RESUMEN
Understanding the recovery process of functional abilities post-COVID-19 in older inpatients with arterial hypertension and ischemic heart disease is important for optimising healthcare delivery and resources. Participants in this study were individuals undergoing hospital-based rehabilitation following COVID-19 (average age 66, n=183). They were categorised into groups with arterial hypertension (n=92), ischemic heart disease (n=18), both conditions (n=38), and a control group without these diseases (n=35). Functional abilities were assessed via the distance walked until signs of exhaustion (meters), handgrip strength (kilograms), and breath-holding time (seconds). Multiple regression analysis revealed that inpatients with arterial hypertension walked shorter distances (ß=-19,183; p=0,050) but showed higher handgrip strength (ß=3,735; p=0,025) compared to the control group. Post-rehabilitation, inpatients with hypertension demonstrated greater performance (ß=40,435, p=0,024) and better improvement rates (ß=47,337; p=0,016) in walked distance than those in the control group. Significant interaction effects between groups and pre-/post-rehabilitation changes were observed only for walking distance (ß=34,74; p=0,02), with no significant interactions found for other measures. The findings indicate that older inpatients with arterial hypertension may experience comparable or enhanced recovery of functional abilities post-COVID-19. The presence of ischemic heart disease, alone or combined with hypertension, does not significantly impair rehabilitation outcomes compared to those without such conditions.
Asunto(s)
COVID-19 , Fuerza de la Mano , Hipertensión , Isquemia Miocárdica , Recuperación de la Función , Humanos , COVID-19/fisiopatología , COVID-19/rehabilitación , COVID-19/complicaciones , COVID-19/epidemiología , Masculino , Femenino , Anciano , Isquemia Miocárdica/rehabilitación , Isquemia Miocárdica/fisiopatología , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Hipertensión/epidemiología , Hipertensión/diagnóstico , Recuperación de la Función/fisiología , Fuerza de la Mano/fisiología , SARS-CoV-2 , Persona de Mediana Edad , Pacientes Internos/estadística & datos numéricosRESUMEN
PURPOSE: Hypertension is a major risk factor for cardiovascular disease. Isometric exercise training (IET) reduces resting and ambulatory blood pressure; however, few studies have investigated the myocardial adaptations following IET. METHODS: We randomly assigned 24 unmedicated hypertensive patients in a cross-over study design to 4-weeks of IET and control period, separated by a 3-week washout period. Speckle tracking echocardiography was used to measure left ventricular (LV) mechanics, and global myocardial work indices were derived from non-invasive LV pressure-strain loops constructed from global longitudinal strain (GLS) indexed to brachial systolic blood pressure. RESULTS: IET significantly improved GLS (- 2.3 ± 2%, p < 0.001) and global work efficiency (2.8 ± 2%, p < 0.001), and significantly reduced global wasted work (- 42.5 ± 30 mmHg%, p < 0.001) with no significant change during the control period. CONCLUSIONS: This is the first evidence to demonstrate that IET significantly improved cardiac health in a relevant patient population. Our findings have important clinical implications for patients with high blood pressure and support the role of IET as a safe and viable therapeutic and preventative intervention in the treatment of hypertension.
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Adaptación Fisiológica , Ejercicio Físico/fisiología , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Función Ventricular Izquierda/fisiología , Adulto , Estudios Cruzados , Ecocardiografía , Femenino , Humanos , MasculinoRESUMEN
BACKGROUND: Concurrent training (CT) has been recommended to minimize the deleterious effects of aging. However, few studies have investigated whether this type of training reduces blood pressure in the elderly. Therefore, our objective was to evaluate the effects of CT on the hemodynamic, cardiorespiratory, and muscle strength responses in medicated hypertensive patients. METHODS: Twenty-three hypertensives (62.65 ± 6.4 years) of both sexes were allocated to the concurrent training group (CTG) or control group (CG). The CTG performed aerobic training (70-85% of reserve heart rate) combined with resistance training with elastic tubes (2sets × 15 repetitions) for 8 weeks. Resting blood pressure (BP), peak oxygen consumption (VO2peak), and right knee and elbow flexion strength were evaluated. RESULTS: A reduction of 6.37% was observed in BP and increases of 16.68% in VO2peak and 16% in muscle strength for right elbow flexion in the CTG compared to CG (p < .05). Intragroup comparisons showed reduction of 5% for BP, and increases of 6.79% for VO2peak, 24.79% for elbow flexion, and 16.47% for knee flexion in the CTG (p < .05), without significant improvement in the CG. CONCLUSION: CT promoted a reduction in BP, and increased cardiorespiratory fitness and muscular strength of the upper limbs in the hypertensive older adults.
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Envejecimiento/fisiología , Hipertensión/rehabilitación , Entrenamiento de Fuerza , Anciano , Articulación del Codo/fisiología , Femenino , Humanos , Hipertensión/fisiopatología , Articulación de la Rodilla/fisiología , Masculino , Persona de Mediana Edad , Fuerza Muscular , Músculo Esquelético/fisiologíaRESUMEN
The aquatic exercise is an effective non-pharmacological therapy for prevention and control of hypertension. The objective of the present study was to investigate the effect of aquatic exercise on mental health, functional autonomy, and oxidative dysfunction in hypertensive adults. Methodologically 29 adults (mean age 53 ± 7.5 years) were included in the study, and were randomly grouped as hypertensive (n = 16) and non-hypertensive (n = 13). Both groups underwent low-intensity aquatic exercise program for 12 weeks. Outcomes were evaluated at week 0 and 12. The values for the following parameters decreased in the hypertensive group post training: anxiety (-6.2 ± 2 score; 60%), Timed Up and Go test (-7.4 ± 0.3 sec; 30%), protein carbonylation (-0.15 ± 0.03 nmol/mg protein; 50%), nitric oxide (12.4 ± 6 nmol/mg protein; 62%), interleukin-6 (-27.6 ± 5.7 pg/mg protein; 46%), and tissue necrosis factor-alpha (-52.4 ± 3.8 pg/mg protein; 40%); however, the values of the following parameters increased before training: Berg score (56 ± 2; 7.8%), flexibility (27 ± 1 cm; 71%); glutathione (3.1 ± 1.3 nmol/mg protein; 138%), and superoxide dismutase (1.6 ± 0.4 nmol/mg; 166%). In conclusion, we suggest that low-intensity aquatic exercise program improved anxiety, functional autonomy, and oxidative dysfunction in hypertensive adults.
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Actividades Cotidianas , Ansiedad/psicología , Terapia por Ejercicio/métodos , Hipertensión/rehabilitación , Salud Mental , Adulto , Ejercicio Físico , Femenino , Glutatión/metabolismo , Humanos , Hipertensión/metabolismo , Hipertensión/fisiopatología , Hipertensión/psicología , Interleucina-6/metabolismo , Masculino , Persona de Mediana Edad , Óxido Nítrico/metabolismo , Estrés Oxidativo , Carbonilación Proteica , Rango del Movimiento Articular , Superóxido Dismutasa/metabolismo , Factor de Necrosis Tumoral alfa/metabolismoRESUMEN
OBJECTIVE: Introduction: Considering the great medical, social and economic significance of the problem of treatment of hypertension, cardiological rehabilitation is of great importance in restorative treatment of patients. The aim: To analyze the scientific literature on the necessity of different methods of cardiorehabilitation, which proved their effectiveness and shown for use in the complex regenerative treatment of patients with hypertonic disease. PATIENTS AND METHODS: Materials and methods: Analysis and generalization of scientific and methodical literature on modern directions and methods of cardiorehabilitation at hypertonic disease. CONCLUSION: Conclusions: The effectiveness of hypertonic disease treatment depends on the complex combination of a wide range of rehabilitation products, such as medical therapy, physical exercises, physiotherapy, ergotherapy, psychological correction; application of them depending on the current tasks of a certain restorative stage of treatment, which allows to achieve optimal physical rehabilitation.
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Hipertensión/rehabilitación , Terapia por Ejercicio , Humanos , Modalidades de FisioterapiaRESUMEN
Hypertension is a worldwide prevalent disease, mostly manifested as its primary ethiology, characterized by a chronic, multifactorial, asymptomatic, and usually incurable state. It is estimated that more than one billion of the world population is hypertensive. Also, hypertension is the main cause of the two most frequent causes of death worldwide: myocardial infarction and stroke. Due to the necessity of the cardiovascular system to manage chronically increased levels of blood pressure, hypertension causes severe alterations in multiple organs, as the heart, vessels, kidneys, eyes and brain, thus increasing the risk of health complications. The heart is the main target organ and suffers several adaptations to compensate the increased blood pressure levels; nevertheless, long-term adaptations without proper control are extremely harmful to cardiovascular health. On the other hand, hypertension is a modifiable risk factor and its adequate control is highly dependent on lifestyle. Pharmacological treatment is of great success when adherence is high. Several classes of antihypertensive drugs are prescribed and can effectively maintain blood pressure within acceptable levels. However, non-pharmacological methods, as diet and exercise training, can not only optimize the treatment but also prevent or postpone hypertension development as well as its complications, acting as important complements to the ideal control of elevated blood pressure, and bringing together benefits beyond blood pressure decrease, as a general health status improvement and increased quality of life. There is consistent evidence that regular exercise training promotes several benefits when properly prescribed and practised, acting as "medicine" for dozens of chronic diseases. The effects of exercise training in blood pressure levels and in its mechanisms of control are of clinical relevance and efficacy. This chapter will describe the classical and recent results on the beneficial effects of different modalities of exercise training in the cardiovascular system of human primary hypertension, focusing on the mechanisms influenced by exercise training which help to decrease blood pressure and improve the cardiovascular system.
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Terapia por Ejercicio/métodos , Ejercicio Físico/fisiología , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Sistema Cardiovascular/efectos de los fármacos , Sistema Cardiovascular/fisiopatología , Humanos , Hipertensión/tratamiento farmacológico , Calidad de VidaRESUMEN
Regular physical activity (PA) reduces the blood pressure (BP) of individuals with hypertension. The present review analysed the scientific evidence for the BP lowering effect of aerobic PA in 27 randomised controlled studies on individuals with hypertension, and shows that regular medium-to-high-intensity aerobic activity reduces the BP by a mean of 11/5â mmâ Hg (level of evidence, 3+). In addition, three randomised controlled trials (RCTs) on isometric (static) activity showed a BP reduction of similar magnitude in hypertensives; dynamic resistance training may show less effect, as shown in five available RCTs (level of evidence 2+). As both the prevalence of hypertension and physical inactivity are high and increasing in today's society, PA has a great role to play as a single (when indicated) or additive treatment for hypertension. Furthermore, as competitive athletes are getting older, it can be expected that more athletes at different competitive levels will have hypertension. Certain considerations must be applied regarding evaluation and treatment of hypertension in athletes. Eligibility for competitive sports may be affected if target organ damage (TOD) is present; however, an athlete with well-controlled BP, having no additional risk factors or TOD, is eligible for all sports.
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Presión Sanguínea , Ejercicio Físico , Hipertensión/rehabilitación , Atletas , Humanos , Hipertensión/fisiopatología , Ensayos Clínicos Controlados Aleatorios como Asunto , Entrenamiento de FuerzaRESUMEN
The authors demonstrate the importance of individual criteria for the choice of dosed physical load for the patients with cardiological problems during hospitalization. The analysis of the functional state and hemodynamic parameters included 68 patients with various cardiovascular diseases before and after performance of the special program of physical rehabilitation. The results suggest high efficiency of the proposed treatment and good prospects for further studies in this field.
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Enfermedad de la Arteria Coronaria , Terapia por Ejercicio/métodos , Hipertensión , Resistencia Física , Adulto , Enfermedad de la Arteria Coronaria/fisiopatología , Enfermedad de la Arteria Coronaria/rehabilitación , Femenino , Hemodinámica , Hospitalización , Humanos , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Masculino , Persona de Mediana Edad , Selección de Paciente , Resultado del TratamientoRESUMEN
AIM: The objective the present work was to study the changes of the types of adaptation in the patients presenting with arterial hypertension under the influence of the spa and health resort-based rehabilitative treatment. MATERIAL AND METHODS: The study included 50 patients with essential hypertension at the age from 54.0 to 62.0 (mean 58.0) years given a course of the spa and health resort-based rehabilitative treatment. All the patients underwent electrocardiographic and echocardiographic examination for the assessment of the systolic and diastolic left ventricular functions. Cardiointervalography with the use of the ORTO Expert diagnostic system was performed in the patients at rest and during the active orthostatic test (AOT); the types of the adaptation were evaluated. The patients were divided into 2 groups depending on the results of repeated AOT obtained after rehabilitation. Group 1 was comprised of the patients showing the improvement of adaptation (n=24), group 2 consisted of the patients in whom the level of adaptation remained unaltered (n=26). RESULTS: The structural characteristics of echocardiography estimated in both groups were not significantly different. The number of patients in group 1 showing the satisfactory level of adaptation intensity in the absence of its failures increased significantly. In group 2, a significant decrease of the following AOT parameters was documented: the tension index of the regulatory system (p=0.02), the standard deviation of NN-intervals (SDNN) (p=0.03), and root mean square of successive differences (RMSSD) (p=0.02). The multiple logistic regression analysis showed that the factors associated with the positive effect of rehabilitation were the normal and low degree of regulatory system tension (p=0.01) and the initially adequate or reduced response in the orthostatic test (p=0.04). CONCLUSION: The improvement of rehabilitation of the adaptive capacity was documented in as many as 48% of the patients who had undergone the spa and health resort-based rehabilitative treatment. The absence of positive dynamics or deterioration of adaptation were associated with the increase of the sympathetic activity at rest and in response to the AOT. The beneficial effect of rehabilitation was observed in the patients with the initially normal or low tension of regulatory systems and with the adequate or reduced baseline response in AOT.
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Adaptación Fisiológica , Sistema Nervioso Autónomo/fisiología , Balneología , Hemodinámica , Hipertensión/rehabilitación , Estudios de Casos y Controles , Femenino , Corazón/fisiología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The development and introduction into clinical practice of non-pharmacological methods for the prevention and treatment of arterial hypertension is a primary objective of modern physical therapy, especially as regards the neurotropic influences. This article was designed to report the results of the investigation into the hypotensive effect of transcerebral magnetic therapy obtained during the treatment of 60 patients presenting with arterial hypertension. The study included the comparative examination of two randomly formed groups containing 30 patients each. The patients of the main group received transcerebral magnetic therapy (to the frontal region) while those in the group of comparison were given magnetotherapy at the collar region. The study has demonstrated that transcerebral magnetic therapy given to the patients of the main group was a more efficient treatment than magnetotherapy at the collar region since it produced a more pronounced hypotensive effect irrespective of the initial hemodynamic type.
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Hipertensión/terapia , Estimulación Magnética Transcraneal/métodos , Femenino , Humanos , Hipertensión/rehabilitación , Masculino , Persona de Mediana Edad , Distribución Aleatoria , Estimulación Magnética Transcraneal/efectos adversosRESUMEN
Objectives of the investigation was to examine the dynamics of emotional and autonomic disorders in patients with peptic duodenal ulcer (DU) associated with arterial hypertension after acute gastrointestinal bleeding during training at School of Combined Pathology (SCP). Main group included 25 patients. The comparison group consisted of 26 patients with the matched pathology, sex and age, but not trained at SCP. Results. Both groups of patients demonstrated improvement in emotional sphere and autonomic regulation. However, in patients who had training at the SCP the indicators of emotional status improved earlier and got a greater extent. Optimization of autonomic regulation was identified in 3 months, not six months, like in untrained patients. Conclusion. Training hypertensive patients with peptic DU at the SCP improves the efficiency of emotional state and autonomic regulation.
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Úlcera Duodenal , Hemorragia Gastrointestinal , Hipertensión , Educación del Paciente como Asunto , Enfermedad Aguda , Adulto , Úlcera Duodenal/complicaciones , Úlcera Duodenal/rehabilitación , Femenino , Hemorragia Gastrointestinal/complicaciones , Hemorragia Gastrointestinal/rehabilitación , Humanos , Hipertensión/etiología , Hipertensión/rehabilitación , Masculino , Persona de Mediana EdadRESUMEN
BACKGROUND: Physical exercise is a strategy to control hypertension and attenuate pressure overload-induced cardiac remodeling. The influence of exercise on cardiac remodeling during uncontrolled hypertension is not established. We evaluated the effects of a long-term low intensity aerobic exercise protocol on heart failure (HF) development and cardiac remodeling in aging spontaneously hypertensive rats (SHR). METHODS: Sixteen month old SHR (n=50) and normotensive Wistar-Kyoto (WKY, n=35) rats were divided into sedentary (SED) and exercised (EX) groups. Rats exercised in treadmill at 12 m/min, 30 min/day, 5 days/week, for four months. The frequency of HF features was evaluated at euthanasia. STATISTICAL ANALYSES: ANOVA and Tukey or Mann-Whitney, and Goodman test. RESULTS: Despite slightly higher systolic blood pressure, SHR-EX had better functional capacity and lower HF frequency than SHR-SED. Echocardiography and tissue Doppler imaging showed no differences between SHR groups. In SHR-EX, however, left ventricular (LV) systolic diameter, larger in SHR-SED than WKY-SED, and endocardial fractional shortening, lower in SHR-SED than WKY-SED, had values between those in WKY-EX and SHR-SED not differing from either group. Myocardial function, assessed in LV papillary muscles, showed improvement in SHR-EX over SHR-SED and WKY-EX. LV myocardial collagen fraction and type I and III collagen gene expression were increased in SHR groups. Myocardial hydroxyproline concentration was lower in SHR-EX than SHR-SED. Lysyl oxidase gene expression was higher in SHR-SED than WKY-SED. CONCLUSION: Exercise improves functional capacity and reduces decompensated HF in aging SHR independent of elevated arterial pressure. Improvement in functional status is combined with attenuation of LV and myocardial dysfunction and fibrosis.
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Envejecimiento/fisiología , Terapia por Ejercicio/métodos , Insuficiencia Cardíaca/prevención & control , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Animales , Modelos Animales de Enfermedad , Ecocardiografía Doppler , Masculino , Condicionamiento Físico Animal , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKYRESUMEN
OBJECTIVE: Daily sessions of slow-breathing (6 breaths/min) significantly reduced 24-h ambulatory blood pressure (ABP) in patients with mild hypertension and this effect persisted at least 6 months after the interruption of sessions. The sequence of changes induced by slow-breathing (SB) daily sessions on the modulation of ambulatory blood pressure, renal resistive index, heart rate variability (HRV), and baroreflex sensitivity (BRS) was thus investigated in a randomized, controlled clinical trial. METHODS: Thirty-seven patients (30-75 years, grade I essential hypertension), untreated with antihypertensive drugs, were randomized to daily sessions (30 min) of music-guided SB (<10 breaths/min) (intervention, n = 24) or simple relaxation (control, n = 13). Office and ambulatory blood pressure monitoring renal Doppler ultrasound, assessment of BRS (sequence method and spectral analysis), and HRV (spectral power in the high- and low-frequency bands) were performed at baseline, and after 1, 4, and 8 weeks. Mixed model analysis was conducted on derived variables given by the difference between each measurement and the baseline value within subjects. RESULTS: After 1 week, the intervention enhanced the parasympathetic modulation (high-frequency power; at least p < 0.05 vs both control and baseline) and reduced renal vascular resistance (p < 0.05 for both comparisons); after 1 month, the enhancement of BRS (p < 0.05 for both comparisons at both methods) paralleled a significant reduction in 24 h ABP (p < 0.05 for all comparisons). INTERPRETATION: Repeated daily session of music-guided SB increased parasympathetic modulation and decreased renal resistive index early in the study. These changes were being followed by a positive modulation of BRS and blood pressure reduction.
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Sistema Nervioso Autónomo/fisiopatología , Hipertensión/rehabilitación , Respiración , Adulto , Anciano , Presión Sanguínea/fisiología , Hipertensión Esencial , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
Aerobic exercise has been recommended in the management of hypertension. However, few studies have examined the effect of walking on ambulatory blood pressure (BP), and no studies have employed home BP monitoring. We investigated the effects of daily walking on office, home, and 24-h ambulatory BP in hypertensive patients. Sixty-five treated or untreated patients with essential hypertension (39 women and 26 men, 60 ± 9 years) were examined in a randomized cross-over design. The patients were asked to take a daily walk of 30-60 min to achieve 10 000 steps/d for 4 weeks, and to maintain usual activities for another 4 weeks. The number of steps taken and home BP were recorded everyday. Measurement of office and ambulatory BP, and sampling of blood and urine were performed at the end of each period. The average number of steps were 5349 ± 2267/d and 10 049 ± 3403/d in the control and walking period, respectively. Body weight and urinary sodium excretion did not change. Office, home, and 24-h BP in the walking period were lower compared to the control period by 2.6 ± 9.4/1.3 ± 4.9 mmHg (p < 0.05), 1.6 ± 6.8/1.5 ± 3.7 mmHg (p < 0.01), and 2.4 ± 7.6/1.8 ± 5.3 mmHg (p < 0.01), respectively. Average 24-h heart rate and serum triglyceride also decreased significantly. The changes in 24-h BP with walking significantly correlated with the average 24-h BP in the control period. In conclusion, daily walking lowered office, home, and 24-h BP, and improved 24-h heart rate and lipid metabolism in hypertensive patients. However, the small changes in BP may limit the value of walking as a non-pharmacologic therapy for hypertension.
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Determinación de la Presión Sanguínea/métodos , Presión Sanguínea/fisiología , Terapia por Ejercicio/métodos , Hipertensión/rehabilitación , Caminata/fisiología , Monitoreo Ambulatorio de la Presión Arterial/métodos , Estudios Cruzados , Manejo de la Enfermedad , Hipertensión Esencial , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana EdadRESUMEN
INTRODUCTION: Food insecurity is associated with diet-sensitive diseases and may be a barrier to successful chronic disease self-management. To evaluate the impact of food insecurity on blood pressure reduction in a pilot clinical trial, we tested the effectiveness of 2 behavioral interventions for hypertension in people with and without food security. METHODS: A group of 28 men and women with type 2 diabetes and uncontrolled hypertension were randomized to either 1) home blood pressure telemonitoring alone or 2) home blood pressure telemonitoring plus telephone-based nurse case management. The primary outcome was 6-month change in systolic blood pressure. RESULTS: The 2 interventions resulted in modest, nonsignificant blood pressure reductions. Food-secure patients experienced clinically and statistically significant reductions in blood pressure, whereas no significant change was seen among food-insecure patients. CONCLUSION: Screening for food insecurity may help identify patients in need of tailored disease management interventions.
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Terapia Conductista/métodos , Monitoreo Ambulatorio de la Presión Arterial/métodos , Presión Sanguínea/fisiología , Manejo de la Enfermedad , Abastecimiento de Alimentos , Hipertensión/rehabilitación , Población Urbana , Femenino , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Ciudad de Nueva York/epidemiología , Prevalencia , Estudios RetrospectivosRESUMEN
Hypertension impairs cerebral vascular function. Vasodilator-stimulated phosphoprotein (VASP) mediates active reorganization of the cytoskeleton via membrane ruffling, aggregation and tethering of actin filaments. VASP regulation of endothelial barrier function has been demonstrated by studies using VASP(-/-) animals under conditions associated with tissue hypoxia. We hypothesize that hypertension regulates VASP expression and/or phosphorylation in endothelial cells, thereby contributing to dysfunction in the cerebral vasculature. Because exercise has direct and indirect salutary effects on vascular systems that have been damaged by hypertension, we also investigated the effect of exercise on maintenance of VASP expression and/or phosphorylation. We used immunohistochemistry, Western blotting and immunocytochemistry to examine the effect of hypertension on VASP expression and phosphorylation in brain endothelial cells in normotensive [Wistar-Kyoto (WKY)] and spontaneously hypertensive (SH) rats under normal and exercise conditions. In addition, we analyzed VASP regulation in normoxia- and hypoxia-induced endothelial cells. Brain endothelial cells exhibited significantly lower VASP immunoreactivity and phosphorylation at the Ser157 residue in SHR versus WKY rats. Exercise reversed hypertension-induced alterations in VASP phosphorylation. Western blotting and immunocytochemistry indicated reduction in VASP phosphorylation in hypoxic versus normoxic endothelial cells. These results suggest that diminished VASP expression and/or Ser157 phosphorylation mediates endothelial changes associated with hypertension and exercise may normalize these changes, at least in part, by restoring VASP phosphorylation.
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Encéfalo/patología , Moléculas de Adhesión Celular/metabolismo , Células Endoteliales/metabolismo , Regulación de la Expresión Génica/genética , Hipertensión/patología , Proteínas de Microfilamentos/metabolismo , Fosfoproteínas/metabolismo , Animales , Presión Sanguínea/genética , Estudios de Casos y Controles , Moléculas de Adhesión Celular/genética , Células Cultivadas , Modelos Animales de Enfermedad , Terapia por Ejercicio , Regulación de la Expresión Génica/efectos de los fármacos , Humanos , Hipertensión/genética , Hipertensión/fisiopatología , Hipertensión/rehabilitación , Hipoxia/fisiopatología , Proteínas de Microfilamentos/genética , Oxígeno/farmacología , Fosfoproteínas/genética , Fosforilación/genética , Ratas , Ratas Endogámicas SHR , Ratas Endogámicas WKY , Serina/metabolismo , Estadísticas no Paramétricas , Natación , Factores de TiempoRESUMEN
Analysis of efficiency of the standard of sanatorium care of patients with arterial hypertension is presented. Rates of arbitrary use of methods of care and their use in accordance with requirements of the standard were compared in patients with diferent results of treatment. It was found that existing standard was insufficiently adequate for application in the work of attending physician. Observance of requirements of the standard was associated with 93 ± 0.8% achievement of positive results. Rates of use of methods of care in groups of patients with positive and negative result of sanatorium stay were significantly different.
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Eficiencia Organizacional , Colonias de Salud/normas , Hipertensión/rehabilitación , Regionalización/organización & administración , Azerbaiyán , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
The article considers new approaches to diagnosis, treatment and rehabilitation of patients with arterial hypertension (AH) applied to the Ministry of Defence contingent. For the medical service of the Armed Forces the problem is relevant because of the significant labor losses, high level of dismission, morbidity and mortality of this disease. In the assessment of the patients limitation of life should be considered a variant AH, the stage, availability and seventy of the organ damage, severity and reversibility of complications, the incidence and severity of hypertensive crises, the effectiveness of treatment, comorbidity, education, occupation, the presence of contra-types and conditions of military service or labor. Military medical expertise of soldiers with AH uses the classification of degrees of arterial hypertension of 2010 and a three-stage-classification hypertonic disease created by the World Health Organization, 1996.
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Presión Sanguínea/efectos de los fármacos , Evaluación de la Discapacidad , Hipertensión , Medicina Militar/métodos , Personal Militar , Índice de Severidad de la Enfermedad , Determinación de la Presión Sanguínea , Humanos , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/rehabilitación , Factores de Riesgo , Federación de RusiaRESUMEN
The aim of the present study was to investigate the association of physical activity with small artery elasticity in the early stage of hypertension. We examined 366 young-to-middle-age stage 1 hypertensives (mean blood pressure 145.6±10.3/92.5±5.8 mmHg), divided into two categories of physical activity, sedentary (n=264) and non-sedentary (n=102) subjects. The augmentation index was measured using the Specaway DAT System. Small artery compliance (C2) was measured by applanation tonometry, at the radial artery, with an HDI CR2000 device. After 6 years of follow-up, arterial distensibility assessment was repeated in 151 subjects. Heart rate was lower in active than in sedentary subjects (71.2±8.9 vs 76.6±9.7 bpm, p<0.001). After adjusting for age, sex, heart rate, smoking, and blood pressure, C2 was higher (8.0±2.6 vs 6.4±3.0 ml/mmHg × 100, p=0.008) in non-sedentary than in sedentary patients. The augmentation index was smaller in the former (8.8±20.1 vs 16.8±26.5%, p=0.044) but the difference lost statistical significance after further adjustment for blood pressure. After 6 years, C2 was still higher in the non-sedentary than sedentary subjects. In addition, an improvement in the augmentation index accompanied by a decline in total peripheral resistance was found in the former. These data show that regular physical activity is associated with improved small artery elasticity in the early phase of hypertension. This association persists over time and is independent of blood pressure and heart rate.
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Arterias/fisiopatología , Presión Sanguínea/fisiología , Hipertensión/fisiopatología , Actividad Motora , Adulto , Factores de Edad , Elasticidad/fisiología , Femenino , Frecuencia Cardíaca/fisiología , Humanos , Hipertensión/rehabilitación , Masculino , Persona de Mediana Edad , Resistencia Vascular/fisiologíaRESUMEN
AIM: The aim of this study is to evaluate the results of rehabilitation, to determine the prevalence of major risk factors in cerebrovascular accident and their consequences, as well as to propose measures and procedures that will affect the better rehabilitation. METHODS: The survey analyzed: age, sex, duration of rehabilitation, activities in daily life through the Barthel index at admission and at discharge, presence of risk factors HTA and DM. The study included a total of 116 patients, the majority of patients are older than 61 years. We had 49% of male patients and 51% of female patients and they spent 31-40 days at the rehabilitation. RESULTS: The most common risk factor is HTA (83%) and diabetes (33%). Most of the patients at admission had a BI from 0 to 4 (32.7%), and at discharge BI in the range 17-20 (36.2%). Statistical analysis shows that there is a statistically significant correlation between the BI at admission, BI at discharge and risk factors of HTA and diabetes mellitus. CONCLUSIONS: The rehabilitation results in most patients is good results of rehabilitation. The most important risk factors in patients are HTA, DM and directly affect on results of rehabilitation. For the better results we should have energetic fight against risk factors for HTA and DM through primary and secondary prevention and patient education about early detection and treatment of these risk factors.