Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association

Gibbs, Bethany Barone; Hivert, Marie‐France; Jerome, Gerald J.; Kraus, William E.; Rosenkranz, Sara K.; Schorr, Erica; Spartano, Nicole L.; Lobelo, Felipe

doi:10.1161/hyp.0000000000000196

Cited by 104 publications

(84 citation statements)

References 54 publications

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“…These data support current recommendations [ 11 , 32 ] encouraging regular physical activity because exercise intensity was associated with beneficial CV and renal outcomes, from a threshold physical activity level of more than two exercise sessions per week. The benefits of activity levels on renal and CV outcomes were seen in patients with and without diabetes.…”

Section: Discussionsupporting

confidence: 87%

Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk

Böhm

Schumacher²,

Werner

et al. 2022

Cardiovasc Diabetol

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Background Guidelines recommend physical activity to reduce cardiovascular (CV) events. The association between physical activity and progression of chronic kidney disease (CKD) with and without diabetes is unknown. We assessed the association of self-reported physical activity with renal and CV outcomes in high-risk patients aged ≥ 55 years over a median follow-up of 56 months in post-hoc analysis of a previously randomized trial program. Methods Analyses were done with Cox regression analysis, mixed models for repeated measures, ANOVA and χ2-test. 31,312 patients, among them 19,664 with and 11,648 without diabetes were analyzed. Results Physical activity was inversely associated with renal outcomes (doubling of creatinine, end-stage kidney disease (ESRD)) and CV outcomes (CV death, myocardial infarction, stroke, heart failure hospitalization). Moderate activity (at least 2 times/week to every day) was associated with lower risk of renal outcomes and lower incidence of new albuminuria (p < 0.0001 for both) compared to lower exercise levels. Similar results were observed for those with and without diabetes without interaction for renal outcomes (p = 0.097–0.27). Physical activity was associated with reduced eGFR decline with a moderate association between activity and diabetes status (p = 0.05). Conclusions Moderate physical activity was associated with improved kidney outcomes with a threshold at two sessions per week. The association of physical activity with renal outcomes did not meaningfully differ with or without diabetes but absolute benefit of activity was even greater in people with diabetes. Thus, risks were similar between those with diabetes undertaking high physical activity and those without diabetes but low physical activity. Clinical trial registration: http://clinicaltrials.gov.uniqueidentifier:NCT00153101.

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Section: Discussionsupporting

confidence: 87%

Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk

Böhm

Schumacher²,

Werner

et al. 2022

Cardiovasc Diabetol

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“…It is numerical data. Physical Activity [ 39 ]: This feature captures the participant’s physical activity and has 4 categories (high 2.6%, medium 11.2%, low 55.4% and very low 30.8%). It is nominal data.…”

Section: Methodsmentioning

confidence: 99%

Machine Learning Methods for Hypercholesterolemia Long-Term Risk Prediction

Δρίτσας

Trigka

2022

Sensors

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Cholesterol is a waxy substance found in blood lipids. Its role in the human body is helpful in the process of producing new cells as long as it is at a healthy level. When cholesterol exceeds the permissible limits, it works the opposite, causing serious heart health problems. When a person has high cholesterol (hypercholesterolemia), the blood vessels are blocked by fats, and thus, circulation through the arteries becomes difficult. The heart does not receive the oxygen it needs, and the risk of heart attack increases. Nowadays, machine learning (ML) has gained special interest from physicians, medical centers and healthcare providers due to its key capabilities in health-related issues, such as risk prediction, prognosis, treatment and management of various conditions. In this article, a supervised ML methodology is outlined whose main objective is to create risk prediction tools with high efficiency for hypercholesterolemia occurrence. Specifically, a data understanding analysis is conducted to explore the features association and importance to hypercholesterolemia. These factors are utilized to train and test several ML models to find the most efficient for our purpose. For the evaluation of the ML models, precision, recall, accuracy, F-measure, and AUC metrics have been taken into consideration. The derived results highlighted Soft Voting with Rotation and Random Forest trees as base models, which achieved better performance in comparison to the other models with an AUC of 94.5%, precision of 92%, recall of 91.8%, F-measure of 91.7% and an accuracy equal to 91.75%.

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“…In addition to the DASH diet, the Mediterranean diet has been recommended as a healthy dietary pattern that helps reduce blood pressure and cardiovascular (CV) risk ( 13 ). It is characterized by a relatively high intake of fruits, vegetables, nuts, legumes, whole grains, and sea food, with moderate alcohol consumption and a low intake of red/processed meat and saturated fat ( 14 ).…”

Section: Introductionmentioning

confidence: 99%

Associations of Adherence to the DASH Diet and the Mediterranean Diet With All-Cause Mortality in Subjects With Various Glucose Regulation States

2022

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Background and AimsA dietary pattern concordant with either the Dietary Approaches to Stop Hypertension (DASH) diet or the Mediterranean diet has been associated with a lower risk of all-cause mortality in general population. We investigated the associations of adherence to the DASH diet and the Mediterranean diet with all-cause mortality across three glucose regulation states (normal glucose tolerance, prediabetes, and diabetes) using data from the National Health and Nutrition Examination Survey (NHANES).MethodsData from the NHANES participants from 1999 to 2010, including their vital status linked to the National Death Index through the end of 2011, were analyzed. Adherence to the DASH diet and the Mediterranean diet was assessed using the DASH score and the alternative Mediterranean Diet Index (aMED), respectively. Weighted Cox proportional hazards regression models were used to compare the hazard ratios for the associations of adherence (diet score >median vs. ≤ median) to the DASH diet and the Mediterranean diet with all-cause mortality.ResultsA total of 28,905 participants were analyzed, and 2,598 of them had died after a median follow-up of 6.3 years. The median DASH score and aMED were 2 and 3, respectively. Adherence to the Mediterranean diet (aMED >3 vs. ≤ 3), but not the DASH diet, was associated with a lower risk of all-cause mortality (adjusted HR 0.74, 95% CI 0.66–0.83, p < 0.001) in the overall population. The findings were consistent across the three glucose regulation states. A joint effect of aMED >3 and DASH score >2 (adjusted HR 0.71, 95% CI 0.52–0.99, p = 0.042) was noted in participants with diabetes.ConclusionsAdherence to the Mediterranean diet (aMED >median) was associated with reduced all-cause mortality in a general population. For people with diabetes, a dietary pattern concordant with both the DASH diet and the Mediterranean diet (DASH score >median and aMED >median) was associated with a lower risk of mortality.

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Physical Activity as a Critical Component of First-Line Treatment for Elevated Blood Pressure or Cholesterol: Who, What, and How?: A Scientific Statement From the American Heart Association

Cited by 104 publications

References 54 publications

Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk

Association between exercise frequency with renal and cardiovascular outcomes in diabetic and non-diabetic individuals at high cardiovascular risk

Machine Learning Methods for Hypercholesterolemia Long-Term Risk Prediction

Associations of Adherence to the DASH Diet and the Mediterranean Diet With All-Cause Mortality in Subjects With Various Glucose Regulation States

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