Hypertension affects 25% of the world's population and is considered a risk factor for cardiovascular disorders and other diseases. The aim of this study was to examine the evidence regarding the acute effect of exercise on blood pressure (BP) using meta-analytic measures. Sixty-five studies were compared using effect sizes (ES), and heterogeneity and Z tests to determine whether the ES were different from zero. The mean corrected global ES for exercise conditions were -0.56 (-4.80 mmHg) for systolic BP (sBP) and -0.44 (-3.19 mmHg) for diastolic BP (dBP; z ≠ 0 for all; p < 0.05). The reduction in BP was significant regardless of the participant's initial BP level, gender, physical activity level, antihypertensive drug intake, type of BP measurement, time of day in which the BP was measured, type of exercise performed, and exercise training program (p < 0.05 for all). ANOVA tests revealed that BP reductions were greater if participants were males, not receiving antihypertensive medication, physically active, and if the exercise performed was jogging. A significant inverse correlation was found between age and BP ES, body mass index (BMI) and sBP ES, duration of the exercise's session and sBP ES, and between the number of sets performed in the resistance exercise program and sBP ES (p < 0.05). Regardless of the characteristics of the participants and exercise, there was a reduction in BP in the hours following an exercise session. However, the hypotensive effect was greater when the exercise was performed as a preventive strategy in those physically active and without antihypertensive medication.

The brain-derived neurotrophic factor (BDNF) is a protein mainly synthetized in the neurons. Early evidence showed that BDNF participates in cognitive processes as measured at the hippocampus. This neurotrophin is as a reliable marker of brain function; moreover, recent studies have demonstrated that BDNF participates in physiological processes such as glucose homeostasis and lipid metabolism. The BDNF has been also studied using the exercise paradigm to determine its response to different exercise modalities; therefore, BDNF is considered a new member of the exercise-related molecules. The high-intensity interval training (HIIT) is an exercise protocol characterized by low work volume performed at a high intensity [i.e., ≥80% of maximal heart rate (HRmax)]. Recent evidence supports the contention that HIIT elicits higher fat oxidation in skeletal muscle than other forms of exercise. Similarly, HIIT is a good stimulus to increase maximal oxygen uptake (VO2max). Few studies have investigated the impact of HIIT on the BDNF response. The present work summarizes the effects of acute and long-term HIIT on BDNF.

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Background:Health-related quality of life measures are widely used in patients with chronic obstructive pulmonary disease (COPD). However, they are extremely limited when used to evaluate patients outside the clinical trials. The aim of this study was to analyse the burden of the disease using a simple, validated, self-administered questionnaire specifically developed for patients in daily clinical practice.Methods:A total of 3935 patients (74.5% men; mean age, 67 years) participated in a cross-sectional study. The burden of COPD on patients was measured using the Clinical COPD Questionnaire (CCQ). COPD was rated at four levels by the forced expiratory volume in one second (FEV1) according to The Global Initiative for Chronic Obstructive Lung Disease (GOLD) scale.Results:The disease mainly affects old men (more than 50% were over 65 years of age) and non-employed men (23% were employed). Of the patients studied, 22.7% continued smoking, especially men (24.4% of men vs. 18.1% of women). Most patients (54%) were diagnosed with moderate stage II COPD. Severity of COPD was lower in women: 29.6% of men had severe COPD compared with 13.7% of women. During the last year, 65.1% had at least one acute exacerbation and 36.6% were admitted to hospital because of COPD exacerbation. No association was found between the body mass index and COPD stage. The variable that most influenced the disease burden was dyspnoea, as progression from grade 0 to grade 4 increased the disease burden by 1.78 points for symptoms, 2.43 for functional state and 1.53 for mental state. The functional classification of COPD also had a significant influence on the disease burden.Conclusions:The present findings show that dyspnoea and the degree of airflow limitation are the clinical variables that most affect the burden of COPD from the patient’s point of view.

SUMMARY BackgroundThe prevalence of gastro-oesophageal reflux disease (GERD), has not been characterized in Spain.

According to the current clinical practice guidelines for chronic obstructive pulmonary disease (COPD), the addition of inhaled corticosteroids (ICS) to long-acting β2 agonist therapy is recommended in patients with moderate-to-severe disease and an increased risk of exacerbations. However, ICS are largely overprescribed in clinical practice, and most patients are unlikely to benefit from long-term ICS therapy.Evidence from recent randomized-controlled trials supports the hypothesis that ICS can be safely and effectively discontinued in patients with stable COPD and in whom ICS therapy may not be indicated, without detrimental effects on lung function, health status, or risk of exacerbations. This article summarizes the evidence supporting the discontinuation of ICS therapy, and proposes an algorithm for the implementation of ICS withdrawal in patients with COPD in clinical practice.Given the increased risk of potentially serious adverse effects and complications with ICS therapy (including pneumonia), the use of ICS should be limited to the minority of patients in whom the treatment effects outweigh the risks.

Background: Brain-derived neurotrophic factor (BDNF) increases neuronal viability and cognitive function, peripheral lipid metabolism and skeletal muscle repair. The primary purpose of this study was to determine the effect of short-term highintensity interval training (HIIT) on serum BDNF concentrations in healthy young women. Methods: Seventeen women (age:22 ± 1 years); body mass index (BMI:24.2 ± 2.2 kg/m²), body fat percentage (% fat:25.8 ± 4.7) participated in the study. Participants were randomly assigned to a control (n = 8) or HIIT group (n = 9). All participants performed a graded exercise test (GXT) on an electronically-braked cycle ergometer to determine maximal aerobic power (MAP, Watts). HIIT was performed three days per week for four weeks. Each HIIT session consisted of three to five cycling bouts of 30 s each at 80% MAP, followed by four-minutes of recovery at 40% MAP. Forty-eight hours after the last bout of exercise, both groups performed a follow-up GXT. Non-fasting blood samples were collected before and immediately after each GXT. Mixed factorial (2 groups x 4 measures, and 2 groups x 2 measures) ANOVA was used to assess BDNF concentrations, performance and anthropometric variables. Results: Serum BDNF concentrations in the HIIT group (21.9 ± 1.3 ng/mL) increased compared to control (19.2 ± 2.8 ng/mL) (∼12%, P < 0.05) following HIIT. In contrast, circulating BDNF concentrations were reduced following the GXT (P < 0.05). The MAP and % Fat did not change with HIIT. Conclusions: Twelve sessions of HIIT increases circulating BDNF concentrations in healthy young women despite no change in physical performance or % fat.

In this study, we assessed initial hydration status (stadium arrival urine specific gravity), fluid balance (pre-and post-game nude body weight, fluid intake, urine collection), and core temperature changes (pre-game, half-time, post-game) during a professional soccer game. We monitored 17 male players (including goalkeepers) between arrival at the stadium and the end of the game (3 h), playing at 34.98C and 35.4% relative humidity, for an average wet bulb globe temperature (WBGT) heat stress index of 31.98C. Data are reported as mean9standard deviation (range). Initial urine specific gravity was 1.0189 0.008 (1.003Á1.036); seven players showed urine specific gravity ]1.020. Over the 3 h, body mass loss was 2.5890.88 kg (1.08Á4.17 kg), a dehydration of 3.3891.11% body mass (1.68Á5.34% body mass). Sweat loss was 444891216 ml (2950Á 6224 ml) versus a fluid intake of 19489954 ml (655Á4288 ml). Despite methodological problems with many players, core temperatures ]39.08C were registered in four players by half-time, and in nine players by the end of the game. Many of these players incurred significant dehydration during the game, compounded by initial hypohydration; thermoregulation may have been impaired to an extent we were unable to measure accurately. We suggest some new recommendations for soccer players training and competing in the heat to help them avoid substantial dehydration.