Blood Pressure In Hypertensive Individuals Research Articles

The acute effect of resistance exercise with blood flow restriction with hemodynamic variables on hypertensive subjects.

The purpose of this study was to analyze systolic blood pressure (SBP), diastolic blood pressure (DBP) and the heart rate (HR) before, during and after training at moderate intensity (MI, 50%-1RM) and at low intensity with blood flow restriction (LIBFR). In a randomized controlled trial study, 14 subjects (average age 45±9,9 years) performed one of the exercise protocols during two separate visits to the laboratory. SBP, DBP and HR measurements were collected prior to the start of the set and 15, 30, 45 and 60 minutes after knee extension exercises. Repeated measures of analysis of variance (ANOVA) were used to identify significant variables (2 × 5; group × time). The results demonstrated a significant reduction in SBP in the LIBFR group. These results provide evidence that strength training performed acutely alters hemodynamic variables. However, training with blood flow restriction is more efficient in reducing blood pressure in hypertensive individuals than training with moderate intensity.

A systematic review and metaanalysis on the effects of garlic preparations on blood pressure in individuals with hypertension.

Many patients prefer herbal medications to conventional drugs. Limited trial evidence suggests that garlic preparations reduce high blood pressure (BP). We searched electronic databases through March 2014 to identify all randomized controlled trials that compared a garlic preparation to placebo in hypertensive patients. Trials were required to report BP values at baseline and after a follow-up of at least 4 weeks. Nine double-blind trials with 482 individuals fulfilled our inclusion criteria. Included trials were rather small, and the quality of the majority of included trials was moderate. Follow-up ranged from 8 to 26 weeks. All trials reported office BP measurements. Systolic BP and diastolic BP (SBP and DBP) were more effectively reduced in individuals treated with garlic preparations than in individuals treated with placebo. However, heterogeneity was high (weighted mean difference (WMD) for SBP was -9.1 mm Hg; 95% confidence interval (CI), -12.7 to -5.4; P for heterogeneity = 0.0006; and I2 = 71%; WMD for BP was -3.8 mm Hg; 95% CI, -6.7 to -1.0; P for heterogeneity = 0.00001; I2 = 80%). When analyses were restricted to higher-quality trials using intention-to-treat analysis or to trials with concealed treatment allocation and standardized and blinded BP measurement, effect sizes for SBP but not for DBP were lower and heterogeneity disappeared. Although evidence from this review suggests that garlic preparations may lower BP in hypertensive individuals, the evidence is not strong. A well-conducted and powered trial of longer duration is needed to confirm these findings.

Immediate effects of upper thoracic spine manipulation on hypertensive individuals

Purpose:The aims of this study were to determine if there were any statistically significant immediate effects of upper thoracic spinal manipulative therapy (SMT) on cardiovascular physiology in hypertensive individuals.Introduction:Preliminary research suggests that SMT to various regions of the spine may be capable of lowering systolic and diastolic blood pressure in hypertensive individuals. Further studies are warranted to corroborate or refute these findings as well as measure how other attributes of cardiovascular physiology are impacted by SMT.Methods:Fifty hypertensive participants (age = 45·5±13·9 years, height = 1·69±0·10 m, body mass = 93·9±21·5 kg: mean±standard deviation (SD)) were equally randomized into a single-blind, controlled trial involving two study groups: supine diversified anterior upper thoracic SMT of T1–4, or a ‘no T-spine contact’ control. Outcome measures were electrocardiogram, bilateral pulse oximetry, and bilateral blood pressure measurement performed at baseline, post 1-minute intervention, and post 10-minute intervention. An independent samples t-test was used to compare between-group differences at baseline. A repeated measures ANOVA was used to compare within-group changes over time.Results:Within-group changes in PR interval and QRS duration demonstrated that the atria were transiently less active post-SMT and the ventricles were more active post-SMT, however the changes were clinically minimal.Conclusion:The results of this study, and the limited existing normotensive, thoracic-specific SMT research in this field, suggest that cardiovascular physiology, short-term, is not affected by upper thoracic spine SMT in hypertensive individuals to a clinically relevant level.

Nurse Management of Hypertension in Rural Western Kenya: Implementation Research to Optimize Delivery

BackgroundHypertension is the leading global risk factor for mortality. Hypertension treatment and control rates are low worldwide, and insufficient human resource capacity is among the contributing factors. Thus, a critical component of hypertension management is to develop novel and effective solutions to the human resources challenge. One potential solution is task redistribution and nurse management of hypertension in these settings. ObjectivesThe aim of this study is to investigate whether nurses can effectively reduce blood pressure in hypertensive patients in rural western Kenya and, by extension, throughout sub-Saharan Africa. MethodsAn initial phase of qualitative inquiry will assess facilitators and barriers of nurse management of hypertension. In addition, we will perform usability and feasibility testing of a novel, electronic tablet-based integrated decision-support and record-keeping tool for the nurses. An impact evaluation of a pilot program for nurse-based management of hypertension will be performed. Finally, a needs-based workforce estimation model will be used to estimate the nurse workforce requirements for stable, long-term treatment of hypertension throughout western Kenya. FindingsThe primary outcome measure of the impact evaluation will be the change in systolic blood pressure of hypertensive individuals assigned to nurse-based management after 1 year of follow-up. The workforce estimation modeling output will be the full-time equivalents of nurses. ConclusionsThis study will provide evidence regarding the effectiveness of strategies to optimize task redistribution and nurse-based management of hypertension that can be applicable to noncommunicable disease management in low- and middle-income countries.

The DASH Diet and Diet Costs Among Ethnic and Racial Groups in the United States

The Dietary Approaches to Stop Hypertension (DASH) diet is perhaps the best example of how a nutrient dense dietary pattern can prevent chronic disease. In randomized trials, DASH dietary patterns lowered blood pressure in hypertensive individuals.1 Subsequent trials and observational studies have consistently found that DASH-type diets reduced cardiovascular and metabolic risk.2

GW24-e3921 Association between the rate of the morning surge in blood pressure and cardiovascular events and stroke

ObjectivesThe exaggerated surge in morning blood pressure (BP) that many patients experience upon awakening may be closely related to target organ damage and may be a predictor of cardiovascular complications....

Acute, quercetin-induced reductions in blood pressure in hypertensive individuals are not secondary to lower plasma angiotensin-converting enzyme activity or endothelin-1: nitric oxide

Quercetin (Q) reduces blood pressure (BP) in hypertensive individuals, but the mechanism is unknown. We hypothesized that acute Q aglycone administration reduces BP in hypertensive men by decreasing angiotensin-converting enzyme (ACE) activity and/or by lowering the ratio of circulating endothelin-1 (ET-1) to nitric oxide and that these alterations will improve endothelial function. Using a double-blind, placebo-controlled, crossover design Q or placebo (P) was administered to normotensive men (n = 5; 24 ± 3 years; 24 ± 4 kg/m(2)) and stage 1 hypertensive men (n = 12; 41 ± 12 years; 29 ± 5 kg/m(2)). As anticipated, ingesting 1095 mg Q did not affect BP in normotensive men but resulted in maximal plasma Q (2.3 ± 1.8 μmol/L) at approximately 10 hours, with Q returning to baseline concentrations (0.4 ± 0.08 μmol/L) by approximately 17 hours. Results from this study provided rationale for determining end-points of interest in stage 1 hypertensive men 10 hours after ingesting Q or P. In stage 1 hypertensive individuals, plasma Q increased(0.6 ± 0.4 vs. 0.05 ± 0.02 μmol/L), and mean BP decreased (103 ± 7 vs 108 ± 7 mm Hg; both P < .05) 10 hours after Q vs P, respectively. Plasma ACE activity (16 ± 10 vs 18 ± 10 U/L), ET-1 (1.6 ± 0.9 vs 1.6 ± 0.8 pg/ml), nitrites (57.0 ± 3.0 vs 56.7 ± 2.6 μmol/L), and brachial artery flow-mediated dilation (6.2 ± 2.9 vs. 6.3 ± 3.2%) were unaffected by Q. A single dose of Q aglycone reduces BP in hypertensive men through a mechanism that is independent of changes in ACE activity, ET-1, or nitric oxide bioavailability and without affecting vascular reactivity.

O3‐09‐03: Longitudinal reduction in blood pressure in hypertensive individuals is associated with increased levels of biomarkers for Alzheimer's disease

O3‐09‐03: Longitudinal reduction in blood pressure in hypertensive individuals is associated with increased levels of biomarkers for Alzheimer's disease

P2-155 Consumption of ultra-processed food is associated with blood pressure in hypertensive individuals

IntroductionThe consumption of the ultra-processed food has been associated with a growing prevalence of chronic diseases.ObjectiveTo assess the effect of processed food consumption on systolic (SBP) and diastolic (DBP) blood...

RESPeRATE

Systemic hypertension has been well documented as a major risk factor for premature cardiovascular morbidity and mortality. Reduction of high blood pressure (BP) by nonpharmacological means is widely recommended, either as a primary prevention therapy or as an adjunctive treatment with antihypertensive drugs. RESPeRATE is a commercially available electronic device that presents a novel nonpharmacological approach to the treatment of hypertension. RESPeRATE-guided slow-paced breathing aimed at achieving a respiratory frequency of <10 breaths per minute has been shown, in multiple studies, to reduce BP in hypertensive individuals by improving the autonomic balance through respiratory control. This article discusses RESPeRATE and the scientific evidence that supports the use of device-guided slow breathing to reduce BP.

Postexercise Hypotension

A single bout of exercise can lead to a postexercise decrease in blood pressure in hypertensive individuals, called postexercise hypotension. Compelling evidence suggests that the central baroreflex pathway plays a crucial role in the development of postexercise hypotension. This review focuses on the exercise-induced changes in brainstem nuclei involved in blood pressure regulation.

Evaluation of the Effect of Dietary Virgin Olive Oil on Blood Pressure and Lipid Composition of Serum and Low-Density Lipoprotein in Elderly Type 2 Diabetic Subjects

Dietary virgin olive oil may help to reduce blood pressure in hypertensive individuals, but little is known about the effect on type 2 diabetic patients. For the present study, 17 type 2 diabetic elderly subjects and 23 healthy elderly controls received a diet rich in virgin olive oil for 4 weeks. Blood pressure, biochemical parameters, low-density lipoprotein (LDL), and oxidized LDL lipids and fatty acids were measured. Systolic blood pressure was reduced after virgin olive oil consumption in both controls and diabetic patients. Although the biochemical parameters were not modified, the intervention protected LDL from oxidation and restored the levels of dihomo-gamma-linolenic acid (20:3, n-6) in serum cholesterol esters and phospholipids of diabetic patients. In conclusion, the present study provides new evidence of the effects of dietary virgin olive oil on blood pressure and LDL oxidation in type 2 diabetics. It is likely that the components responsible for the observed effects are the monounsaturated fatty acids and the presence of antioxidants in the oil, but this needs further investigation.

Percutaneous Renal Nerve Ablation for Persistent Hypertension

What if a simple procedure existed for markedly lowering blood pressure in hypertensive individuals, possibly obviating the need for medical therapy? Noting the association of renal sympathetic hyperactivity with hypertension, these investigators posited that sympathetic denervation of the kidneys would safely reduce blood pressure. They piloted …

Physical Activity and Cardiovascular Disease Prevention: Current Recommendations

Epidemiologic studies support an inverse and robust relationship between physical activity (PA) and mortality risk, even after adjusting for potential confounding factors. The authors have reported 13% lower mortality risk for every 1-MET (metabolic equivalent) increase in exercise capacity. For those with an exercise capacity >7 METs, the mortality risk was approximately 50% to 70% lower when compared with those achieving <5 METs. The risk reduction is, at least in part, attributed to the favorable effect of PA on the cardiovascular risk factors. Increased PA lowers blood pressure in hypertensive individuals, increases high-density lipoprotein cholesterol in a dose-response fashion, and reduces the incidence of diabetes. The health benefits of PA can be realized by engaging in moderate-intensity physical activity (brisk walk) for at least 30 minutes per day, 5 days per week or vigorous activity (jogging) for 20 or more minutes, 3 days per week. Combinations of the 2 types of activity can also be performed.

The Short-term Effect Of Brisk Walking At Different Intensities And Durations On Systolic Blood Pressure In Middle-aged Men

Elevated blood pressure is associated with an increased risk of cardiovascular morbidity and mortality, while exercise studies regularly demonstrate reductions in blood pressure in hypertensive individuals. Reductions in blood pressure are often associated with reductions in body mass and/or increases in aerobic fitness following long-term intervention studies. However, blood pressure can also be reduced immediately following exercise, illustrating that exercise can effect blood pressure independently from body mass losses or increases in aerobic fitness. PURPOSE The purposes of this study were firstly to determine whether walking for 30 minutes at 45% VO2max was sufficient to significantly lower systolic blood pressure (SBP) during the 24 hour post-exercise period compared to a sedentary control session in normo-/hypertensive middle-aged men. Secondly, whether increasing the intensity to 65% VO2max or the walking duration to 60 minutes may influence the magnitude and/or duration of any possible effects. METHODS The study included 13 non-smoking middle-aged males (age 59.92 ± 6.64 years; height 1.79 ± 0.05 cm; mass 94.11 ± 11.17 kg) and employed a repeated measures design, including 4 trials: 1) control trial (CON), 2) walk for 30 min at 45% VO2max (3045), 3) walk for 30 min at 65% VO2max (3065) and 4) walk for 60 min at 45% VO2max (6045). SBP was measured pre-walk, immediately post-walk, and 1-hr, 4-hr & 24-hr post-walk. RESULTS There was a significant interaction between walking intensity and time over the course of the 24 hour period, where SBP decreased significantly for at least 4 hours following 3045 (P=0.023), SBP was only significantly lowered at 1 hour postwalk following 3065 (P=0.032) and back to normal by 4 hours, and SBP was lowered for at least 1 hour but less than 4 hours following 6045 (P=0.006). SBP did not change significantly over the 24 hour period following CON and returned to pre values at 24-hr in each treatment. CONCLUSION Walking for 30 minutes at 45% VO2max is an effective therapy for reducing SBP for at least 4 hours in normotensive/mild-hypertensive middle-aged men. Furthermore, this type of activity appears to be more effective than walking at a higher intensity for the same duration or with an increased duration at the same intensity

The potential anti-inflammatory benefits of improving physical fitness in hypertension

Hypertension is associated with an increased risk of stroke and atherosclerosis. In addition to elevated blood pressure, hypertension is characterized by neuroendocrine and immune activation, including elevated levels of C-reactive protein, inflammatory cytokines, and soluble adhesion molecules, which are predictive of morbidity and mortality outcomes. Pharmacological treatment for hypertension reduces blood pressure, but has limited effectiveness in reducing the accompanying inflammation and its associated morbidity and mortality. Exercise and diet interventions regularly show reductions in blood pressure in hypertensive individuals. Similar interventions in other populations show reductions in many inflammatory markers, but these effects have not been routinely examined in hypertensive individuals. The mechanisms through which exercise might exert an anti-inflammatory action include the sympathetic nervous system, the hypothalamic-pituitary-adrenal axis, as well as direct effects of blood pressure. Here, exercise is promoted as a potentially effective treatment for both the elevated blood pressure and chronic inflammation found in hypertension.

Vascular effects of long-term propranolol administration after chronic nitric oxide blockade

Long-term propranolol treatment reduces arterial blood pressure in hypertensive individuals mainly by reducing peripheral vascular resistance, but mechanisms underlying their vasodilatory effect remain poorly investigated. This study aimed to investigate whether long-term propranolol administration ameliorates the impairment of relaxing responses of aorta and mesenteric artery from rats made hypertensive by chronic nitric oxide (NO) deficiency, and underlying mechanisms mediating this phenomenon. Male Wistar rats were treated with N(omega)-Nitro-L-arginine methyl ester (L-NAME; 20 mg/rat/day) for four weeks. DL-Propranolol (30 mg/rat/day) was given concomitantly to L-NAME in the drinking water. Treatment with L-NAME markedly increased blood pressure, an effect largely attenuated by DL-propranolol. In phenylephrine-precontracted aortic rings, the reduction of relaxing responses for acetylcholine (0.001-10 microM) in L-NAME group was not modified by DL-propranolol, whereas in mesenteric rings the impairment of acetylcholine-induced relaxation by L-NAME was significantly attenuated by DL-propranolol. In mesenteric rings precontracted with KCl (80 mM), DL-propranolol failed to attenuate the impairment of acetylcholine-induced relaxation by L-NAME. The contractile responses to extracellular CaCl2 (1-10 mM) were increased in L-NAME group, and co-treatment with DL-propranolol reduced this response in both preparations in most Ca2+ concentrations used. The NO2/NO3 plasma levels and superoxide dismutase (SOD) activity were reduced in L-NAME-treated rats, both of which were significantly prevented by DL-propranolol. In conclusion, propranolol-induced amplification of the relaxation to acetylcholine in mesenteric arteries from L-NAME-treated rats is sensitive to depolarization. Additional mechanisms involving blockade of Ca2+ entry in the vascular smooth muscle and increase in NO bioavailability contributes to beneficial effects of long-term propranolol treatment.

Analysis of Recent Papers in Hypertension

Analysis of Recent Papers in Hypertension

North American Ginseng Exerts a Neutral Effect on Blood Pressure in Individuals With Hypertension

An early observational study suggested that ginseng could elevate blood pressure. This caused concern because 4.5% of American adults use ginseng, with a popular choice being North American ginseng. To date, North American ginseng lacks hemodynamic evaluation; therefore, we conducted a randomized, double-blinded, controlled trial to investigate its effect on blood pressure in 16 hypertensive individuals (mean+/-SD age 61.1+/-8.1 years; systolic/diastolic blood pressure 132.4+/-12.8/83.3+/-8.1 mm Hg; 13 on antihypertensives). We used 6 batches of North American ginseng root that varied in quality and ginsenoside content, representing the spectrum of this ginseng on the market. On 8 mornings, each participant was fitted with an ambulatory blood pressure monitor, which measured blood pressure during a 30-minute baseline period. Each participant then consumed in a randomized and double-blind fashion 3 g of encapsulated treatment: placebo (on 2 mornings) or powdered North American ginseng (on 6 mornings). After treatment, blood pressure was measured every 10 minutes for 160 minutes, and its change at each post-treatment time point relative to baseline was determined per individual and averaged, and the mean was obtained for the overall 160-minute period. None of the North American ginsengs or their mean differed from placebo in their effect on overall (160 minutes) mean blood pressure change. None affected blood pressure versus placebo at the 10-minute intervals; but their mean versus placebo increased systolic and diastolic blood pressure at 140 and 160 minutes, respectively, and lowered diastolic blood pressure at 100 minutes. The findings together suggested that North American ginseng exerts a neutral acute effect on blood pressure in hypertensive individuals.

Physical Training Increases Renal Injury in Rats with Chronic NOS Inhibition

Nitric oxide (NO) is involved in regulation of vascular tone and renal hemodynamics. Inhibition of NO synthase (NOS) by Nomega-nitro-L-arginine methyl ester (L-NAME) promotes systemic hypertension and glomerular damage. Exercise is effective in reducing elevated blood pressure in hypertensive individuals and rats treated with L-NAME. We investigated the effects of regular aerobic exercise on renal injury in hypertensive rats with NOS inhibition. Adult Wistar rats were divided into four groups: sedentary or exercising, nonhypertensive (two groups) and hypertensive, sedentary or exercising (two groups). Treadmill running exercise was prolonged for 4 weeks (60 min.day(-1), 5 days/week, 20 m.min(-1), no incline), and hypertension was induced by L-NAME given orally to rats for 4 weeks (25 mg.kg(-1).day(-1) in drinking water). Blood pressure was monitored at baseline and then once a week throughout L-NAME administration. Kidney sections were examined for renal histopathology. Hypertensive animals exhibited elevated blood pressure, and exercise partly prevented this elevation. Renal injury observed as arteriolar wall thickening, focal tubular atrophy, and interstitial inflammatory infiltration was apparent in hypertensive animals, and exercise induced further renal damage in hypertensive animals. The present training protocol exacerbates renal insufficiency in NOS-blockage hypertension in rats.