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: 10658613
• 负责人: KATHARINE DIANNE CURRIE
• 金额: $ 65.2万
• 依托单位: MICHIGAN STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10658613
• 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; Female; Future; Goals; Guidelines; Health; Health Status; Hypertension; Hypotension; Individual; Intervention; Isometric Exercise; Life Style Modification; Medicine; Metabolic; Metabolism; Nonpharmacologic Therapy; Older Population; Organ; Outcome; Outcome Assessment; Participant; Pharmaceutical Preparations; Pharmacotherapy; Physical activity; Population; Postmenopause; Prevalence; Recommendation; Research; Research Design; Risk; Series; System; Time; Tissues; Training; Treatment Effectiveness; United States; Woman; age effect; arterial stiffness; blood pressure control; blood pressure regulation; cardiovascular disorder risk; cardiovascular risk factor; combat; exercise intervention; exercise prescription; exercise training; hypertension control; hypertensive; improved; male; modifiable risk; normotensive; novel; personalized medicine; pharmacologic; response; tool; treatment optimization

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 males and females 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 nocturnal BP, post- exercise hypotension, and morning vascular function. Older males and females with hypertension will complete a session of aerobic and isometric handgrip exercise in the morning and late afternoon/evening. BP will be evaluated immediately following exercise and for 24-hr using ambulatory BP monitoring. Endothelial and microvascular function will also be evaluated the morning after each exercise bout. 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 two 6-week periods of aerobic and isometric handgrip exercise training with one period in the morning and one in the late afternoon/evening. Ambulatory BP and vascular function will be assessed pre- and post-training and compared between time of day. 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 6 weeks of exercise training. This proposal has the capacity to optimize treatment options for hypertension by including chronotherapy in the exercise recommendations, 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和老年男性和女性进行追踪。目标 2 将研究急性血压 以及血管对一天中不同时间进行的运动的反应，重点关注夜间血压、运动后血压 运动性低血压和早晨血管功能。患有高血压的老年男性和女性将完成 早上和下午晚些时候/晚上进行有氧和等长握力练习。血压将是 运动后立即进行评估，并使用动态血压监测进行 24 小时评估。内皮细胞和 每次运动后的早晨也会评估微血管功能。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。参与者将完成两个为期 6 周的 一段时间的有氧和等长握力训练，早上一节，晚上一节 下午/晚上。将在训练前后评估动态血压和血管功能并进行比较 一天中的时间之间。总体假设是高血压的特点是血压降低 血管功能的昼夜节律和该人群的晚间运动将比 晨练可在单次运动后和 6 周后降低血压并改善血管健康 的运动训练。该提案有能力优化高血压的治疗方案，包括 运动建议中的时间疗法，这反过来又会改善老年人的健康。