Dose-Response Relationship for Resting Blood Pressure Change to Controlled Aerobic Training in Older Adults

Background: Hypertension or elevated blood pressure (BP) is an important risk factor for aortic dissection (AD); however, few prospective studies concerning this topic have been published. We investigated the association between hypertension/elevated BP and AD in two cohorts and conducted a meta-analysis of published prospective studies, including these two studies. Methods: We analyzed data from the Japan Specific Health Checkups (J-SHC) Study and UK Biobank, which prospectively followed 534,378 and 502,424 participants, respectively. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (95% CIs) for the association of hypertension/elevated BP with AD incidence in the UK Biobank and AD mortality in the J-SHC Study. In the meta-analysis, summary relative risks (RRs) were calculated using random effects models. A potential nonlinear dose-response relationship between BP and AD was tested using fractional polynomial models, and the best-fitting second-order fractional polynomial regression model was determined. Results: In the J-SHC Study and UK Biobank, there were 84 and 182 ADs during 4- and 9-year follow-up, and the adjusted HRs of AD were 3.57 (95% CI, 2.17-6.11) and 2.68 (95% CI: 1.78-4.04) in hypertensive individuals, 1.33 (95% CI: 1.05-1.68) and 1.27 (95% CI: 1.11-1.48) per 20-mmHg increase in systolic BP (SBP), and 1.67 (95% CI: 1.40-2.00) and 1.66 (95% CI: 1.46-1.89) per 10-mmHg increase in diastolic BP (DBP), respectively. In the meta-analysis, the summary RRs were 3.07 (95% CI 2.15-4.38, I2=76.7%, n=7 studies, 2,818 ADs, 4,563,501 participants) for hypertension and 1.39 (95% CI: 1.16-1.66, I2=47.7%, n=3) and 1.79 (95% CI: 1.51-2.12, I2=57.0%, n=3) per 20-mmHg increase in SBP and per 10-mmHg in DBP, respectively. The AD risk showed a strong, positive dose-response relationship with SBP and even more so with DBP. The risk of AD in the nonlinear dose-response analysis was significant at SBP >132 mmHg and DBP >75 mmHg. Conclusions: Hypertension and elevated SBP and DBP are associated with a high risk of AD. The risk of AD was positively dose-dependent, even within the normal BP range. These findings provide further evidence for the optimization of BP to prevent AD.

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Significant Dose-Response Relationship Between Exercise Adherence and Hemoglobin A1C Change for Aerobic Training but Not Resistance or Combined Training

Canadian Journal of Diabetes ◽

10.1016/j.jcjd.2018.08.031 ◽

2018 ◽

Vol 42 (5) ◽

pp. S10

Author(s):

Jamie L. Benham ◽

Jane Booth ◽

Mary J. Dunbar ◽

Steve Doucette ◽

Normand G. Boulé ◽

...

Keyword(s):

Dose Response ◽

Hemoglobin A1c ◽

Aerobic Training ◽

Exercise Adherence ◽

Response Relationship ◽

Dose Response Relationship ◽

Combined Training

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Dose-Response Relationship Between Long-Term Blood Pressure Variability and Cognitive Decline

Stroke ◽

10.1161/strokeaha.120.033697 ◽

2021 ◽

Author(s):

Chenglong Li ◽

Yanjun Ma ◽

Rong Hua ◽

Zhenchun Yang ◽

Baoliang Zhong ◽

...

Keyword(s):

Blood Pressure ◽

Cognitive Decline ◽

Dose Response ◽

Coefficient Of Variation ◽

Blood Pressure Variability ◽

Turning Point ◽

Linear Mixed Model ◽

Response Relationship ◽

Dose Response Relationship

Background and Purpose: We aimed to test whether higher long-term blood pressure variability was associated with accelerated rate of cognitive decline and evaluate potential dose-response relationship. Methods: Original survey data from the Health and Retirement Study and the English Longitudinal Study of Ageing were used. Standardized Z score of cognitive function was the main outcome measure. Visit-to-visit blood pressure SD, coefficient of variation, and variation independent of mean were used. Linear mixed model and restricted spline were applied to assess association and explore dose-response pattern. Segmented regression was used to analyze dose-response relationship and estimate turning point. Meta-analysis using random-effects model was conducted to pool results, with I 2 used to test heterogeneity. Results: A total of 12 298 dementia-free participants were included (mean age: 64.6±8.6 years). Significant association was observed between blood pressure variability and cognitive decline. Each 10% increment in coefficient of variation of systolic and diastolic blood pressure was associated with accelerated global cognitive decline of 0.026 SD/y (95% CI, 0.016–0.036, P< 0.001) and 0.022 SD/y (95% CI, 0.017–0.027, P< 0.001), respectively. Nonlinear dose-response relationship was found ( P< 0.001 for nonlinearity), with clear turning point observed ( P< 0.001 for change in slopes). Conclusions: Higher long-term blood pressure variability was associated with accelerated cognitive decline among general adults aged ≥50 years, with nonlinear dose-response relationship. Further randomized controlled trials are warranted to evaluate potential benefits of blood pressure variability-lowering strategies from a cognitive health perspective.

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