3/26/2023 0 Comments Retrospect trial![]() ![]() ![]() Hypertension in older adults: assessment, management, and challenges. Oliveros E, Patel H, Kyung S, Fugar S, Goldberg A, Madan N, Williams KA. Heart disease and stroke statistics-2022 update: a report from the American Heart Association. Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, et al. Global, regional, and national comparative risk assessment of 84 behavioural, environmental and occupational, and metabolic risks or clusters of risks for 195 countries and territories, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Given blood pressure outcomes with the intervention were only slightly altered by subject baseline characteristics (i.e., age, blood pressure medication, and health status), inspiratory muscle strength training is effective in lowering blood pressure in a broad range of adults. NEW & NOTEWORTHY In young-to-older adult men and women, 6 wk of high-resistance inspiratory muscle strength training lowers casual systolic and diastolic blood pressure by 9 mmHg and 4 mmHg, respectively, with initial reductions observed by week 2 of training. These compiled findings from multiple independent trials provide the strongest evidence to date that high-resistance IMST evokes clinically significant reductions in SBP and DBP, and increases in PI MAX, in adult men and women. Gains in PI MAX had a modest inverse relation with age (β = −0.20 ± 0.09 P = 0.03) and baseline PI MAX (β = −0.15 ± 0.07 P = 0.04) but not to reductions in SBP or DBP. PI MAX increased with high-resistance IMST and low-resistance sham training, with a greater increase from high-resistance IMST (+20 ± 17 vs. Greater reductions in SBP were associated with older age (β = −0.07 ± 0.03 P = 0.04) and greater reductions in DBP associated with medication-naïve BP (β = −3 ± 1 P = 0.02) and higher initial DBP (β = −0.12 ± 0.05 P = 0.04). Select subject characteristics slightly modified the impact of IMST on BP. IMST ( n = 67) reduced systolic BP (SBP) by 9 ± 6 mmHg ( P 0.05). Participants were randomized to high-resistance IMST (75% PI MAX) or low-resistance sham (15% PI MAX) training (30 breaths/day, 5–7 days/wk, 6 wk). In a retrospective analysis of five pilot trials, we assessed the BP-lowering effects of high-resistance inspiratory muscle strength training (IMST) in adults aged 18–82 years and the impact of IMST on maximal inspiratory pressure (PI MAX), a gauge of inspiratory muscle strength and independent disease risk factor. Above-normal blood pressure (BP) is a primary risk factor for cardiovascular diseases. ![]()
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