Effect of exercise training on the blood pressure and hemodynamic features of hypertensive adolescents

doi:10.1016/0002-9149(83)90412-5

The American Journal of Cardiology

Volume 52, Issue 7, 1 October 1983, Pages 763-768

https://doi.org/10.1016/0002-9149(83)90412-5 Get rights and content

Abstract

Twenty-five adolescents (aged 16 ± 1 years) whose blood pressure (BP) was persistently above the 95th percentile for their age and sex were studied before and after 6 ± 1 months of exercise training and again 9 ± 1 months after the cessation of training. Maximal oxygen consumption (V̇O₂₂) increased significantly with training. There was no change in body weight or sum of skinfolds. Both systolic and diastolic BP decreased significantly with training; however, complete BP normalization was not achieved. When the subjects were retested 9 ± 1 months after cessation of training, systolic BP and V̇O₂₂ max had returned to pretraining levels; however, diastolic BP was still below pretraining levels in the subjects who had diastolic hypertension initially. Except in subjects who initially had an elevated cardiac output, no consistent hemodynamic changes were found with training or cessation of training to account for the reductions in BP. The subjects whose resting cardiac outputs were high initially had significantly lower cardiac outputs after training as a result of decreases in both heart rate and stroke volume; however, vascular resistance remained unchanged. Sedentary control subjects with similar BP had no significant change in any of the variables measured over a similar period. These data indicate that moderate endurance exercise training can lower BP in otherwise healthy hypertensive adolescents as an initial therapeutic intervention.

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Citation Excerpt :
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The Park Rx study is a prospective, randomized controlled trial implemented within a federally qualified health center serving a low-income population in Washington, DC.
The 5-year randomized controlled trial will recruit 500 children, ages 6–16 to be randomized to receive either a park prescription (Park Rx) during routine clinical visits (intervention arm) or care as usual (control arm).
Park prescriptions promote both physical activity and exposure to nature. The prescription includes a place (i.e., park), an activity, a frequency, and a duration. Compared to usual care, we expect children receiving a park prescription will have greater physical activity levels and improved physical and mental health outcomes.
The results of the Park Rx trial will demonstrate the efficacy of the intervention and whether it will increase time spent in nature-rich areas (i.e., parks); have any biological impacts on health, including reducing hypercholesterolemia, hypertriglyceridemia, HbA1c, body mass index (BMI), and impact mental health, including stress and cognitive functioning.
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Chronic forced exercise inhibits stress-induced reinstatement of cocaine conditioned place preference
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While pharmacological agents such as glucocorticoid and corticotropin releasing factor (CRF) antagonists, as well as alpha2-adrenergic agonists, have been shown to curb drug cravings and block stress-induced relapse [18,33–36], possible side effects of such treatment must be considered. An alternative to pharmacological treatment could be aerobic exercise, which is free of such side effects, has a myriad of other brain and general physical and psychological health benefits, and is also more cost-effective [37–39]. Clinical research has found that acute and chronic exercise reduces negative mood, withdrawal symptoms, and substance cravings during abstinence, and increases the likelihood of cessation of substance use [40–44].
Stress increases the likelihood of cocaine relapse in humans and animals, even following a prolonged extinction/abstinence period. Exercise has previously been shown to reduce stress and decrease the likelihood of drug dependence, while also reducing cravings in humans and inhibiting relapse behaviors due to other risk factors in rodents. The present study evaluated the efficacy of exercise to reduce stress-induced relapse to cocaine in a rodent model. Young adult female Sprague Dawley rats were tested for cocaine conditioned place preference (CPP), then split into sedentary or exercise (six weeks of one-hour daily treadmill running, five days per week) groups. Following cocaine CPP, rats were tested for extinction behavior, and then tested for stress-primed reinstatement (15 min immobilization) following the six-week intervention period. Exercise inhibited stress-induced reinstatement of cocaine CPP despite increasing serum corticosterone levels following 15 min of immobilization, suggesting that chronic aerobic exercise intervention may result in adaptations of stress pathways. These findings suggest that exercise may help prevent stress-induced drug relapse, adding to a growing body of evidence supporting the utility of exercise to combat substance abuse.
Physical activity, obesity status, and blood pressure in preschool children
2015, Journal of Pediatrics
To examine the combined effects of physical activity and weight status on blood pressure (BP) in preschool-aged children.
The sample included 733 preschool-aged children (49% female). Physical activity was objectively assessed on 7 consecutive days by accelerometry. Children were categorized as sufficiently active if they met the recommendation of at least 60 minutes daily of moderate-to-vigorous physical activity (MVPA). Body mass index was used to categorize children as nonoverweight or overweight/obese, according to the International Obesity Task Force benchmarks. BP was measured using an automated BP monitor and categorized as elevated or normal using BP percentile-based cut-points for age, sex, and height.
The prevalence of elevated systolic BP (SBP) and diastolic BP was 7.7% and 3.0%, respectively. The prevalence of overweight/obese was 32%, and about 15% of children did not accomplish the recommended 60 minutes of daily MVPA. After controlling for age and sex, overweight/obese children who did not meet the daily MVPA recommendation were 3 times more likely (OR 3.8; CI 1.6-8.6) to have elevated SBP than nonoverweight children who met the daily MVPA recommendation.
Overweight or obese preschool-aged children with insufficient levels of MVPA are at significantly greater risk for elevated SBP than their nonoverweight and sufficiently active counterparts.
Breathing awareness meditation and lifeskills training programs influence upon ambulatory blood pressure and sodium excretion among African American adolescents
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Future studies involving LST may benefit from a longer training period and additional opportunities to practice the newly acquired behavioral skills. Physical activity interventions have shown BP reductions through weight reduction [34–36]. Inclusion of school-wide changes in nutrition and physical exercise programs in combination with BAM may help magnify improvements in BP control.
To evaluate the effect of breathing awareness meditation (BAM), Botvin LifeSkills Training (LST), and health education control (HEC) on ambulatory blood pressure and sodium excretion in African American adolescents.
Following 3 consecutive days of systolic blood pressure (SBP) screenings, 166 eligible participants (i.e., SBP >50th–95th percentile) were randomized by school to either BAM (n = 53), LST (n = 69), or HEC (n = 44). In-school intervention sessions were administered for 3 months by health education teachers. Before and after the intervention, overnight urine samples and 24-hour ambulatory SBP, diastolic blood pressure, and heart rate were obtained.
Significant group differences were found for changes in overnight SBP and SBP, diastolic blood pressure, and heart rate over the 24-hour period and during school hours. The BAM treatment exhibited the greatest overall decreases on these measures (Bonferroni adjusted, ps < .05). For example, for school-time SBP, BAM showed a change of –3.7 mmHg compared with no change for LST and a change of −.1 mmHg for HEC. There was a nonsignificant trend for overnight urinary sodium excretion (p = .07), with the BAM group displaying a reduction of −.92 ± 1.1 mEq/hr compared with increases of .89 ± 1.2 mEq/hr for LST and .58 ± .9 mEq/hr for HEC group.
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2007, Journal of Clinical Epidemiology
Citation Excerpt :
In this study, we found a greater cardioprotective benefit of walking among those with diabetes compared to those without diabetes. Diabetes is associated with obesity, higher blood pressure, and cholesterol, factors that improve with exercise [42–45]. Smoking, hypertension, obesity, sedentary lifestyle, hypercholesterolemia, and diabetes are known risk factors for CVD [46].
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After adjusting for sex, age, smoking, body mass index, alcohol, exercise, history of CHD, and other covariates, adults with diabetes who walked ≥1 mile per day were half as likely to die from all causes combined (hazard ratio [HR] = 0.54; 95% confidence interval [CI]: 0.33, 0.88), and less than one-fifth as likely to die from non-CHD CVD (HR = 0.19; 95% CI: 0.04, 0.86) compared to adults with diabetes who did not walk. Walking was also protective among adults with normal glucose tolerance (HR = 0.55; 95% CI: 0.32, 0.96).
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The non-hemodynamic factors of the blood pressure variation in actually active former sports men
2007, Science and Sports
La présente étude transversale avait pour objectifs : 1) de déterminer dans un échantillon d'anciens sportifs demeurés actifs, les paramètres qui différencient les sujets à pression artérielle élevée, des normotendus ; 2) d'identifier dans le même groupe, les paramètres qui expliquent le mieux les variations de la pression artérielle.
Trois indices d'adiposité, le $\dot{V} O_{2max}$ indirect, le cholestérol total, la fréquence cardiaque de repos, la pression artérielle, le périmètre du cou ont été déterminés chez 129 anciens sportifs âgés de 40 ans et plus. Les antécédents de pratique physique et de maladies cardiovasculaires ont été recherchés chez tous les sujets.
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Dans ce groupe d'anciens sportifs demeurés physiquement actifs, la surcharge pondérale, une fréquence cardiaque élevée et une hypercholestérolémie sont associées au risque hypertensif. L'amélioration de leur profil tensionnel passe par le recours à des exercices continus sur de plus longues durées et d'intensité modérée.
The aims of this cross-sectional study were: 1) To determinate the parameters that discriminate subjects with high blood pressure from those with a low one, in a sample of former sports men still active; 2) To identify the non hemodynamic determinants of the blood pressure in the same sample.
Tree adiposity indexes, the indirect ${\dot{V} O}_{2max}$ , the total plasma cholesterol, the resting heart rate, the blood pressure, the neck circumference were measured in 129 elderly sports men of 40 years and over. The history of physical activity and cardiovascular disease were also investigated.
The half of the sample was at a hypertensive risk. The means of the body mass index, the sum of the skinhold thickness, the resting heart rate, the total plasma cholesterol, the diastolic blood pressure and the pulsed pressure were higher (P < 0.05) in the subjects with high blood pressure. After adjusting for age, the body mass index and the resting heart rate explain together, respectively 11% (P = 0.006) and 18% (P = 0.005) of the variations in the systolic and the diastolic blood pressure.
In the studied group, the overweight, a high resting heart rate, and the hypercholesterolemia were associated with the hypertensive risk. To improve their blood pressure profile, these active former sports men must use continuous and moderate exercises, lasting more than the former ones.

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^☆: This study was supported in part by Grant HL-21578, Individual Fellowship HL-05689, and by Training Grant HL-07081, from the National Heart, Lung, and Blood Institute, the National Institutes of Health, Bethesda, Maryland.

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Systemic hypertensionEffect of exercise training on the blood pressure and hemodynamic features of hypertensive adolescents☆

Abstract

Metabolism

J Pediatr

Report of the task force on blood pressure control in children

Pediatrics

Therapeutic approaches to adolescents with elevated blood pressure

Clinical Hypertension

Preliminary observations on physical training for hypertensive males

Circ Res

Hemodynamic and metabolic effects of physical training in four patients with essential hypertension

Can Med Assoc J

Hemodynamic effects of physical training in essential hypertension

Cardiologica

Systemic haemodynamics in mild arterial hypertension before and after physical training

Clin Sci Mol Med

Effects of physical training on coronary risk factors

Am J Cardiol

Exercise therapy in hypertensive men

JAMA

Blood pressure reduction in borderline hypertensives following physical training

Can Med Assoc J

Physical training program in arterial hypertension. A long-term prospective follow-up

Angiology

Systemic hypertension
Effect of exercise training on the blood pressure and hemodynamic features of hypertensive adolescents☆