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      Effects of arm swing exercise training on cardiac autonomic modulation, cardiovascular risk factors, and electrolytes in persons aged 60–80 years with prehypertension: A randomized controlled trial

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          Abstract

          Purpose

          This study aimed to investigate the effect and carry-over effect of arm swing exercise (ASE) training on cardiac autonomic modulation, cardiovascular risk factors, and blood electrolytes in older persons with prehypertension.

          Methods

          Subjects were 50 individuals with prehypertension (aged 66.90 ± 5.50 yr, body mass index 23.84 ± 3.65 kg/m 2). They were randomly assigned into ASE group and control group. Subjects in the ASE group underwent an ASE training program for 3 months at a frequency of 30 min/day, 3 days/week. Subjects in the control group maintained their daily routine activities minus regular exercise. Blood pressure, heart rate variability (HRV), cardiovascular risk factors including blood glucose, lipid profile, high-sensitive C-reactive protein (hsCRP), and electrolytes were evaluated on 3 occasions: before and after the 3-month intervention, and 1 month after intervention ended.

          Results

          Following the 3-month intervention, systolic blood pressure (SBP) and serum hsCRP concentration were significantly lower, while serum high-density lipoprotein (HDL)-cholesterol, potassium (K +), magnesium (Mg 2+) concentrations, standard deviation of normal R-R intervals (RMSSD) and high frequency (HF) power values were higher in the ASE group when compared with the control group (p < 0.05). At the 1-month follow-up interval, SBP and serum hsCRP concentration remained lower while serum HDL-cholesterol and K + concentrations remained higher in the ASE group as compared to the control group (p < 0.05).

          Conclusion

          ASE training decreased SBP and serum hsCRP concentration, increased serum HDL-cholesterol, K +, and Mg 2+ concentrations and increased RMSSD and HF power values in older persons with prehypertension. In addition, there were carry-over effects of ASE training i.e. decreased SBP and serum hsCRP concentration as well as increased serum HDL-cholesterol and K + concentrations.

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          Effects of endurance training on blood pressure, blood pressure-regulating mechanisms, and cardiovascular risk factors.

          Véronique A Cornelissen, Robert Fagard (2005)
          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.
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            Aerobic exercise reduces blood pressure in resistant hypertension.

            Fernando Dimeo, Nikolaos Pagonas, Felix S. Seibert … (2012)
            Regular physical exercise is broadly recommended by current European and American hypertension guidelines. It remains elusive, however, whether exercise leads to a reduction of blood pressure in resistant hypertension as well. The present randomized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension. Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents. Fifty subjects with resistant hypertension were randomly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program (target lactate, 2.0±0.5 mmol/L). Blood pressure was assessed by 24-hour monitoring. Arterial compliance and cardiac index were measured by pulse wave analysis. The training program was well tolerated by all of the patients. Exercise significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg, respectively (P=0.03 each). Regular exercise reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves. Arterial compliance and cardiac index remained unchanged. Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment. It should be included in the therapeutic approach to resistant hypertension.
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              Effects of Magnesium Supplementation on Blood Pressure: A Meta-Analysis of Randomized Double-Blind Placebo-Controlled Trials.

              Xi Zhang, Yufeng Li, Liana C Del Gobbo … (2016)
              The antihypertensive effect of magnesium (Mg) supplementation remains controversial. We aimed to quantify the effect of oral Mg supplementation on blood pressure (BP) by synthesizing available evidence from randomized, double-blind, placebo-controlled trials. We searched trials of Mg supplementation on normotensive and hypertensive adults published up to February 1, 2016 from MEDLINE and EMBASE databases; 34 trials involving 2028 participants were eligible for this meta-analysis. Weighted mean differences of changes in BP and serum Mg were calculated by random-effects meta-analysis. Mg supplementation at a median dose of 368 mg/d for a median duration of 3 months significantly reduced systolic BP by 2.00 mm Hg (95% confidence interval, 0.43-3.58) and diastolic BP by 1.78 mm Hg (95% confidence interval, 0.73-2.82); these reductions were accompanied by 0.05 mmol/L (95% confidence interval, 0.03, 0.07) elevation of serum Mg compared with placebo. Using a restricted cubic spline curve, we found that Mg supplementation with a dose of 300 mg/d or duration of 1 month is sufficient to elevate serum Mg and reduce BP; and serum Mg was negatively associated with diastolic BP but not systolic BP (all P<0.05). In the stratified analyses, a greater reduction in BP tended to be found in trials with high quality or low dropout rate (all P values for interaction <0.05). However, residual heterogeneity may still exist after considering these possible factors. Our findings indicate a causal effect of Mg supplementation on lowering BPs in adults. Further well-designed trials are warranted to validate the BP-lowering efficacy of optimal Mg treatment.
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                Author and article information

                Contributors
                Piyapong Prasertsri
                Journal
                Journal ID (nlm-ta): J Exerc Sci Fit
                Journal ID (iso-abbrev): J Exerc Sci Fit
                Title: Journal of Exercise Science and Fitness
                Publisher: The Society of Chinese Scholars on Exercise Physiology and Fitness
                ISSN (Print): 1728-869X
                ISSN (Electronic): 2226-5104
                Publication date PMC-release: 16 November 2018
                Publication date (Print): 20 January 2019
                Publication date (Electronic): 16 November 2018
                Volume: 17
                Issue: 2
                Pages: 47-54
                Affiliations
                [a ]Faculty of Allied Health Sciences, Burapha University, Chonburi, 20131, Thailand
                [b ]Exercise and Nutrition Sciences and Innovation Research Group, Burapha University, Chonburi, 20131, Thailand
                Author notes
                [* ]Corresponding author. Faculty of Allied Health Sciences, Burapha University, Chonburi, 20131, Thailand. piyapong@ 123456go.buu.ac.th
                Article
                Publisher ID: S1728-869X(18)30049-2
                DOI: 10.1016/j.jesf.2018.11.002
                PMC ID: 6353723
                PubMed ID: 30740133
                SO-VID: c6bbda1b-341d-4df4-a4c8-9aa6145b1c42
                Copyright © © 2018 The Society of Chinese Scholars on Exercise Physiology and Fitness. Published by Elsevier (Singapore) Pte Ltd.
                License:

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                Date received : 19 February 2018
                Date revision received : 25 September 2018
                Date accepted : 1 November 2018
                Categories
                Subject: Original Article

                Keywords: blood pressure,exercise,cardiovascular disease,heart rate variability,electrolyte
                Data availability:
                Keywords: blood pressure, exercise, cardiovascular disease, heart rate variability, electrolyte

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