Background: Aerobic capacity has been shown to be inversely proportionate to cardiovascular mortality and morbidity and there is growing evidence that high-intensity interval training (HIIT) appears to be more effective than moderate-intensity continuous training (MICT) in improving cardiorespiratory fitness within the cardiac population. Previously published systematic reviews in cardiovascular disease have neither investigated the effect that the number of weeks of intervention has on cardiorespiratory fitness changes, nor have adverse events been collated. Objective: We aimed to undertake a systematic review and meta-analysis of randomized controlled trials (RCTs) within the cardiac population that investigated cardiorespiratory fitness changes resulting from HIIT versus MICT and to collate adverse events. Methods: A critical narrative synthesis and meta-analysis was conducted after systematically searching relevant databases up to July 2017. We searched for RCTs that compared cardiorespiratory fitness changes resulting from HIIT versus MICT interventions within the cardiac population. Results: Seventeen studies, involving 953 participants (465 for HIIT and 488 for MICT) were included in the analysis. HIIT was significantly superior to MICT in improving cardiorespiratory fitness overall (SMD 0.34 mL/kg/min; 95% confidence interval [CI; 0.2-0.48]; p<0.00001; I 2 =28%). There were no deaths or cardiac events requiring hospitalization reported in any study during training. Overall, there were more adverse events reported as a result of the MICT (n=14) intervention than the HIIT intervention (n=9). However, some adverse events (n=5) were not classified by intervention group. Conclusion: HIIT is superior to MICT in improving cardiorespiratory fitness in participants of cardiac rehabilitation (CR). Improvements in cardiorespiratory fitness are significant for CR programs of >6-week duration. Programs of 7-12 weeks' duration resulted in the largest improvements in cardiorespiratory fitness for patients with coronary artery disease. HIIT appears to be as safe as MICT for CR participants.
Abstract-Previous human clinical trials have shown that probiotic consumption may improve blood pressure (BP) control.The aim of the present systematic review was to clarify the effects of probiotics on BP using a meta-analysis of randomized, controlled trials. PubMed, Scopus, Cochrane Library (Central), Physiotherapy Evidence Database, and Clinicaltrial.gov databases were searched until January 2014 to identify eligible articles. Meta-analysis using a random-effects model was chosen to analyze the impact of combined trials. Nine trials were included. Probiotic consumption significantly changed systolic BP by −3.56 mm Hg (95% confidence interval, −6.46 to −0.66) and diastolic BP by −2.38 mm Hg (95% confidence interval, −2.38 to −0.93) compared with control groups. A greater reduction was found with multiple as compared with single species of probiotics, for both systolic and diastolic BP. Subgroup analysis of trials with baseline BP ≥130/85 mm Hg compared with <130/85 mm Hg found a more significant improvement in diastolic BP. Duration of intervention <8 weeks did not result in a significant reduction in systolic or diastolic BP. Furthermore, subgroup analysis of trials with daily dose of probiotics <10 11 colony-forming units did not result in a significant meta-analysis effect. The present meta-analysis suggests that consuming probiotics may improve BP by a modest degree, with a potentially greater effect when baseline BP is elevated, multiple species of probiotics are consumed, the duration of intervention is ≥8 weeks, or daily consumption dose is ≥10 The online-only Data Supplement is available with this article at http://hyper.ahajournals.org/lookup/suppl
In people with Coronary Heart Disease (CHD), poor adherence to medication, exercise, and dietary recommendations can compromise prognosis. This study investigated respective associations of the Commonsense Self-Regulation Model (CSM), the Transtheoretical Model (TM), and trait affect with patients' self-reported adherence to treatment. One hundred and forty-two CHD outpatients completed the Illness Perceptions Questionnaire Revised, Self-Efficacy, Stage of Change, Positive and Negative Affect Scale, and General Adherence Questionnaire. Stage of change and self-efficacy were associated with self-reported medication, diet, and exercise adherence. In comparison, the CSM accounted for a smaller proportion of variance in adherence. In hierarchical regression, the variance from CSM variables associated with exercise adherence was no longer significant when TM variables were in the equation. For dietary and medication adherence, in contrast, both emotional representations (CSM) and TM variables contributed independently to the regression equation. There was some evidence that trait affect moderated the association between the CSM variable of emotional representations and dietary adherence. Results suggest that the largest effects for improving adherence to medication, exercise, and dietary recommendations would occur by increasing readiness to change for exercise, increasing domain-specific self-efficacy, and decreasing negative emotions about CHD. Additional implications for research and practice are discussed.
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