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.

项目概要/摘要 高血压是慢性肾脏病（CKD）的主要危险因素。最近发表的 30 年 前瞻性队列研究显示估计肾小球滤过率（eGFR）的年下降率 患有高血压的成年人会加剧。此外，如果尿液中存在白蛋白（即白尿）， 成年高血压患者的 eGFR 每年下降进一步加剧。血管紧张素转换酶 推荐使用抑制剂 (ACEi) 和血管紧张素 II 1 型受体阻滞剂 (ARB) 治疗高血压 以及它们减少蛋白尿的能力。然而，约 54% 的成人高血压患者的血压最高 蛋白尿的分类 目前未接受 ACEi/ARB 治疗。因此，有 更好地开发有效降低血压的非药物方法的巨大机会 压力并减少蛋白尿。然而不幸的是，锻炼可能并不理想，因为只有约 45% 的人 高血压患者遵守体育活动的建议，有些人可能会 不愿意或在锻炼不太可行的情况下受到限制。研究调查有所增加 热疗法的巨大健康益处。热疗是指频繁间歇性增加核心肌群 暴露于高温环境（例如桑拿浴或热水浸泡）引起的温度， 最终引发有益的健康适应。在健康成年人中，短期热疗已被证明可以 减少蛋白尿的发生率。然而，如果热疗提供 对患有高血压的成人的肾脏进行有益的适应，包括减少白蛋白尿，这将 降低 CKD 风险。目前的研究旨在调查热疗是否能有效降低血压 成人高血压患者的血压和蛋白尿。我们将比较 30 次被动热疗 使用热水浸泡 8-10 周可减少未经治疗的升高或 1 期成人的蛋白尿 高血压程度高于同一时间段内进行30次运动训练。此外， 我们将确定 30 次被动热疗是否比 30 次被动热疗更能减少尿 NGAL 对未经治疗的高血压或一期高血压的成人进行运动训练。证明热疗法 可用作高血压和 1 期高血压的新型治疗方法，它是及时且重要的，因为有 显然需要运动训练和药理学方法的替代方案。