Purpose Acute reduction in blood pressure (BP) following an exercise session is evidenced in controlled settings with formal supervision in hypertensive older populations. This study investigated the effect of a self-selected exercise (SSE)-intensity session on ambulatory BP in hypertensive older women in a “real-world” setting. Methods Twenty inactive older women with hypertension (64.9±4.5 years) were included in this randomized, controlled, crossover trial. After baseline assessments, participants performed 30 minutes of an SSE-intensity session on an outdoor track and a control session, separated by 7-10 days. Heart rate (HR), rating of perceived exertion (RPE), and affective response were assessed. Ambulatory BP was monitored for 20 hours following both sessions. Paired t -tests and generalized estimation were used for data analysis. Results Participants exercised at 5.1±1.1 km/h, spent ~90% of the exercise time at moderate–vigorous intensity (≥40% of heart rate reserve). SSE-intensity session was reported as light (RPE 11.0±1.5) and pleasant (affect 3.4±1.2). SSE-intensity session elicited reductions in systolic BP in the first 6 hours postexercise (6.0 mmHg, CI 2.7–9.3 mmHg; P< 0.001). Average systolic BP in the 20-hour (−3.4 mmHg, CI −5.9 to −0.9 mmHg; P =0.010) and awake (−4.0 mmHg, CI −6.4 to −1.6 mmHg; P =0.003) periods were lower following SSE-intensity session compared to control session. No differences were observed in average systolic BP during asleep period and diastolic BP during the 20-hour awake and asleep periods between the SSE-intensity session and control session ( P >0.05). Conclusion An SSE-intensity session elicited a reduction in ambulatory systolic BP in inactive older women with hypertension during awake and 20-hour periods. Also, the SSE-intensity session was reported as light and pleasant.
The effect of physical activity counseling (PAC) in hypertensive adults is unclear. This study investigated the effect of PAC on blood pressure (BP), physical activity level, sitting time, metabolic profile, and body composition in hypertensive adults. Twenty-two hypertensive adults (48.8 ± 7.3 years) participated in this pilot trial. The 12-week PAC was based on the 5 A’s model considering the FITT principle (Frequency, Intensity, Time, and Type) of physical activity. The control group received instructions about FITT in one face-to-face meeting at baseline. Pedometer-measured physical activity, sitting time, resting and ambulatory BP, metabolic profile (cholesterol, triglycerides, fasting glucose), and body composition (fat mass, abdominal fat, fat free mass) were assessed. The PAC group showed higher steps per day (5839 ± 992 vs. 5028 ± 902; p = 0.044) and a trend for lower sitting time (5.6 ± 1.3 vs. 8.0 ± 4.0 h/day; p = 0.059) than the control group. No changes were observed in BP, metabolic profile, and body composition (p > 0.05). In conclusion, 12 weeks of a PAC program based on the 5 A’s model resulted in a modest increase of ~800 steps per day and a trend to decrease ~2 h/day in sitting time, but there were no associated reduction in BP and improvements in metabolic and body composition.
Self-selected exercise intensity (SSE) is a simple approach to encourage an active lifestyle. This study aimed to investigate whether a SSE intensity session meet the recommended intensity for hypertension management (i.e. moderate-vigorous), and whether heart rate (HR), rating of perceived exertion (RPE) and affective responses are reproducible. Thirteen inactive hypertensive older women (age: 64.54 ± 4.16 years; blood pressure: 122.51/62.15 mmHg) performed two 30-minute SSE intensity sessions outdoors. HR reserve (HRR), RPE and affective responses were assessed. Paired t-test, intraclass correlation coefficient (ICC) and typical error (TE) were used for the analyzes. Participants exercised at moderate-vigorous intensity (≥ 40% of HRR). No differences were found for HRR (56.46 ± 8.01% vs. 59.08 ± 10.57%), RPE (11.26 ± 1.14 vs. 10.98 ± 1.52) and affective response (3.47 ± 1.13 vs. 3.38 ± 1.23) (p > 0.05). RPE showed excellent reliability (ICC = 0.82; 95%CI: 0.42; 0.94; p = 0.003). There was a poor reliability for HRR (ICC = 0.40; 95%CI: -0.97; 0.82; p = 0.193) and affective responses (ICC = 0.19; 95%CI: -2.10; 0.76; p = 0.369). TE between sessions for HRR, RPE, and affective response were 8.11 bpm, 0.75 and 1.11, respectively. In conclusion, inactive hypertensive older women seem to meet the recommended intensity for hypertension management when they exercise at a self-selected pace and report it as light-moderate and pleasant. Despite only RPE, but not HR and affective response, has shown good reproducibility, the results seem to support the use of SSE intensity as a simple approach to encourage an active lifestyle in this population.
This study examined the changes in life-space (LS) mobility and objectively measured movement behavior in older adults with hypertension after receiving the COVID-19 vaccine and their associations with housing type. A total of 32 participants were included in this exploratory longitudinal study with a 1-year follow-up. LS mobility and accelerometer-based physical activity (PA) and sedentary behavior (SB) were assessed before and ~2 months after receiving COVID-19 vaccination. Participants residing in apartment/row housing showed an increase in LS mobility composite score (β = 14, p < 0.05). In addition, they showed an increase in light PA on weekdays and the weekend (β = 3.5%; β = 6.5%; p < 0.05) and a decrease in SB on weekdays and the weekend (β = −3.7%; β = −6.6%; p < 0.05). Furthermore, changes in SB pattern were found (less time spent in bouts of ≥10 and 30 min, more breaks/day and breaks/hour). Significant associations were found between changes in LS mobility composite score and PA (positive association) and SB (negative association) in older adults residing in apartment/row housing (p < 0.05). Older adults with hypertension, particularly those who resided in houses with limited outdoor space (apartment/row housing), showed positive changes in LS mobility and objectively measured movement behavior in a period after receiving the COVID-19 vaccine and characterized by social distancing policies without mobility restrictions when compared with the period of social distancing policies with high mobility restrictions and without vaccine.
Purpose: To investigate the short-term effect of self-selected training intensity (SSTI) on ambulatory blood pressure (BP) in hypertensive older women. Participants and Methods: This is a randomized, single-blind, two-arm, parallel-group controlled trial that included 40 medicated hypertensive older women (64.4±3.6 years; resting systolic 118±19 and diastolic BP 68±9 mmHg). SSTI intervention was performed three times per week, 30-50 minutes per session (n=20). The control group participated in health education meetings once per week (n=20). Ambulatory BP (primary outcome) and six-minute walking test performance (secondary outcome) were assessed at baseline and following 8 weeks of intervention. Heart rate (HR), rating of perceived exertion (RPE, 6-20), and affective valence (ie, feeling scale, −5/+5) were recorded during all SSTI sessions. Intention-to-treat and per-protocol analyses were used for data analyses. Results: Fifteen participants from the SSTI group and 17 from the control group completed the study. No differences in ambulatory BP (24-h, awake, and asleep) were observed between SSTI and control groups (intention-to-treat and per-protocol analyses; p>0.05). The SSTI group showed a greater six-minute walking test performance than the control group in the intention-to-treat and per-protocol analyses (p<0.05). The participants exercised at 52±10% of HR reserve reported an RPE of 11±1 and an affective valence of 3.4±1.1 over the 8-week period. Conclusion: SSTI is a feasible approach to induce a more active lifestyle and increase health-related fitness in hypertensive older women, although it does not improve BP control over a short-term period.
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