scholarly journals Blood Pressure Increase and Microvascular Dysfunction Accelerate Arterial Stiffening in Children: Modulation by Physical Activity

2020 ◽  
Vol 11 ◽  
Author(s):  
Giulia Lona ◽  
Christoph Hauser ◽  
Sabrina Köchli ◽  
Denis Infanger ◽  
Katharina Endes ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Microvascular Dysfunction ◽  
Large Artery ◽  
Clinical Trial Registration ◽  
Oscillometric Device ◽  
Artery Disease ◽  
Cv Disease ◽  
Arteriolar Narrowing

BackgroundAtherosclerotic remodeling starts early in life and can accelerate in the presence of cardiovascular risk (CV) factors. Regular physical activity (PA) can mitigate development of large and small artery disease during lifespan. We aimed to investigate the association of changes in body mass index (BMI), blood pressure (BP), PA behavior and retinal microvascular diameters with large artery pulse wave velocity (PWV) in prepubertal children over 4 years.MethodsThe school-based prospective cohort study included 262 children initially aged 6–8 years, assessing the above CV risk factors and retinal vessels by standardized procedures at baseline (2014) and follow-up (2018). PWV was assessed by an oscillometric device at follow-up.ResultsChildren with increased systolic BP over 4 years showed higher PWV at follow-up (β [95% CI] 0.006 [0.002 to 0.011] mmHg per unit, P = 0.002). In contrast, increased vigorous PA corresponded to a lower PWV at follow-up (β [95% CI] −0.009 [−0.018 to <0−0.001] 10 min/day per unit, P = 0.047). Progression of retinal arteriolar narrowing and venular widening were linked to a higher PWV after 4 years (β [95% CI] −0.014 [−0.023 to −0.004] 0.01 changes per unit, P = 0.003).ConclusionIncrease in systolic BP and progression of microvascular dysfunction were associated with higher PWV after 4 years. Children with increasing levels of vigorous PA were found to have lower PWV at follow-up. Habitual vigorous PA has the potential to decelerate the process of early vascular aging in children and may thus help counteract CV disease development later in life.Clinical Trial RegistrationClinicalTrials.gov, Identifier: NCT03085498.

scholarly journals Systolic Blood Pressure and Outcomes in Stable Outpatients with Recent Symptomatic Artery Disease: A Population-Based Longitudinal Study

2021 ◽  
Vol 18 (17) ◽  
pp. 9348
Author(s):  
Juan F. Sánchez Muñoz-Torrero ◽  
Guillermo Escudero-Sánchez ◽  
Julián F. Calderón-García ◽  
Sergio Rico-Martín ◽  
Nicolás Roberto Robles ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Lower Risk ◽  
Multivariable Analysis ◽  
Large Artery ◽  
Risk Of Mortality ◽  
Cardiovascular Morbidity And Mortality ◽  
Artery Disease ◽  
Ischemic Events

Objectives: The most appropriate targets for systolic blood pressure (SBP) levels to reduce cardiovascular morbidity and mortality in patients with symptomatic artery disease remain controversial. We compared the rate of subsequent ischemic events or death according to mean SBP levels during follow-up. Design: Prospective cohort study. FRENA is an ongoing registry of stable outpatients with symptomatic coronary (CAD), cerebrovascular (CVD) or peripheral artery disease (PAD). Setting: 24 Spanish hospitals. Participants: 4789 stable outpatients with vascular disease. Results: As of June 2017, 4789 patients had been enrolled in different Spanish centres. Of these, 1722 (36%) had CAD, 1383 (29%) CVD and 1684 (35%) PAD. Over a mean follow-up of 18 months, 136 patients suffered subsequent myocardial infarction, 125 had ischemic stroke, 74 underwent limb amputation, and 260 died. On multivariable analysis, CVD patients with mean SBP levels 130–140 mm Hg had a lower risk of mortality than those with levels <130 mm Hg (hazard ratio (HR): 0.39; 95% CI: 0.20–0.77), as did those with levels >140 mm Hg (HR: 0.46; 95% CI: 0.26–0.84). PAD patients with mean SBP levels >140 mm Hg had a lower risk for subsequent ischemic events (HR: 0.57; 95% CI: 0.39–0.83) and those with levels 130–140 mm Hg (HR: 0.47; 95% CI: 0.29–0.78) or >140 mm Hg (HR: 0.32; 95% CI: 0.21–0.50) had a lower risk of mortality. We found no differences in patients with CAD. Conclusions: In this real-world cohort of symptomatic arterial disease patients, most of whom are not eligible for clinical trials, the risk of subsequent events and death varies according to the levels of SBP and the location of previous events. Especially among patients with large artery atherosclerosis, PAD or CVD, SBP <130 mm Hg may result in increased mortality. Due to potential factors in this issue, Prospective, well designed studies are warranted to confirm these observational data.

Abstract 30: Behavioral Change after Heart Disease Risk Assessment in Women

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Sonya Parashar ◽  
James L Vacek ◽  
Ashley Simmons
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Risk Assessment ◽  
Heart Disease ◽  
Behavioral Change ◽  
Heart Attack ◽  
Disease Risk ◽  
Behavioral Changes ◽  
Cv Disease

Background: Heart disease is the leading killer of women in the United States. Unfortunately, most women are unaware of their individual risk. Studies have shown that awareness of cardiovascular (CV) disease risks correlates with positive behavior changes, including increased physical activity and weight loss. Methods: The Change of Heart (COH) Program is a university hospital based CV disease risk assessment program. The assessment included baseline weight, height, blood pressure, lipid profile, fasting glucose, and Framingham risk score in women 18 years of age and older. A 90-minute individual discussion of risk and recommendations for healthy lifestyle changes were given. Follow up questionnaires and newsletters designed to assess and encourage heart-healthy behavioral changes were given at 3 and 6 months after the initial visit to participants. We compared baseline vs. follow up self-reported activity levels and readiness for change. Results: At baseline, participants’ average age was 50.6 years, they exercised between 1 to 3 hours each week, and most had either never smoked or had quit smoking. When asked what they thought a woman’s greatest health problem was, 62% answered Heart Disease/Heart Attack. Additionally, 59% of participants felt moderately informed about women’s heart disease and 54% would call 911 if they thought they were having a heart attack. We found a statistically significant improvement in willingness to increase physical activity (p < 0.001), practice good eating habits (p < 0.001), avoid smoking (p <0.01), lose or maintain healthy weight (p <0.001), lower and maintain cholesterol levels (p < 0.001) and blood pressure (p < 0.001) over the course of the study. Conclusion: In a population of women who felt that they were moderately well informed on heart disease, only 62% knew that a woman’s greatest health risk was heart disease or a heart attack. Most women showed improvements in readiness for positive heart-healthy behavioral changes. This emphasizes the ability for a cardiovascular risk reduction program to positively influence a woman’s willingness for behavioral change.

Abstract TP73: Lower Prehospital Blood Pressure Is Not Associated with Larger Infarct Volumes in Non-lacunar Ischemic Stroke Patients

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Rahel T Zewude ◽  
Laura C Gioia ◽  
Mahesh Kate ◽  
Kim Liss ◽  
Brian Rowe ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ischemic Stroke ◽  
Infarct Volume ◽  
Cryptogenic Stroke ◽  
Final Diagnosis ◽  
Large Artery ◽  
Stroke Etiology ◽  
Artery Disease ◽  
Suspected Stroke

Background: Although prehospital blood pressure (BP)-lowering trials in acute stroke have begun, concerns persist that hypotension may exacerbate hypoperfusion and increase infarct volumes, particularly in non-lacunar stroke. We tested the hypothesis that lower prehospital BP is associated with larger infarct volumes in non-lacunar ischemic stroke. Methods: We conducted a retrospective study of consecutive patients with suspected stroke transported by Emergency Medical Services (EMS) during an 18-month period. Serial prehospital BP data were obtained from a centralized EMS database. Hospital charts and neuroimaging were reviewed. Stroke etiology was classified using TOAST criteria. Infarct volumes were measured on follow-up MRI or CT using semi-automated thresholding planimetric techniques by two independent raters, blinded to prehospital BP. Results: Of a total 960 patients transported by EMS, 367 had a final diagnosis of ischemic stroke. Stroke etiology was large artery disease in 51 patients, cardioembolic in 140, lacunar in 44, other determined etiology in 22, and cryptogenic in 110 patients. Follow-up imaging was available in 315 patients (163 MR, 152 CT) at a median (IQR) 1(1) days. The overall median non-lacunar infarct volume was 16.5 (49.6) ml, median NIHSS was 7(10), and mean prehospital SBP was 153 ± 25 mmHg. Mean prehospital SBP was lower in patients with other determined etiology (133.2 ± 26.1 mmHg, p<0.01) than cardioembolic (150.9 ± 25.5 mmHg), large artery disease (157.1 ± 26.1 mmHg) and cryptogenic stroke (157.7 ± 22.9 mmHg). Median infarct volume was similar across categories of stroke etiology (large artery disease (16.3 (60.3) ml), cardioembolic (19.9 (76.2) ml), other determined etiology (23.9 (33.6) ml), and cryptogenic stroke (11.5 (35.9) ml), p=0.12). There was no correlation between mean prehospital SBP and mean infarct volume (r =-0.06, p=0.33). NIHSS score was correlated with mean infarct volume (r=0.6, p<0.001), but not mean prehospital SBP (r=-0.07, p=0.24). Conclusion: These data provide no evidence to suggest that lower prehospital BP is associated with larger infarct volumes in patients with non-lacunar ischemic stroke. The effect of BP reduction on infarct volumes should be assessed as part of randomized trials.

Abstract P199: Keep Moving, Your Health Depends On It: Impact Of Improved Physical Activity And Weight Loss In A Wellness Program

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Ebenezer T Oni ◽  
Ehimen Aneni ◽  
Maribeth Rouseff ◽  
Thinh Tran ◽  
Henry Guzman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Weight Loss ◽  
Intervention Program ◽  
South Florida ◽  
Metabolic Equivalents ◽  
Baseline Weight ◽  
The Mean ◽  
The Difference

Negative impact of CVD as the leading cause of death in the US is worsened by the significant burden of obesity and associated morbidity and concerns about the growing population inactivity. The American Heart Association has emphasized worksite-based interventions to improve CV health. We evaluated the benefits of improved physical activity(PA) and weight loss(WL) among employees of the Baptist Health South Florida enrolled in a wellness intervention program. Methods: Employees with two or more Cardio-metabolic risk factors , such as total cholesterol ≥ 200 mg/dl, systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg, hemoglobin A1C ≥ 6.5%, and body mass index (BMI) ≥ 30 were enrolled in an intervention program themed “My unlimited potential”. Interventions were focused on diet and PA modifications. We defined improved physical activity as the difference in the metabolic equivalents (METs) at 12 weeks follow-up and at baseline. WL (lbs) was the difference in weight at follow-up. The relationship between WL and changes in METs was explored in an ordered logistic regression. Results: Overall 203 (48±10 years, 78% females) employees were enrolled with a retention rate of 89% (n=181) at 12 weeks follow-up. At baseline the median weights was 211 lbs., and mean METs- 8.6, while at follow-up the median weight was 200 lbs, and the mean METs 11. At 12 weeks follow up 38% had significant WL (lost >5% of baseline weight). The median WL was 8.4 (IQR 4.8-13.0) lbs and the mean change in METs was 2.4±1.8. Median WL increased with increasing tertiles of METs change; tertile1- 6.5(4-11) lbs., tertile2- 9(6-13)lbs. tertile3- 11(7-15)lbs. Increased PA was related to increased WL across BMI categories adjusting for age, gender and baseline weight. Conclusion: This study points strongly toward the benefit of increasing PA among other lifestyle modification interventions in controlling weight. Although further follow-up of this population to evaluate sustainability of change is needed, our results clearly relate improved PA and health.

scholarly journals Sustained Long-Term Effectiveness of an Energy Management Training Course on Employee Vitality and Purpose in Life

2019 ◽  
Vol 34 (2) ◽  
pp. 177-188 ◽  
Author(s):  
Sai Krupa Das ◽  
Shawn T. Mason ◽  
Taylor A. Vail ◽  
Caroline M. Blanchard ◽  
Meghan K. Chin ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Repeated Measures ◽  
Short Form ◽  
Depression Scale ◽  
Purpose In Life ◽  
Well Being ◽  
Sf 36

Purpose: Programs designed to sustainably improve employee well-being are urgently needed but insufficiently researched. This study evaluates the long-term effectiveness of a commercial well-being intervention in a worksite setting. Design: A pre/postintervention repeated analysis with follow-up at 6, 12, and 18 months. Setting: Office-based worksites (for-profit, nonprofit, and mixed work-type; n = 8). Participants: One hundred sixty-three employees with a mean age of 47 (11) years (57% female). Intervention: A 2.5-day group-based behavioral program emphasizing vitality and purpose in life (PiL). Measures: Rand Medical Outcomes Survey (MOS) 36-Item Short Form (SF-36) with a focus on vitality (primary outcome), Ryff PiL Scale, Center for Epidemiologic Studies Depression Scale, Profile of Mood States, Rand MOS Sleep Scale, physical activity, body weight, blood pressure, and blood measures for glucose and lipids at baseline, 6, 12, and 18 months. Analysis: General linear models with repeated measures for mean values at baseline and follow-up. Results: At 18-month follow-up, sustained improvements were observed for vitality, general health, and mental health domains of SF-36 and PiL ( P < .001 for all measures). Sleep, mood, vigor, physical activity, and blood pressure were also improved at 18 months ( P < .05 for all measures). Conclusions: An intensive 2.5-day intervention showed sustained improvement in employee quality of life, PiL, and other measures of well-being over 18 months.

Self-Selected and Prescribed Intensity Exercise to Improve Physical Activity Among Inactive Retirees

2018 ◽  
Vol 40 (9) ◽  
pp. 1301-1318 ◽  
Author(s):  
Zhinan Yang ◽  
Marcia A. Petrini
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Waist Circumference ◽  
Negative Affect ◽  
Controlled Study ◽  
Daily Step ◽  
Exercise Programs ◽  
Exercise Interventions ◽  
Step Counts

A randomized controlled study explored the effects of two intensity-oriented exercise interventions on affect to exercise and physical activity behavior. Inactive retirees finished the 12-week group-based exercise intervention and 3-month telephone follow-up with 27 in self-selected intensity group and 26 in prescribed intensity group. Repeated measures of daily step counts (measured by Yamax pedometers), positive and negative affect to exercise, weight, height, waist circumference, and blood pressure were done at baseline, postintervention, and 3-month follow-up. Increased daily step counts and positive affect, and reduced body mass index, waist circumference, blood pressure of both groups, and negative affect of self-selected intensity group were found at different measuring times. Although self-selected intensity group had no significantly different daily step counts from prescribed intensity group, the former had a more positive and less negative affect to exercise. Findings suggest that future exercise programs use self-selected intensity exercise programs to improve pleasure affect to exercise.

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