 Connection
Search Results to
This is a "connection" page, showing the details of why an item matched the keywords from your search.
One or more keywords matched the following properties of
Inspiratory muscle strength training for lowering blood pressure in hypertensive mid-life adults
| Property | Value |
|
abstract
|
Project Summary This R21 application is responsive to NIA PA-18-153 Prevention Research in Mid-Life Adults. Systolic hypertension, defined as systolic blood pressure (SBP) ?130 mmHg, affects 65-70% of mid-life adults (50-64 years), and is a major modifiable risk factor for cardiovascular diseases, cognitive decline/dementia, renal dysfunction and other chronic conditions of aging. Many mid-life adults do not engage in time-intensive healthy lifestyle practices that would reduce SBP due to competing personal and professional time demands that tend to peak during this period of life. The number of mid-life adults is rapidly increasing, necessitating the development of novel, time- and effort-efficient lifestyle interventions to prevent and treat systolic hypertension. Co-I Dr. Fiona Bailey has found that brief (~5 min/day) inspiratory muscle strength training (IMST) consisting of 30 breaths at 75% of maximal inspiratory pressure (PIMAX), 5-6 days/week for 6 weeks lowers casual (resting) SBP by 12 mmHg in patients with obstructive sleep apnea (OSA), with excellent adherence (<10% dropout, 97% of training sessions completed). A primary cause of systolic hypertension with aging is arterial stiffening, demonstrated by increased carotid-femoral pulse wave velocity (CFPWV). Findings in OSA patients and healthy young adults show that IMST reduces systemic vascular resistance and plasma norepinephrine (PNE), a marker of sympathetic activity and vascular smooth muscle constrictor, suggesting actions on vascular tone/stiffness. Oxidative stress-mediated inhibition of nitric oxide (NO) bioavailability and its tonic vasodilatory influence is another key determinant of arterial stiffening that may play a role in IMST- induced improvements in SBP. However, the short-term and long-lasting effects of IMST on SBP, arterial function, sympathetic activity and oxidative stress, and its safety and adherence, in mid-life adults is unknown. We propose a small randomized, double-blind, sham-controlled, parallel design clinical trial to assess the efficacy of 6-weeks of IMST (75% PIMAX) vs. sham training (15% PIMAX) (n=23/group) for decreasing SBP and improving arterial function in mid-life adults with systolic hypertension. We hypothesize that IMST will lower SBP and CFPWV, and increase brachial artery flow-mediated dilation (FMDBA), a measure of NO-mediated endothelium-dependent dilation, and reduce oxidative stress and PNE. We further hypothesize that IMST will be safe, well-tolerated, and associated with high rates of adherence, and that a portion of the improvements in SBP and arterial function will persist 6-weeks after completing post-intervention testing. Aim 1: To measure casual SBP (primary outcome) and 24-hour ambulatory SBP (secondary outcome) before, after and 6-weeks following IMST vs. sham training. Safety, tolerability and adherence will also be assessed; Aim 2: To measure CFPWV, FMDBA and PNE before, after and 6-weeks following IMST vs. sham training; Aim 3: To evaluate tonic oxidative stress-mediated suppression of FMDBA, and markers of oxidative stress and antioxidant defense in endothelial cells from subjects before, after and 6-weeks following IMST/sham training.
|
|
|