Abstract P486: Effects of Isometric Leg Training on Ambulatory Blood Pressure and Morning Blood Pressure Surge in Young Normotensive Men and Women

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Anthony W Baross ◽  
Kevin J Milne ◽  
Cheri L McGowan ◽  
Ian L Swaine
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Repeated Measures ◽  
Stroke Risk ◽  
Heart Association ◽  
Cvd Risk ◽  
Night Time ◽  
Men And Women ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure

Introduction: Cardiovascular disease (CVD) is a major cause of death globally with hypertension reported to be a leading modifiable risk factor. Ambulatory blood pressure (BP), in particular diurnal BP variability, is considered to be associated with CVD risk. In addition, the morning BP surge (MBPS) is thought to be associated with increased stroke risk and to be a destabilizing factor for atherosclerotic plaque. Isometric resistance training (IRT) is an effective method of lowering BP and has been recommended by the American Heart Association as an alternative treatment for reducing BP. To date, few studies have investigated the effects of IRT on ambulatory BP and particularly the morning surge in BP. Therefore, the purpose of this study was to determine whether (i) IRT causes reductions in ambulatory BP and the MBPS, in young normotensives and (ii) there are any sex differences in these changes. Methods: Ambulatory BP was measured prior to, and after, 10 weeks of bilateral leg IRT using an isokinetic dynamometer (4 x 2 minute contractions at 20% MVC, with 2 minute rest periods on 3 days per week). Twenty normotensive individuals (10 men, age=21 ± 4 years; 10 women, age=23 ± 5 years) were recruited. A two-way repeated measures ANOVA was used to assess the within and between groups ambulatory (mean 24-h, daytime, night time and diurnal variation) BP and MBPS. MBPS was calculated as: mean systolic BP 2 hours after waking minus the lowest sleeping 1 hour mean systolic BP. Results: There were significant reductions in 24-h ambulatory (4 ± 2 mmHg, p=0.0001; 4 ± 2 mmHg, p=0.0001) systolic BP in both men and women following IRT. This comprised significant reductions in day time (5 ± 5 mmHg, p=0.019; 5 ± 4 mmHg, p=0.002) but not night time (1 ± 5 mmHg, p=0.75; 1 ± 3 mmHg, p=0.3) systolic BP. Additionally, there were significant reductions in the MBPS (6 ± 8 mmHg, p=0.044; 6 ± 7 mmHg, p=0.019). There were no significant differences between men and women in these changes (p>0.05). Conclusion: These results support previous research showing that IRT is effective in lowering ambulatory BP. Furthermore, the significant reductions in the MBPS offer the potential for clinically meaningful CVD and stroke risk reduction, provided these effects can be demonstrated in those who are at risk.

scholarly journals Effects of isometric leg training on ambulatory blood pressure and morning blood pressure surge in young normotensive men and women

2022 ◽  
Vol 12 (1) ◽  
Author(s):  
Anthony W. Baross ◽  
Robert D. Brook ◽  
Anthony D. Kay ◽  
Reuben Howden ◽  
Ebony C. Gaillard ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Maximum Voluntary Contraction ◽  
Voluntary Contraction ◽  
Men And Women ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
Pressure Surge

AbstractDespite the reported association between diurnal variations in ambulatory blood pressure (BP) and elevated cardiovascular disease risk, little is known regarding the effects of isometric resistance training (IRT), a practical BP-lowering intervention, on ambulatory BP and morning BP surge (MBPS). Thus, we investigated whether (i) IRT causes reductions in ambulatory BP and MBPS, in young normotensives, and (ii) if there are any sex differences in these changes. Twenty normotensive individuals (mean 24-h SBP = 121 ± 7, DBP = 67 ± 6 mmHg) undertook 10-weeks of bilateral-leg IRT (4 × 2-min/2-min rest, at 20% maximum voluntary contraction (MVC) 3 days/week). Ambulatory BP and MBPS (mean systolic BP (SBP) 2 h after waking minus the lowest sleeping 1 h mean SBP) was measures pre- and post-training. There were significant reductions in 24-h ambulatory SBP in men (− 4 ± 2 mmHg, P = 0.0001) and women (− 4 ± 2 mmHg, P = 0.0001) following IRT. Significant reductions were also observed in MBPS (− 6 ± 8 mmHg, p = 0.044; − 6 ± 7 mmHg, P = 0.019), yet there were no significant differences between men and women in these changes, and 24-h ambulatory diastolic BP remained unchanged. Furthermore, a significant correlation was identified between the magnitude of the change in MBPS and the magnitude of changes in the mean 2-h SBP after waking for both men and women (men, r = 0.89, P = 0.001; women, r = 0.74, P = 0.014). These findings add further support to the idea that IRT, as practical lifestyle intervention, is effective in significantly lowering ambulatory SBP and MBPS and might reduce the incidence of adverse cardiovascular events that often occur in the morning.

scholarly journals A Novel Measure of the Power of the Morning Blood Pressure Surge From Ambulatory Blood Pressure Recordings

2010 ◽  
Vol 23 (10) ◽  
pp. 1074-1081 ◽  
Author(s):  
G. A. Head ◽  
K. Chatzivlastou ◽  
E. V. Lukoshkova ◽  
G. L. Jennings ◽  
C. M. Reid
Keyword(s):  
Blood Pressure ◽  
Ambulatory Blood Pressure ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
Pressure Surge

scholarly journals Additional impact of morning haemostatic risk factors and morning blood pressure surge on stroke risk in older Japanese hypertensive patients

2010 ◽  
Vol 32 (5) ◽  
pp. 574-580 ◽  
Author(s):  
Kazuomi Kario ◽  
Yuichirou Yano ◽  
Takefumi Matsuo ◽  
Satoshi Hoshide ◽  
Kazuo Eguchi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Stroke Risk ◽  
Hypertensive Patients ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
Pressure Surge

scholarly journals Chronotherapy for morning blood pressure surge in hypertensive patients: a systematic review and meta-analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ziyan Xie ◽  
Jiahao Zhang ◽  
Chenyu Wang ◽  
Xiaowei Yan
Keyword(s):  
Blood Pressure ◽  
Controlled Trials ◽  
Blood Pressure Lowering ◽  
Night Time ◽  
Hypertensive Patients ◽  
Pressure Lowering ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
Pressure Surge ◽  
Morning Dosage

Abstract Background The morning blood pressure surge (MBPS) is related to an exaggerated risk of cardiovascular diseases and mortality. With increasing attention on circadian change in blood pressure and extensive use of ambulatory blood pressure monitoring (ABPM), chronotherapy that administration of medication according to biological rhythm, is reported to improve cardiovascular outcomes. The aim of this study is to evaluate the influence of chronotherapy of antihypertensive drugs upon MBPS in hypertensive patients. Methods A search strategy was applied in Ovid MEDLINE, EMBASE, Cochrane (Wiley) CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and the Chinese Biomedical literature database. No language and date restrictions. Randomized controlled trials (RCT) assessing the efficacy of evening and morning administration of the same medications in adult patients with primary hypertension were included. Results A total of ten trials, comprising 1724 participants with a mean age of 61 and 51% female, were included in this study. Combined analysis observed significant reduction of MBPS (− 5.30 mmHg, 95% CI − 8.80 to − 1.80), night-time SBP (− 2.29 mmHg, 95% CI − 4.43 to − 0.15), night-time DBP (− 1.63 mmHg, 95 %CI − 3.23 to − 0.04) and increase in night blood pressure dipping (3.23%, 95% CI 5.37 to 1.10) in evening dosage compared with traditional morning dosage of blood pressure-lowering drugs. No significant difference was found in the incidence of overall adverse effects (RR 0.65, 95% CI 0.30 to 1.41) and withdrawal due to adverse effects (RR 0.95, 95% CI 0.53 to 1.71). Conclusions Our study suggested that evening administration of antihypertensive medications exerted better blood pressure-lowering effect on MBPS compared with conventional morning dosage. Safety assessment also indicated that the evening regimen did not increase the risk of adverse events. However, endpoint studies need to be carried out to confirm the significance and feasibility of this treatment regimen in clinical practice.

scholarly journals Morning Blood Pressure Surge and Cardiovascular Disease Events and All-Cause Mortality in Blacks

Hypertension ◽  
2020 ◽  
Vol 75 (3) ◽  
pp. 835-843 ◽  
Author(s):  
John N. Booth ◽  
Byron C. Jaeger ◽  
Lei Huang ◽  
Marwah Abdalla ◽  
Mario Sims ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cvd Risk ◽  
Black Adults ◽  
Morning Blood Pressure Surge ◽  
Morning Blood Pressure ◽  
The Individual ◽  
Multivariable Adjustment

The cardiovascular disease (CVD) and mortality risk associated with morning blood pressure (BP) surge and its components among black adults, a population with high BP during the asleep period, is unknown. We studied Jackson Heart Study participants who completed 24-hour ambulatory BP monitoring at the baseline exam in 2000 to 2004 (n=761). The sleep-trough morning surge was calculated as the mean 2-hour postawakening systolic BP (SBP) minus the lowest nighttime SBP, preawakening morning surge as mean 2-hour postawakening SBP minus mean 2-hour preawakening SBP, and rising morning surge as the first postawakening SBP minus the last preawakening SBP. The primary outcome was the occurrence of CVD events including the composite of coronary heart disease or stroke. Over a median follow-up of 14.0 years, there were 74 CVD (coronary heart disease or stroke) events and 144 deaths. Higher tertiles of sleep-trough, preawakening, and rising SBP surge were not associated with CVD risk after multivariable adjustment. In contrast, the highest tertile of the individual components of morning surge, including postawakening SBP (tertiles 2 and 3 versus 1: hazard ratio [95% CI]: 1.58 [0.71–3.53] and 4.04 [1.91–8.52], respectively), lowest nighttime SBP (1.29 [0.59–2.84] and 2.87 [1.41–5.83]), preawakening SBP (1.26 [0.57–2.80] and 2.79 [1.32–5.93]), first postawakening SBP (1.60 [0.73–3.51] and 2.93 [1.40–6.16]), and last preawakening SBP (1.23 [0.57–2.68] and 2.99 [1.46–6.12]), was associated with increased CVD risk after multivariable adjustment. Among black adults, the components of morning SBP surge, but not morning SBP surge itself, were associated with increased CVD risk.

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