Heat Therapy versus Exercise Training in Hypertension

高血压的热疗与运动训练

• 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
• 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

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.

项目摘要/摘要 在美国，高血压（HTN）占心血管疾病（CVD）相关的死亡人数的多 其他可修改的CVD风险因素，仅次于吸烟作为任何可预防的死亡原因 原因。根据最近更新的临床分类，美国HTN的患病率为46％。重要的是，非 对于大多数患有药理治疗而不是降压药物治疗 HTN基于新的分类（即，那些先前未归类为HTN的分类）。生活方式干预措施 由于定期锻炼被认为是针对HTN和HTN发展的一线预防措施 诊断为HTN的治疗。流行病学研究表明 体育活动，身体健康以及血压水平和HTN。不幸的是，绝大多数 人们对符合锻炼训练方案的运动训练和合规性是沉默寡言的 最低标准非常低。此外，一些患者群体无法进行锻炼 达到许多局限性，或者无法获得锻炼的全部益处，以降低CVD风险。因此， 至关重要的是降低血压和改善CVD风险的替代性非药物选择。 热疗法以热水浴或桑拿的形式是一种古老的习俗，最近在 CVD的预防和处理。芬兰最近的一项20多年的前瞻性队列研究，桑拿浴室的使用是 非常普遍的文化和部分文化，证明了常规桑拿的使用与 降低了HTN的风险，这可能部分解释了全因心血管的发生率 先前在较大的队列中报道的常规桑拿常规使用死亡。迄今为止，还没有临床 在人类中的试验，以确定热疗法是否是一种有效的治疗方法，以降低其中的血压 与htn。因此，我们提出了一项临床试验，以确定热疗法是否可以有效减少血液 HTN的压力。我们将比较热疗法后的血压降压与标准运动 训练。我们假设在8-10周内，使用热水浸入30次被动热疗法 将比运动更大程度地改善HTN个体的血压。此外，我们将评估 HTN的临床措施，关键的血管和自主生物标志物以及心血管健康风险之前和 进行热疗法和运动训练。我们进一步假设热疗法会增加血管 合规性，较低的交感神经流出并改善HTN个体的内皮功能。最后，我们会的 确定热疗法或运动测试后血压急性降低是否会降低 预测热疗法治疗或运动训练后静静静止压力的持续减少 在HTN主题中。这些发现将提供超出基线静止血统的重要预测信息 压力。证明热疗法可以用作基本HTN的新型治疗方法是及时的，并且 重要的是，显然需要替代运动训练和药理学方法。

项目成果

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)
• 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
• 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)
• 作者: Mangum,JoshuaE;Needham,KarenWiedenfeld;Sieck,DylanC;Ely,MatthewR;Larson,EmilyA;Peck,MairinC;Minson,ChristopherT;Halliwill,JohnR
• 通讯作者: Halliwill,JohnR

Cardiovascular and mood responses to an acute bout of cold water immersion.

心血管和情绪对急性冷水浸泡的反应。

• DOI: 10.1016/j.jtherbio.2023.103727
• 发表时间: 2023
• 期刊: Journal of thermal biology
• 影响因子: 2.7
• 作者: Reed,EmmaL;Chapman,ChristopherL;Whittman,EmmaK;Park,TaliaE;Larson,EmilyA;Kaiser,BrendanW;Comrada,LindanN;WiedenfeldNeedham,Karen;Halliwill,JohnR;Minson,ChristopherT
• 通讯作者: Minson,ChristopherT

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)
• 作者: Francisco,MichaelA;Gibson,BrandonM;Simmons,GrantH;Halliwill,JohnR;Minson,ChristopherT
• 通讯作者: Minson,ChristopherT