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Journal of the American Heart... Oct 2020Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and... (Meta-Analysis)
Meta-Analysis
Background Nonpharmacologic interventions that modify lifestyle can lower blood pressure (BP) and have been assessed in numerous randomized controlled trials and pairwise meta-analyses. It is still unclear which intervention would be most efficacious. Methods and Results Bayesian network meta-analyses were performed to estimate the comparative effectiveness of different interventions for lowering BP. From 60 166 potentially relevant articles, 120 eligible articles (14 923 participants) with a median follow-up of 12 weeks, assessing 22 nonpharmacologic interventions, were included. According to the surface under the cumulative ranking probabilities and Grading of Recommendations Assessment, Development and Evaluation (GRADE) quality of evidence, for adults with prehypertension to established hypertension, high-quality evidence indicated that the Dietary Approach to Stop Hypertension (DASH) was superior to usual care and all other nonpharmacologic interventions in lowering systolic BP (weighted mean difference, 6.97 mm Hg; 95% credible interval, 4.50-9.47) and diastolic BP (weighted mean difference, 3.54 mm Hg; 95% credible interval, 1.80-5.28). Compared with usual care, moderate- to high-quality evidence indicated that aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, breathing-control, and meditation could lower systolic BP and diastolic BP. For patients with hypertension, moderate- to high-quality evidence suggested that the interventions listed (except comprehensive lifestyle modification) were associated with greater systolic BP and diastolic BP reduction than usual care; salt restriction was also effective in lowering both systolic BP and diastolic BP. Among overweight and obese participants, low-calorie diet and low-calorie diet plus exercise could lower more BP than exercise. Conclusions DASH might be the most effective intervention in lowering BP for adults with prehypertension to established hypertension. Aerobic exercise, isometric training, low-sodium and high-potassium salt, comprehensive lifestyle modification, salt restriction, breathing-control, meditation and low-calorie diet also have obvious effects on BP reduction.
Topics: Comparative Effectiveness Research; Diet Therapy; Diet, Sodium-Restricted; Exercise; Humans; Hypertension; Prehypertension; Risk Reduction Behavior
PubMed: 32975166
DOI: 10.1161/JAHA.120.016804 -
Scientific Reports May 2020Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves... (Randomized Controlled Trial)
Randomized Controlled Trial
Different exercise training modalities produce similar endothelial function improvements in individuals with prehypertension or hypertension: a randomized clinical trial Exercise, endothelium and blood pressure.
Endothelial dysfunction is a characteristic of systemic arterial hypertension (SAH) and an early marker of atherosclerosis. Aerobic exercise training (AT) improves endothelial function. However, the effects of resistance training (RT) and combined training (CT) on endothelial function remain controversial in individuals with SAH. We determined the effects of AT, RT, and CT on endothelial function and systolic (SBP)/diastolic blood pressure (DBP) in individuals with prehypertension or hypertension. Forty-two participants (54 ± 11 y, resting SBP/DBP 137 ± 9/86 ± 6 mmHg) were randomly allocated into AT (n = 14, 40 min of cycling, 50-75% heart rate reserve), RT (n = 14, 6 resistance exercises, 4 × 12 repetitions, 60% maximum strength) and CT (n = 14, 2 × 12 repetitions of RT + 20 min of AT). All participants performed a 40-minute exercise session twice a week for 8 weeks. Endothelial function was evaluated by brachial artery flow-mediated dilation (FMD). Blood pressure was evaluated through ambulatory monitoring for 24 hours. After 8 weeks of exercise training, blood pressure was reduced in all 3 groups: -5.1 mmHg in SBP (95%CI -10.1, 0.0; p = 0.003) in AT; -4.0 mmHg in SBP (95%CI -7.8, -0.5; p = 0.027) in RT; and -3.2 mmHg in DBP (95%CI -7.9, 1.5; p = 0.001) in CT. All 3 exercise training modalities produced similar improvements in FMD: + 3.2% (95%CI 1.7, 4.6) (p < 0.001) in AT; + 4.0% (95%CI 2.1, 5.7) (p < 0.001) in RT; and +6.8% (95%CI 2.6, 11.1) (p = 0.006) in CT. In conclusion, different exercise training modalities were similarly effective in improving endothelial function but impacts on ambulatory blood pressure appear to be variable in individuals with prehypertension or hypertension.
Topics: Blood Pressure; Endothelium, Vascular; Exercise; Female; Humans; Hypertension; Male; Middle Aged; Prehypertension; Resistance Training
PubMed: 32376984
DOI: 10.1038/s41598-020-64365-x -
Saudi Medical Journal Mar 2020The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of... (Review)
Review
The incidence of prehypertension (blood pressure 120-139 and/or 80-89 mm Hg) in young adults worldwide ranges from ~37.5% to 77.1%. Identifying high-risk groups of prehypertension in young adults is helpful for early and effective interventions and treatments to reduce the occurrence of future hypertension and organ damage. This review summarized the epidemiological characteristics, disease intervention measures, and disease progression characteristics of prehypertension to provide a basis for the development of targeted intervention measures for young adults with prehypertension.
Topics: Adult; Age Factors; Antihypertensive Agents; Cardiovascular Diseases; Coronary Disease; Diet, Healthy; Disease Progression; Female; Humans; Hyperuricemia; Life Style; Male; Obesity; Prehypertension; Risk Factors; Young Adult
PubMed: 32114593
DOI: 10.15537/smj.2020.3.24998 -
Current Hypertension Reports Jan 2016More than a simple "transitional stage" defined by covenanted cut points of systolic pressure from 120 to 139 mm of mercury (mm Hg) or a diastolic pressure from 80 to... (Review)
Review
More than a simple "transitional stage" defined by covenanted cut points of systolic pressure from 120 to 139 mm of mercury (mm Hg) or a diastolic pressure from 80 to 89 mm Hg, prehypertension should be referred to as a categorical term that defines a specific phenotype in the progression from the "absence of disease" to clinically overt disease. While the currently utilized definition of prehypertension stresses the use of blood pressure cut points to establish the diagnosis, it is of relevance to direct our attention to the structural and functional hemodynamic alterations that occur in response to the two cardinal abnormalities in the development of prehypertension and hypertension: autonomic dysfunction and arterial remodeling. Our current review addresses these aspects of the pathophysiology or prehypertension on its progression to hypertension and suggests a new approach to its classification.
Topics: Blood Pressure; Disease Progression; Genotype; Heart Diseases; Humans; Phenotype; Prehypertension
PubMed: 26694821
DOI: 10.1007/s11906-015-0611-8 -
Experimental Gerontology Jun 2023The chronic antihypertensive effect of resistance training (RT) has been widely recognized in mixed-aged populations. However, the specific effect of RT on blood... (Meta-Analysis)
Meta-Analysis Review
The chronic antihypertensive effect of resistance training (RT) has been widely recognized in mixed-aged populations. However, the specific effect of RT on blood pressure (BP) in older individuals (≥60 years) remains unknown. Therefore, this meta-analysis of randomized controlled trials explored the chronic effects of dynamic RT alone on BP in older people. The study followed the PRISMA statement, and the search was performed using MeSH terms "strength training", "blood pressure" and "aged" on MEDLINE (PubMed), SCOPUS, and Web of Science databases. From 1783 potential articles, 24 studies met all inclusion criteria resulting in 835 participants randomized into 26 RT interventions (n = 430) and 24 control groups (n = 405). Overall, BP reduction favoring RT was observed both in SBP (-6.88 [-10.02, -3.73] mmHg) and DBP (-3.37 [-4.71, -2.22] mmHg). Subgroup analysis revealed BP decreases in both participants with hypertension (SBP: -10.42 [-15.67, -5.17]; DBP: -3.99 [-5.76,-2.22] mmHg), and prehypertension (SBP: -4.87 [-7.76, -1.98]; DBP: -2.77 [-4.88, -0.66] mmHg). Improvement in BP was found in studies using traditional RT (free weights and machines) (SBP: -7.04 [-11.04, -3.05]; DBP: -2.60 [-3.72, -1.47] mmHg) and elastic band interventions (SBP: -2.79 [-3.72, -1.86]; DBP:-1.68 [-3.18, -0.18] mmHg). RT performed at moderate intensity (60-80 % 1RM) reduced SBP (-6.98, [-11.93, -2.03]mmHg) and DBP (-3.64 [-5.11, -2.18] mmHg). In conclusion, RT can reduce BP in older people at prehypertensive and hypertensive stage, with traditional RT performed with moderate loads leading to an effect estimate of approximately -7 mmHg for SBP and -4 mmHg for DBP.
Topics: Humans; Aged; Prehypertension; Resistance Training; Hypertension; Blood Pressure; Antihypertensive Agents
PubMed: 37121334
DOI: 10.1016/j.exger.2023.112193 -
Nature Reviews. Cardiology May 2015Prehypertension (blood pressure 120-139/80-89 mmHg) affects ~25-50% of adults worldwide, and increases the risk of incident hypertension. The relative risk of incident... (Review)
Review
Prehypertension (blood pressure 120-139/80-89 mmHg) affects ~25-50% of adults worldwide, and increases the risk of incident hypertension. The relative risk of incident hypertension declines by ~20% with intensive lifestyle intervention, and by 34-66% with single antihypertensive medications. To prevent one case of incident hypertension in adults with prehypertension and a 50% 5-year risk of hypertension, 10 individuals would need to receive intensive lifestyle intervention, and four to six patients would need to be treated with antihypertensive medication. The relative risk of incident cardiovascular disease (CVD) is greater with 'stage 2' (130-139/85-89 mmHg) than 'stage 1' (120-129/80-84 mmHg) prehypertension; only stage 2 prehypertension increases cardiovascular mortality. Among individuals with prehypertension, the 10-year absolute CVD risk for middle-aged adults without diabetes mellitus or CVD is ~10%, and ~40% for middle-aged and older individuals with either or both comorbidities. Antihypertensive medications reduce the relative risk of CVD and death by ~15% in secondary-prevention studies of prehypertension. Data on primary prevention of CVD with pharmacotherapy in prehypertension are lacking. Risk-stratified, patient-centred, comparative-effectiveness research is needed in prehypertension to inform an acceptable, safe, and effective balance of lifestyle and medication interventions to prevent incident hypertension and CVD.
Topics: Antihypertensive Agents; Disease Management; Humans; Incidence; Life Style; Prehypertension; Prevalence; Risk Assessment; Risk Factors
PubMed: 25687779
DOI: 10.1038/nrcardio.2015.17 -
Saudi Journal of Kidney Diseases and... Mar 2012The term "prehypertension" defined as systolic blood pressure between 120 and 139 mmHg and/or diastolic pressures between 80 and 89 mmHg has now gained general... (Review)
Review
The term "prehypertension" defined as systolic blood pressure between 120 and 139 mmHg and/or diastolic pressures between 80 and 89 mmHg has now gained general acceptance. Prehypertension is associated with ~3-fold greater likelihood of developing hypertension, and roughly twice the number of cardiovascular events, than BP < 120/80 mmHg. When compared with normotensive individuals, prehypertensive individuals are more likely to be overweight and obese, to have other cardiovascular risk factors, to progress to established hypertension, and to experience premature clinical cardiovascular disease. The major unresolved issue is the appropriate management of such patients. Lifestyle modification is recommended for all patients with prehypertension as it effectively reduces rate of cardiovascular events. Presently pharmacological therapy is indicated for some patients with prehypertension who have specific comorbidities, including diabetes mellitus, chronic kidney disease, and coronary artery disease.
Topics: Antihypertensive Agents; Blood Pressure; Cardiovascular Diseases; Disease Progression; Humans; Life Style; Prehypertension; Risk Factors
PubMed: 22382212
DOI: No ID Found -
Journal of the American Society of... Nov 2017Prehypertension (systolic blood pressure 120-139 or diastolic blood pressure 80-89 mm Hg) confers a risk of progression to hypertension, impairment of cognitive... (Review)
Review
Prehypertension (systolic blood pressure 120-139 or diastolic blood pressure 80-89 mm Hg) confers a risk of progression to hypertension, impairment of cognitive function, increased left ventricular mass, risk of end-stage renal disease, and an association with arteriosclerosis. Recent studies provide data that could support the rationale for treating prehypertensives subjects with antihypertensive medications in addition to lifestyle modification, especially if they have concomitant cardiovascular risk factors.
Topics: Antihypertensive Agents; Arteriosclerosis; Blood Pressure; Cognitive Dysfunction; Disease Progression; Humans; Hypertension; Hypertrophy, Left Ventricular; Incidence; Kidney Failure, Chronic; Life Style; Prehypertension; Risk Factors
PubMed: 28965768
DOI: 10.1016/j.jash.2017.09.005 -
Journal of Clinical Hypertension... Jun 2012In 2004, the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents recommended a new designation of... (Review)
Review
In 2004, the National High Blood Pressure Education Program Working Group on High Blood Pressure in Children and Adolescents recommended a new designation of prehypertension for children with mildly elevated blood pressure (BP). This description was intended to help identify children most at risk for the development of persistent hypertension for whom targeted prevention programs would be most beneficial and was based largely on expert opinions and epidemiologic normal values. This review summarizes the knowledge that has been gained regarding the epidemiology and risk associated with prehypertension in adolescents since its inception and highlights future challenges in understanding and preventing the development of hypertensive disease in this population.
Topics: Adolescent; Age Factors; Blood Pressure; Cardiovascular Diseases; Disease Progression; Humans; Hypertension; Prehypertension; Prevalence; Risk Assessment; United States
PubMed: 22672089
DOI: 10.1111/j.1751-7176.2012.00663.x -
Texas Heart Institute Journal 2011We investigated the prevalence and risk factors of prehypertension, as well as the predictors of progression from prehypertension to hypertension. To do this, we... (Meta-Analysis)
Meta-Analysis Review
We investigated the prevalence and risk factors of prehypertension, as well as the predictors of progression from prehypertension to hypertension. To do this, we performed a systematic review and meta-analysis of cross-sectional and longitudinal studies, after unrestricted searches of PubMed and The Cochrane Library through September 2010. In addition, we reviewed references, major textbooks, and review articles. Pooled prevalence, standardized mean differences, and odds ratios were estimated by using a random-effects model. Twenty-six articles met our inclusion criteria; these included 20 cross-sectional and 6 longitudinal studies, with a total sample of 250,741 individuals. The overall pooled prevalence of prehypertension was 36%. The pooled prevalence among males was higher than that among females (40% vs 33%). The pooled standardized mean difference for body mass index was 1.37 (95% confidence interval [CI], 1.20-1.55); for total cholesterol, 8.08 (95% CI, 6.71-9.46); for low-density-lipoprotein cholesterol, 5.14 (95% CI, 3.09-7.18); and for fasting plasma glucose, 4.23 (95% CI, 3.28-5.18); all of which showed more significant results in females. The pooled odds ratio was 1.13 (95% CI, 0.93-1.37) for smoking and 0.98 (95% CI, 0.69-1.39) for drinking. In addition, factors such as older age at baseline, male sex, Mongolian race, and being overweight or obese were predictors of progression to hypertension, according to descriptive analysis. The prevalence of prehypertension was relatively high, especially for males. There were many modifiable risk factors associated with prehypertension, to which healthcare providers should pay more attention.
Topics: Adult; Aged; Chi-Square Distribution; Disease Progression; Female; Humans; Hypertension; Male; Middle Aged; Odds Ratio; Prehypertension; Prevalence; Risk Assessment; Risk Factors
PubMed: 22199424
DOI: No ID Found