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1.
Genes (Basel) ; 10(4)2019 04 11.
Artículo en Inglés | MEDLINE | ID: mdl-30979034

RESUMEN

: Background: Exercise is one of the best nonpharmacologic therapies to treat hypertension. The blood pressure (BP) response to exercise is heritable. Yet, the genetic basis for the antihypertensive effects of exercise remains elusive. Methods: To assemble a prioritized gene signature, we performed a systematic review with a series of Boolean searches in PubMed (including Medline) from earliest coverage. The inclusion criteria were human genes in major BP regulatory pathways reported to be associated with: (1) the BP response to exercise; (2) hypertension in genome-wide association studies (GWAS); (3) the BP response to pharmacotherapy; (4a) physical activity and/or obesity in GWAS; and (4b) BP, physical activity, and/or obesity in non-GWAS. Included GWAS reports disclosed the statistically significant thresholds used for multiple testing. Results: The search yielded 1422 reports. Of these, 57 trials qualified from which we extracted 11 genes under criteria 1, 18 genes under criteria 2, 28 genes under criteria 3, 27 genes under criteria 4a, and 29 genes under criteria 4b. We also included 41 genes identified from our previous work. Conclusions: Deep-sequencing the exons of this systematically assembled signature of genes represents a cost and time efficient approach to investigate the genomic basis for the antihypertensive effects of exercise.


Asunto(s)
Presión Sanguínea/genética , Ejercicio Físico , Estudio de Asociación del Genoma Completo , Hipertensión/genética , Antihipertensivos/uso terapéutico , Presión Sanguínea/efectos de los fármacos , Presión Sanguínea/fisiología , Exones/genética , Secuenciación de Nucleótidos de Alto Rendimiento , Humanos , Hipertensión/tratamiento farmacológico , Hipertensión/patología , Hipertensión/rehabilitación
2.
Complement Ther Clin Pract ; 35: 148-153, 2019 May.
Artículo en Inglés | MEDLINE | ID: mdl-31003650

RESUMEN

BACKGROUND: and purpose: We aimed to investigate the adherence to yoga as an antihypertensive intervention through telerehabilitation. MATERIALS AND METHODS: In a randomized controlled trial patients were consecutively enrolled and randomly assigned to intervention or control group. Both groups received standardized yoga training during three weeks of inpatient rehabilitation. The intervention group received telerehabilitation after discharge; the control group received the usual care. Data was collected at admission (t1), discharge (t2) and at follow up after six (t3) and 12 months (t4). The primary endpoint was follow-up adherence assessed in an intention-to-treat analysis. RESULTS: 228 male rehabilitation patients (mean age 53.3 ±â€¯5.8 years, mean blood pressure 139.5 ±â€¯10.2/ 86.7 ±â€¯8.0 mmHg) The intervention resulted in significantly increased adherence compared to control group (t3: 40.0% vs. 19.5%, p = 0.001; t4: 36.5% vs. 23.9%, p = 0.038); blood pressure and quality of life improved. CONCLUSION: Telerehabilitation significantly improves yoga adherence maintaining achieved health benefits in the long term.


Asunto(s)
Hipertensión/rehabilitación , Cooperación del Paciente/estadística & datos numéricos , Telerrehabilitación , Yoga , Adolescente , Adulto , Femenino , Estudios de Seguimiento , Humanos , Análisis de Intención de Tratar , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento , Adulto Joven
3.
PLoS One ; 14(2): e0211032, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30726242

RESUMEN

BACKGROUND AND OBJECTIVES: Management of hypertension in chronic kidney disease (CKD) remains a major challenge. We conducted a systematic review to assess whether exercise is an effective strategy for lowering blood pressure in this population. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: We searched MEDLINE, EMBASE, the Cochrane Library, CINAHL and Web of Science for randomized controlled trials (RCTs) that examined the effect of exercise on blood pressure in adults with non-dialysis CKD, stages 3-5. Outcomes were non-ambulatory systolic blood pressure (primary), other blood pressure parameters, 24-hour ambulatory blood pressure, pulse-wave velocity, and flow-mediated dilatation. Results were summarized using random effects models. RESULTS: Twelve studies with 505 participants were included. Ten trials (335 participants) reporting non-ambulatory systolic blood pressure were meta-analysed. All included studies were a high risk of bias. Using the last available time point, exercise was not associated with an effect on systolic blood pressure (mean difference, MD -4.33 mmHg, 95% confidence interval, CI -9.04, 0.38). The MD after 12-16 and 24-26 weeks of exercise was significant (-4.93 mmHg, 95% CI -8.83, -1.03 and -10.94 mmHg, 95% CI -15.83, -6.05, respectively) but not at 48-52 weeks (1.07 mmHg, 95% CI -6.62, 8.77). Overall, exercise did not have an effect on 24-hour ambulatory blood pressure (-5.40 mmHg, 95% CI -12.67, 1.87) or after 48-52 weeks (-7.50 mmHg 95% CI -20.21, 5.21) while an effect was seen at 24 weeks (-18.00 mmHg, 95% CI -29.92, -6.08). Exercise did not have a significant effect on measures of arterial stiffness or endothelial function. CONCLUSION: Limited evidence from shorter term studies suggests that exercise is a potential strategy to lower blood pressure in CKD. However, to recommend exercise for blood pressure control in this population, high quality, longer term studies specifically designed to evaluate hypertension are needed.


Asunto(s)
Terapia por Ejercicio , Hipertensión/rehabilitación , Insuficiencia Renal Crónica/rehabilitación , Presión Sanguínea/fisiología , Determinación de la Presión Sanguínea , Ejercicio Físico/fisiología , Humanos , Hipertensión/diagnóstico , Hipertensión/etiología , Análisis de la Onda del Pulso , Ensayos Clínicos Controlados Aleatorios como Asunto , Insuficiencia Renal Crónica/complicaciones , Resultado del Tratamiento
4.
J Hypertens ; 37(2): 264-279, 2019 02.
Artículo en Inglés | MEDLINE | ID: mdl-30020240

RESUMEN

OBJECTIVES: Globally, healthcare policy promotes supported self-management as a strategy for people with long-term conditions. This meta-review aimed to explore how people with hypertension make sense of their condition, to assess the effectiveness of supported self-management in hypertension, and to identify effective components of support. METHODS: From a search of eight databases (January 1993-October 2012; update June 2017) we included systematic syntheses of qualitative studies of patients' experiences, and systematic reviews of randomized controlled trials evaluating the impact of supported self-management on blood pressure and medication adherence. We used meta-ethnography, meta-Forest plots and narrative analysis to synthesise the data. RESULTS: Six qualitative and 29 quantitative reviews provided data from 98 and 446 unique studies, respectively. Self-management support consistently reduced SBP (by between 2 and 6 mmHg), and DBP (by between 1 and 5 mmHg). Information about hypertension and treatment, home BP monitoring (HBPM) and feedback (including telehealth) were widely used in effective interventions. Patients' perceptions of a disease with multiple symptoms contrasted with the professional view of an asymptomatic condition. HBPM, in the context of a supportive patient-professional relationship, changed perceptions of the significance of symptoms and fostered confidence in ability to self-manage hypertension. CONCLUSION: Our systematic qualitative and quantitative meta-reviews tell complementary stories. Supported self-management can improve blood pressure control. Interventions are complex and encompass a broad range of support strategies. HBPM (with or without telehealth) within the context of a supportive patient-professional partnership can bridge the gap between medical and lay perspectives of hypertension and enable effective self-management.


Asunto(s)
Hipertensión/rehabilitación , Automanejo , Presión Sanguínea , Determinación de la Presión Sanguínea , Humanos , Cumplimiento de la Medicación , Revisiones Sistemáticas como Asunto , Telemedicina
5.
J Hum Hypertens ; 33(1): 50-56, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30181658

RESUMEN

This study investigated the prevalence of physical activity prescriptions in the management of high blood pressure (BP), the characteristics of people given these, and whether prescriptions were associated with the physical activity beliefs and practices of patients. A retrospective cohort study was undertaken, involving 365 general practitioners (GPs) from across Australia. The records of up to 20 patients per GP with high BP (N = 6512) were audited to identify physical activity and pharmacological prescriptions over four consecutive consultations. A sub-sample (n = 535) of patients completed a physical activity questionnaire. Physical activity prescriptions were recorded for 42.6% of patients with controlled BP, 39.5% for those with mild hypertension and 35.7% of those with moderate to severe hypertension. These were more likely in patients with cardiovascular disease (OR 1.41, 95% CI 1.23-1.62) and diabetes (OR 1.21, 95% CI 1.04-1.42), and less likely in those with moderate to severe hypertension (OR 0.80, 95% CI 0.69-0.94), aged 75 years and over (OR 0.62, 95% CI 0.51-0.74) and with high cholesterol (OR 0.73, 95% CI 0.57-0.94). Patients receiving a physical activity prescription were more likely to report this behaviour as important for their health and that they had increased their levels of participation. Most patients with high BP are not receiving physical activity prescriptions, and GPs show greater readiness to address this behaviour in patients with existing chronic disease. There is a need for efficacious and practical strategies for promoting physical activity that can be adopted in the routine management of high BP in general practice.


Asunto(s)
Manejo de la Enfermedad , Terapia por Ejercicio/métodos , Ejercicio Físico/fisiología , Medicina General/estadística & datos numéricos , Hipertensión/rehabilitación , Prescripciones , Anciano , Australia/epidemiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Incidencia , Masculino , Persona de Mediana Edad , Estudios Retrospectivos
6.
J Cardiopulm Rehabil Prev ; 39(1): 50-55, 2019 01.
Artículo en Inglés | MEDLINE | ID: mdl-30586113

RESUMEN

PURPOSE: The present study compared the effects of 2 different high-intensity interval training (HIIT) protocols on arterial stiffness, lipid profiles, and inflammatory markers in hypertensive patients. METHODS: Thirty hypertensive (stage 1) patients, aged 48.0 ± 3.2 yr, were randomly allocated to the short-duration HIIT (SDHIIT, n = 10), long-duration HIIT (LDHIIT, n = 10), and control (n = 10) groups. After a 2-wk preparatory phase of continuous mild training, patients in the SDHIIT group performed 8 wk of HIIT including 27 repetitions of 30-sec activity at 80% to 100% of (Equation is included in full-text article.)O2peak interspersed with 30-sec passive/active (10%-20% of (Equation is included in full-text article.)O2peak) recovery. Patients in the LDHIIT group performed 8 wk of HIIT, 32 min/session including 4 repetitions of 4-min activity at 75% to 90% of (Equation is included in full-text article.)O2peak interspersed with 4-min passive/active (15%-30% of (Equation is included in full-text article.)O2peak) recovery. Blood pressure (BP), pulse wave velocity (PWV), inflammatory markers, and lipid profiles were measured before and after training. RESULTS: Significant (P < .05) reductions in systolic blood pressure and PWV were found following 2 training protocols, though, only the changes in PWV following the SDHIIT were significantly different than those in the LDHIIT and control groups. Interleukin-6 and triglycerides decreased and interleukin-10 increased significantly (P < .01) following both HIIT programs, whereas the differences between the 2 training protocols were not statistically significant. C-reactive protein and lipids did not change significantly following HIIT. CONCLUSIONS: Performing HIIT improves systolic blood pressure and inflammatory markers in patients with stage 1 hypertension irrespective of the HIIT intensity and duration, and PWV improvement is intensity related.


Asunto(s)
Presión Sanguínea/fisiología , Proteína C-Reactiva/metabolismo , Entrenamiento de Intervalos de Alta Intensidad/métodos , Hipertensión/rehabilitación , Inflamación/sangre , Lípidos/sangre , Rigidez Vascular/fisiología , Biomarcadores/sangre , Tolerancia al Ejercicio/fisiología , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/sangre , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Consumo de Oxígeno/fisiología , Análisis de la Onda del Pulso/métodos , Factores de Tiempo
7.
Curr Hypertens Rev ; 14(2): 161-169, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29651953

RESUMEN

BACKGROUND: Hypertension (HTN) is the main cause of cardiovascular diseases accounting for one-third of global mortality. Physical exercise reduces the incidence and prevalence of HTN and cardiovascular morbidity and mortality. Exercises recommended for hypertensive patients include supervised cardiac rehabilitation, which occurs in rehabilitation centers, and partly supervised rehabilitation, with the individual prescription of exercises conducted at patients' residences. OBJECTIVE: Compare clinical and functional parameters of hypertensive patients subjected to two cardiac rehabilitation protocols: supervised and partly supervised. METHOD: Hypertensive patients stage I or II were randomly divided into group one (G1) (partly supervised cardiac rehabilitation) and group two (G2) (supervised cardiac rehabilitation). All patients performed a warm-up, aerobic exercise, strength training and cool-down. Participants' assessments conducted before and after intervention included: physical examination, six-minute walk test, cardiac stress test, metabolic tests, and central and peripheral blood pressure measurements. RESULTS: A total of 61 patients (mean age 60.3±11.3 years, 78.7% women) were randomized (30 in G1 and 31 in G2). At the end of the intervention, G1 increased 30.6 meters (p=0.004) and G2 increased 55.0 meters (p>0.001) the distance covered in the six-minute walk test. G2 showed an increase in the maximum oxygen consumption from 24.7±8.6 mlO2/Kg/min to 28.4±7.5 mlO2/Kg/min (p=0.003). Compliance with the intervention was similar in G1 and G2 (77.5±11% x 82±10%; p=0.654). CONCLUSION: Participants from both groups improved their physical fitness and showed satisfactory compliance and tolerability to the interventions. The supervised exercise was more effective in improving muscle strength and some physical fitness parameters.


Asunto(s)
Presión Sanguínea , Rehabilitación Cardiaca/métodos , Terapia por Ejercicio/métodos , Hipertensión/rehabilitación , Anciano , Brasil , Tolerancia al Ejercicio , Femenino , Humanos , Hipertensión/diagnóstico , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Fuerza Muscular , Consumo de Oxígeno , Cooperación del Paciente , Aptitud Física , Recuperación de la Función , Factores de Tiempo , Resultado del Tratamiento , Prueba de Paso
8.
Arq Bras Cardiol ; 110(1): 60-67, 2018 Jan.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-29412242

RESUMEN

BACKGROUND: The absence of instruments capable of measuring the level of knowledge of hypertensive patients in cardiac rehabilitation programs about their disease reflects the lack of specific recommendations for these patients. OBJECTIVE: To develop and validate a questionnaire to evaluate the knowledge of hypertensive patients in cardiac rehabilitation programs about their disease. METHODS: A total of 184 hypertensive patients (mean age 60.5 ± 10 years, 66.8% men) were evaluated. Reproducibility was assessed by calculation of the intraclass correlation coefficient using the test-retest method. Internal consistency was assessed by the Cronbach's alpha and the construct validity by the exploratory factorial analysis. RESULTS: The final version of the instrument had 17 questions organized in areas considered important for patient education. The instrument proposed showed a clarity index of 8.7 (0.25). The intraclass correlation coefficient was 0.804 and the Cronbach's correlation coefficient was 0.648. Factor analysis revealed five factors associated with knowledge areas. Regarding the criterion validity, patients with higher education level and higher family income showed greater knowledge about hypertension. CONCLUSION: The instrument has a satisfactory clarity index and adequate validity, and can be used to evaluate the knowledge of hypertensive participants in cardiac rehabilitation programs.


Asunto(s)
Rehabilitación Cardiaca , Conocimientos, Actitudes y Práctica en Salud , Hipertensión/rehabilitación , Encuestas y Cuestionarios , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Proyectos Piloto , Psicometría , Reproducibilidad de los Resultados
9.
J Bodyw Mov Ther ; 22(1): 192-202, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-29332746

RESUMEN

BACKGROUND: Pilates is a system of exercise focusing upon controlled movement, stretching and breathing. Pilates is popular today not only for physical fitness but also for rehabilitation programs. This paper is a review of the literature on the effectiveness of Pilates as a rehabilitation tool in a wide range of conditions in an adult population. METHODS: A systematic literature review was carried out according to the PRISMA guidelines. Electronic databases were searched for cohort studies or randomised controlled trials (RCTs), and inclusion and exclusion criteria were applied. The final RCTs were assessed using the PEDro and CONSORT 2010 checklists. RESULTS: Twenty-three studies, published between 2005 and 2016, met the inclusion criteria. These papers assessed the efficacy of Pilates in the rehabilitation of low back pain, ankylosing spondylitis, multiple sclerosis, post-menopausal osteoporosis, non-structural scoliosis, hypertension and chronic neck pain. Nineteen papers found Pilates to be more effective than the control or comparator group at improving outcomes including pain and disability levels. When assessed using the CONSORT and PEDro scales, the quality of the papers varied, with more falling toward the upper end of the scale. CONCLUSION: The majority of the clinical trials in the last five years into the use of Pilates as a rehabilitation tool have found it to be effective in achieving desired outcomes, particularly in the area of reducing pain and disability. It indicates the need for further research in these many areas, and especially into the benefits of particular Pilates exercises in the rehabilitation of specific conditions.


Asunto(s)
Técnicas de Ejercicio con Movimientos/métodos , Rehabilitación/métodos , Humanos , Hipertensión/rehabilitación , Dolor de la Región Lumbar/rehabilitación , Esclerosis Múltiple/rehabilitación , Osteoporosis Posmenopáusica/rehabilitación , Ensayos Clínicos Controlados Aleatorios como Asunto , Escoliosis/rehabilitación , Espondilitis Anquilosante/rehabilitación
10.
Indian Heart J ; 70 Suppl 3: S28-S35, 2018 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-30595274

RESUMEN

OBJECTIVE: To investigate the effect of combined aerobic and resistance training (CART) on heart rate variability in sedentary, hypertensive women. PARTICIPANTS: A total of twenty-eight hypertensive (Stage 1 and 2) sedentary women (Age 40.54 ±â€¯4.2 yrs; Height 155.14 ±â€¯5.4 cm; Weight 70.96 ±â€¯10.2 kg; BMI 29.6 ±â€¯4.4; Duration of HTN: 6.43 ±â€¯2.5 yrs) were recruited for the study. METHODS: Participants were randomly assigned to either the CART group that performed combined aerobic and resistance exercise of moderate intensity [aerobic exercise 50-80% of HRmax (maximum heart rate) and resistance exercises at 50-80% of 1 Repetition Maximum (RM)], 5 times/week for 4 weeks, or to the control group that followed conventional treatment without any supervised exercise intervention. MAIN OUTCOME MEASURES: Resting blood pressure was measured and standard heart rate variability (HRV) indices were calculated using time domain (SDNN, pNN50, RMSSD) and frequency domain (LFnu, HFnu, LF/HF and TP) analysis. RESULTS: CART group demonstrated an increase in HFnu, TP, SDNN, and RMSSD, (p < 0.05) along with a significant decrease in LFnu, LF/HF ratio, systolic blood pressure, and diastolic blood pressure (p < 0.05). CONCLUSION: CART showed significant improvement in HRV parameters indicating vagal dominance in middle-aged hypertensive women. Therefore, exercise training in combined form (aerobic and resistance) may be incorporated in the management programs of the patients suffering from hypertension in order to augment improvement in their cardiac autonomic control.


Asunto(s)
Sistema Nervioso Autónomo/fisiopatología , Terapia por Ejercicio/métodos , Tolerancia al Ejercicio/fisiología , Frecuencia Cardíaca/fisiología , Hipertensión/rehabilitación , Entrenamiento de Resistencia/métodos , Adulto , Presión Sanguínea/fisiología , Femenino , Humanos , Hipertensión/fisiopatología , Pronóstico , Método Simple Ciego
11.
Clin Exp Hypertens ; 40(6): 547-553, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29172739

RESUMEN

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.


Asunto(s)
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/metabolismo
12.
Psychiatry Res ; 260: 236-240, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-29220680

RESUMEN

This study investigated cardio-metabolic risk factors among patients with severe mental illness who do or do not meet the recommendations of 150min per week of physical activity. A secondary aim was to assess whether those that do meet the recommendations report lower levels of mental health symptoms. 107 (60♀) Ugandan in- and outpatients (mean age=34.4 ± 9.7 years) with severe mental illness (depression=7, bipolar disorder=55, schizophrenia=45) completed the Physical Activity Vital Sign (PAVS) method and Brief Symptoms Inventory -18. Participants were also screened for abdominal obesity (waist circumference>90cm), overweight (body mass index≥25) and hypertension (systolic pressure≥140mmHg and/or diastolic pressure≥90mmHg).48.6% (n = 52) of patients met the physical activity recommendations as assessed by the PAVS method. 41.1% (n = 44) were overweight, 40.2% (n = 43) had abdominal obesity and 23.4% (n = 25) had hypertension. Those who did not meet the physical activity recommendations were significantly older, had a higher BSI-18 somatisation score, and had a higher risk of overweight [relative risk (RR) = 2.88, 95% confidence interval (CI) = 1.59-4.99], abdominal obesity (RR = 1.82, 95%CI = 1.13-2.93), and hypertension (RR = 2.16, 95%CI = 0.99-4.73). The PAVS is a feasible method of assessing physical activity among patients with severe mental illness in a low resource setting. The PAVS may have clinical utility for physical and mental health risk stratification.


Asunto(s)
Trastorno Bipolar/rehabilitación , Enfermedades Cardiovasculares/terapia , Trastorno Depresivo/rehabilitación , Terapia por Ejercicio/estadística & datos numéricos , Hipertensión/rehabilitación , Sobrepeso/rehabilitación , Cooperación del Paciente/estadística & datos numéricos , Medición de Riesgo/métodos , Esquizofrenia/rehabilitación , Trastornos Somatomorfos/rehabilitación , Adulto , Trastorno Bipolar/epidemiología , Enfermedades Cardiovasculares/epidemiología , Trastorno Depresivo/epidemiología , Femenino , Humanos , Hipertensión/epidemiología , Masculino , Persona de Mediana Edad , Sobrepeso/epidemiología , Medición de Riesgo/normas , Esquizofrenia/epidemiología , Trastornos Somatomorfos/epidemiología , Uganda/epidemiología , Adulto Joven
13.
Wiad Lek ; 71(9): 1809-1814, 2018.
Artículo en Ucraniano | MEDLINE | ID: mdl-30737945

RESUMEN

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.


Asunto(s)
Hipertensión/rehabilitación , Terapia por Ejercicio , Humanos , Modalidades de Fisioterapia
14.
Eur J Intern Med ; 47: 17-24, 2018 01.
Artículo en Inglés | MEDLINE | ID: mdl-28911936

RESUMEN

Pulmonary hypertension is a potentially life-threatening condition. Given its evolving definition, the incidence and prevalence of the disease is difficult to define, but registries suggest an increased global awareness. The management of patients with pulmonary arterial hypertension is highly specialised and requires multi-disciplinary input from a range of healthcare professionals, including cardiologists, respiratory physicians, rheumatologists, rehabilitation physicians and cardio-pulmonary physiotherapists. Historically, exercise training in pulmonary hypertension has not been recommended because of safety concerns. However, an increasing number of studies have demonstrated the benefit of exercise training on exercise capacity, peak oxygen consumption and quality of life. Systemic hypertension is one of the most important risk factors for cardiovascular disease, and has been ranked as the leading cause for death and disability worldwide: therefore, adequate control of blood pressure is important for public health. Lowering of blood pressure and prevention of hypertension is in first instance preferable by lifestyle changes. These include weight loss, moderation of alcohol intake, a diet with increased fresh fruit and vegetables, reduced saturated fat, reduced salt intake, reduced stress, and, finally, increased physical activity. With regard to the latter, former guidelines predominantly recommended aerobic exercises such as walking, jogging, and cycling for lowering blood pressure. The main focus of this narrative overview paper is to briefly examine and summarize the benefit of exercise training in patients with pulmonary and systemic hypertension, suggest mechanisms by which exercise may improve symptoms and function and provide evidence-based recommendations regarding the frequency and intensity of exercise in these patients.


Asunto(s)
Terapia por Ejercicio , Hipertensión Pulmonar/prevención & control , Hipertensión Pulmonar/rehabilitación , Hipertensión/prevención & control , Hipertensión/rehabilitación , Presión Sanguínea , Medicina Basada en la Evidencia , Humanos , Estilo de Vida , Calidad de Vida , Factores de Riesgo
15.
Adv Exp Med Biol ; 1000: 65-84, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-29098616

RESUMEN

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.


Asunto(s)
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 Vida
16.
Aten. prim. (Barc., Ed. impr.) ; 49(8): 473-483, oct. 2017. tab, ilus, graf
Artículo en Español | IBECS | ID: ibc-167042

RESUMEN

Objetivo: Evaluar los efectos de un programa recreativo de actividad física general, de intensidad moderada y corta duración, sobre las cifras de hipertensión arterial y otros factores de riesgo cardiovascular (FRCV) en hipertensos mayores de 50 años. Diseño: Estudio cuasi-experimental no aleatorizado con diseño pre-post. Emplazamiento: Íllora (Granada). Participantes: Sesenta sujetos sedentarios de 50-75 años pertenecientes al programa de hipertensos del Centro de Salud. Intervención: Programa lúdico de actividad física general donde predomina la capacidad aeróbica, 3días/semana, durante 4 semanas, y una intensidad del 45-55% de la FC Reserva. Mediciones principales: PAS, PAD, FC, IMC, colesterol total, HDL, LDL, TG y glucosa. Resultados y conclusiones: Disminuciones estadísticamente significativas (p < 0,05) en el IMC (-0,51%; IC95%: 30,26-31,93 unid), la FC (-5,57 lat/min; IC95%: 68,76-71,73 lat/min), la PAS (-14,82 mmHg; IC95%: 131,57-137,52 mmHg), la PAD (-5,33 mmHg; IC95%: 78,94-83,68 mmHg), la glucosa (-7,63 mg/dl; IC95%: 125,06-153,73 mg/dl) y el riesgo REGICOR (-20,46%; IC95%: 5,45-6,90%). Aumentos estadísticamente significativos en el HDL (+2,82mg/dl; IC95%: 46,78-52,11 mg/dl) y los TG (+8,27 mg/dl; IC95% 133,89-152,60 mg/dl). Según el sexo, los hombres presentaron la mayor variación en la FC y la PAD, y las mujeres en la PAS (p < 0,05). Sujetos con valores iniciales de PAS≥160mmHg experimentaron mayores descensos de FC, PAS, PAD, glucosa y TG (-(-10,67lat/min, -31mmHg, -8,27mmHg, -10,86mg/dl y 34,66mg/dl, respectivamente) que aquellos con PAS inicial < 160 mmHg, donde aumentó el HDL y disminuyó el LDL. Tras este programa se obtuvieron mejoras en la presión arterial y otros FRCV en sujetos hipertensos mayores de 50 años (AU)


Objectives: To evaluate the effects of a recreational general physical activity program with moderate intensity and short duration on blood pressure and other cardiovascular risk factors (BMI, cholesterol, Rest Heart Rate, HDL, LDL, Triglycerides) in hypertensive patients older than 50 years. Design: Non-randomised pre-post design, quasi-experimental study. Location: Íllora, Granada, Spain. Participants: A total of 60 subjects aged 50-75 years taking part in the Health Hypertensive Program in the Medical Centre were selected. Intervention: A recreational general physical activity program, mainly aerobic capacity, of 4weeks duration, 3days/week, and an intensity of 45-55% HR Reserve. Main measurements: SBP, DBP, HR, BMI, total cholesterol, HDL, LDL, TG, and Glucose. Results and conclusions: Statistically significant decreases (P < .05) were observed in BMI (-0.51%; 95%CI: 30.26 to 31.93 units), HR (-5.57 beats/min; 95% CI: 68.76 to 71.73 beats/min), SBP (-14.82 mmHg; 95%CI: 131.57 to 137.52 mmHg), DBP (-5.33 mmHg; 95%CI: 78.94 to 83.68 mmHg), Glucose (-7.63 mg/dL; 95%CI: 125.06 to 153.73 mg/dL) and REGICOR risk (-20.46%; 95%CI: 5.45 to 6.90%). Statistically significant increases were observed in HDL (+2.82 mg/dl; 95%CI: 46.78 to 52.11 mmHg), and TG (+8.27 mg/dl; 95%CI: 133.89 to 152.60 mg/dL). Men had a wider variation in HR and DBP, and women in SBP (P<.05). Subjects with baseline SBP≥160 mmHg experienced greater declines in HR, SBP, DBP, Glucose and TG (-10.67 beats/min, -31 mmHg, -8.27 mmHg, -10.86mg/dL, and 34.66mg/dL, respectively) than those with an initial SBP<160 mmHg, where there was an increase in HDL and a decrease in LDL. After this program, improvements in BP and other cardiovascular risk factors were obtained in hypertensive subjects over 50 years (AU)


Asunto(s)
Humanos , Masculino , Femenino , Persona de Mediana Edad , Anciano , Terapia por Ejercicio/métodos , Hipertensión/rehabilitación , Enfermedades Cardiovasculares/prevención & control , Ejercicio Físico/fisiología , Evaluación de Programas y Proyectos de Salud , Programas Gente Sana , Factores de Riesgo , Conducta Sedentaria , Presión Sanguínea/fisiología
17.
Indian Heart J ; 69(4): 485-490, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28822516

RESUMEN

OBJECTIVE: Arterial aging along with increased blood pressure(BP) has become the major cardiovascular(CV) risk in elderly. The aim of the study was to compare the effects of yoga program and walking-exercise on cardiac function in elderly with increased pulse pressure (PP). METHODS: An open label, parallel-group randomized controlled study design was adopted. Elderly individuals aged ≥60 years with PP≥60mmHg were recruited for the study. Yoga (study) group (n=30) was assigned for yoga training and walking (exercise) group (n=30) for walking with loosening practices for one hour in the morning for 6days in a week for 3 months. The outcome measures were cardiac time intervals derived from pulse wave analysis and ECG: resting heart rate (RHR), diastolic time(DT), ventricular ejection time(LVET), upstroke time(UT), ejection duration index (ED%), pre-ejection period (PEP), rate pressure product (RPP) and percentage of mean arterial pressure (%MAP). RESULTS: The mean within-yoga group change in RHR(bpm) was 4.41 (p=0.031), PD(ms): -50.29 (p=0.042), DT(ms): -49.04 (p=0.017), ED%: 2.107 (p=0.001), ES(mmHg/ms): 14.62 (p=0.118), ET(ms): -0.66 (p=0.903), UT(ms): -2.54 (p=0.676), PEP(ms): -1.25 (p=0.11) and %MAP: 2.08 (p=0.04). The mean within-control group change in HR (bpm) was 0.35 (p=0.887), PD (ms): 11.15(p=0.717), DT (ms): 11.3 (p=0.706), ED%: -0.101 (p=0.936), ES (mmHg/ms): 0.75 (p=0.926), ET(ms): 2.2 (p=0.721), UT(ms):4.7(p=455), PEP (ms): 2.1(p=0.11), %MAP: 0.65 (p=0.451). A significant difference between-group was found in RHR (p=0.036), PD (p=0.02), ED% (p=0.049), LVET (p=0.048), DT (p=0.02) and RPP (p=0.001). CONCLUSIONS: Yoga practice for 3 months showed a significant improvement in diastolic function with a minimal change in systolic function. Yoga is more effective than walking in improving cardiac function in elderly with high PP.


Asunto(s)
Presión Sanguínea/fisiología , Frecuencia Cardíaca/fisiología , Hipertensión/rehabilitación , Volumen Sistólico/fisiología , Función Ventricular Izquierda/fisiología , Caminata/fisiología , Yoga , Anciano , Electrocardiografía , Femenino , Humanos , Hipertensión/fisiopatología , Masculino , Persona de Mediana Edad , Factores de Tiempo
18.
Turk Kardiyol Dern Ars ; 45(5): 434-440, 2017 Jul.
Artículo en Turco | MEDLINE | ID: mdl-28694397

RESUMEN

OBJECTIVE: Pulmonary arterial hypertension (PAH) is a rare disease. Although muscle strength, exercise capacity, quality of life, and activities of daily living of patients with PAH are affected, it is not known how they are affected by disease severity. The purpose of the present study was to investigate effects of disease severity on upper extremity muscle strength, exercise capacity, and performance of activities of daily living in patients with PAH. METHODS: Twenty-five patients with disease severity classified according to the New York Heart Association (NYHA) as functional class II (n=14) or class III (n=11) were included in the study. Upper-extremity exercise capacity and limitations in performing activities of daily living were assessed with 6-minute pegboard and ring test (6PBRT) and the Milliken activities of daily living scale (MAS), respectively. Shoulder flexion, elbow extension, elbow flexion muscle strength, and handgrip strength were measured with dynamometer. RESULTS: There were no significant differences in age, gender, body mass index, or mean pulmonary artery pressure between groups (p>0.05). The 6PBRT, MAS, and elbow flexion (right) and grip strength (right and left) results were significantly lower in NYHA III group than in NYHA II group (p=0.004, p=0.002, p=0.043, p=0.002 and p=0.003, respectively). There was no significant difference in shoulder flexion, elbow flexion (left), or elbow extension between groups (p>0.05). CONCLUSION: Results suggest that upper extremity exercise capacity, elbow flexion muscle strength (right), and handgrip strength decrease and that limitations in activities of daily living grow as disease severity increases in patients with PAH. When planning rehabilitation programs, disease severity should be considered and evaluations and treatments for the upper extremities should be included.


Asunto(s)
Actividades Cotidianas , Ejercicio Físico/fisiología , Hipertensión/fisiopatología , Fuerza Muscular/fisiología , Arteria Pulmonar/fisiopatología , Extremidad Superior/fisiopatología , Anciano , Índice de Masa Corporal , Codo/fisiopatología , Femenino , Fuerza de la Mano , Humanos , Hipertensión/rehabilitación , Masculino , Persona de Mediana Edad , Dinamómetro de Fuerza Muscular , Presión Esfenoidal Pulmonar , Rango del Movimiento Articular/fisiología , Índice de Severidad de la Enfermedad , Articulación del Hombro/fisiopatología
19.
Clinics (Sao Paulo) ; 72(6): 363-369, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28658436

RESUMEN

OBJECTIVES:: The objective of this study was to compare the effects of a combination of aerobic and resistance training to those of isolated aerobic training on blood pressure, body composition, and insulin sensitivity in hypertensive older adults. METHOD:: Forty-four patients were randomly assigned to the aerobic group, resistance and aerobic group, and control group. Before and after 10 weeks, the following data were obtained: 24-hour ambulatory blood pressure data, abdominal circumference, waist circumference, body mass index, lean mass, fat mass, and insulin sensitivity. The study was conducted with 3 training sessions per week. RESULTS:: Comparison revealed significant reductions in the body mass index, abdominal and waist circumferences, and ambulatory blood pressure (24-hour, wakefulness and sleep systolic/diastolic blood pressures) in both the aerobic group and the resistance and aerobic (combined) group. The fat mass only changed in the combined group. There was no difference in the insulin sensitivity in any group. CONCLUSIONS:: The combined treatment and aerobic treatment alone were equally effective in reducing the blood pressure, body mass index, and abdominal and waist circumferences, although the addition of the resistance component also helped reduce the fat mass.


Asunto(s)
Presión Sanguínea/fisiología , Terapia por Ejercicio/métodos , Hipertensión/rehabilitación , Resistencia a la Insulina/fisiología , Entrenamiento de Resistencia/métodos , Adulto , Anciano , Monitoreo Ambulatorio de la Presión Arterial , Composición Corporal/fisiología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
20.
Arq Bras Cardiol ; 108(6): 539-545, 2017.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-28562833

RESUMEN

Background:: Baroreceptors act as regulators of blood pressure (BP); however, its sensitivity is impaired in hypertensive patients. Among the recommendations for BP reduction, exercise training has become an important adjuvant therapy in this population. However, there are many doubts about the effects of resistance exercise training in this population. Objective:: To evaluate the effect of resistance exercise training on BP and baroreceptor sensitivity in spontaneously hypertensive rats (SHR). Method:: Rats SHR (n = 16) and Wistar (n = 16) at 8 weeks of age, at the beginning of the experiment, were randomly divided into 4 groups: sedentary control (CS, n = 8); trained control (CT, n = 8); sedentary SHR (HS, n = 8) and trained SHR (HT, n = 8). Resistance exercise training was performed in a stairmaster-type equipment (1.1 × 0.18 m, 2 cm between the steps, 80° incline) with weights attached to their tails, (5 days/week, 8 weeks). Baroreceptor reflex control of heart rate (HR) was tested by loading/unloading of baroreceptors with phenylephrine and sodium nitroprusside. Results:: Resistance exercise training increased the soleus muscle mass in SHR when compared to HS (HS 0.027 ± 0.002 g/mm and HT 0.056 ± 0.003 g/mm). Resistance exercise training did not alter BP. On the other hand, in relation to baroreflex sensitivity, bradycardic response was improved in the TH group when compared to HS (HS -1.3 ± 0.1 bpm/mmHg and HT -2.6 ± 0.2 bpm/mmHg) although tachycardia response was not altered by resistance exercise (CS -3.3 ± 0.2 bpm/mmHg, CT -3.3 ± 0.1 bpm/mmHg, HS -1.47 ± 0.06 bpm/mmHg and HT -1.6 ± 0.1 bpm/mmHg). Conclusion:: Resistance exercise training was able to promote improvements on baroreflex sensitivity of SHR rats, through the improvement of bradycardic response, despite not having reduced BP. Fundamento:: Os barorreceptores atuam como reguladores da pressão arterial (PA); no entanto, sua sensibilidade encontra-se prejudicada em pacientes hipertensos. Dentre as recomendações para a redução da PA, o treinamento físico tem se tornado um importante adjunto na terapia dessa população. Porém, ainda há diversos questionamentos sobre os efeitos de treinamento físico resistido nessa população. Objetivo:: Avaliar o efeito do treinamento físico resistido na PA e na sensibilidade de barorreceptores em ratos espontaneamente hipertensos (SHR). Método:: Ratos SHR (n = 16) e Wistar (n = 16) com 08 semanas de idade foram aleatoriamente divididos em 4 grupos: controle sedentário (CS, n = 8); controle treinado (CT, n = 8); SHR sedentário (HS, n = 8) e SHR treinado (HT, n = 8). O treinamento físico foi realizado em aparato com degraus (1,1 × 0,18 m, 2 cm entre os degraus, 80° inclinação) com peso fixado na cauda, (5 vezes por semana durante 8 semanas). O controle barorreflexo da frequência cardíaca (FC) foi testado com estímulos de fenilefrina e nitroprussiato de sódio. Resultados:: O treinamento resistido foi capaz de aumentar a massa muscular do sóleo em ratos SHR (HS 0,027 ± 0,002 g/mm e HT 0,056 ± 0,003 g/mm). Não houve alteração da PA com o treinamento. Por outro lado, houve melhora na resposta bradicárdica da sensibilidade barorreflexa no grupo HT (HS -1,3 ± 0,1 bpm/mmHg e HT -2,6 ± 0,2 bpm/mmHg), no entanto, a resposta taquicárdica não foi alterada pelo exercício resistido (CS -3,3 ± 0,2 bpm/mmHg, CT -3,3 ± 0,1 bpm/mmHg, HS -1,47 ± 0,06 e HT -1,6 ± 0,1). Conclusão:: O exercício físico resistido foi capaz de otimizar a sensibilidade barorreflexa dos ratos SHR por meio da melhora à resposta bradicárdica, apesar de não alterar a PA.


Asunto(s)
Barorreflejo/fisiología , Hipertensión/rehabilitación , Condicionamiento Físico Animal/fisiología , Entrenamiento de Resistencia , Animales , Hipertensión/fisiopatología , Masculino , Ratas , Ratas Endogámicas SHR , Ratas Wistar
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