Inter-individual variations in response to aerobic and resistance training in hypertensive older adults

Exercise interventions to improve physical frailty and physical frailty components in older adults with hypertension: A systematic review

Physical frailty and hypertension are both highly prevalent among older adults. Furthermore, physical frailty may impact the risk-benefit ratio of pharmacological hypertension treatment. Thus, it may be prudent to focus on physical activity and exercise interventions to achieve better patient outcomes that addresses both conditions. This systematic review aimed to investigate the effects of exercise interventions on physical frailty components and hypertension-related outcomes in older adults with hypertension. PubMed/Medline, Embase, Cochrane Library, Cinahl and PEDro were searched for exercise trials in older adults with hypertension, measuring physical frailty or physical frailty components. Preferred Reporting Items for Systematic Review and Meta-Analysis protocol (PRISMA-P) and Physiotherapy Evidence Database (PEDro) scale were used for internal validity. The searches retrieved 4965 titles without duplicates. Ninety-four potential full texts were evaluated, and 30 original studies were included in the review. Mean methodological quality of the included studies was 5.7 out of 10. Only one study measured frailty (using a cumulative deficit model) in older adults with hypertension. Different types of exercise training demonstrated improvements in components of physical frailty. This systematic review shows that there is no evidence whether exercise ameliorates the effects of physical frailty and hypertension and there is a need for more data to be generated.

Blood pressure responsiveness to resistance training in the hypertensive older adult: a randomized controlled study

Different lifestyle changes have been employed to improve clinical hypertension. However, there is scarce evidence on the blood pressure responsiveness to resistance training (RT) in hypertensive older adults. Consequently, little is known about some participants clinically reducing blood pressure and others not. Thus, we investigate the effects and responsiveness of RT on blood pressure in hypertensive older adults. We secondarily evaluated the biochemical risk factors for cardiovascular disease and functional performance. Older participants with hypertension were randomly assigned into RT (n = 27) and control group (n = 25). Blood pressure, functional performance (timed up and go, handgrip strength, biceps curl and sit-to-stand), fasting glucose, and lipid profiles were evaluated preintervention and postintervention. The statistic was performed in a single-blind manner, the statistician did not know who was the control and RT. RT was effective in reducing systolic blood pressure (SBP) (pre 135.7 ± 14.7; post 124.7 ± 11.0; P  < 0.001) and the responses to RT stimuli varied noticeably between hypertensive older adults after 12 weeks. For example, 13 and 1 responders displayed a minimal clinical important difference for SBP attenuation (10.9 mmHg) in the RT and control groups, respectively. RT improved the functional performance of older people with hypertension, while no differences were found in biochemical parameters (triglycerides, HDL, LDL, fasting glucose) after 12 weeks. In conclusion, responses to RT stimuli varied noticeably between hypertensive individuals and RT was effective in reducing SBP.

Acute and chronic cardiovascular responses to concentric and eccentric exercise in older adults with knee osteoarthritis

PURPOSE

Muscle contraction type in resistance exercise training may confer benefits besides strength in individuals with osteoarthritis and cardiovascular disease (CVD) risks. The purpose of the study was to explore whether Eccentric-resistance training (RT) improved hemodynamic responses to acute walking exercise stress compared to Concentric-RT among individuals with knee OA over four months.

METHODS

This was a secondary analysis from a randomized, controlled, single-blinded study. Participants (N = 88; 68.3 ± 6.4 yrs; 67.4% female) were randomized to one of two work-matched resistance training (RT) programs against a non-RT control group. Pre-training and month four, participants completed a self-paced Six-Minute Walk Test (6MWT) and progressive treadmill exercise test. Heart rates, blood pressures and mean arterial pressures (MAP) were captured during each test. Antihypertensive medications use was documented at each time point.

RESULTS

Leg strength improved in both training groups by month four (p < .05). Changes in 6MWT distance and progressive treadmill test time were not different across groups over four months. Neither Concentric or Eccentric RT produced different hemodyamic responses during the 6MWT compared to the control group post-training. However, Concentric RT was associated with 6.0%-7.4% reductions in systolic blood pressure during the graded treadmill walking test at 50%, 75% and 100% of the test time compared to Eccentric RT and the controls (p = .045). MAP values were lower at 75% and 100% of the treadmill test after Concentric RT (5.7%-6.0% reductions) compared to Eccentric RT (1.0%-2.4% reductions) and controls (1.5% and 4.0% elevations) post-training (p = .024). Antihypertensive medication use did not change in any group.

CONCLUSIONS

The repeated, progressive exposures of Concentric RT-induced blunted the hypertensive responses to acute exercise compared to Eccentric-RT. Among people with knee OA, Concentric-RT may confer strength benefits to manage OA and possibly reduce cardiovascular stress during exercise.

Nutritional status, health risk behaviors, and eating habits are correlated with physical activity and exercise of brazilian older hypertensive adults: a cross-sectional study

BACKGROUND

Nutritional status, health risk behaviors, eating habits, and other comorbidities (such as diabetes) may be associated with recommended amounts of physical activity (PA) and exercise (EX) in healthy older adults. However, these associations are still unclear for older hypertensive adults, who require greater care from health professionals. The purpose of this study was to associate the nutritional status, health risk behaviors, eating habits, and the presence of diabetes with recommended amounts of physical activity and exercise practice of older hypertensive adults.

METHODS

Ten thousand seven hundred eighty-nine older hypertensive adults (70.9 ± 7.4 years) from the VIGITEL telephone survey were classified according to PA levels (insufficiently active/sufficiently active) and EX practice (non-practitioners/practitioners). Binary logistic regression was used to observe the odds ratio (OR) between independent variables (nutritional status [body mass index], sociodemographic characteristics [age/sex/years of study], risk behaviors [screen time/alcohol/tobacco consumption], eating habits [minimally/ultra-processed foods consumption score], and the presence of diabetes) with recommended amounts of PA/EX (dependent variable).

RESULTS

Highest nutritional status (OR_PA = 0.975 [95%-CI: 0.965 - 0.985]; OR_EX = 0.981[95%-CI: 0.972 - 0.991]), age (OR_PA = 0.955 [95%-CI: 0.949 - 0.961]; OR_EX = 0.980[95%-CI: 0.975 - 0.986]), screen time (OR_PA = 0.909[95%-CI: 0.835 - 0.990]), alcohol consumption (OR_PA = 0.683[95%-CI: 0.621 - 0.758]; OR_EX = 0.702[95%-CI: 0.637 - 0.779]), tobacco (OR_PA = 0.601 [95%-CI: 0.492 - 0.736]; OR_EX = 0.464[95%-CI: 0.384 - 0.562]) ultra-processed foods consumption score (OR_PA = 0.896[95%-CI: 0.871 - 0.921]; OR_EX = 0.886[95%-CI: 0.863 - 0.909]) and having diabetes (OR_PA = 0.780[95%-CI: 0.708 - 0.859]; OR_EX = 0.831[95%-CI: 0.759 - 0.909]) reduced the odds of being sufficiently active/practicing exercise (p < 0.05). Male sex (OR_PA = 1.633[95%-CI: 1.491 - 1.789]; OR_EX = 1.247[95%-CI: 1.140 - 1.363]), years of study (OR_PA = 1.026[95%-CI: 1.018 - 1.035]; OR_EX = 1.050[95%-CI: 1.041 - 1.058]), and minimally processed foods consumption score increased the odds of being sufficiently active/practicing exercise (OR_PA = 1.132[95%-CI: 1.109 - 1.155]; OR_EX = 1.167[95%-CI: 1.145 - 1.191], respectively; p < 0.05).

CONCLUSION

Nutritional status, health risk behaviors, eating habits, and the presence of diabetes were associated with the odds of older hypertensive adults complying with PA and EX recommendations. The results may help health professionals understand how these factors are associated with the changes of older hypertensive adults participating in physical activity and exercise.