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.

项目总结/摘要 在美国，高血压（HTN）导致的心血管疾病（CVD）相关死亡比任何 其他可改变的心血管疾病风险因素，仅次于吸烟作为任何可预防的死亡原因， 原因的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 对于大多数患有高血压的成年人， 基于新分类的HTN（即，以前未被归类为HTN的人）。生活方式干预， 因为定期锻炼被认为是预防HTN发展的一线措施， 治疗诊断的HTN。流行病学研究表明， 身体活动和身体健康以及血压和HTN水平。不幸的是，绝大多数 人们不愿意开始运动训练，也不愿意遵守符合 最低标准极低。此外，一些患者群体不能进行锻炼， 一些限制或无法获得运动的全部益处，以降低CVD风险。因此，在本发明中， 迫切需要降低血压和改善CVD风险的替代非药物选择。 热疗法，以热水浴或桑拿浴的形式，是一种古老的做法，最近重新受到关注， CVD的预防和治疗。最近一项来自芬兰的20多年前瞻性队列研究， 非常普遍和文化的一部分，已经证明，经常使用桑拿浴与 降低发生HTN的风险，这可能部分解释了全因心血管疾病的发生率降低。 以前在较大的队列中报告的经常使用桑拿浴的死亡。到目前为止，还没有临床 在人类中进行的试验，以确定热疗法是否是一种有效的治疗方法，以降低那些 关于HTN因此，我们建议进行一项临床试验，以确定热疗法是否能有效地减少血液中的 HTN压力。我们将比较热疗后的血压下降与标准运动 训练我们假设30个疗程的被动热疗使用热水浸泡超过8-10周 将在更大程度上改善HTN患者的血压。此外，我们将评估 HTN的临床指标、关键血管和自主神经生物标志物以及治疗前和治疗后的心血管健康风险 经过热疗和运动训练。我们进一步假设热疗法会增加血管 顺应性，降低交感神经流出，并改善HTN患者的内皮功能。最后，我们将 确定热疗或运动试验后血压的急性下降是否会 预测热疗治疗或运动训练后静息血压的持续降低 在HTN受试者中。这些发现将提供基线静息血液以外的重要预测信息 压力证明热疗法可以作为一种新的治疗原发性HTN是及时的， 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

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

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