The impact of aerobic exercise on blood pressure variability

Combined exercise training (CT) including aerobic plus resistance exercises could be more effective in comparison with aerobic exercise (AT) alone in reducing blood pressure variability (BPV) in hypertensive patients. We report that CT was indeed more effective than AT in reducing short-term BPV, and both exercise modalities reduced BP levels to the same extent. CT appears to be a more appropriate exercise modality if the objective is to reduce BPV in addition to BP levels.

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The impact of systolic and diastolic blood pressure variability on mortality is age dependent: Data from the Dublin Outcome Study

European Journal of Preventive Cardiology ◽

10.1177/2047487319872572 ◽

2019 ◽

Vol 27 (4) ◽

pp. 355-364 ◽

Cited By ~ 3

Author(s):

Grzegorz Bilo ◽

Eamon Dolan ◽

Eoin O'Brien ◽

Rita Facchetti ◽

Davide Soranna ◽

...

Keyword(s):

Blood Pressure ◽

Standard Deviation ◽

Confidence Interval ◽

Diastolic Blood Pressure ◽

Cardiovascular Mortality ◽

Blood Pressure Variability ◽

Strong Predictor ◽

Outcome Study ◽

Short Term ◽

The Impact

Background Twenty-four-hour blood pressure variability (BPV) is independently related to cardiovascular outcomes, but limited and conflicting evidence is available on the relative prognostic importance of systolic and diastolic BPV. The aim of this study was to verify the hypothesis that the association of systolic and diastolic blood pressure variability over 24 h with cardiovascular mortality in untreated subjects is affected by age. Design and methods The study included 9154 untreated individuals assessed for hypertension between 1982 and 2002 in the frame of the Dublin Outcome Study, in which 24 h ambulatory blood pressure monitoring was obtained (age 54.1 ± 14.3 years, 47% males). The association of short-term systolic and diastolic blood pressure variability with cardiovascular and all-cause mortality in the entire sample and separately in younger and older age subgroups was assessed over a median follow-up period of 6.3 years. Results Diastolic BPV was directly and independently related to cardiovascular mortality (adjusted hazard ratio (adjHR) for daytime standard deviation 1.16 (95% confidence interval 1.08–1.26)) with no significant differences among age groups. Conversely, systolic BPV was independently associated with cardiovascular mortality only in younger (<50 years) subjects (adjHR for daytime standard deviation 1.72 (95% confidence interval 1.33–2.23)), superseding the predictive value of diastolic BPV in this group. Conclusions Diastolic short-term BPV independently predicts cardiovascular mortality in hypertensive subjects at all ages, while systolic BPV seems a particularly strong predictor in young adults. If confirmed, these findings might improve the understanding of the prognostic value of BPV, with new perspectives for its possible clinical application.

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[OP.4A.07] THE IMPACT OF BLOOD PRESSURE VARIABILITY ON ADVERSE OUTCOMES AFTER KIDNEY TRANSPLANTATION

Journal of Hypertension ◽

10.1097/01.hjh.0000491443.84800.c1 ◽

2016 ◽

Vol 34 ◽

pp. e42 ◽

Cited By ~ 1

Author(s):

N. Pagonas ◽

F. Seibert ◽

F. Bauer ◽

K. Markakis ◽

M. Seidel ◽

...

Keyword(s):

Blood Pressure ◽

Kidney Transplantation ◽

Blood Pressure Variability ◽

Adverse Outcomes ◽

The Impact

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The value of blood pressure variability in clinical practice. Opportunities of amlodipine in reducing blood pressure variability (based on the Russian program «VARIATIONS»)

Systemic Hypertension ◽

10.26442/sg29000 ◽

2014 ◽

Vol 11 (1) ◽

pp. 11-16

Author(s):

O D Ostroumova ◽

O V Bondarets ◽

T F Guseva

Keyword(s):

Blood Pressure ◽

Clinical Practice ◽

Diastolic Blood Pressure ◽

Blood Pressure Variability ◽

Short Term ◽

Different Types ◽

Practice Opportunities ◽

The Impact ◽

Dose Dependent ◽

Russian Program

The article discusses the importance of different types of variability in blood pressure (BP) as an independent risk factor for stroke and myocardial infarction in patients with arterial hypertension. The results of the Russian observation program (1500 patients) on the impact of amlodipine show BP variability in real clinical practice. According to the results, amlodipine 5-10 mg after 2 weeks of treatment significantly reduces the variability of systolic and diastolic blood pressure in both sexes. His influence on the short-term variability in diastolic blood pressure is dose-dependent.

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Longitudinal study on the effect of surgical weight loss on beat-to-beat blood pressure variability in patients undergoing bariatric surgery: a study protocol

BMJ Open ◽

10.1136/bmjopen-2021-050957 ◽

2021 ◽

Vol 11 (10) ◽

pp. e050957

Author(s):

Souha Fares ◽

Nour-Mounira Z Bakkar ◽

Ramzi Alami ◽

Issam Lakkis ◽

Kamal Badr

Keyword(s):

Blood Pressure ◽

Bariatric Surgery ◽

Longitudinal Study ◽

Blood Pressure Variability ◽

Morbidly Obese ◽

Study Results ◽

Non Linear ◽

Obese Subjects ◽

Normotensive Subjects ◽

The Impact

IntroductionAlterations in linear and non-linear parameters of beat-to-beat blood pressure variability (BPV) have been shown to predict disease prognosis and distinguish between risk categories in various pathological conditions, independently of average blood pressure levels. Obesity places subjects at elevated risk of vascular diseases, including hypertension, resulting in serious cardiac, respiratory and cerebral events. However, little is known about the status of vascular dynamics in obese and morbidly obese adults.Methods and analysisIn this present quasi-experimental longitudinal study, changes in beat-to-beat BPV, using continuous, non-invasive blood pressure monitoring, in obese subjects undergoing bariatric surgery are characterised. The capacity of linear and non-linear measures of BPV to detect differences between hypertensive, prehypertensive and normotensive obese subjects prebariatric and postbariatric surgery are tested. Additionally, potential correlations between beat-to-beat BPV and age, body mass index, gender and comorbidities will be investigated. In parallel, the impact of the unsteady fluctuations of beat-to-beat blood pressure on the dynamic stresses imparted by blood flow on blood vessel walls will be explored. We expect to find altered BPV profiles in hypertensive and prehypertensive subjects as compared with normotensive subjects. We also expect to see differential normalisation in BPV profiles between hypertensive, prehypertensive and normotensive subjects over time.Ethics and disseminationThe study has been approved by the Institutional Review Board at the American University of Beirut (IRB ID: BIO-2018-0040). Study results will be made available to the public through publications in peer-reviewed journals and conference papers and/or presentations.

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Blood Pressure Variability and Incidence of New-Onset Atrial Fibrillation

Hypertension ◽

10.1161/hypertensionaha.119.13708 ◽

2020 ◽

Vol 75 (2) ◽

pp. 309-315 ◽

Cited By ~ 6

Author(s):

So-Ryoung Lee ◽

You-Jung Choi ◽

Eue-Keun Choi ◽

Kyung-Do Han ◽

Euijae Lee ◽

...

Keyword(s):

Atrial Fibrillation ◽

Blood Pressure ◽

Diastolic Blood Pressure ◽

Blood Pressure Variability ◽

Blood Pressure Measurement ◽

Population Based ◽

Increased Risk ◽

Complete Set ◽

The Impact ◽

Fourth Quartile

Blood pressure variability is a well-known risk factor for cardiovascular disease, but its association with atrial fibrillation (AF) is uncertain. We aimed to evaluate the association between visit-to-visit blood pressure variability and incident AF. This population-based cohort study used database from the Health Screening Cohort, which contained a complete set of medical claims and a biannual health checkup information of the Koran population. A total of 8 063 922 individuals who had at least 3 health checkups with blood pressure measurement between 2004 and 2010 were collected after excluding subjects with preexisting AF. Blood pressure variability was defined as variability independence of the mean and was divided into 4 quartiles. During a mean follow-up of 6.8 years, 140 086 subjects were newly diagnosed with AF. The highest blood pressure variability (fourth quartile) was associated with an increased risk of AF (hazard ratio, 95% CI; systolic blood pressure: 1.06, 1.05–1.08; diastolic blood pressure: 1.07, 1.05–1.08) compared with the lowest (first quartile). Among subjects in the fourth quartile in both systolic and diastolic blood pressure variability, the risk of AF was 7.6% higher than those in the first quartile. Moreover, this result was consistent in both patients with or without prevalent hypertension. In subgroup analysis, the impact of high blood pressure variability on AF development was stronger in high-risk subjects, who were older (≥65 years), with diabetes mellitus or chronic kidney disease. Our findings demonstrated that higher blood pressure variability was associated with a modestly increased risk of AF.

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The impact of aerobic and isometric exercise on different measures of dysfunctional high-density lipoprotein in patients with hypertension

European Journal of Preventive Cardiology ◽

10.1177/2047487319848199 ◽

2019 ◽

Vol 26 (12) ◽

pp. 1301-1309 ◽

Cited By ~ 5

Author(s):

Nikolaos Pagonas ◽

Stergios Vlatsas ◽

Frederic Bauer ◽

Felix S Seibert ◽

B Sasko ◽

...

Keyword(s):

Blood Pressure ◽

Exercise Training ◽

High Density Lipoprotein ◽

Aerobic Exercise ◽

Isometric Exercise ◽

Density Lipoprotein ◽

High Density ◽

Hdl Function ◽

Antioxidant Function ◽

The Impact

Background Exercise training increases high-density lipoprotein (HDL) cholesterol, but its effect on HDL function is unclear. In hypertensives, exercise improves endothelial dysfunction, which is related to HDL function. In the present study, we assess for the first time the effects of different exercise modalities on two cell-free assays of HDL function. Design The study was conducted as a prospective randomized controlled trial in 75 hypertensive patients. Methods Patients were randomized in three groups: (a) handgrip isometric training five times weekly; (b) placebo-handgrip; and (c) aerobic exercise training at least three times per week. HDL function was assessed in serum samples at baseline and after 12 weeks of training by two independent assays that determine the proinflammatory phenotype (haptoglobin content) of a specific amount of HDL (Haptoglobin-HDL [HPHDL]) and oxidized HDL (HDLox) as a measure of reduced antioxidant function of HDL. HDL function measures were normalized by the measures of a pooled control of sera from healthy participants and by HDL-C levels (normalized ratio, no units). Results Aerobic exercise led to significant reduction of the HDLox from 0.99 ± 0.27 to 0.90 ± 0.29 (no units, p = 0.03). The HPHDL did not change in any training group. Changes of HDLox correlated with reduction of the systolic blood pressure only after aerobic exercise ( R = 0.64, p = 0.03). Conclusions Aerobic but not isometric exercise improves the antioxidant function of HDL in patients with hypertension. This improvement correlates positively with reductions of blood pressure.

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Abstract P440: Inpatient Blood Pressure Variability is Associated With Mortality and Poor Functional Outcome in Patients With Intracerebral Hemorrhage

Stroke ◽

10.1161/str.52.suppl_1.p440 ◽

2021 ◽

Vol 52 (Suppl_1) ◽

Author(s):

Evangelos Pavlos Myserlis ◽

Jessica R Abramson ◽

Haitham Alabsi ◽

Christopher D Anderson ◽

Alessandro Biffi ◽

...

Keyword(s):

Blood Pressure ◽

Intracerebral Hemorrhage ◽

Functional Outcome ◽

Blood Pressure Variability ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Poor Functional Outcome ◽

Logistic Regression Models ◽

Established Risk Factor ◽

The Impact

Introduction: Although elevated blood pressure (BP) is an established risk factor for intracerebral hemorrhage (ICH), the impact of acute BP fluctuations on ICH outcomes remains unclear. In this study, we sought to investigate the effect of acute BP variability (BPV) on mortality and functional outcome in ICH survivors. Methods: Subjects were consecutive ICH patients ≥ 18 years with available inpatient BP data, who survived hospitalization. Four measures of systolic BPV were calculated: standard deviation (SD), coefficient of variation (CoV), average real variability (ARV), and successive variation (SV). Our outcomes were (1) death and (2) poor functional outcome, defined as a modified Rankin Score (mRS) of 3-6 in a period between 60-120 days after discharge. We assessed the effect of hyperacute (ICH event-72 hours) and acute/subacute (72 hours-discharge) BPV on outcomes. We constructed Cox proportional hazards and logistic regression models to investigate the associations of BPV (per 10 mmHg increase) with mortality and poor functional outcome, respectively, after adjustment for potential confounders. Results: We included 345 patients, 120 of whom had available mRS data. 151 (43.8%) patients were female and 280 (81.2%) were white; mean age was 71 (±13) years. SBP ARV and SBP SV were the strongest predictors of mortality (HR 2.53-2.91 per 10 mmHg increase), while SBP SD, CoV, and SV were the strongest predictors of poor functional outcome (OR 2.89-5.14 per 10 mmHg increase) (Table) . These associations remained significant when analyzing both hyperacute as well as acute/subacute BPV. Compared to hyperacute BPV, acute/subacute BPV was more strongly associated with both mortality and poor functional outcome. Conclusion: Inpatient blood pressure variability is an important determinant of mortality and poor functional outcome in ICH survivors. Further studies are needed to investigate the role of addressing BPV as a potential target for intervention.

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Abstract P160: Long-term Blood Pressure Variability And Cognitive Decline And Dementia Among Community-dwelling Elderly

Hypertension ◽

10.1161/hyp.76.suppl_1.p160 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Michael E Ernst ◽

Joanne Ryan ◽

Enayet K Chowdhury ◽

Anne M Murray ◽

Robyn L Woods ◽

...

Keyword(s):

Blood Pressure ◽

Cognitive Decline ◽

Blood Pressure Variability ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Community Dwelling ◽

Immortal Time Bias ◽

Incident Dementia ◽

The Impact

Greater blood pressure variability (BPV) in midlife increases the risk of dementia, but the impact of BPV in cognitively intact older adults is unknown. We examined the risk of incident dementia and cognitive decline associated with long-term, visit-to-visit BPV in participants of the ASPirin in Reducing Events in the Elderly (ASPREE) study, a randomized primary prevention trial of daily low-dose aspirin in community-dwelling adults in Australia and the US aged 70 and older (65 if US minority), who were free of dementia or evidence of cognitive impairment at enrollment. The mean of three BPs using an automated cuff was recorded at baseline and annually; participants also underwent baseline and biennial standardized assessments of global cognition, delayed episodic memory, verbal fluency, processing speed and attention. Cognitive decline was pre-specified as a >1.5 standard deviation (SD) decline in score from baseline on any of the cognitive tests, while incident dementia was a pre-specified secondary endpoint of ASPREE which was adjudicated using DSM-IV criteria. BPV was estimated using within-individual SD of mean systolic BP across baseline and the first two annual visits, and participants with cognitive decline or incident dementia during this period were excluded from the analysis to avoid immortal time bias. After adjustment for key covariates, Cox proportional hazards regression revealed increased risks for dementia and cognitive decline during follow-up for individuals in the highest SD tertile of BPV (Table). Our findings suggest that high BPV in older ages should be considered a potential therapeutic target to preserve cognitive function.

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