Inter-individual responses of post-exercise hypotension in older adults with hypertension: An exploratory analysis of different exercise modalities.

Background: Various physical exercise modalities can acutely reduce blood pressure (BP). However, not all individuals respond similarly after an exercise session. Purpose: To measure inter-individual variations in 24-h BP after a single bout of various exercise modalities in older adults with hypertension. Methods: This retrospective study analyzed data from participants with hypertension (≥60 years) previously included in three randomized controlled trials on this topic. BP was assessed using ambulatory BP monitoring. We compared the mean changes in total 24-h, daytime, and nighttime BP after aerobic (AE, n = 19), combined (COMB, n = 19), resistance (RES, n = 23), and isometric handgrip (ISO, n = 18) exercise sessions to a non-exercising control session (C). The minimum detectable changes to classify the participant as a "Responder" for the corresponding exercise protocol were 4 and 2 mmHg for systolic and diastolic BP, respectively. Results: The prevalence of Responders for systolic BP was as follows: AE 24-h: 37%, daytime: 47% and nighttime: 37%; COMB 24-h: 26%, daytime: 21% and nighttime: 32%; RES 24-h: 26%, daytime: 26% and nighttime: 35%; and ISO 24-h: 22%, daytime: 22% and nighttime: 39%. For diastolic BP, the prevalence of Responders was as follows: AE 24-h: 53%, daytime: 53% and nighttime: 31%; COMB 24-h: 26%, daytime: 26% and nighttime: 31%; RES 24-h: 35%, daytime: 22% and nighttime: 52%; and ISO 24-h: 44%, daytime: 33% and nighttime: 33%. Conclusion: There was a high inter-individual variation of BP after a single bout of various exercises in older adults. Responders had higher BP values on the control day without exercise. Various exercise modalities might acutely reduce 24-h BP in older adults with hypertension.

Isometric handgrip exercise impacts only on very short-term blood pressure variability, but not on short-term blood pressure variability in hypertensive individuals: A randomized controlled trial.

Background: The effect of a single isometric handgrip exercise (IHG) on blood pressure (BP) variability (BPV) has not been addressed. This randomized controlled trial evaluated the effect of IHG vs. sham on BPV and BP. Methods: Hypertensive patients using up to two BP-lowering medications were randomly assigned to IHG (4 × 2 min; 30% of maximal voluntary contraction, MVC, with 1 min rest between sets, unilateral) or sham (protocol; 0.3% of MVC). Systolic and diastolic BP were assessed beat-to-beat in the laboratory before, during, and post-intervention and also using 24-h ambulatory BP monitoring (ABPM). BPV was expressed as average real variability (ARV) and standard deviation (SD). Results: Laboratory BPV, ARV and SD variability, had marked increase during the intervention, but not in the sham group, decreasing in the post-intervention recovery period. The overall change in ARV from pre- to 15 min post-intervention were 0.27 ± 0.07 (IHG) vs. 0.05 ± 0.15 (sham group), with a statistically significant p-value for interaction. Similarly, mean systolic BP increased during the intervention (IHG 165.4 ± 4.5 vs. sham 152.4 ± 3.5 mmHg; p = 0.02) as did diastolic BP (104.0 ± 2.5 vs. 90.5 ± 1.7 mmHg, respectively; p < 0.001) and decreased afterward. However, neither the short-term BPV nor BP assessed by ABPM reached statistically significant differences between groups. Conclusion: A single session of IHG reduces very short-term variability but does not affect short-term variability. IHG promotes PEH in the laboratory, but does not sustain 24-h systolic and diastolic PEH beyond the recovery period.

Aerobic exercise and telomere length in patients with systolic heart failure: protocol study for a randomized controlled trial.

BACKGROUND: Heart failure (HF) with reduced ejection fraction (HFrEF) is a syndrome that leads to fatigue and reduced functional capacity due to disease-related pathophysiological mechanisms. Aerobic exercise (AERO) plays a key role in improving HF outcomes, such as an increase in peak oxygen uptake (VO2peak). In addition, HF promotes cell senescence, which involves reducing telomere length. Several studies have shown that patients with a worse prognosis (i.e., reduced VO2 peak) also have shorter telomeres. However, the effects of AERO on telomere length in patients with HFrEF are still unknown. In an attempt to fill this gap, we designed a study to determine the effects of 16 weeks of aerobic training (32 sessions) on telomere length in HFrEF patients. METHODS: In this single-center randomized controlled trial, men and women between 50 and 80 years old will be allocated into two different groups: a moderate-intensity aerobic training and a control grouTelomere length, functional capacity, echocardiographic variables, endothelial function, and walking ability will be assessed before and after the 16-week intervention period. DISCUSSION: Understanding the role of physical exercise in biological aging in HFrEF patients is relevant. Due to cell senescence, these individuals have shown a shorter telomere length. AERO can delay biological aging according to a balance in oxidative stress through antioxidant action. Positive telomere length results are expected for the aerobic training group. TRIAL REGISTRATION: ClinicalTrials.gov NCT03856736 . Registered on February 27, 2019.

Night shift work, short sleep and obesity.

BACKGROUND: Obesity is associated with increased general mortality and comorbidities, it is multifactorial and some evidence has shown that sleep duration and shift work may be implicated in its pathogenesis. OBJECTIVES: The aim of this study was to evaluate the association between shift work, quality of life and obesity among healthcare workers of a Brazilian University Hospital. METHODS: A cross-sectional study was performed from April 2013 to December 2014 with 200 workers of a University Hospital. Sociodemographic data were evaluated and BREF WHOQOL was used for quality of life. The physical activity was evaluated using the International Physical Activity Questionnaire (IPAQ), Chronotypes and daily sleep preference were investigated using Munich Chronotype Questionnaire (MCTQ). Venous blood was collected after 12-h of fasting for laboratory tests. RESULTS: In this sample, the night shift workers had higher income and were older compared to day shift workers. Night shift workers sleep less hours, had higher weight, body mass index and abdominal circumference when compared to the day shift workers. Night shift workers had almost 3 times higher association with abdominal obesity independent of age and gender, than day shift workers. MCTQ parameters showed that night shift workers had lower sleep duration during working days and also during free days, associated with a higher level of social jetlag. Social jetlag had an association with obesity. We found no difference for quality of life between shifts. CONCLUSIONS: Night work was a risk factor for abdominal obesity, social jetlag was higher in night shift workers and it was associated with presence of obesity.

[Six-minute walk work is not correlated to the degree of airflow obstruction in patients with Chronic Obstructive Pulmonary Disease (COPD)].

INTRODUCTION: The six-minute walking test distance, despite being considered the main parameter, does not consider body weight which is known to influence exercise capacity. A body of evidence shows the degree of airflow obstruction does not correlate to walking distance and the body weight affects the work/energy required to perform the walk. OBJECTIVE: To verify if the degree of airflow obstruction correlates to six-minute walk work obtained by weight-walking distance product. PATIENT AND METHODS: A total of 60 patients with chronic obstructive pulmonary disease were evaluated. The physiological and functional variables were correlated to distance and body weight walking distance product (WxW). RESULTS: There were no correlations between six- minute walk work and the degree of airflow obstruction. A positive and significant correlation were observed between the distance and Carbon Monoxide Diffusing Capacity (DLCO) (r=0.6; p<0.01) and between the distance and final SatO 2 (r= 0.3 ; p <0.05). Correlation between distance and Borg scale was negative and significant (r= -0.3; p<0.05). The six-minute walk work was positive and significantly correlated to DLCO (r= 0.7; p<0.01) and negative but significantly correlated to Borg scale in the initial (r= - 0.3; p<0.01) and final of the test (r= -0.4; p<0.05). CONCLUSION: Based on this data, there was no correlation between the degree of airflow obstruction and six-minute walk work test. The DLCO was the only respiratory functional parameter significantly correlated to the distance and to the six- minute walk work.