Garcia C, Bertoquini S, Ribau V, Teixeira M, Ribeiro IP, Melo JB, Oliveira J, Figueiredo D, Guimarães GV, Pescatello LS, Polonia J, Alves AJ, Ribeiro F. Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial. JAMA Cardiol 2021; 6:1317-1323. [PMID: 34347008 DOI: 10.1001/jamacardio.2021.2735] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Importance Limited evidence suggests exercise reduces blood pressure (BP) in individuals with resistant hypertension, a clinical population with low responsiveness to drug therapy. Objective To determine whether an aerobic exercise training intervention reduces ambulatory BP among patients with resistant hypertension. Design, Settings, and Participants The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial is a prospective, 2-center, single-blinded randomized clinical trial performed at 2 hospital centers in Portugal from March 2017 to December 2019. A total of 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years were prospectively enrolled and observed at the hospitals' hypertension outpatient clinic. Interventions Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group. The exercise group performed three 40-minute supervised sessions per week in addition to usual care. Main Outcomes and Measures The powered primary efficacy measure was 24-hour ambulatory systolic BP change from baseline. Secondary outcomes included daytime and nighttime ambulatory BP, office BP, and cardiorespiratory fitness. Results A total of 53 patients completed the study, including 26 in the exercise group and 27 in the control group. Of these, 24 (45%) were women, and the mean (SD) age was 60.1 (8.7) years. Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg (95% CI, -12.8 to -1.4; P = .02). Additionally, 24-hour ambulatory diastolic BP (-5.1 mm Hg; 95% CI, -7.9 to -2.3; P = .001), daytime systolic BP (-8.4 mm Hg; 95% CI, -14.3 to -2.5; P = .006), and daytime diastolic BP (-5.7 mm Hg; 95% CI, -9.0 to -2.4; P = .001) were reduced in the exercise group compared with the control group. Office systolic BP (-10.0 mm Hg; 95% CI, -17.6 to -2.5; P = .01) and cardiorespiratory fitness (5.05 mL/kg per minute of oxygen consumption; 95% CI, 3.5 to 6.6; P < .001) also improved in the exercise group compared with the control group. Conclusions and Relevance A 12-week aerobic exercise program reduced 24-hour and daytime ambulatory BP as well as office systolic BP in patients with resistant hypertension. These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a standard coadjutant therapy targeting this patient population. Trial Registration ClinicalTrials.gov Identifier: NCT03090529.
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Affiliation(s)
- Susana Lopes
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - José Mesquita-Bastos
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal.,Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Catarina Garcia
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia, Maia, Portugal
| | - Susana Bertoquini
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Verónica Ribau
- Cardiology Department, Hospital Infante D. Pedro, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal
| | - Manuel Teixeira
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | - Ilda P Ribeiro
- University of Coimbra, Cytogenetics and Genomics Laboratory, Institute of Cellular and Molecular Biology, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - Joana B Melo
- University of Coimbra, Cytogenetics and Genomics Laboratory, Institute of Cellular and Molecular Biology, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR) and Center of Investigation on Environment Genetics and Oncobiology (CIMAGO), Faculty of Medicine and Clinical Academic Center of Coimbra (CACC), Coimbra, Portugal
| | - José Oliveira
- Research Centre in Physical Activity, Health and Leisure (CIAFEL), Faculty of Sport, University of Porto, Porto, Portugal
| | - Daniela Figueiredo
- Center for Health Technology and Services Research (CINTESIS.UA), School of Health Sciences, University of Aveiro, Aveiro, Portugal
| | | | | | - Jorge Polonia
- Centre for Health Technology and Services Research (CINTESIS), Faculty of Medicine, University of Porto, Porto, Portugal.,Hypertension and Cardiovascular Risk Unit, Unidade Local de Saúde Matosinhos, Matosinhos, Portugal
| | - Alberto J Alves
- Research Center in Sports Sciences, Health and Human Development (CIDESD), University Institute of Maia, Maia, Portugal.,OncoMove, Associação de Investigação de Cuidados de Suporte em Oncologia (AICSO), Vila Nova de Gaia, Portugal
| | - Fernando Ribeiro
- Institute of Biomedicine (iBiMED), School of Health Sciences, University of Aveiro, Aveiro, Portugal
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Bufi R, Chen S, Wu Y, Wong KK, Livingston J, Pescatello LS. THE EFFECT OF EXERCISE ON PATIENTS WITH NON-ALCOHLIC FATTY LIVER DISEASE: A META-ANALYSIS. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764524.76776.2a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Berkowsky RS, Taylor BA, Zaleski AL, Parducci PM, Chen MH, Gans KM, Wu Y, Thompson PD, Fernandez AB, Pescatello LS. Firefighter Calcium Intake Influences The Blood Pressure Response To Strenuous Physical Exertion. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000762260.48695.76] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Morrissey MC, Wu Y, Zuk EF, Livingston J, Casa DJ, Pescatello LS. The impact of body fat on thermoregulation during exercise in the heat: A systematic review and meta-analysis. J Sci Med Sport 2021; 24:843-850. [DOI: 10.1016/j.jsams.2021.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 05/28/2021] [Accepted: 06/07/2021] [Indexed: 12/16/2022]
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Rudin LR, Dunn L, Lyons K, Livingston J, Waring ME, Pescatello LS. Professional Exercise Recommendations For Healthy Women Who Are Pregnant: A Systematic Review. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764516.46049.6e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Cilhoroz B, Zaleski A, Taylor B, Fernandez A, Santos L, Leister K, Thompson PD, Pescatello LS. THE RELATIONSHIP BETWEEN POST-EXERCISE HYPOTENSION AND HEART RATE VARIABILITY BEFORE AND AFTER TRAINING. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760124.24363.6a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Wu Y, Hennessy EA, Day CA, Korzenowski HJ, Livingston J, Johnson BT, Pescatello LS. THE IMMEDIATE BLOOD PRESSURE RESPONSE TO ACUTE AEROBIC EXERCISE: A META-ANALYSIS. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000760116.56568.06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Chen S, Wu Y, Zemaitaitis CI, Sudduth RM, Bushey EL, Berardo AL, Pescatello LS. Evaluation Of Mobile Exercise Prescription Applications For Adults With Cardiovascular Risk Factors. Med Sci Sports Exerc 2021. [DOI: 10.1249/01.mss.0000764560.51083.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Farinatti P, Polito MD, Massaferri R, Monteiro WD, Vasconcelos D, Johnson BT, Pescatello LS. Postexercise hypotension due to resistance exercise is not mediated by autonomic control: A systematic review and meta-analysis. Auton Neurosci 2021; 234:102825. [PMID: 34118764 DOI: 10.1016/j.autneu.2021.102825] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 01/29/2021] [Accepted: 05/20/2021] [Indexed: 10/21/2022]
Abstract
Changes in autonomic control have been suggested to mediate postexercise hypotension (PEH). We investigated through meta-analysis the after-effects of acute resistance exercise (RE) on blood pressure (BP) and autonomic activity in individuals with normal and elevated BP. Electronic databases were searched for trials including: adults; exclusive RE interventions; and BP and autonomic outcomes measured pre- and postintervention for at least 30 min. Analyses incorporated random-effects assumptions. Thirty trials yielded 62 interventions (N = 480). Subjects were young (33.6 ± 15.6 yr), with systolic BP (SBP)/diastolic BP (DBP) of 124.2 ± 8.9/71.5 ± 6.6 mm Hg. Overall, RE moderately reduced SBP (normal BP: ~1 to 4 mm Hg, p < 0.01; elevated BP: ~1 to 12 mm Hg, p < 0.01) and DBP (normal BP: ~1 to 4 mm Hg, p < 0.03; elevated BP: ~0.5 to 7 mm Hg, p < 0.01), which was in general parallel to sympathetic increase (normal BP: g = 0.49 to 0.51, p < 0.01; elevated BP: g = 0.41 to 0.63, p < 0.01) and parasympathetic decrease (normal BP: g = -0.52 to -0.53, p < 0.01; elevated BP: g = -0.46 to -0.71, p < 0.01). The meta-regression showed inverse associations between the effect sizes of BP vs. sympathetic (SBP: slope - 0.19 to -3.45, p < 0.01; DBP: slope - 0.30 to -1.60, p < 0.01), and direct associations vs. parasympathetic outcomes (SBP: slope 0.17 to 2.59, p < 0.01; DBP: slope 0.21 to 1.38, p < 0.01). In conclusion, changes in BP were concomitant to sympathetic increase and parasympathetic decrease, which questions the role of autonomic fluctuations as potential mechanisms of PEH after RE.
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Affiliation(s)
- Paulo Farinatti
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, RJ, Brazil; Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, RJ, Brazil.
| | - Marcos D Polito
- Department of Physical Education, Londrina State University, PR, Brazil
| | - Renato Massaferri
- Graduate Program in Operational Human Performance, AirForce University, RJ, Brazil
| | - Walace D Monteiro
- Laboratory of Physical Activity and Health Promotion, University of Rio de Janeiro State, RJ, Brazil; Graduate Program in Physical Activity Sciences, Salgado de Oliveira University, RJ, Brazil
| | - Denilson Vasconcelos
- School of Physical Education and Sports, Federal University of Rio de Janeiro, RJ, Brazil
| | - Blair T Johnson
- Department of Psychological Sciences, University of Connecticut, Storrs, CT, USA
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Wu Y, Johnson BT, Chen S, Chen Y, Livingston J, Pescatello LS. Tai Ji Quan as antihypertensive lifestyle therapy: A systematic review and meta-analysis. J Sport Health Sci 2021; 10:211-221. [PMID: 32360952 PMCID: PMC7987647 DOI: 10.1016/j.jshs.2020.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Revised: 12/20/2019] [Accepted: 01/13/2020] [Indexed: 05/17/2023]
Abstract
BACKGROUND Professional health organizations are not currently recommending Tai Ji Quan alongside aerobic exercise to treat hypertension. We aimed to examine the efficacy of Tai Ji Quan as antihypertensive lifestyle therapy. METHODS Tai Ji Quan interventions published in English and Chinese were included when they involved healthy adults, reported pre- and post-intervention blood pressure (BP), and had a non-exercise/non-diet control group. We systematically searched 11 electronic databases for studies published through July 31, 2018, yielding 31 qualifying controlled trials. We (1) evaluated the risk of bias and methodological study quality, (2) performed meta-regression analyses following random-effects assumptions, and (3) generated additive models representing the largest possible clinically relevant BP reductions. RESULTS Participants (n = 3223) were middle-aged (56.6 ± 15.1 years of age, mean ± SD) adults with prehypertension (systolic BP (SBP) = 136.9 ± 15.2 mmHg, diastolic BP (DBP) = 83.4 ± 8.7 mmHg). Tai Ji Quan was practiced 4.0 ± 1.4 sessions/week for 54.0 ± 10.6 min/session for 22.3 ± 20.2 weeks. Overall, Tai Ji Quan elicited significant reductions in SBP (-11.3 mmHg, 95%CI: -14.6 to -8.0; d+ = -0.75) and DBP (-4.8 mmHg, 95%CI: -6.4 to -3.1; d+ = -0.53) vs. control (p < 0.001). Controlling for publication bias among samples with hypertension, Tai Ji Quan trials published in English elicited SBP reductions of 10.4 mmHg and DBP reductions of 4.0 mmHg, which was half the magnitude of trials published in Chinese (SBP reductions of 18.6 mmHg and DBP reductions of 8.8 mmHg). CONCLUSION Our results indicate that Tai Ji Quan is a viable antihypertensive lifestyle therapy that produces clinically meaningful BP reductions (i.e., 10.4 mmHg and 4.0 mmHg of SBP and DBP reductions, respectively) among individuals with hypertension. Such magnitude of BP reductions can lower the incidence of cardiovascular disease by up to 40%.
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Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA.
| | - Blair T Johnson
- Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA; Department of Psychological Sciences, University of Connecticut, Storrs, CT 06269, USA
| | - Shiqi Chen
- Department of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA
| | - Yiyang Chen
- School of Kinesiology, Shanghai University of Sport, Shanghai 200438, China
| | - Jill Livingston
- Homer Babbidge Library, University of Connecticut, Storrs, CT 06269, USA
| | - Linda S Pescatello
- Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA; Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut, Storrs, CT 06269, USA
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Pescatello LS, Wu Y, Panza GA, Zaleski A, Guidry M. Development of a Novel Clinical Decision Support System for Exercise Prescription Among Patients With Multiple Cardiovascular Disease Risk Factors. Mayo Clin Proc Innov Qual Outcomes 2021; 5:193-203. [PMID: 33718793 PMCID: PMC7930885 DOI: 10.1016/j.mayocpiqo.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Cardiovascular disease (CVD) risk factors cluster in an individual. Exercise is universally recommended to prevent and treat CVD. Yet, clinicians lack guidance on how to design an exercise prescription (ExRx) for patients with multiple CVD risk factors. To address this unmet need, we developed a novel clinical decision support system to prescribe exercise (prioritize personalize prescribe exercise [P3-EX]) for patients with multiple CVD risk factors founded upon the evidenced-based recommendations of the American College of Sports Medicine (ACSM) and American Heart Association. To develop P3-EX, we integrated (1) the ACSM exercise preparticipation health screening recommendations; (2) an adapted American Heart Association Life's Simple 7 cardiovascular health scoring system; (3) adapted ACSM strategies for designing an ExRx for people with multiple CVD risk factors; and (4) the ACSM frequency, intensity, time, and time principle of ExRx. We have tested the clinical utility of P3-EX within a university-based online graduate program in ExRx among students that includes physicians, physical therapists, registered dietitians, exercise physiologists, kinesiologists, fitness industry professionals, and kinesiology educators in higher education. The support system P3-EX has proven to be an easy-to-use, guided, and time-efficient evidence-based approach to ExRx for patients with multiple CVD risk factors that has applicability to other chronic diseases and health conditions. Further evaluation is needed to better establish its feasibility, acceptability, and clinical utility as an ExRx tool.
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Key Words
- 1-RM, one repetition maximum
- ACSM, American College of Sports Medicine
- AHA, American Heart Association
- AHA7CVH, American Heart Association Life’s Simple 7 cardiovascular health scoring system
- BG, blood glucose
- BMI, body mass index
- BP, blood pressure
- CV, cardiovascular
- CVD, cardiovascular disease
- CVH, cardiovascular health
- DBP, diastolic blood pressure
- Ex Rx, exercise prescription
- FITT, frequency, intensity, time, and type
- HDL-C, high-density lipoprotein cholesterol
- HR, heart rate
- HRR, heart rate reserve
- HTN, hypertension
- LDL-C, low-density lipoprotein cholesterol
- P3-EX, prioritize personalize prescribe exercise clinical decision support system
- PNF, proprioceptive neuromuscular facilitation
- RPE, rating of perceived exertion
- SBP, systolic blood pressure
- SOB, shortness of breath
- T1DM, type 1 diabetes mellitus
- T2DM, type 2 diabetes mellitus
- TC, total cholesterol
- VO2R, oxygen uptake reserve
- WC, waist circumference
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Affiliation(s)
| | - Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Gregory A. Panza
- Department of Kinesiology, University of Connecticut, Storrs, CT
| | - Amanda Zaleski
- Department of Kinesiology, University of Connecticut, Storrs, CT
- Department of Preventive Cardiology, Hartford Hospital, Hartford, CT
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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] [What about the content of this article? (0)] [Affiliation(s)] [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.
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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
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Cordeiro R, Mira PA, Monteiro W, Cunha F, Laterza MC, Pescatello LS, Martinez DG, Farinatti P. Hemodynamics and cardiac autonomic modulation after an acute concurrent exercise circuit in older individuals with pre- to established hypertension. Clinics (Sao Paulo) 2021; 76:e1971. [PMID: 33503175 PMCID: PMC7798120 DOI: 10.6061/clinics/2021/e1971] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 11/12/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Few studies have investigated whether post-exercise hypotension (PEH) after concurrent exercise (CEX) is related to changes in cardiac output (Q) and systemic vascular resistance (SVR) in older individuals. We tested whether PEH after a single bout of CEX circuits performed in open-access facilities at the Third Age Academies (TAA) in Rio de Janeiro City (Brazil) would be concomitant with decreased Q and SVR in individuals aged ≥60 years with prehypertension. Moreover, we assessed autonomic modulation as a potential mechanism underlying PEH. METHODS Fourteen individuals (age, 65.8±0.9 y; systolic/diastolic blood pressure [SBP/DBP], 132.4±12.1/72.8±10.8 mmHg; with half of the patients taking antihypertensive medications) had their blood pressure (BP), heart rate (HR), Q, SVR, HR variability (HRV), and spontaneous baroreflex sensitivity (BRS) recorded before and 50 min after CEX (40-min circuit, including seven stations of alternate aerobic/resistance exercises at 60-70% HR reserve) and non-exercise control (CONT) sessions. The study protocol was registered in a World Health Organization-accredited office (Trial registration RBR-7BWVPJ). RESULTS SBP (Δ=-14.2±13.1 mmHg, p=0.0001), DBP (Δ=-5.2±8.2 mmHg, p= 0.04), Q (Δ=-2.2±1.5 L/min, p=0.0001), and BRS (Δ=-3.5±2.6 ms/mmHg; p=0.05) decreased after CEX as compared with the CONT session. By contrast, the HR increased (Δ=9.4±7.2 bpm, p<0.0001), and SVR remained stable throughout the postexercise period as compared with the CONT session (Δ=0.10±0.22 AU, p=0.14). We found no significant difference between the CEX and CONT with respect to the HRV indexes reflecting autonomic modulation. CONCLUSION CEX induced PEH in the older individuals with prehypertension status. At least in the first 50 min, PEH occurred parallel to the decreased Q and increased HR, while SVR was not different. The changes in autonomic outflow appeared to be unrelated to the acute cardiac and hemodynamic responses.
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Affiliation(s)
- Ricardo Cordeiro
- Programa de Graduacao em Ciencias da Atividade Fisica, Universidade Salgado de Oliveira, Niteroi, RJ, BR
- Laboratorio de Atividade Fisica e Promocao da Saude (LABSAU), Instituto de Educacao Fisica e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Pedro Augusto Mira
- Departamento de Fisiologia e Farmacologia, Laboratorio de Ciencia do Exercicio, Universidade Federal Fluminense, Niteroi, RJ, BR
- Unidade de Investigacao Cardiovascular e Fisiologia do Exercicio, Hospital Universitario e Faculdade de Educacao Fisica e Desportos, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR
| | - Walace Monteiro
- Programa de Graduacao em Ciencias da Atividade Fisica, Universidade Salgado de Oliveira, Niteroi, RJ, BR
- Laboratorio de Atividade Fisica e Promocao da Saude (LABSAU), Instituto de Educacao Fisica e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Felipe Cunha
- Laboratorio de Atividade Fisica e Promocao da Saude (LABSAU), Instituto de Educacao Fisica e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
| | - Mateus C. Laterza
- Unidade de Investigacao Cardiovascular e Fisiologia do Exercicio, Hospital Universitario e Faculdade de Educacao Fisica e Desportos, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR
| | | | - Daniel G. Martinez
- Unidade de Investigacao Cardiovascular e Fisiologia do Exercicio, Hospital Universitario e Faculdade de Educacao Fisica e Desportos, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, BR
| | - Paulo Farinatti
- Programa de Graduacao em Ciencias da Atividade Fisica, Universidade Salgado de Oliveira, Niteroi, RJ, BR
- Laboratorio de Atividade Fisica e Promocao da Saude (LABSAU), Instituto de Educacao Fisica e Desportos, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, BR
- *Corresponding author. E-mail:
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Carey C, Gordish-Dressman H, Thompson PD, Price TB, Angelopoulos TJ, Clarkson PM, Gordon PM, Moyna NM, Pescatello LS, Visich PS, Zoeller RF, Hoffman EP, Hubal MJ. Muscle Strength And Size Correlations At Baseline And Following Unilateral Resistance Training. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000677596.02812.78] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pescatello LS. Exercise and Antihypertensive Medications: Are their Blood Pressure Effects Equal to the Sum of their Parts? Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000675452.04824.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Kramarz MA, Taylor BA, Berkowsky R, Chen MH, Eror E, Pescatello LS. A Randomized Controlled Trial Comparing Two Different Approaches To Prescribe Exercise. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000684416.38717.b2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Zaleski AL, Vonk T, Taylor BA, Santos LP, Eijsvogels T, Panza G, Kramarz M, McCormick K, Thompson PD, Fernandez A, Chen MH, Pescatello LS. Relationship Between The Blood Pressure Responses To Acute And Chronic Aerobic Exercise Among Adults With Hypertension. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000682940.42254.cd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Pierce WB, Manuel K, Wu Y, Livingston J, Pescatello LS. The Need For Exercise Recommendations For Children And Adolescents Post-Bariatric Surgery: A Systematic Review. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000681276.59296.dc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Manuel KM, Pierce WB, Wu Y, Livingston J, Pescatello LS. The Role Of Exercise In Preventing Weight Regain In Adults Post-weight Loss Surgery. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000681280.74923.6d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Berkowsky RS, Taylor BA, Zaleski AL, Parducci PM, Chen MH, Gans KM, Wu Y, Thompson PD, Fernandez AB, Pescatello LS. Caffeine Intake Influences The Blood Pressure Response To Strenuous Physical Exertion Among Firefighters. Med Sci Sports Exerc 2020. [DOI: 10.1249/01.mss.0000670000.80602.8a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Babcock MC, Robinson AT, Migdal KU, Watso JC, Martens CR, Edwards DG, Pescatello LS, Farquhar WB. High Salt Intake Augments Blood Pressure Responses During Submaximal Aerobic Exercise. J Am Heart Assoc 2020; 9:e015633. [PMID: 32406312 PMCID: PMC7660875 DOI: 10.1161/jaha.120.015633] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Background High sodium (Na+) intake is a widespread cardiovascular disease risk factor. High Na+ intake impairs endothelial function and exaggerates sympathetic reflexes, which may augment exercising blood pressure (BP) responses. Therefore, this study examined the influence of high dietary Na+ on BP responses during submaximal aerobic exercise. Methods and Results Twenty adults (8F/12M, age=24±4 years; body mass index 23.0±0.6 kg·m−2; VO2peak=39.7±9.8 mL·min−1·kg−1; systolic BP=111±10 mm Hg; diastolic BP=64±8 mm Hg) participated in this randomized, double‐blind, placebo‐controlled crossover study. Total Na+ intake was manipulated via ingestion of capsules containing either a placebo (dextrose) or table salt (3900 mg Na+/day) for 10 days each, separated by ≥2 weeks. On day 10 of each intervention, endothelial function was assessed via flow‐mediated dilation followed by BP measurement at rest and during 50 minutes of cycling at 60% VO2peak. Throughout exercise, BP was assessed continuously via finger photoplethysmography and every 5 minutes via auscultation. Venous blood samples were collected at rest and during the final 10 minutes of exercise for assessment of norepinephrine. High Na+ intake increased urinary Na+ excretion (placebo=140±68 versus Na+=282±70 mmol·24H−1; P<0.001) and reduced flow‐mediated dilation (placebo=7.2±2.4 versus Na+=4.2±1.7%; P<0.001). Average exercising systolic BP was augmented following high Na+ (placebo=Δ30.0±16.3 versus Na+=Δ38.3±16.2 mm Hg; P=0.03) and correlated to the reduction in flow‐mediated dilation (R=−0.71, P=0.002). Resting norepinephrine concentration was not different between conditions (P=0.82). Norepinephrine increased during exercise (P=0.002), but there was no Na+ effect (P=0.26). Conclusions High dietary Na+ augments BP responses during submaximal aerobic exercise, which may be mediated, in part, by impaired endothelial function.
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Affiliation(s)
- Matthew C Babcock
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE
| | - Austin T Robinson
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE.,School of Kinesiology Auburn University Auburn AL
| | - Kamila U Migdal
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE
| | - Joseph C Watso
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE
| | | | - David G Edwards
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE
| | | | - William B Farquhar
- Department of Kinesiology and Applied Physiology University of Delaware Newark DE
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Affiliation(s)
- Yin Wu
- Department of Kinesiology, University of Connecticut, Storrs, CT
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Pescatello LS, Buchner DM, Jakicic JM, Powell KE, Kraus WE, Bloodgood Sheppard B, Campbell WW, Dietz S, Dipietro L, George SM, Mctiernan A, Pate RR, Piercy KL. Response. Med Sci Sports Exerc 2020; 52:1003-1004. [PMID: 32175979 DOI: 10.1249/mss.0000000000002264] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Babcock MC, Robinson AT, Watso JC, Migdal KU, Martens CR, Edwards DG, Pescatello LS, Farquhar WB. Salt Loading Blunts Central and Peripheral Postexercise Hypotension. Med Sci Sports Exerc 2020; 52:935-943. [PMID: 31609296 PMCID: PMC7144834 DOI: 10.1249/mss.0000000000002187] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION High salt intake is a widespread cardiovascular risk factor with systemic effects. These effects include an expansion of plasma volume, which may interfere with postexercise hypotension (PEH). However, the effects of high salt intake on central and peripheral indices of PEH remain unknown. We tested the hypothesis that high salt intake would attenuate central and peripheral PEH. METHODS Nineteen healthy adults (7 female/12 male; age, 25 ± 4 yr; body mass index, 23.3 ± 2.2 kg·m; V[Combining Dot Above]O2peak, 41.6 ± 8.7 mL·min·kg; systolic blood pressure (BP), 112 ± 9 mm Hg; diastolic BP, 65 ± 9 mm Hg) participated in this double-blind, randomized, placebo-controlled crossover study. Participants were asked to maintain a 2300 mg·d sodium diet for 10 d on two occasions separated by ≥2 wk. Total salt intake was manipulated via ingestion of capsules containing either table salt (3900 mg·d) or placebo (dextrose) during each diet. On the 10th day, participants completed 50 min of cycling at 60% V[Combining Dot Above]O2peak. A subset of participants (n = 8) completed 60 min of seated rest (sham trial). Beat-to-beat BP was measured in-laboratory for 60 min after exercise via finger photoplethysmography. Brachial and central BPs were measured for 24 h after exercise via ambulatory BP monitor. RESULTS Ten days of high salt intake increased urinary sodium excretion (134 ± 70 (dextrose) vs 284 ± 74 mmol per 24 h (salt), P < 0.001), expanded plasma volume (7.2% ± 10.8%), and abolished PEH during in-laboratory BP monitoring (main effect of diet, P < 0.001). Ambulatory systolic BPs were higher for 12 h after exercise during the salt and sham trials compared with the dextrose trial (average change, 3.6 ± 2.1 mm Hg (dextrose), 9.9 ± 1.4 mm Hg (salt), 9.8 ± 2.5 mm Hg (sham); P = 0.01). Ambulatory central systolic BP was also higher during the salt trial compared with dextrose trial. CONCLUSION High salt intake attenuates peripheral and central PEH, potentially reducing the beneficial cardiovascular effects of acute aerobic exercise.
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Affiliation(s)
- Matthew C. Babcock
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Austin T. Robinson
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Joseph C. Watso
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | - Kamila U. Migdal
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | | | - David G. Edwards
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
| | | | - William B. Farquhar
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE
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Gorin AA, Powers TA, Gettens K, Cornelius T, Koestner R, Mobley AR, Pescatello LS, Huedo-Medina TB. A randomized controlled trial of a theory-based weight-loss program for couples. Health Psychol 2020; 39:137-146. [PMID: 31789558 PMCID: PMC6957719 DOI: 10.1037/hea0000808] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Weight gain occurs during marriage, yet obesity treatment is focused on individuals. Outcomes may be improved by targeting joint weight loss and the interpersonal milieu that fosters spousal interdependence. Self-determination theory (SDT) posits that autonomy-supportive environments (e.g., promote meaningful choice, minimize control) produce better health outcomes. This trial tested an SDT-informed weight-loss intervention intended to facilitate autonomy support in couples. METHOD Sixty-four couples were randomized to standard behavioral weight loss (BWL) that couples attended together or to a SDT-informed weight-loss intervention (SDT-WL) that aimed to bolster autonomy support (AS). Groups met weekly for 6 months with assessments at 0, 3, 6, and 12 months. RESULTS Percent weight loss at 6 and 12 months was 10.4% ± 6.5% and 9.2% ± 8.2%. No differences were observed between the BWL and SDT-WL conditions in percent weight loss or changes in AS. Across conditions, higher baseline AS predicted greater weight loss at 6 and 12 months (ps <.001). Increases in AS over time predicted greater weight loss at 6 and 12 months (ps ≤ .02). Post hoc moderation analysis indicated that only participants with low (but not high) baseline AS achieved greater gains in AS at 12 months in SDT-WL than in the BWL conditions (p < .02). CONCLUSIONS Although no differences were found between conditions on weight loss or changes in autonomy support behavior, autonomy support from one's spouse predicted weight loss in both couples-based weight-loss approaches. For couples with low levels of AS, an SDT-informed approach was effective at increasing this desirable interpersonal behavior. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Amy A Gorin
- Department of Psychological Sciences, Institute for Collaboration on Health, Intervention, and Policy, University of Connecticut
| | | | - Katelyn Gettens
- Department of Psychological Sciences, University of Connecticut
| | - Talea Cornelius
- Center for Behavioral Cardiovascular Health, Columbia University Medical Center
| | | | - Amy R Mobley
- Department of Health Education and Behavior, University of Florida
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Jakicic JM, Powell KE, Campbell WW, Dipietro L, Pate RR, Pescatello LS, Collins KA, Bloodgood B, Piercy KL. Physical Activity and the Prevention of Weight Gain in Adults: A Systematic Review. Med Sci Sports Exerc 2019; 51:1262-1269. [PMID: 31095083 DOI: 10.1249/mss.0000000000001938] [Citation(s) in RCA: 84] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE To conduct a systematic literature review to determine if physical activity is associated with prevention of weight gain in adults. METHODS The primary literature search was conducted for the 2018 Physical Activity Guidelines Advisory Committee and encompassed literature through June 2017, with an additional literature search conducted to include literature published through March 2018 for inclusion in this systematic review. RESULTS The literature review identified 40 articles pertinent to the research question. There is strong evidence of an association between physical activity and prevention of weight gain in adults, with the majority of the evidence from prospective cohort studies. Based on limited evidence in adults, however, there is a dose-response relationship and the prevention of weight gain is most pronounced when moderate-to-vigorous intensity physical activity (≥3 METs) is above 150 min·wk. Although there is strong evidence to demonstrate that the relationship between greater time spent in physical activity and attenuated weight gain in adults is observed with moderate-to-vigorous intensity physical activity, there is insufficient evidence available to determine if there is an association between light-intensity activity (<3 METs) and attenuated weight gain in adults. CONCLUSIONS The scientific evidence supports that physical activity can be an effective lifestyle behavior to prevent or minimize weight gain in adults. Therefore, public health initiatives to prevent weight gain, overweight, and obesity should include physical activity as an important lifestyle behavior.
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Affiliation(s)
- John M Jakicic
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Wayne W Campbell
- Department of Nutritional Science, Purdue University, West Lafayette, IN
| | - Loretta Dipietro
- Milken Institute School of Public Health, George Washington University, Washington, DC
| | - Russell R Pate
- Arnold School of Public Health, University of South Carolina, Columbia, SC
| | | | - Katherine A Collins
- Department of Health and Physical Activity, University of Pittsburgh, Pittsburgh, PA
| | | | - Katrina L Piercy
- Office of Disease Prevention and Health Promotion, U.S. Department of Health and Human Services, Rockville, MD
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