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。最近出版的一份30年报告 前瞻性队列研究显示，估计肾小球滤过率(EGFR)的年下降率 在患有高血压的成年人中会加剧。此外，如果白蛋白存在于尿液中(即蛋白尿)， 在患有高血压的成年人中，EGFR的年度减少进一步加剧。血管紧张素转换酶 推荐使用血管紧张素II 1型受体阻滞剂(ARB)和血管紧张素转换酶抑制剂(ACEI)治疗高血压 以及他们减少蛋白尿的能力。然而，约54%的成年人高血压患者的最高 蛋白尿分类目前没有接受ACEI/ARB治疗。因此，有 更好地开发有效降低血液的非药物方法的巨大机会 降压和减少蛋白尿。然而，不幸的是，锻炼可能并不理想，因为只有45%的人 高血压患者坚持体力活动的建议，有些人可能 在锻炼不太可行的地方不愿意或有限制。研究调查出现了上升趋势。 热疗的巨大健康益处。热疗指的是使用频繁的间歇性核心增加 由于暴露在高温环境中而产生的温度，如桑拿浴或热水浸泡 最终导致有益的健康适应。在健康的成年人中，短期热疗已被证明可以 减少蛋白尿的发生率。然而，如果热疗提供了一个关键的知识缺口 对患有高血压的成年人的肾脏有益的适应，包括减少蛋白尿，这将 降低慢性肾脏病的风险。目前的研究目的是调查热疗是否能有效降低血液。 成人高血压患者的血压和蛋白尿。我们会比较30个疗程的被动热疗 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 高血压的程度超过同一时间段内30次运动训练的程度。另外， 我们将确定30个疗程的被动热疗是否在更大程度上减少尿NGAL 未经治疗的高血压升高症或1期高血压成人的运动训练。证明了热疗 可以作为一种新的治疗高血压的方法，而且1期高血压是及时和重要的，因为有 明确需要替代运动训练和药理学方法。