Chrono-exercise is Medicine: Improving Blood Pressure and Vascular Function through Chronotherapy

计时运动是良药：通过计时疗法改善血压和血管功能

• 批准号: 10687416
• 负责人: KATHARINE DIANNE CURRIE
• 金额: $ 68.6万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-06 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10687416
• 关键词: Acute; Adult; Aerobic; Affect; Age; Aging; Ambulatory Blood Pressure Monitoring; Blood Pressure; Blood Vessels; Cardiovascular Diseases; Cardiovascular system; Cause of Death; Chronic; Chronotherapy; Circadian Rhythms; Clinical Trials; Combination Medication; Cross-Over Studies; Data; Disease; Disease Outcome; Diurnal Rhythm; Educational Intervention; Elderly; Endothelium; Exercise; Future; Goals; Guidelines; Health; Health Status; Hypertension; Hypotension; Individual; Intervention; Isometric Exercise; Life Style Modification; Medicine; Metabolic; Nonpharmacologic Therapy; Older Population; Outcome; Outcome Assessment; Participant; Pharmaceutical Preparations; Pharmacology; Pharmacotherapy; Physical activity; Population; Postmenopause; Prevalence; Recommendation; Research; Research Design; Risk; Series; Time; Tissues; Training; Treatment Effectiveness; Treatment Efficacy; United States; Woman; age effect; arterial stiffness; blood pressure control; blood pressure regulation; body system; cardiovascular risk factor; circadian; combat; exercise intervention; exercise prescription; exercise training; hypertension control; hypertension treatment; hypertensive; improved; modifiable risk; normotensive; novel; older men; older women; personalized medicine; response; tool; treatment optimization; young adult

PROJECT SUMMARY/ABSTRACT This proposal will determine if exercise chronotherapy improves nocturnal blood pressure (BP) in older adults with hypertension. Hypertension is the leading modifiable risk factor for cardiovascular disease, which is the leading cause of death in the U.S. Hypertension is estimated to affect 75% of older adults. While typically managed using a combination of medications and lifestyle modifications, it is estimated that only 21% of adults with hypertension have controlled BP. Therefore, optimizing treatment options for adults with hypertension is of paramount importance. Nocturnal BP is an emerging target in the management of BP, given its association with cardiovascular outcomes. Chronotherapy combined with hypertension medications is effective at lowering nocturnal BP and future cardiovascular risk, with medications taken in the evening being more effective than medications taken in the morning. Preliminary evidence suggests chronotherapy combined with exercise (i.e., planned physical activity) may impact the acute and chronic responses to exercise. This research will characterize diurnal rhythms of vascular health outcomes across age and disease and guide timing of exercise intervention and outcome assessment, which will lead to improved BP management and vascular function. Three specific aims will accomplish this goal. Aim 1 will comprehensively evaluate the effect of age and hypertension on macrovascular and microvascular diurnal rhythms. Endothelial function, microvascular function and arterial stiffness will be evaluated along with 48-hr ambulatory BP monitoring and physical activity tracking in young and older adults with and without hypertension. Aim 2 will study the acute BP and vascular responses to exercise performed at different times of the day, focusing on post-exercise hypotension, in particular nocturnal BP. Older adults with hypertension will complete a session of aerobic and isometric handgrip exercise in the morning and evening. Baseline and post-exercise BP responses will be evaluated immediately following exercise and for 24-hr using ambulatory BP monitoring. Endothelial function and microvascular function will also be assessed at baseline and 12-hr post-exercise. Aim 3 will determine the long-term impacts of exercise chronotherapy by evaluating exercise training time of day effects on nocturnal BP and vascular function in postmenopausal women with hypertension. Participants will complete 8 weeks of aerobic and isometric handgrip exercise training in the morning and evening. Ambulatory BP and vascular function will be assessed pre- and post-training. The overarching hypothesis is that hypertension is characterized by the reduction of diurnal rhythms in vascular function and that evening exercise in this population will be more effective than morning exercise at lowering BP and improving vascular health both after a single exercise bout and 8 weeks of exercise training. This proposal will facilitate a paradigm shift in the treatment of hypertension to include chronotherapy in the exercise recommendations, optimizing treatment options for hypertension which in turn will improve the health of older adults.

项目概要/摘要 该提案将确定运动时间疗法是否可以改善老年人的夜间血压（BP） 患有高血压。高血压是心血管疾病的主要可改变危险因素， 据估计，高血压影响着美国 75% 的老年人。虽然通常 通过结合药物治疗和生活方式改变进行管理，估计只有 21% 的成年人 高血压患者血压已得到控制。因此，优化成人高血压的治疗方案至关重要 至关重要。夜间血压是血压管理中的一个新兴目标，因为它与 与心血管结局。计时疗法与高血压药物相结合可有效降低血压 夜间血压和未来心血管风险，晚上服用药物比晚上服用药物更有效 早上服用的药物。初步证据表明时间疗法与运动相结合（即 计划的身体活动）可能会影响对运动的急性和慢性反应。这项研究将 描述不同年龄和疾病的血管健康结果的昼夜节律，并指导运动时间 干预和结果评估，这将改善血压管理和血管功能。 三个具体目标将实现这一目标。目标1将综合评估年龄和年龄的影响 高血压对大血管和微血管昼夜节律的影响。内皮功能、微血管 功能和动脉僵硬度将与 48 小时动态血压监测和体力活动一起进行评估 对患有或不患有高血压的年轻人和老年人进行追踪。目标 2 将研究急性血压和血管 对一天中不同时间进行的运动的反应，重点关注运动后低血压， 特别是夜间血压。患有高血压的老年人将完成有氧运动和等长运动 早晚进行握力练习。将评估基线和运动后血压反应 运动后立即进行，并使用动态血压监测进行 24 小时。内皮功能和 还将在基线和运动后 12 小时评估微血管功能。目标 3 将确定 通过评估一天中的运动训练时间对夜间的影响来研究运动时间疗法的长期影响 绝经后高血压妇女的血压和血管功能。参与者将完成为期8周的 早晚进行有氧和等长握力训练。动态血压和血管 将在培训前和培训后评估功能。总体假设是高血压是 其特点是血管功能的昼夜节律减少以及晚上的锻炼 人群在降低血压和改善血管健康方面比晨练更有效 经过单次运动和 8 周的运动训练后。该提案将促进范式转变 高血压治疗将时间疗法纳入运动建议中，优化治疗 高血压的选择反过来又会改善老年人的健康。