Prehypertension In Young Adults Research Articles

Effectiveness of Mental and Physical Training on Blood Pressure and Resting Heart rate among Prehypertensive Young Adults

Mental and physical training (MAP) has been reported to improve outcomes related to mental health issues, but there is scarcity in current literature with regards to its effect on blood pressure (BP) in prehypertensive population. Therefore, aim of this study was to evaluate the effect of MAP on BP and resting heart rate (RHR) among prehypertensive young male adults. Methods – A single blinded randomized controlled trial with 43 prehypertensive (BP 120-139/80-89 mmHg) participants were divided into 2 experimental and 1 control groups. Mental training group (MT) participated in mindfulness meditation, while physical training group (PT) engaged in moderate intensity aerobic exercise. Both groups underwent training for 6-weeks, 3 sessions/week, each session lasting for 20 minutes. Control group did not participate in any training and was debriefed about Dietary Approaches to Stop Hypertension (DASH) eating plan. Participants in all 3 groups were instructed not to engage in any type of relaxation training or physical activity throughout this study. Systolic BP, diastolic BP, and RHR were assessed at baseline, at end of 3-weeks and 6-weeks intervention. Results – Mean age of participants in MT, PT and DASH group were 20.8±1.5, 20.1±1.8 and 19.8±1.8 respectively. Within group time effect demonstrated a significant difference in SBP (F=42.392, P=0.000), DBP (F=1836.863, P=0.000) and a non-significant difference in RHR (F=1.856, P=0.171), while between group analysis did not show significant difference in SBP (F=0.222, P=0.802); DBP (=0.325, P=0.739), and RHR (=0.63, P=0.939). Conclusions – All 3 interventions are equally effective in reducing the BP in pre-hypertensive young adults, however they did not have any effect on RHR.

Effect Of 14 Days Physical Activity Walking Regime on Blood Pressure in Pre-Hypertensive Young Adults: A Randomised Controlled Trial

Background: Hypertension is a non-communicable disease characterised by chronic increase in blood pressurethat results in cardiovascular illness including stroke, coronary artery disease and peripheral vascular disease.Recent literature suggests that increase in sedentary lifestyle is due to decline in physical activity and increases therate of morbidity and mortality The incidence of prehypertension among young adults was found to be rangingapproximately from 37.5 to 77.1%. Walking is a form of physical activity and a common ADL, that is feasible,low cost and has low risk and can be implemented into daily living. Here we describe the acute effect of walkingregimen on blood pressure in pre-hypertensive young adults by using Harvard step test.Methodology: Participants of either gender having pre-hypertensive state between the age 18-25 were recruitedfor the study. 34 subjects were selected and divided in two groups. Group A had to walk 10000 steps and groupB walked to their maximum capacity. In pre-intervention both groups were assessed for blood pressure, Harvardtest, and ideal body weight using brocca’s index. Data was collected based on post intervention.Conclusion: This study concluded that a short-term walking program of 10,000 steps per day can potentially leadto significant improvements in several health outcomes, including blood pressure, heart rate, Spo2 and physicalfitness and have important implication for the prevention and management of hypertension in pre-hypertensiveyoung adults.

OR14-1 Preimplantation embryo development is associated with both birth size and post-natal growth and can predict adult cardiovascular risk

Abstract Background The link between birth-size, early childhood growth and later life cardiovascular (CV) risk is well recognised. The contribution to CV risk of growth and cell differentiation during pre-implantation embryo development is unknown. Aims Develop a transcriptomic model of developmental trajectory in the pre-implantation embryo and link this model to birthweight, child growth and CV risk in later life. Methods Single cell RNA velocity1 and pseudotime analyses were used to infer developmental trajectory in the preimplantation human embryo2. Time series clustering was used to identify genes with similar activity patterns. These data were compared with independent genomic data from four further data sets. I) Birthweight genome wide association study (GWAS)3. II) Genes correlated with gestation4. III) A previously identified set of 55 genes that classify pre-hypertensive young adults using their blood methylome at age 0, 7 and 17 years5. IV) A set of genes with differential methylation associated with linear childhood growth6. Data sets III) and IV) were derived from the Avon Longitudinal Study of Parents and Children (n=6487). Enrichment was assessed using the hypergeometric test and confirmed via random permutation (1×105-fold) and z-score analysis. Random Forest was used to determine the predictive value presented as the area under the curve (AUC) of the receiver operating characteristic. Results 8256 genes contributed to the velocity of mRNA change in the preimplantation embryo and a temporal wave pattern was revealed with peaks of velocity at 3, 4, and 5-days post-fertilisation. Genes associated with the velocity of the developmental trajectory formed 6 clusters, in which metabolic pathways were over-represented (adj. p<0.02). We found that 16/60 birthweight GWAS (I) and 3096/10521 gestation correlated genes (II) were associated with embryonic developmental trajectory (both 2-fold enrichment, p<5×10-3). Furthermore, 11/55 pre-hypertensive associated genes (III) were linked with embryonic developmental trajectory (>10-fold enrichment, p<1×10-8), these 11 genes predicted adult pre-hypertension in small for gestational age catch-up growth (cuSGA) with an AUC=0.98. Of the 8256 developmental trajectory genes, 307 were differentially methylated in linear childhood growth (IV) (2.3-fold over-enrichment, p<1×10-8). Conclusion Waves of gene expression velocity occur in preimplantation human embryos. These waves mark major developmental transitions and form a transcriptomic developmental trajectory which is associated with both birthweight and gestation. The transcriptomic developmental trajectory genes are over-enriched for genes associated with the linear phase of childhood growth and for genes associated with and predictive for the development of adult pre-hypertension in cuSGA. Pre-implantation gene expression can therefore be linked to the origins of adult disease. 1. LaManno, et al. (2018). Nature. 560(7719): 494-8. 2. Petropoulos, et al. (2016). Cell. 165(4): 1012-26. 3. Horikoshi, et al. (2016). Nature 538(7624): 248-252. 4. Rasmussen, et al. (2022). Nature. https://doi.org/10.1038/s41586-021-04249-w 5. Garner, et al (2021). JES. 5: A654–A655. 6. Garner, et al (2019) ESPE Abstracts 92FC12.6 Presentation: Sunday, June 12, 2022 11:00 a.m. - 11:15 a.m.

Effectiveness of High-Intensity Interval Training and Continuous Moderate-Intensity Training on Blood Pressure in Physically Inactive Pre-Hypertensive Young Adults.

The likelihood of pre-hypertensive young adults developing hypertension has been steadily increasing in recent years. Despite the fact that aerobic exercise training (AET) has demonstrated positive results in lowering high blood pressure, the efficacy of different types of AET among pre-hypertensive young adults has not been well-established. The objective of this study was to evaluate the effectiveness of high-intensity interval training (HIIT) and continuous moderate-intensity training (CMT) on the blood pressure (BP) of physically inactive pre-hypertensive young adults. In total, 32 adults (age 20.0 ± 1.1 years and BMI 21.5 ± 1.8) were randomly assigned to three groups: HIIT, CMT and control (CON). The HIIT and CMT groups participated in 5 weeks of AET, while the CON group followed a DASH diet plan only. The HIIT protocol consisted of a 1:4 min work to rest ratio of participants, at an 80–85% heart rate reserve (HR-reserve) and a 40–60% HR-reserve, respectively, for 20 min; the CMT group exercised at 40–60% of their HR-reserve continuously for 20 min. In both the HIIT and CMT groups, systolic blood pressure (SBP) (3.8 ± 2.8 mmHg, p = 0.002 vs. 1.6 ± 1.5 mmHg, p = 0.011) was significantly reduced, while significant reductions in the diastolic blood pressure (DBP) (2.9 ± 2.2 mmHg, p = 0.002) and mean arterial pressure (MAP) (3.1 ± 1.6 mmHg, p < 0.0005) were noted only in the HIIT group. No significant differences in SBP (−0.4 ± 3.7 mmHg, p = 0.718), DBP (0.4 ± 3.4 mmHg, p = 0.714), or MAP (0.1 ± 2.5 mmHg, p = 0.892) were observed in the CON group. Both HIIT and CMT decreased BP in physically inactive pre-hypertensive young adults; however, HIIT yielded more beneficial results in terms of reducing the SPB, DBP and MAP.

Effect of Isometric Exercise on Heart Rate Variability in Prehypertensive Young Adults

Background and Objective: Heart rate variability (HRV) is a sensitive and specific non-invasive tool to evaluate the degree of heart rate variation under the balanced influence of sympathetic and parasympathetic components of the cardiac autonomic nervous system. The aim was to study the effect of isometric hand grip exercise on HRV in prehypertensive young adults and to find a correlation of HRV with body mass index (BMI). Materials and Methods: This observational study was done on 60 healthy young adults aged 18–30 years. All the subjects were divided into three groups of 20 each on the level of their BMI and systolic and diastolic blood pressures. Group I were subjects with BMI &lt;25 and normotensive, group II with BMI &lt;25 and prehypertensive, and group III with BMI &gt;25 and prehypertensive. HRV analysis (Chart HRV module, ADInstruments Pty Ltd) was performed with the following parameters calculated: low-frequency power (LF), high-frequency power (HF), and LF/HF ratio. Results: LF/HF ratio was significantly increased (P&lt;0.001) in prehypertensive subjects (groups II and III) when compared with the normotensive subjects (group I), which indicates a heightened sympathetic discharge in prehypertensives. A positive correlation between anthropometric parameters and cardiac autonomic activity parameters and increased sympathetic activity in obese subjects were noted. Conclusion: An increase in anthropometric indices is associated with a change in cardiac autonomic activity, especially toward sympathetic activity. Regular anthropometric assessment can prevent the development of cardiac abnormalities and the incidence of sudden cardiac death.

Pre-Hypertension and Its Determinants in Healthy Young Adults: Analysis of Data from the Korean National Health and Nutrition Examination Survey VII.

The purpose of this cross-sectional study was to identify risk factors in the normotensive and pre-hypertensive group based on the blood pressure results of healthy young adults from the Korean National Health and Nutrition Examination Survey 2018. The participants were 2225 healthy young adults between the ages of 19 and under 45, excluding those with a diagnosis of hypertension or taking antihypertensive medications. Of the 2225 participants, the normotensive group was 1498 (67.3%) and the pre-hypertensive group 727 (32.7%). Determinants of pre-hypertension were analyzed using multiple logistic regression based on a complex sample design. Factors related to pre-hypertension in young adults were age, smoking, waist circumference, diabetes, anemia, cholesterol levels including HDL cholesterol, and uric acid levels. Pre-hypertension is a pre-stage that can prevent the morbidity of hypertension through lifestyle control, so its management is very important. Furthermore, a young adult is a stage in the growth and development of human beings, in which lifestyles such as healthy behaviors, eating habits, and exercise are fixed. Therefore, it is very important to improve lifestyles such as diet, exercise, and smoking cessation and to control risk factors in young adults who are at the pre-hypertension stage for health promotion. Continuous health examinations should be conducted for young adults, and education that can be practiced based on clinical data through this should be implemented for community health.

An Epigenomic Signature in Children Born Small for Gestational Age (SGA) With “Catch-up” Growth Is Present From Birth and Predicts Early Adulthood Pre-Hypertension

Abstract Background: Cardiometabolic conditions in adulthood are more common in children born SGA1. The relationship of the transcriptome (gene expression) and epigenome (DNA methylation) to birth size and the future development of cardiometabolic disease has not been characterized. Aims: To identify I) the relationship between epigenome at age 0, 7 and 17 years, transcriptome at age 9 years and birth size in a normal population; II) links between the transcriptome and epigenome in childhood and adult cardiometabolic risk. Study Design: Normal children (n=6487) from the Avon Longitudinal Study of Parents and Children were assigned to groups based on birth size using bodyweight (BW) and gestation and divided into groups using the population 10th centile. Adverse cardiometabolic risk at age 17 years was defined by the National Heart Lung and Blood Institute criteria of prehypertension using systolic and diastolic blood pressure as well as HDL and LDL2. Blood transcriptome at age 9 and blood epigenome at age 0, 7, and 17 years and were available from 980 and 947 children, respectively. Hypernetworks were used to integrate differentially expressed genes in the transcriptome (DEGs) and differentially methylated points (DMPs) in the epigenome, identifying functional links. Random Forest, a machine learning approach, was used to determine the predictive value of ‘omic data presented as the area under the curve (AUC) of the receiver operating characteristic. Results: Pre-hypertensive participants at age 17 years were distinguished from normotensive participants and this group was enriched for children born small who caught up by age 7 years (155/611 unhealthy/healthy SGA compared to 1979/12746 in all other BW groups; 1.6-fold, p&amp;lt;1x10-5). This group had a greater height velocity during their catch-up period than the normotensive participants (1.2-fold, p=0.027). Hypernetwork integration of ‘omic data identified a functional relationship between 55 DEGs at age 9 years and DMPs at age 7 years. Random forest analysis was able to accurately predict the presence of pre-hypertensive young adults from the age 9 transcriptome (AUC: 0.973). Using a gene-level contraction of DMPs which map to the 55 DEGs (i.e. cis-DMPs), we demonstrated accurate classification of pre-hypertensive young adults from their blood methylome at age 0 (AUC [95% CI]: 0.92 [0.89-0.95]), 7 (0.90 [0.87-0.93]), and 17 (0.91 [0.88-0.94]) years. Conclusions: Through the integration of transcriptome and epigenome, we have identified a set of genes with an epigenomic and transcriptomic signature which predict pre-hypertension in children born SGA who catch up. Specifically, we have shown that the associated epigenomic signature tracks from birth to early adulthood, indicating the possibility of early detection of risk and primordial prevention. 1 Barker etal. (1988) BMJ 297(6641):134-135. 2 Chobanian etal. (2003) JAMA 289(19):2560-2571.

Relaxing music reduces blood pressure and heart rate among pre-hypertensive young adults: A randomized control trial.

Prevalence of pre‐hypertension is higher among young adults and may increase the risk for hypertension and cardiovascular morbidity. Music therapy has been investigated to reduce the blood pressure in the hypertensive population; however, its efficacy on blood pressure in pre‐hypertensive young adults is not known. Thirty pre‐hypertensive (systolic blood pressure [SBP] = 120‐139 mmHg and diastolic blood pressure [DBP] = 80‐89 mmHg) young adults were recruited and randomly assigned into two groups. Music group (N = 15) received music therapy by passive listening to music for 30 minutes/day, 5 days/week for 4 weeks, along with Dietary Approaches to Stop Hypertension (DASH) eating plan (a diet rich in fruits and vegetables, low‐fat dairy or unsaturated fat) and limit the daily sodium intake less than 100 mmol/day. The control group (N = 15) practiced only DASH eating plan and sodium restriction. The SBP, DBP, and heart rate (HR) were measured before and after 4 weeks of intervention. There was a significant reduction in SBP (8.73 mmHg, p < .001) and HR (6.42 beats/minute, p = .002); however, the reduction in DBP (1.44 mmHg, p = .101) was not statistically significant in the music group. Control group did not exhibit any significant reduction in SBP (0.21 mmHg, p < .836), DBP (0.81 mmHg, p < .395) and HR (0.09 beats/minute, p < .935). In conclusion, music therapy reduced significantly SBP and HR suggesting that it could be a promising tool to prevent the progression of pre‐hypertension toward hypertension among young adults.

A cross-sectional study on prevalence of hypertension and pre-hypertension among young adults at urban field practice area, Gandhi Medical College, Secunderabad

Background: Hypertension is also known as high or raised blood pressure. It is a condition in which the blood vessels have persistently raised pressure. Hypertension is directly responsible for 57% of all stroke deaths and 24% of all coronary heart disease deaths in India. Young adults have been deemed to be at lower risk in their development of hypertension due to resultant gaps in the literature. Hence the present study was aimed to determine the prevalence of hypertension and pre-hypertension among young adults (18-35 years) residing in Urban Field Practice Area of Gandhi Medical College. Objectives of the study was to determine the prevalence of hypertension and pre-hypertension in young adults and to identify the risk factors and sociodemographic factors associated with hypertension and pre-hypertension.Methods: A sample of 233 young adults (18-35 years) was included in the community based cross sectional study by simple random sampling followed by systematic random sampling in Bholakpur. All the participants were assessed for blood pressure and BMI status. Data was analysed in MS Excel version 7.2 Software.Results: The prevalence of hypertension was 9.85% (n=23) and pre–hypertension was 23.65% (n=55). About 13.3% of the study population were smokers and 26.6% of them were alcoholics. Twenty seven percent of the study participants were obese and overweight.Conclusions: Higher proportion of hypertensives and pre-hypertensives were found in the category of males, smoking, alcohol intake and obesity than their counter ones.

The management of prehypertension in young adults

The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of prehypertension in young adults is helpful for early and effective interventions and treatments to reduce the occurrence of future hypertension and organ damage. This review summarized the epidemiological characteristics, disease intervention measures, and disease progression characteristics of prehypertension to provide a basis for the development of targeted intervention measures for young adults with prehypertension.

Prevalence of prehypertension in young adults in South India

Prevalence of prehypertension in young adults in South India

Leucocytic DNA Methylation of Interleukin-6 Promoter Reduction in Pre-Hypertensive Young Adults.

BackgroundPre-hypertension is associated with increased risk of cardiovascular disease. Chronic inflammation plays an important role in the pathophysiology of essential hypertension, with epigenetic dysregulation involvement. Nevertheless, the role of DNA methylation in prehypertensive state is unknown. The aim of this study was to investigate the association between DNA methylation level of interleukin-6 (IL-6) promoter in pre-hypertensive (PreHT) and normotensive (NT) young adults.MethodsA total of 80 NT and 80 PreHT healthy subjects aged between 18–45 years were recruited in Kuantan, Pahang, Malaysia using an observational cross-sectional study approach. DNA methylation level of IL-6 promoter in peripheral leukocytes were measured using bisulphite conversion and MethyLight assay.ResultsThere was no significant difference in age between NT and PreHT (P = 0.655). The mean blood pressure was 110(8)/73(5) mmHg in NT and 125(7)/82(5) mmHg in PreHT subjects. The IL-6 promoter methylation level was significantly lower in PreHT compared to NT subjects (P < 0.001).ConclusionThe current study demonstrates that hypomethylation of IL-6 promoter was associated with pre-hypertension in young adults. Thus, IL-6 methylation could be used as an early indicator for predicting hypertension and related risk of cardiovascular diseases in prehypertensive subjects. Gene expression and longitudinal studies are warranted to examine the methylation effect on IL-6 expression over time.

High sensitivity C-reactive protein in pre-hypertensive young adults

Abstract High sensitivity C-reactive protein (hs-CRP) levels have been recommended by the Center for Disease Control and Prevention (CDC) and the American Heart Association (AHA) to be part of the global risk prediction assessment for cardiovascular diseases (CVD) in asymptomatic individuals. Hypertension is one of the major risk factors of CVD. It is usually preceded by a pre-hypertensive state in which, without intervention may lead to hypertension at an accelerated rate. Since studies have reported variation in the hs-CRP levels amongst different ethnic groups, it is therefore crucial to study the hs-CRP values in our population for it to be more a more reliable parameter when used as an early predictor of CVD. This study was conducted to compare the hs-CRP levels between the normotensive and pre-hypertensive categories of blood pressure (BP) among young adults in Kuantan, Pahang, Malaysia. Methods: A total of 167 young adults were recruited in this comparative cross sectional study, 96 (57.5%) in the normotensive (NT) and 71 (42.5%) pre-hypertensive (PHT) groups. Blood samples were assayed for hs-CRP levels. There was significant difference in the levels of the hs-CRP (p= 0.031) between the NT and PHT groups. The geometric mean of hs-CRP at 95% CI for NT was 0.87mg/L (0.79 to 0.96) and PHT, 1.42 mg/L (0.95 to 2.12), respectively. In our study, the hs-CRP levels in the PHT subjects were significantly higher compared to the NT group.

CRT-500.06 Related Variables in the Screening for Prevalence of Prehypertension in Young Adults Students at Technical School

Worldwide, several studies have been conducted about the association between hypertension in childhood and adolescence and socio-demographic factors: lifestyle, family history and anthropometry. This study aims to identify the prevalence of prehypertension and related variables in young adults.

Prevalence of prehypertension in young adults in a semi-urban district in Telangana

Background: Referred to as silent killer, is one of the leading causes of cardiovascular diseases. The risk of cardiovascular disease in people with prehypertension increases with the increase in burden of the other risk factors such as obesity, diabetes mellitus and dyslipidaemia. This study was undertaken to estimate the prevalence of prehypertension among the young adults in our area. Methods: 2658 patients, between 18-35 years of age, were included in the study. Complete physical and clinical examination, blood pressure, blood tests for cholesterol levels, blood glucose levels, and triglyceride levels were done. BMI, waist to hip ratio was also calculated. Results: 1433 (53.9%) of the patients were females and 1225 (46.1%) were males. Pre hypertension was found in 846 (31.8%) hypertension in 261(9.8%) young adults. There was a higher rate of BMI, blood glucose levels and cholesterol in these patients. Conclusions: There is a high prevalence of prehypertension among the young adults in our geographical. Therefore, awareness among the community, lifestyle modifications such as proper nutrition and less of fatty foods, regular check-ups especially for those with risk factors and timely treatment are very essential for curbing outcomes such as cardiovascular diseases.

Effect of 6 weeks pranava yoga training on cardiovascular parameters in prehypertensive young adults

Background: Hypertension is the major problem in developing countries. Blood pressure is usually maintained in a range by various regulatory mechanisms involving hormones, nervous system, and other local factors. Any rise in blood pressure above the normal range for a prolonged period is labeled as hypertension which is usually preceded by high normal blood pressure known as prehypertension. Various aerobic exercises and yoga may be beneficial in prehypertensive people. Of many yogic exercises, pranava yoga seems to be simplest. Pranava yoga involves chanting of word “Aum.” Aims and Objectives: Aim of the study was to find out the effect of 6 weeks Pranava yoga training on cardiovascular parameters of prehypertensive young adults. Materials and Methods: Subjects were divided into two groups of 30 each. Group A (control group) comprised normotensive subjects and Group B comprised prehypertensive subjects. Cardiovascular parameters were recorded using impedance cardiovasograph and mercury sphygmomanometer. After training of pranava yoga, subjects of Group B practiced it for 15 min daily for 6 weeks. All parameters were recorded in both groups before and after 6 weeks pranava yoga practice. Statistical analysis was done by one-way ANOVA and Tukey post-hoc tests. Results: Results showed that in comparison to Group A, all cardiovascular parameters were significantly higher (P 0.05) after 6 weeks training of pranava yoga. Conclusion: Results indicate a significant improvement in cardiovascular parameters in prehypertensive subjects after 6 weeks practice of pranava yoga.

Correlation between hypertension and hyperglycemia among young adults in India.

To assess the correlation between blood pressure levels and fasting plasma glucose levels among young adults attending Chatrapati Shahuji Maharaj University, Kanpur, India. The present study was cross-sectional in nature, conducted among students in the Institute of Paramedical Sciences, Chatrapati Shahuji Maharaj University, Kanpur. Study subjects included 185 young adults. Among them, 94 were males and 91 were females, in the age group 17 to 19 years. Mean age among males was 18.5 ± 1.5 years and among females was 17.9 ± 1.8 years. Of the total 185 study subjects, 61 (32.9%) were classified as pre-diabetic and 20 (10.8%) as pre-hypertensive. Mean waist circumference, systolic blood pressure and serum high density lipoprotein did not vary significantly between normoglycemic and pre-diabetic subjects. However, the mean diastolic blood pressure of pre-diabetics (82 ± 5 mmHg) was significantly higher than normoglycemics (79 ± 6 mmHg). Mean serum cholesterol, serum triglycerides, serum low density lipoprotein (LDL) and serum very low density lipoprotein was also higher among pre-diabetic subjects in comparison to normoglycemic subjects and the difference was statistically significant. Upon multiple linear regression analysis, it was observed that body mass index (BMI) (β = 0.149), diastolic blood pressure (β = 0.375) and serum LDL (β = 0.483) were significantly associated with fasting plasma glucose. Multiple linear regression with diastolic blood pressure as the outcome variable showed that BMI (β = 0.219), fasting blood glucose (β = 0.247) and systolic blood pressure (β = 0.510) were significantly associated. A significant prevalence of pre-diabetes and pre-hypertension in young adults is a matter of concern therefore all young adults need to be targeted for screening of diabetes and hypertension and lifestyle modification.

Lifestyle and Risk of Hypertension: Follow-Up of a Young Pre-Hypertensive Cohort

Objectives: To determine whether healthy lifestyle decreases the risk of developing hypertension in pre-hypertensive patients.Study design: A longitudinal study.Setting & participants: Randomly selected pre-hypertensive young adults 20-45 years old without any vascular disease such as stroke or diabetes.Predictors: Four lifestyle factors (a body mass index [BMI] of 18.5-24.9 kg/m2, regular physical activity, no alcohol use and 6-8 h of sleep per day), individually and in combination.Outcomes: Hypertension was defined as a systolic blood pressure (SBP) ≥ 140 mmHg, or a diastolic BP (DBP) ≥ 90 mmHg or self-reported hypertension.Measurements: Multivariate adjusted Cox proportional hazards.Results: During a median follow-up of 4.7 years, 1009 patients were enrolled in our study, and 182 patients developed hypertension. Compared with a BMI of 18.5-24.9 kg/m2, a BMI of 25-30 kg/m2 and a BMI of >30 kg/m2 were associated with an increased risk of hypertension occurrence (hazard ratio [HR], 1.83; 95% confidence interval [CI], 1.19-2.84 and HR, 2.62; 95% CI, 1.01-6.80, respectively). Compared with sleep duration of >8 h/day, 6-8 h/day of sleep was associated with a lower risk of hypertension occurrence (HR, 0.40; 95% CI, 0.18-0.86). There were no statistically significant associations between physical activity or alcohol use and hypertension occurrence (P>0.05).Limitation: All lifestyle factors were measured only once.Conclusion: Healthy BMI (18.5-24.9 kg/m2) and sleep duration (6-8 h/day) were associated with a lower risk of the occurrence of hypertension in pre-hypertension patients.

Cardiovagal Modulation, Oxidative Stress, and Cardiovascular Risk Factors in Prehypertensive Subjects: Cross-Sectional Study

Hypertension, one of the modifiable risk factors for cardiovascular disease (CVD), is known to be associated with increased oxidative stress and reduced cardiovagal modulation. Similar to hypertension, prehypertension is associated with increased risk of adverse cardiovascular (CV) events. We planned this study to find the association between prehypertension, cardiovagal modulation, oxidative stress, and associated CV risk factors. We recruited 178 subjects through hypertension screening camps conducted in Puducherry, India. Subjects were grouped into prehypertensive (n = 97) and normotensive (n = 81) groups. They were further subdivided, based on age, as young (20-39 years) and middle-aged (40-60 years) adults. We measured basal physiological parameters, heart rate variability, oxidative stress (thiobarbituric acid reactive substance and total antioxidant capacity (TAC)), and CV risk factors. We found significant increase in oxidative stress in prehypertensive subjects of both age groups but the cardiovagal modulation decreased significantly in young prehypertensive subjects when compared with normotensive subjects. Correlation of TAC with root mean square of the sum of successive R wave to R wave (RR) interval differences (RMSSD), a cardiovagal modulation parameter (r = 0. 437; P < 0.001), and mean arterial pressure (MAP) (r = -0.318; P < 0.001) was significant even after adjusting for CV risk factors. The correlation between MAP and RMSSD (r = 0.199; P = 0.009) was reduced after adjusting for CV risk factors. Prehypertension in young adults is associated with increased oxidative stress and altered cardiovagal modulation. The risk factors for CVDs in prehypertensive young adults were found to be equivalent to that of middle-aged adults who are in the twilight zone for developing CV dysfunctions.

Heart Rate Variability Biofeedback Decreases Blood Pressure in Prehypertensive Subjects by Improving Autonomic Function and Baroreflex

Individuals with prehypertension are at risk of hypertension and cardiovascular diseases, and yet efficient interventions are lagging behind. Studies indicate that heart rate variability-biofeedback (HRV-BF) increases HRV and baroreflex sensitivity (BRS) as well as reduces related pathological symptoms, suggesting potentially beneficial effects of HRV-BF on prehypertension, but little is known about these effects. In this study, these effects were investigated and their mechanisms were explored. The effect of HRV-BF on prehypertension in young adults and its potential mechanism were explored. Forty-three (43) individuals with prehypertension were recruited and classified into three categories: HRV-BF group, slow abdominal breathing group, and control group. All groups were assessed with measurements of noninvasive blood pressure (BP), BRS, respiration, and galvanic skin response (GSR) at pre-intervention, in the entire process of each session, at postintervention, as well as at a 3-month follow-up. Subjects participated in a 10-session HRV-BF protocol or simple slow abdominal breathing protocol conducted over 5 weeks. A 3-month follow-up was also performed on these individuals. The incidence of prehypertension was as high as 14.5% in young college students. Individuals with prehypertension were lower in BRS (7.5±5.2 ms/mm Hg) and HRV (log10-transformed of the standard deviation of normal-to-normal beats [SDNN]=1.62±0.13 ms, lgTotal power of spectral density in the range of frequencies between 0 and 0.4Hz (TP)=8.02±0.55 ms2) than those with normal blood pressure (BRS=18.4±7.4 ms/mm Hg, lgSDNN=1.79±0.10 ms, lgTP=8.68±0.85 ms2). HRV-BF reduced blood pressure (from 131.7±8.7/79.3±4.7 mm Hg to 118.9±7.3 mm Hg/71.9±4.9 mm Hg, p<0.01), increased BRS (from 7.0±5.9 ms/mm Hg to 15.8±5.3 ms/mm Hg, p<0.01) and increased HRV (lgSDNN from 1.61±0.11 to 1.75±0.05 ms, and lgTP from 8.07±0.54 to 9.08±0.41 ms2, p<0.01). These effects were more obvious than those of the slow-breathing group, and remained for at least 3 months. HRV-BF also significantly increased vagus-associated HRV indices and decreased GSR (indices of sympathetic tone). These effects suggest that HRV-BF, a novel behavioral neurocardiac intervention, could enhance BRS, improve the cardiac autonomic tone, and facilitate BP adjustment for individuals with prehypertension.