Blood pressure response during exercise testing in individuals with and without hypertension: The value of the recovery phase.

BACKGROUND: Hypertension and exercise testing are essential for cardiovascular risk assessment. However, an exact description of blood pressure (BP) in patients with a hypertensive response during exercise (HRE), especially in the recovery phase is lacking. Herein, we aimed to analyse BP and heart rate during exercise testing and recovery in patients with an HRE. METHODS: 800 patients aged 17-90 with an HRE during a standardized bicycle ergometry test were recruited. The BP behaviour during exercise testing was correlated with clinical data. Furthermore, data were analysed according to the presence of pre-existent hypertension. RESULTS: Of the 800 patients included in this study 497 (62%) were previously diagnosed with hypertension. Analysis of covariance showed a significantly faster systolic (ß [95% CI] 8.0 [4.9-11.1]) and diastolic (2.4 [0.4-4.4]) BP recovery 3 min after maximal exercise in patients without hypertension in univariable models. These results remained robust in fully adjusted models taking into account age, sex, body mass index, cardiovascular disease, and antihypertensive treatment for systolic (5.3 [1.2-9.4]) and diastolic BP (4.5 [1.9-7.0]). Furthermore, patients with hypertension displayed higher systolic BP during maximal exercise in univariable (3.8 [0.1-7.5]) and fully adjusted (5.5 [1.1-10.0]) models. There was no difference in maximum diastolic BP between groups. CONCLUSION: In this large cohort study, patients without hypertension showed a faster systolic and diastolic BP recovery and lower maximal systolic BP compared to patients with hypertension. Overall, this study provides new insights into cardiovascular health during recovery phase.

Observation of universal dynamics in a spinor Bose gas far from equilibrium.

Predicting the dynamics of quantum systems far from equilibrium represents one of the most challenging problems in theoretical many-body physics1,2. While the evolution of a many-body system is in general intractable in all its details, relevant observables can become insensitive to microscopic system parameters and initial conditions. This is the basis of the phenomenon of universality. Far from equilibrium, universality is identified through the scaling of the spatio-temporal evolution of the system, captured by universal exponents and functions. Theoretically, this has been studied in examples as different as the reheating process in inflationary Universe cosmology3,4, the dynamics of nuclear collision experiments described by quantum chromodynamics5,6, and the post-quench dynamics in dilute quantum gases in non-relativistic quantum field theory7-11. However, an experimental demonstration of such scaling evolution in space and time in a quantum many-body system has been lacking. Here we observe the emergence of universal dynamics by evaluating spatially resolved spin correlations in a quasi-one-dimensional spinor Bose-Einstein condensate12-16. For long evolution times we extract the scaling properties from the spatial correlations of the spin excitations. From this we find the dynamics to be governed by an emergent conserved quantity and the transport of spin excitations towards low momentum scales. Our results establish an important class of non-stationary systems whose dynamics is encoded in time-independent scaling exponents and functions, signalling the existence of non-thermal fixed points10,17,18. We confirm that the non-thermal scaling phenomenon involves no fine-tuning of parameters, by preparing different initial conditions and observing the same scaling behaviour. Our analogue quantum simulation approach provides the basis with which to reveal the underlying mechanisms and characteristics of non-thermal universality classes. One may use this universality to learn, from experiments with ultracold gases, about fundamental aspects of dynamics studied in cosmology and quantum chromodynamics.

Sports-related sudden cardiac arrest in young adults.

AIMS: Data on sports-related sudden cardiac arrest (SrSCA) among young adults in the general population are scarce. We aimed to determine the overall SrSCA incidence, characteristics, and outcomes in young adults. METHODS AND RESULTS: Prospective cohort study of all cases of SrSCA between 2012 and 2019 in Germany and Paris area, France, involving subjects aged 18-35 years. Detection of SrSCA was achieved via multiple sources, including emergency medical services (EMS) reporting and web-based screening of media releases. Cases and aetiologies were centrally adjudicated. Overall, a total of 147 SrSCA (mean age 28.1 ± 4.8 years, 95.2% males) occurred, with an overall burden of 4.77 [95% confidence interval (CI) 2.85-6.68] cases per million-year, including 12 (8.2%) cases in young competitive athletes. While bystander cardiopulmonary resuscitation (CPR) was initiated in 114 (82.6%), automated external defibrillator (AED) use by bystanders occurred only in a minority (7.5%). Public AED use prior to EMS arrival (odds ratio 6.25, 95% CI 1.48-43.20, P = 0.02) was the strongest independent predictor of survival at hospital discharge (38.1%). Among cases that benefited from both immediate bystander CPR and AED use, survival rate was 90.9%. Coronary artery disease was the most frequent aetiology (25.8%), mainly through acute coronary syndrome (86.9%). CONCLUSION: Sports-related sudden cardiac arrest in the young occurs mainly in recreational male sports participants. Public AED use remains disappointingly low, although survival may reach 90% among those who benefit from both bystander CPR and early defibrillation. Coronary artery disease is the most prevalent cause of SrSCA in young adults.

Alive and kicking: suicide rates and major soccer events in Austria, Germany and Switzerland.

BACKGROUND: Major sporting events are postulated to reduce suicide rates by increased social connectedness, by identifying with winning teams, or, conversely, to increase suicide rates by the 'broken promise effect'. METHODS: In our observational epidemiological study, we investigated changes in suicide rates between 1970 and 2017 in Austria, Germany and Switzerland during the European and World Soccer Championships in general, and on days that the home team played, won or lost. RESULTS: Combining all three studied nations no statistically significant change in the incidence of daily suicides during soccer championships compared to a control period was noted (38.29 ± 9.02 vs. 37.33 ± 10.58; incidence risk ratio = 1.03; 95% confidence interval: 1.01-1.05, P = 0.05). Essentially, no differences in the expected directions were found, and none remained statistically significant after correcting for multiple comparisons in subgroups for country, age and gender in all three studied countries. Compared to a control period, neither a significant difference in the respective national suicide rate was found after Germany's four championship victories nor after Austria's emotional only win over Germany. CONCLUSION: Our results do not support the assumption of increased social connectedness and, thus, lowered suicide risk during major sporting events or changes in suicide risk depending on the outcome of important games as predicted by the broken promise effect or changes in self-efficacy by identification with winning teams.

Vortex Motion Quantifies Strong Dissipation in a Holographic Superfluid.

Holographic duality provides a description of strongly coupled quantum systems in terms of weakly coupled gravitational theories in a higher-dimensional space. It is a challenge, however, to quantitatively determine the physical parameters of the quantum systems corresponding to generic holographic theories. Here, we address this problem for the two-dimensional holographic superfluid, known to exhibit strong dissipation. We numerically simulate the motion of a vortex dipole and perform a high-precision matching of the corresponding dynamics resulting from the dissipative Gross-Pitaevskii equation. Excellent agreement is found for the vortex core shape and the spatiotemporal trajectories. A further comparison to the Hall-Vinen-Iordanskii equations for point vortices interacting with the superfluid allows us to determine the friction parameters of the holographic superfluid. Our results suggest that holographic vortex dynamics can be applied to experimentally accessible superfluids like strongly coupled ultracold Bose gases or thin helium films with temperatures in the Kelvin range. This would make holographic far-from-equilibrium dynamics and turbulence amenable to experimental tests.

Impact of early sports specialisation on paediatric ECG.

Athletes of pediatric age are growing in number. They are subject to a number of risks, among them sudden cardiac death (SCD). This study aimed to characterize the pediatric athlete population in Switzerland, to evaluate electrocardiographic findings based on the International Criteria for electrocardiography (ECG) Interpretation in Athletes, and to analyze the association between demographic data, sport type, and ECG changes. Retrospective, observational study of pediatric athletes (less than 18 years old) including medical history, physical examination, and a 12-lead resting ECG. The primary focus was on identification of normal, borderline, and abnormal ECG findings. The secondary observation was the relation between ECG and demographic, anthropometric, sport-related, and clinical data. The 891 athletes (mean 14.8 years, 35% girls) practiced 45 different sports on three different levels, representing all types of static and dynamic composition of the Classification of Sports by Mitchell. There were 75.4% of normal ECG findings, among them most commonly early repolarization, sinus bradycardia, and left ventricular hypertrophy; 4.3% had a borderline finding; 2.1% were abnormal and required further investigations, without SCD-related diagnosis. While the normal ECG findings were related to sex, age, and endurance sports, no such observation was found for borderline or abnormal criteria. Our results in an entirely pediatric population of athletes demonstrate that sex, age, and type of sports correlate with normal ECG findings. Abnormal ECG findings in pediatric athletes are rare. The International Criteria for ECG Interpretation in Athletes are appropriate for this age group.

Athletes and Hypertension.

PURPOSE OF REVIEW: We reviewed most current medical literature in order to describe the epidemiology, clinical manifestation, outcome, and management of hypertension in athletes. RECENT FINDINGS: An estimated quarter of the world's population is suffering from hypertension and this prevalence is also reflected in athletes and in individuals involved in leisure time sport activities. Several studies found an inverse relationship between physical activity and blood pressure. Therefore, physical exercise is recommended to prevent, manage, and treat hypertension. On the other hand, the prevalence of hypertension may vary by sport and in some cases may even be higher in athletes competing in certain disciplines than in the general population. Hypertension is the most common medical condition in athletes and may raise concerns about its management and the individual's eligibility for competitive sports. A thorough clinical evaluation should be performed to correctly diagnose or rule out hypertension in athletes, describe the individual's risk profile, rule out secondary causes, and detect possible hypertension-mediated organ damage caused by hypertension at an early stage. Based on most recent clinical research and international consensus documents, we propose a diagnostic algorithm as well the non-pharmacological and pharmacological management of hypertension in athletes. Although elevated blood pressure levels are less common in the active population, athletes are not protected from hypertension. A thorough diagnostic approach may help to identify individual at risk for adverse cardiovascular events and to address the optimal treatment as well as sport recommendations.

Collisions of Three-Component Vector Solitons in Bose-Einstein Condensates.

Ultracold gases provide an unprecedented level of control for the investigation of soliton dynamics and collisions. We present a scheme for deterministically preparing pairs of three-component solitons in a Bose-Einstein condensate. Our method is based on local spin rotations which simultaneously imprint suitable phase and density distributions. This enables us to observe striking collisional properties of the vector degree of freedom which naturally arises for the coherent nature of the emerging multicomponent solitons. We find that the solitonic properties in the quasi-one-dimensional system are quantitatively described by the integrable repulsive three-component Manakov model.

Effects of active commuting to work for 12 months on cardiovascular risk factors and body composition.

Active commuting has the potential to decrease cardiovascular risk by increasing physical activity. We aimed to investigate the effects of active commuting to work for 12 months on body composition and cardiovascular risk factors. Therefore, 73 hospital employees (age: 46 ± 9 years, 36% males), with a predominantly passive way of commuting, were randomly assigned to an intervention group (IG) and a control group (CG) in a 2:1 fashion. The IG was further divided into a public transportation plus active commuting group (IG-PT) and a cycling group (IG-C). Both IGs were prompted to reach 150 min/wk of moderate intensity exercise. Daily self-reported commuting details were verified by GPS tracking. All subjects underwent assessment of body composition, resting blood pressure, glycemic control, and lipid profile at the beginning and end of the study. Data for final analyses were available in 62 subjects. Commuting details indicated that the subjects randomized to IG changed their commuting habits. HbA1c decreased by 0.2% [95%CI: -0.3, -0.2] in IG-PT but was not statistically different between groups (P = .06). LDL cholesterol decreased in IG-C by 0.8 mmol/L [-1.1, -0.4] and by 0.6 mmol/L [-1.2, 0.1] in IG-PT which can be considered biologically relevant but did not yield statistical significance. Body composition and blood pressure did not differ between groups. Active commuting to work for 12 months did not change body composition but yielded relevant changes in lipid profile and glycemic control. Health benefits of active commuting should be addressed by healthcare professionals when counseling individuals that seek to improve their cardiovascular risk profile.