Resting Blood Pressure Research Articles

Ergogenic effects of spinal cord stimulation on exercise performance following spinal cord injury.

Cervical or upper-thoracic spinal cord injury (SCI, ≥T6) often leads to low resting blood pressure (BP) and impaired cardiovascular responses to acute exercise due to disrupted supraspinal sympathetic drive. Epidural spinal cord stimulation (invasive, ESCS) and transcutaneous spinal cord stimulation (non-invasive, TSCS) have previously been used to target dormant sympathetic circuits and modulate cardiovascular responses. This case series compared the effects of cardiovascular-optimised ESCS and TSCS versus sham ESCS and TSCS on modulating cardiovascular responses and improving submaximal upper-body exercise performance in individuals with SCI. Seven males with a chronic, motor-complete SCI between C6 and T4 underwent a mapping session to identify cardiovascular responses to spinal cord stimulation. Subsequently, four participants (two ESCS and two TSCS) completed submaximal exercise testing. Stimulation parameters (waveform, frequency, intensity, epidural electrode array configuration, and transcutaneous electrode locations in the lumbosacral region) were optimised to elevate cardiovascular responses (CV-SCS). A sham condition (SHAM-SCS) served as a comparison. Participants performed arm-crank exercise to exhaustion at a fixed workload corresponding to above ventilatory threshold, on separate days, with CV-SCS or SHAM-SCS. At rest, CV-SCS increased BP and predicted left ventricular cardiac contractility and total peripheral resistance. During exercise, CV-SCS increased time to exhaustion and peak oxygen pulse (a surrogate for stroke volume), relative to SHAM-SCS. Ratings of perceived exertion also tended to be lower with CV-SCS than SHAM-SCS. Comparable improvements in time to exhaustion with ESCS and TSCS suggest that both approaches could be promising ergogenic aids to support exercise performance or rehabilitation, along with reducing fatigue during activities of daily living in individuals with SCI.

Association of Fibroblast Growth Factor 23 with Blood Pressure in Primary Proteinuric Glomerulopathies

Introduction: Fibroblast growth factor 23 (FGF23) has direct effects on the vasculature and myocardium, and high levels of FGF23 are a risk factor for cardiovascular disease (CVD); however, the impact of FGF23 on CVD in primary proteinuric glomerulopathies has not been addressed. Methods: The associations of baseline plasma intact FGF23 levels with resting blood pressure (BP) and lipids over time among adults and children with proteinuric glomerulopathies enrolled in the Nephrotic Syndrome Study Network (NEPTUNE) were analyzed using generalized estimating equation regression analyses. Models were adjusted for age, sex, glomerular diagnosis, follow-up time, estimated glomerular filtration rate, urine protein/creatinine ratio, obesity, and serum phosphorous levels. Results: Two hundred and four adults with median FGF23 77.5 (IQR 51.3–119.3) pg/mL and 93 children with median FGF23 62.3 (IQR 44.6–83.6) pg/mL were followed for a median of 42 (IQR 20.5–54) months. In adjusted models, each 1 µg/mL increase in FGF23 was associated with a 0.3 increase in systolic BP index at follow-up (p < 0.001). Greater baseline FGF23 was associated with greater odds of hypertensive BP (OR = 1.0003; 95% CI 1.001–1.006, p = 0.03) over time. Compared to tertile 1, tertile 2 (OR = 2.1; 95% CI 1.12–3.99, p = 0.02), and tertile 3 (OR = 3; 95% CI 1.08–8.08, p = 0.04), FGF23 levels were associated with greater odds of hypertensive BP over time. Tertile 2 was associated with greater triglycerides compared to tertile 1 (OR = 48.1; 95% CI 4.4–91.9, p = 0.03). Conclusion: Overall, higher baseline FGF23 was significantly associated with hypertensive BP over time in individuals with proteinuric glomerulopathies. Further study of FGF23 as a therapeutic target for reducing CVD in proteinuric glomerular disease is warranted.

BLOOD PRESSURE MEASURES ARE NOT CORRELATED WITH NIH TOOLBOX COGNITIVE BATTERY PERFORMANCE IN BLACK OLDER ADULTS

Abstract Elevated blood pressure has been inconsistently associated with cognitive performance in older adults. Black adults experience higher rates of elevated blood pressure and cognitive impairment than White adults. This study investigated whether blood pressure measurements were associated with cognitive performance on the NIH Toolbox Cognition Battery (NIHTB-CB) in older Black adults. 77 older Black adults 65+ years of age (M=72.6, SD=4.9) with subjective cognitive decline were administered the NIHTB-CB, a battery of computer-based cognitive tests. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured before and after cognitive testing and a cognitive task-based EEG/ERP. Average SBP, DBP, and pulse pressure (PP) were calculated. Difference scores from pre- to post-EEG/ERP served as a reactivity index following cognitive task engagement. A ratio of the difference scores to the baseline measures controlled for resting blood pressure. Bayesian correlations examined the relations between blood pressure measurements and NIHTB-CB performance. Data analysis used fully corrected T scores from the NIHTB-CB subtests. Average SBP, SBP difference scores, and baseline SBP were not associated with NIHTB-CB performance on any measurement (all BF10 &amp;lt; 3.0). Similarly, DBP and PP were unrelated to NIHTB-CB performance. Systolic and diastolic blood pressure were not associated with any NIHTB-CB measure. Additionally, blood pressure reactivity was not related to cognitive performance. Future research may investigate the relationship between SBP reactivity and cognitive performance across multiple measurement periods. Antihypertensive medication and duration of hypertension among hypertensive individuals may also be an important consideration in future studies.

Blood pressure status in patients with metabolic syndrome

Relevance. Metabolic syndrome (MetS) is existence of many abnormalities, such as abdominal obesity, hypertension, dyslipidemia, and glucose intolerance. The occurrence of MetS in hypertensive people is linked to poorly managed hypertension. One of the parameters for the diagnosis of the syndrome is the presence of increased blood pressure; nevertheless, research shows that MetS patients are likely to experience hypertension often. Materials and Methods. 300 metabolic subjects were selected from the medicine OPD as study participants based on the joint interim statement’s 2009 definition of the metabolic syndrome. They were divided into three groups (normotensive, pre-hypertensive, and hypertensive) based on blood pressure readings that met the American Heart Association’s (AHA) Asian blood pressure criteria. The following parameters were recorded for data collection: anthropometric (Weight, Height, Body Mass Index Waist Hip Ratio), Blood pressure, biochemical (Fasting blood glucose, Lipid profile parameters). Results and Discussion. According to the resting blood pressure readings, out of 300 metabolic syndrome participants, 37 were normotensive [male (40.54 %); female (59.45 %)], 115 were pre-hypertensive [male (58.26 %); female (41.74 %), and 148 were hypertensive [male (52.7 %); female (47.3 %)]. In several parameters, there was no such significant difference between male and female participants across all groups. However, the levels of blood total cholesterol, triglycerides, and low-density lipoprotein were considerably greater in hypertensive and pre-hypertensive metabolic participants than in normotensive subjects, while the levels of high-density lipoprotein were lower. Conclusion. Study findings suggest, hypertension and pre-hypertension were more prevalent in the group with metabolic syndrome. Additionally, hypertensives have a higher chance of manifesting dyslipidemia.

The association between cardiovascular health and cognition in adults with Down syndrome

IntroductionEvidence in the general population suggests that predictors of cardiovascular health such as moderate to vigorous physical activity (MVPA), cardiorespiratory fitness, and systolic blood pressure are associated with cognitive function. Studies supporting these associations in adults with Down syndrome (DS) are limited. The purpose of this study was to examine the associations between systolic blood pressure, cardiorespiratory fitness, and MVPA on cognition in adults with DS.MethodsThis is a cross-sectional analysis using baseline data from a trial in adults with DS. Participants attended a laboratory visit where resting blood pressure, cardiorespiratory fitness (VO2 Peak), and cognitive function (CANTAB® DS Battery) were obtained. The cognitive battery included tests measuring multitasking, episodic memory, and reaction time. Physical activity (accelerometer) was collected over the week following the laboratory visit. Pearson correlations and linear regressions were used to measure the impact of systolic blood pressure, cardiorespiratory fitness, and MVPA on cognitive outcomes.ResultsComplete data was available for 72 adults with DS (26.8 ± 9.3 years of age, 57% female). At baseline, VO2 Peak (21.1 ± 4.2 ml/kg/min) and MVPA were low (14.4 ± 14.4 min/day), and systolic blood pressure was 118.3 ± 13.3 mmHg. VO2 Peak was correlated with simple movement time (rho = − 0.28, p = 0.03) but was not significant using a linear regression controlling for age and sex. Systolic blood pressure was significantly associated with episodic memory (first attempt memory score: β = − 0.11, p = 0.002; total errors: β = 0.58, p = 0.001) and reaction time (five-choice movement time: β = 4.11, p = 0.03; simple movement time: β = 6.14, p = 0.005) using age- and sex-adjusted linear regressions. No associations were observed between MVPA and multitasking, episodic memory, or reaction time.ConclusionPredictors of cardiovascular health, including cardiorespiratory fitness and systolic blood pressure, were associated with some aspects of cognition in adults with DS. While future research should examine the role of improved cardiovascular health on delaying decreases in cognitive function and dementia in adults with DS, we recommend that health care providers convey the importance of exercise and cardiovascular health to their patients with DS.Trial registrationNCT04048759, registered on August 7, 2019.

Associations between Aging and Vitamin D Status with Whole-Body Nitric Oxide Production and Markers of Endothelial Function

BackgroundAging and vitamin D deficiency have been associated with reduced nitric oxide (NO) synthesis and impaired endothelial function (EF) but the evidence in humans remains weak. ObjectivesTwo independent cross-sectional studies were designed to evaluate the association between age, sex, and plasma vitamin D concentrations with physiological and biochemical biomarkers of NO synthesis and EF in young and older healthy participants (Study 1) and in overweight and obese postmenopausal females (Study 2). MethodsIn Study 1, 40 young (20–49 y) and older (50–75 y) males and females (10 participants per age and sex group) were included. Resting blood pressure and ear-to-finger peripheral pulse wave velocity (PWV) were measured. A stable-isotopic method was used to determine whole-body NO production. Plasma 25-hydroxyvitamin D (25(OH)D), nitrate, nitrite, and asymmetric dimethylarginine (ADMA) concentrations were determined. In Study 2, 80 older overweight and obese females (age 61.2 ± 6.2 y, body mass index 29.5 ± 4.4 kg/m2) were recruited. Postocclusion reactive hyperemia (PORH) and peripheral PWV were measured. Plasma concentrations of 25(OH)D, nitrate, cyclic guanosine monophosphate, 3-nitrotyrosine (3-NT), endothelin-1, vascular endothelial growth factor, and ADMA were determined. ResultsIn Study 1, whole-body NO production was significantly greater in young compared with older participants (0.61 ± 0.30 μmol·h−1·kg−1 compared with 0.39 ± 0.10 μmol·h−1·kg−1, P = 0.01) but there was no evidence of a sex difference (P = 0.81). Plasma 25(OH)D concentration was not associated with PWV (r = 0.18, P = 0.28) or whole-body NO production (r = −0.20, P = 0.22). Plasma ADMA concentration was associated positively with age (r = 0.35, P = 0.03) and negatively with whole-body NO production (r = −0.33, P = 0.04). In Study 2, age was associated with lower PORH (r = −0.28, P = 0.02) and greater ADMA concentrations (r = 0.22, P = 0.04). Plasma 25(OH)D concentration was inversely associated with 3-NT concentrations (r = −0.31, P = 0.004). ConclusionsOlder age was associated with lower whole-body NO production. Plasma vitamin D concentrations were not associated with NO production or markers of EF but showed a weak, significant correlation with oxidative stress in postmenopausal overweight females.

Prevalence of Elevated Blood Pressure and Its Relationship With Anthropometric Risk Factors in Students of a Pre-university Girls' College in Bangalore: A Cross-Sectional Study.

Background There is a growing concern regarding elevated blood pressure in adolescence. Children and adolescents with high blood pressure are at risk for adult hypertension. Being overweight and obese are important risk factors for hypertension. This study aimed to determinethe prevalence of elevated blood pressure and its association with anthropometric risk factors among students of a pre-university girls' college. Methodology A cross-sectional study was conducted among 337 students at a pre-university girls' college aged 15-19 years in urban Bangalore. A self-administered, semi-structured, pretested questionnaire collected the sociodemographic details, family history, and lifestyle. Height, weight, waist circumference (WC), and hip circumference were measured. Standard cut-off levels were used for body mass index (BMI), WC, waist-hip ratio (WHR), and waist-height ratio (WHtR). Resting blood pressure was determined using a digital blood pressure monitor. It was classified into normotensive, pre-hypertension (>90th to <95th percentile), and hypertension (>95th percentile). Data were analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). Pre-hypertension and hypertension were considered as having elevated blood pressure. Results The prevalence of pre-hypertension and hypertension was 21.4% (n = 72, 95% confidence interval (CI) = 17.0-25.7) and 9.8% (n = 33, 95% CI = 6.6-13.0), respectively. The prevalence of overweight was 20.2% (n = 68, 95% CI = 15.9-24.5) and obesity was 12.2% (n = 41, 95% CI = 8.7-15.7). WC, WHR, and WHtR were abnormal in 34.7% (n = 117, 95% CI = 29.6-39.8), 47.5% (n = 160, 95% CI = 42.1-52.8), and 45.7% (n = 154, 95% CI = 50.4-51.0), respectively. There was a statistically significant correlation betweensystolic blood pressure and BMI (p < 0.001), WC (p < 0.001), and WHtR (p < 0.001), as well asdiastolic blood pressure and BMI (p < 0.001), WC (p = 0.008), and WHtR (p = 0.011). Statistically significant differences in mean BMI (p = 0.004), WC (p < 0.001), WHR (p = 0.007), and WHtR (p = 0.001) between normal, pre-hypertensive, and hypertensive students were also noted. Conclusions Pre-hypertension and hypertension are fundamental problems in pre-university girl students. With a similarly increased prevalence of obesity and other anthropometric risk factors, students must be aware of hypertension and its risk factors.

Patient Perceptions and Clinical Assessments of Cardiometabolic Disease After Subacute Spinal Cord Injury

ObjectivesTo investigate the effectiveness of health care team communication regarding cardiometabolic disease (CMD) risk factors with patients with subacute spinal cord injury (SCI). DesignMulti-site prospective cross-sectional study. SettingFive National Institute on Disability, Independent Living, and Rehabilitation Research Model SCI Rehabilitation Centers. ParticipantsNinety-six patients with subacute SCI, aged 18-70 years, with SCI (neurologic levels of injury C2-L2, American Spinal Injury Association Impairment Scale grades A-D), and enrolled within 2 months of initial rehabilitation discharge (N=96). InterventionsNone. Main Outcome Measure(s)Objective risk factors of CMD (body mass index, fasting glucose, insulin, high-density lipoprotein cholesterol, triglyceride levels, and resting blood pressure). Patient reported recall of these present risk factors being shared with them by their health care team. Medications prescribed to patients to address these present risk factors were checked against guideline- assessed risk factors. ResultsObjective evidence of 197 CMD risk factors was identified, with patients recalling less than 12% of these (P<.0001) being shared with them by their health care team. Thirty-one individuals (32%) met criteria for a diagnosis of CMD, with only 1 of these patients (3.2%) recalling that this was shared by their health care team (P<.0001). Pharmacologic management was prescribed to address these risk factors only 7.2% of the time. ConclusionsDespite high prevalence of CMD risk factors after acute SCI, patients routinely do not recall being told of their present risk factors. Multifaceted education and professionals’ engagement efforts are needed to optimize treatment for these individuals.

Hypertension is associated with reduced medial temporal lobe neural flexibility in older African Americans

AbstractBackgroundHypertension disproportionately affects African Americans (AA) and is an established mid‐life risk factor for Alzheimer’s disease (AD). However, previous research suggests there is inconclusive data examining late‐life hypertension and Alzheimer’s risk. Recently, a dynamic rearrangement (neural flexibility) imaging method was validated for evaluating cognitive decline in the medial temporal lobe (MTL), which is a key region affected by AD. But whether hypertension mediates MTL neural flexibility in older AA individuals is unknown. Therefore, we investigated MTL flexibility in older hypertensive and normotensive AA.MethodOne hundred and thirteen AA (60‐74y) completed demographic surveys, weight and height measurements, resting blood pressure (BP) screening procedure, and a 6‐minute walking distance test as an indirect measure of aerobic capacity. All individuals also completed a 10‐minute resting‐state functional magnetic resonance screening to assess MTL neural flexibility. Participants were separated into normotensive (systolic BP &lt; 130mmHg, n = 36, 83% female, 64.8 ± 0.4y; 13.8 ± 0.2y of education) vs. hypertensive (systolic BP ³ 130mmHg, n = 77, 82% female, 66.4 ± 0.3y; 14.1 ± 0.1y of education). An ANCOVA was used to examine group differences in MTL neural flexibility with age, sex, and education used as covariates.ResultAlthough individuals with hypertension had a higher BMI (36.9 ± 1.8 vs. 31.3 ± 2.6 kg/m2, p = .070), this was not statistically different. However, normotensive participants had significantly higher MTL neural flexibility compared to hypertensive individuals (.42 ± .23 vs. .32 ± .25, p = .04), and this was independent of estimated aerobic capacity (14.9 ± 2.3 vs. 14.9 ± 2.5 ml/kg/min; ml/kg/min; p = .864).ConclusionHypertensive AA between the ages 60‐74 years old demonstrated lower MTL neural flexibility compared to their normotensive counterparts. These results were independent of obesity and aerobic fitness, suggesting additional work is needed to understand how blood pressure mediates neuronal connectivity to prevent and/or treat AD cognitive decline in AA.

Former SARS-CoV-2-Infection is related to decreased peak VO2 and exercise hyperten-sion in athletes

Abstract Background The COVID-19 pandemic dramatically changed lifestyle worldwide, including sport activities. Although most competitive athletes have an asymptomatic or mildly symptomatic SARS-CoV-2-infection course and are a low-risk population to develop cardiac and other complications after SARS-CoV-2-infection, a post-COVID-19 screening strategy primarily based on symptoms should detect cardiac involvement and other complications from SARS-CoV-2-infection and should enable save and early return-to-sport. However, incidence, complications and performance consequences of COVID-19-infection in athletes are not fully understood. Purpose Thus, the primary aim of the present study was to identify differences in athletes with former COVID-19-infections in comparison to those athletes without COVID-19-infection presenting for their preparticipation screening examination. Methods Competitive athletes of any age, who presented for preparticipation screening 04/2020-10/2021 were included in this study and stratified for former COVID-19-infection. Athletes with and without former COVID-19-infection were compared. Exercise hypertension was defined on the basis of the systolic blood pressure (BP)/MET slope-method: The Δ regarding systolic BP was calculated as maximum systolic BP during exercise–systolic BP at rest and was indexed by the increase in MET from rest (Δ regarding MET was calculated as peak MET – 1) to obtain the systolic BP/MET slope. In accordance with previous studies, a cut-off value &amp;gt; 6.2 mmHg/MET was used to define an exercise hypertension. Results Overall, 1200 athletes (mean age 21.9±11.6years; 34.3% females) were included in this study 04/2020-10/2021. Among these, 158 (13.1%) athletes had former COVID-19-infection. Athletes with former COVID-19-infection were older (23.4±7.1 vs. 21.7±12.1years, P&amp;lt;0.001) and more often of male sex (87.7% vs. 64.0%, P&amp;lt;0.001). While systolic/diastolic BP at rest was comparable between both groups, maximum systolic (190.0 [170.0/210.0] vs. 180.0 [160.0/205.0] mmHg, P=0.007) and diastolic BP (70.0 [65.0/75.0] vs. 70.0 [60.0/75.0] mmHg, P=0.012) during exercise-test and frequency of exercise hypertension (54.2% vs. 37.8%, P&amp;lt;0.001) were both higher in athletes with COVID-19-infection. While former COVID-19-infection was not independently associated with higher BP values at rest and maximum BP values during exercise, former COVID-19-infection was related with exercise hypertension (OR 2.13 [95%CI 1.39–3.28], P&amp;lt;0.001). VO2-peak value during exercise was lower in athletes with former COVID-19-infection compared to those without COVID-19-infection (43.4 [38.3/48.0] vs. 45.3 [39.1/50.6] ml/min/kg, P=0.010). SARS-CoV-2-Infection affected VO2 peak during exercise negatively (OR 0.94 [95%CI 0.91–0.97], P&amp;lt;0.0019) independent of age, sex and body-mass-index. Conclusions Former COVID-19-infection in athletes was accompanied by higher frequency of exercise hypertension and reduced peak VO2 during exercise testing.

Screening for atrial fibrillation by village doctors in rural areas of china: the jiangsu province rural community atrial fibrillation project

Abstract Background No study has systematically investigated the quality of long-term care delivered to the rural elderly with chronic diseases in China. Since atrial fibrillation (AF) is becoming an increasing burden on healthcare systems worldwide. Purpose We conducted an AF screening programme in rural elderly and evaluated healthcare efficiency led by the village doctors in China. Methods This cross-sectional study of the rural population aged ≥65 years was conducted from April to June 2019 in our towns of Jiangsu Province. AF was identified using 12-lead electrocardiography in the first-step (government-led health examination) and single-lead electrocardiography in the second-step (in-house AF screening). Questionnaire surveys were designed for the AF patients and their village doctors, respectively. Results Among the 31,342 registered subjects, 12,630 (40·3%) declined, 7,956 (25·3%) participated in the first-step and 10,756 (34·3%) in the second-step (Figure 1). The overall AF detection rate was 4·3% (810/18,712). Of the 810 patients with AF (mean age 76·1±5·9 years; 51·4% female), 51·5% had education level below primary school, 2·6% could use smartphone applications, and 8·1% lived with their children. Common risk factors were older age, men, hypertension, diabetes, prior stroke, vascular disease, and congestive heart failure. Among the 402 patients who were aware of AF, there were 367 were at high risk of stroke (CHA2DS2-VASc score ≥3 in women or ≥2 in men) and OAC was currently used in only 10·9% (40/367) of these (Figure 2). Only 17·6% (91/516) of patients with known hypertension had a resting blood pressure level &amp;lt;140/90 mmHg, and 6·0% (8/132) of patients with known diabetes had a fasting blood glucose level ≤6·1 mmol/L. Our questionnaire survey for village doctors showed that only 7·3% (9/122) reported having the knowledge or ability for providing integrated care AF management. Conclusions This screening project in rural villages identified AF in 4·3%, but AF management was suboptimal with low use of oral anticoagulation. The current village doctor-dominant rural healthcare system is far from delivering optimal standardized AF management for older patients in rural China. There is a urgent need to support these rural clinics and empower the village doctors in optimising the care of AF patients.The flow chart of this studyThe use of oral anticoagulation

Effects of dietary nitrate and vitamin C co-ingestion on blood pressure and hand-grip strength in young adults.

Background: Co-administration of vitamin C and inorganic nitrate ([Formula: see text]) may reduce oxidative stress, boost the conversion of nitrite ([Formula: see text]) into NO and elicit positive vascular effects. Aims: We aimed to test the effects of oral inorganic [Formula: see text] and vitamin C co-supplementation on vascular function, muscular strength, and on concentrations of urinary [Formula: see text], vitamin C, 8-isoprostanes and salivary [Formula: see text] in healthy young adults. Methods: Ten young healthy participants were enrolled in a randomised, double-blind (only for the [Formula: see text] intervention) crossover clinical trial. Participants consumed in random order: 1) nitrate-rich beetroot juice and vitamin C (N+VC), 2) nitrate-rich beetroot juice alone (N) or 3) nitrate-depleted beetroot juice alone (ND). Resting blood pressure (BP) was measured at the research centre and at home. Non-invasive, continuous measurements of BP and cardiac function parameters were performed using a Finometer device. Free-living physical activity and hand-grip strength were assessed. Salivary [Formula: see text] and [Formula: see text] and urinary [Formula: see text], 8-isoprostanes and vitamin C concentrations were measured. Results: There were no significant differences for any of the vascular outcomes between the three interventions groups. However, analyses of within-intervention changes showed a significant lower daily systolic BP in the [Formula: see text]+vitamin C (N+VC) group only (P=0.04). Urinary [Formula: see text] (P=0.002) and salivary [Formula: see text] (P=0.001) were significantly higher in the N+VC group compared to the N and ND groups. Conclusion: These preliminary findings suggest that combining dietary [Formula: see text] with vitamin C could have protective effects on vascular function in young adults and could represent an effective strategy for the maintenance of healthy cardiovascular trajectories.

Fourteen weeks of multicomponent training associated with flexibility training modifies postural alignment, joint range of motion and modulates blood pressure in physically inactive older women: a randomized clinical trial.

Background: Body relaxation and pain reduction are some of the reported benefits of flexibility training (through active stretching exercises), however their effects on posture and blood circulation are uncertain. We aimed to investigate the effects of flexibility training (through active stretching exercises) in combination with multicomponent training (MT) on blood pressure (BP), and the correlation with changes in body alignment and flexibility in physically inactive women. Methods: Women aged 60-70years were into three groups: multicomponent training group (MT), multicomponent training plus flexibility training group (FT), and control group (CG). After randomization, the resting blood pressure was measured and the participants were reallocated into subgroups according to pressure values >130/80mmHg (This classification is according to the American Heart Association (AHA), resulting in the subgroups: flexibility training (FT); flexibility training for hypertensive patients (FTSAH); multicomponent training (MT); multicomponent training for hypertensive patients (MTSAH); control group (CG); control group of hypertensive patients (CGSAH). The interventions lasted 14weeks. Systolic (sBP) and diastolic (dBP) BP, range of motion (flexion and extension), and postural analysis by asymmetry in the frontal plane and asymmetry in the sagittal plane, displacement and the flexibility test were collected before (Pre) and after training (Post). In total, 141 women participated in the study (without SAH: FT = 23, MT = 20, and CG = 21; with SAH: FTSAH = 28, MTSAH = 23, and CGSAH = 26). Results: Systolic blood pressure, in the pre and post moments were: FT (116 ± 6.7 vs. 114 ± 4.7); FTSAH (144 ± 16.5 vs. 121 ± 10.1); MT: (120 ± 6.8 vs. 121 ± 7.3); MTSAH: (137 ± 10.6 vs. 126 ± 13.0); CG: (122 ± 5.3 vs. 133 ± 19.2); and CGSAH: (140 ± 9.7 vs. 143 ± 26.2), presenting an F value (p-value - group x time) of 12.00 (<0.001), with improvement in the groups who trained. The diastolic blood pressure in the pre and post moments were: FT (71 ± 4.7 vs. 74 ± 6.8); FTSAH (88 ± 9.6 vs. 70 ± 12.0); MT: (74 ± 4.5 vs. 77 ± 11.7); MTSAH: (76 ± 10.4 vs. 76 ± 10.2); CG: (69 ± 7.11 vs. 82 ± 11.4); and CGSAH: (76 ± 13.4 vs. 86.6 ± 7.7), presenting an F value (p-value - group x time) of 8.00 (p < 0.001), with improvement in the groups who trained. In the Elastic Net Regression, sBP was influenced by height (β: -0.044); hip flexion (β: 0.071); Shoulder extension (β: 0.104); low back flexion (β: 0.119) and dBP (β: 0.115). In the Elastic Net Regression, dBP was influenced by asymmetry in the sagittal plane variables (0.040); asymmetry in the frontal plane (β: 0.007); knee flexion (β: -0.398); BM (β: 0.007); Shoulder flexion (β: -0.142); Hip flexion (β: -0.004); sBP (β: 0.155) and Ankle Flexion (β: -0.001). Conclusion: The displacement of the asymmetry in the frontal plane and asymmetry in the sagittal plane, and the increase in the flexion position in the hip, lumbar, head, and knee regions, influenced the highest-pressure levels. Multicomponent training associated with flexibility training promoted improvement in body alignment, COM, and joint angles, and decreased blood pressure.

Exploring the interactive effects of oral contraceptive use and dietary fat intake on blood pressure, cardiovascular reactivity, and glucose tolerance in normotensive women.

Objective: To understand how dietary fat consumption and the use of oral contraceptives interact to affect blood pressure, cardiovascular reactivity, and glucose tolerance in normotensive women. Study Design: Cross-section study. Setting: Hayatabad Medical Complex, Peshawar. Period: December 2022 to April 2023. Material &amp; Methods: A total of 120 normotensive women aged between 18 and 35 years were recruited from local healthcare centers, clinics, and educational institutions. Demographic characteristics, oral contraceptive use, and dietary fat intake were assessed through self-reporting and validated food frequency questionnaires. Resting blood pressure measurements, cardiovascular reactivity during standardized stressors, and glucose tolerance through oral glucose tolerance tests were recorded. Results: The study found no significant associations between oral contraceptive use and blood pressure, cardiovascular reactivity, or glucose tolerance. Similarly, dietary fat intake did not significantly influence these health parameters. Conclusion: The results emphasize the importance of personalized healthcare recommendations for women using oral contraceptives, considering individual variations and other lifestyle factors. Further research with larger, longitudinal studies is warranted to elucidate the potential long-term effects of these interactions and promote cardiovascular health for women worldwide.

Exploring the direct and indirect effects of cardiovascular disease risk factors on exercise blood pressure.

Exaggerated exercise blood pressure (BP) is independently associated with cardiovascular disease (CVD) outcomes. However, it is unknown how individual CVD risk factors may interact with one another to influence exercise BP. The aim of this study was to quantify direct and indirect associations between CVD risk factors and exercise BP, to determine what CVD risk factor/s most-strongly relate to exercise BP. In a cross-sectional design, 660 participants (44 ± 2.6 years, 54% male) from the population-based Childhood Determinants of Adult Health Study had BP measured during low-intensity fixed-workload cycling. CVD risk factors were measured, including body composition, clinic (rest) BP, blood biomarkers, and cardiorespiratory fitness. Associations between CVD risk factors and exercise BP were assessed using linear regression, with direct and indirect pathways of association assessed via structural equation model. Sex, waist-to-hip ratio, fitness, and clinic BP were independently associated with exercise systolic BP (SBP), and along with age, had direct associations with exercise SBP (p < 0.05 all). Most CVD risk factors were indirectly associated with exercise SBP via a relation with clinic BP (p < 0.05 all). Clinic BP, waist-to-hip ratio, and fitness were most-strongly associated (direct and indirect association) with exercise SBP (β[95% CI]: 9.35 [8.04, 10.67], 4.91 [2.56, 7.26], and -2.88 [-4.25, -1.51] mm Hg/SD, respectively). Many CVD risk factors are associated with exercise BP, mostly with indirect effects via clinic BP. Clinic BP, body composition, and fitness were most-strongly associated with exercise BP. These results may elucidate how lifestyle modification could be a primary strategy to decrease exaggerated exercise BP-related CVD risk.

Minimal Detectable Change in Resting Blood Pressure and Cardiorespiratory Fitness: A Secondary Analysis of a Study on School-Based High-Intensity Interval Training Intervention.

High-intensity interval training (HIIT) effects on resting blood pressure (BP) and cardiorespiratory fitness (CRF) have already been studied. Furthermore, the responses of responders and non-responders to HIIT in terms of these physiological outcomes have also been examined. However, the minimal detectable change (MDC) in BP and CRF has not been addressed yet. Therefore, the current study aimed to compare the MDC90 of BP (systolic and diastolic) and CRF (fitness index (FI) results) in the context of a school-based HIIT program for adolescents. Participants were adolescents, with an average age of 16.16 years (n = 141; 36.6% males). A preplanned secondary analysis was conducted using pre-post data from the control group to estimate MDC90. The MDC90 of SBP, DBP, and FI were 7.82 mm HG, 12.45 mm HG, and 5.39 points, respectively. However, taking into account the relative values of these changes, MDC90 required a greater change in DBP (17.27%) than FI (12.15%) and SBP (6.68%). Any training-induced physiological changes in the average values of the outcomes did not exceed MDC90. However, a comparison of the participants who exceeded and did not exceed MDC90 showed statistically significant differences. These findings reveal the huge variability in and insensitivity to the intervention effect for all measurements. This is likely because of the large subgroup of participants with low sensitivity to the physiological stimulus. As such, there is a considerable need to create individually tailored intervention programs.

Occupational physical activity and resting blood pressure in male construction workers.

This study investigated the association between occupational physical activity (OPA) and resting blood pressure in a cohort of Swedish construction workers. The final sample included 241,176 male construction workers. Occupations with low OPA were foremen and white-collar workers. The most frequent occupations in the medium OPA group were electricians, pipe workers, and machine operators, and in the high OPA group woodworkers, concrete workers, and painters. Mixed effects models showed higher systolic and lower diastolic blood pressure with higher OPA, but the associations varied depending on the year of participation and participant age as shown by significant interaction terms (OPA*age, OPA*calendar year, age*calendar year). Age-stratified linear regression analyses showed a pattern of slightly higher systolic (1.49, 95% confidence interval: 1.08-1.90 mmHg) and lower diastolic (0.89, 95% confidence interval: 0.65-1.13 mmHg) blood pressure when comparing low with high OPA, but not among the oldest age groups. Despite a rather large contrast in OPA, the differences in systolic and diastolic blood pressure according to OPA were small.

T-Cadherin Deficiency Is Associated with Increased Blood Pressure after Physical Activity.

T-cadherin is a regulator of blood vessel remodeling and angiogenesis, involved in adiponectin-mediated protective effects in the cardiovascular system and in skeletal muscles. GWAS study has previously demonstrated a SNP in the Cdh13 gene to be associated with hypertension. However, the role of T-cadherin in regulating blood pressure has not been experimentally elucidated. Herein, we generated Cdh13∆Exon3 mice lacking exon 3 in the Cdh13 gene and described their phenotype. Cdh13∆Exon3 mice exhibited normal gross morphology, life expectancy, and breeding capacity. Meanwhile, their body weight was considerably lower than of WT mice. When running on a treadmill, the time spent running and the distance covered by Cdh13∆Exon3 mice was similar to that of WT. The resting blood pressure in Cdh13∆Exon3 mice was slightly higher than in WT, however, upon intensive physical training their systolic blood pressure was significantly elevated. While adiponectin content in the myocardium of Cdh13∆Exon3 and WT mice was within the same range, adiponectin plasma level was 4.37-fold higher in Cdh13∆Exon3 mice. Moreover, intensive physical training augmented the AMPK phosphorylation in the skeletal muscles and myocardium of Cdh13∆Exon3 mice as compared to WT. Our data highlight a critically important role of T-cadherin in regulation of blood pressure and stamina in mice, and may shed light on the pathogenesis of hypertension.

O.4.1-3 Effects of novel isometric resistance training on resting and ambulatory blood pressure measures: a comparison between exercise modes

Abstract Purpose Isometric resistance training (IRT) can reduce clinical resting, and ambulatory blood pressure measures (ABPM) irrespective of hypertensive status, yet adopted methods are expensive, require specialised equipment, and may limit accessibility for those with mobility restrictions. Previous work undertaken in our laboratory has established a novel isometric training band (ITB) and associated protocol as a method of safely performing acute IRT. However, the chronic effects of ITB on clinical resting blood pressure (BP) and ABPM remains unknown. Therefore, the aim of this study was to validate the novel IRT method by comparing the effects of the ITB on BP following 4-weeks of IRT. Methods Forty-two healthy normotensive adults (22 male, 20 female, [Mean ± SD], age 31 ± 14 years, height 170 ± 10 cm, mass 75 ± 16 kg, systolic [SBP], 120 ± 5 mmHg, diastolic [DBP], 72 ± 7 mmHg, mean arterial [MAP], 88 ± 6 mmHg, heart rate [HR[ 67 ± 12 bpm·-1) were randomised to a control (CON), isometric handgrip (IHG) or isometric training band (ITB) group. Clinical resting (SBP, DBP, MAP, &amp; HR) and ABPM (n = 38; 24-hour, daytime, and night-time SBP, DBP, MAP, &amp; HR) were measured pre-and post-4-weeks of supervised IRT (4 x 2-minute contractions at 30%MVC [IHG] or 4 x 2-minute contractions at CR-10 values equivalent to 30%MVC [ITB]). Data were analysed using two-way repeated measures ANOVAs to examine any significant (P &amp;lt;.05) within-and between group differences. Results Clinical resting SBP was reduced for IHG (-4.6 ± 3.6 mmHg, P &amp;lt;.05) and ITB (-4.5 ± 3 mmHg, P &amp;lt;.05) following 4-weeks of IRT. No differences were seen within-or between groups for clinical resting DBP and MAP or for resting HR (P &amp;gt;.05). No differences were found over time or between groups for ABPM (P &amp;gt;.05 across all measures). Conclusions These findings suggest 4-weeks of IRT using the novel ITB can elicit reductions in clinical resting BP in normotensives comparable to IHG. As such, the ITB may offer a practical and cost-effective alternative to long-established IRT methods. Yet further research is needed to ascertain the ABPM-lowering effects of the ITB for normotensive groups.

Aging in females is associated with changes in respiratory modulation of sympathetic nerve activity and blood pressure.

Sympathetic nerve activity (SNA) is tightly coupled with the respiratory cycle. In healthy human males, respiratory modulation of SNA does not change with age. However, it is unclear how this modulation is affected by age in females. We investigated whether respiratory sympathetic modulation is altered in healthy postmenopausal (PMF) versus premenopausal female (YF), and younger male (YM) adults, and determined its relationship to resting blood pressure. Muscle SNA (MSNA; microneurography), respiration (transducer belt), ECG, and continuous blood pressure were measured in 12 YF, 13 PMF, and 12 YM healthy volunteers. Respiratory modulation of MSNA was quantified during two phases of the respiratory cycle: mid-late expiration and inspiration/postinspiration. All groups showed respiratory modulation of MSNA (P < 0.0005). There was an interaction between the respiratory phase and group for MSNA [bursts/100 heartbeats (HB) (P = 0.004) and bursts/min (P = 0.029)], with smaller reductions in MSNA during inspiration observed in PMF versus the other groups. Respiratory modulation of blood pressure was also reduced in PMF versus YF (6 [2] vs. 12 [9] mmHg, P = 0.008) and YM (13 [13] mmHg, P = 0.001, median [interquartile range]). The magnitude of respiratory sympathetic modulation was related to resting blood pressure in PMF only, such that individuals with less modulation had greater resting blood pressure. The data indicate that aging in postmenopausal females is associated with less inspiratory inhibition of MSNA. This correlated with a higher resting blood pressure in PMF only. Thus, the reduced modulation of MSNA could contribute to the age-related rise in blood pressure that occurs in females.NEW & NOTEWORTHY The current study demonstrates that respiratory modulation of sympathetic nerve activity (SNA) is reduced in healthy postmenopausal (PMF) versus premenopausal females (YF). Furthermore, respiratory sympathetic modulation was negatively related to resting blood pressure in postmenopausal females, such that blood pressure was greater in individual with less modulation. Reduced respiratory sympathetic modulation may have implications for the autonomic control of blood pressure in aging postmenopausal females, by contributing to age-related sympathetic activation and reducing acute, respiratory-linked blood pressure variation.