Exercise vs. Heat Therapy Effects on Kidney Function in Adults with Untreated Hypertension

运动与热疗对未经治疗的高血压成人肾功能的影响

• 批准号: 10794929
• 负责人: Christopher L Chapman
• 金额: $ 0.63万
• 依托单位: UNIVERSITY OF OREGON
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-05-01 至 2023-06-02
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10794929
• 关键词: Acceleration; Adult; Albumins; Albuminuria; Angiotensin II Type 1 Receptor Blockers; Angiotensin-Converting Enzyme Inhibitors; Bathing; Biological; Blood Pressure; Cardiovascular system; Chronic Kidney Failure; Classification; Clinical Trials; Data; Dietary Intervention; Dietary Sodium; Environment; Excretory function; Exercise; Exposure to; Fellowship; Funding; General Population; Glomerular Filtration Rate; Health; Health Benefit; Heat Stress Disorders; Heating; Human; Hypertension; Immersion; Incidence; Individual; Injury; Intervention; K-Series Research Career Programs; Kidney; Knowledge; LCN2 gene; Mentorship; Patients; Pharmaceutical Preparations; Phenotype; Physical activity; Physiological; Prospective, cohort study; Publishing; Recommendation; Renal function; Reporting; Research; Research Personnel; Risk; Risk Factors; Sauna; Seminal; Temperature; Testing; Therapeutic heat application; Time; Training; Tubular formation; United States National Institutes of Health; Urine; Water; Work; aged; blood pressure reduction; blood pressure regulation; cardiovascular disorder prevention; efficacy study; efficacy testing; exercise training; hypertension treatment; improved; normotensive; novel; pharmacologic; prevent; urinary

PROJECT SUMMARY/ABSTRACT Hypertension is the leading risk factor for chronic kidney disease (CKD). A recently published 30-year prospective cohort study revealed that the annual rate of decline in estimated glomerular filtration rate (eGFR) is exacerbated in adults with hypertension. Moreover, if albumin is present in the urine (i.e., albumuria), the annual reductions in eGFR are further exacerbated in adults with hypertension. Angiotensin converting enzyme inhibitors (ACEi) and angiotensin II type 1 receptor blockers (ARBs) are recommended to treat hypertension and for their ability to reduce albuminuria. However, ~54% of adults with hypertension with the highest classification of albuminuria are not currently undergoing treatment with ACEi/ARBs. Thus, there is tremendous opportunity to better develop non-pharmacological approaches that are effective at lowering blood pressure and reducing albuminuria. Unfortunately, however, exercise may not be ideal because only ~45% of patients with hypertension adhere to recommendations for physical activity and some individuals may be unwilling or have limitations where exercise is less feasible. There has been an uptick in research investigating the vast health benefits of heat therapy. Heat therapy refers to the use of frequent episodic increases in core temperature induced by exposures to hot environments, such as sauna bathing or hot water immersion, that ultimately induces beneficial health adaptations. In healthy adults, short-term heat therapy has been shown to reduce the incidence of albuminuria. However, a critical knowledge gap remains if heat therapy provides beneficial adaptations for the kidneys in adults with hypertension, including reducing albuminuria which would lower the risk for CKD. The current study aims investigate whether heat therapy is effective at lowering blood pressure and albuminuria in adults with hypertension. We will compare if 30 sessions of passive heat therapy using hot water immersion over 8-10 weeks reduces albuminuria in adults with untreated Elevated or Stage 1 Hypertension to a greater extent than 30 sessions of exercise training over the same time period. Additionally, we will determine whether 30 sessions of passive heat therapy reduces urinary NGAL to a greater extent than exercise training in adults with untreated Elevated or Stage 1 Hypertension. Demonstrating that heat therapy can be used as a novel treatment for Elevated and Stage 1 Hypertension is timely and important as there is a clear need for alternatives to exercise training and pharmacological approaches.

项目摘要/摘要 高血压是慢性肾脏疾病（CKD）的主要危险因素。最近出版的30年 前瞻性队列研究表明，估计肾小球过滤率（EGFR）的年度下降率 患有高血压的成年人会加剧。此外，如果白蛋白存在于尿液中（即专辑里亚）， 在患有高血压的成年人中，EGFR的年度减少进一步加剧。血管紧张素转化酶 建议使用抑制剂（ACEI）和血管紧张素II型受体阻滞剂（ARB）来治疗高血压 以及他们减少蛋白尿的能力。但是，约有54％的患有高血压的成年人 蛋白尿的分类目前尚未接受ACEI/ARB的治疗。因此，有 更好地开发有效降低血液的非药理方法的巨大机会 压力和减少蛋白尿。但是，不幸的是，锻炼可能不是理想的，因为只有约45％ 高血压的患者遵守体育活动的建议，有些人可能是 在锻炼不太可行的情况下不愿意或有局限性。研究调查有所增加 热疗法的巨大健康益处。热疗法是指核心频繁的发作增加的使用 暴露于热环境（例如桑拿沐浴或浸入热水的热环境）引起的温度， 最终导致有益的健康适应。在健康的成年人中，已经证明短期热疗法 减少蛋白尿的发生率。但是，如果热疗法提供了关键的知识差距 患有高血压的成年人肾脏的有益适应性，包括减少蛋白尿 降低CKD的风险。当前的研究旨在研究热疗法是否有效降低血液 高血压成人的压力和蛋白尿。我们将比较30次被动热疗法 在8-10周内使用热水浸入可减少未经治疗高架或第1阶段的成年人的蛋白尿 在同一时期，高血压比30次运动训练更大。此外， 我们将确定30次被动热疗法是否会比 未经治疗的升高或1期高血压的成人运动训练。证明热疗法 可以用作升高和1期高血压的新型治疗方法，因为有一个 明确需要替代运动训练和药理方法。