2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

Eckel, Robert H.; Jakicic, John M.; Ard, Jamy D.; Jesus, Janet de; Miller, Nancy Houston; Hubbard, Van S.; Lee, I-Min; Lichtenstein, Alice H.; Loria, Catherine M.; Millen, Barbara E.; Nonas, Cathy; Sacks, Frank M.; Smith, Sidney C.; Svetkey, Laura P.; Wadden, Thomas A.; Yanovski, Susan Z.

doi:10.1016/j.jacc.2013.11.003

Cited by 1,052 publications

(415 citation statements)

References 117 publications

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“…Unlike the other professional societies’ guidelines, the JNC 8 panel did not address topics outside of their chosen critical questions, specifically given the paucity of randomized trial evidence addressing such questions. While they endorsed the AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk,50 the JNC 8 does not address lifestyle modifications or a timeline for attempting them. Another limitation is that ambulatory BP monitoring, including cut‐off values for diagnosing hypertension based on home BP readings, is not addressed.…”

Section: Jnc 8 Recommendations 6 Tomentioning

confidence: 99%

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

Kovell

Ahmed

Misra

et al. 2015

JAHA

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Section: Jnc 8 Recommendations 6 Tomentioning

confidence: 99%

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

Kovell

Ahmed

Misra

et al. 2015

JAHA

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“…2013; Eckel et al. 2014). Evidence indicates an inverse, dose‐dependent relationship between levels of physical activity and cardiovascular disease, with reductions in blood pressure being one proposed mechanism (Eckel et al.…”

Section: Introductionmentioning

confidence: 99%

Acute cardiac functional and mechanical responses to isometric exercise in prehypertensive males

et al. 2017

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Isometric exercise (IE) training has been shown to reduce resting arterial blood pressure (ABP) in hypertensive, prehypertensive, and normotensive populations. However, the acute hemodynamic response of the heart to such exercise remains unclear. We therefore performed a comprehensive assessment of cardiac structure, function, and mechanics at rest and immediately post a single IE session in 26 male (age 44.8 ± 8.4 years) prehypertensive participants. Conventional echocardiography recorded standard and tissue Doppler measures of left ventricular (LV) structure and function. Speckle tracking echocardiography was used to measure LV global longitudinal, circumferential, and radial strain and strain rate. From this data, apical and basal rotation and rotational velocities, LV twist, systolic twist velocity, untwist velocity, and torsion were determined. IE led to a significant post exercise reduction in systolic (132.6 ± 5.6 vs. 109.4 ± 19.6 mmHg, P < 0.001) and diastolic (77.6 ± 9.4 vs. 58.8 ± 17.2 mmHg, P < 0.001) blood pressure, with no significant change in heart rate (62 ± 9.4 vs. 63 ± 7.5b·min−1, P = 0.63). There were significant reductions in LV end systolic diameter (3.4 ± 0.2 vs. 3.09 ± 0.3 cm, P = 0.002), LV posterior wall thickness (0.99 ± 0.1 vs. 0.9 ± 0.1 cm, P = 0.013), relative wall thickness (0.4 ± 0.06 vs. 0.36 ± 0.05, P = 0.027) estimated filling pressure (E/E' ratio 6.08 ± 1.87 vs. 5.01 ± 0.82, P = 0.006) and proportion of participants with LV concentric remodeling (30.8% vs. 7.8%, P = 0.035), and significant increases in LV ejection fraction (60.8 ± 3 vs. 68.3 ± 4%, P < 0.001), fractional shortening (31.6 ± 4.5 vs. 39.9 ± 5%, P < 0.001), cardiac output (4.3 ± 0.7 vs. 6.1 ± 1L·min−1, P < 0.001), and stroke volume (74.6 ± 11 vs. 96.3 ± 13.5 ml, P < 0.001). In this setting, there were significant increases in global longitudinal strain (−17.8 ± 2.4 vs. −20 ± 1.8%, P = 0.002) and strain rate (−0.88 ± 0.1 vs. −1.03 ± 0.1%, P < 0.001), basal rotation (−5 ± 3.5 vs. −7.22 ± 3.3°, P = 0.047), basal systolic rotational velocity (−51 ± 21.9 vs. −79.3 ± 41.3°·s−1, P = 0.01), basal diastolic rotational velocity (48.7 ± 18.9 vs. 62.3 ± 21.4°·s−1, P = 0.042), LV twist (10.4 ± 5.8 vs. 13.8 ± 5°, P = 0.049), systolic twist velocity (69.6 ± 27.5 vs. 98.8 ± 35.8°·s−1, P = 0.006), and untwist velocity (−64.2 ± 23 vs. −92.8 ± 38°·s−1, P = 0.007). These results suggest that IE improves LV function and mechanics acutely. This may in turn be partly responsible for the observed reductions in ABP following IE training programs and may have important implications for clinical populations.

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“…Regular engagement in PA is an important factor in maintaining cardiovascular health, and as such, several scientific and public health bodies have created minimum PA guidelines for improving cardiovascular health 6, 19, 20. However, despite these guidelines, questions remain about the proper prescription of PA among several populations—including older adults with mobility limitations.…”

Section: Discussionmentioning

confidence: 99%

Association of Accelerometry‐Measured Physical Activity and Cardiovascular Events in Mobility‐Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study

Cochrane

Chen

Fitzgerald

et al. 2017

JAHA

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BackgroundData are sparse regarding the value of physical activity (PA) surveillance among older adults—particularly among those with mobility limitations. The objective of this study was to examine longitudinal associations between objectively measured daily PA and the incidence of cardiovascular events among older adults in the LIFE (Lifestyle Interventions and Independence for Elders) study.Methods and ResultsCardiovascular events were adjudicated based on medical records review, and cardiovascular risk factors were controlled for in the analysis. Home‐based activity data were collected by hip‐worn accelerometers at baseline and at 6, 12, and 24 months postrandomization to either a physical activity or health education intervention. LIFE study participants (n=1590; age 78.9±5.2 [SD] years; 67.2% women) at baseline had an 11% lower incidence of experiencing a subsequent cardiovascular event per 500 steps taken per day based on activity data (hazard ratio, 0.89; 95% confidence interval, 0.84–0.96; P=0.001). At baseline, every 30 minutes spent performing activities ≥500 counts per minute (hazard ratio, 0.75; confidence interval, 0.65–0.89 [P=0.001]) were also associated with a lower incidence of cardiovascular events. Throughout follow‐up (6, 12, and 24 months), both the number of steps per day (per 500 steps; hazard ratio, 0.90, confidence interval, 0.85–0.96 [P=0.001]) and duration of activity ≥500 counts per minute (per 30 minutes; hazard ratio, 0.76; confidence interval, 0.63–0.90 [P=0.002]) were significantly associated with lower cardiovascular event rates.ConclusionsObjective measurements of physical activity via accelerometry were associated with cardiovascular events among older adults with limited mobility (summary score >10 on the Short Physical Performance Battery) both using baseline and longitudinal data.Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01072500.

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2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk

Cited by 1,052 publications

References 117 publications

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

US Hypertension Management Guidelines: A Review of the Recent Past and Recommendations for the Future

Acute cardiac functional and mechanical responses to isometric exercise in prehypertensive males

Association of Accelerometry‐Measured Physical Activity and Cardiovascular Events in Mobility‐Limited Older Adults: The LIFE (Lifestyle Interventions and Independence for Elders) Study

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