Lifestyle Modification and blood Pressure Study (LIMBS)

生活方式改变和血压研究 (LIMBS)

• 批准号: 7662892
• 负责人: DEBBIE L COHEN
• 金额: $ 34.1万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-05-01 至 2014-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7662892
• 关键词: Address; Adult; Affect; Ambulatory Blood Pressure Monitoring; Anger; Area; Blood; Blood Pressure; Body Weight decreased; Breathing; Cardiovascular system; Categories; Cerebrovascular Circulation; Chronic; Clinical Trials; Competence; Complementary and alternative medicine; Control Groups; Data; Development; Diabetes Mellitus; Diastolic blood pressure; Equilibrium; Equipment and supply inventories; Event; Functional Magnetic Resonance Imaging; Gait; Health; Health Transition; Hostility; Hour; Hypertension; Hypotension; Intervention; Kidney; Life Style; Lifestyle Therapy; Living Wills; Measures; Meditation; Metabolic syndrome; Mind; Mind-Body Intervention; Modality; Modification; Moods; Movement; Patients; Pharmacotherapy; Physical activity; Physiological; Pilot Projects; Prefrontal Cortex; Prevalence; Psyche structure; Public Health; Quality of life; Questionnaires; Randomized; Reading; Recommendation; Reporting; Rest; Risk; Risk Factors; Spin Labels; Staging; Stress; Stroke; Structure; Symptoms; Testing; United States; Yoga; base; body-mind; cardiovascular disorder prevention; cingulate gyrus; clinically significant; cooking; disturbance in affect; experience; falls; flexibility; group intervention; health related quality of life; improved; neuroimaging; non-drug; normotensive; programs; psychologic; public health relevance; response

DESCRIPTION (provided by applicant): Hypertension prevalence continues to increase in the United States. Yoga, a form of mind body therapy has become increasingly popular in the United States and represents an alternative to drug therapy. In our previous pilot study we assessed the effects of yoga vs. enhanced lifestyle modification in lowering blood pressure in subjects with prehypertension and stage 1 hypertension. Our results showed that yoga practice did result in clinically meaningful decreases in 24 hour ambulatory blood pressure readings. In this proposed study we plan to determine the effects of yoga therapy vs. enhanced lifestyle modification vs. the combined intervention of yoga therapy and lifestyle modification on lowering blood pressure in subjects with prehypertension and stage 1 hypertension. We believe that the combined intervention will result in significant clinically meaningful decreases in blood pressure. If this study shows significant decreases in blood pressure, this combined intervention can be incorporated into patients lifestyles as an intervention to avoid drug therapy. Specific aims to be addressed are: 1. To determine the effect of a structured 24-week yoga program on reducing blood pressure in adults with high-normal to stage I hypertension. 2. To determine if the combined effects of yoga and lifestyle modification are more effective at reducing 24 ambulatory blood pressure than either group alone. 3. To test if the effects of yoga on changes in blood pressure are reflected in changes in cerebral blood flow (CBF) as measured by arterial spin labeling (ASL) functional magnetic resonance imaging (fMRI). This will be accomplished by performing fMRI during a resting and stimulated state and observing changes in regional CBF in the prefrontal cortex and cingulate gyrus before and after 24 weeks of yoga, lifestyle modification or the combined intervention. 4. To compare changes in mean scores of both psychological and physiological measures of mood, perceived stress and health competence with changes in blood pressure within the intervention groups. PUBLIC HEALTH RELEVANCE: This proposed study will determine if yoga therapy combined with enhanced lifestyle modification will result in clinically meaningful decreases in blood pressure and can be used as an alternative to drug therapy in subjects with prehypertension and stage 1 hypertension.

描述（由申请人提供）： 在美国，高血压患病率持续上升。瑜伽是一种身心疗法，在美国越来越受欢迎，是药物疗法的替代方案。在我们之前的试点研究中，我们评估了瑜伽与加强生活方式改变在降低高血压前期和 1 期高血压受试者血压方面的效果。我们的结果表明，瑜伽练习确实导致 24 小时动态血压读数降低，具有临床意义。在这项拟议的研究中，我们计划确定瑜伽疗法与强化生活方式改变以及瑜伽疗法和生活方式改变联合干预对高血压前期和 1 期高血压受试者降低血压的效果。我们相信，联合干预将导致血压显着降低，具有临床意义。如果这项研究显示血压显着下降，则可以将这种联合干预措施纳入患者的生活方式，作为避免药物治疗的干预措施。需要解决的具体目标是： 1. 确定为期 24 周的结构化瑜伽计划对降低正常高至 I 期高血压成人血压的效果。 2. 确定瑜伽和生活方式改变的综合效果是否比单独使用任何一组更能有效降低 24 动态血压。 3. 测试瑜伽对血压变化的影响是否反映在通过动脉自旋标记 (ASL) 功能磁共振成像 (fMRI) 测量的脑血流量 (CBF) 的变化中。这将通过在休息和刺激状态下进行功能磁共振成像，并观察 24 周瑜伽、生活方式改变或联合干预前后前额皮质和扣带回区域 CBF 的变化来实现。 4. 比较干预组内情绪、感知压力和健康能力的心理和生理测量平均分的变化与血压的变化。公共健康相关性：这项拟议的研究将确定瑜伽疗法与加强生活方式改变相结合是否会导致具有临床意义的血压下降，并可作为高血压前期和 1 期高血压患者药物治疗的替代方案。