The frequency of the ACE I/D polymorphism in South America: a systematic review and meta-analysis

Angiotensin-converting enzyme (ACE) is a key component of the renin-angiotensin system and plays an important role in homeostasis and maintenance of blood pressure. However, little is known about allele and genotypic frequencies, as well as phenotypic characteristics associated with ACE polymorphism genotypes in South American populations. This study aimed to verify the allelic predominance and genotype frequency of ACE I/D polymorphism in South America and its association with the main diseases and related conditions. We conducted a systematic review considering studies published in the last 25 years available in PubMed, Scielo, LILACS, LIPECS, Coleciona SUS, CUMED, BINACIS, IBECS, and MEDLINE databases, resulting in the inclusion of 121 studies. Quality of the studies was assessed according to the Strengthening the Reporting of Genetic Association (STREGA) guidelines. We mapped the frequency of the ACE I/D polymorphism in South American populations. 8,856 (32.1%) subjects were DD, 13,050 were ID (47.4%), and 5,644 were II (20.5%) carriers. The main associated conditions included systemic arterial hypertension and other cardiovascular conditions, cardiorespiratory or respiratory characteristics, physical activity level, kidney conditions, aging-related diseases, as well as different types of cancers and metabolic conditions. 61.1% of the studies found no significant association between the respective conditions investigated and the ACE I/D polymorphism. Considering DD genotype or D allele, 21.5% of the studies observed negative and 4.9% positive outcomes. Regarding ID genotype, 4.1% of the studies identified negative and 0.8% positive outcomes, and for II genotype or I allele, 4.1% of the results had negative and 10.7% positive associations.

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.

Exerkines and long-term synaptic potentiation: Mechanisms of exercise-induced neuroplasticity

Physical exercise may improve cognitive function by modulating molecular and cellular mechanisms within the brain. We propose that the facilitation of long-term synaptic potentiation (LTP)-related pathways, by products induced by physical exercise (i.e., exerkines), is a crucial aspect of the exercise-effect on the brain. This review summarizes synaptic pathways that are activated by exerkines and may potentiate LTP. For a total of 16 exerkines, we indicated how blood and brain exerkine levels are altered depending on the type of physical exercise (i.e., cardiovascular or resistance exercise) and how they respond to a single bout (i.e., acute exercise) or multiple bouts of physical exercise (i.e., chronic exercise). This information may be used for designing individualized physical exercise programs. Finally, this review may serve to direct future research towards fundamental gaps in our current knowledge regarding the biophysical interactions between muscle activity and the brain at both cellular and system levels.

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

BACKGROUND

Hemodynamic responses to physical training are not homogenous and uniform, and considerable inter-individual variations in the blood pressure of hypertensive individuals are noted in both aerobic and resistance training protocols. In this context, this study aimed to evaluate the effects of resistance and aerobic exercise on the blood pressure responses of hypertensive older adults.

METHODS

Groups were randomly divided into resistance training, n = 20; aerobic training, n = 20; control group, n = 21). After the first intervention period (12 weeks), individuals underwent a washout period (six detraining weeks), followed by a second intervention. This process is called the 'cross-over' model, where individuals who performed the aerobic exercise protocol also performed resistance training and vice-versa, constituting another 12 weeks of intervention. Blood pressure, functional performance, glycated hemoglobin and lipid profiles were evaluated preintervention and postintervention.

RESULTS

Varying responses to resistance training or aerobic training stimuli were observed in the hypertensive older adult participants. Both resistance training (pre 133.2 ± 14.1; post 122.4 ± 7.3; P < 0.05) and aerobic training (pre 134.2 ± 14.4; post 123 ± 9.4; P < 0.0.5) were effective in decreasing SBP, but only aerobic training (pre 9955.3 ± 1769.4; post 8800.9 ± 1316.1; P < 0.05) resulted in a decreased double product, and only the resistance training group improved functional performance.

CONCLUSION

Responses to resistance training or aerobic training stimuli varied noticeably between hypertensive older adults and both resistance training and aerobic training were effective in reducing SBP. This knowledge may be useful in providing individually tailored exercise prescriptions for hypertensive older adults.

A Review of Vascular Traits and Assessment Techniques, and Their Heritability

Various tools are available to assess atherosclerosis, arterial stiffening, and endothelial function. They offer utility in the assessment of hypertensive phenotypes, in cardiovascular risk prediction, and as surrogate endpoints in clinical trials. We explore the relative influence of participant genetics, with reference to large-scale genomic studies, population-based cohorts, and candidate gene studies. We find heritability estimates highest for carotid intima-media thickness (CIMT 35–65%), followed by pulse wave velocity as a measure of arterial stiffness (26–43%), and flow mediated dilatation as a surrogate for endothelial function (14–39%); data were lacking for peripheral artery tonometry. We furthermore examine genes and polymorphisms relevant to each technique. We conclude that CIMT and pulse wave velocity dominate the existing evidence base, with fewer published genomic linkages for measures of endothelial function. We finally make recommendations regarding planning and reporting of data relating to vascular assessment techniques, particularly when genomic data are also available, to facilitate integration of these tools into cardiovascular disease research.

Influence of Angiotensin Converting Enzyme I/D Polymorphism on Hemodynamic and Antioxidant Response to Long-Term Intradialytic Resistance Training in Patients With Chronic Kidney Disease: A Randomized Controlled Trial

ABSTRACT

Corrêa, HdL, Deus, LA, Neves, RVP, Reis, AL, de Freitas, GS, de Araújo, TB, da Silva Barbosa, JM, Prestes, J, Simões, HG, Amorim, CE, dos Santos, MAP, Haro, A, de Melo, GF, Gadelha, AB, Neto, LS, and Rosa, TdS. Influence of angiotensin converting enzyme I/D polymorphism on hemodynamic and antioxidant response to long-term intradialytic resistance training in patients with chronic kidney disease: a randomized controlled trial. J Strength Cond Res 35(10): 2902-2909, 2021-The aim of the study was to verify the influence of Angiotensin-converting enzyme (ACE) I/D genotype on blood pressure, muscle mass, and redox balance response to long-term resistance training (RT) in end-stage renal disease patients. Three hundred and twenty subjects were randomized into 4 groups: II + ID control (II + ID CTL, n = 80), II + ID RT (II + ID RT, n = 79), DD control (DD CTL n = 83), and DD RT (DD RT, n = 78). The RT lasted 24 weeks with a frequency of 3 times per week, on alternative days. Each section consisted of 3 sets of 8-12 repetitions in 11 exercises, with training loads at 6 point (somewhat hard) to 8 point (hard) based on OMNI-RES scale and was prescribed during dialysis (intradialytic). Statistical significance was accepted with p < 0.05. The most relevant benefits in blood pressure were found for DD homozygotes (p < 0.0001), whereas allele I carriers displayed a higher increase in muscle mass (p < 0.0001). Hemodialysis clinics that already use RT for their patients could include the genotyping of ACE to identify the predisposal of the patients to respond to RT and to counteract kidney disease-related comorbidities.

Low-load resistance training with blood flow restriction prevent renal function decline: The role of the redox balance, angiotensin 1-7 and vasopressin✰,✰✰

AIMS

We sought to investigate the effect of resistance training (RT) and low-load RT with moderate blood flow restriction (RT+BFR) on blood pressure, exercise pressor response, redox balance and vasoactive peptides, body composition and muscle strength in patients with stage two of chronic kidney disease (CKD).

METHODS

We conducted a 6-month randomized controlled exercise intervention in 90 male and female hypertensive CKD patients (58±9 years with estimated glomerular filtration rate (eGFR; of 66.1 ± 1.2 mL/kg/1.73m²). Participants were randomized to one of three groups (n = 30/group); control group (CTL), RT, and RT+BFR. RT and RT+BFR performed three weekly training sessions using similar periodization for six months (two-month mesocycles), but of different intensities.

RESULTS

There was similarly effects between RT and RT+BFR in reducing systolic and diastolic blood pressure during daytime and 24hour period (RT: 10.4%; RT+BFR: 10.3% of decrease), fat mass, F₂-isoprostanes, asymmetric dimethylarginine (ADMA) and vasopressin (p<0.05 pre-vs post). Also promoted the increase of angiotensin 1-7, nitric oxide (NO), catalase, Trolox equivalent and muscle strength (p<0.05). Both training models attenuated the decline of estimated glomerular filtration rate (p<0.0001 vs CTL). However, only RT+BFR was associated with lower discomfort during exercise (p<0.0001 pre-vs post). Statistical significance was considered with p < 0.05.

CONCLUSION

These findings suggest low-load RT+BFR as a promising non-pharmacological strategy to control blood pressure, oxidative stress, vasoactive peptides, and consequently, attenuate the decrease of the eGFR.

Saffron (Crocus sativus L.) in combination with resistance training reduced blood pressure in the elderly hypertensive men: A randomized controlled trial

AIMS

We aimed to determine the independent and combined effects of saffron and resistance training on blood pressure (BP) and some chemical biomarkers in the elderly with hypertension.

METHODS

The present study was a randomized clinical trial on hypertensive men aged 60-70 years who were assigned to a control group (CO) and 3 experimental groups; resistance training (RT); saffron (S); and resistance training + saffron (RTS) for 12 weeks. Dynamic resistance training was applied with moderate intensity. Patients in S and RTS received 1 tablet containing 200 mg of saffron daily. BP variables, chemical biomarkers and anthropometric indicators were measured at weeks 0, 6, 12 and 18. Data were analysed by repeated measurements ANOVA with 95% confidence interval (CI).

RESULTS

In comparison to the CO (153.3 ± 1.18, CI = 10.9-20.2, P < .001) and S (143.3 ± 1.18, CI = 0.97-10.2, P = .01), RTS (137.7 ± 1.18) reduced systolic BP with the effect size partial η² of 0.68. Nitric oxide increased in the RTS compared to the CO group (CI = 0.13-0.62, P = .001). There was a significant increase and decrease in adiponectin and endothelin-1 in the S (CI = 0.03-1.20, P = .012; CI = 4.30-17.3, P < .001) and RT (CI = 0.36-1.60, P < .001; CI = 2.26-15.3, P = .003) compared to the CO, respectively. The partial η² for nitric oxide, adiponectin and ET-1 were 0.35, 0.35 and 0.38, respectively. There was no significant difference between the groups for atrial natriuretic peptide.

CONCLUSIONS

Resistance training and consumption of saffron can improve BP in the elderly with hypertension by affecting the factors involved in altering vascular endothelial resistance. The present study was approved by the Ethics Committee of Iran's sports science research institution (IR.SSRC.REC.1398.020) and registered at the Iranian Registry of Clinical Trials (IRCT20190731044398N1).

Preliminary study about the relationship between estimated training status and RAS polymorphisms on blood pressure and ACE activity in the elderly

Objective:

Polymorphisms of the renin angiotensin system (RAS) are associated with increases in blood pressure (BP). Physical exercise has been considered the main strategy to prevent this increase. This study aimed to investigate the relationship between estimated training status (TS), BP and angiotensin-converting enzyme (ACE) activity in elderly people classified as low or high risk to develop hypertension according to genetic profile.

Methods:

A total of 155 elderly participants performed the following assessments: general functional fitness index (GFFI), systolic BP (SBP) and diastolic BP (DBP), blood collection for ACE activity and analyses of the RAS polymorphisms.

Results:

Uncontrolled hypertensive (UHT) participants presented higher values of SBP and DBP compared with normotensive (NT) and controlled hypertensive (CHT) participants. No differences were found in ACE activity and GFFI between groups. In the high risk group, UHT presented higher values of SBP and DBP compared with other groups. CHT presented higher values of SBP compared with NT. Furthermore, UHT presented higher values of ACE activity compared with CHT and lower values of GFFI compared with NT.

Conclusion:

MDA, TIA and TIC genetic combinations were associated with high risk of developing hypertension while the maintenance of good levels of TS was associated with lower BP values and ACE activity.