Rest Systolic Blood Pressure Research Articles

Nitric oxide contribution to endothelium-mediated vasodilation is attenuated in postmenopausal compared to premenopausal females

Background: Hypertension prevalence increases in females following menopause. Poor endothelial microvascular function increases risk of hypertension. Endothelial-mediated vasodilation is dependent on nitric oxide (NO). Estrogen enhances NO production; therefore, reduced estrogen levels in postmenopausal females may result in a reduced contribution of NO to endothelial-mediated vasodilation, although studies are limited. Herein, we aimed to investigate the contribution of NO to endothelial-mediated vasodilation in premenopausal and postmenopausal females. We hypothesized that postmenopausal females would have attenuated endothelium-mediated vasodilation and reduced contribution of NO compared to premenopausal females. Methods: Ten premenopausal (27±3 yrs) and eleven postmenopausal (59±4 yrs) normotensive females were studied. Resting brachial blood pressures were measured using a standard arm cuff. Brachial arterial catheters were placed for continuous blood pressure measurement and pharmacologic infusions. Forearm blood flow (FBF) was measured using venous occlusion plethysmography at baseline (saline) and during infusion of an endothelium-dependent vasodilator (acetylcholine; 1.0, 2.0, 4.0, and 8.0 μg/100mL tissue/min) with and without a NO synthase inhibitor (L-NG-monomethylarginine [L-NMMA]; 1.0 mg/min) co-infusion. Forearm vascular conductance (FVC) was calculated as FBF/mean arterial pressure✕100. Data were analyzed using a two-way repeated-measures ANOVA. Results: Resting systolic blood pressure (SBP) but not diastolic blood pressure (DBP) was greater in postmenopausal compared to premenopausal females (SBP: 121±15 vs. 103±9 mmHg, respectively; P<0.01; DBP: 72±11 vs. 65±5 mmHg, respectively; P=0.07). FBF responses to acetylcholine did not differ between premenopausal and postmenopausal females (Group Main Effect: P=0.11). When correcting for blood pressure, premenopausal females exhibited greater FVC responses to acetylcholine compared to postmenopausal females (Group Main Effect: P=0.04). In premenopausal females, FBF and FVC responses to acetylcholine were reduced with co-infusion of L-NMMA compared to acetylcholine infusion only (L-NMMA Main Effect: P=0.02 and P=0.01, respectively). In postmenopausal females, the FBF and FVC responses to acetylcholine were unaffected by L-NMMA (L-NMMA Main Effect: P=0.79 and P=0.76, respectively). Conclusion: Compared to premenopausal females, postmenopausal females have impaired endothelial microvascular function. Attenuated NO contribution during endothelium-mediated vasodilation in postmenopausal women may partially contribute to the increased hypertension risk in this population. AHA 14PRE18040000, AHA 898649, NIH HL083947, NIH HL148144, NCATS UL1 TR000135 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

Effects of Differences in Exercise Programs With Regular Resistance Training on Resting Blood Pressure in Hypertensive Adults: A Systematic Review and Meta-Analysis.

Igarashi, Y. Effects of differences in exercise programs with regular resistance training on resting blood pressure in hypertensive adults: A systematic review and meta-analysis. J Strength Cond Res 37(1): 253-263, 2023-This systematic review and meta-analysis aimed to evaluate changes in resting blood pressure (RBP) with differences in regular resistance training (RT) programs. Inclusion criteria were randomized controlled trials involving hypertensive adults and interventions involving only RT of both the upper and lower limbs for ≥7 weeks. The weighted mean difference (WMD) was defined as the mean difference between the exercise and control groups, weighted by the inverse of the squared standard error for each study, and all WMDs in RBP were pooled as overall effects. A simple meta-regression analysis was performed to evaluate the relationship between RT variables (percentage 1 repetition maximum [1RM], number of repetitions, number of sets, and weekly frequency) and changes in RBP. Seventeen studies (646 subjects) were analyzed. The pooled WMDs in the resting systolic blood pressure (RSBP) and resting diastolic blood pressure (RDBP) decreased significantly but contained significant heterogeneity {RSBP, -4.7 mm Hg (95% confidence interval [CI], -6.7 to -2.8; I2 = 46.6%); RDBP, -3.5 mm Hg (95% CI, -4.9 to -2.1; I2 = 39.1%)}. Meta-regression analysis revealed that an increase in % 1RM was significantly associated with a decrease in the RSBP (γ = -0.25x 0 + 10.85, where γ represents the mean difference in RSBP, and x 0 represents % 1RM [%]), and heterogeneity was alleviated ( I2 = 0.0%). For reducing RSBP, regular RT with moderate or heavy loads may be more beneficial than regular RT with light loads.

Usefulness of the corporate wellness projects in primary prevention at the population level: a study on the prevalence, awareness, and control of hypertension in the Ferrari company.

The aim of our study was to evaluate the prevalence, awareness, and control of hypertension in an apparently healthy company population. We conducted a cross-sectional study on a total sample of 2058 individuals with a mean age of 38 ± 9 years, enrolled for the first time to the Ferrari corporate wellness program "Formula Benessere". Hypertension was defined as systolic blood pressure (SBP) level ≥140 mmHg or diastolic BP (DBP) ≥90 mmHg or use of antihypertensive medication, whereas BP control was defined as BP level <130/80 mmHg. All 2058 participants were divided into three groups based on age: Group 1 aged <40 years (n = 1177, 57%), Group 2 aged 40-50 years (n = 627, 30%), and Group 3 aged >50 years (n = 254, 13%). Four-hundred and one subjects had BP levels ≥130/80 mmHg (19.5%). Two-hundred and sixty-one individuals (12.7%) had high-normal BP values and 140 subjects had rest SBP ≥140 mmHg and/or DBP ≥90 mmHg (6,8%), of which 41 (29.3%) with grade 2 hypertension. In the overall population, 259 individuals (12.5%) were affected by hypertension, the prevalence increasing with age. Only a minority (51%) was aware of being hypertensive and already treated with antihypertensive medications (45.9%). An adequate BP control was achieved in only 57% of subjects who received BP-lowering therapy. Corporate wellness programs may represent an essential tool in identifying apparently healthy subjects with an inadequate control of cardiovascular (CV) risk factors, such as hypertension. These preventive programs in the workplace may help to improve and spread primary CV prevention at the population level.

Comparison of Muscular Endurance and Hypertrophy Resistance Training on Cardiovascular Disease Risk in Sedentary Male Smokers

Background: Cardiovascular disease (CVD) exemplifies a major medical problem as it is the most considerable cause of morbidity and mortality. While sport conditioning specialists understand and differentiate the different benefits of resistance training (RT) subtypes on athletic performance, this distinction is less clear for health professionals when designing CVD risk reduction programs. Objectives: This study attempted to investigate and compare the effects of hypertrophy and muscular endurance RT on CVD risk in sedentary males. Methods: Sedentary male smokers were randomly assigned to either an eight-week hypertrophy RT group (HTG) (n = 15), muscular endurance RT groups (METG) (n = 15), or a non-exercising control group (CON) (n = 15) to assess their impact on smoking, blood pressure, cholesterol, and cardiorespiratory fitness (VO2max) variables associated with the four most prominent CVD risk factors. Data were analyzed using SPSS-25 software using a paired sample t-test and ANOVA. Results: Significant (P ≤ 0.05) improvements were found in three of the 15 measured variables in the HTG (resting mean arterial pressure (RMAP) (P = 0.024); total cholesterol (TC): HDL-C ratio (P = 0.009), and HDL-C: low-density lipoprotein cholesterol (LDL-C) ratio (P = 0.038), with a deleterious decrease in high-density lipoprotein cholesterol (HDL-C) (P = 0.027). In turn, significant improvements were found in the METG in 10 of the 15 measured variables, namely; cigarettes smoked per day (P = 0.037), resting systolic blood pressure (RSBP) (P = 0.002), resting diastolic blood pressure (RDBP) (P = 0.006), RMAP (P = 0.000), TC (P = 0.010), triglycerides (TG) (P = 0.010), LDL-C (P = 0.007), HDL-C: LDL-C (P = 0.018), non-HDL-C (n-HDL-C) (P = 0.010), and VO2max (P = 0.001), and a deleterious decrease in HDL-C (P = 0.026). Conclusions: While the oversimplification of RT design for CVD reduction has resulted in cardio-centric CVD training programs, this study demonstrates that some subtypes of RT (i.e. muscular endurance training) may prove more useful than others in reducing multiple CVD risk factors simultaneously.

Effects Of Different Non-pharmacological Methods On Recovery From Delayed Onset Muscle Soreness

PURPOSE: To investigate the effects of diverse recovery methods on delayed onset muscle soreness (DOMS) and muscle performance. METHODS: Ten healthy males (age = 24.1 ± 3.2 years; height = 173.3 ± 7.7 cm; weight = 81.5 ± 17 kg) participated in a crossover study with three randomized recovery treatment methods that were foam rolling (FR), Theragun (TGUN), or vibration platform (VP). The first session started with a 5-min seated rest, followed by the recording of the subjects’ resting systolic blood pressure (RSBP) and heart rate (HR) values. The subjects warmed-up on a treadmill at 4.5 mph, 0% gradient, for 5-min. Three trials of vertical jump (VJ) test were performed and the best jump performance was recorded. Subjects continued to leg extensions, which consisted of 1 warm-up set and then 4 sets at 80-85% of one repetition maximum (1-RM) until failure to induce DOMS. Rep tempo involved 1-sec concentric and 3-sec eccentric contractions. Subjects returned on day 2, which included 5-min rest followed by RSBP and HR measurements, then soreness levels were measured with Likert scale and Forge Gage. The subjects warmed-up on a treadmill, followed by the recovery method chosen for that session. VP consisted of 10 1-min sets with 1-min rest in between. FR and TGUN were used for 10-min on each side of the lower limb with 1-min rest in between. Following recovery methods, subjects repeated VJ test and leg extension exercises and number of reps were recorded. The exact procedure of day 2 was performed on day 3. RESULTS: A significant main effect for condition with the VP method showing higher RSBP values than the TGUN (p < 0.01). There were significant condition*time interaction and condition and time main effects for the total number of reps (p < 0.03). A higher number of reps performed following TGUN compared to VP and higher number of reps were performed on day 1 compared to day 2 (p < 0.03), with no contrast between day 1 and day 3. Significant time main effect was also seen in VJ values, suggesting day 1 values were higher compared to day 2 (p < 0.05) and day 3 values (p < 0.05). CONCLUSION: The results suggest that TGUN is an effective recovery method for reducing soreness, which can be attributed to higher muscle adhesion breakdown, and/or increased blood flow and O2 delivery to the muscle, and/or reduced pain perception due to inhibition of nociceptor activity.

Investigation of Multiparameter Trends and Anthropometric Measurements for Cardiorespiratory Fitness Assessment Among UTM Staff

Cardiorespiratory fitness (CRF) is known to reduce metabolic-related diseases like cardiovascular diseases (CVD), obesity, hypertension, and type II diabetes. On the other hand, the gold standard to measure CRF is by measuring maximal oxygen consumption, VO2 max over the years. This study is performed to identify parameters that influence CRF without solely relying on invasive features such as VO2 max. A number of 31 UTM staff aged between 30 and 40 years old have participated in this study with 17 female subjects and 14 male subjects. Anthropometric measurements are obtained by direct measurement and body composition analysis using a body composition monitor. Multiparameter trend measurements were obtained from vital sign monitors at rest. Single feature analysis was performed in terms of accuracy, specificity and sensitivity to identify which feature influences CRF the most. The features collected are body mass index (BMI), body fat (BF), muscle mass (MM), bone density (BD), waist circumference (WC), resting heart rate (RHR), resting systolic blood pressure (RSBP), forced expiratory volume in one second (FEV1), and recovery trend heart rate (RecHR). Next, all these features were validated using Naïve Bayes (NB) and Decision Tree (DT) classifiers. Finally, six features which are BF, BM, BD, RHR, RSBP and FEV1, with accuracy more than 70% were selected and identified as the features which influence CRF of UTM staff.

Interrupting Prolonged Sitting With Different Walking Intensities And Durations: Effects On Resting Blood Pressure

BACKGROUND: Greater time spent in sedentary behaviour is associated with an increased risk of cardiovascular disease, type-2 diabetes, and mortality. Regularly interrupting prolonged sitting with 2-min light-intensity and 2-min moderate-intensity walking every 20 minutes without matching for energy expenditure has been shown to reduce resting blood pressure. However, little is known whether interrupting prolonged sitting with 3-min light-intensity walking and 1.5-min brisk walking every 30 min when the energy expenditure of these trials is matched provides similar benefits on resting blood pressure. PURPOSES: To compare the effects of 1.5-min moderate-intensity walking every 30 minutes and 3-min light-intensity walking every 30 minutes on resting blood pressure in young men with central obesity when the energy expenditure of these trials is matched. METHODS: Sixteen East-Asian men with central obesity (mean age: 22.3 ± 4.2 years; body mass index: 29.9 ± 1.7 kg·m-2; waist circumference: 100.3 ± 5.9 cm) completed three, 7-h laboratory-based conditions in a randomised order: 1) prolonged sitting (SIT), 2) 3-min (at 20 - 39% of VO2 reserve) and 3) 1.5-min (at 40 - 59% of VO2 reserve). Each trial was separated by a 6-day washout period. Resting blood pressure was measured hourly using automated sphygmomanometer in a seated position (mean of two recordings, ≥ 15-min post-activity). Generalised Estimating Equations were used to examine differences among the three conditions. RESULTS: Resting systolic blood pressure (SBP) reduced in the 3-min condition (mean ± SEM; 119 ± 2 mmHg) but not in 1.5-min condition (120 ± 2 mmHg) when compared with SIT condition (123 ± 3 mmHg, P = 0.028). Resting diastolic blood pressure (DBP) reduced in both 3-min (75 ± 2 mmHg) and 1.5-min (75 ± 2 mmHg) conditions compared with SIT condition (76 ± 2 mmHg, P = 0.024 and P = 0.001, respectively). CONCLUSIONS: Interrupting prolonged sitting with 3-min of light-intensity walking every 30 minutes is more effective on reducing resting blood pressure when compared to the trial with 1.5-min of moderate-intensity walking every 30 minutes in young East-Asian men with central obesity.

Running to Lower Resting Blood Pressure: A Systematic Review and Meta-analysis.

According to previous epidemiological studies, there are pros and cons for the relationship between running regularly and changes in resting blood pressure (RBP), and the changes may depend on the form of exercise. The aims of the current systematic review were to summarize the effects of running regularly on RBP and to investigate the most efficacious form of running in reducing RBP for this purpose. The inclusion criteria were: randomized controlled trials, involving healthy adults or adults with hypertension, the exercise group only performed regular running and the control group did not exercise, and the study reported the mean resting systolic blood pressure (RSBP) and/or diastolic blood pressure (RDBP). The mean difference (MD) in RBP in each trial was defined as follows: (mean value at post-intervention in the exercise group - mean value at baseline in the exercise group) - (mean value at post-intervention in the control group - mean value at baseline in the control group) and was calculated. The weighted MD (WMD) was defined as the synthesis of all MD. A linear meta-regression analysis, exercise intensity [the percentage of maximum heart rate] (%) and total exercise time throughout the intervention (hours) were selected as explanatory variables and the MD in RBP served as the objective variable. Twenty-two trials (736 subjects) were analyzed. When trials were limited to those involving healthy subjects, the WMD in RBP decreased significantly [RSBP: - 4.2mmHg (95% confidence intervals (95% CI) - 5.9 to - 2.4); RDBP: - 2.7mmHg (95% CI - 4.2 to - 1.1)] and did not contain significant heterogeneity (RSBP: P = 0.67, I2 = 0.0%; DBP: P = 0.38, I2 = 7.2%). When trials were limited to those involving subjects with hypertension, the WMD in RBP decreased significantly [RSBP: - 5.6mmHg (95% CI - 9.1 to - 2.1); RDBP: - 5.2mmHg (95% CI - 9.0 to - 1.4)] but contained significant heterogeneity (RSBP: P = 0.01, I2 = 62.2%; DBP: P < 0.01, I2 = 87.7) and a meta-regression analysis showed that the percentage of maximum heart rate was significantly associated with the WMD in RSBP [slope: 0.56 (95% CI 0.21 to 0.92), intercept: - 48.76 (95% CI - 76.30 to - 21.22), R2 = 0.88] and RDBP [slope: 0.45 (95% CI 0.01 to 0.87), intercept: - 38.06 (95% CI - 72.30 to - 4.08), R2 = 0.41]. When trials were limited to those involving subjects with hypertension and a mean age ≥ 40years, a meta-regression analysis showed that total exercise time throughout the intervention was significantly associated with the WMD in RDBP [slope: 0.82 (95% CI 0.54 to 1.09), intercept: - 22.90 (95% CI - 29.04 to - 16.77), R2 = 0.99]. Running regularly decreases RBP, but the changes in subjects with hypertension may differ depending on exercise intensity or total exercise time. Therefore, running regularly at moderate intensity and at a restrained volume is recommended to lower RBP in subjects with hypertension.

Non-thrust cervical manipulations reduce short-term pain and decrease systolic blood pressure during intervention in mechanical neck pain: a randomized clinical trial

ABSTRACTObjectives: To evaluate the association of resting blood pressure with pain response and evaluate the cardiovascular effects of anterior-to-posterior [AP] versus lateral [LAT] techniques of cervical spine non-thrust manipulation [NTM].Methods: Forty-three (23 females) participants with non-chronic neck pain (mean age 29.00 ± SD 9.09 years) randomly received AP or LAT NTM to the cervical spine. Blood pressure and heart rate were measured before, during, and after the intervention. Disability and pain were measured pre- and post-intervention.Results: Resting systolic blood pressure (SBP) was significantly associated with average pain reduction two days later on univariate and multivariate analyses (coefficients −0.029 ± SD 0.013, p = 0.036; −0.026 ± 0.012, p = 0.032).No significant differences existed between AP and LAT NTM groups in disability, pain reduction, and cardiovascular variables. The decrease in ‘worst neck pain’ rating 2-days post-intervention was clinically significant within the AP (mean −2.43 ± SD 2.66) group. Mixed-effect model ANOVA revealed a significant change in SBP over time (estimate −1.94 ± SD 0.70, p = 0.007).Discussion: This spinal NTM study was the first to relate resting SBP with short-term pain reduction, demonstrating SBP-related hypoalgesia. In normotensive individuals with unilateral non-chronic neck pain, each 10 mmHg higher resting SBP was associated with a 0.29-unit decrease in average pain at follow-up when holding baseline pain constant.AP and LAT NTM equally reduced short-term pain and decreased SBP during-intervention, suggesting SBP-sympathoinhibition. These techniques have previously been shown to be sympatho-excitatory when delivered under different dosage parameters. SBP’s mediating and moderating role should be investigated.“Level of Evidence: 1b.”

One-Year Changes in Cardiovascular Risk Markers in Police Officers

PURPOSE: The present study retrospectively examined one-year changes in certain traditional and non-traditional cardiovascular disease (CVD) risk markers in police officers (n = 84). Subjects were full time police officers employed by a moderate-to-large municipality. METHODS: As a part of their annual physical exam, police officers underwent evaluation of several CVD risk markers including body weight, a graded exercise test (GXT; Bruce protocol), pushups completed in 1 minute, situps completed in 1 minute, handgrip strength, body composition (through DEXA), and fasting bloodwork. Maximal oxygen uptake (VO2max) was estimated using the Foster equation. Resting systolic blood pressure (RSBP) and resting diastolic blood pressure (RDBP) were measured before the start of the GXT protocol. Blood analysis was performed by a College of American Pathologists-accredited laboratory. All blood samples were analyzed for total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL) cholesterol (HDL-C), low-density lipoprotein (LDL) cholesterol (LDL-C), glucose (GLU), LDL particle number (LDLnum), LDL size (LDLsz), small LDL particle number (sLDLnum), HDL particle number (HDLnum), and HDL size (HDLsz). All data were analyzed using paired t-tests (p < 0.05). RESULTS: With respect to the fitness testing variables measured, significant increases were noted in pushups performed (4 pushups) and handgrip strength (4.45 kg) while RDBP was significantly reduced (4 mm/Hg). Within the traditional fasting blood panel, GLU was significantly increased (5.5 mg/dL) while LDL-C was significantly reduced (8.4 mg/dL). Non-traditional CVD risk markers were also significantly altered. Increases were noted in LDLnum (309 nmol/L), sLDLnum (347 nmol/L), and HDLnum (6.6 umol/L) while reductions in LDLsz (0.53 nm) and HDLsz (0.5 nm) researched statistical significance. CONCLUSIONS: While beneficial changes were noted in several traditional CVD risk markers, unfavorable alterations occurred in the majority of the non-traditional CVD risk markers measured. In addition, these findings support the need for required health and fitness programs for law enforcement personnel.

Family History, BMI and Sympathetic Hyperactivity in Healthy Offsprings of Hypertensive Parents

Objective&#x0D; Hypertension is associated with large and growing health and economic burden of Cardiovascular and renal diseases. Hypertension doubles the risk of cardiovascular disease, including coronary heart disease(CHD), congestive heart failure, ischemic and hemorrhagic stroke, renal failure and peripheral arterial disease.&#x0D; Recent study suggests prevalence of Hypertension is increasing as a consequence of increasing obesity. Both environmental and Genetic factors contribute to the increased prevalence of Hypertension. Obesity and weight gain are strong, independent risk factors for hypertension. Aim of this study was to assess relation between Family history, BMI and autonomic function tests in healthy offsprings of hypertensive parents.&#x0D; Method&#x0D; The present study was conducted in 35 normotensive healthy offsprings of Hypertensive parents (Study Group) and 35 normotensive healthy offsprings of Nonhypertensive parents (Control Group), in the age groupof 18–21 years, randomnly selected from 1st and 2nd MBBS Students of Shri. BM patil Medical College. Bijapur.&#x0D; Results&#x0D; There is also significant increase in sympathetic function tests and insignificant increase in the readings of parasympathetic function tests and significant increase in resting Respiratory rate and Resting Systolic Blood Pressure in study group compared to control group.&#x0D; Conclusion&#x0D; This cross sectional study showed increase in prevalence of cardiac autonomic dysfunction more of sympathetic overactivity in normotensive healthy offsprings of Hypertensive parents, compared to normotensive healthy offsprings of Nonhypertensive parents.

PO-060 Changes of Cardiovascular Function during Exercise Tolerance Testing in Sedentary Postmenopausal Women after Exercise Intervention

Objective Previous studies suggested that being postmenopausal could increase the risk of cardiovascular disease(CVD). If we can master the change characteristics of postmenopausal women’ cardiovascular function when they doing exercise, we may prevent or reduce the risk of CVD which induced by exercise. To get a more accurate tolerant judgment of the intensity of exercise, we discussed the change of cardiovascular function in sedentary postmenopausal women during exercise tolerance testing after exercise intervention, wish to provide more reliable theory basis in preventing exercise emergence and make an appropriate exercise prescription.&#x0D; Methods Thirty postmenopausal women participated the study. PAR-Q questionnaires and International Physical Activity Questionnaire-Short Forms were used to screen participants. They were randomly divided into control group(n=15) and experimental group (n=15). The experimental group had an exercise intervention with 3 months walking while the control group lived as usual. Using an exercise tolerance testing by cycle ergometer, let participants do one-time maximal graded exercise test to exhaustion, get the indicators of heart rate, blood pressure, VO2max, then analyzed the changes of cardiovascular function indexes before and after exercise intervention in experimental group, compared with control group in the same age categories, explored the similarities and differences between index variation.&#x0D; Results (1) After 3 months of exercise intervention, the rest systolic blood pressure in the experimental group was significantly lower than that in the control group(P&lt;0.05). (2) With the increase of exercise intensity, heart rate tend to rise in both two groups (P&lt;0.05). After 3 months of exercise intervention, the amplitude of heart rate variation between two intensities got smaller in the experimental group. (3) With the enlargement of exercise intensity, systolic blood pressure tend to increase in both two groups (P&lt;0.05). After 3 months of exercise intervention, the amplitude of systolic blood pressure variation between two grades got smaller in the experimental group. (4) The exercise intervention can effectively improve the cardiac functional capacity of postmenopausal women (P&lt;0.05).&#x0D; Conclusions Exercise for 3 month can efficiently increase the ability of postmenopausal women’s cardiovascular system in the quiet state, increase the reaction and adaptability of intensity stimulation of heart.

The Pulse Wave Velocity is Linearly Correlated with Resting Systolic and Diastolic Blood Pressure in Hypertensive Patients

Introduction: Aortic stiffness is an independent predictor for cardiovascular event. If arteries lose their natural elasticity, systolic blood pressure become higher and dia­stolic blood pressure become lower. Method of evaluating arterial stiffness is aortic pulse wave velocity (PWV). Therefore, PWV has a potential application for screening vascular damage in large population.2 Recent reports have shown that PWV obtained by noninvasive automatic devices (i.e. tonometry, cuff pressure) is not only a marker of vascular damages, but also a prognostic predictor in patients with hypertension.3 The aim of this study is to investigate the correlation between PWV and systolic and diastolic blood pressure.&#x0D; Methods : Male hypertensive patients, aged 40-60 years old who underwent Doppler Vascular were included in this study. The measurement of carotid-femoral PWV is made by dividing the distance (from the carotid point to the femoral point) by the so-called transit time (the time of travel of the foot of the wave over the distance). Hence, PWV = D (meters)/Dt (seconds). The correlation between PWV and systolic and diastolic blood pressure were analysed using linear regression test.&#x0D; Results : A total 40 patients were included in this study. Those were significant correla­tion between PWV and systolic (R=0.473, p=0.002) and diastolic (R=0.454, p=0.003) blood pressure.&#x0D; Conclusion : increasing PWV is linearly associated with systolic and diastolic blood pressure.&#x0D; &#x0D; Abstrak&#x0D; Pendahuluan: Kekakuan aorta adalah prediktor independen untuk kejadian kardiovaskular. Jika elastisitas alami arteri hilang, tekanan darah sistolik menjadi lebih tinggi dan tekanan darah diastolik menjadi lebih rendah. Metode evaluasi kekakuan arteri adalah kecepatan gelombang pulsasi (pulse wave velocity/PWV). Oleh karena itu, PWV dapat diterapkan untuk skrining kerusakan vaskular pada populasi besar.2 Laporan terbaru menunjukkan bahwa PWV yang diperoleh dengan perangkat otomatis non-invasif (yaitu tonometri, tekanan manset) tidak hanya merupakan penanda kerusakan vaskular, tetapi juga prediktor prognostik pada pasien dengan hipertensi.3 Tujuan dari penelitian ini adalah untuk mengetahui hubungan antara PWV dan tekanan darah sistolik dan diastolik.&#x0D; Metode: Pasien pria dengan hipertensi, berusia 40-60 tahun yang menjalani Doppler Vascular dimasukkan dalam penelitian ini. Pengukuran PWV karotid-femoralis dilakukan dengan membagi jarak (dari titik karotid ke titik femoral) dengan waktu transit. Oleh karena itu, PWV = D (meter) / Dt (detik). Korelasi antara tekanan darah PWV dan sistolik dan diastolik dianalisis dengan menggunakan uji regresi linier.&#x0D; Hasil: Sebanyak 40 pasien dimasukkan dalam penelitian ini. Itu adalah korelasi yang signifikan antara tekanan darah PWV dan sistolik (R = 0,473, p = 0,002) dan diastolik (R = 0,454, p = 0,003).&#x0D; Kesimpulan: Peningkatan PWV berhubungan linear dengan tekanan darah sistolik dan diastolik.

Effects of progressive aerobic exercise on the cardiopulmonary functions of premenopausal and postmenopausal breast cancer survivors

The incidence rate of breast cancer (BC) continues to rise as the survival rate is still poor in economically developing countries. Therapeutic approaches to improve cardiopulmonary functions and the survival rate of BC survivors are pressing concerns. This study investigated the effects of progressive aerobic exercise on the cardiopulmonary parameters of female BC survivors.Fifty-eight BC survivors with stage I, II and III breast cancer, referred from the Radiotherapy and Oncology Department of Lagos University Teaching Hospital, participated in the study and 48 of them completed it. The participants were randomly assigned to groups A and B and each group was further subdivided into subgroups 1 (premenopausal women) and 2 (postmenopausal women) based on their menopausal status. Group A underwent aerobic exercise using the treadmill and also had educational and counselling sessions while Group B had only educational and counselling sessions. Selected cardiopulmonary parameters were measured at baseline, 3rd ,6th , 9th and 12th weeks of intervention.Significant improvements were observed in the cardiovascular variables of Groups A (1&amp;2) (Resting systolic blood pressure (RSBP) (A1 :p = 0.00*; A2 : p = 0.01*), Resting diastolic blood pressure (RDBP) (A1 : p = 0.03*; A2 : p = 0.01*), Resting rate pressure product (RRPP) (A 1: p = 0.01*; A2 : p = 0.00*). With the exception of SaO2 (p = 0.05*) of Group A2, changes in the pulmonary variables of Groups A(1&amp;2) were not significant. No significant. differences were observed in the cardiovascular and pulmonary variables of Groups B(1&amp;2).Aerobic exercise brought about significant therapeutic effects on selected cardiovascular parameters in female BC survivors.Keywords: Aerobic exercise, cardiopulmonary, breast cancer

Meta-analysis of trimetazidine treatment for cardiomyopathy.

To explore the effect of trimetazidine (TMZ) in cardiomyopathy treatment. Literatures, related with TMZ treatment for cardiomyopathy, were retrieved between 1990 and February 2018 in the Pubmed, Embase, and Cochrane Library systems. Cardiopulmonary exercise testing [resting heart rate (RHR), peak heart rate (PHR), peak systolic blood pressure (PSBP), and resting systolic blood pressure (RSBP)] and echocardiographic results [left ventricular ejection fraction (LVEF), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), systolic wall thickening score index (SWTSI), left ventricular end-systolic diameter (LVESD), and left ventricular end-diastolic diameter (LVEDD)] were merged to detect the publication bias. Total 898 patients with cardiomyopathy were divided into two groups: TMZ-treated group (n=456) and control group (n=442). There was no difference in the improvement of cardiomyopathy between the TMZ and control group. No publication bias was shown for PHR (t= 0.9791, P=0.5067). There were significant differences in LVEF, LVESV, SWTSI, LVESD, and LVEDD between the TMZ group and the control group. TMZ-treatment significantly increased the level of LVEF (95% confidence interval (CI): 5.46–7.84, P<0.001), and reduced the level of LVESV (95% CI: −18.73 to −7.77, P<0.001), SWTSI (95% CI: −0.47 to −0.15, Z = −3.85, P=0.001), LVESD (95% CI: −1.09 to −0.08, P<0.001), and LVEDD (95% CI: −0.55 to −0.26, P=0.023). There was no publication bias except for LVEDV (t = 2.5456, P=0.0438). TMZ is effective for cardiomyopathy treatment and worth to popularize in clinic.

Variable prognostic value of blood pressure response to exercise

AimThe aim of this study was to evaluate the impact of patient background including exercise capacity on the relationship between the blood pressure (BP) response to exercise and prognosis in patients visiting a cardiovascular hospital. MethodsA total of 2134 patients who were referred to our hospital underwent symptom-limited maximal cardiopulmonary exercise testing, and were followed through medical records and mail. The BP response to exercise was defined as the difference between peak and rest systolic BP. The end point was set as cardiovascular events including cardiovascular death, acute coronary syndrome, hospitalization for heart failure, and cerebral infarction. ResultsDuring a median follow-up period of 3 years, 179 (8%) patients reached the end point (2.5%/year). Multivariate analysis showed that BP response was independently and negatively associated with the occurrence of the end point. This prognostic significance of BP response was consistent regardless of left ventricular ejection fraction, renal function, presence of heart failure symptoms, the presence of organic heart disease, and hypertension. However, peak VO2 showed a significant interaction with the effects of BP response on the end point, suggesting that the prognostic value of BP response was limited in patients with preserved exercise capacity. ConclusionsThe role of BP response to exercise as the predictor depends on exercise capacity of each patient.

Relationship of aerobic fitness with cardiovascular risk factors in firefighters.

Epidemiological studies on the general population have shown that increased physical activity and aerobic fitness (AF) significantly decrease the risk of coronary artery disease. Finding ways to decrease such risk factors can promote the health of firefighters. This study was conducted in a large industrial facility in Tehran. AF assessment and submaximal aerobic fitness testing of participants were performed according to the guidelines of the American College of Sports Medicine (ACSM). AF was determined using a bicycle ergometer. Other information was collected using a specifically designed questionnaire, physical examination and blood test. Data were analyzed using SPSS. Level of significance was set at P < 0.05. A total of 157 male firefighters were evaluated in an industrial facility. The results of logistic regression analysis revealed that AF was significantly correlated with age, body mass index (BMI), cigarette smoking, physical activity, hemoglobin level, low-density lipoprotein (LDL) level, high-density lipoprotein (HDL) level, resting systolic blood pressure (RSBP), diastolic blood pressure (RDBP) and heart rate (RHR) (P < 0.05). Firefighters with greater AF had lower cardiovascular disease (CVD) risk factors. Longitudinal studies are required to further confirm this finding. Increasing the AF may decrease CVD risk factors in firefighters.

Effect of Aerobic Exercise Training on Physiological Parameters of Rehabilitative Stroke Patients

Aim: Stroke constitutes a considerable cause of morbidity and mortality in any society. Despite the increasing effect of stroke, information about the prophylactic effect of aerobics exercise on the health disorder in Ghana is rare. The objective of the study is to Original Research Article International Journal of TROPICAL DISEASE & Health, 4(11): 1179-1190, 2014 1180 investigate the effect of aerobic exercise (AE) training on rehabilitative stroke patients considering their body mass index (BMI), resting systolic blood pressure (RSBP), resting diastolic blood pressure (RDBP), resting heart rate (RHR) and resting blood oxygen saturation (RSp02). Study Design: Quasi-experimental research design with pre-post test was employed. Place and Duration of Study: The study was conducted at physiotherapy clinic of Komfo Anokye Teaching Hospital, Kumasi, Ghana. The AE training and measurement were conducted from November, 2013 to April, 2014 in the gymnasium of the physiotherapy clinic. Methodology: The study comprised of fifty rehabilitative stroke [partial (36, 72.0%) and permanent (14, 28.0%)] patients with mean age of 54.04±13.07 years attending physiotherapy clinic. Age ranged from 26 to 80 years. The patients [male (27, 54.0%) and female (23, 46.0%)] went through moderate intensity, two sections a week of AE training for two months. Forty (80.0%) of the participants has experience in exercise programme while ten (20.0%) has none prior to the AE training programme. Physiological parameters of BMI, RSBP, RDBP, RHR and RSp02 were measured two days before and after the AE training period, and analysed. Results: The BMI (24.89±3.56 vs 23.11±2.89; t=9.237, p<0.05), RSBP (131.48±23.43 vs 120.94±7.42; t = 3.468, p<0.05), RDBP (87.70±16.03 vs 79.50±6.26, t = 3.577, p<0.05), RHR (84.22±8.47 vs 74. 22±3.80; t = 8.879, p<0.05) and RSp02 (93.44± 5.14 vs 96.56±1.98; t =-4.905, p<0.05) significantly changed after two months of AE training. There is significant difference in gender-based analysis on the effect of AE training on BMI (22.36 ±2.70 vs23.99±3.00; t=-2.058, p<0.05) and RDBP (81.63±5.83 vs 77.00± 5.92; t=2.779, p<0.05). There was no significant differences in the effect of AE training on physiological parameters analysed based on degree of stroke and exercise experience. Conclusion: AE training was effective on the BMI, RSBP, RDBP, RHR and RSp02 of rehabilitative stroke patients irrespective of gender and degree of stroke. Significance attention should be given to aerobic exercise in the rehabilitating process of stroke patients to minimize adverse affects of some drugs on their blood pressure, heart rate and oxygen saturation.

Pedlar inexpensive ergometer-based exercise program improves activity intolerance in a heart failure case

This paper reports on the efficacy of a pedlar inexpensive ergometer-based structured exercise program in improving activity intolerance in a heart failure case. Data were collected between May 15, 2010 and May 20, 2010 using physical assessments, observations, and interviews. Several home visits were conducted after hospital discharge until August 8. Health problems identified included disease-related weakness, inability to complete daily activities, activity intolerance, malnutrition, and ineffective tissue perfusion. In addition to providing nutrition and dietary guidance, we designed an exercise rehabilitation program to improve activity intolerance both during hospitalization and after hospital discharge. Outcome measurements included the six-minute walk test, blood pressure, heart rate, oxygen saturation, and self-perceived improvement. Improvements achieved by the 12th week of the exercise training program included: (1) Able to complete the six-minute walk test (initially unable). (2) Walking distance increased by 54 meters. (3) Target heart rate achieved 40-60% of the maximum heart rate. (4) Resting systolic blood pressure and heart rates decreased tremendously, and (5) Fatigue and shortness of breath improved greatly. Results indicate the pedlar inexpensive ergometer exercise program may help improve the health of heart failure cases suffering from activity intolerance.

Safety and feasibility of regadenoson use for suboptimal heart rate response during symptom-limited standard Bruce exercise stress test

BackgroundRegadenoson during exercise stress test (ETT) can provide maximal hyperemia for myocardial perfusion imaging (MPI), along with exercise information. Our aim was to study the feasibility and safety of regadenoson injection at peak ETT for submaximal heart rate (HR) response. MethodsConsecutive patients who underwent SPECT MPI with standard Bruce ETT or supine-regadenoson (Supine-Reg) were analyzed. ETT patients were grouped as ETT-Max [maximal HR > 0.85 * (220 − age), N = 1,522], ETT-Submax (submaximal HR no regadenoson, N = 504), ETT-Reg (submaximal HR and regadenoson, N = 211). ResultsThe HR during ETT was submaximal in 715 (32%) patients. Of these, 211 patients (30%) underwent ETT-Reg (mean exercise duration: 5.5 ± 2.5 minutes). ETT-Reg patients had a higher frequency of hypertension, diabetes, smoking and beta-blocker use, similar rest systolic blood pressure (SBP), but lower rest and peak HR and peak SBP compared to ETT-Max patients. There were no serious complications with regadenoson. Side effects (49% vs 6%, P < .0001) were fewer and aminophylline use was lower with ETT-Reg compared to Supine-Reg (0.5% vs 8.1%, P = .001). ConclusionsSubmaximal HR response to ETT is common. ETT-Reg is safe, feasible, and well-tolerated. ETT-Reg facilitates a diagnostic MPI with reporting of functional capacity, exercise ECG/hemodynamic changes and MPI at maximal hyperemia.