061 Sleep Hygiene as an Intervention to Lower Blood Pressure

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A25-A26
Author(s):  
Michael Vazquez ◽  
Huan Yang ◽  
Rammy Dang ◽  
Monika Haack ◽  
Janet Mullington
Keyword(s):  
Blood Pressure ◽  
Positive Impact ◽  
Sleep Hygiene ◽  
Science Center ◽  
Wait List Control ◽  
Sleep Timing ◽  
Lower Blood ◽  
Hospital Stays ◽  
Underlying Mechanisms ◽  
The Relationship

Abstract Introduction Insufficient sleep has been shown to increase the risk of a person developing hypertension. Impaired baroreflex sensitivity (BRS) is one of the known underlying mechanisms involved that is responsible for increasing blood pressure (BP). This project investigates the relationship between sleep, BRS, and BP during Valsalva’s Maneuver (VM). Methods Fifty participants (59.8 ± 1.5 years; 31 women) completed 3 overnight in-hospital stays. The first stay (S1) was a baseline control; the second stay (S2) followed a 4-week wait-list control condition; the third stay (S3) followed an 8-week randomly assigned intervention that used sleep hygiene approaches and scheduling to either A) stabilize sleep timing, or B) stabilize and extend the bed period. The study is still ongoing, and we are blind to whether participants were randomized to arm A or B of the study. A linear regression model analyzing the R-R Interval (RRI) and corresponding systolic BP was used to calculate the BRS function and the maximum change in SBP (BPMax) during Early Phase II (EPII) of VM. Results There was an increasing BRS trend across the three stays during EPII (p=.051). There was no significant increase between S1 and S2 (p=.876), but BRS significantly increased following 8 weeks of intervention at S3 compared to S1 (p=0.033) and S2 (p=0.037). There was also a significant decrease in BPMax across the three stays during EPII (p<.001). There was no significant decrease in EPII BPMax between S1 and S2 (p=.325), but BPMax significantly decreased in S3 compared to S1 (p<0.001) and S2 (p=0.002). Conclusion While we are still blind to condition, both conditions are considered active as they both involve stabilizing the sleep period using sleep hygiene. These preliminary data suggest that stabilization of sleep timing and possibly duration, has a positive impact on BP regulation. Support (if any) NIH (R01HL125379 to Dr. Janet Mullington), Harvard Catalyst, Harvard Clinical and Translational Science Center (UL1TR001102).

Abstract P207: Sleep Hygiene As An Intervention To Improve Autonomic Function

Hypertension ◽  
2021 ◽  
Vol 78 (Suppl_1) ◽  
Author(s):  
Michael Vazquez ◽  
Huan Yang ◽  
Rammy Dang ◽  
Monika Haack ◽  
Janet Mullington
Keyword(s):  
Autonomic Function ◽  
Positive Impact ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Sleep Hygiene ◽  
Wait List Control ◽  
Sleep Timing ◽  
Autonomic Testing ◽  
Hospital Stays ◽  
Resting Period

Introduction: Insufficient sleep is associated with increased heart rate (HR) and blood pressure (BP). Exaggerated cardiovascular reactivity to the cold pressor test (CPT) has been linked to an increased incidence of hypertension. This project investigates the effects of improved sleep hygiene on autonomic function at rest and in response to CPT. We hypothesize a decrease in BP and HR at rest, and attenuated BP and HR response during CPT. Methods: Fifty participants (59.8 ± 1.5 years; 31 women) completed 3 overnight in-hospital stays in which they had continuous ECG and beat-to-beat BP monitoring. The first stay (S1) was a baseline control; the second stay (S2) was a 4-week wait-list control; the third stay (S3) followed an 8-week randomly assigned intervention that used sleep hygiene approaches along with scheduling to either A) stabilize sleep timing, or B) stabilize and extend the bed period. This study is still ongoing, so we are blind to the specific arm that the participants were randomized to. During each stay, autonomic testing was performed about four hours after the participant awoke, including a 5-minute resting period where breathing was controlled (BL), a 3-minute resting period where breathing was not controlled (CPT BL), and 2-minute CPT when participants then submerged their hand in 3°C water. Linear mixed models analyzing the changes in HR and systolic BP (SBP) across the three stays were used. Results: During the 5-minute BL, HR did not significantly decrease from S1 to S2 (p=.310) but did significantly decrease by 2 bpm from S2 to S3 (p=.006). SBP decreased by 7 mmHg from S1 to S2 (p=.022) but did not significantly decrease from S2 to S3 (p=.907). During CPT in all stays, HR and SBP significantly increased compared to CPT BL (p<0.05). There was a significant stay x test interaction effect in HR (interaction, p=.042), but not in SBP (interaction p=.361). Conclusion: While we are still blind to condition, both arms actively improve sleep hygiene. These preliminary data suggest that stabilization of sleep timing and possibly duration, has a positive impact on autonomic function as seen through the decreases in HR at rest and during CPT.

scholarly journals Breastfeeding in the First Days of Life Is Associated With Lower Blood Pressure at 3 Years of Age

2021 ◽  
Author(s):  
Kozeta Miliku ◽  
Theo J. Moraes ◽  
Allan B. Becker ◽  
Piushkumar J. Mandhane ◽  
Malcolm R. Sears ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Body Mass Index ◽  
Breast Milk ◽  
Body Mass ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Maternal Body Mass Index ◽  
Lower Blood Pressure ◽  
Lower Blood ◽  
Underlying Mechanisms

Background Breastfeeding in infancy is associated with lower cardiovascular disease risk in adulthood; however, the amount of breastfeeding required to achieve this benefit is unknown. Methods and Results In the CHILD (Canadian Healthy Infant Longitudinal Development) Cohort Study, we analyzed 2382 children with complete data on early life feeding and blood pressure. Infant feeding was documented from hospital records in the first few days of life and reported by mothers throughout infancy. Blood pressure was measured at 3 years of age. Analyses controlled for birth weight, gestational age, socioeconomic status, maternal body mass index, and other potential confounders. We found that nearly all children (2333/2382; 97.9%) were ever breastfed, of whom 98 (4.2%) only briefly received breast milk during their birth hospitalization (“early limited breastfeeding”). At 3 years of age, blood pressure was higher in children who were never breastfed (mean systolic/diastolic 103/60 mm Hg) compared with those who were ever breastfed (99/58 mm Hg), including those who received only early limited breastfeeding (99/57 mm Hg). These differences in systolic blood pressure persisted in adjusted models (ever breastfed: −3.47 mm Hg, 95% CI, −6.14 to −0.80; early limited breastfeeding: −4.24 mm Hg, 95% CI, −7.45 to −1.04). Among breastfed children, there was no significant dose‐response association according to the duration or exclusivity of breastfeeding. Associations were not mediated by child body mass index. Conclusions Although the benefits of sustained and exclusive breastfeeding are indisputable, this study indicates any breastfeeding, regardless of duration or exclusivity, is associated with lower blood pressure at 3 years of age. Further research examining the bioactive components of early breast milk, underlying mechanisms, and long‐term associations is warranted.

The Relationship between Religious Activities and Blood Pressure in Older Adults

1998 ◽  
Vol 28 (2) ◽  
pp. 189-213 ◽  
Author(s):  
Harold G. Koenig ◽  
Linda K. George ◽  
Judith C. Hays ◽  
David B. Larson ◽  
Harvey J. Cohen ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
High Blood Pressure ◽  
Religious Activity ◽  
Religious Activities ◽  
The Bible ◽  
Lower Blood ◽  
Religious Services ◽  
Blood Pressures ◽  
The Relationship

Objective: To examine the relationship between religious activities and blood pressure in community-dwelling older adults. Method: Blood pressure and religious activities were assessed in a probability sample of 3,963 persons age sixty-five years or older participating in the Duke EPESE survey. Participants were asked if their doctor had ever informed them that they had high blood pressure and if they were currently taking medication for high blood pressure. After the interview, systolic and diastolic blood pressures were measured following a standardized protocol. Data were available for three waves of the survey (1986, 1989–90, and 1993–94). Analyses were stratified by age (65–74 vs. over 75) and by race (Whites vs. Blacks) and were controlled for age, race, gender, education, physical functioning, body mass index, and, in longitudinal analyses, blood pressure from the previous wave. Results: Cross-sectional analyses revealed small (1–4 mm Hg) but consistent differences in measured systolic and diastolic blood pressures between frequent (once/wk) and infrequent (< once/wk) religious service attenders. Lower blood pressures were also observed among those who frequently prayed or studied the Bible (daily or more often). Blood pressure differences were particularly notable in Black and younger elderly, in whom religious activity at one wave predicted blood pressures three years later. Among participants who both attended religious services and prayed or studied the Bible frequently, the likelihood of having a diastolic blood pressure of 90 mm Hg or higher was 40 percent lower than found in participants who attended religious services infrequently and prayed or studied the Bible infrequently (OR 0.60, 95% CI, 0.48–0.75, p < .0001). Among participants told they had high blood pressure, religiously active persons were more likely to be taking their blood pressure medication; this could not, however, explain the differences in blood pressure observed. While most religious activity was associated with lower blood pressure, those who frequently watched religious TV or listened to religious radio actually had higher blood pressures. Conclusions: Religiously active older adults tend to have lower blood pressures than those who are less active. This applies to attendance at religious services and private religious activities, but not to religious media. Physiological mechanisms are discussed.

scholarly journals Selenium levels and hypertension: a systematic review of the literature

2013 ◽  
Vol 17 (6) ◽  
pp. 1342-1352 ◽  
Author(s):  
Dulanji Kuruppu ◽  
Hugh C Hendrie ◽  
Lili Yang ◽  
Sujuan Gao
Keyword(s):  
Systematic Review ◽  
Blood Pressure ◽  
Glutathione Peroxidase ◽  
Conclusive Evidence ◽  
Outcome Variable ◽  
Review Of The Literature ◽  
Lower Blood ◽  
Study Population ◽  
The Relationship ◽  
Antioxidant Micronutrient

AbstractObjectiveSe is an antioxidant micronutrient and has been studied for its potential role in CVD prevention. The purpose of the present study was to conduct a systematic review of the literature on the relationship between Se and hypertension.DesignWe conducted a systematic literature search in PubMed and OVID of studies on Se levels and hypertension or blood pressure published in English up to June 2011. Articles meeting inclusion criteria were reviewed and the following information was gathered from each publication: study setting, participant demographics, exclusion criteria, intervention if applicable, medium of Se measure, mean level of Se, outcome definition, relationship between Se and the outcome variable, significance of this relationship, and covariates. In studies that also reported glutathione peroxidase levels, we extracted results on the relationship between glutathione peroxidase and hypertension.ResultsTwenty-five articles were included. Approximately half of the studies reported no significant relationship between Se and hypertension. Of the remaining studies, about half found that higher Se levels were associated with lower blood pressure and the other half found the opposite relationship. The studies varied greatly in terms of study population, study design and Se levels measured in participants.ConclusionsBased on the present systematic review, there is no conclusive evidence supporting an association between Se and hypertension. Randomized controlled trials and prospective studies with sufficient sample size in populations with different Se levels are needed to fully investigate the relationship between Se and hypertension.

scholarly journals Salt and Bread: Latvia’S Experience

2013 ◽  
Vol 67 (4-5) ◽  
pp. 383-388
Author(s):  
Daiga Kunkulberga ◽  
Endija Mūrniece
Keyword(s):  
Blood Pressure ◽  
Salt Intake ◽  
Positive Impact ◽  
Critical Role ◽  
Blood Pressure Level ◽  
World Health ◽  
Salt Reduction ◽  
Lower Blood ◽  
Health Organization ◽  
Common Vision

Abstract Much research has shown that reduction in salt intake can have a very positive impact on human health, as salt intake plays a critical role in regulating blood pressure. According to the World Health Organization, populations with low salt intake, all other factors being equal, usually have lower blood pressure level, in that way decreasing the risk of cardiovascular disease. The main source of salt in the diet is ready-made food, and only about 11% of overall salt intake is the salt people add to their food themselves. A common EU framework for salt reduction has been developed, which describes a common vision for a general European approach towards salt reduction. Bread has been identified as an important contributor to the daily salt intake in many countries. On the other hand, salt has important technological functions in bakery products. It improves the qualities of dough, fermentation, and flavour of bread. The aim of this paper was to evaluate the amount of salt in Latvian bread and to assess the need for decreasing the amount of salt in bread. The majority of Latvian bread contains 1.1 to 1.2% salt in flour, but in some other kinds of bread it is even less.

scholarly journals Dietary patterns and cardiovascular disease

2013 ◽  
Vol 72 (4) ◽  
pp. 407-411 ◽  
Author(s):  
C. M. Williams ◽  
J. A. Lovegrove ◽  
B. A. Griffin
Keyword(s):  
Dietary Patterns ◽  
Positive Impact ◽  
Dietary Guidelines ◽  
Cvd Risk ◽  
Potential Benefits ◽  
Underlying Mechanisms ◽  
Intervention Trials ◽  
Risk Biomarkers ◽  
Randomised Controlled ◽  
The Relationship

Despite strong prospective epidemiology and mechanistic evidence for the benefits of certain micronutrients in preventing CVD, neutral and negative outcomes from secondary intervention trials have undermined the efficacy of supplemental nutrition in preventing CVD. In contrast, evidence for the positive impact of specific diets in CVD prevention, such as the Dietary Approaches to Stop Hypertension (DASH) diet, has focused attention on the potential benefits of whole diets and specific dietary patterns. These patterns have been scored on the basis of current guidelines for the prevention of CVD, to provide a quantitative evaluation of the relationship between diet and disease. Using this approach, large prospective studies have reported reductions in CVD risk ranging from 10 to 60% in groups whose diets can be variously classified as ‘Healthy’, ‘Prudent’, Mediterranean’ or ‘DASH compliant’. Evaluation of the relationship between dietary score and risk biomarkers has also been informative with respect to underlying mechanisms. However, although this analysis may appear to validate whole-diet approaches to disease prevention, it must be remembered that the classification of dietary scores is based on current understanding of diet–disease relationships, which may be incomplete or erroneous. Of particular concern is the limited number of high-quality intervention studies of whole diets, which include disease endpoints as the primary outcome. The aims of this review are to highlight the limitations of dietary guidelines based on nutrient-specific data, and the persuasive evidence for the benefits of whole dietary patterns on CVD risk. It also makes a plea for more randomised controlled trials, which are designed to support food and whole dietary-based approaches for preventing CVD.

scholarly journals Vascular age concept: role in assessing risk and choosing therapy

2020 ◽  
pp. 51-57
Author(s):  
S. R. Gilyarevsky ◽  
M. V. Golshmid ◽  
N. G. Bendeliani ◽  
I. M. Kuzmina ◽  
G. Y. Zaharova ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Arterial Stiffness ◽  
Lower Blood Pressure ◽  
Lower Blood ◽  
Combination Drugs ◽  
Vascular Age ◽  
The Relationship

The article discusses the vascular age concept and modern approaches to assessing vascular age. It describes modern methods for measuring arterial stiffness (applanation tonometry or ultrasonic Doppler examination) as the most frequently used index of vascular age. The authors discuss the role of antihypertensive therapy and statins in preventing early vascular aging, and the relationship between the role of achieving lower blood pressure levels and the choice of certain antihypertensive agents to reduce arterial stiffness and ensure optimal vascular age. Increased arterial stiffness has been reported to be a marker of risk for developing severe complications of cardiovascular diseases, in particular, a meta-analysis showed that after taking into account the known risk factors for developing cardiovascular complications, higher carotid stiffness was associated with an increased risk of stroke. It is stated that in addition to biological age, vascular age may increase due to the cumulative effect of such risk factors as high blood pressure, impaired glucose homeostasis, obesity and hypercholesterolemia. Modern approaches to the preservation and maintenance of vascular age are discussed. The key role of achieving lower blood pressure levels is considered. It is emphasized that the role of combination drugs in preventing complications of cardiovascular diseases is strengthened, and approaches to choosing the optimal components of such combination drugs are also considered. The relationship between increased arterial stiffness and the development of cognitive disorders is discussed. The article describes the role of statins and effectiveness of the concomitant use of statins and combination antihypertensive therapy in reducing the pulse wave velocity.

scholarly journals Symptomatic hypotensive episodes in patients with hypertension. Relationship with blood pressure self-monitoring parameters

2021 ◽  
Vol 26 (2S) ◽  
pp. 4440
Author(s):  
S. A. Ermasova ◽  
I. M. Sokolov ◽  
Yu. G. Shvarts
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Cardiovascular Events ◽  
Antihypertensive Drugs ◽  
Blood Pressure Level ◽  
Self Monitoring ◽  
Prior Myocardial Infarction ◽  
Opposite Trend ◽  
Lower Blood ◽  
The Relationship

Aim. To study the relationship between symptomatic hypotensive episodes (SHEs) and parameters of self-monitoring of blood pressure (SMPB) in patients with hypertension (HTN).Material and methods. A total of 77 patients from 40 to 76 years old with HTN were examined. To identify SHEs, an original questionnaire was used. Patients underwent SMBP in the morning and evening, as well as recorded SHE in the diary. The self-monitoring period lasted 4 weeks. Patients without prior myocardial infarction and/or stroke are conventionally called “uncomplicated” HTN, while with cardiovascular events in history — “complicated” HTN.Results. According to the questionnaire, 48 (62,3%) patients noted SHEs. Uncomplicated HTN was recorded in 19 (51,4%) participants, while complicated one — in 29 (72,5%) (p=0,05). Blood pressure during SHEs was on average higher in patients with complicated HTN than in uncomplicated HTN (103/60 vs 95/60 mm Hg (p=0,05)). With a combination of uncomplicated HTN and SEG, mean systolic blood pressure (SBP) (125,9±10,5 vs 137,9±8,2 mm Hg), evening SBP (125,3±8,1vs 133,3±10,4 mm Hg), maximum SBP (149,8±11,8 vs 161,7±12,1 mm Hg) in the morning, as well as minimum SBP in the evening (101,8±10,8 vs 113,7±9,7 mm Hg) were lower than in patients without SHEs (p<0,05).In complicated HTN, an opposite relationship was observed: patients with SHEs had higher mean SBP (133,49±12,4 vs 118,93±15,3 mm Hg), maximum SBP (162,8±11,6 vs 141,7±12,0 mm Hg), and diastolic blood pressure (DBP) (91,5±5,6 vs 83,5±8,8 mm Hg) in the morning (p<0,05), as well as higher variability of morning (11,8±2,1 vs 8,2±2,7 mm Hg) and evening SBP (11,9±4,2 vs 8,6±3,2 mm Hg) compared with patients without SHEs (p<0,05). There were no significant differences in antihypertensive therapy.Conclusion. More than half of patients with hypertension report SHEs. SHEs in patients without prior myocardial infarction and/or stroke were characterized by lower blood pressure level than in subjects with prior cardiovascular events. Among patients with SHEs without cardiovascular events, the values of morning, evening, and maximum SBP in the morning are lower than in patients without SHEs. In patients with complicated HTN and SHEs, the opposite trend was observed: higher SBP and DBP in the morning, as well as greater variability of morning and evening SBP, in comparison with those without SHEs. These patterns cannot be explained by the antihypertensive drugs taken.

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