Older Women with Controlled Isolated Systolic Hypertension

Ubolsakka-Jones, Chulee; Sangthong, Benjarat; Aueyingsak, Sahachat; Jones, David A.

doi:10.1249/mss.0000000000000883

Cited by 11 publications

(16 citation statements)

References 31 publications

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“…There was no normotensive CON group in the present study, but there is every reason to think that the patients had abnormally high responses to handgrip exercise before training. In a previous study of ISH (Ubolsakka‐Jones et al, ), the upper bound (+2SD) of sBP at the end of the 2‐min handgrip exercise was 156 mmHg for the normotensive age‐matched subjects and 206 mmHg for the ISH patients; in the present study, the 95th percentile for the ISH patients was 209 mmHg.…”

Section: Discussionsupporting

confidence: 47%

“…There are also indications that there are changes in the central control of BP in ISH. Older people with ISH also show an exaggerated response to muscle contraction compared with age matched normotensive subjects (Ubolsakka‐Jones et al, ) with evidence of an increased metaboreflex, which is reduced with SLB training (Ubolsakka‐Jones et al, and Figure here), most likely through the same mechanism as with essential hypertension.…”

Section: Discussionmentioning

confidence: 91%

“…One of the limitations of the handgrip exercise is that BP was registered with an arm cuff rather than using beat‐by‐beat methodology. Although beat‐by‐beat measurements would be desirable, we have argued elsewhere (Ubolsakka‐Jones et al, ; Ubolsakka‐Jones et al, ) that this mainly affects the variance, but not necessarily the mean value of the measurements made at the end of the contraction because it is difficult to be very precise as to when the measurement is taken. The arm cranking exercise presents problems in terms of measuring BP, but without an indwelling arterial line, it is difficult to see how measurements at the ankle could be improved on.…”

Section: Discussionmentioning

confidence: 99%

“…Some other form of nonpharmacological treatment may be of benefit to these patients, and we have previously demonstrated that SLB is effective in reducing resting sBP (Sangthong et al, ; Ublosakka‐Jones et al, a). Although it is important to reduce resting BP, it would be valuable if the treatment also decreased the exaggerated increase in BP seen during exercise in ISH (Ubolsakka‐Jones et al, ). The results reported here show that 8 weeks of SLB training not only reduced resting BP and HR but also the responses to both static and dynamic exercise.…”

Section: Discussionmentioning

confidence: 99%

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The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

Ubolsakka-Jones

Tongdee

Jones

2019

Physiotherapy Res Intl

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Objectives Slow loaded breathing training has been shown to reduce resting blood pressure (BP) in isolated systolic hypertension (ISH), but it is not known whether this also reduces their exaggerated BP responses to exercise. Methods The study was a randomized controlled trial with block allocation stratified by sex. Twenty ISH patients (68 ± 5 yrs, 11 males) were randomized with one group undertaking 8‐weeks training with slow loaded breathing (SLB: 25% maximum inspiratory pressure, 6 breaths per minute, 60 breaths every day) or deep breathing control (CON), with 8 weeks follow‐up. Outcome measures were home BP and heart rate (HR) with laboratory measures of BP and HR responses to static handgrip and dynamic arm cranking exercise. Data were compared with a two‐week run‐in baseline. Results Home systolic BP fell by 22 mmHg (20–23; mean, 95% CI), diastolic BP by 9 mmHg (7–11), and HR by 12 bpm (9–15; all p < .001) as a result of SLB training. Systolic BP at the end of 2‐min isometric handgrip was 189 ± 10 mmHg (mean, SD) before training and 157 ± 6 mmHg following SLB training. After 4‐min arm exercise, systolic BP, measured at the ankle, was reduced from 243 ± 8 mmHg during the run‐in period to 170 ± 15 mmHg after SLB training with no change for CON. The reduction in exercise BP, in both types of exercise, was partly due to a reduction in resting BP and to a smaller increase above resting. Systolic and pulse pressures remained below run‐in values 8 weeks after the end of SLB training, and BP response to handgrip exercise remained below run‐in values at 4 weeks after SLB training. Conclusions SLB not only reduces resting BP in ISH but also the responses to both static and dynamic exercise, potentially reducing the negative aspect of exercise for cardiovascular health.

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Section: Discussionsupporting

confidence: 47%

Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

Ubolsakka-Jones

Tongdee

Jones

2019

Physiotherapy Res Intl

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“…About 67 million American adults (31%) are affected by HTN, while only 47% of patients maintain normal BP control [3]. Further, HTN has also been found associated with other health issues in various groups of populations, such as the elderly and pregnant women, to name a few [4,5].…”

Section: Introductionmentioning

confidence: 99%

Cuff-Less and Continuous Blood Pressure Monitoring: A Methodological Review

et al. 2017

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Blood pressure (BP) is one of the most important monitoring parameters in clinical medicine. For years, the cuff-based sphygmomanometer and the arterial invasive line have been the gold standards for care professionals to assess BP. During the past few decades, the wide spread of the oscillometry-based BP arm or wrist cuffs have made home-based BP assessment more convenient and accessible. However, the discontinuous nature, the inability to interface with mobile applications, the relative inaccuracy with movement, and the need for calibration have rendered those BP oscillometry devices inadequate for next-generation healthcare infrastructure where integration and continuous data acquisition and communication are required. Recently, the indirect approach to obtain BP values has been intensively investigated, where BP is mathematically derived through the "Time Delay" in propagation of pressure waves in the vascular system. This holds promise for the realization of cuffless and continuous BP monitoring systems, for both patients and healthy populations in both inpatient and outpatient settings. This review highlights recent efforts in developing these next-generation blood pressure monitoring devices and compares various mathematical models. The unmet challenges and further developments that are crucial to develop "Time Delay"-based BP devices are also discussed.

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Priorities in tackling noncommunicable diseases among the population aged 60 years and older in China, 1990–2021: A population-based study

Dai,

Teng,

Zhang

et al. 2024

Ageing Research Reviews

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Older Women with Controlled Isolated Systolic Hypertension

Abstract: Despite being well controlled and normotensive control subjects at rest, ISH patients had high SBP responses to both dynamic and static exercises, which may constitute a risk for cardiovascular incidents.

Cited by 11 publications

References 31 publications

The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

The effects of slow loaded breathing training on exercise blood pressure in isolated systolic hypertension

Cuff-Less and Continuous Blood Pressure Monitoring: A Methodological Review

Priorities in tackling noncommunicable diseases among the population aged 60 years and older in China, 1990–2021: A population-based study

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