Heat Therapy versus Exercise Training in Hypertension

高血压的热疗与运动训练

基本信息

批准号：
10199776
负责人：
John R. Halliwill
金额：
$ 59.98万
依托单位：
UNIVERSITY OF OREGON
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-07-15 至 2025-06-30
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10199776
关键词：
Acute Adult Advisory Committees Aerobic Exercise American American Heart Association Antihypertensive Agents Attention Bathing Biological Markers Blood Pressure Blood Vessels Cardiology Cardiovascular Diseases Cardiovascular system Cause of Death Centers for Disease Control and Prevention (U.S.)Cessation of life Chronic Classification Clinic Clinical Clinical Trials Data Development Diagnosis Endothelium Essential Hypertension Exercise Exercise Test Finland General Population Goals Gold Guidelines Health Heat Stress Disorders Human Hypertension Immersion Individual Intention Measures Muscle Nerve Oxidative Stress Patients Pharmaceutical Preparations Pharmacology Phenotype Physical Fitness Physical activity Prevalence Prevention Prospective cohort study Publishing Randomized Clinical Trials Regimen Reporting Research Research Design Research Personnel Resolution Rest Risk Risk Factors Sauna Therapeutic heat application Time United States Update Water Work base blood pressure reduction blood pressure regulation cardiovascular disorder prevention cardiovascular disorder risk cardiovascular health cigarette smoking clinical biomarkers cohort college disability-adjusted life years effective therapy efficacy testing epidemiology study exercise intervention exercise training hypertension control hypertension treatment improved innovation lifestyle intervention normotensive novel predictive test prehypertension prevent prospective relating to nervous system response sedentary standard of care stressor success systemic inflammatory response treatment effect

项目摘要

PROJECT SUMMARY/ABSTRACT In the U.S., hypertension (HTN) accounts for more cardiovascular disease (CVD)-related deaths than any other modifiable CVD risk factor, second only to cigarette smoking as a preventable cause of death for any reason. Based on recently updated clinical classifications, the US prevalence of HTN is 46%. Importantly, non- pharmacological treatment rather than antihypertensive medication is recommended for most adults who have HTN based on the new classifications (i.e., those not previously classified as HTN). Lifestyle interventions such as regular exercise are considered a first-line preventative against the development of HTN and in the treatment of diagnosed HTN. Epidemiological studies have demonstrated an inverse relationship between physical activity and physical fitness and level of blood pressure and HTN. Unfortunately, the vast majority of people are reticent to initiate exercise training and compliance in exercise training regimens that meet the minimum standards are extremely low. Additionally, some patient groups are not able to perform exercise due to a number of limitations or are not able to obtain the full benefits of exercise to reduce CVD risk. Thus, alternative non-pharmacological options to lower blood pressure and improve CVD risk are critically needed. Heat therapy, in the form of hot bath or sauna, is an ancient practice that has recently regained attention in the prevention and treatment of CVD. A recent 20+year prospective cohort study from Finland, where sauna use is extremely common and part of the culture, has demonstrated that regular sauna use was associated with reduced risk of developing HTN, which may explain in part the reduced rates of all-cause cardiovascular deaths with regular sauna use previously reported in the larger cohort. To date, there have been no clinical trials in humans to determine whether heat therapy is an effective treatment to reduce blood pressure in those with HTN. As such, we propose a clinical trial to determine whether heat therapy can effectively reduce blood pressure in HTN. We will compare the blood pressure reductions following heat therapy to standard exercise training. We hypothesize that 30 sessions of passive heat therapy using hot water immersion over 8-10 weeks will improve blood pressure in HTN individuals to a greater extent than exercise. In addition, we will evaluate clinical measures, key vascular and autonomic biomarkers of HTN, and cardiovascular health risk before and following heat therapy and exercise training. We further hypothesize that heat therapy will increase vascular compliance, lower sympathetic outflow, and improve endothelial function in individuals with HTN. Lastly, we will determine whether the acute decreases in blood pressure following a heat therapy session or exercise test will predict the sustained reduction in resting blood pressures following heat therapy treatment or exercise training in HTN subjects. These findings would provide significant predictive information beyond baseline resting blood pressures. Demonstrating that heat therapy can be used as a novel treatment for essential HTN is timely and important as there is a clear need for alternatives to exercise training and pharmacological approaches.

项目概要/摘要在美国，高血压 (HTN) 导致的心血管疾病 (CVD) 相关死亡人数比任何其他疾病都多其他可改变的 CVD 危险因素，是仅次于吸烟的可预防死亡原因原因。根据最近更新的临床分类，美国高血压患病率为 46%。重要的是，非对于大多数患有高血压的成年人，建议进行药物治疗而不是抗高血压药物治疗基于新分类的 HTN（即以前未分类为 HTN 的分类）。生活方式干预措施，例如因为定期锻炼被认为是预防高血压发生的一线措施，治疗确诊的 HTN。流行病学研究表明，两者之间存在反比关系。身体活动和身体健康以及血压和高血压水平。不幸的是，绝大多数人们不愿意开始运动训练并且遵守符合要求的运动训练方案最低标准极低。此外，一些患者群体由于以下原因无法进行锻炼：受到一些限制或无法获得运动的全部益处以降低 CVD 风险。因此，迫切需要替代的非药物选择来降低血压和改善心血管疾病风险。热疗，以热水浴或桑拿的形式，是一种古老的疗法，最近在人们中重新受到关注。 CVD的预防和治疗。芬兰最近进行的一项为期 20 多年的前瞻性队列研究显示，桑拿浴的使用率非常普遍，并且是文化的一部分，已证明经常使用桑拿与患高血压的风险降低，这可能部分解释了全因心血管疾病发生率降低的原因之前在较大队列中报道过经常使用桑拿导致的死亡。迄今为止，临床上尚未发现人体试验以确定热疗法是否是降低血压的有效方法与HTN。因此，我们建议进行一项临床试验，以确定热疗是否可以有效减少血液 HTN 中的压力。我们将比较热疗和标准运动后的血压降低情况训练。我们假设在 8-10 周内进行 30 次使用热水浸泡的被动热疗与运动相比，可以更大程度地改善高血压患者的血压。此外，我们还将评估临床测量、HTN 的关键血管和自主生物标志物以及治疗前和治疗前的心血管健康风险热疗和运动训练后。我们进一步假设热疗会增加血管顺应性，降低交感神经流出，并改善高血压患者的内皮功能。最后，我们将确定热疗或运动测试后血压急剧下降是否会影响血压预测热疗或运动训练后静息血压的持续降低在 HTN 科目中。这些发现将提供超出基线静息血液的重要预测信息压力。证明热疗法可以作为治疗原发性高血压的一种新方法是及时且有效的重要的是，显然需要运动训练和药理学方法的替代方案。

项目成果

期刊论文数量（11）

专著数量（0）

科研奖励数量（0）

会议论文数量（0）

专利数量（0）

The impact of elevated body core temperature on critical power as determined by a 3-min all-out test.

通过 3 分钟全力测试确定身体核心温度升高对临界功率的影响。

DOI：
10.1152/japplphysiol.00253.2021
发表时间：
2021
期刊：
Journal of applied physiology (Bethesda, Md. : 1985)
影响因子：
0
作者：
Kaiser,BrendanW;Kruse,Ka'eoK;Gibson,BrandonM;Santisteban,KelseyJ;Larson,EmilyA;Wilkins,BradW;Jones,AndrewM;Halliwill,JohnR;Minson,ChristopherT
通讯作者：
Minson,ChristopherT

Brachial and carotid hemodynamic response to hot water immersion in men and women.

男性和女性对热水浸泡的肱动脉和颈动脉血流动力学反应。

DOI：
10.1152/ajpregu.00110.2021
发表时间：
2021
期刊：
American journal of physiology. Regulatory, integrative and comparative physiology
影响因子：
0
作者：
Larson,EmilyA;Ely,BrettR;Brunt,ViennaE;Francisco,MichaelA;Harris,SarianneM;Halliwill,JohnR;Minson,ChristopherT
通讯作者：
Minson,ChristopherT

The effect of local passive heating on skeletal muscle histamine concentration: implications for exercise-induced histamine release.

局部被动加热对骨骼肌组胺浓度的影响：对运动引起的组胺释放的影响。

DOI：
10.1152/japplphysiol.00740.2021
发表时间：
2022
期刊：
Journal of applied physiology (Bethesda, Md. : 1985)
影响因子：
0
作者：
Mangum,JoshuaE;Needham,KarenWiedenfeld;Sieck,DylanC;Ely,MatthewR;Larson,EmilyA;Peck,MairinC;Minson,ChristopherT;Halliwill,JohnR
通讯作者：
Halliwill,JohnR

Serum from young, sedentary adults who underwent passive heat therapy improves endothelial cell angiogenesis via improved nitric oxide bioavailability.

DOI：
10.1080/23328940.2019.1614851
发表时间：
2019-01-01
期刊：
Temperature (Austin, Tex.)
影响因子：
0
作者：
Brunt, Vienna E;Weidenfeld-Needham, Karen M;Minson, Christopher T
通讯作者：
Minson, Christopher T

Cholinergic nerve contribution to cutaneous active vasodilation during exercise is similar to whole body passive heating.

运动期间胆碱能神经对皮肤主动血管舒张的贡献类似于全身被动加热。

DOI：
10.1152/japplphysiol.00299.2022
发表时间：
2023
期刊：
Journal of applied physiology (Bethesda, Md. : 1985)
影响因子：
0
作者：
Francisco,MichaelA;Gibson,BrandonM;Simmons,GrantH;Halliwill,JohnR;Minson,ChristopherT
通讯作者：
Minson,ChristopherT