Effect of Reducing Sedentary Behavior on Blood Pressure

减少久坐行为对血压的影响

基本信息

批准号：
10198014
负责人：
MATTHEW F MULDOON
金额：
$ 61.05万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2017
资助国家：
美国
起止时间：
2017-08-15 至 2024-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10198014
关键词：
Accounting Acute Address Adherence Adult Affect Aldosterone American Attention Behavior Behavior Therapy Behavioral Blood Pressure Blood Vessels Cardiovascular Diseases Cessation of life Clinical Computers Counseling Coupled Cross-Over Studies Data Diastolic blood pressure Distal Dose Energy Metabolism Evaluation Exercise Future Goals Guidelines Health Health Benefit Health Care Costs Hour Hypertension Individual Interruption Intervention Intervention Studies Laboratories Laboratory Study Lead Leisures Light Link Measures Mediating Modification Monitor Morbidity - disease rate Movement Obesity Observational Study Occupational Occupations Outcome Perception Persons Pharmacotherapy Physical activity Physiologic pulse Plasma Population Posture Public Health Randomized Clinical Trials Recommendation Renin Renin-Angiotensin-Aldosterone System Research Research Design Rest Risk Risk Factors Stream Structure Telephone Testing Text Messaging Time Walking Wrist adverse outcome arm arterial stiffness base blood pressure reduction blood pressure regulation cardiometabolic risk cardiorespiratory fitness cardiovascular disorder risk cardiovascular health cardiovascular risk factor efficacy evaluation fight against fitness improved innovation insulin sensitivity intervention effect light intensity moderate-to-vigorous physical activity mortality novel novel strategies novel therapeutic intervention prehypertension primary outcome prognostic programs randomized trial recruit response secondary outcome sedentary lifestyle therapy design tool trial comparing vigorous intensity

项目摘要

PROJECT ABSTRACT Elevated blood pressure (BP), including hypertension (HTN) and preHTN, affects 2 in 3 American adults and is a major contributor to cardiovascular disease (CVD) morbidity, mortality, and healthcare costs. Despite widespread use of pharmacotherapy, only about half of HTN is controlled, highlighting a need for innovative strategies to decrease the burden of elevated BP. Though regular exercise in the form of moderate-to-vigorous physical activity (MVPA) occurring in bouts of at least 10 minutes is recommended to decrease BP, we propose that reducing time spent sitting or `sedentary behavior' (SED) is a distinct, novel strategy that could lower BP in individuals with preHTN and HTN. Recent occupational and leisure changes (e.g., computers, video streaming) have resulted in more than half of the American day being spent in SED. At the same time, many observational studies have linked excessive SED with adverse outcomes, including HTN and CVD. Moreover, same day laboratory studies suggest that reducing or interrupting SED decreases BP acutely and our preliminary data suggest that systolic BP (SBP) is reduced by 4-6 mmHg after a 12-week SED intervention. Yet, there have been no robust, randomized trials of sufficient size and duration to demonstrate that reducing SED has sustained benefits on BP. Before clinical or public health SED recommendations can be made, such experimental evidence is imperative. Thus, the goal of this application is to demonstrate the efficacy of SED reduction to decrease BP in a 3-month randomized, clinical trial (intervention vs. control) in 300 adults (150 per group) with pre-to-Stage I HTN who have structured, prolonged SED as desk workers. We will use our proven approach that intervenes on multiple levels (individual, environmental modification with a sit-stand desk attachment) and utilizes behavioral strategies (individual counseling, self-monitoring, external prompting with a wrist-worn monitor light-intensity physical activity (LPA) (standing, light movement) and short spurts (<10 min) of activity (sporadic MVPA) as replacement behaviors. We will comprehensively study the effects of our intervention on vascular health by assessing resting BP, ambulatory BP, and carotid-femoral pulse wave velocity (cfPWV) (Aim 1) and key potential mechanisms (plasma renin activity, aldosterone) (Aim 2). We will use objective activity monitoring to evaluate dose-response relationships between amount of achieved SED reduction (and resulting increases in LPA and sporadic MVPA) with changes in outcomes (Aim 3). We will also study adiposity, fitness, and insulin sensitivity as exploratory outcomes that could change with our intervention, and if so, might relate to BP. Results from this study will determine whether decreasing SED can improve BP and vascular health and inform the necessary dose of SED reduction for clinically meaningful benefits. Also, evaluation of our novel intervention approach will inform future interventions for SED research and for designing translatable, population-level programs. If SED reduction improves BP, it could provide an important additional tool in the fight against elevated BP and CVD. and text messaging). These strategies will facilitate a targeted 2-4 hr/day SED reduction by increasing

项目摘要血压升高（BP），包括高血压（HTN）和PERHTN，影响3个美国成年人中的2个造成心血管疾病（CVD）发病率，死亡率和医疗保健费用的主要贡献者。尽管药物治疗的广泛使用，只有大约一半的HTN受到控制，强调了对创新的需求减轻BP升高负担的策略。虽然以中度到vi的形式进行定期锻炼我们建议在至少10分钟的回合中进行体育锻炼（MVPA），以减少BP 减少坐着的时间或“久坐行为”（SED）是一种独特的新型策略，可以降低BP 患有PreHTN和HTN的人。最近的职业和休闲变化（例如计算机，视频流）在SED中度过了一半以上的美国日。同时，许多观察研究已将过度SED与包括HTN和CVD在内的不良结果联系起来。而且，同一天实验室研究表明，减少或中断SED会急性降低BP和我们的初步数据表明在12周的SED干预后，收缩BP（SBP）减少了4-6 mmHg。但是，有没有足够大小和持续时间的强大的随机试验证明减少SED已经持续 BP的好处。在提出临床或公共卫生建议之前，此类实验证据是势在必行的。因此，该应用的目的是证明降低降低的功效以降低BP 在300名成年人（每组150）的3个月随机临床试验（干预与对照）中， HTN构成了延长的SED，作为办公桌工作人员。我们将使用介入的经过验证的方法多个级别（单个，环境修改，带有站立式桌面附件），并利用行为策略（个人咨询，自我监控，外部提示与腕上戴的监视器光强度体育锻炼（LPA）（站立，轻运动）和短暂的活动（<10分钟）的活动（零星MVPA）替代行为。我们将全面研究干预对血管健康的影响评估静息BP，门诊BP和颈动脉脉搏波速度（CFPWV）（AIM 1）和关键电位机理（血浆肾素活性，醛固酮）（AIM 2）。我们将使用客观活动监控来评估实现的SED减少量之间的剂量反应关系（以及LPA和零星MVPA）随着结果的变化（AIM 3）。我们还将研究肥胖，健身和胰岛素敏感性随着探索性结果可能随我们的干预而改变，如果是的话，可能与BP有关。结果研究将确定减少SED是否可以改善BP和血管健康并告知必要减少SED的剂量，以获得有意义的好处。此外，对我们新颖的干预方法的评估将告知未来的干预措施，以进行SED研究和设计可翻译的人群级计划。如果SED 减少可以改善BP，它可以为与升高的BP和CVD提供重要的额外工具。和文字消息）。这些策略将通过增加有针对性的2-4 hr/天sed降低