Effects of Different Doses of Physical Activity on Cardiorespiratory Fitness Among Sedentary, Overweight or Obese Postmenopausal Women With Elevated Blood Pressure

Background and objectives: Justification for application of 2017 American College of Cardiology/American Heart Association (ACC/AHA) guidelines to detect hypertension (HTN) among Bangladeshi population is understudied. This prompted us to examine the level of agreement between 2017 ACC/AHA and Joint National Committee 7 (JNC 7) guidelines to detect postmenopausal HTN in a rural area of Bangladesh. Materials and Methods: This cross-sectional study recruited 265 postmenopausal women of 40–70 years of age who visited a rural primary health care centre of Bangladesh. HTN was diagnosed based on two definitions: the JNC 7 guidelines (SBP ≥ 140 or DBP ≥ 90 mmHg), and the 2017 ACC/AHA guidelines (SBP ≥ 130 mmHg, or DBP ≥ 80 mmHg). The prevalence of postmenopausal HTN, its sub-types and stages were reported and compared using frequency and percentage. Agreement was evaluated using Cohen’s Kappa (κ), Prevalence-Adjusted Bias-Adjusted Kappa (PABAK) and First-order Agreement Coefficient (AC1). Results: The prevalence of postmenopausal HTN was 67.5% and 41.9% using 2017 ACC/AHA and JNC 7 guidelines respectively. Among the HTN sub-types and stages, the new 2017 ACC/AHA guideline classified higher proportion of respondents as having isolated systolic hypertension (ISH) (42.6%) and stage 2 HTN (35.8%) compared to JNC 7 (28.7% and 6.8% respectively). On the other hand, the JNC 7 guideline identified more respondents as pre-hypertensive (32.5%) when compared with the 2017 ACC/AHA guideline (3.8%). Between two guidelines, highest agreement was observed for ISH (86.03%) and those had pre-hypertension/elevated blood pressure (71.3%). Similarly, Landis & Koch’s approach detected highest agreement for ISH (κ = 0.74, substantial; PABAK = 0.76, substantial; AC1 = 0.84, excellent; p < 0.001) and pre-hypertension/elevated blood pressure (κ= 0.12, slight; PABAK = 0.42, moderate; AC1 = 0.83, excellent; p < 0.001). Conclusions: The 2017 ACC/AHA HTN guideline reported high agreement and detected more participants as hypertensive when compared with JNC 7 guideline for Bangladeshi postmenopausal women that demands further large-scale study in general population to clarify the current findings more precisely.

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Low Cardiorespiratory Fitness Levels and Elevated Blood Pressure

Hypertension ◽

10.1161/hypertensionaha.109.131656 ◽

2009 ◽

Vol 54 (1) ◽

pp. 91-97 ◽

Cited By ~ 34

Author(s):

Caroline Rhéaume ◽

Benoit J. Arsenault ◽

Stéphane Bélanger ◽

Louis Pérusse ◽

Angelo Tremblay ◽

...

Keyword(s):

Blood Pressure ◽

Cardiorespiratory Fitness ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Fitness Levels

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Low Physical Activity Is a Determinant for Elevated Blood Pressure in High Cardiovascular Risk Obstructive Sleep Apnea

Respiratory Care ◽

10.4187/respcare.02948 ◽

2013 ◽

Vol 59 (8) ◽

pp. 1218-1227 ◽

Cited By ~ 13

Author(s):

M. Mendelson ◽

R. Tamisier ◽

D. Laplaud ◽

S. Dias-Domingos ◽

J.-P. Baguet ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Obstructive Sleep Apnea ◽

Cardiovascular Risk ◽

Sleep Apnea ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

High Cardiovascular Risk ◽

Obstructive Sleep

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Different Influence of Blood Pressure on New-Onset Atrial Fibrillation in Pre- and Postmenopausal Women

Hypertension ◽

10.1161/hypertensionaha.120.16513 ◽

2021 ◽

Author(s):

Yun Gi Kim ◽

Kyung-Do Han ◽

Do Young Kim ◽

Yun Young Choi ◽

Ha Young Choi ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Risk Factor ◽

Systolic Blood Pressure ◽

Postmenopausal Women ◽

Premenopausal Women ◽

Elevated Blood Pressure ◽

Elevated Blood ◽

Onset Atrial Fibrillation ◽

New Onset

The characteristics of hypertension in pre- and postmenopausal women are different. Hypertension is a known risk factor for new-onset atrial fibrillation (AF), but its interaction with the menopause state is not fully established. We investigated whether menopause influences the adverse impact of high blood pressure on new-onset AF using a nationwide population-based cohort in Korea. People who underwent both a national health check-up and national cancer screening program were included in this study. A total of 3 280 834 women were assessed with 23 781 070 person*year follow-up data. Menopause was observed in 1 439 161 women. The risk of new-onset AF and blood pressure showed a linear relationship in premenopausal women ( P <0.001 for both systolic and diastolic blood pressure). The risk of new-onset AF was increased by 58.8% if systolic blood pressure was ≥160 mm Hg compared with the reference group (100 mm Hg ≤ systolic blood pressure <110 mm Hg; hazard ratio=1.588 [95% CI, 1.383–1.823]) in premenopause group. However, no consistent correlation was observed between blood pressure and the risk of new-onset AF in postmenopausal women. The increased risk of new-onset AF attributable to elevated blood pressure was more pronounced in patients not taking antihypertension medications ( P for interaction <0.001). In conclusion, elevated blood pressure, especially systolic blood pressure, was a significant risk factor for new-onset AF in premenopausal women. Postmenopausal women showed a significantly attenuated association between blood pressure and the risk of new-onset AF. Elevated systolic blood pressure had a more profound impact on new-onset AF in women not taking medications for hypertension.

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Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association

Hypertension ◽

10.1161/hyp.0000000000000196 ◽

2021 ◽

Author(s):

Bethany Barone Gibbs ◽

Marie-France Hivert ◽

Gerald J. Jerome ◽

William E. Kraus ◽

Sara K. Rosenkranz ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Heart Association ◽

Lifestyle Changes ◽

Elevated Blood Pressure ◽

Blood Cholesterol ◽

Elevated Blood ◽

First Line ◽

Moderate Risk ◽

Scientific Statement

Current guidelines published by the American Heart Association and the American College of Cardiology broadly recommend lifestyle approaches to prevent and treat elevated blood pressure and cholesterol. For patients with mildly or moderately elevated blood pressure and blood cholesterol, lifestyle-only approaches are the first line of therapy. The purpose of this scientific statement is to: (1) highlight the mild-moderate–risk patient groups indicated for lifestyle-only treatment for elevated blood pressure or cholesterol; (2) describe recommendations, average effects, and additional considerations when prescribing lifestyle treatment with physical activity; and (3) provide guidance and resources for clinicians to assess, prescribe, counsel, and refer to support increased physical activity in their patients. An estimated 21% and 28% to 37% of US adults, respectively, have mild-moderate–risk blood pressure and cholesterol and should receive lifestyle-only as first-line treatment. Of the recommended lifestyle changes, increasing physical activity has extensive benefits, including improving both blood pressure and blood cholesterol, that are comparable, superior, or complementary to other healthy lifestyle changes. Physical activity assessment and prescription are an excellent lifestyle behavior treatment option for all patients, including for the large population of mild-moderate–risk patients with elevated blood pressure and blood cholesterol.

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