Among samples with hypertension in trials of higher study quality, CET rivals aerobic exercise training as antihypertensive therapy. Because of the moderate quality of this literature, additional randomized controlled CET trials that examine BP as a primary outcome among samples with hypertension are warranted to confirm our promising findings.
The overall pattern of a diet (diet quality) is recognized as more important to health and chronic disease risk than single foods or food groups. Indexes of diet quality can be derived theoretically from evidence-based recommendations, empirically from existing datasets, or a combination of the two. We used these methods to derive diet quality indexes (DQI), generated from a novel dietary assessment, and to evaluate relationships with cardiometabolic risk factors in young adults with (n = 106) or without (n = 106) diagnosed depression (62% female, mean age = 21). Participants completed a liking survey (proxy for usual dietary consumption). Principle component analysis of plasma (insulin, glucose, lipids) and adiposity (BMI, Waist-to-Hip ratio) measures formed a continuous cardiometabolic risk factor score (CRFS). DQIs were created: theoretically (food/beverages grouped, weighted conceptually), empirically (grouping by factor analysis, weights empirically-derived by ridge regression analysis of CRFS), and hybrid (food/beverages conceptually-grouped, weights empirically-derived). The out-of-sample CRFS predictability for the DQI was assessed by two-fold and five-fold cross validations. While moderate consistencies between theoretically- and empirically-generated weights existed, the hybrid outperformed theoretical and empirical DQIs in cross validations (five-fold showed DQI explained 2.6% theoretical, 2.7% empirical, and 6.5% hybrid of CRFS variance). These pilot data support a liking survey that can generate reliable/valid DQIs that are significantly associated with cardiometabolic risk factors, especially theoretically- plus empirically-derived DQI.
In previous studies, we found an endothelial nitric oxide synthase gene (NOS3) variant rs2070744 associated with the ambulatory blood pressure (BP) response following bouts of moderate and vigorous intensity acute exercise, termed post‐exercise hypotension (PEH). In a validation cohort, we sequenced NOS3 exons for associations with PEH. Obese (30.9 ± 3.6 kg.m−2) African American (n = 14) [AF] and Caucasian (n = 9) adults 42.0 ± 9.8 years with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous and moderate intensity cycling and control. Subjects were attached to an ambulatory BP monitor for 19 h. We performed deep‐targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. Variant genotypes were coded as number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini–Yekutieli multiple testing‐corrected P‐values under time‐adjusted linear models for 19 hourly BP measurements for each subject. After vigorous intensity over 19 h, among NOS3 variants passing multiple testing thresholds, as the #MA increased in rs891512 (P = 6.4E‐04), rs867225 (P = 6.5E‐04), rs743507 (P = 2.6E‐06), and rs41483644 (P = 2.4E‐04), systolic (SBP) decreased from 17.5 to 33.7 mmHg; and in rs891512 (P = 9.7E‐05), rs867225 (P = 2.6E‐05), rs41483644 (P = 1.6E‐03), rs3730009 (P = 2.6E‐04), and rs77325852 (P = 5.6E‐04), diastolic BP decreased from 11.1 mmHg to 20.3 mmHg among AF only. In contrast, after moderate intensity over 19 h in NOS3 rs3918164, as the #MA increased, SBP increased by 16.6 mmHg (P = 2.4E‐04) among AF only. NOS3 variants exhibited associations with PEH after vigorous, but not moderate intensity exercise among AF only. NOS3 should be studied further for its effects on PEH in a large, ethnically diverse sample of adults with hypertension to confirm our findings.
FURIN is a proprotein convertase subtilisin/kexin enzyme important in pro‐renin receptor processing, and FURIN (furin, paired basic amino acid cleaving enzyme) variants are involved in multiple aspects of blood pressure (BP) regulation. Therefore, we examined associations among FURIN variants and the immediate blood pressure (BP) response to bouts of aerobic exercise, termed postexercise hypotension (PEH). Obese (30.9 ± 3.6 kg m−2) Black‐ (n = 14) and White‐ (n = 9) adults 42.0 ± 9.8 year with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous (VIGOROUS) and moderate (MODERATE) intensity cycling and control. Subjects were then attached to an ambulatory BP monitor for 19 h. We performed deep‐targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. FURIN genotypes were coded as the number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini–Yekutieli multiple testing corrected P‐values under time‐adjusted linear models for 19 hourly BP measurements. After VIGOROUS over 19 h, as FURIN #MA increased in rs12917264 (P = 2.4E‐04) and rs75493298 (P = 6.4E‐04), systolic BP (SBP) decreased 30.4–33.7 mmHg; and in rs12917264 (P = 1.6E‐03) and rs75493298 (P = 9.7E‐05), diastolic BP (DBP) decreased 17.6–20.3 mmHg among Blacks only. In addition, after MODERATE over 19 h in FURIN rs74037507 (P = 8.0E‐04), as #MA increased, SBP increased 20.8 mmHg among Blacks only. Whereas, after MODERATE over the awake hours in FURIN rs1573644 (P = 6.2E‐04), as #MA increased, DBP decreased 12.5 mmHg among Whites only. FURIN appears to exhibit intensity and race‐dependent associations with PEH that merit further exploration among a larger, ethnically diverse sample of adults with hypertension.
Objectives To test the relationship of diet quality and health behavior indexes derived from a validated food liking survey with cardiometabolic health in a convenience sample of non-diabetic patients with diagnosed depression from a psychiatric facility and age-gender matched students from a University setting. Methods One hundred six patients and 106 controls (62% female, mean age = 21) completed a 100-item liking survey comprised of foods, beverages, and physical and sedentary activities. Nutritional items were conceptually grouped, weighted and averaged into a Diet Quality Index (DQI). A Healthy Behavior Index (HBI) was the average of the weighted nutritional and physical activity groups. Higher indexes reflected healthier behaviors. Multiple linear regression was used to relate DQI and HBI with blood pressure and fasting insulin, glucose and serum lipids. BMI, biologic sex and patient status were included as covariates. Some serum markers required transformation to approach normal distribution. Results From BMI, 4% were underweight, 57% normal, 25% overweight, and 14% obese. The liking survey took minutes for participants to complete and little processing to generate the indexes. The DQI and HBI were internally reliable (α = 0.68–0.69), reflected greater than one dimension (principal component analysis), and were normally distributed. Higher DQI scores were significantly related to higher HDL (standardized β = 0.16, P = 0.019) and lower glucose (β = –0.19, P = 0.005), insulin (β = –0.18, P = 0.005) and diastolic blood pressure (β = –0.32, P < 0.001). Adding physical activity, HBI also was related to glucose (β = –0.19, P = 0.008), triglycerides (β =–0.14, P = 0.04) and insulin (β = –0.18, P = 0.006). Patient status was not a significant independent contributor in the models. Conclusions A simple liking survey can produce reliable and valid indexes of diet quality and health behaviors that significantly associated with multiple cardiometabolic risk factors. Funding Sources USDA NIFA, Hatch project.
Female runners using OCs did not exhibit disproportionately increased coagulation. The use of compression socks in women on OCs, surprisingly, resulted in a greater increase in d-dimer after exercise.
Adverse alterations in the skeletal muscle response to exercise have been noted among adults with hypertension. The influence of resting blood pressure (BP) on muscle strength is unknown. We hypothesized that adults with high BP would exhibit lower muscular strength than adults with normal BP. An isokinetic dynamometer tested 21 measures of isometric and isokinetic muscle strength. BP was measured by auscultation. Patients were categorized into having normal (<120 and <80 mmHg) or high (≥120 and/or ≥80 mmHg) BP. Height (cm) and weight (kg) were measured to calculate BMI (kg/m). Analysis of covariance tested differences in muscle strength between BP groups with sex, age, and height as covariates. Patients [420 (49%) men] were middle-aged (44.1±16.1 years) and overweight (26.4±4.8 kg/m) with 187 having normal (107.7±7.3/68.3±6.3 mmHg) and 233 having high (127.8±9.8/80.8±8.1 mmHg) BP. For upper body, three of five extension measures and five of five flexion measures, as well as handgrip, were greater in the high than the normal BP group (P≤0.05). For lower body, five of five extension measures were greater in the high than the normal BP group, whereas there were no differences between BP groups for the five flexion measures (P>0.05). Contrary to our hypothesis, adults with high BP displayed greater muscle strength than adults with normal BP. Reasons for our findings are unclear, but may be because of shifts in muscle fiber type from type I to type IIb/x and oxidative to glycolytic metabolism; alterations may result in a more strength-adapted phenotype among adults with high BP such as we observed.
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