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A single exercise session evokes immediate blood pressure (BP) reductions that persist for at least 24 h, termed postexercise hypotension (PEH). Self-monitoring of PEH may foster positive outcome expectations of exercise, and thus, enhance exercise adherence among adults with hypertension.To compare the efficacy of self-monitoring of exercise (EXERCISE) versus exercise and PEH (EXERCISE + PEH) to improve exercise adherence and BP control among adults with hypertension.Adults with high BP were randomized to EXERCISE (n = 12) or EXERCISE + PEH (n = 12). Participants underwent supervised, moderate intensity aerobic exercise training for 40-50 min/session, 3 days/week for 12 weeks and encouraged to exercise unsupervised at home at least 30 min/day, 1-2 days/week. EXERCISE + PEH also self-monitored BP before and after exercise. Adherence was calculated as [(no. of exercise sessions performed/no. of possible exercise sessions) × 100%]. BP was measured pre and posttraining.Healthy, middle-aged (52.3 ± 10.8 years) men (n = 11) and women (n = 13) with hypertension (136.2 ± 10.7/85.2 ± 8.9 mmHg) completed exercise training with 87.9 ± 12.1% adherence. EXERCISE + PEH demonstrated greater adherence to supervised training (94.3 ± 6.6%) than EXERCISE (81.6 ± 13.2%; P = 0.007). EXERCISE + PEH performed 32.6 ± 22.5 min/week more unsupervised home exercise than EXERCISE (P = 0.004), resulting in greater exercise adherence (107.3 ± 18.7%) than EXERCISE (82.7 ± 12.2%; P = 0.002). Post versus pretraining BP was reduced -7.4 ± 11.3/-4.9 ± 9.9 mmHg (P 0.025) with no statistical difference between EXERCISE (-5.2 ± 13.3/-3.6 ± 6.1 mmHg) and EXERCISE + PEH (-9.9 ± 11.3/-6.1 ± 6.9 mmHg; P 0.344).The current study is the first to demonstrate that PEH self-monitoring is an efficacious tool to improve exercise adherence among a small sample of adults with hypertension. Future research among a larger, more diverse sample is needed to confirm these novel findings and determine whether EXERCISE + PEH translates to better BP control relative to EXERCISE self-monitoring alone.

Purpose: The present cross-sectional study aimed to investigate whether a maximal oxygen uptake (VO2max) verification phase (VER) could improve the accuracy of a previous graded exercise test (GXT) to assess individual VO2max in hypertensive individuals. \ud Methods: Thirtythree older adults with hypertension (24 women) taking part in the Hypertension Approaches in the Elderly Study (NCT03264443) were recruited. Briefly, after performing a treadmill GXT to exhaustion, participants rested for 10 min and underwent a multistage VER to confirm GXT results. Individual VO2max, respiratory exchange ratio (RER), maximal heart rate (HRmax), and rating of perceived exertion (RPE) were measured during both GXT and VER tests. Mean values were compared between bouts using paired sample t-tests and VO2max was also compared between GXT and VER on an individual basis. \ud Results: Testing was well tolerated by all participants. Both absolute (p=0.011) and relative (p=0.014) VO2max values were higher in VER than in GXT. RER (p

O conhecimento do perfil de saúde dos usuários de programas públicos para promoção em saúde pode otimizar a elaboração e aperfeiçoamento de intervenções para controle doenças ou de eventos associados ao estilo de vida, com potencial impacto para a saúde pública. O objetivo deste estudo foi caracterizar o perfil da situação de saúde dos usuários idosos do programa público de atividade física, em 11 centros comunitários da cidade de Porto Alegre (RS, Brasil). Entre abril/2018 e fevereiro/2019, foram medidos domínios de saúde por questionários autoaplicados, avaliações sanguíneas e testes funcionais. O tamanho amostral foi ponderado pela quantidade de alunos atendidos por centro, com amostragem por aleatorização simples. As análises basearam-se em estatística descritiva. No total, 351 idosos (69±6 anos) foram incluídos. Houve elevadas prevalências de fatores de risco, sendo transtorno do sono (55%), hipercolesterolemia (54%), e hipertensão arterial (49%) as mais altas. Entre as doenças autorrelatadas, os participantes listaram condições cardiovasculares (14%), câncer prévio (15%), diabetes (13%), artrite reumatóide (30%) e depressão (19%). A capacidade de caminhada em 6 minutos e força de preensão manual estiveram em níveis de pessoas ativas. Este estudo possibilita contrastar as condições prevalentes dos idosos usuários de um programa público de atividade física com estimativas populacionais, servindo como levantamento inicial para futuro monitoramento de avaliações e/ou intervenções específicas às condições sensíveis nesta população.

This Study Within a Trial (SWAT) is hosted by the multicenter, randomized study “Hypertension Approaches in the Elderly: a Lifestyle study” by using public and patient involvement. We aim to explore two different face-to-face formats (individual or group contexts) for delivering individual results to older participants (age ≥ 60 years old), assessing the understanding, satisfaction, and short-term psychological well-being generated by different delivery formats.

Type 2 diabetes (T2DM) is a chronic disease that requires multidisciplinary patient-centered treatment. Although important, promoting self-care strategies is still a challenge. Methods: Patients with T2DM and poor glycemic control (HbA1c > 7.5%) were randomly assigned to participate in the Self-Care Multidisciplinary Workshop for Diabetes (MW) or usual care (UC). The MW consisted of 15-minute individual meetings with each T2DM providers (nurse, pharmacist, dietitian, physical educator and social worker) to approach diabetes self-care topics. It was offered in 3 different modules through 12 weeks aiming to bring knowledge and skills necessary for patients to improve their diabetes care. UC included 3 brief meetings in which printed educational folders were provided. Both groups maintained standard care at outpatient T2DM clinic with endocrinologists. Generalized estimating equation model was performed to assess HbA1c, Diabetes-related Quality of Life and Summary of Diabetes Self-Care Activities questionnaires variation from baseline to 12 months. Results: Ninety-six patients (59 ±9 years-old, 60% women, diabetes duration of 16 ±10 years, 62% medium-low/low socio-economic status, HbA1c 9.6 ±1.4%) were included. Variation from baseline of HbA1c [UC -0.52% (CI 95% -1.08 to 0.26) vs. MW -0.30% (CI 95% -1.05 to 0.45) p=0.072], healthful eating plan in the last 7 days (d) [UC -0.22 d (CI 95% -1.27 to 0.82) vs. MW -0.03 d (CI 95% -0.85 to 0.79) p=0.15] and foot exam in the last 7 d [UC 0.51 d (CI 95% -0.75 to 1.77) vs. MW 1.1 d (CI 95% -0.16 to 2.39) p=0.329] to 12 months were not different between groups. There was a decrease in worry about future effects of diabetes in MW [-0.46 (CI -0.81 to -0.12)], not found in UC [0.11 (CI -0.20 to 0.42) p=0.004]. Conclusion: A short-term MW reduced worry about diabetes but failed to improve glycemic control and self-care activities in long-standing T2DM patients of a low-income country. ClinicalTrials.gov Identifier: NCT03074383. Disclosure S. Piccoli Garcia: None. G.H. Telo: None. J. Schneiders: None. C. Blume: None. G. Berlanda: None. K. Sparrenberger: None. A.N. Gossenheimer: None. M.M. Madalosso: None. L.G. Bottino: None. A.S.O. Schein: None. A.C.P. Macedo: None. L. Helal: None. C. Christofoli: None. L.P. Santos: None. B.D. Schaan: None. Funding Fundo de Incentivo à Pesquisa e Eventos do Hospital de Clínicas de Porto Alegre

This is the protocol for development of a COS related to clinical trials with physical activity interventions for overweight or obese children and adolescents, as well as categorize them into specific domains.

Despite the fact that simultaneous performance of resistance and aerobic exercises (i.e., concurrent exercise) has become a standard exercise prescription for the elderly, no information is available on its effects on post-exercise hypotension (PEH) in elderly men with hypertension. Purpose To compare the effects of different types of exercise on PEH in elderly men with hypertension. Methods Twenty elderly men with essential hypertension participated in three crossover interventions, in random order, and on separate days: a non-exercise control session at seated rest, aerobic exercise performed for 45 min, and 45 min of concurrent resistance and aerobic exercise consisted of 4 sets of 8 repetitions at 70% 1RM of resistance exercise followed by aerobic exercise on treadmill. After each session, blood pressure (BP) was measured continuously for 1 h in the laboratory and for 24 h under ambulatory conditions. Results During the first hour in laboratory, diastolic BP was lower after aerobic (− 5 mm Hg) and concurrent exercise (− 6 mm Hg) in comparison with Control. Day-time diastolic BP was significantly lower after aerobic exercise (− 7 mm Hg) when compared to the control. No significant differences were found among the three experimental sessions for night-time and 24-hour diastolic BP, as well as day-time, night-time and 24-hour systolic BP. Conclusion Concurrent exercise produced acute PEH similar to aerobic exercise but such effect did not last as long as aerobic exercise in elderly patients with essential hypertension.

Brentano, MA, Umpierre, D, Santos, LP, Lopes, AL, Radaelli, R, Pinto, RS, and Kruel, LFM. Muscle damage and muscle activity induced by strength training super-sets in physically active men. J Strength Cond Res 31(7): 1847-1858, 2017-In strength training, muscle activity is often analyzed by surface electromyography (EMG) and muscle damage through indirect markers, such as plasma concentrations of creatine kinase (CK) after exercise. However, there is little information about the influence of the strength exercises order on these parameters. The purpose of this study is to analyze the effect of strength exercises order (super-sets) in muscle activity and indirect markers of muscle damage. Twenty men were randomly assigned to one of the strength training sessions (TS). Each TS (5 sets × 8-10 repetition maximum) consisted of 2 exercises for the knee extensor muscles and 2 exercises for the horizontal shoulder flexors performed in a different order: exercises for the same muscle group grouped (grouped exercises [GE]: n = 10; 26.6 ± 3.4 years; 17.4 ± 3.4 body fat) or separated (separated exercises [SE]: n = 10; 24.9 ± 2.6 years; 15.4 ± 5.9 body fat). Muscle activity was analyzed by surface EMG (vastus lateralis [VL], vastus medialis [VM], rectus femoris [RF], pectoralis major [PM], and anterior deltoid [AD]), and the main indirect marker of muscle damage was the CK, evaluated immediately before and after the first 5 days of each TS. There was a higher EMG activity of GE in the RF (GE: 88.4% × SE: 73.6%) and AD (GE: 176.4% × SE: 100.0%), in addition to greater concentration of CK (GE: 632.4% × SE: 330.5%) after exercise. Our findings suggest that, in physically active men, implementing super-sets with GE promotes greater muscle effort and muscle damage, wherein 5 days are not enough to recover the trained muscle groups.

Objectives The questionable quality of evidence has been increasingly documented in medical research, denoting that scientific findings may ultimately be, at least, of limited usability. Some of the countermeasures to reduce the waste of research include (i) resources for transparency such as public repositories and registry platforms; and (ii) initiatives to improve research communication (e.g., The EQUATOR Network) or promote education on methodological issues (e.g., The Catalogue of Bias). Although such resources are fundamental to improve biomedical research as a whole, many research fields still neglect the need to improve the evidence quality. Therefore, we propose a discipline-based initiative to foster awareness for better quality evidence and increase the adherence to widely recommended methodological and reporting practices. Herein, we present The S trengthening the E vidence in E xercise S ciences Initiative (SEES Initiative) by which we will prospectively conduct surveillance of published articles and feedback to study authors and journal editors. Method Our rationale and methods are presented in a protocol article whereas detailed assessment guidance is described in a manual of standardised procedures. Both documents are available on our website (www.sees-initiative.org). We conduct our processes at a monthly-basis, as follows: (i) a pre-assessment stage comprises the use of sensitive filters to search newly-published articles reporting randomised clinical trials (RCTs) or systematic review with meta-analyses (SRMAs) in nine exercise sciences journals and five general medicine journals; (ii) at the assessment stage, RCTs and SRMAs having a research question related to sport, exercise, or physical activity are assessed in duplicate by independent RCT and SRMA teams based on 30+ items derived from established tools or recommendations; (iii) at the dissemination stage, we carry out the analyses, report results on the website and to study authors and journal editors, as well as deposit prespecified files at a public repository (OSF). Results We completed a census to characterize the types of studies published in 2018 by the nine-journal cohort in exercise sciences. From a total of 3,205 individual references, we respectively classified 277 (9%; min-max range, 5 to 92) and 248 (8%; min-max range, 6 to 72) articles as RCTs and SRMAs. Currently, our three-stage process is ongoing and, from the two first months of surveillance, 38 RCTs and 27 SRMAs were eligible for analysis. We consolidated a comprehensive assessment using items from CONSORT 2010 and TIDieR checklist to appraise RCTs and from PRISMA, AMSTAR-2, and ROBIS to appraise SRMAs. In addition to full study reports with our assessment for all items, we proposed aggregated results using seven components (aggregating from 4 to 11 assessed items) that relate to: transparency, completeness, methodological rigor, participants, interventions/exposures, outcome, and critical appraisal. Conclusions Inspired by the Mertonian principles and Doug Altman’s wisdom, the SEES Initiative is a living, scalable, open project to promote adequate reporting, feedback stakeholders toward increased research uptake, and disrupt/denounce inadequate practices whenever necessary.

Background/Objective The energy expenditure (EE) in strength training (ST) is analyzed both during and after each training session. However, little information exists about the influence of strength exercises supersets on EE. We aimed to determine whether supersets of ST exercises influenced EE during and after one strength exercise session. Methods Twenty men were randomly divided to perform either a session with grouped exercises for the same muscle (GE: 26.6 ± 3.4 years; 17.4 ± 3.4 body fat) or a session with separated exercises (SE: 24.9 ± 2.6 years; 15.4 ± 5.9 body fat). Four exercises (5 sets of 8–10 maximum repetitions) for knee extensor muscles and shoulder horizontal flexor muscles were executed in both training sessions. The EE of each experimental session was obtained through the analysis of oxygen uptake during and after exercise (60 minutes postsession). Results Total work during the session and increases in lactate concentrations were similar between the GE and SE Groups. During exercise, EE was greater in the SE Group when compared with the GE Group (GE: 123.8 ± 14.36 kcal vs. SE: 131.77 ± 20.91 kcal). During the postexercise period, GE induced greater EE when compared with SE (GE: 25.12 ± 7.86 kcal vs. SE: 19.76 ± 5.53 kcal). However, the exercise sequence did not influence overall EE (GE: 148.92 ± 18.72 kcal vs. SE: 151.53 ± 17.97 kcal, p = 0.920). Conclusion Our findings indicate that, in physically active men, ST supersets do not influence total EE during and 60 minutes after a single session.

Resistant hypertension often exposes patients to poor blood pressure (BP) control, resulting in clinical vulnerability, possible need for device-based procedures (denervation) and increased therapy costs. Regular exercise markedly benefits patients with hypertension, including resistant patients. However, little is known about short-term exercise effects in resistant hypertension.To evaluate acute hemodynamic effects of exercise in resistant hypertension.After maximal exercise testing, 20 patients (54.0 ± 5.7 years, 30.2 ± 4.9 kg/m) with resistant hypertension participated in three crossover interventions, in random order, and on separate days: control (45' of rest), and light intensity and moderate intensity (45' of aerobic exercise at 50 and 75% of maximum heart rate, respectively). Ambulatory BP, forearm blood flow (with subsequent calculation of vascular resistance), and reactive hyperemia were measured before and after interventions trough venous occlusion plethysmography.Compared with control, both exercise intensities reduced ambulatory systolic pressure over 5 h (light: -7.7 ± 2.4 mmHg and moderate: -9.4 ± 2.8 mmHg, P 0.01), whereas only light intensity reduced diastolic pressure (-5.7 ± 2.2 mmHg, P 0.01). Light intensity also lowered systolic and diastolic pressures over 10-h daytime (-3.8 ± 1.3 and -4.0 ± 1.3 mmHg, respectively, P 0.02), night-time (-6.0 ± 2.4 and -6.1 ± 1.6 mmHg, respectively, P 0.05), and diastolic pressure over 19 h (-4.8 ± 1.2 mmHg, P 0.01). Forearm blood flow changed (decreased) compared with baseline only at 50 min after light intensity (P 0.05). After the control and light intensity sessions, vascular resistance increased at the end of 1 h, and after moderate intensity, it decreased only at the moment (∼2 min) immediately after intervention (P 0.05).A single session of light or moderate aerobic exercise acutely reduces ambulatory BP in resistant hypertension, although benefits persist longer following light intensity.

FURIN is a proprotein convertase subtilisin/kexin enzyme important in pro‐renin receptor processing, and FURIN (furin, paired basic amino acid cleaving enzyme) variants are involved in multiple aspects of blood pressure (BP) regulation. Therefore, we examined associations among FURIN variants and the immediate blood pressure (BP) response to bouts of aerobic exercise, termed postexercise hypotension (PEH). Obese (30.9 ± 3.6 kg m−2) Black‐ (n = 14) and White‐ (n = 9) adults 42.0 ± 9.8 year with hypertension (139.8 ± 10.4/84.6 ± 6.2 mmHg) performed three random experiments: bouts of vigorous (VIGOROUS) and moderate (MODERATE) intensity cycling and control. Subjects were then attached to an ambulatory BP monitor for 19 h. We performed deep‐targeted exon sequencing with the Illumina TruSeq Custom Amplicon kit. FURIN genotypes were coded as the number of minor alleles (#MA) and selected for additional statistical analysis based upon Bonferonni or Benjamini–Yekutieli multiple testing corrected P‐values under time‐adjusted linear models for 19 hourly BP measurements. After VIGOROUS over 19 h, as FURIN #MA increased in rs12917264 (P = 2.4E‐04) and rs75493298 (P = 6.4E‐04), systolic BP (SBP) decreased 30.4–33.7 mmHg; and in rs12917264 (P = 1.6E‐03) and rs75493298 (P = 9.7E‐05), diastolic BP (DBP) decreased 17.6–20.3 mmHg among Blacks only. In addition, after MODERATE over 19 h in FURIN rs74037507 (P = 8.0E‐04), as #MA increased, SBP increased 20.8 mmHg among Blacks only. Whereas, after MODERATE over the awake hours in FURIN rs1573644 (P = 6.2E‐04), as #MA increased, DBP decreased 12.5 mmHg among Whites only. FURIN appears to exhibit intensity and race‐dependent associations with PEH that merit further exploration among a larger, ethnically diverse sample of adults with hypertension.

Introduction: Patients with resistant hypertension are usually exposed to poor blood pressure (BP) control, resulting in clinical vulnerability, possibility of device-based procedures (denervation), and cumulative costs with drug therapy. Regular aerobic exercise promotes marked benefits in hypertension, including the subset of resistant patients. However, little is known about acute effects of exercise on patients with resistant hypertension. Hypothesis: We hypothesized that a single aerobic session would reduce BP and improve vascular variables. Thus, we compared ambulatory BP and vascular parameters in response to two intensities of aerobic sessions and a non-exercise control session in patients with resistant hypertension. Methods: After a maximal exercise test, 18 patients (54±6 years, 30.2±4.9 kg/m2) participated in three interventions in random order, crossover design, and on separate days: control session (45’ of rest), light intensity (LI) and moderate intensity (MI) sessions (45’ of aerobic exercise at 50% and 75% of HRmax, respectively). Ambulatory BP monitoring (Space Labs, 90702) comprised a 19h period after each session. Vascular variables were measured at the non-dominant forearm by venous occlusion plethysmography (Hokanson Inc) before and up to 1h after all sessions. Results: Compared with control session, both exercise sessions reduced ambulatory systolic BP in a 5h period (LI: -7.7±2.4mm Hg and MI: -9.4±2.8mm Hg, p Conclusions: A single aerobic exercise session in light or moderate intensities induces beneficial changes in ambulatory BP in resistant hypertension, with advantages in effect length for lighter intensities.