Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension

Zaleski, Amanda L.; Taylor, Beth A.; Park, Crystal L.; Santos, Lucas Porto; Panza, Gregory A.; Kramarz, Melody; McCormick, Kyle; Thompson, Paul D.; Fernández, Antonio B.; Chen, Ming Hui; Blissmer, Bryan; Gans, Kim M.; Pescatello, Linda S.

doi:10.1097/hjh.0000000000002115

Cited by 24 publications

(48 citation statements)

References 32 publications

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“…Second, the use of self‐measurement of BP at home instead of ambulatory BP monitoring could be seen as a limitation. However, a recent study indicated that adults self‐monitoring their BP at home showed greater adherence both to a supervised and unsupervised exercise, compared with those that did not use BP self‐monitoring 15 . Third, in the present study we cannot conclude about post‐exercise hypotension, as the formula used to assess the difference between BP levels pre‐ and post‐exercise (post‐exercise BP – pre‐exercise BP) does not cover possible changes in BP that can occur independently of exercise (eg, circadian effects) 16 .…”

Section: Discussionmentioning

confidence: 98%

Low‐ and moderate‐intensity aerobic exercise acutely reduce blood pressure in adults with high‐normal/grade I hypertension

Lopes

Fonseca

Torres‐Costoso

et al. 2020

J of Clinical Hypertension

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The global burden of arterial hypertension was projected to rise from 918 million adults in 2000 to 1.56 billion in 2025. 1 Hypertension is a major, modifiable risk factor for serious health conditions, such as heart failure, and cardiovascular and cerebrovascular acute events. 2 Regular physical exercise has been widely recognized as an important strategy to control blood pressure (BP) in individuals with hypertension. 3,4 The reduction in BP observed after a single session of exercise, that is post-exercise hypotension, showed a strong positive correlation with the chronic reduction in BP observed after 8 weeks of exercise training 5 ; suggesting that the acute decrease in BP may be linked to long-term adaptations to exercise. 6 The studies in older adults are scarce, and there is a lack of studies in active hypertensive individuals. In addition, controversial results have been described regarding BP response depending on the intensity of the exercise 7,8 or physical fitness status of the subjects (trained or untrained), as some studies showed no differences 9 and others showed that untrained subjects present a greater BP decrease than trained subjects. 10 Therefore, this study aims to compare the acute effects of two aerobic exercise intensities (low and moderate) on post-exercise BP in adults with high-normal BP/essential grade I hypertension and regular exercise participation. 2 | ME THODS 2.1 | Study design This is a cross-over, repeated-measures study. Each participant completed two randomly assigned experiments (aerobic exercise at 30% and 60% of the heart rate reserve (HRres). The order of the experiments was randomized using a sealed, opaque, envelope. BP was measured before and after the acute experiments, and at every hour until 3 hours post-exercise. Both experiments were conducted at the

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Section: Discussionmentioning

confidence: 98%

Low‐ and moderate‐intensity aerobic exercise acutely reduce blood pressure in adults with high‐normal/grade I hypertension

Lopes

Fonseca

Torres‐Costoso

et al. 2020

J of Clinical Hypertension

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“…Other studies reported that wearable cuff-less devices, which use PPG technology, also show good accuracy and high correlation with manual blood pressure measurements [ 82 ], one of which has been validated under static and dynamic conditions and showed high fidelity to rapid changes in blood pressure as well as greater preservation of sleep quality during blood pressure monitoring overnight [ 83 ]. Even though evidence is sparse for the validity of WDs to measure blood pressure during exercise, more so in older adults, these devices can still play an important role in capturing the effects of active lifestyles on blood pressure and guide exercise prescription, as it has been recently demonstrated that blood pressure self-monitoring before and after exercise leads to improve exercise adherence among adults with hypertension [ 84 ].…”

Section: Monitoring Cardiac Function and Cardiovascular Healthmentioning

confidence: 99%

Wearable Devices for Physical Activity and Healthcare Monitoring in Elderly People: A Critical Review

et al. 2021

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The availability of wearable devices (WDs) to collect biometric information and their use during activities of daily living is significantly increasing in the general population. These small electronic devices, which record fitness and health-related outcomes, have been broadly utilized in industries such as medicine, healthcare, and fitness. Since they are simple to use and progressively cheaper, they have also been used for numerous research purposes. However, despite their increasing popularity, most of these WDs do not accurately measure the proclaimed outcomes. In fact, research is equivocal about whether they are valid and reliable methods to specifically evaluate physical activity and health-related outcomes in older adults, since they are mostly designed and produced considering younger subjects’ physical and mental characteristics. Additionally, their constant evolution through continuous upgrades and redesigned versions, suggests the need for constant up-to-date reviews and research. Accordingly, this article aims to scrutinize the state-of-the-art scientific evidence about the usefulness of WDs, specifically on older adults, to monitor physical activity and health-related outcomes. This critical review not only aims to inform older consumers but also aid researchers in study design when selecting physical activity and healthcare monitoring devices for elderly people.

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“…Prior studies have reported a significant reduction in BP-leveraging pedometer and smartphone-based physical activity promotion interventions [ 7 ]. Home BP is a stronger predictor of adverse cardiovascular outcomes compared with in-office BP [ 11 ], and self-monitoring of postexercise hypotension can improve exercise adherence [ 33 ]. Nearly one in five Americans currently own a smartwatch [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Association of Habitual Physical Activity With Home Blood Pressure in the Electronic Framingham Heart Study (eFHS): Cross-sectional Study

Sardana¹,

Lin²,

Zhang³

et al. 2021

J Med Internet Res

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Background When studied in community-based samples, the association of physical activity with blood pressure (BP) remains controversial and is perhaps dependent on the intensity of physical activity. Prior studies have not explored the association of smartwatch-measured physical activity with home BP. Objective We aimed to study the association of habitual physical activity with home BP. Methods Consenting electronic Framingham Heart Study (eFHS) participants were provided with a study smartwatch (Apple Watch Series 0) and Bluetooth-enabled home BP cuff. Participants were instructed to wear the watch daily and transmit BP values weekly. We measured habitual physical activity as the average daily step count determined by the smartwatch. We estimated the cross-sectional association between physical activity and average home BP using linear mixed effects models adjusting for age, sex, wear time, antihypertensive drug use, and familial structure. Results We studied 660 eFHS participants (mean age 53 years, SD 9 years; 387 [58.6%] women; 602 [91.2%] White) who wore the smartwatch 5 or more hours per day for 30 or more days and transmitted three or more BP readings. The mean daily step count was 7595 (SD 2718). The mean home systolic and diastolic BP (mmHg) were 122 (SD 12) and 76 (SD 8). Every 1000 increase in the step count was associated with a 0.49 mmHg lower home systolic BP (P=.004) and 0.36 mmHg lower home diastolic BP (P=.003). The association, however, was attenuated and became statistically nonsignificant with further adjustment for BMI. Conclusions In this community-based sample of adults, higher daily habitual physical activity measured by a smartwatch was associated with a moderate, but statistically significant, reduction in home BP. Differences in BMI among study participants accounted for the majority of the observed association.

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Using the immediate blood pressure benefits of exercise to improve exercise adherence among adults with hypertension

Cited by 24 publications

References 32 publications

Low‐ and moderate‐intensity aerobic exercise acutely reduce blood pressure in adults with high‐normal/grade I hypertension

Low‐ and moderate‐intensity aerobic exercise acutely reduce blood pressure in adults with high‐normal/grade I hypertension

Wearable Devices for Physical Activity and Healthcare Monitoring in Elderly People: A Critical Review

Association of Habitual Physical Activity With Home Blood Pressure in the Electronic Framingham Heart Study (eFHS): Cross-sectional Study

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