Effects of forest bathing on pre-hypertensive and hypertensive adults: a review of the literature.

The aim in this literature review was (1) to explore the physiologically and psychologically therapeutic benefits of forest bathing on adults suffering from pre-hypertension or hypertension, and (2) to identify the type, duration, and frequency of an effective forest bathing intervention in the management of pre-hypertension and hypertension, so as to provide directions for future interventions or research. The electronic databases PubMed, Cochrane Library, CINAHL, PsyINFO, and the China Academic Journals (CAJ) offered through the Full-text Database (CNKI) were searched for relevant studies published from the inception of the databases to April 2019. Of the 364 articles that were identified, 14 met the criteria for inclusion in this review. The synthesis of the findings in the included studies revealed that forest bathing interventions were effective at reducing blood pressure, lowering pulse rate, increasing the power of heart rate variability (HRV), improving cardiac-pulmonary parameters, and metabolic function, inducing a positive mood, reducing anxiety levels, and improving the quality of life of pre-hypertensive or hypertensive participants. Forest walking and forest therapy programs were the two most effective forest bathing interventions. Studies reported that practicing a single forest walking or forest therapy program can produce short-term physiological and psychological benefits. It is concluded that forest bathing, particularly forest walking and therapy, has physiologically and psychologically relaxing effects on middle-aged and elderly people with pre-hypertension and hypertension.

Raw garlic consumption is inversely associated with prehypertension in a large-scale adult population.

Previous studies have shown that allicin can lower blood pressure (BP) by reducing oxidative stress and inflammation. However, the association between habitual raw garlic intake (as allicin source) and prehypertension are unclear. The aim of this study was to investigate how raw garlic consumption is associated with prehypertension in an adult population. A cross-sectional study was conducted with 22,812 adults (mean [standard deviation] age: 39.4 [10.7] years; males, 47.7%) in Tianjin, China. Raw garlic consumption was assessed using a validated food frequency questionnaire. BP was measured at least twice by trained nurses using an automatic device. Prehypertension was defined as systolic BP of 120-139 mmHg and/or diastolic BP of 80-89 mmHg without taking antihypertensive medication. Multiple logistic regression models were used to assess the association between raw garlic consumption and prehypertension. The prevalence of prehypertension was 49.9%. After fully adjusting for potential confounders, the ORs (95% confidence intervals) of having prehypertension by increasing frequency of raw garlic consumption were 1.00 (reference) for ≤3 times/week, 0.96 (0.87, 1.06) for 4 times/week to 1 time/day, and 0.69 (0.52, 0.90) for ≥2 times/day (p for trend = 0.06). In contrast, no associations were observed between other kinds of allium vegetables consumption and prehypertension. In conclusion, our results suggested that a more frequent consumption of raw garlic was inversely associated with prehypertension. This is the first large-scale study on the association between raw garlic consumption and prehypertension in the general population.

Dietary proteins improve endothelial function under fasting conditions but not in the postprandial state, with no effects on markers of low-grade inflammation.

Endothelial dysfunction (ED) and low-grade inflammation (LGI) have a role in the development of CVD. The two studies reported here explored the effects of dietary proteins and carbohydrates on markers of ED and LGI in overweight/obese individuals with untreated elevated blood pressure. In the first study, fifty-two participants consumed a protein mix or maltodextrin (3×20 g/d) for 4 weeks. Fasting levels and 12 h postprandial responses of markers of ED (soluble intercellular adhesion molecule 1 (sICAM), soluble vascular cell adhesion molecule 1 (sVCAM), soluble endothelial selectin and von Willebrand factor) and markers of LGI (serum amyloid A, C-reactive protein and sICAM) were evaluated before and after intervention. Biomarkers were also combined into mean Z-scores of ED and LGI. The second study compared 4 h postprandial responses of ED and LGI markers in forty-eight participants after ingestion of 0·6 g/kg pea protein, milk protein and egg-white protein. In addition, postprandial responses after maltodextrin intake were compared with a protein mix and sucrose. The first study showed significantly lower fasting ED Z-scores and sICAM after 4 weeks on the high-protein diet (P≤0·02). The postprandial studies found no clear differences of ED and LGI between test meals. However, postprandial sVCAM decreased more after the protein mix compared with maltodextrin in both studies (P≤0·04). In conclusion, dietary protein is beneficial for fasting ED, but not for fasting LGI, after 4 weeks of supplementation. On the basis of Z-scores, postprandial ED and LGI were not differentially affected by protein sources or carbohydrates.

Higher Maternal Plasma n-3 PUFA and Lower n-6 PUFA Concentrations in Pregnancy Are Associated with Lower Childhood Systolic Blood Pressure.

BACKGROUND: Suboptimal maternal diet during pregnancy might lead to fetal cardiovascular adaptations with persistent consequences in the offspring. OBJECTIVE: We assessed the associations of maternal polyunsaturated fatty acid (PUFA) concentrations during pregnancy with childhood blood pressure. METHODS: In a population-based prospective cohort study among 4455 mothers and their children, we measured maternal second-trimester n-3 (ω-3) and n-6 (ω-6) PUFA concentrations in plasma glycerophospholipids and expressed n-3 and n-6 PUFAs as proportions of total PUFAs (wt%). Childhood blood pressure was measured at the median age of 6.0 y (95% range: 5.7-7.9 y). We used linear regression models to assess the associations of maternal PUFA wt% with childhood blood pressure at 6 y. RESULTS: Higher total maternal n-3 PUFA wt% and, specifically, docosahexaenoic acid (DHA; 22:6n-3) wt% were associated with lower childhood systolic blood pressure [differences: -0.28 (95% CI: -0.54, -0.03) and -0.29 mm Hg (95% CI: -0.54, -0.03) per SD increase of total n-3 PUFAs and DHA wt%, respectively], but not with childhood diastolic blood pressure. Total maternal n-6 PUFA wt% was positively associated with childhood systolic blood pressure [differences: 0.36 mm Hg (95% CI: 0.09, 0.62) per SD increase of total n-6 PUFA wt%], but not with childhood diastolic blood pressure. A higher n-6:n-3 PUFA ratio was associated with higher childhood systolic blood pressure (P < 0.05). Pregnancy and childhood characteristics only partly explained the observed associations. CONCLUSIONS: Higher maternal plasma n-3 PUFA and lower n-6 PUFA concentrations during pregnancy are associated with a lower systolic blood pressure in childhood. Further studies are needed to replicate these findings, explore the underlying mechanisms, and examine the long-term cardiovascular consequences.

[Study on pathogenesis and treatment of pre-hypertension in traditional Chinese medicine].

The forward-shift prevention and treatment strategy is the current trend of the development of clinical medicine. As hypertension is an important risk factor for cardiovascular diseases, it is curtail to pay attention to the prevention and treatment of prehypertension. Pre-hypertension refers to the blood pressure value between the normal blood pressure and high blood pressure, which easily develops into hypertension with complications. In recent years, pre-hypertension has attracted attentions both at home and abroad. The traditional Chinese medicinal theory of "preventive treatment of disease" shows its unique advantages in preventing and treating pre-hypertension and high blood pressure. With the socio-economic development and the changes in lifestyle, traditional pathogenetic theories have no longer kept pace with the occurrence regularity of modern high blood pressure and pre-hypertension. Therefore, the in-depth study on the pathogenesis of pre-hypertension is of great significance in the guidance of clinical prevention and treatment. It is believed that the etiologies of pre-hypertension are related to improper diet, sedentariness and emotional instability. In other words, stasis in six forms such as qi stagnation, dyspepsia, damp obstruction, phlegm stasis, blood stasis and fire stagnation is an crucial pathogenesis of pre-hypertension. Consequently, on the basis of the traditional Chinese medicinal theory of "preventive treatment of disease", the combination of the treatment based on syndrome differentiation and the correspondence of prescriptions and the syndromes in treating pre-hypertension is worth clinically promoting and applying.

Randomized controlled trial of mindfulness-based stress reduction for prehypertension.

OBJECTIVE: Mindfulness-based stress reduction (MBSR) is an increasingly popular practice demonstrated to alleviate stress and treat certain health conditions. MBSR may reduce elevated blood pressure (BP). Treatment guidelines recommend life-style modifications for BP in the prehypertensive range (systolic BP [SBP] 120-139 mm Hg or diastolic BP [DBP] 80-89 mm Hg), followed by antihypertensives if BP reaches hypertensive levels. MBSR has not been thoroughly evaluated as a treatment of prehypertension. A randomized clinical trial of MBSR for high BP was conducted to determine whether BP reductions associated with MBSR exceed those observed for an active control condition consisting of progressive muscle relaxation (PMR) training. METHODS: Fifty-six men (43%) and women (57%) averaging (standard deviation) 50.3 (6.5) years of age (91% white) with unmedicated BP in the prehypertensive range were randomized to 8 weeks of MBSR or PMR delivered in a group format. Treatment sessions were administered by one treatment provider and lasted approximately 2.5 hours each week. Clinic BP was the primary outcome measure. Ambulatory BP was a secondary outcome measure. RESULTS: Analyses were based on intent to treat. Patients randomized to MBSR exhibited a 4.8-mm Hg reduction in clinic SBP, which was larger than the 0.7-mm Hg reduction observed for PMR (p = .016). Those randomized to MBSR exhibited a 1.9-mm Hg reduction in DBP compared with a 1.2-mm Hg increase for PMR (p = .008). MBSR did not result in larger decreases in ambulatory BP than in PMR. CONCLUSIONS: MBSR resulted in a reduction in clinic SBP and DBP compared with PMR. Trial Registration ClinicalTrials.gov identifier: NCT00440596.

Blood pressure-lowering effects of beetroot juice and novel beetroot-enriched bread products in normotensive male subjects.

A number of vegetables have a high nitrate content which after ingestion can be reduced to nitrite by oral bacteria, and further to vasoprotective NO endogenously. In the present study, two separate randomly controlled, single-blind, cross-over, postprandial studies were performed in normotensive volunteers. Ambulatory blood pressure (BP) was measured over a 24 h period following consumption of either four doses of beetroot juice (BJ), 0, 100, 250 and 500 g (n 18), or three bread products, control bread (0 g beetroot), red beetroot- and white beetroot-enriched breads (n 14). Total urinary nitrate/nitrite (NO(x)) was measured at baseline, and at 2, 4 and 24 h post-ingestion. BJ consumption significantly, and in a near dose-dependent manner, lowered systolic BP (SBP, P < 0·01) and diastolic BP (DBP, P < 0·001) over a period of 24 h, compared with water control. Furthermore, bread products enriched with 100 g red or white beetroot lowered SBP and DBP over a period of 24 h (red beetroot-enriched bread, P <0·05), with no statistical differences between the varieties. Total urinary NO(x) significantly increased following the consumption of 100 g (P < 0·01), 250 g (P <0·001) and 500 g BJ (P <0·001) and after red beetroot-enriched bread ingestion (P <0·05), but did not reach significance for white beetroot-enriched bread compared with the no-beetroot condition. These studies demonstrated significant hypotensive effects of a low dose (100 g) of beetroot which was unaffected by processing or the presence of betacyanins. These data strengthen the evidence for cardioprotective BP-lowering effects of dietary nitrate-rich vegetables.