Hypertension update, JNC8 and beyond

Shrout, Tara; Rudy, David W.; Piascik, Michael T.

doi:10.1016/j.coph.2017.03.004

Cited by 29 publications

(26 citation statements)

References 35 publications

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“…In this regard, high-intensity interval training (HIIT, defined as repeated bouts of high-intensity exercise interspersed with rest periods) has been reported to be a powerful regimen for improving body composition and cardiovascular, metabolic, and performance variables ( Gibala et al, 2012 ). HIIT also reduces both arterial stiffness and microvascular dysfunction in hypertensive individuals ( Shrout et al, 2017 ), and increases the expression of key proteins such as peroxisome proliferator-activated receptor-γ coactivator 1α and vascular endothelial growth factor, that play an important role in arterial remodeling, in trained/healthy subjects ( Lim et al, 2012 ). Moreover, when compared with endurance exercise, HIIT has been shown to improve endothelial function in subjects at risk for HTN ( Guimaraes et al, 2010 ) and also in patients with metabolic syndrome ( Tjønna et al, 2008 ).…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Non-responders for Blood Pressure and Cardiometabolic Risk Factors Among Prehypertensive Women After Long-Term High-Intensity Interval Training

et al. 2018

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Background: Exercise is known to improve cardiometabolic outcomes; however, results are typically reported as mean values, and there is wide interindividual variability in terms of response that has not been explored in populations at risk for hypertension. Our aim was to investigate both the effects on and the prevalence of non-responders (NRs) for decreasing blood pressure (BP) and other risk factors among prehypertensive women after long-term high-intensity interval training (HIIT). A secondary aim was to report potential variables that can predict decreases in BP after HIIT.Methods: Sedentary overweight/obese women (age 35.9 ± 5.4 year; body mass index [BMI] 30.9 ± 6.2 kg/m2) were assigned to a prehypertensive (PreHTN; N = 44) or normotensive (NT; N = 40) group according to their ambulatory BP at baseline. Subjects underwent a thrice-weekly 16-week HIIT program (7–10 × 1 min exercise with 2 min of rest). Training-induced changes in body composition and cardiovascular, metabolic, strength, and endurance performance markers were measured, and the prevalence of NRs was reported as a percentage. All outcomes were analyzed by multivariable regression.Results: Statistically significant (P < 0.05) decreases in systolic BP (SBP) were detected in the PreHTN group (Δ −8 mmHg) compared with baseline, whereas the NT group (Δ + 3 mmHg) showed a non-significant increase in SBP. Diastolic BP (DBP) was significantly decreased in the PreHTN group (Δ −5.8 mmHg) and non-significantly decreased (Δ −2 mmHg) in the NT group. Also, there were significant differences (P < 0.0001) in the prevalence of NRs based on SBP between the PreHTN and NT groups (11.4 vs. 68.8%), but similar prevalence of NRs based on DBP. SBP alone was a powerful predictive factor for a beneficial SBP reduction, explaining 51.2% of the results, which was similar to other more complex models tested.Conclusion: The prevalence of NRs based on SBP and DBP was different between prehypertensive and normotensive subjects after 16 weeks of HIIT. Other comorbidities such as body composition and metabolic outcomes showed almost similar modifications between prehypertensive and normotensive subjects, being the most basic predictive factor for BP reduction baseline SBP, which we refer to as ‘BP health status’ (51.2%). This improvement in BP was accompanied by other known improvements of HIIT on body composition, metabolic and endurance performance in both study cohorts.Trial Registration: ClinicalTrials.gov ID: NCT03000140 (Register 20 December, 2016).

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Section: Introductionmentioning

confidence: 99%

Prevalence of Non-responders for Blood Pressure and Cardiometabolic Risk Factors Among Prehypertensive Women After Long-Term High-Intensity Interval Training

et al. 2018

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“…Worldwide primary prevention of hypertension is crucial to decreasing associated vascular morbidity and mortality including ischemic heart disease and stroke, two of the leading causes of death (World Health Organization, 2018). The etiology of vascular disease is extensively studied in more developed countries and is attributed to a complex combination of genetics, demographics, nutrition and environment (Shrout, Rudy, & Piascik, 2017). Obesity and physical inactivity are key environmental risk factors for hypertension (Huai et al, 2013;Shihab et al, 2012).…”

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confidence: 99%

Body Mass Index and Risk of Hypertension: 8-Year Prospective Findings From a Nationwide Thai Cohort Study

Thawornchaisit¹,

Looze²,

Reid³

et al. 2019

GJHS

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OBJECTIVE: As Thailand modernizes an ensuing health risk transition associates with rising chronic non-communicable diseases, especially hypertension. This is a driving force for emerging vascular disease, especially stroke and hypertension. Studies in other countries have shown hypertension is associated with obesity. Longitudinal information is needed forthailand and here we present our cohort data collected over 8 years And recording incidence of hypertension and exposure to elevated abnormal BMI. DESIGN & METHODS: BMI effects on incident hypertension were investigated prospectively in a nationwide Thai Cohort Study (TCS) from 2005 to 2013. Data were derived from 42 785 off-campus Sukhothai Thammathirat Open University students returning mail-based questionnaire surveys in both 2005 and 2013. Participants analysed were normotensive at the start (40 548). Multivariable regression estimated adjusted relative risks estimate linking obesity (measured by BMI) and hypertension (self-reported) among Thai men and women. RESULTS: In Thailand from 2005 to 2013 the TCS 8-Year Incidence of hypertension was 5.1% (men 7.1%, women 3.6%), which meant 1958 participants developed hypertension. BMI was directly associated with an increased risk of hypertension. Compared to participants with a normal BMI (18.5-22.9 Kg/M2), The relative risks (95% confidence interval) of developing hypertension with a BMI of ≤ 18.5.23.0–24.9, 25-29.9 and >30 Kg/m2 were 0.54 (0.3-0.97), 1.8(1.49-2.18), 3.27 (2.73-3.91) and 6.73 (5.1-8.97) for men and 0.65 (0.45-0.95), 2.28 (1.81-2.88), 3.71 (2.96-4.64) and 9.72 (7.09-13.32) for women respectively (p-trend <0.0001). CONCLUSION: Our data confirmed the adverse effects of long-term high bmi on an increased risk of hypertension in Thai people. Therefore, Ministry of Public Health should develop a national program to encourage people to remain healthy with a normal BMI. There are many health gains from such a program and the information presented here shows clearly that decreased hypertension would be one of the expected benefits for the Thai population.

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“…The term Pulse Pressure (PP) refers to the difference (in mmHg) between the systolic and diastolic pressures, while the Mean Arterial Pressure (MAP) is the average BP during a single cardiac cycle [ 1 , 2 , 3 ]. Clinicians consider 140 mmHg as the maximum normal adult SBP value, and 90 mmHg as the upper limit for normal DBP value, as suggested by the World Health Organization (WHO) [ 4 ]. Usually, high SBP is caused by the narrowing of the arterioles.…”

Section: Introductionmentioning

confidence: 99%

Advances in the Genetics of Hypertension: The Effect of Rare Variants

Russo

Gaetano

Cugliari

et al. 2018

IJMS

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Worldwide, hypertension still represents a serious health burden with nine million people dying as a consequence of hypertension-related complications. Essential hypertension is a complex trait supported by multifactorial genetic inheritance together with environmental factors. The heritability of blood pressure (BP) is estimated to be 30–50%. A great effort was made to find genetic variants affecting BP levels through Genome-Wide Association Studies (GWAS). This approach relies on the “common disease–common variant” hypothesis and led to the identification of multiple genetic variants which explain, in aggregate, only 2–3% of the genetic variance of hypertension. Part of the missing genetic information could be caused by variants too rare to be detected by GWAS. The use of exome chips and Next-Generation Sequencing facilitated the discovery of causative variants. Here, we report the advances in the detection of novel rare variants, genes, and/or pathways through the most promising approaches, and the recent statistical tests that have emerged to handle rare variants. We also discuss the need to further support rare novel variants with replication studies within larger consortia and with deeper functional studies to better understand how new genes might improve patient care and the stratification of the response to antihypertensive treatments.

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Hypertension update, JNC8 and beyond

Cited by 29 publications

References 35 publications

Prevalence of Non-responders for Blood Pressure and Cardiometabolic Risk Factors Among Prehypertensive Women After Long-Term High-Intensity Interval Training

Prevalence of Non-responders for Blood Pressure and Cardiometabolic Risk Factors Among Prehypertensive Women After Long-Term High-Intensity Interval Training

Body Mass Index and Risk of Hypertension: 8-Year Prospective Findings From a Nationwide Thai Cohort Study

Advances in the Genetics of Hypertension: The Effect of Rare Variants

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