Effect of exercise and physical activity on blood pressure in adults with resistant hypertension: a protocol for a systematic review

2020 ◽  
Vol 25 (2) ◽  
pp. 128-134
Author(s):  
Suranga Dassanayake ◽  
Gisela Sole ◽  
Gerard Wilkins ◽  
Margot Skinner
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Resistant Hypertension

scholarly journals Effect of workplace physical activity interventions on the cardio-metabolic health of working adults: systematic review and meta-analysis

2019 ◽  
Vol 16 (1) ◽  
Author(s):  
Rubina Mulchandani ◽  
Ambalam M. Chandrasekaran ◽  
Roopa Shivashankar ◽  
Dimple Kondal ◽  
Anurag Agrawal ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Body Weight ◽  
Waist Circumference ◽  
Meta Analysis ◽  
Workplace Interventions ◽  
Working Adults ◽  
Reduced Body ◽  
Physical Activity Interventions

Abstract Background Adults in urban areas spend almost 77% of their waking time being inactive at workplaces, which leaves little time for physical activity. The aim of this systematic review and meta-analysis was to synthesize evidence for the effect of workplace physical activity interventions on the cardio-metabolic health markers (body weight, waist circumference, body mass index (BMI), blood pressure, lipids and blood glucose) among working adults. Methods All experimental studies up to March 2018, reporting cardio-metabolic worksite intervention outcomes among adult employees were identified from PUBMED, EMBASE, COCHRANE CENTRAL, CINAHL and PsycINFO. The Cochrane Risk of Bias tool was used to assess bias in studies. All studies were assessed qualitatively and meta-analysis was done where possible. Forest plots were generated for pooled estimates of each study outcome. Results A total of 33 studies met the eligibility criteria and 24 were included in the meta-analysis. Multi-component workplace interventions significantly reduced body weight (16 studies; mean diff: − 2.61 kg, 95% CI: − 3.89 to − 1.33) BMI (19 studies, mean diff: − 0.42 kg/m2, 95% CI: − 0.69 to − 0.15) and waist circumference (13 studies; mean diff: − 1.92 cm, 95% CI: − 3.25 to − 0.60). Reduction in blood pressure, lipids and blood glucose was not statistically significant. Conclusions Workplace interventions significantly reduced body weight, BMI and waist circumference. Non-significant results for biochemical markers could be due to them being secondary outcomes in most studies. Intervention acceptability and adherence, follow-up duration and exploring non-RCT designs are factors that need attention in future research. Prospero registration number: CRD42018094436.

scholarly journals Effect of the physical activity program on the treatment of resistant hypertension in primary care

2018 ◽  
Vol 19 (6) ◽  
pp. 575-583 ◽  
Author(s):  
Piotr J. Kruk ◽  
Michał Nowicki
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Primary Care ◽  
Resistant Hypertension ◽  
Lifestyle Modification ◽  
Heart Association ◽  
Pressure Control ◽  
Physical Activity Program ◽  
Activity Program ◽  
The Impact

AbstractBackgroundRegular physical activity is widely recommended for patients with arterial hypertension as an essential component of lifestyle modification. Much less is known about the impact of physical exercise on the management of treatment of resistant hypertension (RH). The aim was to assess the effect of physical activity program intensified by mobile phone text reminders on blood pressure control in subjects with RH managed in the primary care.MethodsIn total, 53 patients with primary hypertension were qualified, including 27 who met the criteria for RH and 26 with well-controlled hypertension (WCH). Ambulatory 24-h blood pressure was monitored and body composition evaluated with bioimpedance and habitual physical activity profile was determined continuously over 72 h with accelerometer. All measurements were performed at baseline and after three and six months. The patients were asked to modify their lifestyle according to American Heart Association Guidelines that included regular aerobic physical activity tailored to individual needs.FindingsPhysical activity in RH increased significantly after six months compared with control subjects (P=0.001). Office systolic blood pressure (SBP) and diastolic blood pressure (DBP) in the RH group decreased significantly after three months but after six months only office DBP remained significantly lower. After three months 24-h SBP decreased by 3.1±11 mmHg (P=0.08) and DBP by 2.0±6 mmHg (P=0.17) in RH, whereas in WCH respective changes were +1.2±10 and −0.3±6 mmHg. After six months 24-h BP changes were similar.ConclusionIndividualized structured physical activity program increases physical activity in the treatment of resistant hypertensives in primary care but the effect on 24-h blood pressure is only transient.

scholarly journals Effectiveness of a 12-week physical exercise programme on blood pressure in adults with true resistant hypertension and high risk of obstructive sleep apnoea: a study protocol for a pre-post test non randomised clinical trial

2020 ◽  
Vol 7 (2) ◽  
pp. 112
Author(s):  
Suranga Dassanayake ◽  
Gerard Wilkins ◽  
Gisela Sole ◽  
Margot Skinner
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
High Risk ◽  
Obstructive Sleep Apnoea ◽  
Resistant Hypertension ◽  
Randomised Clinical Trial ◽  
Exercise Programme ◽  
Primary Outcome Measure ◽  
Sleep Apnoea ◽  
Obstructive Sleep

<p class="abstract"><strong>Background:</strong> Resistant hypertension, a special phenotype of hypertension, is associated with increased cardiovascular risk. Exercise and physical activity are recommended as non-pharmacological interventions to manage blood pressure in hypertension. Little is known about the effectiveness of exercise in resistant hypertension. A bidirectional relationship has been identified between resistant hypertension and obstructive sleep apnoea but the literature pertaining to the benefit of exercise for populations with both conditions, is minimal. This study aims to identify the effectiveness of exercise in reducing blood pressure in a cohort of adults with resistant hypertension and high risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Methods:</strong> Dunedin based adults with resistant hypertension and high risk of obstructive sleep apnoea will be recruited from the community and health centres to participate in the study. Consenting volunteers (no. of fourteen) will participate in a 12-week exercise programme including aerobic and strength training. The primary outcome measure will be 24h ambulatory blood pressure while the secondary outcomes will be anthropometrics, activity parameters, sleep parameters, cardiac structure and function, and quality of life. The measurements at the end of the 12-week exercise programme will be compared with baseline to determine the effectiveness of exercise in reducing blood pressure in the cohort with resistant hypertension and risk of obstructive sleep apnoea.</p><p class="abstract"><strong>Conclusions: </strong>Exercise and physical activity are recommended to manage hypertension. Therefore, it is anticipated that the exercise programme will have a positive effect on the blood pressure of the participants. The findings have potential to change the direction of research in the area by filling the knowledge gaps.</p><p class="abstract"><strong>Trial Registration:</strong> The Ministry of Health, New Zealand (Ethics Ref: 18/CEN/257), Trial registry: ACTRN12618001881224p).</p>

scholarly journals May the brief physical activity assessment tool accurately measure physical activity in patients with resistant hypertension?

2021 ◽  
Vol 20 (Supplement_1) ◽  
Author(s):  
S Lopes ◽  
J Mesquita-Bastos ◽  
C Garcia ◽  
D Figueiredo ◽  
P Carvalho ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
Resistant Hypertension ◽  
Assessment Tool ◽  
Physical Activity Assessment ◽  
Major Health Problem ◽  
Activity Assessment ◽  
Specificity And Sensitivity ◽  
Increased Risk ◽  
Active Patients

Abstract Funding Acknowledgements Type of funding sources: Public grant(s) – EU funding. Main funding source(s): FEDER Funds through the Operational Competitiveness Factors Program—COMPETE National Funds through the Portuguese Foundation for Science and Technology (FCT) “PTDC/DTP-DES/1725/2014”. SL is a PhD fellow supported by the FCT (Grant Ref: SFRH/BD/129454/2017). Introduction Resistant hypertension is a major health problem due to the increased risk of cardiovascular events and mortality. Physical activity and exercise reduces blood pressure in resistant hypertension and is associated with lower cardiovascular risk and mortality. It is presently recommended that physical activity assessment should be a priority in all visits to health settings Purpose This study aims to determine if the Brief Physical Activity Assessment Tool (BPAAT), a 2-question tool to assess physical activity, is a valid instrument to detect inactive patients with resistant hypertension.  Methods Sixty patients with a diagnosis of resistant hypertension were recruited. Outcome measures included clinical data, blood pressure and daily physical activity. Physical activity was objectively measured over a 7-day period with an accelerometer and subjectively assessed (self-assessment) by the BPAAT. The association between the BPAAT and accelerometry, according to the BPAAT scoring categories, was assessed bythe percentage of agreement, Cohen’s Kappa and sensitivity and specificity. Results Patients (33 were male) had a mean age of 59.4 ± 9.1years, were on average overweight (BMI 29.5 ± 4.5 kg/m2) and on an average of 4.5 ± 0.7 antihypertensive medications. Forty-two patients (70%) were classified as insufficiently active by the BPAAT compared to the 38 (63.3%) insufficiently active patients identified by the accelerometry data. Regarding the questionnaire’s specificity and sensitivity, the BPAAT correctly identified 32 [84.2 (73.1 – 95.3) %] of the 38 ‘insufficiently active’ patients and 12 [54.5 (34.3 – 74.7) %] of the 22 ‘sufficiently active’ patients identified by accelerometry. The agreement between BPAAT and accelerometry to identify sufficiently/insufficiently active patients, according to the BPAAT’s cut-off values was fair to moderate (Kappa = 0.403 (0.162 – 0.674), with a percentage of agreement of 73.3%. Conclusion The BPAAT, a 2-question tool to assess physical activity, seems to be a valid and fast solution to identify insufficiently active adults with resistant hypertension during routine clinical visits.

scholarly journals Diet and physical activity in pregnancy and offspring’s cardiovascular health: a systematic review

2018 ◽  
Vol 10 (3) ◽  
pp. 286-298 ◽  
Author(s):  
T. M. van Elten ◽  
M. D. A. Karsten ◽  
M. N. M. van Poppel ◽  
A. Geelen ◽  
J. Limpens ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Cardiovascular Health ◽  
Data Extraction ◽  
Maternal Diet ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Core Outcome Sets ◽  
Diet And Physical Activity

AbstractThere is increasing evidence linking maternal diet and physical activity before and during pregnancy with offspring’s cardiovascular health. Although many studies examined this association, the evidence has not been reviewed systematically. We therefore undertook a systematic review to synthesize evidence examining the association of maternal diet and physical activity before and during pregnancy with offspring’s blood pressure and vascular health. We systematically searched the databases MEDLINE and EMBASE from inception to June 30, 2017. Eligibility screening, data extraction and quality assessment were performed by two independent reviewers. A total of 19 articles were included comprising three randomized controlled trials and 16 observational studies. Of the studies that examined the association of interest, 60% (three out of five studies) showed that high maternal carbohydrate intake was associated with higher offspring’s blood pressure. Maternal protein intake during pregnancy was negatively associated with offspring carotid intima-media thickness in two out of two studies. No consistent findings for maternal fatty acid intake were found. There were too few studies to draw conclusions on energy intake, fibre intake, protein/carbohydrate ratio, specific foods, dietary patterns and maternal physical activity. Heterogeneity in exposure and outcome assessment hampered pooling. Also, owing to the observational nature of most studies, causality cannot be established. Harmonization of valid exposure and outcome measurements, and the development of core outcome sets are needed to enable more robust conclusions.

scholarly journals Effects of sedentary behaviour interventions on biomarkers of cardiometabolic risk in adults: systematic review with meta-analyses

2020 ◽  
pp. bjsports-2019-101154 ◽  
Author(s):  
Nyssa T Hadgraft ◽  
Elisabeth Winkler ◽  
Rachel E Climie ◽  
Megan S Grace ◽  
Lorena Romero ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Blood Pressure ◽  
Sedentary Behaviour ◽  
Vascular Function ◽  
Cardiometabolic Risk ◽  
Evidence Base ◽  
Fat Free Mass ◽  
Percentage Body Fat ◽  
Meta Analyses

Context/purposeObservational and acute laboratory intervention research has shown that excessive sedentary time is associated adversely with cardiometabolic biomarkers. This systematic review with meta-analyses synthesises results from free living interventions targeting reductions in sedentary behaviour alone or combined with increases in physical activity.MethodsSix electronic databases were searched up to August 2019 for sedentary behaviour interventions in adults lasting for ≥7 days publishing cardiometabolic biomarker outcomes covering body anthropometry, blood pressure, glucose and lipid metabolism, and inflammation (54 studies). The pooled effectiveness of intervention net of control on 15 biomarker outcomes was evaluated using random effects meta-analyses in the studies with control groups not providing other relevant interventions (33 studies; 6–25 interventions analysed).ResultsInterventions between 2 weeks and <6 months in non-clinical populations from North America, Europe and Australia comprised much of the evidence base. Pooled effects revealed small, significant (p<0.05) beneficial effects on weight (≈ −0.6 kg), waist circumference (≈ −0.7 cm), percentage body fat (≈ −0.3 %), systolic blood pressure (≈ −1.1 mm Hg), insulin (≈ −1.4 pM) and high-density lipoprotein cholesterol (≈ 0.04 mM). Pooled effects on the other biomarkers (p>0.05) were also small, and beneficial in direction except for fat-free mass (≈ 0.0 kg). Heterogeneity ranged widely (I2=0.0–72.9).ConclusionsOur review of interventions targeting sedentary behaviour reductions alone, or combined with increases in physical activity, found evidence of effectiveness for improving some cardiometabolic risk biomarkers to a small degree. There was insufficient evidence to evaluate inflammation or vascular function. Key limitations to the underlying evidence base include a paucity of high-quality studies, interventions lasting for ≥12 months, sensitive biomarkers and clinical study populations (eg, type 2 diabetes).PROSPERO trial registration numberCRD42016041742

scholarly journals Mind–Body Physical Activity Interventions and Stress-Related Physiological Markers in Educational Settings: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 18 (1) ◽  
pp. 224
Author(s):  
Ildiko Strehli ◽  
Ryan D. Burns ◽  
Yang Bai ◽  
Donna H. Ziegenfuss ◽  
Martin E. Block ◽  
...  
Keyword(s):  
Physical Activity ◽  
Higher Education ◽  
Systematic Review ◽  
Blood Pressure ◽  
Heart Rate ◽  
Comparison Group ◽  
Cochrane Library ◽  
Preventive Strategy ◽  
Educational Settings ◽  
Meta Analyses

Mind–Body Physical Activity (MBPA) in educational settings is one possible preventive strategy for ameliorating stress-related physiological health parameters. The objectives of this study were to conduct a systematic review of the literature with meta-analyses on the effects of MBPA on stress-related physiological health markers in primary, secondary, and higher education students. In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, the search for peer-reviewed articles published in English was conducted in PubMed, EBSCOhost, PsychInfo, Scopus, and Cochrane Library databases. Criteria for inclusion consisted of empirical studies targeting the student population (primary, secondary, higher education), studies examining the effectiveness of an MBPA intervention, studies including a control or comparison group (pre-test/post-test studies excluded), studies targeting physiological marker outcomes such as heart rate, blood glucose, cortisol, and blood pressure, and finally, studies examining interventions implemented within educational settings. Twenty-six interventions were eligible for the review and quantitative synthesis, which comprised a total of 1625 participants, with 783 students serving within the control/comparison group. There were statistically significant and large pooled effects for MBPA effectiveness for lowering heart rate (Hedges’ g = −1.71, 95% Confidence Interval (CI): −2.43, −0.98), cortisol (Hedges’ g = −1.32, 95% CI: −2.50, −0.16), and systolic and diastolic blood pressure (Hedges’ g = −1.04, 95% CI: −1.53, −0.58). These effects tended to be stronger in older students compared to younger students. Most analyses were characterized as having high heterogeneity and only 10 of the 26 studies were characterized as good quality (38.4%). MBPA interventions may have a positive impact on specific physiological health markers in students, especially in students within higher education. However, higher-quality research is needed in this area.

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