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 ◽  
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.

scholarly journals Characteristics of US adults who would be recommended for lifestyle modification without antihypertensive medication to manage blood pressure

2020 ◽  
Author(s):  
Sandra L Jackson ◽  
Soyoun Park ◽  
Fleetwood Loustalot ◽  
Angela M Thompson-Paul ◽  
Yuling Hong ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Lifestyle Modification ◽  
Sodium Intake ◽  
Heart Association ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Stage 1

Abstract Background The 2017 American College of Cardiology / American Heart Association Guideline for blood pressure (BP) management newly classifies millions of Americans with elevated blood pressure or stage 1 hypertension for recommended lifestyle modification alone (without pharmacotherapy). This study characterized these adults, including their CVD risk factors, barriers to lifestyle modification, and healthcare access. Methods This cross-sectional study examined nationally representative National Health and Nutrition Examination Survey data, 2013-2016, on 10,205 US adults aged ≥18, among whom 2,081 had elevated blood pressure or stage 1 hypertension and met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone. Results An estimated 22% of US adults (52 million) would be recommended for lifestyle modification alone. Among these, 58% were men, 43% had obesity, 52% had low quality diet, 95% consumed excess sodium, 43% were physically inactive, and 8% consumed excess alcohol. Many reported attempting lifestyle changes (range: 39%-60%). Those who reported receiving health professional advice to lose weight (adjusted prevalence ratio 1.21, 95% confidence interval 1.06-1.38), reduce sodium intake (2.33, 2.00-2.72), or exercise more (1.60, 1.32-1.95) were significantly more likely to report attempting changes. However, potential barriers to lifestyle modification included 28% of adults reporting disability, asthma, or arthritis. Additionally, 20% had no health insurance and 22% had no healthcare visits in the last year. Conclusions One fifth of US adults met 2017 ACC/AHA BP Guideline criteria for lifestyle modification alone, and many reported attempting behavior change. However, barriers exist such as insurance gaps, limited access to care, and physical impairment.

scholarly journals Thoracic Aortic Calcification and Pre-Clinical Hypertension by New 2017 ACC/AHA Hypertension Guidelines

Diagnostics ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 1027
Author(s):  
Ya-Ting Jan ◽  
Pei-Shan Tsai ◽  
Chris T. Longenecker ◽  
Dao-Chen Lin ◽  
Chun-Ho Yun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Surrogate Marker ◽  
Heart Association ◽  
Aortic Calcification ◽  
Elevated Blood Pressure ◽  
Elevated Blood ◽  
Contributing Factors ◽  
Hypertension Guidelines ◽  
Pressure Threshold ◽  
Thoracic Aortic Calcification

The recently revised 2017 American College of Cardiology/American Heart Association (ACC/AHA) hypertension (HTN) guidelines employ a lower blood pressure threshold to define HTN, aiming for earlier prevention of HTN-related cardiovascular diseases (CVD). Thoracic aortic calcification (TAC), a new surrogate marker of aging and aortic medial layer degeneration, and different stages of HTN, according to the 2017 ACC/AHA HTN guidelines, remain unknown. We classified 3022 consecutive asymptomatic individuals enrolled into four HTN categories using the revised 2017 ACC/AHA guidelines: normal blood pressure (NBP), elevated blood pressure (EBP), and stage 1 (S1) and stage 2 (S2) HTN. The coronary artery calcification score and TAC metrics (total Agaston TAC score, total plaque volume (mm3), and mean density (Hounsfield units, HU)) were measured using multi-detector computed tomography. Compared to NBP, a graded and significant increase in the TAC metrics was observed starting from EBP and S1 and S2 HTN, using the new 2017 ACC/AHA guidelines (NBP as reference; all trends: p < 0.001). These differences remained consistent after being fully adjusted. Older age (>50 years), S1 and S2 HTN, prevalent diabetes, and chronic kidney disease (<60 mL/min/1.73 m2) are all independently contributing factors to higher TAC risk using multivariate stepwise logistic regressions (all p ≤ 0.001). The optimal cutoff values of systolic blood pressure, diastolic blood pressure, and pulse pressure were 121, 74, and 45 mmHg, respectively, for the presence of TAC after excluding subjects with known CVD and ongoing HTN medication treatment. Our data showed that the presence of TAC starts at a stage of elevated blood pressure not categorized as HTN from the updated 2017 ACC/AHA hypertension guidelines.

Cross-talk between ANGPTL4 gene SNP rs1044250 and weight management is a risk factor of Mets

2020 ◽  
Author(s):  
Zhoujie Tong ◽  
Jie Peng ◽  
Hongtao Lan ◽  
Wenwen Sai ◽  
Yulin Li ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Risk Factor ◽  
Waist Circumference ◽  
Weight Management ◽  
Independent Risk Factor ◽  
Lifestyle Changes ◽  
Elevated Blood Pressure ◽  
Base Line ◽  
Elevated Blood

Abstract Background The prevalence of metabolic syndrome (Mets) is closely related to the increased incidence of cardiovascular events. Angiopoietin-like protein 4 (ANGPTL4) is contributory to the regulation of lipid metabolism, herein, may provide a target for gene-aimed therapy of Mets. This case-control study was designed to elucidate the relationship between Angiopoietin-like protein 4 (ANGPTL4) gene single nucleotide polymorphism (SNP) rs1044250 and the onset of Mets, and to explore the effect of interaction between SNP rs1044250 and weight management on Mets. Methods We have recruited 1018 Mets cases and 1029 controls in this study. The SNP rs1044250 was detected, base-line information and Mets-related indicators were collected. A 5-year follow-up survey was carried out to track the lifestyle changes, drug treatments and changes in Mets-related indicators. Results ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference (OR 1.618, 95% CI [1.119–2.340]; p = 0.011) and elevated blood pressure (OR 1.323, 95% CI [1.002–1.747]; p = 0.048), the prevalence of Mets (OR 1.875, 95% CI [1.363–2.580]; p < 0.001) is increased. The follow-up survey shows that rs1044250 CC genotype patients with weight gain have an increased number of Mets components (M [Q1, Q3]: CC 1 (0, 1), CT + TT 0 [-1, 1]; p = 0.021); The interaction between SNP rs1044250 and weight management is a risk factor for increased SBP (β = 0.075, p < 0.001) and increased DBP (β = 0.097, p < 0.001), the synergistic effect is negative (S < 1). Conclusion ANGPTL4 gene SNP rs1044250 is an independent risk factor for increased waist circumference and elevated blood pressure, therefore, for Mets. Weight management that interacts negatively with ANGPTL4 polymorphism is an essential lifestyle intervention approach for elevated blood pressure.

A5697 School-level inequality of physical activity is associated with prevalence of overweight/obese, elevated blood pressure and high stress in 13-year olds

2018 ◽  
Vol 36 ◽  
pp. e301
Author(s):  
Yun Chen ◽  
Katarina Laundy Frisenstam ◽  
Victoria Belin Benninge ◽  
Eva Gronowitz ◽  
Ann-Katrine Karlsson ◽  
...  
Keyword(s):  
Physical Activity ◽  
Blood Pressure ◽  
High Stress ◽  
School Level ◽  
Elevated Blood Pressure ◽  
Elevated Blood

scholarly journals Lactotripeptides and antihypertensive effects: a critical review

2008 ◽  
Vol 101 (6) ◽  
pp. 776-786 ◽  
Author(s):  
Esther Boelsma ◽  
Joris Kloek
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Blood Pressure Response ◽  
Lifestyle Changes ◽  
Healthy Diet ◽  
Elevated Blood Pressure ◽  
Current Evidence ◽  
Elevated Blood ◽  
Blood Pressure Lowering ◽  
Pressure Lowering

Hypertension or high blood pressure is a significant health problem worldwide. Typically, lifestyle changes, including adopting a healthy diet, are recommended for people with an elevated blood pressure. Lactotripeptides are bioactive milk peptides with potential antihypertensive properties in man. These peptides, as part of a food product or as nutraceutical, may contribute to the prevention and treatment of hypertension. This paper reviews the current evidence of the blood pressure control properties of lactotripeptides in man. Blood pressure-lowering effects of lactotripeptides are typically measured after 4–6 weeks of treatment. However, in some cases, a blood pressure response has been observed after 1–2 weeks. Maximum blood pressure reductions approximate 13 mmHg (systolic blood pressure) and 8 mmHg (diastolic blood pressure) after active treatment compared with placebo, and are likely reached after 8–12 weeks of treatment. Effective dosages of lactotripeptides range from 3·07 to 52·5 mg/d. Evidence indicates that lactotripeptides are only effective at elevated blood pressure; no further lowering of normal blood pressure has been observed. Concomitant intake of antihypertensive medication does not seem to influence the potency of lactotripeptides to lower blood pressure. Similarly, ethnicity has not been found to influence the extent of lactotripeptide-induced blood pressure lowering. Based on the currently available data, lactotripeptides appear to be safe and effective. Thus, they can be part of a healthy diet and lifestyle to prevent or reduce high blood pressure.

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

2013 ◽  
Vol 59 (8) ◽  
pp. 1218-1227 ◽  
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

scholarly journals Prevalence of Risk Factors of non-communicable Diseases in an Adult Population of Rural Bangladesh

2018 ◽  
Vol 10 (2) ◽  
pp. 126-134
Author(s):  
Palash Chandra Banik ◽  
M Mostafa Zaman ◽  
Jasimuddin Ahmed ◽  
Sohel Reza Choudhury ◽  
Mohammad Moniruzzaman
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Blood Pressure ◽  
Adult Population ◽  
Lifestyle Changes ◽  
Capillary Blood ◽  
Blood Cholesterol ◽  
Noncommunicable Diseases ◽  
Sample Treatment ◽  
Treatment Rate

Background:A community based survey was carried out to determine the distribution of major noncommunicable diseases risk factors as well as to explore the detection and treatment rate of diabetes mellitus and hypertension in rural adult population of Bangladesh.Methods: The survey was done in2006 among 545 individualsaged 25 to 64 years randomly drawn from a village (Ekhlaspur under Chandpur district) of Bangladesh. Information on diet, physical activity, alcohol and tobacco, and treatment history for hypertension and diabetes were collected. Height, weight, waist circumference, blood pressure, capillary blood glucose and total cholesterol were measured.Results: There were 269 men and 276 women with the mean age of 43.9 years (standard deviation, 11.6 years). Six in ten (62.4%) of them used tobacco in some form (smoking or smokeless), 93.7% did not consume adequate fruits and vegetables (five servings or more), and 7.4% of them had low physical activity. More than 6% were overweight or obese (BMI ≥25kg/m2) and 10% had hypertension (blood pressure ≥140/ 90 mmHg or medication). Capillary blood measurement and history of medication combined provided a prevalence of 3.1% for diabetes while prevalence of hypercholesterolemia (≥240 mg/dL) was 2.9% based on capillary blood cholesterol level alone. Less than half of hypertensive and less than one-tenth diabetes subjects were receiving treatmentfor their respective conditions.Conclusions: Prevalence of noncommunicable diseases risk factorsis fairly high even in thisruralBangladeshi sample. Treatment rate for hypertension and diabetes is quite low. Interventionsshould address lifestyle changes and treatment of diabetes and hypertension.Cardiovasc. j. 2018; 10(2): 126-134

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