
ACE I/D and ACTN3 R/X polymorphisms as potential factors in modulating exercise-related phenotypes in older women in response to a muscle power training stimuli.
Pereira Ana,Costa Aldo M,Izquierdo Mikel,Silva António J,Bastos Estela,Marques Mário C
Age (Dordrecht, Netherlands)
Genetic variation of the human ACE I/D and ACTN3 R577X polymorphisms subsequent to 12 weeks of high-speed power training on maximal strength (1RM) of the arm and leg muscles, muscle power performance (counter-movement jump), and functional capacity (sit-to-stand test) was examined in older Caucasian women [n = 139; mean age 65.5 (8.2) years; 67.0 (10.0) kg and 1.57 (0.06) m]. Chelex 100 was used for DNA extraction, and genotype was determined by PCR-RFLP methods. Muscular strength, power, and functional testing were conducted at baseline (T1) and after 12 weeks (T2) of high-speed power training. At baseline, the ACE I/D and ACTN3 R/X polymorphisms were not associated with muscle function or muscularity phenotypes in older Caucasian women. After the 12-week high-speed training program, subjects significantly increased their muscular and functional capacity performance (p < 0.05). For both polymorphisms, significant genotype-training interaction (p < 0.05) was found in all muscular performance indices, except for 1RM leg extension in the ACE I/D (p = 0.187). Analyses of the combined effects between genotypes showed significant differences in all parameters (p < 0.05) in response to high-speed power training between the power (ACTN3 RR + RX & ACE DD) versus "non-power" muscularity-oriented genotypes (ACTN3 XX & ACE II + ID)]. Our data suggest that the ACE and ACTN3 genotypes (single or combined) exert a significant influence in the muscle phenotypes of older Caucasian women in response to high-speed power training. Thus, the ACE I/D and ACTN3 R/X polymorphisms are likely factors in modulating exercise-related phenotypes in older women, particularly in response to a resistance training stimuli.
10.1007/s11357-012-9461-3
Etiopathophysiological role of the renin-angiotensin-aldosterone system in age-related muscular weakening: RAAS-independent beneficial role of ACE2 in muscle weakness.
Journal of biochemical and molecular toxicology
Aging is accompanied by major changes in body composition that can negatively affect functional status in older adults, including a progressive decrease in muscle mass, strength, and quality. The prevalence of sarcopenia has varied considerably, depending on the definition used and the population surveyed-a 2014 meta-analysis across several countries found estimates ranging from 1% to 29% for people aged 60 years or older, who live independently. The potentially relevant studies were retrieved from the ScienceDirect/Medline/PubMed/Public library of science/Mendeley/Springer link and Google Scholar. Multiple keywords were used for the literature search both alone and in combination. Some of the important keywords used for literature search were as follows: "Epidemiology of muscle weakness/muscle disorders," "Pathogenesis of RAAS in muscle weakness," "Role of Angiotensin 1-7/ACE-2/Mas R axis in muscle weakness," and "Correction pathophysiology of muscle weakness via ACE2." The renin-angiotensin system (RAAS), a major blood pressure regulatory system, is a candidate mediator that may promote aging-associated muscle weakness. Previously, studies explored the proof concept for RAAS inhibition as a therapeutic target. Furthermore, in RAAS, angiotensin II, and angiotensin-converting enzyme 2 (ACE2) have been reported to induce endoplasmic reticulum (ER) stress via glucose-regulated protein 78/eukaryotic translation initiation factor 2α (eIF2α)/activating transcription factor 4 (ATF4)/CHOP axis in the liver. In addition, other mitochondria and ER physical interactions contribute to skeletal muscle dysfunction. However, very few studies have investigated the relationship between RAAS and ER stress-associated pathophysiological events and ACE2-mediated biological consequences in muscle weakness. Thus, the study has been designed to investigate the RAAS-independent beneficial role of ACE2 in muscle weakness.
10.1002/jbt.23030
Keeping pace with ACE: are ACE inhibitors and angiotensin II type 1 receptor antagonists potential doping agents?
Wang Pei,Fedoruk Matthew N,Rupert Jim L
Sports medicine (Auckland, N.Z.)
In the decade since the angiotensin-converting enzyme (ACE) gene was first proposed to be a 'human gene for physical performance', there have been numerous studies examining the effects of ACE genotype on physical performance phenotypes such as aerobic capacity, muscle function, trainability, and athletic status. While the results are variable and sometimes inconsistent, and corroborating phenotypic data limited, carriers of the ACE 'insertion' allele (the presence of an alu repeat element in intron 16 of the gene) have been reported to have higher maximum oxygen uptake (VO2max), greater response to training, and increased muscle efficiency when compared with individuals carrying the 'deletion' allele (absence of the alu repeat). Furthermore, the insertion allele has been reported to be over-represented in elite athletes from a variety of populations representing a number of endurance sports. The mechanism by which the ACE insertion genotype could potentiate physical performance is unknown. The presence of the ACE insertion allele has been associated with lower ACE activity (ACEplasma) in number of studies, suggesting that individuals with an innate tendency to have lower ACE levels respond better to training and are at an advantage in endurance sporting events. This could be due to lower levels of angiotensin II (the vasoconstrictor converted to active form by ACE), higher levels of bradykinin (a vasodilator degraded by ACE) or some combination of the two phenotypes. Observations that individuals carrying the ACE insertion allele (and presumably lower ACEplasma) have an enhanced response to training or are over-represented amongst elite athletes raises the intriguing question: would individuals with artificially lowered ACEplasma have similar training or performance potential? As there are a number of drugs (i.e. ACE inhibitors and angiotensin II type 1 receptor antagonists [angiotensin receptor blockers--ARBs]) that have the ability to either reduce ACEplasma activity or block the action of angiotensin II, the question is relevant to the study of ergogenic agents and to the efforts to rid sports of 'doping'. This article discusses the possibility that ACE inhibitors and ARBs, by virtue of their effects on ACE or angiotensin II function, respectively, have performance-enhancing capabilities; it also reviews the data on the effects of these medications on VO2max, muscle composition and endurance capacity in patient and non-patient populations. We conclude that, while the direct evidence supporting the hypothesis that ACE-related medications are potential doping agents is not compelling, there are insufficient data on young, athletic populations to exclude the possibility, and there is ample, albeit indirect, support from genetic studies to suggest that they should be. Unfortunately, given the history of drug experimentation in athletes and the rapid appropriation of therapeutic agents into the doping arsenal, this indirect evidence, coupled with the availability of ACE-inhibiting and ACE-receptor blocking medications may be sufficiently tempting to unscrupulous competitors looking for a shortcut to the finish line.
10.2165/00007256-200838120-00008
Associations of Body Composition with Blood Pressure and Hypertension.
Ye Sunyue,Zhu Chaonan,Wei Chen,Yang Min,Zheng Weifang,Gan Da,Zhu Shankuan
Obesity (Silver Spring, Md.)
OBJECTIVE:The present study investigated the associations of body composition, including skeletal muscle and fat mass, with blood pressure (BP) and hypertension. METHODS:Data from 3,130 participants aged 18 to 80 years were analyzed. Body composition and total skeletal muscle (TSM) were measured or calculated based on dual-energy x-ray absorptiometry. Multivariate linear and logistic regression models were used to analyze the associations of TSM, body fat percentage, android to gynoid fat ratio, and leg and arm lean body mass (LBM) with BP and hypertension. The Wald test was used to estimate the differences in the coefficients. RESULTS:TSM indices, body fat percentage, and android to gynoid fat ratio were significantly associated with higher odds ratio for prehypertension and hypertension, except for TSM/weight, after controlling for potential confounders. The standardized beta coefficients of arm LBM indices for systolic and diastolic BP were higher than relevant indices of leg LBM. CONCLUSIONS:Different indices of TSM, especially in arm LBM, were all positively associated with elevated BP, prehypertension, and hypertension in Chinese adults, after considering potential confounding factors, including body fat and fat distribution. Future longitudinal studies are warranted to confirm our findings.
10.1002/oby.22291
A prospective cohort study on the association of lean body mass estimated by mid-upper arm muscle circumference with hypertension risk in Chinese residents.
Journal of clinical hypertension (Greenwich, Conn.)
The associations of lean body mass (LBM) with elevated blood pressure (BP) and hypertension were controversial, and the causalities have never been shown. Mid-upper arm muscle circumference (MAMC), an easily obtained anthropometric measurement, could provide an accurate estimate for LBM. Therefore, a prospective cohort study in general Chinese residents aiming to find out the relationship between LBM estimated using MAMC and hypertension risk was performed. Eight thousand one hundred eighty-five eligible participants were included in the baseline analysis, among whom 3442 were subsequently selected into cohort analysis. MAMC was calculated using mid-upper arm circumference (MUAC) and triceps skinfold thickness (TST). Associations of MAMC with BP values and hypertension prevalence were estimated by linear and logistic regression models. Associations with hypertension incidence were estimated by COX regression models, hazard ratio (HR) and 95% confidence interval (CI) were given. Nonlinear relationship between MAMC and hypertension risk was estimated using restricted cubic spline method. Standardized coefficients of MUAC and TST were compared to estimate their strengths of associations with hypertension. Baseline analysis showed that after adjusted for confounders, the increase of systolic BP per standard deviation (SD) of MAMC were 1.97 mmHg (95%CI: 1.46, 2.48) and 1.63 mmHg (95%CI: 1.10, 2.16) respectively in men and women, and the increases of diastolic BP per SD were 1.58 mmHg (95%CI: 1.23, 1.92) and 1.08 mmHg (95%CI: 0.74, 1.42). Additionally, the association of MAMC with the prevalence of hypertension were also found in both men and women (OR = 1.36, 95%CI: 1.26, 1.47 in men; OR = 1.33, 95%CI: 1.22, 1.44 in women). Cohort analysis showed that MAMC increased the risk of hypertension (HR = 1.10, 95%CI: 1.01, 1.19 for men; HR = 1.15, 95%CI: 1.06, 1.26 for women), and a trend of J-shaped relationship was found. Additionally, the stronger associations of MUAC with both BP values and hypertension than that of TST were found in both baseline and cohort analyses. Findings in our study implied that we cannot neglect the capacity of LBM in predicting hypertension risk, and LBM estimates should be recommended in general health surveys or examinations.
10.1111/jch.14412
The impact of isometric handgrip exercise and training on health-related factors: A review.
Yamada Yujiro,Spitz Robert W,Wong Vickie,Bell Zachary W,Song Jun Seob,Abe Takashi,Loenneke Jeremy P
Clinical physiology and functional imaging
Isometric handgrip exercise has been suggested to promote some health-related factors (e.g., lowering blood pressure). However, there is a need to evaluate whether this type of exercise can be included as an option to elicit these health-related outcomes. The purpose of the article was to systematically review the acute and chronic effects of isometric handgrip exercise on resting blood pressure, pain sensation, cognitive function and blood lipids and lipoproteins. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A total of 89 studies met our inclusion criteria. Most randomized controlled trials (17/26) reported reductions in resting blood pressure (mostly systolic blood pressure) following isometric handgrip training. There were inconsistent results in isometric handgrip exercise-induced hypotension (i.e., acute response). There was convincing evidence observed in randomized controlled trials (4/6) for isometric handgrip exercise-induced hypoalgesia. Some randomized controlled trials (2/2) supported an improvement in memory performance, but not interference control (0/2), after a session of isometric handgrip exercise. None of the included studies found any effects of isometric handgrip training on blood lipids and lipoproteins. Isometric handgrip exercise appears to be an effective method to improve certain health-related factors. The acute reductions in pain and blood pressure may share a similar central mechanism. However, training-induced reductions in resting blood pressure may be driven by changes in the periphery. Additional work is needed to better understand if (and to what extent) isometric handgrip exercise (or training) influences cognitive function and blood lipids and lipoproteins.
10.1111/cpf.12741
Potential Mechanisms Behind the Blood Pressure-Lowering Effect of Dynamic Resistance Training.
Fecchio Rafael Y,Brito Leandro C,Peçanha Tiago,de Moraes Forjaz Cláudia Lúcia
Current hypertension reports
PURPOSE OF REVIEW:To elucidate the hemodynamic, autonomic, vascular, hormonal, and local mechanisms involved in the blood pressure (BP)-lowering effect of dynamic resistance training (DRT) in prehypertensive and hypertensive populations. RECENT FINDINGS:The systematic search identified 16 studies involving 17 experimental groups that assessed the DRT effects on BP mechanisms in prehypertensive and/or hypertensive populations. These studies mainly enrolled women and middle-aged/older individuals. Vascular effects of DRT were consistently reported, with vascular conductance, flow-mediated dilation, and vasodilatory capacity increases found in all studies. On the other hand, evidence regarding the effects of DRT on systemic hemodynamics, autonomic regulation, hormones, and vasoactive substances are still scarce and controversial, not allowing for any conclusion. The current literature synthesis shows that DRT may promote vascular adaptations, improving vascular conductance and endothelial function, which may have a role in the BP-lowering effect of this type of training in prehypertensive and hypertensive individuals. More studies are needed to explore the role of other mechanisms in the BP-lowering effect of DRT.
10.1007/s11906-021-01154-5
The influence of resistance exercise training prescription variables on skeletal muscle mass, strength, and physical function in healthy adults: An umbrella review.
Journal of sport and health science
PURPOSE:The aim of this umbrella review was to determine the impact of resistance training (RT) and individual RT prescription variables on muscle mass, strength, and physical function in healthy adults. METHODS:Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically searched and screened eligible systematic reviews reporting the effects of differing RT prescription variables on muscle mass (or its proxies), strength, and/or physical function in healthy adults aged >18 years. RESULTS:We identified 44 systematic reviews that met our inclusion criteria. The methodological quality of these reviews was assessed using A Measurement Tool to Assess Systematic Reviews; standardized effectiveness statements were generated. We found that RT was consistently a potent stimulus for increasing skeletal muscle mass (4/4 reviews provide some or sufficient evidence), strength (4/6 reviews provided some or sufficient evidence), and physical function (1/1 review provided some evidence). RT load (6/8 reviews provided some or sufficient evidence), weekly frequency (2/4 reviews provided some or sufficient evidence), volume (3/7 reviews provided some or sufficient evidence), and exercise order (1/1 review provided some evidence) impacted RT-induced increases in muscular strength. We discovered that 2/3 reviews provided some or sufficient evidence that RT volume and contraction velocity influenced skeletal muscle mass, while 4/7 reviews provided insufficient evidence in favor of RT load impacting skeletal muscle mass. There was insufficient evidence to conclude that time of day, periodization, inter-set rest, set configuration, set end point, contraction velocity/time under tension, or exercise order (only pertaining to hypertrophy) influenced skeletal muscle adaptations. A paucity of data limited insights into the impact of RT prescription variables on physical function. CONCLUSION:Overall, RT increased muscle mass, strength, and physical function compared to no exercise. RT intensity (load) and weekly frequency impacted RT-induced increases in muscular strength but not muscle hypertrophy. RT volume (number of sets) influenced muscular strength and hypertrophy.
10.1016/j.jshs.2023.06.005
Sarcopenia definition: Does it really matter? Implications for resistance training.
Ageing research reviews
The loss of muscle mass, strength and function, known as sarcopenia, is common in older adults, and is associated with falls, fractures, cardiometabolic diseases, and lower quality of life. Sarcopenia can also occur secondarily to chronic diseases. Recently, sarcopenia was recognized as a disease with an International Classification of Disease (ICD) code, yet, at least five definitions for its clinical identification exist. Most definitions include three themes: low muscle mass, strength and physical performance. However, the definitions vary by the number of themes needed to diagnose sarcopenia and, within each theme various parameters and cut-off levels exist. The lack of consensus on what constitutes a diagnosis can create confusion and hesitation in sarcopenia diagnosis. Currently, no pharmacological treatment exists for sarcopenia. Resistance training (RT) is safe and effective to improve muscle mass, strength and physical performance in older adults and clinical populations. Based on current guidelines, whether an individual is defined as "sarcopenic", or not, does not change the way RT is prescribed. Here, we present evidence and the inconsistencies in sarcopenia definitions and recommend that focus should be on optimizing ways to prescribe RT and increase long-term adherence, rather than on slight modifications to sarcopenia definitions.
10.1016/j.arr.2022.101617
Correlates of the hemodynamic determinants of blood pressure.
Daniels S R,Kimball T R,Khoury P,Witt S,Morrison J A
Hypertension (Dallas, Tex. : 1979)
The purpose of this study was to investigate the association of sex, race, lean body mass, and fat mass with the hemodynamic determinants of blood pressure, including stroke volume, heart rate, and total peripheral vascular resistance. The study included 201 subjects aged 6 to 17 years, 105 of whom were male and 98 of whom were black. Lean body mass and fat mass were both significant (P < .05) independent determinants of stroke volume, cardiac output, and total peripheral vascular resistance. However, the direction of the effect of lean body mass was opposite for stroke volume and cardiac output compared with that of total peripheral vascular resistance. The direct relationship of lean body mass with systolic blood pressure (SBP) and diastolic blood pressure (DBP) (regression coefficients, 0.55 +/- 0.05 for SBP and 0.47 +/- 0.05 for DBP) indicates that the effect of lean body mass on cardiac output may predominate. Lean body mass explained substantially more of the variance of the hemodynamic variables than did fat mass. After control for the effects of body size, male subjects had higher heart rate and cardiac output, and female subjects had higher vascular resistance. White subjects had higher stroke volume and cardiac output, and black subjects had higher peripheral vascular resistance. This study demonstrates that lean body mass is a more important correlate of the hemodynamic determinants of blood pressure than is fat mass and that sex and race have significant independent relationships with the hemodynamic determinants of blood pressure in children and adolescents.
10.1161/01.hyp.28.1.37
Hypertension prevalence, awareness, treatment and control in Germany 1998 and 2008-11.
Neuhauser H K,Adler C,Rosario A S,Diederichs C,Ellert U
Journal of human hypertension
Germany was reported to have higher blood pressure (BP) and lower awareness, treatment and control of BP than other western countries based on 1998 data. BP distribution and hypertension management were examined for 1998 and 2008-11 in 7108 adult participants of the German National Health Interview and Examination Survey 1998 (GNHIES98) and in 7095 adult participants the German Health Interview and Examination Survey for Adults 2008-11 (DEGS1) aged 18-79 years. Age- and sex-standardized mean systolic BP (SBP) dropped from 129.0 to 124.1 mm Hg (women 127.3-120.8, men 130.7-127.4), mean diastolic BP (DBP) from 78.3 to 73.2 mm Hg (women 78.0-71.2, men 78.5-75.3). Mean SBP and DBP decreased most in treated hypertensives but were also lower in participants without hypertension. The overall prevalence of hypertension, including controlled hypertension, remained almost unchanged (30% vs 32%). Uncontrolled hypertension (BP⩾140/90 mm Hg) decreased from 23% to 15% (women 22-13%, men 24-18%). Among hypertensives, awareness increased from 69% to 82% (women 74-87%, men 65-78%), treatment increased from 55% to 72% (women 62-79%, men 48-65%) and control increased from 23% to 51% (women 25-58%, men 20-45%). However, men aged 18-29 years had an opposite trend with 1.5 mm Hg higher SBP and increased prevalence of hypertension, which was mostly uncontrolled. These findings suggest that BP has decreased substantially in Germany, while leaving a persistent gender gap in management and room for further improvement of prevention and treatment, particularly in men.
10.1038/jhh.2014.82
Normalized handgrip strength and future risk of hypertension: findings from a prospective cohort study.
Kunutsor Setor K,Mäkikallio Timo H,Voutilainen Ari,Hupin David,Laukkanen Jari A
Scandinavian cardiovascular journal : SCJ
Previous reports of an association between handgrip strength (HGS) and the risk of hypertension have utilized cross-sectional designs. We aimed to assess the prospective association between HGS and hypertension risk in a general population. Handgrip strength was assessed at baseline in 463 Finnish men and women aged 61-73 years. Handgrip strength was normalized (HGS/body weight). After 16 years median follow-up, 110 hypertension cases occurred. Comparing the extreme tertiles of normalized HGS, the multivariable adjusted hazard ratio (95% CI) for hypertension was 0.63 (0.38-1.04). Previous evidence of associations may have been driven by study design limitations such as lack of temporality.
10.1080/14017431.2021.1983206
Handgrip strength as a predictor of incident hypertension in the middle-aged and older population: The TCLSIH cohort study.
Gu Yeqing,Dong Jun,Meng Ge,Zhang Qing,Liu Li,Wu Hongmei,Zhang Shunming,Wang Yawen,Zhang Tingjing,Wang Xuena,Sun Shaomei,Wang Xing,Jia Qiyu,Song Kun,Liu Qiang,Niu Kaijun
Maturitas
OBJECTIVES:The independent role of muscular strength in the prevention of chronic disease is increasingly being recognized. However, no cohort study has assessed the relationship between handgrip strength and the incidence of hypertension among the middle-aged and older population. The aim of this prospective cohort study was to investigate whether handgrip strength is related to incident hypertension among people aged 40 years and over. STUDY DESIGN:This prospective cohort study (n = 8,480) was performed between 2013 and 2019 as part of the Tianjin Chronic Low-grade Systemic Inflammation and Health (TCLSIH) Cohort Study, Tianjin, China. MAIN OUTCOME MEASURES:Participants without baseline hypertension were followed up for ~6 years (median 4.0 years). Hypertension was defined according to the JNC7 criteria. Handgrip strength was measured using a hydraulic handheld dynamometer. Adjusted Cox proportional hazards regression models were used to assess the relationships between weight-adjusted handgrip strength and the risk of incident hypertension. RESULTS:The incidence rate of hypertension per 1000 person-years was 70. The fully adjusted hazards ratios (95% confidence interval) of the incidence of hypertension for increasing quartiles of weight-adjusted handgrip strength were: 1.00(reference), 0.84 (0.75-0.95), 0.78 (0.69-0.88), and 0.66 (0.58-0.75) (P for trend<0.0001). Moreover, the adjusted hazards ratio (95% confidence interval) of incident hypertension for per unit increase in weight-adjusted handgrip strength was 0.17 (0.10-0.27) (P<0.0001). Similar results were observed in males and females. CONCLUSIONS:The present cohort study is the first to find that high weight-adjusted handgrip strength, but not absolute handgrip strength, is significantly and independently related to low risk of incident hypertension among the middle-aged and older population.
10.1016/j.maturitas.2021.06.002
Comparison of field- and laboratory-based estimates of muscle quality index between octogenarians and young older adults: an observational study.
Nascimento Dahan da Cunha,Prestes Jonato,de Sousa Diniz Joyce,Beal Pedro Rodrigues,Alves Vicente Paulo,Stone Whitley,Beal Fabiani Lage Rodrigues
Journal of exercise rehabilitation
Muscle quality (the ratio of strength to lean muscle mass) might be a better indicator of muscle function than strength alone. Differences in muscle quality index (MQI) between octogenarians and young older adults remain unclear. The aims of the present cross-sectional study were to compare (1) MQI between octogenarians and young older adults, (2) lab versus field-based MQI tools, and (3) determine possible confounding factors affecting MQI in older adults. Compiled data from two cross-sectional studies included 175 younger and older adults (31 men and 144 women) with a mean age of 75.93±9.49 years. Participants with age ≥80 years old were defined as octogenarians (n=79) and <80 years was defined as young older adults (n=96). Laboratory MQI was derived from the ratio of grip strength to arm muscle mass (in kg) measured by dual-energy x-ray absorptiometry. Field-based MQI was quantified from the ratio of grip strength to body mass index (BMI). Octogenarians displayed lower field (=0.003) and laboratory MQI (<0.001) as compared with young older adults. There was a strong correlation effect between field MQI and laboratory MQI (=0.001, =0.85). BMI (=0.001), and diabetes mellitus (=0.001) negatively affected MQI. Women presented lower MQI (=0.001) values than men. In light of this information, rehabilitation specialists should consider the use of field-based MQI as a tool for evaluation and follow-up of older population.
10.12965/jer.2040668.334
Association between relative handgrip strength and abdominal obesity, type-2 diabetes and hypertension in a Mexican population.
Nutricion hospitalaria
INTRODUCTION:Background: handgrip strength (HGS) is a health-status parameter associated with multicomorbidity in the adult population. Objective: the aim of the present study was to determine the association between HGS (i.e., absolute and relative) and abdominal obesity (AO), type-2 diabetes (T2D), and hypertension (HT), as well as to determine the association between low relative HGS with the presence of multicomorbidity (i.e., the co-occurrence of two or more comorbidities together) in a Mexican population. Methodology: a cross-sectional study was carried out in 860 participants from the south of Mexico (661 women and 199 men). The age range evaluated was from 18 to 65 years. Assessments were made of sociodemographic data, clinical history, anthropometric parameters, and measurement of maximal HGS. Results: the regression models adjusted by age show that the presence of comorbidities (i.e., AO, HT and T2D) was linked negatively to HGS (i.e., absolute and relative). Moreover, in men, a low relative HGS in both hands reported an association with the presence of three simultaneous comorbidities (right, RR: 17.2, p < 0.001; left, RR: 11.92, p = 0.020). In women the same association was found (right, RR: 10.42, p < 0.001; left, RR: 9.90, p < 0.001). Conclusion: lower levels of relative HGS were linked to the presence of simultaneous comorbidities (i.e., the joint presence of AO, T2D and HT). Furthermore, HGS (i.e., absolute and relative) presented an inverse association with individual anthropometric and clinical parameters related to cardiovascular risk in the Mexican population.
10.20960/nh.03732
Usefulness of Relative Handgrip Strength as a Simple Indicator of Cardiovascular Risk in Middle-Aged Koreans.
Kim Won Bin,Park Jun-Bean,Kim Yong-Jin
The American journal of the medical sciences
BACKGROUND:Reduced muscular strength, measured by handgrip strength, has been associated with increased risk for cardiovascular disease (CVD) and mortality. However, the prognostic significance of handgrip strength has been less well-studied in the middle-aged Korean population. This study determined whether handgrip strength predicted 10-year CVD risk in this population and whether there is a sex-specific difference. METHODS:The data were derived from the 2015 Korean National Health and Nutrition Examination Survey that included total of 2776 participants aged 40-69 years without prior history of CVD (men: 1184; women: 1592). Isometric relative handgrip strength was calculated by dividing absolute handgrip strength by body mass index. Participants were classified into three groups by their 10-year Framingham cardiovascular risk score: low (<10%), intermediate (10-19%), and high (≥20%). RESULTS:In men, relative handgrip strength was higher in the absence of hypertension, dyslipidemia, and diabetes compared with in the presence of these CVD risk factors. In women, a higher relative handgrip strength was observed in the absence of hypertension and dyslipidemia but not in the absence of diabetes compared with their counterparts. Advanced age was inversely associated with relative handgrip strength for both sexes. Multivariate logistic regression analysis demonstrated that an increased relative handgrip strength was a significant and independent predictor of low 10-year CVD risk among middle-aged women (odds ratio range 0.09-0.49, p < 0.001), but not among men. CONCLUSIONS:Handgrip strength is a simple and effective screening tool for risk stratification for CVD in middle-aged Korean women.
10.1016/j.amjms.2021.07.010
Relative Handgrip Strength is Inversely Associated with Hypertension in Consideration of Visceral Adipose Dysfunction: A Nationwide Cross-Sectional Study in Korea.
Frontiers in physiology
This study investigated the associations of relative handgrip strength (rHGS) and hypertension. Individual differences in visceral adipose dysfunction (VAD) were evaluated to verify whether rHGS was associated with a reduction in the risk of hypertension, even in individuals with VAD. We included 77,991 participants (50,616 women) from nationwide cohorts in Korea. Participants were categorized into three groups based on sex-specific tertiles of rHGS (Low, Mid, and High). The visceral adiposity index (VAI) was used to evaluate VAD. The multiple logistic regression model was used to assess the risk of hypertension. High rHGS is associated with reduction of hypertension risk in 38 and 26% of men and women, respectively, although rHGS was significantly low in women compared to men. The benefit of rHGS was observed from middle-aged to older participants in both sexes. High rHGS is associated with risk reduction for hypertension in both VAD and non-VAD groups. In the VAD group, compared to Low rHGS, High rHGS was associated with 32 and 22% risk reductions in hypertension in men and women, respectively, and these associations remained significant even when classified according to age, such as in middle-aged and older subgroups. Therefore, the present study suggests that high levels of rHGS are significantly associated with a reduced risk of hypertension even in participants with VAD. Thus, maintaining a higher level of rHGS may be associated with protective benefits against hypertension.
10.3389/fphys.2022.930922
Body mass index and relative handgrip strength are associated with the prevalence of hypertension in Korean elderly: Korean national fitness assessment in 2019.
Kim Ji Young,Park Hun-Young,Kim Jisu,Lim Kiwon
Physical activity and nutrition
PURPOSE:This study aimed to analyze the prevalence of hypertension according to the body mass index (BMI) and relative handgrip strength (RHGS) among elderly individuals in Korea. METHODS:We analyzed the data of 44,183 Korean elderly individuals over 65 years old (men: n = 15,798, age = 73.31 ± 5.04 years, women: n = 28,385, age = 72.14 ± 5.04 years) obtained from the Korean National Fitness Assessment in 2019. All the participants were categorized into three groups according to the BMI and RHGS; additionally, one-way ANOVA and logistic regression analysis were performed. RESULTS:Overweight (men: 1.16 odds ratio [OR] 1.06-1.26, 95% confidence interval [CI]; women: 1.15 OR, 1.07-1.23 95% CI) and obese (men: 1.54 OR, 1.42-1.66 95% CI; women: 1.44 OR, 1.36-1.53 95% CI) elderly individuals showed a higher prevalence of hypertension than elderly individuals with normal weight, after controlling for age. In men, a lower RHGS was associated with a higher prevalence of hypertension after controlling for age (weak RHGS: 1.09 OR, 1.00-1.17 95% CI; middle RHGS: 1.21 OR, 1.12-1.31 95% CI vs. strong RHGS). CONCLUSION:A higher BMI was associated with the prevalence of hypertension in the elderly Korean population. In addition, a lower RHGS was associated with the prevalence of hypertension in elderly Korean men.
10.20463/pan.2021.0012
The Relative Handgrip Strength and Risk of Cardiometabolic Disorders: A Prospective Study.
Frontiers in physiology
BACKGROUND:This study aims to investigate the association between handgrip strength (HGS) and cardiometabolic disorders (CMD), including hypertension, diabetes, and dyslipidemia, in a prospective study. METHODS:The association between HGS and CMD was examined using the data from 5,271 Chinese adult participants ≥45 years old enrolled in the CHARLS (Chinese Health and Retirement Prospective Cohort Study) during 2011-2015. Relative HGS, calculated as maximal absolute HGS from both hands divided by body mass index, was used in the primary analysis and divided into three groups according to the tertiles (T1, T2, and T3). RESULTS:The participants with higher relative HGS had a lower risk of hypertension, diabetes, and dyslipidemia than those with lower HGS, although did not reach statistical significance for diabetes and hypertension in males. Participants with higher HGS had significantly lower risk of hypertension [T3 vs. T1: OR = 0.69, 95% CI = 0.51-0.91, = 0.010] and dyslipidemia (OR = 0.65, 95% CI = 0.51-0.83, < 0.001) in males. For females, participants with higher HGS had significantly lower risks of dyslipidemia (OR = 0.67, 95% CI = 0.54-0.83, < 0.001). CONCLUSION:A consistent association was observed between higher relative HGS and lower risk of CMD. Further research is required to evaluate whether relative HGS can be a convincing predictor for the occurrence of CMD and as a target for intervention in the high-risk population.
10.3389/fphys.2020.00719
Association between relative handgrip strength and hypertension in Chinese adults: An analysis of four successive national surveys with 712,442 individuals (2000-2014).
Feng Qiang,Jiang Chongmin,Wang Mei,Cai Rui,Wang Huan,Wu Dongming,Wang Fubaihui,Lin Lizi,Nassis George P
PloS one
OBJECTIVES:This study aimed to identify the 15-year trends of handgrip strength-to-weight (relative HS) and assess the association between relative HS and hypertension among Chinese adults aged 20-69. METHODS:Using a complex, stratified, multistage probability cluster sampling, we analyzed data collected from 712,442 adults aged 20-69 years in four successive national surveys (2000-2014). We used a handheld dynamometer to measure strength and divided by body weight to calculate the relative HS. Blood pressure was recorded with a sphygmomanometer and hypertension was defined as resting systolic blood pressure at least 140 mmHg or diastolic at least 90 mmHg. The Mann-Kendall trend test examined trends in relative HS over time. We also computed odd ratios (OR) and 95% confidence intervals (95% CI) by tertile of relative HS and examined the association between relative HS and hypertension. RESULTS:The relative HS level decreased with the increase of age in both male and females (p trend <0.001). In each of four surveys, one interquartile decrease in relative HS was associated with an increased risk of hypertension by 44% (OR = 1.44, 95%CI: 1.40-1.47), 58% (OR = 1.58, 95%CI: 1.54-1.62), 48% (OR = 1.48, 95%CI: 1.45-1.52), 43% (OR = 1.43, 95%CI: 1.40-1.47), respectively. CONCLUSION:In the Chinese adult population, the relative HS level decreased from 2000 to 2014 across all ages in both males and females. A lower relative HS was associated with a higher risk of hypertension. The findings provided evidence for the association between muscle strength and hypertension in large-scaled population.
10.1371/journal.pone.0258763
Low relative skeletal muscle mass predicts incident hypertension in Korean men: a prospective cohort study.
Han Ji Min,Lee Mi-Yeon,Lee Kyu-Beck,Kim Hyang,Hyun Young Youl
Journal of hypertension
OBJECTIVE:Previous cross-sectional studies suggest an association between low muscle mass and hypertension. However, whether low muscle mass predicts the development of hypertension is unknown. The aim of this study is to investigate the relationship between relative muscle mass and incident hypertension in a large prospective cohort of Korean adults. METHODS:In this prospective cohort study, we analyzed 132 324 participants without hypertension at baseline who underwent two health check-ups in 2012 and 2016 or in 2013 and 2017 with a 4-year interval. The participants were divided according to skeletal muscle mass index quartiles (Q1--Q4) according to their baseline skeletal muscle mass index [skeletal muscle mass index (%) = total skeletal muscle mass (kg)/body weight (kg) × 100). Multivariate logistic regression was used to estimate the odds ratio and 95% confidence interval for the development of hypertension after 4 years. RESULTS:After 4 years, 7180 (5.43%) participants developed hypertension. The incidence rates of hypertension were 12.11, 8.58, 6.93, and 4.37% in men and 4.02, 2.29, 1.73, and 1.18% in women in Q1, Q2, Q3, and Q4, respectively. The multivariate adjusted odds ratios (95% confidence intervals) for incident hypertension in Q1, Q2, and Q3, in comparison with Q4, were 1.46 (1.3-1.63), 1.31 (1.19-1.46), and 1.26 (1.14-1.40) in men and 0.97 (0.76-1.23), 1.12 (0.90-1.38), and 1.14 (0.92-1.42) in women, respectively. CONCLUSION:Low relative skeletal muscle mass was independently and significantly associated with the incidence of hypertension only in Korean men. Further research is required to understand the underlying mechanisms of this relationship.
10.1097/HJH.0000000000002530
Muscle fiber-type distribution as a predictor of blood pressure: a 19-year follow-up study.
Hernelahti Miika,Tikkanen Heikki O,Karjalainen Jouko,Kujala Urho M
Hypertension (Dallas, Tex. : 1979)
The known association between physical activity and low blood pressure may be influenced by inherited characteristics. Skeletal muscle consists of type I (slow-twitch) and type II (fast-twitch) muscle fibers, with proportions highly variable between individuals and mostly determined by genetic factors. A high percentage of type I fibers (type I%) has been associated with low blood pressure in cross-sectional studies. We investigated whether type I percentage predicts future blood pressure levels and explains part of the association between physical activity and blood pressure. At baseline, in 1984, muscle fiber-type distribution, physical activity, and body mass index (BMI) were determined in 64 healthy men (age, 32 to 58 years). At follow-up, in 2003, blood pressure, physical activity, and BMI were determined in these men. In subjects without antihypertensive medication (n=43), type I percentage accounted for 5%/18% of the variation in systolic/diastolic blood pressure. A high type I percentage predicted, independent of both baseline (in 1984) and follow-up (in 2003), physical activity, BMI, and low systolic and diastolic blood pressure. Adjusted for all baseline covariates, a 20-unit higher type I percentage predicted a 11.6-mm Hg lower systolic blood pressure (P=0.018) and a 5.0-mm Hg lower diastolic blood pressure (P=0.018). High levels of physical activity in 1984 predicted low diastolic blood pressure, but this association was lost when type I percentage was included into the model. A high proportion of type I fibers in skeletal muscle is an independent predictor of low blood pressure and explains part of the known association between high levels of physical activity and low blood pressure.
10.1161/01.HYP.0000165023.09921.34
Heavy-resistance training in older Scandinavian men and women: short- and long-term effects on arm and leg muscles.
Lexell J,Downham D Y,Larsson Y,Bruhn E,Morsing B
Scandinavian journal of medicine & science in sports
The short- and long-term effects of heavy-resistance training (85% of one-repetition maximum (RM)) on elbow flexion and knee extension dynamic and isokinetic strength and on morphology in the biceps brachii and vastus lateralis muscles were evaluated during 1 year in 35 Scandinavian men and women, aged 70-77 years, 12 of whom formed a control group. After the first 11 weeks of training (n = 23; 3 times/week) elbow flexion and knee extension dynamic strength (1 RM) had increased [mean +/- SD] 49% +/- 16 and 163% +/- 75, respectively, with no significant difference between men and women. For the following 27 weeks, strength was maintained with one training session per week (n = 12) but dropped without training (n = 11). After the final 11 weeks of training (n = 11; 3 times/week), strength had further increased 32% +/- 16 in both the arm and the leg. Isokinetic strength measurements (Cybex II; 30 degrees/s) revealed similar but smaller gains than for dynamic strength. Muscle biopsies (n = 20) taken at the start and after the first 11 weeks of training showed a significant increase in the area of both type 1 and type 2 fibers in the biceps brachii muscle and a positive significant correlation between the percentage increase in the proportional area of type 2 fibers in the vastus lateralis muscle and the percentage increase in knee extension dynamic muscle strength. In conclusion, older Scandinavian men and women have a high capacity both to improve and to maintain muscle strength, some of which is mediated through an adaptation in the muscle fiber type population.
10.1111/j.1600-0838.1995.tb00055.x
Muscle fiber hypertrophy, hyperplasia, and capillary density in college men after resistance training.
McCall G E,Byrnes W C,Dickinson A,Pattany P M,Fleck S J
Journal of applied physiology (Bethesda, Md. : 1985)
Twelve male subjects with recreational resistance training backgrounds completed 12 wk of intensified resistance training (3 sessions/wk; 8 exercises/session; 3 sets/exercise; 10 repetitions maximum/set). All major muscle groups were trained, with four exercises emphasizing the forearm flexors. After training, strength (1-repetition maximum preacher curl) increased by 25% (P < 0.05). Magnetic resonance imaging scans revealed an increase in the biceps brachii muscle cross-sectional area (CSA) (from 11.8 +/- 2.7 to 13.3 +/- 2.6 cm2; n = 8; P < 0.05). Muscle biopsies of the biceps brachii revealed increases (P < 0.05) in fiber areas for type I (from 4,196 +/- 859 to 4,617 +/- 1,116 microns2; n = 11) and II fibers (from 6,378 +/- 1,552 to 7,474 +/- 2,017 microns2; n = 11). Fiber number estimated from the above measurements did not change after training (293.2 +/- 61.5 x 10(3) pretraining; 297.5 +/- 69.5 x 10(3) posttraining; n = 8). However, the magnitude of muscle fiber hypertrophy may influence this response because those subjects with less relative muscle fiber hypertrophy, but similar increases in muscle CSA, showed evidence of an increase in fiber number. Capillaries per fiber increased significantly (P < 0.05) for both type I (from 4.9 +/- 0.6 to 5.5 +/- 0.7; n = 10) and II fibers (from 5.1 +/- 0.8 to 6.2 +/- 0.7; n = 10). No changes occurred in capillaries per fiber area or muscle area. In conclusion, resistance training resulted in hypertrophy of the total muscle CSA and fiber areas with no change in estimated fiber number, whereas capillary changes were proportional to muscle fiber growth.
10.1152/jappl.1996.81.5.2004
Muscle fiber number in the biceps brachii muscle of young and old men.
Klein Cliff S,Marsh Greg D,Petrella Robert J,Rice Charles L
Muscle & nerve
We have compared the number of muscle fibers in the biceps brachii muscle (BB) of six old men (82.3 +/- 4.3 years) and six young men (21.2 +/- 1.9 years). Muscle fiber number was estimated by dividing the maximal area of the BB, determined with magnetic resonance imaging, by the mean fiber area of the BB determined in a muscle biopsy. The percentage of type II fibers in the BB ( approximately 60%) and the type I fiber area were not different between the groups. The BB area (-26%), type II fiber area (-24%), mean fiber area (-20%), and maximal voluntary contraction strength (MVC) of the elbow flexor muscles (-27%) were lower in the old than young group. However, the estimated number of muscle fibers was not significantly different between the young (253000) and old (234000) men. Consequently, the smaller BB area of the old men could be explained primarily by a smaller type II fiber size. These findings suggest that old age is not associated with a reduced number of muscle fibers in the BB. The relative contribution of a reduction in fiber number to age-related muscle atrophy may be muscle-dependent.
10.1002/mus.10386
The decline in skeletal muscle mass with aging is mainly attributed to a reduction in type II muscle fiber size.
Nilwik Rachel,Snijders Tim,Leenders Marika,Groen Bart B L,van Kranenburg Janneau,Verdijk Lex B,van Loon Luc J C
Experimental gerontology
BACKGROUND:The loss of skeletal muscle mass with aging has been attributed to a decline in muscle fiber number and muscle fiber size. OBJECTIVE:To define to what extent differences in leg muscle cross-sectional area (CSA) between young and elderly men are attributed to differences in muscle fiber size. METHODS:Quadriceps muscle CSA and type I and type II muscle fiber size were measured in healthy young (n=25; 23 ± 1 y) and older (n=26; 71 ± 1 y) men. Subsequently, the older subjects performed 6 months of resistance type exercise training, after which measurements were repeated. Differences in quadriceps muscle CSA were compared with differences in type I and type II muscle fiber size. RESULTS:Quadriceps CSA was substantially smaller in older versus young men (68 ± 2 vs 80 ± 2 cm(2), respectively; P<0.001). Type II muscle fiber size was substantially smaller in the elderly vs the young (29%; P<0.001), with a tendency of smaller type I muscle fibers (P=0.052). Differences in type II muscle fiber size fully explained differences in quadriceps CSA between groups. Prolonged resistance type exercise training in the elderly increased type II muscle fiber size by 24 ± 8% (P<0.01), explaining 100 ± 3% of the increase in quadriceps muscle CSA (from 68 ± 2 to 74 ± 2 cm(2)). CONCLUSION:Reduced muscle mass with aging is mainly attributed to smaller type II muscle fiber size and, as such, is unlikely accompanied by substantial muscle fiber loss. In line, the increase in muscle mass following prolonged resistance type exercise training can be attributed entirely to specific type II muscle fiber hypertrophy.
10.1016/j.exger.2013.02.012
Associations of muscle mass, strength, and quality with all-cause mortality in China: a population-based cohort study.
Chinese medical journal
BACKGROUND:It remains unclear about the association of muscle mass, strength, and quality with death in the general Chinese population of diverse economical and geographical backgrounds. The present study aimed to comprehensively examine such associations across different regions in China. METHODS:Based on the China Kadoorie Biobank study, the present study included 23,290 participants who were aged 38 to 88 years and had no prevalent cardiovascular diseases or cancer. Muscle mass and grip strength were measured using calibrated instruments. Arm muscle quality was defined as the ratio of grip strength to arm muscle mass. Low muscle mass, grip strength, and arm muscle quality were defined as the sex-specific lowest quintiles of muscle mass index, grip strength, and arm muscle quality, respectively. Cox proportional hazards models yielded hazard ratios (HRs) and 95% confidence intervals (CIs) for risks of all-cause mortality in relation to muscle mass, strength, and quality. RESULTS:During a median follow-up of 3.98 years, 739 participants died. The HR (95% CI) of all-cause mortality risk was 1.28 (1.08-1.51) for low appendicular muscle mass index, 1.38 (1.16-1.62) for low total muscle mass index, 1.68 (1.41-2.00) for low grip strength, and 1.41 (1.20-1.66) for low arm muscle quality in models adjusted for sociodemographic characteristics, lifestyle factors, and medical histories. CONCLUSION:Low muscle mass, grip strength, and arm muscle quality are all associated with short-term increased risks of mortality, indicating the importance of maintaining normal muscle mass, strength, and quality for general Chinese adults.
10.1097/CM9.0000000000002193
Relationship between grip strength and global muscle strength in community-dwelling older people.
Porto Jaqueline Mello,Nakaishi Ana Paula Midori,Cangussu-Oliveira Luciana Mendes,Freire Júnior Renato Campos,Spilla Sállua Berlanga,Abreu Daniela Cristina Carvalho de
Archives of gerontology and geriatrics
There are still conflicting results regarding the association between grip and global muscle strength in older people. Therefore, the objective of the present study was to determine the association between grip strength and global muscle strength, as well as between grip strength and individual trunk, hip, knee and ankle muscle strengths. METHODS:Grip strength was assessed using a manual dynamometer, and trunk, hip, knee and ankle muscle strength with an isokinetic dynamometer, in order to obtain the global muscle strength variable, in 150 older men and women from the community. The association between grip and global muscle strength and between grip strength and the strength of each muscle group was determined through the Pearson correlation test, followed by multivariate linear regression adjusted for sex, age, body mass index, level of physical activity and number of comorbidities. RESULTS:A positive significant association was found between grip strength and global muscle strength in older people (r = 0.690; β = 10.07; p < 0.001; R = 0.604), even after adjustment. There was also a low to moderate association between all the muscle groups and grip strength. However, when the model was adjusted, the relationship between grip strength and ankle dorsiflexor peak torque lost significance (p = 0.924). CONCLUSION:Grip strength can represent global muscle strength in younger older people in the community, even when confounding variables are considered in the statistical model. However, grip strength does not eliminate the need for specific assessment of different muscle groups, when indicated.
10.1016/j.archger.2019.03.005
Muscle mass is the main somatic growth indicator associated with increasing blood pressure with age in children and adolescents.
Zaniqueli Divanei,Alvim Rafael de O,Baldo Marcelo P,Morra Elis A,Mill José Geraldo
Journal of clinical hypertension (Greenwich, Conn.)
Studies have shown that lean mass must be an important determinant of blood pressure value in children and adolescents. The absence of adjustment for the collinearity between lean and fat mass (FM), restricted age span, and lack of separate analysis by sex leave a gap in the literature. This study determined direct and indirect effects of the somatic growth indicators linked to the association between age and systolic blood pressure (SBP) in boys and girls. This is a cross-sectional study comprising 1,510 participants (6-18 years). Path analysis was used to test a model in which the association between age and SBP would have a direct and independent component, but also indirect mediating paths through muscle mass (MM), FM, and height. There was no significant association between age and SBP (unstandardized β ± SE) for both girls (0.072 ± 0.236, P = .761) and boys (0.238 ± 0.264, P = .368). Height was not a mediator for the association between age and SBP in both girls (-0.291 ± 0.156, P = .062) and boys (-0.015 ± 0.187, P = .935). Mediating effect of MM was significant for both girls (0.909 ± 0.137, P < .001) and boys (1.341 ± 0.161, P < .001), whereas mediating path through FM was significant only for boys (0.069 ± 0.023, P = .003). In conclusion, muscle mass was the strongest somatic growth indicator associated with the blood pressure value in children and adolescents. Further increase in body fat mass may affect systolic blood pressure more in boys than in girls.
10.1111/jch.14007
It is not just muscle mass: a review of muscle quality, composition and metabolism during ageing as determinants of muscle function and mobility in later life.
McGregor Robin A,Cameron-Smith David,Poppitt Sally D
Longevity & healthspan
Worldwide estimates predict 2 billion people will be aged over 65 years by 2050. A major current challenge is maintaining mobility and quality of life into old age. Impaired mobility is often a precursor of functional decline, disability and loss of independence. Sarcopenia which represents the age-related decline in muscle mass is a well-established factor associated with mobility limitations in older adults. However, there is now evidence that not only changes in muscle mass but other factors underpinning muscle quality including composition, metabolism, aerobic capacity, insulin resistance, fat infiltration, fibrosis and neural activation may also play a role in the decline in muscle function and impaired mobility associated with ageing. Importantly, changes in muscle quality may precede loss of muscle mass and therefore provide new opportunities for the assessment of muscle quality particularly in middle-aged adults who could benefit from interventions to improve muscle function. This review will discuss the accumulating evidence that in addition to muscle mass, factors underpinning muscle quality influence muscle function and mobility with age. Further development of tools to assess muscle quality in community settings is needed. Preventative diet, exercise or treatment interventions particularly in middle-aged adults at the low end of the spectrum of muscle function may help preserve mobility in later years and improve healthspan.
10.1186/2046-2395-3-9
Low muscle strength and increased arterial stiffness go hand in hand.
König Maximilian,Buchmann Nikolaus,Seeland Ute,Spira Dominik,Steinhagen-Thiessen Elisabeth,Demuth Ilja
Scientific reports
Low handgrip strength and increased arterial stiffness are both associated with poor health outcomes, but evidence on the relationship between handgrip strength and arterial stiffness is limited. In this cross-sectional analysis of combined baseline datasets from the LipidCardio and Berlin Aging Study II cohorts we aimed to examine whether handgrip strength (HGS) is associated with arterial stiffness. 1511 participants with a median age of 68.56 (IQR 63.13-73.08) years were included. Arterial stiffness was assessed by aortal pulse wave velocity (PWV) with the Mobil-O-Graph device. Handgrip strength was assessed with a handheld dynamometer.The mean HGS was 39.05 ± 9.07 kg in men and 26.20 ± 7.47 kg in women. According to multivariable linear regression analysis per 5 kg decrease in handgrip strength there was a mean increase in PWV of 0.08 m/s after adjustment for the confounders age, sex, coronary artery disease, systolic blood pressure, body mass index, cohort, and smoking. Thus, there was evidence that low handgrip strength and increased arterial stiffness go hand in hand. Arterial stiffness can possibly create the missing link between low handgrip strength and increased cardiovascular morbidity and mortality. Causality and direction of causality remain to be determined.
10.1038/s41598-021-81084-z
Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors.
Cornelissen Véronique A,Fagard Robert H
Hypertension (Dallas, Tex. : 1979)
Previous meta-analyses of randomized controlled trials on the effects of chronic dynamic aerobic endurance training on blood pressure reported on resting blood pressure only. Our aim was to perform a comprehensive meta-analysis including resting and ambulatory blood pressure, blood pressure-regulating mechanisms, and concomitant cardiovascular risk factors. Inclusion criteria of studies were: random allocation to intervention and control; endurance training as the sole intervention; inclusion of healthy sedentary normotensive or hypertensive adults; intervention duration of > or =4 weeks; availability of systolic or diastolic blood pressure; and publication in a peer-reviewed journal up to December 2003. The meta-analysis involved 72 trials, 105 study groups, and 3936 participants. After weighting for the number of trained participants and using a random-effects model, training induced significant net reductions of resting and daytime ambulatory blood pressure of, respectively, 3.0/2.4 mm Hg (P<0.001) and 3.3/3.5 mm Hg (P<0.01). The reduction of resting blood pressure was more pronounced in the 30 hypertensive study groups (-6.9/-4.9) than in the others (-1.9/-1.6; P<0.001 for all). Systemic vascular resistance decreased by 7.1% (P<0.05), plasma norepinephrine by 29% (P<0.001), and plasma renin activity by 20% (P<0.05). Body weight decreased by 1.2 kg (P<0.001), waist circumference by 2.8 cm (P<0.001), percent body fat by 1.4% (P<0.001), and the homeostasis model assessment index of insulin resistance by 0.31 U (P<0.01); HDL cholesterol increased by 0.032 mmol/L(-1) (P<0.05). In conclusion, aerobic endurance training decreases blood pressure through a reduction of vascular resistance, in which the sympathetic nervous system and the renin-angiotensin system appear to be involved, and favorably affects concomitant cardiovascular risk factors.
10.1161/01.HYP.0000184225.05629.51
Impact of high- and low-intensity resistance training on arterial stiffness and blood pressure in adults across the lifespan: a review.
Figueroa Arturo,Okamoto Takanobu,Jaime Salvador J,Fahs Christopher A
Pflugers Archiv : European journal of physiology
Resistance training (RT) is performed for improvements in body composition in young healthy adults and for health benefits in middle-aged and older adults. Traditionally, RT is prescribed at moderate- to high-intensity to promote benefits on skeletal muscle mass and strength in middle-aged and older adults without considering the vascular effects. Recent evidence suggests that muscle strength may be more protective than muscle mass for cardiovascular disease prevention and that muscle strength can be importantly improved with low-intensity RT. The main purpose of this review was to examine the effects of RT intensity on arterial stiffness and blood pressure (peripheral and central) in young and older adults. Although small increases in central arterial stiffness (carotid β and carotid-femoral pulse wave velocity [PWV]) have been reported in young and middle-aged men, this review suggests that low- and high-intensity RT may not affect arterial stiffness whereas low-intensity RT may decrease systemic arterial stiffness (brachial-ankle PWV) in young healthy adults or not affect arterial stiffness in middle-aged and older adults. Independently of the intensity, RT may be effective to reduce blood pressure (peripheral and central) in middle-aged and older adults with at least elevated blood pressure at baseline. Further studies are needed to examine the impact of RT on arterial stiffness, central blood pressure, and wave reflection in middle-aged and older adults.
10.1007/s00424-018-2235-8
American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.
Medicine and science in sports and exercise
In order to stimulate further adaptation toward specific training goals, progressive resistance training (RT) protocols are necessary. The optimal characteristics of strength-specific programs include the use of concentric (CON), eccentric (ECC), and isometric muscle actions and the performance of bilateral and unilateral single- and multiple-joint exercises. In addition, it is recommended that strength programs sequence exercises to optimize the preservation of exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher-intensity before lower-intensity exercises). For novice (untrained individuals with no RT experience or who have not trained for several years) training, it is recommended that loads correspond to a repetition range of an 8-12 repetition maximum (RM). For intermediate (individuals with approximately 6 months of consistent RT experience) to advanced (individuals with years of RT experience) training, it is recommended that individuals use a wider loading range from 1 to 12 RM in a periodized fashion with eventual emphasis on heavy loading (1-6 RM) using 3- to 5-min rest periods between sets performed at a moderate contraction velocity (1-2 s CON; 1-2 s ECC). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 d x wk(-1) for novice training, 3-4 d x wk(-1) for intermediate training, and 4-5 d x wk(-1) for advanced training. Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training and 2) use of light loads (0-60% of 1 RM for lower body exercises; 30-60% of 1 RM for upper body exercises) performed at a fast contraction velocity with 3-5 min of rest between sets for multiple sets per exercise (three to five sets). It is also recommended that emphasis be placed on multiple-joint exercises especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (>15) using short rest periods (<90 s). In the interpretation of this position stand as with prior ones, recommendations should be applied in context and should be contingent upon an individual's target goals, physical capacity, and training status.
10.1249/MSS.0b013e3181915670
American College of Sports Medicine position stand. Progression models in resistance training for healthy adults.
Kraemer William J,Adams Kent,Cafarelli Enzo,Dudley Gary A,Dooly Cathryn,Feigenbaum Matthew S,Fleck Steven J,Franklin Barry,Fry Andrew C,Hoffman Jay R,Newton Robert U,Potteiger Jeffrey,Stone Michael H,Ratamess Nicholas A,Triplett-McBride Travis,
Medicine and science in sports and exercise
In order to stimulate further adaptation toward a specific training goal(s), progression in the type of resistance training protocol used is necessary. The optimal characteristics of strength-specific programs include the use of both concentric and eccentric muscle actions and the performance of both single- and multiple-joint exercises. It is also recommended that the strength program sequence exercises to optimize the quality of the exercise intensity (large before small muscle group exercises, multiple-joint exercises before single-joint exercises, and higher intensity before lower intensity exercises). For initial resistances, it is recommended that loads corresponding to 8-12 repetition maximum (RM) be used in novice training. For intermediate to advanced training, it is recommended that individuals use a wider loading range, from 1-12 RM in a periodized fashion, with eventual emphasis on heavy loading (1-6 RM) using at least 3-min rest periods between sets performed at a moderate contraction velocity (1-2 s concentric, 1-2 s eccentric). When training at a specific RM load, it is recommended that 2-10% increase in load be applied when the individual can perform the current workload for one to two repetitions over the desired number. The recommendation for training frequency is 2-3 d x wk(-1) for novice and intermediate training and 4-5 d x wk(-1) for advanced training. Similar program designs are recommended for hypertrophy training with respect to exercise selection and frequency. For loading, it is recommended that loads corresponding to 1-12 RM be used in periodized fashion, with emphasis on the 6-12 RM zone using 1- to 2-min rest periods between sets at a moderate velocity. Higher volume, multiple-set programs are recommended for maximizing hypertrophy. Progression in power training entails two general loading strategies: 1) strength training, and 2) use of light loads (30-60% of 1 RM) performed at a fast contraction velocity with 2-3 min of rest between sets for multiple sets per exercise. It is also recommended that emphasis be placed on multiple-joint exercises, especially those involving the total body. For local muscular endurance training, it is recommended that light to moderate loads (40-60% of 1 RM) be performed for high repetitions (> 15) using short rest periods (< 90 s). In the interpretation of this position stand, as with prior ones, the recommendations should be viewed in context of the individual's target goals, physical capacity, and training status.
2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines.
Whelton Paul K,Carey Robert M,Aronow Wilbert S,Casey Donald E,Collins Karen J,Dennison Himmelfarb Cheryl,DePalma Sondra M,Gidding Samuel,Jamerson Kenneth A,Jones Daniel W,MacLaughlin Eric J,Muntner Paul,Ovbiagele Bruce,Smith Sidney C,Spencer Crystal C,Stafford Randall S,Taler Sandra J,Thomas Randal J,Williams Kim A,Williamson Jeff D,Wright Jackson T
Circulation
10.1161/CIR.0000000000000596
Hypertension Prevalence Among Adults Aged 18 and Over: United States, 2017-2018.
Ostchega Yechiam,Fryar Cheryl D,Nwankwo Tatiana,Nguyen Duong T
NCHS data brief
Hypertension is a major risk factor for cardiovascular disease. Lowering blood pressure has been shown to decrease the incidences of stroke, heart attack, and heart failure (1,2). This report provides 2017-2018 U.S. hypertension prevalence estimates using the 2017 American College of Cardiology and American Heart Association definition of hypertension (3) and new guidelines, which redefine hypertension by lowering the previous threshold levels of 140/90 mmHg to 130/80 mmHg (4). This change categorizes a greater percentage of people as having hypertension.
Problematic drinking in the old and its association with muscle mass and muscle function in type II diabetes.
Buchmann Nikolaus,Spira Dominik,König Maximilian,Norman Kristina,Demuth Ilja,Steinhagen-Thiessen Elisabeth
Scientific reports
Problematic drinking behavior is common in the old and negative consequences of hypoglycemic episodes in type 2 diabetes (T2D) as a result of alcohol consumption have been described previously. Although, associations between such hypoglycemic episodes with reduced muscle mass are discussed, it is uncertain if problematic drinking behavior drives decline of muscle mass and/or muscle function. In the current study, we analyzed data of the Berlin Aging Study II (BASE-II) to examine the association of problematic drinking behavior with muscle mass and grip strength in T2D. Cross-sectional data of 1451 old BASE-II participants (51.6% women; 60-84 years old) were analyzed. Problematic drinking behavior was assessed using the Alcohol Use Identification Test (AUDIT). Muscle mass was measured using dual energy X-ray absorptiometry (DXA), grip strength using a Smedley dynamometer. Adjusted regression models were calculated to assess the association of problematic drinking with muscle mass and grip strength. Problematic drinking was evident in 11.2% of BASE-II participants and in 12.5% of BASE-II participants diabetes was evident. In the fully adjusted model (adjusted for age, trunk fat mass, HbA1c, antidiabetic medication, TSH, CRP, testosterone, physical inactivity, depression (GDS-score), morbidities, smoking status and total energy intake/day, we found a statistically significant association between problematic drinking and muscle mass (β-3.7, SE: 1.3, R 0.481, partial eta square 0.166, observed power 0.816, p-value 0.005) and grip strength (β-8.1, SE: 3.3, R 0.222, partial eta square 0.134, observed power 0.670, p-value 0.018) in old diabetic men. These associations were not evident in women and subjects without T2D. Problematic drinking behavior was associated with lower muscle mass and grip strength in old men with diabetes. This topic should be addressed in these subjects as they could be at increased risk for early functional decline, sarcopenia or frailty.
10.1038/s41598-019-47787-0
Strength and muscle quality in a well-functioning cohort of older adults: the Health, Aging and Body Composition Study.
Newman Anne B,Haggerty Catherine L,Goodpaster Bret,Harris Tamara,Kritchevsky Steve,Nevitt Michael,Miles Toni P,Visser Marjolein,
Journal of the American Geriatrics Society
OBJECTIVES:To determine whether lower lean mass and higher fat mass have independent effects on the loss of strength and muscle quality in older adults and might explain part of the effect of age. DESIGN:Single-episode, cross-sectional analyses of a cohort of subjects in the Health, Aging and Body Composition (Health ABC) Study. SETTING:Ambulatory clinic and research laboratory. PARTICIPANTS:Two thousand six hundred twenty-three men and women aged 70 to 79 from the Health ABC Study. MEASUREMENTS:Upper and lower extremity strength was measured using isokinetic (knee extension) and isometric (grip strength) dynamometers. Body composition (lean mass and fat mass) was determined by measuring lean mass of upper and lower extremities and the total body by dual-energy x-ray absorptiometry. Muscle quality was ascertained by taking the ratio of strength to muscle mass for both upper and lower extremities. RESULTS:Upper and lower extremity strength and muscle quality decreased as age increased. Most of the explained variance in strength was due to differences in muscle mass, but, in those at the extremes of body fat and lower leg muscle quality, the association with body fat was independent of the effect of age. Although blacks had greater muscle strength and mass than whites, leg muscle quality tended to be lower in blacks than in whites. Upper extremity strength adjusted for lean mass and muscle quality were also associated inversely and independently with age, body fat, and black race. CONCLUSION:In this older cohort, lower strength with older age was predominantly due to a lower muscle mass. Age and body fat also had significant inverse associations with strength and muscle quality. Both preservation of lean mass and prevention of gain in fat may be important in maintaining strength and muscle quality in old age.
10.1046/j.1532-5415.2003.51105.x
Sarcopenia: revised European consensus on definition and diagnosis.
Age and ageing
Background:in 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) published a sarcopenia definition that aimed to foster advances in identifying and caring for people with sarcopenia. In early 2018, the Working Group met again (EWGSOP2) to update the original definition in order to reflect scientific and clinical evidence that has built over the last decade. This paper presents our updated findings. Objectives:to increase consistency of research design, clinical diagnoses and ultimately, care for people with sarcopenia. Recommendations:sarcopenia is a muscle disease (muscle failure) rooted in adverse muscle changes that accrue across a lifetime; sarcopenia is common among adults of older age but can also occur earlier in life. In this updated consensus paper on sarcopenia, EWGSOP2: (1) focuses on low muscle strength as a key characteristic of sarcopenia, uses detection of low muscle quantity and quality to confirm the sarcopenia diagnosis, and identifies poor physical performance as indicative of severe sarcopenia; (2) updates the clinical algorithm that can be used for sarcopenia case-finding, diagnosis and confirmation, and severity determination and (3) provides clear cut-off points for measurements of variables that identify and characterise sarcopenia. Conclusions:EWGSOP2's updated recommendations aim to increase awareness of sarcopenia and its risk. With these new recommendations, EWGSOP2 calls for healthcare professionals who treat patients at risk for sarcopenia to take actions that will promote early detection and treatment. We also encourage more research in the field of sarcopenia in order to prevent or delay adverse health outcomes that incur a heavy burden for patients and healthcare systems.
10.1093/ageing/afy169
Effects of Resistance Training on Muscle Quality Index, Muscle Strength, Functional Capacity, and Serum Immunoglobulin Levels between Obese and Non-obese Older Women.
Silva Paulo Roberto,Nascimento Dahan DA Cunha,DE Sousa Neto Ivo Vieira,Funghetto Silvana Schwerz,Tibana Ramires Alsamir,Navalta James W,Beal Fabiani Lage Rodrigues,Prestes Jonato
International journal of exercise science
Considering the negative impact of obesity on neuromuscular and immune systems, we sought to compare the effects of a 10-week resistance training (RT) program on muscle quality index (MQI), muscle strength, functional capacity, and immunoglobulins in older women with and without obesity. Thirty-nine older women participated in the present study (age: 69.02 ± 6.16, fat (%): 38.80% ± 6.28) and underwent a linear RT program performed on two non-consecutive days of the week. Body composition, functional tests, immunoglobulins, muscle quality of upper and lower limbs and absolute muscular strength of the upper and lower limbs were measured. Both groups displayed an increased statistically significant difference in MQI between pre-post training, however obese participants showed a lower field and laboratory MQI when compared to non-obese participants at the same time-points. Obese participants displayed an increased statistically significant 30-second chair stand test, with no differences for non-obese participants. Obese participants showed a higher statistically significant difference for immunoglobulin M when compared to the non-obese group at post-training. Finally, both groups displayed an increased statistically significant difference in muscle strength between pre-post-training. However, obese participants showed a statistically significant lower 10-RM low row score when compared to non-obese participants at post-training. Obese older women showed a lower field and laboratory MQI when compared to non-obese post-training, besides a lower 10-RM low row score which reinforces that obesity blunts the beneficial effects of RT on muscle quality and strength.
Lifestyle factors associated with muscle quality in community-dwelling older people with type 2 diabetes in Japan and Taiwan: a cross-sectional study.
Psychogeriatrics : the official journal of the Japanese Psychogeriatric Society
BACKGROUND:Type 2 diabetes mellitus (T2DM), common in older people, is an important reason for muscle loss in Japanese and Taiwanese populations. However, little is known about the association between lifestyle behaviours and muscle quality. We aimed to compare the lifestyle behaviours of Japanese and Taiwanese older adults with T2DM and to the identify lifestyle factors associated with muscle quality. METHODS:This cross-sectional study was conducted among community-dwelling individuals with T2DM aged ≥65 years in Taiwan and Japan. Totally, 114 Japanese and 226 Taiwanese participants were enrolled in the study. Outcomes were measured by blood biochemical examinations, body composition analyses and structured self-reported questionnaires to assess lifestyle behaviours and muscle quality. Linear regression models were used to examine the relationship between lifestyle factors and muscle quality using SPSS version 27.0 with a statistical significance level of P < 0.05. RESULTS:Japanese subjects were more likely to be smokers and alcohol consumers, and they were less likely to have well-balanced diets and engage in more physical activity as compared to Taiwanese subjects. The muscle quality in the Japanese subjects was significantly poorer than that in the Taiwanese subjects. Physical activity, dietary habits and smoking were associated with muscle quality, after adjusting for age, gender and body mass index. CONCLUSIONS:Physical activity of insufficient intensity, unhealthy dietary habits and smoking could be risk factors for poor muscle quality. These findings can contribute to the development of effective strategies to improve muscle quality in community-dwelling older Asian people with T2DM.
10.1111/psyg.12878
Associations Between Copper and Zinc and Risk of Hypertension in US Adults.
Yao Jie,Hu Ping,Zhang Dongfeng
Biological trace element research
Evidence linking copper and zinc to hypertension are limited and conflicting. Data from the National Health and Nutrition Examination Survey (NHANES) 2007-2014 were used. Zinc and copper intake from diet and supplements was assessed with 24-h dietary recall. Hypertension was defined as systolic blood pressure (SBP) ≥ 140 mmHg/diastolic blood pressure (DBP) ≥ 90 mmHg/treatment with hypertensive medications. In a sensitivity analysis, according to the 2017 American College of Cardiology and American Heart Association guideline, hypertension was also defined as SBP ≥ 130 mmHg/DBP ≥ 80 mmHg/treatment with hypertensive medications. A total of 17,811 adults (8430 men and 9381 women) were included. After adjustment for age, gender, body mass index (BMI), race, educational level, smoking status, family income, and total daily energy intake, the OR of hypertension for highest vs. lowest quartile intake of copper, zinc, and copper/zinc ratio was 1.11 (0.90-1.37), 1.11 (0.90-1.35), and 0.95 (0.81-1.11), respectively. In stratified analysis by BMI (< 25 kg/m, 25-30 kg/m, > 30 kg/m), no significant association was found between hypertension and intakes of copper, zinc, and copper/zinc ratio (highest vs. lowest quartile) in multivariate analysis. In multivariate analysis, the OR of hypertension for highest vs. lowest quartile levels of serum copper, zinc, and copper/zinc ratio was 1.11 (0.61-2.04), 1.43 (0.84-2.44), and 0.68 (0.34-1.33), respectively. Similar results were found in the sensitivity analysis. Zinc and copper might be not independently associated with hypertension in US adults.
10.1007/s12011-018-1320-3
Serum Klotho and pulse pressure; insight from NHANES.
International journal of cardiology
BACKGROUND:Low levels of the Klotho protein are associated with accelerated tissue aging, including arterial stiffness, in patients with cardiovascular and renal diseases. However, this association has not been examined in a diverse cohort. We aimed to investigate the association between serum Klotho protein levels and pulse pressure, as an indicator of arterial stiffness, in a cohort representative of the US population. METHODS:We used the National Health and Nutrition Examination Survey (NHANES) from 2007 to 2016. Association between pulse pressure and Klotho levels as a continuous variable and in quartiles were examined using survey weight-adjusted linear regression models. Multivariable models were adjusted for age, gender, race, BMI, hypertension, diabetes, smoking, alcohol use, total cholesterol, and estimated GFR. RESULTS:Of the 13,362 participants, 3954(29.6%) were > 65 years, 5792(43%) were Caucasian, and 6773(50.7%) had hypertension. Mean(SD) Klotho was 0.85(0.31) ng/mL and pulse pressure was 55.8(18.5) mmHg. In unadjusted and adjusted models, each ng/mL increase in Klotho was associated with a 3.88mmHg (95%CI = -5.19,-2.57; P < 0.001) and 1.63mmHg (95%CI = -3.01,-0.24; P = 0.02) decrease in pulse pressure, respectively. Similarly, participants in the highest quartile of Klotho had lower pulse pressure than those in the lowest quartile (-3.05mmHg; 95%CI = -4.05,-2.05; P < 0.001), and this difference remained significant in adjusted models (-1.10mmHg; 95%CI = -2.20,-0.01; P = 0.05). CONCLUSION:In this large diverse cohort, we found an inverse and independent association between serum Klotho levels and pulse pressure suggesting that Klotho is associated with arterial stiffness. The mechanisms underlying this association need further study.
10.1016/j.ijcard.2022.02.021
Association of Coffee Consumption With Total and Cause-Specific Mortality Among Nonwhite Populations.
Annals of internal medicine
BACKGROUND:Coffee consumption has been associated with reduced risk for death in prospective cohort studies; however, data in nonwhites are sparse. OBJECTIVE:To examine the association of coffee consumption with risk for total and cause-specific death. DESIGN:The MEC (Multiethnic Cohort), a prospective population-based cohort study established between 1993 and 1996. SETTING:Hawaii and Los Angeles, California. PARTICIPANTS:185 855 African Americans, Native Hawaiians, Japanese Americans, Latinos, and whites aged 45 to 75 years at recruitment. MEASUREMENTS:Outcomes were total and cause-specific mortality between 1993 and 2012. Coffee intake was assessed at baseline by means of a validated food-frequency questionnaire. RESULTS:58 397 participants died during 3 195 484 person-years of follow-up (average follow-up, 16.2 years). Compared with drinking no coffee, coffee consumption was associated with lower total mortality after adjustment for smoking and other potential confounders (1 cup per day: hazard ratio [HR], 0.88 [95% CI, 0.85 to 0.91]; 2 to 3 cups per day: HR, 0.82 [CI, 0.79 to 0.86]; ≥4 cups per day: HR, 0.82 [CI, 0.78 to 0.87]; P for trend < 0.001). Trends were similar between caffeinated and decaffeinated coffee. Significant inverse associations were observed in 4 ethnic groups; the association in Native Hawaiians did not reach statistical significance. Inverse associations were also seen in never-smokers, younger participants (<55 years), and those who had not previously reported a chronic disease. Among examined end points, inverse associations were observed for deaths due to heart disease, cancer, respiratory disease, stroke, diabetes, and kidney disease. LIMITATION:Unmeasured confounding and measurement error, although sensitivity analysis suggested that neither was likely to affect results. CONCLUSION:Higher consumption of coffee was associated with lower risk for death in African Americans, Japanese Americans, Latinos, and whites. PRIMARY FUNDING SOURCE:National Cancer Institute.
10.7326/M16-2472
Association of Coffee, Decaffeinated Coffee and Caffeine Intake from Coffee with Cognitive Performance in Older Adults: National Health and Nutrition Examination Survey (NHANES) 2011-2014.
Dong Xue,Li Shiru,Sun Jing,Li Yan,Zhang Dongfeng
Nutrients
The aim of this study was to examine the association of coffee, caffeinated coffee, decaffeinated coffee and caffeine intake from coffee with cognitive performance in older adults. we used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Coffee and caffeine intake were obtained through two 24-hour dietary recalls. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) test, Animal Fluency test and Digit Symbol Substitution Test (DSST). Binary logistic regression and restricted cubic spline models were applied to evaluate the association of coffee and caffeine intake with cognitive performance. A total of 2513 participants aged 60 years or older were included. In the fully adjusted model, compared to those reporting no coffee consumption, those who reported 266.4-495 (g/day) had a multivariate adjusted odd ratio (OR) with 95% confidence interval (CI) of 0.56(0.35-0.89) for DSST test score, compared to those reporting no caffeinated coffee consumption, those who reported ≥384.8 (g/day) had a multivariate-adjusted OR (95% CI) of 0.68(0.48-0.97) for DSST test score, compared to the lowest quartile of caffeine intake from coffee, the multivariate adjusted OR (95% CI) of the quartile (Q) three was 0.62(0.38-0.98) for the CERAD test score. L-shaped associations were apparent for coffee, caffeinated coffee and caffeine from coffee with the DSST test score and CERAD test score. No significant association was observed between decaffeinated coffee and different dimensions of cognitive performance. Our study suggests that coffee, caffeinated coffee and caffeine from coffee were associated with cognitive performance, while decaffeinated coffee was not associated with cognitive performance.
10.3390/nu12030840
Normative values of muscle strength across ages in a 'real world' population: results from the longevity check-up 7+ project.
Landi Francesco,Calvani Riccardo,Martone Anna Maria,Salini Sara,Zazzara Maria Beatrice,Candeloro Matteo,Coelho-Junior Hélio José,Tosato Matteo,Picca Anna,Marzetti Emanuele
Journal of cachexia, sarcopenia and muscle
BACKGROUND:Low muscle strength is a powerful predictor of negative health-related events and a key component of sarcopenia. The lack of normative values for muscle strength across ages hampers the practical appraisal of this parameter. The aim of the present study was to produce normative values for upper and lower extremity muscle strength across a wide spectrum of ages, in a large sample of community-dwellers recruited in the Longevity check-up (Lookup) 7+ project. METHODS:Lookup 7+ is an ongoing project that started in June 2015 and conducted in unconventional settings (i.e. exhibitions, malls, and health promotion campaigns) across Italy with the aim of fostering the adoption of healthy lifestyles in the general population. Candidate participants are eligible for enrolment if they are 18+ years and provide written informed consent. Upper and lower extremity muscle strength is assessed by handgrip strength and five-repetition chair-stand [5 × sit-to-stand (STS)] tests, respectively. Cross-sectional centile and normative values for handgrip strength and 5 × STS tests from age 18 to 80+ years were generated for the two genders. Smoothed normative curves for the two tests were constructed for men and women using the lambda-mu-sigma method. RESULTS:From 1 June 2015 to 30 May 2019, 11 448 participants were enrolled. The mean age of participants was 55.6 years (standard deviation: 11.5 years; range: 18-98 years), and 6382 (56%) were women. Normative values for handgrip strength and the 5 × STS test, both absolute and normalized by body mass index, were obtained for men and women, stratified by age groups. Values of upper and lower extremity muscle strength across ages identified three periods in life: an increase to peak in young age and early adulthood (18-24 years), preservation through midlife (25-44 years), and a decline from midlife onwards (45+ years). CONCLUSIONS:Our study established age-specific and gender-specific percentile reference values for handgrip strength and the 5 × STS test. The normative curves generated can be used to interpret the assessment of muscle strength in everyday practice for the early detection of individuals with or at risk of sarcopenia.
10.1002/jcsm.12610
Race, Ethnicity, Hypertension, and Heart Disease: JACC Focus Seminar 1/9.
Ogunniyi Modele O,Commodore-Mensah Yvonne,Ferdinand Keith C
Journal of the American College of Cardiology
Hypertension is the leading cause of cardiovascular morbidity and mortality globally. In the United States, the prevalence of hypertension (blood pressure ≥130/80 mm Hg) among adults is approximately 45%. Racial/ethnic disparities in hypertension prevalence are well documented, especially among Black adults who are disproportionately affected and have one of the highest rates of hypertension globally. Hypertension control remains a persistent public health crisis. Recently published data indicate suboptimal hypertension control rates, particularly for racial/ethnic minority groups in the United States. This requires urgent action because of the significant health care burden from cardiovascular- and stroke-related morbidity and mortality. This clinical review delineates racial/ethnic disparities in the epidemiology of hypertension, and the impact of social determinants of health on the quality of cardiovascular care and outcomes. Clinical practice guideline recommendations and various national programs targeted toward hypertension control and proposed solutions to eliminate these disparities are discussed.
10.1016/j.jacc.2021.06.017
[Management of arterial hypertension : ESC/ESH guidelines 2018].
Schunkert H
Herz
The ESC/ESH guidelines 2018 for the treatment of arterial hypertension are designed for adults with hypertension, i. e. ≥18 years. The guidelines reflect new findings and assess them for the recommendations. The specific objectives of these guidelines were to develop pragmatic guidance on how to improve the detection and treatment of hypertension and to improve poor blood pressure control rates by promoting simple and effective treatment strategies. This overview also presents the differences to the last guidelines on hypertension from the year 2013.
10.1007/s00059-018-4758-3
Effect of Exercise Training on Ambulatory Blood Pressure Among Patients With Resistant Hypertension: A Randomized Clinical Trial.
JAMA cardiology
Importance:Limited evidence suggests exercise reduces blood pressure (BP) in individuals with resistant hypertension, a clinical population with low responsiveness to drug therapy. Objective:To determine whether an aerobic exercise training intervention reduces ambulatory BP among patients with resistant hypertension. Design, Settings, and Participants:The Exercise Training in the Treatment of Resistant Hypertension (EnRicH) trial is a prospective, 2-center, single-blinded randomized clinical trial performed at 2 hospital centers in Portugal from March 2017 to December 2019. A total of 60 patients with a diagnosis of resistant hypertension aged 40 to 75 years were prospectively enrolled and observed at the hospitals' hypertension outpatient clinic. Interventions:Patients were randomly assigned in a 1:1 ratio to a 12-week moderate-intensity aerobic exercise training program (exercise group) or a usual care control group. The exercise group performed three 40-minute supervised sessions per week in addition to usual care. Main Outcomes and Measures:The powered primary efficacy measure was 24-hour ambulatory systolic BP change from baseline. Secondary outcomes included daytime and nighttime ambulatory BP, office BP, and cardiorespiratory fitness. Results:A total of 53 patients completed the study, including 26 in the exercise group and 27 in the control group. Of these, 24 (45%) were women, and the mean (SD) age was 60.1 (8.7) years. Compared with the control group, among those in the exercise group, 24-hour ambulatory systolic BP was reduced by 7.1 mm Hg (95% CI, -12.8 to -1.4; P = .02). Additionally, 24-hour ambulatory diastolic BP (-5.1 mm Hg; 95% CI, -7.9 to -2.3; P = .001), daytime systolic BP (-8.4 mm Hg; 95% CI, -14.3 to -2.5; P = .006), and daytime diastolic BP (-5.7 mm Hg; 95% CI, -9.0 to -2.4; P = .001) were reduced in the exercise group compared with the control group. Office systolic BP (-10.0 mm Hg; 95% CI, -17.6 to -2.5; P = .01) and cardiorespiratory fitness (5.05 mL/kg per minute of oxygen consumption; 95% CI, 3.5 to 6.6; P < .001) also improved in the exercise group compared with the control group. Conclusions and Relevance:A 12-week aerobic exercise program reduced 24-hour and daytime ambulatory BP as well as office systolic BP in patients with resistant hypertension. These findings provide clinicians with evidence to embrace moderate-intensity aerobic exercise as a standard coadjutant therapy targeting this patient population. Trial Registration:ClinicalTrials.gov Identifier: NCT03090529.
10.1001/jamacardio.2021.2735
Effects of Differences in Exercise Programs With Regular Resistance Training on Resting Blood Pressure in Hypertensive Adults: A Systematic Review and Meta-Analysis.
Journal of strength and conditioning research
ABSTRACT:Igarashi, Y. Effects of differences in exercise programs with regular resistance training on resting blood pressure in hypertensive adults: A systematic review and meta-analysis. J Strength Cond Res 37(1): 253-263, 2023-This systematic review and meta-analysis aimed to evaluate changes in resting blood pressure (RBP) with differences in regular resistance training (RT) programs. Inclusion criteria were randomized controlled trials involving hypertensive adults and interventions involving only RT of both the upper and lower limbs for ≥7 weeks. The weighted mean difference (WMD) was defined as the mean difference between the exercise and control groups, weighted by the inverse of the squared standard error for each study, and all WMDs in RBP were pooled as overall effects. A simple meta-regression analysis was performed to evaluate the relationship between RT variables (percentage 1 repetition maximum [1RM], number of repetitions, number of sets, and weekly frequency) and changes in RBP. Seventeen studies (646 subjects) were analyzed. The pooled WMDs in the resting systolic blood pressure (RSBP) and resting diastolic blood pressure (RDBP) decreased significantly but contained significant heterogeneity {RSBP, -4.7 mm Hg (95% confidence interval [CI], -6.7 to -2.8; I2 = 46.6%); RDBP, -3.5 mm Hg (95% CI, -4.9 to -2.1; I2 = 39.1%)}. Meta-regression analysis revealed that an increase in % 1RM was significantly associated with a decrease in the RSBP (γ = -0.25x 0 + 10.85, where γ represents the mean difference in RSBP, and x 0 represents % 1RM [%]), and heterogeneity was alleviated ( I2 = 0.0%). For reducing RSBP, regular RT with moderate or heavy loads may be more beneficial than regular RT with light loads.
10.1519/JSC.0000000000004236
Mechanisms for blood pressure reduction following isometric exercise training: a systematic review and meta-analysis.
Journal of hypertension
OBJECTIVE:Isometric exercise training (IET) is established as an effective antihypertensive intervention. Despite this, the physiological mechanisms driving blood pressure (BP) reductions following IET are not well understood. Therefore, we aimed to perform the first meta-analysis of the mechanistic changes measured following IET. METHODS:PubMed, Cochrane library and SPORTDiscus were systematically searched for randomized controlled trials published between January 2000 and December 2021 reporting the effects of IET on resting BP and at least one secondary mechanistic parameter following a short-term intervention (2-12 weeks). RESULTS:Eighteen studies with a pooled sample size of 628 participants were included in the final analysis. IET produced significant reductions in resting systolic and diastolic BP of 9.35 mmHg (95% confidence interval [CI] = -7.80 to -10.89, P < 0.001) and 4.30 mmHg (CI = -3.01 to -5.60, P < 0.001), respectively. Mechanistically, IET produced a statistically significant reduction in resting heart rate (mean difference [MD]: -1.55 bpm, CI = -0.14 to -2.96, P = 0.031) and a significant increase in stroke volume (MD: 6.35 ml, CI = 0.35 to 12.60, P = 0.038), with no significant change in cardiac output. Conversely, total peripheral resistance (TPR) significantly decreased following IET (MD: -100.38 dyne s -1 cm 5 , CI = -14.16 to -186.61, P = 0.023), with significant improvements in the low frequency to high frequency heart rate variability ratio (MD: -0.41, CI = -0.09 to -0.73, P = 0.013) and baroreceptor reflex sensitivity (MD: 7.43 ms/mmHg, P < 0.001). CONCLUSION:This work demonstrates that a reduction in TPR, potentially mediated through enhanced autonomic vasomotor control, is primarily responsible for BP reductions following IET. Furthermore, this novel analysis suggests wall squat interventions to be the most effective IET mode, with clinically relevant differences in BP reductions compared to handgrip and leg extension IET; although future direct comparative research is required.
10.1097/HJH.0000000000003261
Global burden of hypertension: analysis of worldwide data.
Kearney Patricia M,Whelton Megan,Reynolds Kristi,Muntner Paul,Whelton Paul K,He Jiang
Lancet (London, England)
BACKGROUND:Reliable information about the prevalence of hypertension in different world regions is essential to the development of national and international health policies for prevention and control of this condition. We aimed to pool data from different regions of the world to estimate the overall prevalence and absolute burden of hypertension in 2000, and to estimate the global burden in 2025. METHODS:We searched the published literature from Jan 1, 1980, to Dec 31, 2002, using MEDLINE, supplemented by a manual search of bibliographies of retrieved articles. We included studies that reported sex-specific and age-specific prevalence of hypertension in representative population samples. All data were obtained independently by two investigators with a standardised protocol and data-collection form. RESULTS:Overall, 26.4% (95% CI 26.0-26.8%) of the adult population in 2000 had hypertension (26.6% of men [26.0-27.2%] and 26.1% of women [25.5-26.6%]), and 29.2% (28.8-29.7%) were projected to have this condition by 2025 (29.0% of men [28.6-29.4%] and 29.5% of women [29.1-29.9%]). The estimated total number of adults with hypertension in 2000 was 972 million (957-987 million); 333 million (329-336 million) in economically developed countries and 639 million (625-654 million) in economically developing countries. The number of adults with hypertension in 2025 was predicted to increase by about 60% to a total of 1.56 billion (1.54-1.58 billion). INTERPRETATION:Hypertension is an important public-health challenge worldwide. Prevention, detection, treatment, and control of this condition should receive high priority.
10.1016/S0140-6736(05)17741-1
American College of Sports Medicine position stand. Exercise and hypertension.
Pescatello Linda S,Franklin Barry A,Fagard Robert,Farquhar William B,Kelley George A,Ray Chester A,
Medicine and science in sports and exercise
Hypertension (HTN), one of the most common medical disorders, is associated with an increased incidence of all-cause and cardiovascular disease (CVD) mortality. Lifestyle modifications are advocated for the prevention, treatment, and control of HTN, with exercise being an integral component. Exercise programs that primarily involve endurance activities prevent the development of HTN and lower blood pressure (BP) in adults with normal BP and those with HTN. The BP lowering effects of exercise are most pronounced in people with HTN who engage in endurance exercise with BP decreasing approximately 5-7 mm HG after an isolated exercise session (acute) or following exercise training (chronic). Moreover, BP is reduced for up to 22 h after an endurance exercise bout (e.g.postexercise hypotension), with greatest decreases among those with highest baseline BP. The proposed mechanisms for the BP lowering effects of exercise include neurohumoral, vascular, and structural adaptations. Decreases in catecholamines and total peripheral resistance, improved insulin sensitivity, and alterations in vasodilators and vasoconstrictors are some of the postulated explanations for the antihypertensive effects of exercise. Emerging data suggest genetic links to the BP reductions associated with acute and chronic exercise. Nonetheless, definitive conclusions regarding the mechanisms for the BP reductions following endurance exercise cannot be made at this time. Individuals with controlled HTN and no CVD or renal complications may participated in an exercise program or competitive athletics, but should be evaluated, treated and monitored closely. Preliminary peak or symptom-limited exercise testing may be warranted, especially for men over 45 and women over 55 yr planning a vigorous exercise program (i.e. > or = 60% VO2R, oxygen uptake reserve). In the interim, while formal evaluation and management are taking place, it is reasonable for the majority of patients to begin moderate intensity exercise (40-<60% VO2R) such as walking. When pharmacological therapy is indicated in physically active people it should be, ideally: a) lower BP at rest and during exertion; b) decrease total peripheral resistance; and, c) not adversely affect exercise capacity. For these reasons, angiotensin converting enzyme (ACE) inhibitors (or angiotensin II receptor blockers in case of ACE inhibitor intolerance) and calcium channel blockers are currently the drugs of choice for recreational exercisers and athletes who have HTN. Exercise remains a cornerstone therapy for the primary prevention, treatment, and control of HTN. The optimal training frequency, intensity, time, and type (FITT) need to be better defined to optimize the BP lowering capacities of exercise, particularly in children, women, older adults, and certain ethnic groups. based upon the current evidence, the following exercise prescription is recommended for those with high BP: Frequency: on most, preferably all, days of the week. Intensity: moderate-intensity (40-<60% VO2R). Time: > or = 30 min of continuous or accumulated physical activity per day. Type: primarily endurance physical activity supplemented by resistance exercise.
American College of Sports Medicine position stand. Exercise and physical activity for older adults.
,Chodzko-Zajko Wojtek J,Proctor David N,Fiatarone Singh Maria A,Minson Christopher T,Nigg Claudio R,Salem George J,Skinner James S
Medicine and science in sports and exercise
The purpose of this Position Stand is to provide an overview of issues critical to understanding the importance of exercise and physical activity in older adult populations. The Position Stand is divided into three sections: Section 1 briefly reviews the structural and functional changes that characterize normal human aging, Section 2 considers the extent to which exercise and physical activity can influence the aging process, and Section 3 summarizes the benefits of both long-term exercise and physical activity and shorter-duration exercise programs on health and functional capacity. Although no amount of physical activity can stop the biological aging process, there is evidence that regular exercise can minimize the physiological effects of an otherwise sedentary lifestyle and increase active life expectancy by limiting the development and progression of chronic disease and disabling conditions. There is also emerging evidence for significant psychological and cognitive benefits accruing from regular exercise participation by older adults. Ideally, exercise prescription for older adults should include aerobic exercise, muscle strengthening exercises, and flexibility exercises. The evidence reviewed in this Position Stand is generally consistent with prior American College of Sports Medicine statements on the types and amounts of physical activity recommended for older adults as well as the recently published 2008 Physical Activity Guidelines for Americans. All older adults should engage in regular physical activity and avoid an inactive lifestyle.
10.1249/MSS.0b013e3181a0c95c
Personalized exercise prescription in the prevention and treatment of arterial hypertension: a Consensus Document from the European Association of Preventive Cardiology (EAPC) and the ESC Council on Hypertension.
Hanssen Henner,Boardman Henry,Deiseroth Arne,Moholdt Trine,Simonenko Maria,Kränkel Nicolle,Niebauer Josef,Tiberi Monica,Abreu Ana,Solberg Erik Ekker,Pescatello Linda,Brguljan Jana,Coca Antonio,Leeson Paul
European journal of preventive cardiology
Treatment of hypertension and its complications remains a major ongoing health care challenge. Around 25% of heart attacks in Europe are already attributed to hypertension and by 2025 up to 60% of the population will have hypertension. Physical inactivity has contributed to the rising prevalence of hypertension, but patients who exercise or engage in physical activity reduce their risk of stroke, myocardial infarction, and cardiovascular mortality. Hence, current international guidelines on cardiovascular disease prevention provide generic advice to increase aerobic activity, but physiological responses differ with blood pressure (BP) level, and greater reductions in BP across a population may be achievable with more personalized advice. We performed a systematic review of meta-analyses to determine whether there was sufficient evidence for a scientific Consensus Document reporting how exercise prescription could be personalized for BP control. The document discusses the findings of 34 meta-analyses on BP-lowering effects of aerobic endurance training, dynamic resistance training as well as isometric resistance training in patients with hypertension, high-normal, and individuals with normal BP. As a main finding, there was sufficient evidence from the meta-review, based on the estimated range of exercise-induced BP reduction, the number of randomized controlled trials, and the quality score, to propose that type of exercise can be prescribed according to initial BP level, although considerable research gaps remain. Therefore, this evidence-based Consensus Document proposes further work to encourage and develop more frequent use of personalized exercise prescription to optimize lifestyle interventions for the prevention and treatment of hypertension.
10.1093/eurjpc/zwaa141
Pharmacology of dipeptidyl peptidase-4 inhibitors and its use in the management of metabolic syndrome: a comprehensive review on drug repositioning.
Rameshrad Maryam,Razavi Bibi Marjan,Ferns Gordon A A,Hosseinzadeh Hossein
Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences
OBJECTIVES:Despite advances in our understanding of metabolic syndrome (MetS) and the treatment of each of its components separately, currently there is no single therapy approved to manage it as a single condition. Since multi-drug treatment increases drug interactions, decreases patient compliance and increases health costs, it is important to introduce single therapies that improve all of the MetS components. EVIDENCE ACQUISITION:We conducted a PubMed, Scopus, Google Scholar, Web of Science, US FDA, utdo.ir and clinicaltrial.gov search, gathered the most relevant preclinical and clinical studies that have been published since 2010, and discussed the beneficial effects of dipeptidyl peptidase (DPP)-4 inhibitors to prevent and treat different constituent of the MetS as a single therapy. Furthermore, the pharmacology of DPP-4 inhibitors, focusing on pharmacodynamics, pharmacokinetics, drug interactions and their side effects are also reviewed. RESULTS:DPP-4 inhibitors or gliptins are a new class of oral anti-diabetic drugs that seem safe drugs with no severe side effects, commonly GI disturbance, infection and inflammatory bowel disease. They increase mass and function of pancreatic β-cells, and insulin sensitivity in liver, muscle and adipose tissue. It has been noted that gliptin therapy decreases dyslipidemia. DPP-4 inhibitors increase fatty oxidation, and cholesterol efflux, and decrease hepatic triglyceride synthase and de novo lipogenesis. They delay gastric emptying time and lead to satiety. Besides, gliptin therapy has anti-inflammatory and anti-atherogenic impacts, and improves endothelial function and reduces vascular stiffness. CONCLUSION:The gathered data prove the efficacy of DPP-4 inhibitors in managing MetS in some levels beyond anti-diabetic effects. This review could be a lead for designing new DPP-4 inhibitors with greatest effects on MetS in future. Introducing drugs with polypharmacologic effects could increase the patient's compliance and decrease the health cost that there is not in multi-drug therapy. Graphical abstract ᅟ.
10.1007/s40199-019-00238-7
Hypertension in older adults: Assessment, management, and challenges.
Clinical cardiology
Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho-social factors, and must therefore be individualized. Non-pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin-angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.
10.1002/clc.23303
Salt Reduction to Prevent Hypertension and Cardiovascular Disease: JACC State-of-the-Art Review.
He Feng J,Tan Monique,Ma Yuan,MacGregor Graham A
Journal of the American College of Cardiology
There is strong evidence for a causal relationship between salt intake and blood pressure. Randomized trials demonstrate that salt reduction lowers blood pressure in both individuals who are hypertensive and those who are normotensive, additively to antihypertensive treatments. Methodologically robust studies with accurate salt intake assessment have shown that a lower salt intake is associated with a reduced risk of cardiovascular disease, all-cause mortality, and other conditions, such as kidney disease, stomach cancer, and osteoporosis. Multiple complex and interconnected physiological mechanisms are implicated, including fluid homeostasis, hormonal and inflammatory mechanisms, as well as more novel pathways such as the immune response and the gut microbiome. High salt intake is a top dietary risk factor. Salt reduction programs are cost-effective and should be implemented or accelerated in all countries. This review provides an update on the evidence relating salt to health, with a particular focus on blood pressure and cardiovascular disease, as well as the potential mechanisms.
10.1016/j.jacc.2019.11.055
Can high-intensity interval training improve physical and mental health outcomes? A meta-review of 33 systematic reviews across the lifespan.
Journal of sports sciences
High-intensity-interval-training (HIIT) has been suggested to have beneficial effects in multiple populations across individual systematic reviews, although there is a lack of clarity in the totality of the evidence whether HIIT is effective and safe across different populations and outcomes. The aim of this meta-review was to establish the benefits, safety and adherence of HIIT interventions across all populations from systematic reviews and meta-analyses. Major databases were searched for systematic reviews (with/without meta-analyses) of randomised & non-randomised trials that compared HIIT to a control. Thirty-three systematic reviews (including 25 meta-analyses) were retrieved encompassing healthy subjects and people with physical health complications. Evidence suggested HIIT improved cardiorespiratory fitness, anthropometric measures, blood glucose and glycaemic control, arterial compliance and vascular function, cardiac function, heart rate, some inflammatory markers, exercise capacity and muscle mass, versus non-active controls. Compared to active controls, HIIT improved cardiorespiratory fitness, some inflammatory markers and muscle structure. Improvements in anxiety and depression were seen compared to pre-training. Additionally, no acute injuries were reported, and mean adherence rates surpassed 80% in most systematic reviews. Thus, HIIT is associated with multiple benefits. Further large-scale high-quality studies are needed to reaffirm and expand these findings. ACSM: American College of Sports Medicine; BMI: Body Mass Index; BNP: Brain Natriuretic Peptide; BP: Blood Pressure; CAD: Coronary Artery Disease; CHD: Coronary Heart Disease; COPD: Chronic Obstructive Pulmonary Disease; CRP: c- reactive Protein; CVD: Cardiovascular Disease; DBP: Diastolic Blood Pressure; ES: Effect Size; FAS: Reduced Fatty Acid Synthase; FATP-1: Reduced Fatty Acid Transport Protein 1; FMD: Flow Mediated Dilation; Hs-CRP: High-sensitivity c- reactive Protein; HDL: High Density Lipoprotein; HIIT: High-Intensity Interval Training; HOMA: Homoeostatic Model Assessment; HR: Heart Rate; HTx: Heart Transplant Recipients; IL-6: Interleukin-6; LDL: Low Density Lipoprotein; LV: Left Ventricular; LVEF: Left Ventricular Ejection Fraction; MD: Mean Difference; MetS: Metabolic Syndrome; MPO: Myeloperoxidase; MICT: Moderate-Intensity Continuous Training; NO: Nitric Oxide; NRCT: Non-Randomised Controlled Trial; PA: Physical Activity; PAI-1: Plasminogen-activator-inhibitor-1; QoL: Quality of Life; RCT: Randomised Controlled Trial; RoB: Risk of Bias; RPP: Rate Pressure Product; RT: Resistance Training; SBP: Systolic Blood Pressure; SD: Standardised Difference; SMD: Standardised Mean Difference; TAU: Treatment-As-Usual; T2DM: Type 2 Diabetes Mellitus; TC: Total Cholesterol; TG: Triglycerides; TNF-alfa: Tumour Necrosis Factor alpha; UMD: Unstandardised Mean Difference; WC: Waist Circumference; WHR: Waist-to-Hip Ratio; WMD: Weighted Mean Difference: HIIT may improve cardiorespiratory fitness, cardiovascular function, anthropometric variables, exercise capacity, muscular structure and function, and anxiety and depression severity in healthy individuals and those with physical health disorders.Additionally, HIIT appears to be safe and does not seem to be associated with acute injuries or serious cardiovascular events.
10.1080/02640414.2019.1706829
Cardiovascular Responses to Muscle Stretching: A Systematic Review and Meta-analysis.
Thomas Ewan,Bellafiore Marianna,Gentile Ambra,Paoli Antonio,Palma Antonio,Bianco Antonino
International journal of sports medicine
The aim of this study will be to review the current body of literature to understand the effects of stretching on the responses of the cardiovascular system. A literature search was performed using the following databases: Scopus, NLM Pubmed and ScienceDirect. Studies regarding the effects of stretching on responses of the cardiovascular system were investigated. Outcomes regarded heart rate(HR), blood pressure, pulse wave velocity (PWV of which baPWV for brachial-ankle and cfPWV for carotid-femoral waveforms), heart rate variability and endothelial vascular function. Subsequently, the effects of each outcome were quantitatively synthetized using meta-analytic synthesis with random-effect models. A total of 16 studies were considered eligible and included in the quantitative synthesis. Groups were also stratified according to cross-sectional or longitudinal stretching interventions. Quality assessment through the NHLBI tools observed a "fair-to-good" quality of the studies. The meta-analytic synthesis showed a significant effect of d=0.38 concerning HR, d=2.04 regarding baPWV and d=0.46 for cfPWV. Stretching significantly reduces arterial stiffness and HR. The qualitative description of the studies was also supported by the meta-analytic synthesis. No adverse effects were reported, after stretching, in patients affected by cardiovascular disease on blood pressure. There is a lack of studies regarding vascular adaptations to stretching.
10.1055/a-1312-7131
Myocardial performance index as a measure of global left ventricular function improves following isometric exercise training in hypertensive patients.
Hypertension research : official journal of the Japanese Society of Hypertension
As the leading cause of cardiovascular disease and mortality, hypertension remains a global health problem. Isometric exercise training (IET) has been established as efficacious in reducing resting blood pressure (BP); however, no research to date has investigated its effects on the myocardial performance index (MPI). Twenty-four unmedicated hypertensive patients were randomized to 4 weeks of IET and a control period in a crossover design. Tissue Doppler imaging was used to acquire cardiac time intervals pre- and post-IET and during the control periods. IET significantly improved all measures of cardiac time intervals, including isovolumic relaxation time (83.1 ± 10.3 vs. 76.1 ± 11.2 ms, p = 0.006), isovolumic contraction time (84.8 ± 10.3 vs. 72.8 ± 6.4 ms, p < 0.001), ejection time (304.6 ± 30.2 vs. 321.4 ± 20.8 ms, p = 0.015) and the MPI (0.56 ± 0.09 vs. 0.47 ± 0.05, p < 0.001). This is the first study to demonstrate that IET significantly improves cardiac time intervals. These findings may have important clinical implications, highlighting the potential utility of IET in the management of cardiac health in hypertensive patients.
10.1038/s41440-022-01019-7
Higher HEI-2015 Score Is Associated with Reduced Risk of Depression: Result from NHANES 2005-2016.
Wang Kai,Zhao Yudi,Nie Jiaqi,Xu Haoling,Yu Chuanhua,Wang Suqing
Nutrients
Globally, the total estimated number of people living with depression increased by 18.4% between 2005 and 2015, with the prevalence being 4.8% in 2015. Many nutrient and diet patterns are proven to be correlated to depression, so we conducted this analysis to explore whether the Healthy Eating Index 2015 (HEI-2015) score is associated with depression, and possibly to provide dietary measures to reduce the risk of depression. Data came from the National Health and Nutrition Examination Survey (2005-2016), a cross-sectional and nationally representative database. The analytic sample was limited to adults: (1) age ≥20 with complete information of HEI-2015 and depression; (2) no missing data of demographics, BMI, drinking, smoking, and fasting plasma glucose. HEI-2015 was calculated using the Dietary Interview: Total Nutrient Intakes, First Day data file. Depression was assessed using the Patient Health Questionnaire-9 (PHQ-9). Weighted logistic regression models were used to explore the relationship between the HEI-2015 score and depression. The final study sample included 10,349 adults, with 51.4% of them being men, representing a population of about 167.8 million non-institutionalized U.S. adults. After multivariable adjustment, average HEI status (OR: 0.848, 95% CI: 0.846-0.849) and optimal HEI status (OR: 0.455, 95% CI: 0.453-0.456) were associated with reduced odds of depression. Poor diet quality is significantly associated with elevated depressive symptoms in U.S. adults. Aligning with the Dietary Guidelines for Americans reduces the risk of depression.
10.3390/nu13020348
A Matlab Tool for Organizing and Analyzing NHANES Data.
Cichosz Simon Lebech,Jensen Morten Hasselstrøm,Larsen Thomas Kronborg,Hejlesen Ole
Studies in health technology and informatics
Automation of organizing and analyzing NHANES data can provide easier access to data and potentially reducing risk of introducing bias. This study investigates the potential for developing a software for this purpose. MATLAB R2016b was used for transforming and analyzing data from the NHANES. The software was tested successful by analyzing the association between smoking and glucose metabolism in the general population.
10.3233/SHTI200351
Inverse Association of Telomere Length With Liver Disease and Mortality in the US Population.
Rattan Puru,Penrice Daniel D,Ahn Joseph C,Ferrer Alejandro,Patnaik Mrinal,Shah Vijay H,Kamath Patrick S,Mangaonkar Abhishek A,Simonetto Douglas A
Hepatology communications
Physiologic aging leads to attrition of telomeres and replicative senescence. An acceleration of this process has been hypothesized in the progression of chronic liver disease. We sought to examine the association of telomere length (TL) with liver disease and its impact on mortality risk. A cohort of 7,072 adults with leukocyte TL measurements from the National Health and Nutrition Examination Survey 1999-2002 with mortality follow-up through 2015 was analyzed. Liver disease was defined by aminotransferase levels and classified into etiology-based and advanced fibrosis categories. Multivariable-adjusted linear regression models estimated effect sizes, with 95% confidence intervals (CIs), of the presence of liver disease on TL. Cox regression models evaluated associations between TL and all-cause mortality risk using adjusted hazard ratios (HRs). The cohort was representative of the US population with mean age 46.1 years and mean TL 5.79 kilobase pairs. No overall association between TL and liver disease was found; however, there was a significant negative association of TL and advanced liver fibrosis in individuals aged 65 and above. The liver disease cohort (HR 1.22, 95% CI 0.99-1.51) and those with metabolic syndrome (HR 1.26, 95% CI 0.96-1.67) had increased mortality risk with shorter TL. The relationship between TL and all-cause mortality was stronger in women (HR 1.51, 95% CI 1.02-2.23) and in non-Hispanic Whites (HR 1.37, 95% CI 1.02-1.84). Conclusion: Shortened leukocyte TL is independently associated with advanced liver disease at older ages, and with a higher risk of all-cause mortality in those with liver disease. These associations reaffirm the need to better understand the role of telomeres in the progression of liver disease.
10.1002/hep4.1803
Prescription of exercise training for hypertensives.
Sakamoto Shizuo
Hypertension research : official journal of the Japanese Society of Hypertension
In Japan, there were an estimated 43 million patients with hypertension in 2010. The management of this condition is given the highest priority in disease control, and the importance of lifestyle changes for the prevention and treatment of hypertension has been recognized in Japan. In particular, emphasis has been placed on increasing the levels of activities of daily living and physical exercise (sports). In this literature review, we examined appropriate exercise prescriptions (e.g., type, intensity, duration per session, and frequency) for the prevention and treatment of hypertension as described in Japanese and foreign articles. This review recommends safe and effective whole-body aerobic exercise at moderate intensity (i.e., 50-65% of maximum oxygen intake, 30-60 min per session, 3-4 times a week) that primarily focuses on the major muscle groups for the prevention and treatment of hypertension. Resistance exercise should be performed at low-intensity without breath-holding and should be used as supplementary exercise, but resistance exercise is contraindicated in patients with hypertension who have chest symptoms such as chest pain.
10.1038/s41440-019-0344-1
Exercise to Treat Hypertension: Late Breaking News on Exercise Prescriptions That FITT.
Current sports medicine reports
ABSTRACT:Hypertension is the leading risk factor for cardiovascular disease and an independent predictor of mortality. The prevalence of hypertension has doubled in the last two decades and evidence suggests that almost half the individuals are unaware of their condition. The antihypertensive effects of exercise are now undisputable, and exercise training is recommended by the major professional and scientific societies, including the American College of Sports Medicine (ACSM), as first-line treatment to prevent, treat, and control hypertension. This review aims to overview the evidence supporting the current ACSM Frequency, Intensity, Time, and Type exercise recommendations for hypertension, discuss new and emerging evidence on exercise in the treatment of hypertension from our laboratories; and propose future directions of research integrating this new and emerging evidence.
10.1249/JSR.0000000000000983
Muscle-strengthening exercise and prevalent hypertension among 1.5 million adults: a little is better than none.
Bennie Jason A,Lee Duck-Chul,Brellenthin Angelique G,De Cocker Katrien
Journal of hypertension
BACKGROUND:Clinical evidence suggests that muscle-strengthening exercise (using weight machines/body weight exercises) may be an important antihypertensive lifestyle therapy. However, epidemiological research on the association between muscle-strengthening exercise and hypertension is limited. We conducted the first population-level study describing the associations between muscle-strengthening exercise and prevalent hypertension among a large sample of US adults. METHODS:In this cross-sectional study, data were pooled from four US health surveillance surveys (2011-2017) (n = 1 539 309, aged ≥18 years). Muscle-strengthening exercise frequency and self-reported clinically diagnosed hypertension (n = 431 313; 28%) were assessed using the same items across each survey. Generalized linear models using Poisson regression with robust error variance were used to calculate the prevalence ratios of hypertension (outcome variable) across muscle-strengthening exercise [exposure variables: 0 (reference); 1 to ≥7 times/week), adjusting for potential cofounders. RESULTS:Compared with those doing none, the adjusted prevalence ratios for hypertension were 0.67 (95% CI: 0.66-0.68), 0.67 (95% CI: 0.67-0.68), 0.70 (95% CI: 0.69-0.70), 0.61 (95% CI: 0.60-0.63), 0.62 (95% CI: 0.61-0.64), 0.60 (95% CI: 0.58-0.62) and 0.83 (95% CI: 0.82-0.84) among the groups engaging in muscle-strengthening exercise one, two, three, four, five, six, and at least seven times/week, respectively. Associations remained after stratification for sociodemographic factors (age, sex), lifestyle characteristics (aerobic exercise, BMI, self-rated health, smoking, alcohol) and comorbidities (e.g. arthritis, diabetes, depression). CONCLUSION:Among over 1.5 million adults, compared with those doing none, any weekly frequency in muscle-strengthening exercise was associated with a lower prevalence of hypertension. Longitudinal studies and large-scale muscle-strengthening exercise interventions with population representative samples are needed to confirm these preliminary cross-sectional observations.
10.1097/HJH.0000000000002415
Relative Handgrip Strength and Incidence of Hypertension: A Case-Cohort Study From Ravansar Non-Communicable Diseases Cohort.
Journal of physical activity & health
BACKGROUND:The present study assessed the association between relative handgrip strength (RHGS) and hypertension incidence in healthy adults. METHODS:We performed a case-cohort study on 3784 participants from Ravansar Non-Communicable Diseases cohort study. The absolute HGS was measured using a digital dynamometer. Hypertension was defined as systolic/diastolic blood pressure ≥140/90 mm Hg and/or use of antihypertensive medications. Cox regression analysis was utilized to estimate hazard ratios of incident hypertension events with RHGS. RESULTS:Physical activity was significantly higher in the participants with hypertension compared with nonhypertensive participants (P < .001). High-level physical activity in the subjects with lower, middle, and upper RHGS was 19.6%, 33.1%, and 47.3%, respectively (P < .001). RHGS was significantly higher in individuals with greater skeletal muscle mass (P < .001). The men and women with the upper RHGS, had an 80% (hazard ratio: 0.2; 95% confidence interval, 0.1-0.3) and 70% (hazard ratio: 0.3; 95% confidence interval, 0.1-1.2), were lower risk of hypertension compared with those with the lower RHGS, respectively. This association remains significant after adjustment for confounding factors in men. CONCLUSION:The study demonstrated that middle and upper levels of RHGS were associated with a lower risk of hypertension incidence. RHGS may be a protective factor for hypertension. We suggested muscle strengthening exercises.
10.1123/jpah.2021-0774
Sarcopenia is associated with hypertension in older adults: a systematic review and meta-analysis.
Bai Tingting,Fang Fang,Li Feika,Ren Yan,Hu Jiaan,Cao Jiumei
BMC geriatrics
BACKGROUND:Sarcopenia, particularly low handgrip strength has been observed and correlated in association with hypertension among the older people. However, the results reported in different studies were inconsistent. In the current study, we conducted a systematic review and meta-analysis to reveal the significant association between sarcopenia, handgrip strength, and hypertension in older adults. METHODS:PubMed, MEDLINE, Cochrane Library, and EMBASE databases were searched from inception to 15 November 2019 to retrieve the original research studies that addressed the association between sarcopenia, handgrip strength, and hypertension. All the relevant data were retrieved, analyzed, and summarized. RESULTS:Twelve articles met the inclusion criteria and a total of 21,301 participants were included in the meta-analysis. Eight eligible studies have reported the odd ratios (ORs) of hypertension and sarcopenia, and the ORs ranged from 0.41 to 4.38. When pooled the ORs together, the summarized OR was 1.29 [95% confidence interval (CI) =1.00-1.67]. The summarized OR for the Asian group 1.50 (95% CI = 1.35-1.67) was significantly higher than that of Caucasian group 1.08 (95% CI = 0.39-2.97). Eleven studies have provided the data on association between handgrip strength and hypertension. The overall OR and 95% CI was 0.99 (95% CI = 0.80-1.23), showing no significant association. CONCLUSION:Sarcopenia was associated with hypertension, but no correlation was found between handgrip strength and hypertension in older adults.
10.1186/s12877-020-01672-y
Physical activity and fitness for the prevention of hypertension.
Bakker Esmée A,Sui Xuemei,Brellenthin Angelique G,Lee Duck-Chul
Current opinion in cardiology
PURPOSE OF REVIEW:The aim of this review is to evaluate the most recent literature about the role of physical activity, exercise, and fitness in hypertension prevention. RECENT FINDINGS:Strong evidence indicates that performing moderate-to-vigorous physical activity, particularly aerobic exercise, and improving cardiorespiratory fitness (CRF) reduce blood pressure (BP) levels and lower hypertension incidence. Although evidence is limited, performing resistance exercise or improving muscular strength appears to be associated with a lower incidence of hypertension. Furthermore, reducing sedentary time or replacing sedentary time with physical activity might lower BP. SUMMARY:To lower the risk of hypertension, promoting physical activity and improving fitness, especially CRF, should be encouraged. More research is needed to determine the effects of sedentary behavior, resistance exercise, and muscle strength on the development of hypertension across diverse populations and settings. Future studies should focus on dose-response relationships of exercise and physical activity with the development of hypertension to determine the minimal and optimal amount of exercise and physical activity for hypertension prevention.
10.1097/HCO.0000000000000526
Loss of muscle strength, mass (sarcopenia), and quality (specific force) and its relationship with functional limitation and physical disability: the Concord Health and Ageing in Men Project.
Hairi Noran N,Cumming Robert G,Naganathan Vasi,Handelsman David J,Le Couteur David G,Creasey Helen,Waite Louise M,Seibel Markus J,Sambrook Philip N
Journal of the American Geriatrics Society
OBJECTIVES:To determine the association between loss of muscle strength, mass, and quality and functional limitation and physical disability in older men. DESIGN:Cross-sectional study of older men participating in the Concord Health and Ageing in Men Project (CHAMP). SETTING:Elderly men living in a defined geographical region in Sydney, Australia. PARTICIPANTS:One thousand seven hundred five community-dwelling men aged 70 and older who participated in the baseline assessments of CHAMP. MEASUREMENTS:Upper and lower extremity strength were measured using dynamometers for grip and quadriceps strength. Appendicular skeletal lean mass was assessed using dual X-ray absorptiometry. Muscle quality was defined as the ratio of strength to mass in upper and lower extremities. For each parameter, subjects in the lowest 20% of the distribution were defined as below normal. Functional limitation was assessed according to self-report and objective lower extremity performance measures. Physical disability was measured according to self-report questionnaire. RESULTS:After adjusting for important confounders, the prevalence ratio (PR) for poor quadriceps strength and self-reported functional limitation was 1.91 (95% confidence interval (CI) = 1.10-2.40); for performance-based functional limitation the PR was 1.81 (95% CI = 1.45-2.24). The adjusted PR for poor grip strength and physical disability in instrumental activities of daily living (IADLs) was 1.37 (95% CI = 1.20-1.56). The adjusted PR for low skeletal lean mass (adjusted for fat mass) and physical disability in basic activities of daily living was 2.08 (95% CI = 1.37-3.15). For muscle quality, the PR for lower extremity specific force and functional limitation and physical disability was stronger than upper extremity specific force. CONCLUSION:Muscle strength is the single best measure of age-related muscle change and is associated with physical disability in IADLs and functional limitation.
10.1111/j.1532-5415.2010.03145.x
Handgrip strength and muscle quality in Australian women: cross-sectional data from the Geelong Osteoporosis Study.
Journal of cachexia, sarcopenia and muscle
BACKGROUND:Low handgrip strength (HGS) is a measure of poor skeletal muscle performance and a marker of ill health and frailty. Muscle quality (MQ) is a measure of muscle strength relative to muscle mass. We aimed to develop normative data for HGS and MQ, report age-related prevalence of low HGS and MQ, and determine the relationship with age, anthropometry, and body composition for women in Australia. METHODS:This cross-sectional analysis included data from 792 women (ages 28-95 years) assessed by the Geelong Osteoporosis Study. Duplicate measures of HGS were performed for each hand with a dynamometer (Jamar) and the mean of maximum values used for analyses. Dual energy X-ray absorptiometry-derived lean mass for the arms was used to calculate MQ as HGS/lean mass (kg/kg). Body mass index (BMI) was categorized as normal (BMI < 25.0 kg/m ), overweight (25.0-29.9 kg/m ), and obese (>30.0 kg/m ). Fat mass index (FMI) was calculated as whole body fat/height (kg/m ) and appendicular lean mass index (ALMI) as lean mass of arms and legs/height (kg/m ). RESULTS:Mean (±SD) of HGS values for normal BMI, overweight, and obese groups were 25 (±7), 24 (±7), and 24 (±7) kg, P = 0.09, and for MQ, 12 (±3), 11 (±3), and 10 (±3) kg/kg, P < 0.001. Our data indicated a quadratic relationship between age and HGS or MQ. Mean HGS and MQ remained stable until the fifth age decade then declined steadily with increasing age; therefore, we used data for women (n = 283) aged 28-49 years as the young adult reference group, with mean (SD) values for HGS 28 (±6) kg and MQ 12 (±3) kg/kg. The prevalence of low (T-score < -2) HGS and MQ for women 80 years and older was 52.2% and 39.6%, respectively. In multivariable models, age-adjusted HGS was associated with FMI (B = -0.13, P = 0.004) and ALMI (1.03, <0.001) while age-adjusted MQ was associated with BMI (-0.15, <0.001) but not with FMI. In a sensitivity analysis, the same pattern remained after the removal of 129 women who reported hand and/or arm pain. CONCLUSIONS:Mean HGS and MQ declined with advancing age in older women. Our data suggest that while mean HGS increased with appendicular lean mass and decreased with body fat mass, there was no association with BMI. By contrast, MQ decreased with increasing BMI, but not with increasing adiposity.
10.1002/jcsm.12544
Effects of an integrated health education and elastic band resistance training program on physical function and muscle strength in community-dwelling elderly women: Healthy Aging and Happy Aging II study.
Oh Seung-Lyul,Kim Hee-Jae,Woo Shinae,Cho Be-Long,Song Misoon,Park Yeon-Hwan,Lim Jae-Young,Song Wook
Geriatrics & gerontology international
AIM:In the present study, we determined the effect of an integrated health education and elastic band resistance training program on body composition, physical function, muscle strength and quality in community-dwelling elderly women. METHODS:We recruited participants with eligibility inclusion criteria, and randomly assigned them to either the control group (n = 19) or the intervention group (n = 19). The integrated intervention program comprised of health education and individual counseling, and elastic band training for 18 weeks (8 weeks of supervised training and 10 weeks of self-directed training). We assessed body composition, muscle strength and quality, and physical function at pre-, after 8 weeks (mid-) and 18 weeks (post-training). RESULTS:After the intervention, there were no significant changes in skeletal muscle index, fat free mass, total lean mass and total fat mass for both the control group and intervention group. However, the interaction effect was significantly different in SPPB score (P < 0.05), isokinetic strength (60 deg/s, P < 0.001; 120 deg/s; P < 0.05) and muscle quality (P < 0.05) after 18 weeks of intervention relative to the baseline of the control and intervention groups. The supervised elastic band training of 8 weeks did not improve short physical performance battery score and isokinetic strength, whereas there was a significant increase of those outcomes (10.6% improvement, 9.8~23.5% improvement) after 10 weeks of following self-directed exercise compared with the baseline. CONCLUSIONS:These results show the effectiveness of following self-directed resistance training with health education after supervised training cessation in improvement of short physical performance battery and leg muscle strength. This intervention program might be an effective method to promote muscle strength and quality, and to prevent frailty in elderly women. Geriatr Gerontol Int 2017; 17: 825-833.
10.1111/ggi.12795
Effects of strength training and detraining on muscle quality: age and gender comparisons.
Ivey F M,Tracy B L,Lemmer J T,NessAiver M,Metter E J,Fozard J L,Hurley B F
The journals of gerontology. Series A, Biological sciences and medical sciences
Maximal force production per unit of muscle mass (muscle quality, or MQ) has been used to describe the relative contribution of non-muscle-mass components to the changes in strength with age and strength training (ST). To compare the influence of age and gender on MQ response to ST and detraining, 11 young men (20-30 years), nine young women (20-30 years), 11 older men (65-75 years), and 11 older women (65-75 years), were assessed for quadriceps MQ at baseline, after 9 weeks of ST, and after 31 weeks of detraining. MQ was calculated by dividing quadriceps one repetition maximum (IRM) strength by quadriceps muscle volume determined by magnetic resonance imaging. All groups demonstrated significant increases in IRM strength and muscle volume after training (all p < .05). All groups also increased their MQ with training (all p < .01), but the gain in MQ was significantly greater in young women than in the other three groups (p < .05). After 31 weeks of detraining, MQ values remained significantly elevated above baseline levels in all groups (p < .05), except the older women. These results indicate that factors other than muscle mass contribute to strength gains with ST in young and older men and women, but those other factors may account for a higher portion of the strength gains in young women. These factors continue to maintain strength levels above baseline for up to 31 weeks after cessation of training in young men and women, and in older men.
10.1093/gerona/55.3.b152
Muscle quality index improves with resistance exercise training in older adults.
Fragala Maren S,Fukuda David H,Stout Jeffrey R,Townsend Jeremy R,Emerson Nadia S,Boone Carleigh H,Beyer Kyle S,Oliveira Leonardo P,Hoffman Jay R
Experimental gerontology
INTRODUCTION:Sarcopenia is currently best described as an age-related decline in skeletal muscle mass and function. However, no consensus exists as to how to best quantify muscle function in older adults. The muscle quality index (MQI) was recently recommended as an ideal evidence-based assessment of functional status in older adults. Nevertheless, the usefulness of MQI to assess physical function is limited by whether it is reflective of muscle qualitative changes to an intervention. Thus, the purpose of this investigation was to determine whether MQI changes in response to resistance exercise training and detraining and how such changes correspond to other recommended measures of physical function proposed by suggested definitions of sarcopenia. METHODS:Twenty-five older adults (70.6±6.1y; BMI=28.1±5.4kg·m(-2)) completed a 6-week resistance training program in a wait-list controlled, cross-over design. MQI was determined as power output from timed sit to stand (STS), body mass, and leg length. Gait speed, hand grip strength, get-up-and-go and lean body mass (LBM) were evaluated before and after exercise training and detraining. MQI and functional changes to training and detraining were evaluated with repeated measures ANOVA and clinical interpretations of magnitude based inferences. RESULTS:Short term resistance training significantly and clinically improved MQI (203.4±64.31 to 244.3±82.92W), gait time (1.85±0.36 to 1.66±0.27s) and sit to stand performance (13.21±2.51 to 11.05±1.58s). Changes in LBM and hand grip strength were not significant or clinically meaningful. De-training for 6-weeks did not result in significant changes in any measure from post-training performance.
10.1016/j.exger.2014.01.027
Behavior of the muscle quality index and isometric strength in elderly women.
Jerez-Mayorga Daniel,Delgado-Floody Pedro,Intelangelo Leonardo,Campos-Jara Christian,Arias-Poblete Leonidas,García-Verazaluce Juan,Garcia-Ramos Amador,Chirosa Luis Javier
Physiology & behavior
This study aimed (I) to compare the muscle quality index (MQI) and the isometric hip strength between younger and older women, and (II) to determine the relationship of the MQI with the sit-to-stand test (STS) and isometric hip strength in younger and older women. Twenty-eight elderly women (age= 66.2 ± 5.6 years) and twenty younger women (21.2 ± 2.2 years) participated in the study. The following dependent variables were measured: MQI, STS, body composition, and the peak isometric strength of the hip (PF) which was also normalized using three different methods (PF/Body Mass, PF/Fat-Free Mass, and PF/Body Mass). Older women presented a lower PF in hip flexion, extension and external rotation regardless of the method of normalization (p < 0.001), but the PF of hip abductors and internal rotators was higher for older women (p < 0.05). No significant differences were found in the MQI between older and younger women (p = 0.443). The MQI was negatively correlated with the time in the STS in older women (r = -0.706, p < 0.001) and younger women (r = -0.729, p < 0.001), while the correlations of MQI with isometric hip strength were weaker in older women (r range: -0.082 - 0.556) and younger women (r range: -0.020 - 0.309). MQI is a clinical and practical tool to assess the muscular power of the lower extremities.
10.1016/j.physbeh.2020.113145
Strength training increases skeletal muscle quality but not muscle mass in old institutionalized adults: a randomized, multi-arm parallel and controlled intervention study.
Strasser Eva-Maria,Hofmann Marlene,Franzke Bernhard,Schober-Halper Barbara,Oesen Stefan,Jandrasits Waltraud,Graf Alexandra,Praschak Markus,Horvath-Mechtler Barbara,Krammer Christine,Ploder Martin,Bachl Norbert,Quittan Michael,Wagner Karl-Heinz,Wessner Barbara
European journal of physical and rehabilitation medicine
BACKGROUND:Age related loss of skeletal muscle mass is accompanied by changes in muscle quality leading to impairment of functional status. AIM:This study investigated the effect of resistance training and nutritional supply on muscle mass and muscle quality in very old institutionalized adults. DESIGN:Prospective, randomized, multi-arm parallel and controlled intervention study. SETTING:This study was conducted in five retirement care facilities. POPULATION:This subgroup of the Vienna Active Ageing Study included 54 women and men (82.4±6.0 years) with impaired health status. Participants were randomly assigned either to elastic band resistance training (N.=16), training with nutritional supplementation (N.=21) or control group (N.=17). METHODS:Health status was assessed at baseline with functional tests, cognitive status, nutritional status, sum of medications as well as sum of diseases. Skeletal muscle mass, determined by dual-energy X-ray absorptiometry, isokinetic knee extension and flexion force and handgrip strength were assessed at baseline and after 6 months. Muscle quality of lower extremities was defined as ratio of the extensor (MQ_LE (Ext.)) or flexor strength (MQ_LE (Flex.)) to lean leg mass. Muscle quality of upper extremity was defined as ratio of handgrip strength to lean arm mass. Follow-up examinations were performed after 12 and 18 months of intervention. RESULTS:Muscle quality, but not muscle mass, showed significant correlations to functional tests at baseline (0.300 - 0.614, P<0.05). Resistance training significantly enhanced muscle quality of lower extremity after 6 months (MQ_LE (Ext.) +19.8%, MQ_LE (Flex.) +30.8%, P<0.05). Nutritional supplementation could not further increase the training effect. Participants with lower muscle quality at baseline benefit most from the training intervention. Skeletal muscle mass was not changed by any intervention. CONCLUSIONS:Resistance training with elastic bands improved muscle quality in very old people. Additional nutritional supplementation was not able to further improve the effects obtained by training alone. CLINICAL REHABILITATION IMPACT:Elastic band resistance training could be safely used to improve muscle quality even in old people with impaired health status. Weak and chronically ill participants benefit most from this training.
10.23736/S1973-9087.18.04930-4
Effects of Different Types of Exercise on Body Composition, Muscle Strength, and IGF-1 in the Elderly with Sarcopenic Obesity.
Chen Hung-Ting,Chung Yu-Chun,Chen Yu-Jen,Ho Sung-Yen,Wu Huey-June
Journal of the American Geriatrics Society
OBJECTIVES:To investigate the influence of resistance training (RT), aerobic training (AT), or combination training (CT) interventions on the body composition, muscle strength performance, and insulin-like growth factor 1 (IGF-1) of patients with sarcopenic obesity. DESIGN:Randomized controlled trial. SETTING:Community center and research center. PARTICIPANTS:Sixty men and women aged 65-75 with sarcopenic obesity. INTERVENTION:Participants were randomly assigned to RT, AT, CT, and control (CON) groups. After training twice a week for 8 weeks, the participants in each group ceased training for 4 weeks before being examined for the retention effects of the training interventions. MEASUREMENTS:The body composition, grip strength, maximum back extensor strength, maximum knee extensor muscle strength, and blood IGF-1 concentration were measured. RESULTS:The skeletal muscle mass (SMM), body fat mass, appendicular SMM/weight %, and visceral fat area (VFA) of the RT, AT, and CT groups were significantly superior to those of the CON group at both week 8 and week 12. Regarding muscle strength performance, the RT group exhibited greater grip strength at weeks 8 and 12 as well as higher knee extensor performance at week 8 than that of the other groups. At week 8, the serum IGF-1 concentration of the RT group was higher than the CON group, whereas the CT group was superior to the AT and CON groups. CONCLUSION:Older adults with sarcopenic obesity who engaged in the RT, AT, and CT interventions demonstrated increased muscle mass and reduced total fat mass and VFA compared with those without training. The muscle strength performance and serum IGF-1 level in trained groups, especially in the RT group, were superior to the control group.
10.1111/jgs.14722
Evidence for the role of isometric exercise training in reducing blood pressure: potential mechanisms and future directions.
Millar Philip J,McGowan Cheri L,Cornelissen Véronique A,Araujo Claudio G,Swaine Ian L
Sports medicine (Auckland, N.Z.)
Hypertension, or the chronic elevation in resting arterial blood pressure (BP), is a significant risk factor for cardiovascular disease and estimated to affect ~1 billion adults worldwide. The goals of treatment are to lower BP through lifestyle modifications (smoking cessation, weight loss, exercise training, healthy eating and reduced sodium intake), and if not solely effective, the addition of antihypertensive medications. In particular, increased physical exercise and decreased sedentarism are important strategies in the prevention and management of hypertension. Current guidelines recommend both aerobic and dynamic resistance exercise training modalities to reduce BP. Mounting prospective evidence suggests that isometric exercise training in normotensive and hypertensive (medicated and non-medicated) cohorts of young and old participants may produce similar, if not greater, reductions in BP, with meta-analyses reporting mean reductions of between 10 and 13 mmHg systolic, and 6 and 8 mmHg diastolic. Isometric exercise training protocols typically consist of four sets of 2-min handgrip or leg contractions sustained at 20-50 % of maximal voluntary contraction, with each set separated by a rest period of 1-4 min. Training is usually completed three to five times per week for 4-10 weeks. Although the mechanisms responsible for these adaptations remain to be fully clarified, improvements in conduit and resistance vessel endothelium-dependent dilation, oxidative stress, and autonomic regulation of heart rate and BP have been reported. The clinical significance of isometric exercise training, as a time-efficient and effective training modality to reduce BP, warrants further study. This evidence-based review aims to summarize the current state of knowledge regarding the effects of isometric exercise training on resting BP.
10.1007/s40279-013-0118-x
The antihypertensive effects of aerobic versus isometric handgrip resistance exercise.
Ash Garrett I,Taylor Beth A,Thompson Paul D,MacDonald Hayley V,Lamberti Lauren,Chen Ming-Hui,Farinatti Paulo,Kraemer William J,Panza Gregory A,Zaleski Amanda L,Deshpande Ved,Ballard Kevin D,Mujtaba Mohammadtokir,White C Michael,Pescatello Linda S
Journal of hypertension
BACKGROUND:Aerobic exercise reduces blood pressure (BP) on average 5-7 mmHg among those with hypertension; limited evidence suggests similar or even greater BP benefits may result from isometric handgrip (IHG) resistance exercise. METHOD:We conducted a randomized controlled trial investigating the antihypertensive effects of an acute bout of aerobic compared with IHG exercise in the same individuals. Middle-aged adults (n = 27) with prehypertension and obesity randomly completed three experiments: aerobic (60% peak oxygen uptake, 30 min); IHG (30% maximum voluntary contraction, 4 × 2 min bilateral); and nonexercise control. Study participants were assessed for carotid-femoral pulse wave velocity pre and post exercise, and left the laboratory wearing an ambulatory BP monitor. RESULTS:SBP and DBP were lower after aerobic versus IHG (4.8 ± 1.8/3.1 ± 1.3 mmHg, P = 0.01/0.04) and control (5.6 ± 1.8/3.6 ± 1.3 mmHg, P = 0.02/0.04) over the awake hours, with no difference between IHG versus control (P = 0.80/0.83). Pulse wave velocity changes following acute exercise did not differ by modality (aerobic increased 0.01 ± 0.21 ms, IHG decreased 0.06 ± 0.15 ms, control increased 0.25 ± 0.17 ms, P > 0.05). A subset of participants then completed either 8 weeks of aerobic or IHG training. Awake SBP was lower after versus before aerobic training (7.6 ± 3.1 mmHg, P = 0.02), whereas sleep DBP was higher after IHG training (7.7 ± 2.3 mmHg, P = 0.02). CONCLUSION:Our findings did not support IHG as antihypertensive therapy but that aerobic exercise should continue to be recommended as the primary exercise modality for its immediate and sustained BP benefits.
10.1097/HJH.0000000000001176
Isometric handgrip exercise training attenuates blood pressure in prehypertensive subjects at 30% maximum voluntary contraction.
Nigerian journal of clinical practice
BACKGROUND:Prehypertension highlights a category of subjects who are at high risk of developing hypertension. AIM:This study assessed the blood pressure attenuating effect of isometric handgrip exercise in the management of prehypertension. MATERIALS AND METHODS:A total of 400 prehypertensive subject with a mean age of 40 ± 10 years and recently diagnosed as prehypertension were recruited for the study. They were randomly distributed into exercise and control groups (n = 200). The control group was placed on lifestyle modification only, while the exercise group performed a 24 consecutive days isometric hand grip exercise training at 30% maximum voluntary contraction (MVC) for 2 min each day in combination with lifestyle modification protocol. RESULTS:The results show a statistically significant reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP). The exercise group had a mean reduction of 7.48 ± 0.06 and 6.41 ± 1.01 mmHg of the SBP and DBP, respectively. It was further observed that both the SBP and DBP and pulse rate significantly increased acutely within 5 min post exercise at 30% MVC with a mean value of 8.60 ± 0.20 mmHg, 7.33 ± 0.03 mmHg, and 8.24 ± 0.20 beats/min of the SBP and DBP and pulse rate, respectively. However, this increase returned to pre-exercise value within 10 min post exercises to a mean value of -0.68 + 1.64 mmHg, 1.48 ± 1.02 mmHg, and 3.00 ± 0.11 beats/min, respectively. CONCLUSION:This study has shown that isometric handgrip exercise is effective in the attenuation of blood pressure in prehypertensive subjects especially when combined with the routinely recommended lifestyle modifications. However, caution should be taken when recommending it because of acute increase in blood pressure.
10.4103/njcp.njcp_240_18
The differential impact of aerobic and isometric handgrip exercise on blood pressure variability and central aortic blood pressure.
Seidel Maximilian,Pagonas Nikolaos,Seibert Felix S,Bauer Frederic,Rohn Benjamin,Vlatsas Stergios,Mühlberger Dominic,Nina Babel,Westhoff Timm H
Journal of hypertension
BACKGROUND:Blood pressure variability and central SBP are independent markers of cardiovascular risk. Data on lifestyle-interventions to reduce these parameters are sparse. The present work reports the differential effects of aerobic vs. isometric handgrip exercise on blood pressure variability and central SBP in a prospective randomized trial. METHODS:Seventy-five hypertensive patients were randomized to one of the following 12-week programs: isometric handgrip training five times weekly; 'Sham-handgrip training' five times weekly; aerobic exercise training (30 min three to five times/week). Blood pressure variability was assessed by the coefficient of variation in 24-h ambulatory blood pressure monitoring (ABPM). Central SBP was measured noninvasively by the SphygmoCor device (AtCor Medical, Australia). RESULTS:The aerobic exercise program significantly decreased systolic daytime variability (12.1 ± 2.5 vs. 10.3 ± 2.8, P = 0.04), whereas diastolic daytime blood pressure variability was not significantly altered (P = 0.14). Night-time variability was not significantly affected (P > 0.05). Central SBP was reduced from 145±15 to 134 ± 19 mmHg (P = 0.01). Isometric handgrip and sham-handgrip exercise did not significantly affect blood pressure variability (P > 0.05 each). Isometric exercise tended to reduce central SBP (142 ± 19 to 136 ± 17 mmHg, P = 0.06). ANCOVA revealed significant intergroup differences for the change of daytime SBP and DBP variability (P = 0.048 and 0.047, respectively). CONCLUSION:Aerobic exercise reduces blood pressure variability and central SBP. Isometric handgrip exercise does not reduce blood pressure variability but tends to lower central SBP in this hypertensive population.
10.1097/HJH.0000000000002774
Impact of resistance training on blood pressure and other cardiovascular risk factors: a meta-analysis of randomized, controlled trials.
Cornelissen Véronique A,Fagard Robert H,Coeckelberghs Ellen,Vanhees Luc
Hypertension (Dallas, Tex. : 1979)
We reviewed the effect of resistance training on blood pressure and other cardiovascular risk factors in adults. Randomized, controlled trials lasting ≥4 weeks investigating the effects of resistance training on blood pressure in healthy adults (age ≥18 years) and published in a peer-reviewed journal up to June 2010 were included. Random- and fixed-effects models were used for analyses, with data reported as weighted means and 95% confidence limits. We included 28 randomized, controlled trials, involving 33 study groups and 1012 participants. Overall, resistance training induced a significant blood pressure reduction in 28 normotensive or prehypertensive study groups [-3.9 (-6.4; -1.2)/-3.9 (-5.6; -2.2) mm Hg], whereas the reduction [-4.1 (-0.63; +1.4)/-1.5 (-3.4; +0.40) mm Hg] was not significant for the 5 hypertensive study groups. When study groups were divided according to the mode of training, isometric handgrip training in 3 groups resulted in a larger decrease in blood pressure [-13.5 (-16.5; -10.5)/-6.1(-8.3; -3.9) mm Hg] than dynamic resistance training in 30 groups [-2.8 (-4.3; -1.3)/-2.7 (-3.8; -1.7) mm Hg]. After dynamic resistance training, Vo(2) peak increased by 10.6% (P=0.01), whereas body fat and plasma triglycerides decreased by 0.6% (P<0.01) and 0.11 mmol/L (P<0.05), respectively. No significant effect could be observed on other blood lipids and fasting blood glucose. This meta-analysis supports the blood pressure-lowering potential of dynamic resistance training and isometric handgrip training. In addition, dynamic resistance training also favorably affects some other cardiovascular risk factors. Our results further suggest that isometric handgrip training may be more effective for reducing blood pressure than dynamic resistance training. However, given the small amount of isometric studies available, additional studies are warranted to confirm this finding.
10.1161/HYPERTENSIONAHA.111.177071
New Prediction Equations to Estimate Appendicular Skeletal Muscle Mass Using Calf Circumference: Results From NHANES 1999-2006.
Santos Leonardo Pozza,Gonzalez Maria Cristina,Orlandi Silvana Paiva,Bielemann Renata Moraes,Barbosa-Silva Thiago G,Heymsfield Steven B,
JPEN. Journal of parenteral and enteral nutrition
BACKGROUND:Low appendicular skeletal muscle mass (ASM) is associated with negative outcomes, but its assessment requires proper limb muscle evaluation. We aimed to verify how anthropometric circumferences are correlated to ASM and to develop new prediction equations based on calf circumference and other anthropometric measures, using dual-energy X-ray absorptiometry (DEXA) as the reference method. METHODS:DEXA and anthropometric information from 15,293 adults surveyed in the 1999-2006 NHANES were evaluated. ASM was defined by the sum of the lean soft tissue from the limbs. Anthropometric data included BMI and calf, arm, thigh, and waist circumferences. Correlations were assessed by Pearson's correlation, and multivariable linear regression produced 4 different ASM prediction equations. The concordance and the overall 95% limits of agreement between measured and estimated ASM were assessed using Lin's coefficient and Bland-Altman's approach. RESULTS:Calf and thigh circumferences were highly correlated with ASM, independent of age and ethnicity. Among the models, the best performance came from the equation constituted solely by calf circumference, sex, race, and age as independent variables, which was able to explain almost 90% of the DEXA-measured ASM variation. The inclusion of different anthropometric parameters in the model increased collinearity without improving estimates. Concordance between the four developed equations and DEXA-measured ASM was high (Lin's concordance coefficient >0.90). CONCLUSION:Despite the good performance of the four developed equations in predicting ASM, the best results came from the equation constituted only by calf circumference, sex, race, and age. This equation allows satisfactory ASM estimation from a single anthropometric measurement.
10.1002/jpen.1605
Targeted proteomics of appendicular skeletal muscle mass and handgrip strength in black South Africans: a cross-sectional study.
Scientific reports
Although appendicular skeletal muscle mass (ASM) and handgrip strength (HGS) are key components of sarcopenia, their underlying biological mechanisms remain poorly understood. We aimed to investigate associations of circulating biomarkers with ASM and HGS in middle-aged black South Africans. This study consisted of 934 black South Africans (469 men and 465 women, aged 41-72 years) from the Middle-aged Soweto cohort. Linear regression models were used to examine relationships between 182 biomarkers (measured with proximity extension assay) and dual-energy X-ray absorptiometry-measured ASM and dynamometer-measured HGS. Age, height, sex, smoking, alcohol, food insecurity, physical activity, visceral adipose tissue, HIV and menopausal status were included as confounders. Regression models showing sex-interactions were stratified by sex. The Benjamini-Hochberg false discovery rate (FDR) was used to control for multiple testing, and FDR-adjusted P values were reported. In the total sample, 10 biomarkers were associated with higher ASM and 29 with lower ASM (P < 0.05). Out of these 39 biomarkers, 8 were also associated with lower HGS (P < 0.05). MMP-7 was associated with lower HGS only (P = 0.011) in the total sample. Sex-interactions (P < 0.05) were identified for 52 biomarkers for ASM, and 6 for HGS. For men, LEP, MEPE and SCF were associated with higher ASM (P < 0.001, = 0.004, = 0.006, respectively), and MEPE and SCF were also associated with higher HGS (P = 0.001, 0.012, respectively). Also in men, 37 biomarkers were associated with lower ASM (P < 0.05), with none of these being associated with lower HGS. Furthermore, DLK-1 and MYOGLOBIN were associated with higher HGS only (P = 0.004, 0.006, respectively), while GAL-9 was associated with lower HGS only (P = 0.005), among men. For women, LEP, CD163, IL6, TNF-R1 and TNF-R2 were associated with higher ASM (P < 0.001, = 0.014, = 0.027, = 0.014, = 0.048, respectively), while IGFBP-2, CTRC and RAGE were associated with lower ASM (P = 0.043, 0.001, 0.014, respectively). No biomarker was associated with HGS in women. In conclusion, most biomarkers were associated with ASM and not HGS, and the associations of biomarkers with ASM and HGS displayed sex-specificity in middle-aged black South Africans. Proteomic studies should examine ASM and HGS individually. Future research should also consider sexual dimorphism in the pathophysiology of sarcopenia for development of sex-specific treatment and diagnostic methods.
10.1038/s41598-022-13548-9
How to assess functional status: a new muscle quality index.
The journal of nutrition, health & aging
Aging is associated with decreases in muscle mass, muscle strength and muscle power, with muscle strength declining at a higher rate than muscle mass, but at a lower rate than muscle power. This progressive mismatch suggests a deterioration of muscle "quality" that may lead to functional incapacities. Although it may be difficult to synthesize the concept of muscle quality, the aim of the present paper was to propose a clinical definition of muscle quality in regard to the functional status. Accordingly, the muscle strength or muscle power per unit of muscle mass ratios appear to be clinically relevant markers of muscle quality. Several mechanisms susceptible to influence these ratios have been described, among which age, gender, sex hormones, obesity, physical activity and fibrosis. Various methods to assess muscle quality in both the clinical and research fields have also been listed, with a particular interest for the tests used to measure muscle power. Finally, we proposed a clinical screening tool to detect individuals at risk of functional incapacities. Briefly, the muscle quality score is based on handgrip strength assessment by hand dynamometer, muscle mass measurement by bioelectrical analysis, and leg muscle power estimation using a chair stand test.
10.1007/s12603-012-0004-5
Association Between Blood Lead Level With High Blood Pressure in US (NHANES 1999-2018).
Frontiers in public health
Background:Lead is a toxic metal for human health, but the effect on blood pressure (BP) is still controversial. The object of this study was to demonstrate the association between blood lead levels with BP and hypertension (HTN). Methods:We used the database from the National Health and Nutrition Examination Survey (NHANES, 1999-2018) to perform a cross-sectional study. We performed multivariate regressions to examine the association between blood lead level with HTN and BP, and then a subgroup analysis was performed. Results:A total of 32,289 participants were included in this study, but no significant difference was found between blood lead levels and HTN. However, the association between blood lead levels with systolic and diastolic pressure became positive. In the subgroup analysis stratified by race, the association between non-Hispanic white and black people still existed. Conclusion:The association between blood lead levels with HTN was not significant, but it was positively associated with BP. Besides, the association between non-Hispanic white and black people was also significant.
10.3389/fpubh.2022.836357
Association between handgrip strength and cardiovascular risk factors among Korean adolescents.
Kim Kyoung Kon,Lee Kyu Rae,Hwang In Cheol
Journal of pediatric endocrinology & metabolism : JPEM
Background It remains unclear whether muscle strength, which reduces cardiovascular (CV) risk in adults, is associated with similar protection in Asian adolescents. This study investigated the association between handgrip strength and CV health in a large Korean sample of school-age adolescents. Methods We performed a cross-sectional analysis of adolescents aged 10-18 years (n=4,018) from the Korean National Health and Nutrition Survey between 2014 and 2017. Handgrip strength was measured using a dynamometer. CV risk factors include waist circumference, blood pressure, fasting glucose or hemoglobin A1c, and lipid levels. Logistic regression models were applied with adjustment for potential confounders. Results The mean age of participants was 14.0 years, and 53.6% were boys. Mean handgrip strength was 30.4 kg for boys and 22.0 kg for girls. Boys more frequently had high systolic blood pressure and impaired fasting glucose, whereas girls more frequently had low high-density lipoprotein cholesterol. Multivariate logistic regression analysis revealed that in boys only, handgrip strength was negatively associated with central obesity and hypertriglyceridemia and positively associated with higher systolic blood pressure. Conclusion Handgrip strength is independently associated with some CV risk factors only in boys.
10.1515/jpem-2020-0167
Associations of body fat and skeletal muscle with hypertension.
Han Thang S,Al-Gindan Yasmin Y,Govan Lindsay,Hankey Catherine R,Lean Michael E J
Journal of clinical hypertension (Greenwich, Conn.)
Hypertension is known to be associated with obesity, while its relationship to skeletal muscle, SM (SM; a marker of general health and body function), remains uncertain. We analyzed population-based data of 22 591 men (mean age: 51.6 ± 16.9 years) and 27 845 nonpregnant women (50.6 ± 16.9 years) from Scottish Health Surveys (2003, 2008-2011) and Health Surveys for England (2003-2006, 2008-2013) including 2595 non-insulin- and 536 insulin-treated diabetic patients. Compared with normotensive individuals (no hypertension history with normal systolic [SBP < 140 mm Hg] and diastolic blood pressure [DBP < 90 mm Hg]), percent body fat (BF%) was significantly higher and percent SM lower (P < 0.001) in undetected (no hypertension history with raised SBP ≥ 140 and/or DBP ≥ 90 mm Hg), controlled (hypertension history with normal BP), uncontrolled (hypertension history with raised BP), and untreated hypertension. The prevalences of hypertension within BF% quintiles were 11.8%, 24.8%, 41.4%, 56.8%, and 71.6% and SM% quintiles were 67.5%, 53.3%, 39.5%, 27.4%, and 18.5%. Compared to referent groups (lowest BF% quintile or highest SM% quintile), odds ratio (age, sex, smoking, ethnicity, country, survey year, and diabetes adjusted) for having all types of hypertension in the highest BF% quintile was 5.5 (95% confidence interval = 5.0-5.9) and lowest SM% quintile was 2.3 (2.2-2.5). Compared with those without diabetes, individuals with diabetes had a 2.3-fold-2.6-fold greater risk of hypertension, independent of confounding factors and BF% or SM%. The associations of hypertension with BF% were higher than those with body mass index (BMI). In conclusion, both BF and SM should be considered when analyzing results from health surveys, rather than relying on BMI which does not discriminate between the two.
10.1111/jch.13456
Hypertension modifies the associations of body mass index and waist circumference with all-cause mortality among older Chinese: a retrospective cohort study.
BMC geriatrics
BACKGROUND:The effect of baseline hypertension status on the BMI-mortality association is still unclear. We aimed to explore the relationships of body mass index (BMI) and waist circumference (WC) with all-cause mortality among older hypertensive and normotensive Chinese individuals. METHODS:This retrospective cohort study was conducted in Xinzheng, Henan Province, Central China. The data came from the residents' electronic health records of the Xinzheng Hospital Information System. A total of 77,295 participants (41,357 hypertensive participants and 35,938 normotensive participants) aged ≥ 60 years were included from January 2011 to November 2019. Cox proportional hazard regression model was used to examine the relationships. RESULTS:During a mean follow-up of 5.3 years, 10,755 deaths were identified (6,377 in hypertensive participants and 4,378 in normotensive participants). In adjusted models, compared with a BMI of 18.5-24 kg/m, the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of BMI < 18.5, 24-28 and ≥ 28 kg/m for mortality in hypertensive participants were 1.074 (0.927-1.244), 0.881 (0.834-0.931) and 0.856 (0.790-0.929), respectively, and 1.444 (1.267-1.646), 0.884 (0.822-0.949) and 0.912 (0.792-1.051), respectively, in normotensive participants. Compared with normal waist circumference, the adjusted HRs and 95% CIs of central obesity for mortality were 0.880 (0.832-0.931) in hypertensive participants and 0.918 (0.846-0.996) in normotensive participants. A sensitivity analysis showed similar associations for both hypertensive and normotensive participants. CONCLUSION:Low BMI and WC were associated with a higher risk of all-cause mortality regardless of hypertension status in older Chinese individuals. The lowest risk of death associated with BMI was in the overweight group in normotensive participants and in the obesity group in hypertensive participants.
10.1186/s12877-022-03057-9
Sexual Difference in Effect of Long Sleep Duration on Incident Sarcopenia after Two Years in Community-Dwelling Older Adults.
Annals of geriatric medicine and research
BACKGROUND:Sarcopenia, a progressive and generalized skeletal muscle disorder involving an accelerated loss of muscle mass and muscle function, is a common condition in older individuals. This study aimed to determine whether sleep latency and duration were independently associated with incident sarcopenia and to explore sex differences in these associations. METHODS:This 2-year longitudinal analysis of cohort study data included community-dwelling participants of the 2016-2017 Korea Frailty and Aging Cohort Study aged 70-84 years at baseline survey who completed the 2-year follow-up survey. Logistic regression was used to calculate the odds ratios (ORs) for sarcopenia and sarcopenia components. Sarcopenia was defined using the 2019 Asian Working Group for Sarcopenia guidelines. RESULTS:Among 1,353 non-sarcopenic participants in the baseline survey, 1,160 (85.8%) and 193 (14.2%) were classified as non-sarcopenic and sarcopenic, respectively, after 2 years. Long sleep duration (>8 hours per night) was associated with incident sarcopenia in male-OR=2.41 (95% confidence interval [CI], 1.13-5.17) after adjusting for confounding factors. Long sleep duration was specifically associated with the development of low skeletal muscle mass and low muscle strength in male-adjusted OR=2.16 (95% CI, 1.02-4.61) and adjusted OR=2.70 (95% CI, 1.13-6.43), respectively. In female, compared to normal sleep duration, the adjusted ORs for long and short sleep duration for sarcopenia were 2.093 (95% CI, 0.753-5.812; p=0.157) and 0.852 (95% CI, 0.520-1.393; p=0.522), respectively, which were not significant. CONCLUSION:In male, long sleep duration was associated with incident sarcopenia, specifically the development of low muscle mass and low muscle strength, but not with low physical performance.
10.4235/agmr.22.0093
Muscle distribution in relation to all-cause and cause-specific mortality in young and middle-aged adults.
Journal of translational medicine
BACKGROUND:The relationship between muscle and prognosis, especially that between muscle distribution across different body parts, and the related prognosis is not well established. OBJECTIVE:To investigate the relationship between muscle distribution and all-cause and cause-specific mortality and their potential modifiers. DESIGN:Longitudinal cohort study. C-index, IDI, and NRI were used to determine the best indicator of prognosis. COX regression analysis was performed to explore the relationship between variables and outcomes. Interaction and subgroup analyses were applied to identify the potential modifiers. PARTICIPANTS:A total of 5052 participants (weighted: 124,841,420) extracted from the NHANES 2003-2006 of median age 45 years and constituting 50.3% men were assessed. For validation, we included 3040 patients from the INSCOC cohort in China. MAIN MEASURES:Muscle mass and distribution. KEY RESULTS: COX regression analysis revealed that upper limbs (HR = 0.41, 95% CI 0.33-0.51), lower limbs (HR = 0.54, 95% CI 0.47-0.64), trunk (HR = 0.71, 95% CI, 0.59-0.85), gynoid (HR = 0.47, 95% CI 0.38-0.58), and total lean mass (HR = 0.55, 95% CI 0.45-0.66) were all associated with the better survival of participants (P < 0.001). The changes in the lean mass ratio of the upper and lower limbs and the lean mass ratio of the android and gynoid attenuated the protective effect of lean mass. Age and sex acted as potential modifiers, and the relationship between lean mass and the prognosis was more significant in men and middle-aged participants when compared to that in other age groups. Sensitive analyses depicted that despite lean mass having a long-term impact on prognosis (15 years), it has a more substantial effect on near-term survival (5 years). CONCLUSION:Muscle mass and its distribution affect the prognosis with a more significant impact on the near-term than that on the long-term prognosis. Age and sex acted as vital modifiers.
10.1186/s12967-023-04008-7
Muscle quality index is associated with trouble sleeping: a cross-sectional population based study.
BMC public health
BACKGROUND:Trouble sleeping is one of the major health issues nowadays. Current evidence on the correlation between muscle quality and trouble sleeping is limited. METHODS:A cross-sectional study design was applied and participants aged from 18 to 60 years in the National Health and Nutrition Examination Survey (NHANES) 2011-2014 was used for analysis. Muscle quality index (MQI) was quantitatively calculated as handgrip strength (HGS, kg) sum/ arm and appendicular skeletal muscle mass (ASM, kg) by using the sum of the non-dominant hand and dominant hand. Sleeping data was obtained by interviews and self-reported by individuals. The main analyses utilized weighted multivariable logistic regression models according to the complex multi-stage sampling design of NHANES. Restricted cubic spline model was applied to explore the non-linear relationship between MQI and trouble sleeping. Moreover, subgroup analyses concerning sociodemographic and lifestyle factors were conducted in this study. RESULTS:5143 participants were finally included in. In the fully adjusted model, an increased level of MQI was significantly associated with a lower odds ratio of trouble sleeping, with OR = 0.765, 95% CI: (0.652,0.896), p = 0.011. Restricted cubic spline showed a non-linear association between MQI and trouble sleeping. However, it seemed that the prevalence of trouble sleeping decreased with increasing MQI until it reached 2.362, after which the odds ratio of trouble sleeping reached a plateau. Subgroup analyses further confirmed that the negative association between the MQI and trouble sleeping was consistent and robust across groups. CONCLUSION:Overall, this study revealed that MQI can be used as a reliable predictor in odds ratio of trouble sleeping. Maintaining a certain level of muscle mass would be beneficial to sleep health. However, this was a cross-sectional study, and causal inference between MQI and trouble sleeping was worthy of further exploration.
10.1186/s12889-023-15411-6
Sex and population-specific cutoff values of muscle quality index: Results from NHANES 2011-2014.
Clinical nutrition (Edinburgh, Scotland)
BACKGROUND & AIMS:Muscle quality index (MQI) is used to measure the quality of the muscles. It is defined as the ratio of muscle strength per unit of muscle mass, but since this might vary by rage and ethnicity, we aimed to develop sex, and population-specific normative data and cutoff values for MQI (extremally low and low) using the arm or appendicular skeletal muscle mass (ASM) obtained from a population-representative sample. METHODS:This cross-sectional analysis included data from 4849 volunteers (aged 20-59 years) from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. Measures of handgrip strength (HGS) were performed using a hand dynamometer. ASM was assessed by dual-energy X-ray absorptiometry (DXA). Arm ASM mass was used to calculate MQI [dominant HGS/dominant arm ASM (kg/kg)]; ASM was used to calculate MQI [dominant HGS/ASM (kg/kg)]; and the sum of the non-dominant hand and dominant hand were used to calculate MQI [HGS sum/ASM (kg/kg)]. Cutoff values were derived from a young reference subgroup (n = 1625 aged, 20-39 years), with low and extremely low MQI defined as 1 and 2 sex-specific standard deviations below the mean, respectively. RESULTS:MQI MQI and MQI differed by sex and population studied. Overall, using the proposed cutoffs, men showed lower values of MQI than women, and higher MQI and MQI values. Compared to non-Hispanic Whites, non-Hispanic Asians had higher values of MQI while non-Hispanic Black people had lower values. CONCLUSION:MQIs cutoffs were established for both sexes and different populations studied. MQI, MQI and MQI values were lower after the fifth-decade in men, but not in women.
10.1016/j.clnu.2022.04.026
Grip Strength as a Marker of Hypertension and Diabetes in Healthy Weight Adults.
American journal of preventive medicine
INTRODUCTION:Muscle strength may play a role in cardiometabolic disease. We examined the relationship between hand grip strength and diabetes and hypertension in a sample of healthy weight adults. METHODS:In 2015, we analyzed the National Health and Nutrition Examination Survey 2011-2012 for adults aged ≥20 years with healthy BMIs (between 18.5 and <25) and no history of cardiovascular disease (unweighted n=1,467; weighted n=61,587,139). Hand grip strength was assessed with a dynamometer. Diabetes was based on hemoglobin A1c level and reported diabetes diagnosis. Hypertension was based on measured blood pressure and reported hypertension diagnosis. RESULTS:Individuals with undiagnosed diabetes compared with individuals without diabetes had lower grip strength (51.9 vs 69.8, p=0.0001), as did individuals with diagnosed diabetes compared with individuals without diabetes (61.7 vs 69.8, p=0.008). Mean grip strength was lower among individuals with undiagnosed hypertension compared with individuals without hypertension (63.5 vs 71.5, p=0.008) as well as among individuals with diagnosed hypertension compared with those without hypertension (60.8 vs 71.5, p<0.0001). In adjusted analyses controlling for age, sex, race, smoking status, and first-degree relative with disease, mean grip strength was lower for undiagnosed diabetes (β=-10.02, p<0.0001) and diagnosed diabetes (β=-8.21, p=0.03) compared with individuals without diabetes. In adjusted analyses, grip strength was lower among individuals with undiagnosed hypertension (β=-6.6, p=0.004) and diagnosed hypertension (β=-4.27, p=0.04) compared with individuals without hypertension. CONCLUSIONS:Among healthy weight adults, combined grip strength is lower in individuals with diagnosed and undiagnosed diabetes and hypertension.
10.1016/j.amepre.2015.05.025
Higher blood pressure is associated with higher handgrip strength in the oldest old.
Taekema Diana G,Maier Andrea B,Westendorp Rudi G J,de Craen Anton J M
American journal of hypertension
BACKGROUND:Aging is associated with progressive loss of muscle strength. Muscle tissue is vascularized by an elaborate vascular network. There is evidence that blood pressure (BP) is associated with muscle function in middle age. It is unknown how BP associates with muscle function in oldest old people. We studied the association between BP and handgrip strength in middle and old age. METHOD:BP was measured automatically in middle-aged subjects and with a mercury sphygmomanometer in the oldest old. Handgrip strength was measured with a handgrip strength dynamometer. Cross-sectional measurements of handgrip strength and BP were available for 670 middle-aged subjects (mean 63.2 ± 6.6 years) and 550 oldest old subjects (all 85 years). Prospective data were available for oldest old subjects only with a 4-year follow-up at 89 years. The association between BP and handgrip strength was analyzed by linear regression analysis. RESULTS:In middle-aged subjects, BP and handgrip strength were not statistically significantly associated. In oldest old subjects, higher systolic BP (SBP), mean arterial pressure (MAP), and pulse pressure (PP) were associated with higher handgrip strength after adjusting for comorbidity and medication use (all P < 0.02). Furthermore, in oldest old subjects, changes in SBP, MAP, and PP after 4 years was associated with declining handgrip strength (all, P < 0.05). CONCLUSION:In oldest old, higher BP is associated with better muscle strength. Further study is necessary to investigate whether BP is a potential modifiable risk factor for prevention of age-associated decline in muscle strength.
10.1038/ajh.2010.185
Handgrip strength is positively related to blood pressure and hypertension risk: results from the National Health and nutrition examination survey.
Ji Chao,Zheng Liqiang,Zhang Rui,Wu Qijun,Zhao Yuhong
Lipids in health and disease
BACKGROUND:Isometric handgrip resistance exercise, a nonpharmacological lifestyle modification, has been recommended as a first-line treatment for hypertension. This study aimed to examine the relationship of handgrip strength to blood pressure and the risk of hypertension. METHODS:The responses and examination of 4597 participants in the National Health and Nutrition Examination Survey (NHANES) were analyzed in this study. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were transformed to age- and sex-specific z-scores. Handgrip strength was adjusted by weight (kg) and converted to an age- and sex-specific z-score. The relationships of SBP and DBP to handgrip strength were analyzed by Pearson correlation test and multivariable linear regression. Binary logistic regression was used to analyze the association between handgrip strength and prevalence of hypertension. RESULTS:Handgrip strength was positively related to higher DBP in men and women. In men, logistic regression models revealed that increased handgrip strength was associated with higher risk of hypertension after adjusting for age, BMI, smoking and drinking status; OR was 1.24 (95%CI: 1.04-1.48). After stratifying on BMI, handgrip strength was significantly associated with higher risk of hypertensions after adjusting for age, BMI, smoking and drinking status in overweight and obese men; OR was 1.31 (95%CI: 1.05-1.63). No significant associations were observed in women. CONCLUSIONS:Increased handgrip strength is associated with higher DBP in men and women. In men, especially overweight and obese men, strong handgrip strength may be associated with higher risk of hypertension.
10.1186/s12944-018-0734-4
The efficacy of isometric resistance training utilizing handgrip exercise for blood pressure management: A randomized trial.
Carlson Debra J,Inder Jodie,Palanisamy Suresh K A,McFarlane James R,Dieberg Gudrun,Smart Neil A
Medicine
INTRODUCTION:Hypertension is a major risk factor contributing to cardiovascular disease, which is the number one cause of deaths worldwide. Although antihypertensive medications are effective at controlling blood pressure, current first-line treatment for hypertension is nonpharmacological lifestyle modifications. Recent studies indicate that isometric resistance training (IRT) may also be effective for assisting with blood pressure management. The aim of this study was to determine the efficacy of IRT for blood pressure management and the suitability of a low-intensity working control group. METHODS:Forty hypertensive individuals, aged between 36 and 65 years, conducted IRT for 8 weeks. Participants were randomized into 2 groups, working at an intensity of either 5% or 30% of their maximum voluntary contraction. Participants performed 4 × 2 minute isometric handgrip exercises with their nondominant hand, each separated by a 3-minute rest period, 3 days a week. RESULTS:Blood pressure measurements were conducted at baseline and at the end of the protocol using a Finometer. Eight weeks of isometric resistance training resulted in a 7-mmHg reduction of resting systolic blood pressure (SBP) (136 ± 12 to 129 ± 15; P = 0.04) in the 30% group. Reductions of 4 mmHg were also seen in mean arterial pressure (MAP) (100 ± 8 to 96 ± 11; P = 0.04) in the 30% group. There were no statistically significant reductions in diastolic blood pressure for the 30% group, or any of the data for the 5% group. CONCLUSION:Isometric resistance training conducted using handgrip exercise at 30% of maximum voluntary contraction significantly reduced SBP and MAP. A lack of reduction in blood pressure in the 5% group indicates that a low-intensity group may be suitable as a working control for future studies.
10.1097/MD.0000000000005791
The association between blood pressure and grip strength in adolescents: does body mass index matter?
Dong Bin,Wang Zhiqiang,Arnold Luke,Song Yi,Wang Hai-Jun,Ma Jun
Hypertension research : official journal of the Japanese Society of Hypertension
Increased body mass index (BMI) has been related to both low grip strength and high blood pressure (BP) in adolescents. Previous reports of high BP associated with decreased grip strength could be due to the inherent increase in BP in youths with high BMI. This cross-sectional study aimed to examine the association between grip strength and BP in adolescents independent of BMI. A total of 88 865 Chinese adolescents aged 13-17 years were included in this study. Sex-, age- and height-specific references were applied to calculate the BP z-score and define elevated BP. Grip strength was evaluated as handgrip (kg)/weight (kg) and converted into a sex- and age-specific z-score for analysis. Using fractional polynomial regression, we found that increased BMI was associated with enhanced BP and decreased grip strength; however, after stratification by or adjustment for BMI, strong grip strength was related to an increased BP. Logistic regression models revealed that a one s.d. increase in boys' grip strength z-score was associated with an 18% (95% confidence interval: 12, 25) to 37% (19, 59) higher risk of elevated BP when adjusted for BMI. These associations remained significant after further adjustment for cardiorespiratory fitness. A similar pattern was also observed in girls. These results indicated that strong grip strength was associated with increased adolescent BP after adjustment for BMI. Our findings raise questions about using muscle-strengthening training as an approach to improve the BP profile in adolescents.
10.1038/hr.2016.84
Muscle strength is a major determinant of the blood pressure response to isometric stress testing: the Asklepios population study.
Van Daele Caroline M,Chirinos Julio A,De Meyer Tim,De Buyzere Marc L,Langlois Michel R,Bekaert Sofie,Segers Patrick,Gillebert Thierry C,Rietzschel Ernst R,
Journal of hypertension
AIM:Maximal handgrip strength is a strong predictor of cardiovascular mortality in economically and socioculturally diverse countries, yet the main determinants of cardiovascular response to change in afterload during handgrip are not well known. We examined the blood pressure (BP) responses during submaximal handgrip (at 25% of grip strength) and the determinants of grip strength. METHODS:We studied 2215 participants from a population-based random sample without overt clinical disease (Asklepios Study; mean age 56.2 years). Handgrip testing was performed using a modified Jamar dynamometer with direct visual feedback. Simultaneously, a validated finger plethysmographic device measured continuous BP and heart rate. RESULTS:During handgrip, SBP and DBP rose by, respectively, 20 ± 13 and 10 ± 6 mmHg. These changes were normally distributed and consistently higher in men. The main independent determinants of mean arterial pressure response during handgrip were: grip strength (F = 191.4; P < 0.001), baseline pulse pressure (F = 32.0; P < 0.001), height (F = 16.4; P < 0.001) and age (F = 12.8; P < 0.001). Grip strength was associated with muscle mass, better metabolic health, but also with higher baseline DBP. There was a significant graded increase in maximum pressure achieved and in the magnitude of pressure change during handgrip with increasing BP categories (P for trend <0.001). CONCLUSION:The population BP response to handgrip is variable and its predominant determinant turned out to be grip strength itself, which should be accounted for in future analyses. Higher baseline BP, even within the normotensive range, acted as an independent and graded predictor of BP increase during handgrip.
10.1097/HJH.0000000000002272
Resistance training to reduce resting blood pressure and increase muscle strength in users and non-users of anti-hypertensive medication: A meta-analysis.
Polito Marcos D,Dias Jayme R,Papst Rafael R
Clinical and experimental hypertension (New York, N.Y. : 1993)
The aim of this study was to conduct a systematic review with meta-analysis to analyze the effect of resistance training variables prescription on resting systolic (SBP) and diastolic blood pressure (DBP) and muscle strength changes. The search was conducted in the PubMed, Web of Science, and SPORTDiscus databases until August 2020 for randomized controlled trials with non-exercising control group. In total, 36 studies qualified for inclusion in this meta-analysis. Eleven studies included users of antihypertensive medication, while the remaining 25 studies were conducted with non-users of antihypertensive medication. Resistance training only reduced SBP (-0.56 [-0.77 to -0.35]; < .001) and DBP (-0.46 [-0.68 to -0.24]; < .001) in anti-hypertensive medication users, with changes ranging from -6.1 to -2.8 mmHg for SBP and -4.6 to -1.6 mmHg for DBP. Muscle strength increased significantly in both users (0.76 [0.49 to 1.02]; < .001) and non-users of antihypertensive medication (0.94 [0.71 to 1.16]; < .001). Resistance training should be performed by users and non-users of antihypertensive medication for 8 to 16 weeks (2 to 3 days a week) and 8 to 12 non-failure repetitions. However, users should train with less load (60-80 vs 70-85% 1RM) and exercise sets (1-3 vs 2-4) than non-users of antihypertensive medication. Resistance training increases muscle strength and reduces resting SBP and DBP in individuals under BP pharmacological therapy, while in individuals who do not use antihypertensive drugs, resistance training only increases strength.
10.1080/10641963.2021.1901111
Handgrip Strength and Blood Pressure in Children and Adolescents: Evidence From NHANES 2011 to 2014.
American journal of hypertension
BACKGROUND:Previous studies have reported that handgrip strength, a measure of muscular fitness, is associated with cardiovascular risk factors. However, the association of handgrip strength with blood pressure (BP) in children has been inconsistent. We tested the association of handgrip strength with systolic and diastolic BP in children and adolescents from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. METHODS:The study included 3,929 participants aged 8-19 years who underwent a handgrip test. The sum of the maximum handgrip strength from both hands was used. General linear models were used to examine the associations between handgrip strength and the outcome variables. RESULTS:After adjustment for age, race, sex, body mass index, and physical activities, handgrip strength was significantly and positively associated with systolic (P < 0.0001) and diastolic (P = 0.01) BP. There was an increasing trend in systolic BP as handgrip strength increased from the bottom quartile to the top quartile, with 2.1 mm Hg difference between the top and the bottom quartiles (P for trend <0.0001). Similar results were observed for diastolic BP. CONCLUSIONS:Muscular fitness is positively associated with BP in children and adolescents. The implications and underlying mechanisms for these results need further examinations.
10.1093/ajh/hpy032
Muscle strength is associated with lower diastolic blood pressure in schoolchildren.
Cohen D D,López-Jaramillo P,Fernández-Santos J R,Castro-Piñero J,Sandercock Grh
Preventive medicine
Cardiorespiratory fitness (CRF) provides protection against the elevated blood pressure in overweight youth. Less is known regarding any similar protective effect of muscular fitness. We investigated how handgrip strength, an easy to implement measure of muscular strength, interacted with CRF and BMI to determine blood pressure in youth. We measured systolic (SBP) and diastolic (DBP) blood pressure, handgrip strength (HG), CRF and body mass index (BMI) in n=7329 10-16year-olds (47% girls). We defined elevated blood pressure as >91st percentile and Good HG as >33rd percentile. Participants were classified as Fit or Unfit and as Normal or Overweight/Obese based on international standards. The prevalence of elevated SBP was 23%, and 44% of participants had elevated DBP. In unfit participants Good HG was associated with lower SBP (z=0.41 (95%CI: 0.20-0.61) and DBP (z=0.29 (95%CI: 0.12-0.47). In Overweight/Obese participants, DBP was z=0.24 (95%CI: 0.14-0.34) lower in the Good (versus Low) HG group. Overweight/Obese participants with Good HG also had a 32% lower risk of elevated DBP (OR: 0.68, 95%CI: 0.57-0.82). This association was attenuated but remained important after adjusting for BMI (20% risk reduction, OR: 0.80, 95%CI: 0.63-1.01). Muscular fitness appears to play some protective role against the risk of elevated blood pressure; particularly for the more prevalent measure: elevated DBP (44%). Effects may be restricted to Overweight / Obese or unfit youth, who have an increased risk of elevated BP and also may be less likely to engage in traditional cardiorespiratory fitness training. Research to determine the effects of muscular fitness training on blood pressure is warranted in these subgroups.
10.1016/j.ypmed.2016.11.006