This study aimed to review the blood pressure and heart rate variability responses after different cervical manipulation. A comprehensive literature search was conducted across CINAHL, Cochrane Library, PubMed®, and SciELO databases on December 26, 2024. From an initial pool of 84,625 studies, five met the inclusion criteria for this review. The findings suggest that cervical manipulation may induce a hypotensive response in systolic blood pressure while promoting an overall enhancement in cardiovascular regulation, particularly through an increase in parasympathetic activity. Specifically, 80 % of the reviewed studies reported a reduction in systolic blood pressure following cervical manipulation, highlighting its potential as a therapeutic strategy for blood pressure management. Additionally, 66 % of the included studies demonstrated improvements in sympathetic-vagal balance regulation. Other findings pointed to reductions in both blood pressure and plasma norepinephrine levels, which could indirectly support autonomic and hemodynamic stability. Although these results reinforce the potential benefits of cervical manipulation as a complementary approach for managing blood pressure and autonomic function, the limited number of available studies (n = 5) and their methodological variability (ranging from moderate to high quality) warrant caution in extrapolating these findings to broader clinical populations.

Isometric handgrip exercise (IHE) is recommended as a non-pharmacological treatment for managing blood pressure. However, the effect of various modes of IHE on neuromuscular fatigue and post-exercise blood pressure responses have not been explored. The purpose of this study was to investigate the effects of the duration and muscle mass factors of IHE on post-exercise blood pressure responses.

Twenty healthy participants were recruited for this repeated-measures study. Three isometric protocols with similar exercise load were conducted on 3 different days including: 1) unilateral IHE at 30% of maximal voluntary contraction (MVC) for 2 minutes; 2) bilateral IHE at 30% MVC for 1 minute; and 3) unilateral IHE at 20% MVC for 3 minutes. Each exercise had four bouts of IHE with two minutes of rest between bouts. The median frequency (MDF) and root mean square (RMS) of surface electromyography was used to assess the level of neuromuscular fatigue in the flexor digitorum superficialis (FDS), extensor carpi radialis longus (ECR), flexor carpi ulnaris (FCU), and extensor carpi ulnaris (ECU).

Correlation analysis revealed that FDS MDF fatigue during the bilateral IHE was moderately correlated with the immediate post-exercise systolic blood pressure change (SBP, r=0.456, P<0.05) and diastolic blood pressure change (DBP, r=0.682, P<0.01) and ten-minute post-exercise SBP change (r=0.510, P<0.05) and DBP change (r=0.569, P<0.01) during bilateral IHE at 30% MVC for 1 min. The RMS results indicate a significant correlation between ECR and DBP immediate post-exercise (r=-0.634, P<0.01) and DBP 10-minute post exercise (r=-0.484, P<0.05).

This study suggests that neuromuscular fatigue of FDS and ECR of IHE are related to post-exercise blood pressure changes.

The first part of this Inter-Society Document describes the mechanisms involved in the development of cardiovascular diseases, particularly arterial hypertension, in adults and the elderly. It will also examine how consistent physical exercise during adolescence and adulthood can help maintain blood pressure levels and prevent progression to symptomatic heart failure. The discussion will include experimental and clinical evidence on the use of specific exercise programs for preventing and controlling cardiovascular diseases in adults and the elderly. In the second part, the clinical relevance of cardiac-specific biomarkers in assessing cardiovascular risk in the general adult population will be examined, with a focus on individuals engaged in sports activities. This section will review recent studies that suggest a significant role of biomarkers in assessing cardiovascular risk, particularly the presence of cardiac damage, in athletes who participate in high-intensity sports. Finally, the document will discuss the potential of using cardiac-specific biomarkers to monitor the effectiveness of personalized physical activity programs (Adapted Physical Activity, APA). These programs are prescribed for specific situations, such as chronic diseases or physical disabilities, including cardiovascular diseases. The purposes of this Inter-Society Document are the following: 1) to discuss the close pathophysiological relationship between physical activity levels (ranging from sedentary behavior to competitive sports), age categories (from adolescence to elderly age), and the development of cardiovascular diseases; 2) to review in detail the experimental and clinical evidences supporting the role of cardiac biomarkers in identifying athletes and individuals of general population at higher cardiovascular risk; 3) to stimulate scientific societies and organizations to develop specific multicenter studies that may take into account the role of cardiac biomarkers in subjects who follow specific exercise programs in order to monitor their cardiovascular risk.

Primary hypertension (PH) affects over one billion individuals globally, yet less than 30% achieve controlled blood pressure (BP) with medication. Many patients require a combination of multiple medications to reach targets, but adverse effects and financial burdens undermine adherence. Additionally, prehypertension affects 25%-50% of adults, increasing the risk of cardiovascular complications. Early detection and management of prehypertension are crucial for delaying the need for pharmacological interventions. In recent years, clinical guidelines have increasingly emphasised non-pharmacological interventions for PH management. However, the diversity of non-pharmacological therapies and the inconsistencies in efficacy challenge clinical decision-making. This study aims to use network meta-analysis (NMA) to synthesise existing evidence on non-pharmacological interventions for PH, offering updated clinical insights and evidence-based support to optimise treatment strategies. It will also provide recommendations for integrating these interventions into community-based chronic disease management.

To identify potentially relevant randomised controlled trials, a reverse search strategy will be employed to ascertain all non-pharmacological interventions for PH. A well-constructed search strategy will be applied across nine academic databases (Web of Science, Embase, PubMed, PsycINFO, CENTRAL, AMED, CNKI, WF and VIP database) and three clinical trial registries (WHO ICTRP, ClinicalTrials.gov and ChiCTR) for studies conducted between 1 January 2014 and 1 August 2024. Two investigators will independently extract information from eligible articles and document reasons for exclusions. The primary outcomes will encompass changes in systolic and diastolic BP. Pairwise and Bayesian NMA will be conducted using 'meta' and 'GeMTC' package (R 4.4.1). Risk of bias will be assessed using the Risk of Bias 2 tool, and the quality of evidence will be evaluated according to the Grading of Recommendations, Assessment, Development and Evaluation approach.

As this review involves secondary analysis of previously published data, ethical approval is not required. The results will be published in peer-reviewed journals.

CRD42023451073.

Hypertension, a common chronic disease, often leads to serious complications. While conventional management relies on antihypertensive drugs, which can cause side effects and adherence issues, alternative treatments like herbal medicine are gaining attention. This study examines the efficacy and safety of modified Saengmaeksan, an East Asian herbal remedy, in treating hypertension.

This single-arm, prospective, observational study will be conducted at Kyunghee Bichedam Korean Medicine Clinic from October 23, 2023 to August 30, 2024, enrolling 30 hypertensive patients. Over 12 weeks, participants will undergo 4 visits, receiving modified Saengmaeksan twice daily for 8 weeks, with a subsequent 4-week follow-up. Primary outcome is the change in systolic blood pressure from the baseline to week 8. Secondary outcomes include diastolic blood pressure changes, radial artery tonometry, and quality of life evaluations. Safety assessments will include monitoring hematologic parameters and adverse events. Data will be analyzed using an ANCOVA model for adjusting confounders.

Modified Saengmaeksan has shown potential for lowering blood pressure in clinical settings, supported by animal and cell studies. However, human studies are scarce. This research will employ radial artery tonometry to analyze blood pressure comprehensively, exploring Saengmaeksan's hemodynamic effects. The study's goal is to support the approval of modified Saengmaeksan as a hypertension treatment by the South Korean Food and Drug Administration and to promote the industrialization of traditional herbal medicine in managing hypertension. The findings will provide essential data for future clinical research, aiding in feasibility assessments and sample size determinations for randomized controlled trials.

Background/Objectives: Cardiovascular diseases are a leading cause of death, and psychosocial stress is considered a contributing factor to these issues. With the rising number of heart surgeries, proper rehabilitation post-surgery is essential. Previous studies have demonstrated the positive impact of yoga and transcendental meditation on the cardiovascular system. This pilot study aimed to investigate the effects of yoga and transcendental meditation on retinal microcirculation in cardiac patients before (admission), after (discharge), and following (3 weeks after discharge) rehabilitation. Methods: This study examined changes in retinal microcirculation in three rehabilitation groups of patients after heart surgery. The control group received standard exercise therapy, while the meditation group incorporated 20 min of meditation, and the yoga group incorporated 20 min of yoga practice, twice per day for the duration of four weeks of rehabilitation. Retinal images were captured using a non-mydriatic digital retinal camera (Canon CR-2, Canon Medical Systems Europe B.V., Netherlands), and the microcirculation parameters central retinal artery equivalent, central retinal vein equivalent, and artery-to-vein ratio were analyzed using MONA REVA software ((version 2.1.1), VITO, Mol, Belgium). Repeated measures ANOVA was performed to evaluate differences between the three groups in the course of rehabilitation. Results: None of the parameters revealed significant differences in retinal microcirculation between the three rehabilitation groups. Conclusions: The study evaluating changes in retinal microcirculation, as an indicator of central circulation in cardiac patients undergoing rehabilitation, did not observe any significant changes. As yoga and meditation are underestimated approaches in cardiac rehabilitation, this pilot study acts as a basis for providing preliminary information for future studies to encourage the research community to fill the gap in this area.

The aim of this cross-sectional study was to examine the baroreflex sensitivity alterations in regulating arterial blood pressure during prolonged isometric exercise at different intensities in elite artistic gymnastic athletes compared to non-athletes.

Fourteen young males participated in the study; 7 international level artistic gymnastics athletes and 7 physically active students inexperienced to isometric or resistance training. On two occasions, both groups performed 3 minutes of isometric handgrip exercise either at 30% or 50% of maximum voluntary contraction (MVC), in a randomized order. Force production, arterial blood pressure and baroreflex sensitivity through finger plethysmograph were continuously recorded.

At rest, arterial blood pressure was normal in both groups (systolic blood pressure [SBP], athletes [A]: 128±9.0 mmHg, non-athletes [NA]: 130±7.2 mmHg, P=0.62; DIA, A: 75.6±5.2, NA: 78.5±4.6, P=0.31) but baroreflex sensitivity (BRS) was higher in athletes than in non-athletes (A: 16.6±7.4, NA: 12.0±7.9, P=0.02). During prolonged isometric exercise at 30% MVC, blood pressure was similar between groups (SBP, A: 176.9±16 mmHg vs. NA: 189.5±15.1 mmHg P=0.9, diastolic blood pressure [DBP], A: 108±11 mmHg vs. NA: 118±11 mmHg, P=0.6) and BRS was still higher in athletes (A: 13.28±5.75 ms/mmHg vs. NA: 6.72±3.83, P=0.04), whereas at 50% MVC, blood pressure was lower in the athletes compared to the control group (SBP, A: 182.5±15 mmHg vs. NA: 222.1±19.3 mmHg, P=0.001; DBP A: 115±14 mmHg vs. NA: 141±20 mmHg, P=0.02,without statistically significant difference in BRS between groups (A: 7.39±5.34 ms/mmHg vs. NA: 3.9±1.73 ms/mmHg, P=0.44).

The results of our cross-sectional study revealed that after years of exposure in high amounts of training loads, baroreflex sensitivity is increased in healthy athletes probably in order to prevent excessive increases in blood pressure during exercise.

Primary hypertension significantly impacts global cardiovascular health, contributing to increased mortality rates and posing a substantial public health challenge. Recognizing the growing evidence supporting non-pharmacological interventions (NPIs) for controlling primary hypertension, our study employs Network Meta-Analysis (NMA) to comprehensively assess their efficacy.

This review updates a prior systematic review by searching for original literature on NPIs for primary hypertension from 2013 to 2024. We conducted a thorough search in eight databases, including PubMed, Embase, Web of Science, Cochrane Central Register of Controlled Trials, Allied and Complementary Medicine Database, CNKI, WanFang Data, and Chongqing VIP, identifying potential randomized controlled trials (RCTs) from January 1, 2013, to August 1, 2024. Primary outcomes included the mean changes in blood pressure before and after treatment. Analysis was performed using GeMTC package (R 4.2.3), and Stata 17.0. The confidence of evidence was examined using Confidence in Network Meta-Analysis (CINeMA).

Utilizing NMA, we reviewed 9,189 studies, identifying 54 eligible articles with 5,827 participants. Investigating 22 distinct NPIs, the focus was on changes in systolic and diastolic blood pressure pre and post-treatment. Lifestyle intervention + Tai Chi significantly reduced systolic (-21.75 mm Hg; 95% CI -33.25 to -10.02) and diastolic blood pressure (-13.62 mm Hg; 95% CI -23.14 to -3.71) compared to usual care and other NPIs. Consistency and regression analyses did not reveal significant differences.

This review provides a comprehensive evaluation of NPIs for primary hypertension, emphasizing lifestyle + Tai Chi as a preferred NPI. Breathing exercises show potential in lowering systolic blood pressure, and acupuncture + tui na demonstrates effectiveness in reducing diastolic blood pressure, outperforming other interventions. The study reinforces the role of NPIs in managing primary hypertension, providing a foundation for future hypertension research.

In China and other Asian nations, traditional medicine has long been utilized in the treatment of cardiovascular diseases (CVD). While Chinese authorities have incorporated traditional Chinese medicine (TCM) treatment experiences as a supplementary guide for CVD, its international recognition remains limited due to a scarcity of high-quality and reliable randomized controlled trials (RCTs) evidence. The purpose of this study was to examine the clinical outcomes with TCM for CVD after the recent publication of large trials adding >20,000 individuals to the published data. Here, we systematically reviewed 55 published RCTs (modified Jadad scores > 4) in the past 20 years, involving a total of 36,261 patients. In most studies, TCM has been associated with significant improvements in alternative endpoints such as hypertension, coronary heart disease, stroke and heart failure. A total of 19 trials reported on primary outcomes such as cardiovascular events and death events. During the follow-up period, some Chinese patent medicines can effectively reduce the "hard" endpoints of coronary heart disease, stroke, and heart failure, the overall trend of cardiovascular outcomes is lower. The risk of adverse effects was not significantly increased compared to the control group, suggesting its potential as an alternative approach for primary and secondary prevention of CVD based on the available evidence.

Buddhist meditation practices, including Samadhi meditation, which forms the basis for mindfulness practice, are broadly promoted as pathways to wellbeing, but evidence of their adverse effects is emerging. In a single-group observational study with assessments of autonomic system before, during, and after Samadhi meditation, we explore the relationship between post-meditation nausea symptoms and the degree of change in autonomic system activity during meditation as compared to before and after in 57 university students (42 women; mean age = 22.6) without any previous experience in meditation or yoga practices. We hypothesize that nauseous feelings in meditation are connected to a rapid increase of activity in the sympathetic nervous system, as indicated by decreased heart-rate variability (HRV). We additionally explore links between meditation-induced nausea and two markers of parasympathetic activity: increased HRV and vasovagal syncope. Engaging in meditation and increased nausea during meditation were both associated with increased markers of HRV parasympathetic activity, but 12 individuals with markedly higher nausea demonstrated increased HRV markers of sympathetic activity during meditation. Vasovagal syncope was observed but found to be unrelated to nausea levels. Drivers of adverse effects of meditation in some individuals require further investigation.

Purpose of Study: Given the enormity of the most recent challenges to clinician well-being, intensified by the pandemic, we decided to explore the influence of Transcendental Meditation® (TM)® on the well-being of clinical nurses. The purpose of our study was to use qualitative analysis to enhance our understanding of the experiences of clinical nurses who practiced TM, as viewed through the lens of our conceptual model and Watson's holistic unitary caring science theory. Design and Method: This qualitative study involved a thematic analysis of clinical nurses' written descriptions following the completion of the TM program during the COVID-19 pandemic. Findings: The nurse participants shared their experiences with the practice of TM as creating present moment focus, leading to enhanced self-care, and development of authentic presence with others. The overall theme uncovered in the analysis is that authentic presence is veritas (truth) in knowing, being, doing, and becoming. Conclusions: The findings were congruent with Watson's unitary caring science theory and provided illumination of the holistic value of TM as a self-care strategy for supporting nurses' well-being with the goal of retaining nurses in practice. When nurses care for themselves, they are more likely and able to care for others, thus helping them to enjoy their nursing careers.

Hypertension management typically relies on standardized treatment regimens, which may not account for individual genetic variations that affect drug metabolism and response.

The objective of this study was to evaluate the effectiveness of personalized antihypertensive therapy, guided by pharmacogenetic testing, in terms of blood pressure (BP) control and medication tolerability.

A retrospective cohort study was conducted at Jinnah Postgraduate Medical Centre, Karachi, from January 2023 to December 2023. The study included 330 hypertensive patients who received either conventional care (n = 165) or personalized therapy directed by pharmacogenetic testing (n = 165). Data on patient demographics, genetic test results, antihypertensive drug prescriptions, and blood pressure readings at baseline, three months, and six months were extracted from electronic health records. Reports of adverse effects were used to assess medication tolerability. Independent t-tests were employed for statistical analysis (SPSS version 25 (IBM Corp., Armonk, NY)) to evaluate changes in blood pressure and adverse effects between the two groups, with a significance level set at p < 0.05.

Among the 330 hypertensive patients, the Personalized Therapy group (n = 165) showed a significant reduction in systolic blood pressure by 17.8 mmHg (±6.4) and diastolic blood pressure by 11.3 mmHg (±5.7) over six months, compared to reductions of 8.7 mmHg (±6.7) and 5.7 mmHg (±4.8), respectively, in the Standard Therapy group (n = 165) (p < 0.001). Additionally, the Personalized Therapy group experienced fewer adverse effects, with 15 patients reporting dizziness and five reporting gastrointestinal issues, compared to 30 patients with dizziness and 10 with gastrointestinal issues in the Standard Therapy group.

Personalized antihypertensive therapy based on pharmacogenetic testing significantly improves blood pressure control and medication tolerability compared to standard treatment, supporting its broader implementation in hypertension management.

The aim of this study was to examine the effects of free swimming (FS), aquatic resistance training (ART), and their combination (FS&ART) on the body composition, blood pressure, and physical fitness of older adults. The study employed a randomized controlled design, comparing three experimental groups with a control group. Eighty volunteers aged between sixty and seventy years (age: 66.2 ± 2.3 years; body mass index: 25.8 ± 4.3 kg/m²) participated in the 16-week intervention, consisting of two weekly sessions. Assessments were conducted at baseline and post-intervention, including anthropometric measurements, blood pressure readings, and the Senior Fitness Test. Significant differences were found between groups in post-intervention considering the chair stand test (p = 0.017; ES = 0.125), arm curl test (p = 0.029; ES = 0.111), 8-foot up and go test (p = 0.042; ES = 0.102), and walk test - 6 min (p = 0.005; ES = 0.156). Specifically, both ART (+ 20.1%; p < 0.05) and FS&ART (+ 19.5%; p < 0.05) showed significantly greater improvements in the chair stand test compared to the control group. Similarly, ART (+ 23.1%; p < 0.05) and FS&ART (+ 18.7%; p < 0.05) performed better than the control group. FS&ART also exhibited a significant improvement over the control group in the 8-foot up-and-go test (+ 14.6%; p < 0.05). In the 6-minute walk test, FS (+ 19.4%; p < 0.05) and FS&ART (+ 15.9%; p < 0.05) both significantly outperformed the control group. This study found that FS improves cardiovascular endurance, while ART enhances muscular strength and endurance in older adults, with combined benefits for agility, suggesting integration of combined modalities into community wellness initiatives for enhanced physical fitness and health outcomes.

Psychological distress has a demonstrable impact on cardiovascular diseases (CVD) and risk factors. Transcendental Meditation (TM) has been shown to reduce stress and improve health and well-being. The current review aimed to synthesize the evidence on the effects of TM on cardiometabolic outcomes and identify gaps for future research. We searched PubMed/MEDLINE, EMBASE, SCOPUS, and Web of Science databases for relevant literature. Forty-five papers that reported studies of TM on cardiometabolic risk factors and diseases were included. Evidence shows that TM is effective in reducing blood pressure (BP). We found some evidence that TM can improve insulin resistance and may play a role in improving dyslipidemia, exercise tolerance, and myocardial blood flow, and in reducing carotid intima-media thickness and left ventricular mass. Studies show that long-term TM practice can reduce the risk of myocardial infarction, stroke, and CVD mortality. This review identified that certain studies have high participant drop-out rates, and fewer studies targeted comprehensive cardiometabolic outcomes beyond BP with longer follow-up periods. We found that most studies were conducted in specific populations, which may limit generalizability. In conclusion, TM has the potential to improve cardiometabolic health; however, research gaps highlight the need for larger phase III multicenter clinical trials with long-term follow-ups.

Arterial hypertension (AH) is one of the most common pathologic conditions and uncontrolled AH is a leading risk factor for cardiovascular disease and mortality. AH chronically causes myocardial and arterial remodelling with hemodynamic changes affecting the heart and other organs, with potentially irreversible consequences leading to poor outcomes. Therefore, a proper and early treatment of AH is crucial after the diagnosis. Beyond medical treatment, physical exercise also plays a therapeutic role in reducing blood pressure, given its potential effects on sympathetic tone, renin-angiotensin-aldosterone system, and endothelial function. International scientific societies recommend physical exercise among lifestyle modifications to treat AH in the first stages of the disease. Moreover, some studies have also shown its usefulness in addition to drugs to reduce blood pressure further. Therefore, an accurate, personalized exercise prescription is recommended to optimize the prevention and treatment of hypertension. On the other hand, uncontrolled AH in athletes requires proper risk stratification and careful evaluation to practice competitive sports safely. Moreover, the differential diagnosis between hypertensive heart disease and athlete's heart is sometimes challenging and requires a careful and comprehensive interpretation in order not to misinterpret the clinical findings. The present review aims to discuss the relationship between hypertensive heart disease and physical exercise, from diagnostic tools to prevention and treatment strategies.

Isometric handgrip training (IHT) has been shown to reduce blood pressure (BP) in hypertensive patients. However, factors that predict responsiveness to IHT are largely unknown. The aim of this study was to investigate the patient characteristics associated with the antihypertensive response to IHT using a recommended statistical approach for evaluating interindividual responses.

Data from four randomized controlled trials were combined, totaling 81 patients undergoing IHT (48.8% women; 60 ± 11 years) and 90 control patients (45.6% women; 62 ± 12 years). IHT consisted of 4 × 2 min isometric contractions at 30% of maximal voluntary contraction, performed three times/week for 8-12 weeks. BP was measured at baseline and following IHT and control interventions. The interindividual variation was assessed by the standard deviation of the individual responses (SD ir ), and linear regression analyses were conducted to explore response predictors.

IHT significantly decreased both SBP (-5.4; 95% confidence interval (CI) -9.5 to -1.3 mmHg) and DBP (-2.8; 95% CI -5.1 to -0.6 mmHg). The interindividual variation of BP change was moderate for systolic (SD ir  = 5.2 mmHg, 0.30 standardized units) and low for diastolic (SD ir  = 1.7 mmHg, 0.15 standardized units). Sex, age, and BMI were not associated with the antihypertensive effect of IHT. However, a higher baseline SBP ( b  = -0.467, P  < 0.001) and absence of dihydropyridine calcium channel blockers use ( b  = 0.340, P  = 0.001) were associated with greater BP reductions.

IHT reduced BP in medicated hypertensive patients regardless of age, sex, and BMI. Patients with a higher baseline SBP and those not prescribed dihydropyridine calcium channel blockers were more responsive to IHT.

Myocardial fibrosis is a pathological, physiological change that results from alterations, such as inflammation and metabolic dysfunction, after myocardial infarction (MI). Excessive fibrosis can cause cardiac dysfunction, ventricular remodeling, and heart failure. Caffeic acid (CA), a natural polyphenolic acid in various foods, has cardioprotective effects. This study aimed to explore whether CA exerts a cardioprotective effect to inhibit myocardial fibrosis post-MI and elucidate the underlying mechanisms. Histological observations indicated that CA ameliorated ventricular remodeling induced by left anterior descending coronary artery ligation in MI mice and partially restored cardiac function. CA selectively targeted transforming growth factor-β receptor 1 (TGFBR1) and inhibited TGFBR1-Smad2/3 signaling, reducing collagen deposition in the infarcted area of MI mice hearts. Furthermore, cell counting (CCK-8) assay, 5-ethynyl-2'-deoxyuridine assay, and western blotting revealed that CA dose-dependently decreased the proliferation, collagen synthesis, and activation of the TGFBR1-Smad2/3 pathway in primary cardiac fibroblasts (CFs) stimulated by TGF-β1 in vitro. Notably, TGFBR1 overexpression in CFs partially counteracted the inhibitory effects of CA. These findings suggest that CA effectively mitigates myocardial fibrosis and enhances cardiac function following MI and that this effect may be associated with the direct targeting of TGFBR1 by CA.

Background.Non-invasive continuous blood pressure (BP) monitoring is of longstanding interest in various cardiovascular scenarios. In this context, pulse arrival time (PAT), i.e., a surrogate parameter for systolic BP (change), became very popular recently, especially in the context of cuffless BP measurement and dedicated lifestyle interventions. Nevertheless, there is also understandable doubt on its reliability in uncontrolled and mobile settings.Objective.The aim of this work is therefore the investigation whether PAT follows oscillometric systolic BP readings during moderate interventions by physical or mental activity using a medical grade handheld device for non-invasive PAT assessment.Approach.A study was conducted featuring an experimental group performing a physical and a mental task, and a control group. Oscillometric BP and PAT were assessed at baseline and after each intervention. Interventions were selected randomly but then performed sequentially in a counterbalanced order. Multivariate analyses of variance were used to test within-subject and between-subject effects for the dependent variables, followed by univariate analyses for post-hoc testing. Furthermore, correlation analysis was performed to assess the association of intervention effects between BP and PAT.Mainresults.The study included 51 subjects (31 females). Multivariate analysis of variances showed that effects in BP, heart rate, PAT and pulse wave parameters were consistent and significantly different between experimental and control groups. After physical activity, heart rate and systolic BP increased significantly whereas PAT decreased significantly. Mental activity leads to a decrease in systolic BP at stable heart rate. Pulse wave parameters follow accordingly by an increase of PAT and mainly unchanged pulse wave analysis features due to constant heart rate. Finally, also the control group behaviour was accurately registered by the PAT method compared to oscillometric cuff. Correlation analyses revealed significant negative associations between changes of systolic BP and changes of PAT from baseline to the physical task (-0.33 [-0.63, 0.01],p< 0.048), and from physical to mental task (-0.51 [-0.77, -0.14],p= 0.001), but not for baseline to mental task (-0.12 [-0,43,0,20],p= 0.50) in the experimental group.Significance.PAT and the used digital, handheld device proved to register changes in BP and heart rate reliably compared to oscillometric measurements during intervention. Therefore, it might add benefit to future mobile health solutions to support BP management by tracking relative, not absolute, BP changes during non-pharmacological interventions.

In the midst of global armed conflicts, notably the Israel-Hamas and Ukraine-Russia wars, there is an urgent need for innovative public health strategies in peacebuilding. The devastating impact of wars, including mortality, injury, disease, and the diversion of healthcare resources, necessitates effective and durable interventions. This perspective aligns with WHO recommendations and examines the role of evidence-based meditation from Ayurveda and Yoga in public health to mitigate collective stress and prevent collective violence and war. It highlights the Transcendental Meditation program, recognized for reducing stress, with contemporary evidence supporting its effectiveness in mental health, mind-body disorders, cardiovascular disease, and public health. Empirical studies with cross-cultural replications indicate that these Traditional Medicine meditation practices can reduce collective stress and prevent collective violence and war activity while improving quality of life. The mechanisms of group meditation in mitigating collective violence are explored through public health models, cognitive neuroscience, population neuroscience, quantum physics principles, and systems medicine. This perspective suggests that Transcendental Meditation and the advanced TM-Sidhi program, as a component of Traditional Medicine, can provide a valuable platform for enhancing societal well-being and peace by addressing brain-based factors fundamental to collective stress and violence.

Wuwei Jiangya decoction (WJD) is a traditional Chinese medicinal formula (Fangji) composed of Gastrodiae Rhizoma, Chuanxiong Rhizoma, Puerariae Lobatae Radix, Cyathulae Radix, and Achyranthis Bidentatae Radix, all of which have been verified to combat hypertension. However, the integrative "shot-gun" mechanism of WJD and its primary active ingredients are still unclear.

To investigate the anti-hypertensive effects of WJD and its originating ingredients.

Network-based degree distribution analysis combined with in vivo experiments were performed.

A total of 144 active ingredients in WJD were identified to regulate 84 hypertension-related targets, which are mainly involved in blood pressure and blood vessel diameter regulation. However, for the anti-hypertension effects, "more does not mean better". The majority (76%) of the hubs in the H-network were regulated by no more than four ingredients. We identified 16 primary ingredients that accounted for the therapeutic action against hypertension. For compatibility, the five herbs consistently focused on blood pressure, vascular diameter, and angiogenesis, with the renin-angiotensin system as a primary target. The characteristics of each herb were involved in processes such as lipid localization and oxidative stress, which interact to constitute the regulatory network targeting hypertension, its risk factors, and organ damage. In vivo, WJD significantly reduced systolic blood pressure (SBP), improved left ventricular mass index, and ameliorated cardiac hypertrophy and vascular injury by moderating the renin-angiotensin system via activating the ACE2/Ang-(1-7)/Mas signaling pathway.

WJD can lower SBP and ameliorate cardiac hypertrophy and vascular injury through the ACE2/Ang-(1-7)/Mas pathway, thus providing new insights into the development of traditional Chinese medicine as a therapeutic agent for hypertension.

Introduction: Hypertension is one of the most important, modifiable risk factors for cardiovascular disease. The popularity of wearable devices provides an opportunity to test whether device guided slow mindful breathing may serve as a non-pharmacological treatment in the management of hypertension. Methods: Fitbit Versa-3 and Sense devices were used for this study. In addition, participants were required to own an FDA or Health Canada approved blood pressure measuring device. Advertisements were shown to 655,910 Fitbit users, of which 7,365 individuals expressed interest and filled out the initial survey. A total of 1,918 participants entered their blood pressure readings on at least 1 day and were considered enrolled in the study. Participants were instructed to download a guided mindful breathing app on their smartwatch device, and to engage with the app once a day prior to sleep. Participants measured their systolic and diastolic blood pressure prior to starting each mindful breathing session, and again after completion. All measurements were self reported. Participants were located in the United States or Canada. Results: Values of systolic and diastolic blood pressure were reduced following mindful breathing. There was also a decrease in resting systolic and diastolic measurements when measured over several days. For participants with a systolic pressure ≥ 130 mmHg, there was a decrease of 9.7 mmHg following 15 min of mindful breathing at 6 breaths per minute. When measured over several days, the resting systolic pressure decreased by an average of 4.3 mmHg. Discussion: Mindful breathing for 15 min a day, at a rate of 6 breaths per minute is effective in lowering blood pressure, and has both an immediate, and a short term effect (over several days). This large scale study demonstrates that device guided mindful breathing with a consumer wearable for 15 min a day is effective in lowering blood pressure, and a helpful complement to the standard of care.

The present study has two objectives: 1) to verify the effect of Maitland mobilization, manual massage (MM), and static stretching (SS) on the acute range-of-motion (ROM) responses, over 30 min, in the elderly; 2) to verify the effect of Maitland's mobilization, MM, and SS on blood pressure (BP) responses, over 60 min, in the elderly. Sixteen inactive elderly men were recruited. After familiarization, all subjects performed the experimental conditions throughout four remaining sessions. Each session included two baselines ROM measures in randomized order. After baseline, participants completed the control group, Maitland, MM, and SS conditions and retesting immediately (Post-0) e again throughout 30-min following intervention. All conditions increased ankle, hip, and shoulder ROM for at least 10-min post-intervention. Systolic BP hypotensive effects were found for all experimental protocols when compared to baseline values. In conclusion, it was observed that Maitland, MM, and SS conditions enhance ROM and promote hypotensive effect post-intervention. These results have a practical prescription and rehabilitation implications and may be used in the elderly population, since a movement limitation can be treated by global interventions in a non-limited, as well as promoting cardiovascular protection through the hypotensive effects in the same experimental session.

Review of some of the best-known biological and non-biological complementary/alternative therapies/medicines (CAM) and their relationship with blood pressure (BP) and hypertension (HT).

Narrative review assessing a recent series of systematic reviews, meta-analyses, and clinical trials published in recent years, focusing on the effects of CAM on BP and HT.

We searched EMBASE, MEDLINE, Cochrane Library and Google Scholar, obtaining a total of 4336 articles, finally limiting the search to 181 after applying filters.

Some studies on biological therapies show some usefulness in BP reduction with an adequate benefit-risk balance, although there is a scarcity of high-quality trials that support these results. Some mind-body therapies have shown hypothetical benefit; in contrast, others lack robust evidence.

Although some therapies present a reasonable risk-benefit ratio, they should in no case replace pharmacological treatment when indicated.

To investigate the effectiveness of paced breathing guided by biofeedback on clinical and functional outcomes of patients with chronic obstructive pulmonary disease (COPD). An uncontrolled pilot study comprising a training with paced breathing guided by biofeedback (three sessions of 35 min per week) was conducted over four weeks (12 sessions). Assessments included respiratory muscle strength (using a manovacuometer), anxiety (Beck Anxiety Inventory), depression (Beck Depression Inventory), dyspnea (Baseline Dyspnea Index), functionality (Timed Up and Go Test), health status (COPD Assessment Test) and health-related quality of life (Saint George's Respiratory Questionnaire). The sample consisted of nine patients with a mean age of 68.2 ± 7.8 years. After intervention, patients significantly improved in health status and health-related quality of life, assessed using the COPD Assessment Test (p < 0.001) and Saint George's Respiratory Questionnaire (p < 0.001); anxiety (p < 0.001); and depression (p = 0.001). Patients also significantly improved in dyspnea (p = 0.008), TUG (p = 0.015), CC Score (p = 0.031), and maximum inspiratory (p = 0.004) and expiratory pressures (p < 0.001). An intervention with paced breathing guided by biofeedback promoted positive results on dyspnea, anxiety, depression, health status and perceived health-related quality of life in patients with COPD. Moreover, gains in respiratory muscle strength and functional performance were observed, affecting the performance of daily activities.

To assess the effectiveness of Cognitive Behavioral Therapy for Insomnia (CBT-I) on cardiometabolic health biomarkers.

Cochrane CENTRAL, Embase, Medline, and PsycINFO were searched, and records were screened by two independent reviewers. Inclusion criteria were adult population, delivery of CBT-I, randomized controlled trial design, ≥1 cardiometabolic health outcome, and peer-review. Hedge's g effect sizes were calculated, and the quality of the evidence was appraised using the Cochrane Risk of Bias 2 tool.

After screening 1649 records, 15 studies were included (total N = 2067). Inflammatory markers (CRP, IL-6, TNF-α), blood pressure (SBP, DBP), and glycemic regulation (HbA1c) were most frequently reported (in ≥3 studies each). HbA1c and CRP were reduced in the CBT-I group compared to the control group (in 3 studies each). Effects varied or were null for IL-6, TNF-α, SBP, and DBP. Six studies were judged as low, four as moderate, and five as high risk of bias.

CBT-I was most consistently associated with improved HbA1c and CRP, which are relatively temporally stable, suggesting influences on enduring habits rather than short-term behavior changes. High risk of bias limits the interpretation of findings. Methodologically adequate studies are needed to better understand cardiometabolic effects of CBT-I.

The Wim Hof method (WHM) is a multi-disciplinary approach to physical and mental well-being combining cold exposure, breathing exercises, and meditation. This study evaluated the effects of a 15 days WHM intervention on cardiovascular parameters at rest and during a cold pressor test (CPT), as well as on various psychological parameters. Forty two participants were randomized into an intervention (IG) and a control group. Throughout the 15 days intervention, the IG performed the WHM daily. Before and after the intervention, systolic (SBP) and diastolic blood pressure (DBP), pulse wave velocity (PWV), heart rate (HR), root mean sum of squared distance (RMSSD), and standard deviation of RR-intervals (SDNN) were assessed at rest and during a CPT. Furthermore, perceived stress (PSS), positive affect (PANAS+), negative affect (PANAS-), and subjective vitality (trait (SVSt) and state (SVSs)) was determined. No significant time × group interactions could be detected in HR (p = 0.709); RMSSD (p = 0.820), SDNN (p = 0.186), SBP (p = 0.839), DBP (p = 0.318), PWV (p = 0.983), PANAS+ (p = 0.427), PANAS- (p = 0.614), SVSt (p = 0.760), SVSs (p = 0.366), and PSS (p = 0.364). No significant time × group effects could be detected during the CPT (ΔHR: p = 0.596; ΔSBP: p = 0.366; ΔDBP: p = 0.999; ΔPWV: p = 0.635; perceived pain: p = 0.231). Performing the WHM daily did not exert positive effects on cardiovascular and psychological parameters.

It is well known that muscular fitness has been associated with hypertension. However, it is less known which cut-off values of muscular fitness may predict the presence of hypertension. The main purpose of this study was to establish criterion-referenced standards of muscular fitness to define the presence of hypertension in Croatian older adults.

In this cross-sectional study, we recruited men and women over 60 years of age. Muscular fitness was assessed by handgrip strength and normalized by height squared. Hypertension was defined as having systolic blood pressure ≥130 mm/Hg or diastolic blood pressure ≥80 mm/Hg.

In older men, the optimal cut-point of muscular fitness in defining hypertension was 15.4 kg/m2. The area under the curve (AUC) was 0.85 (96% CI 0.77 to 0.92, p < 0.001). In older women, the optimal cut-point was 11.8 kg/m2, with an AUC of 0.84 (95% CI 0.80 to 0.89, p < 0.001). Men and women with cut-points of < 15.4 kg/m2 and < 11.8 kg/m2 were 11.8 (OR = 11.8, 95% CI 4.3 to 32.4, p < 0.001) and 10.6 (OR = 10.6, 95% CI 5.7 to 19.7, p < 0.001) times more likely to be diagnosed with hypertension.

Our newly developed cut-points of muscular fitness assessed by the handgrip strength and normalized by height squared have satisfactory predictive validity properties in detecting men and women aged 60-81 years with hypertension.

This randomised controlled trial (RCT) assessed the effect of a 1-year, partially supervised, physical activity (PA) intervention on a cardiovascular disease (CVD) risk score in adult survivors of childhood cancer.

We included childhood cancer survivors ≥16 y at enrolment, <16 y at diagnosis and ≥5 y in remission. The intervention group was asked to perform an additional ≥2.5 h of intense physical activity/week, controls continued exercise as usual; assessments were performed at baseline, 6 months (T6) and 12 months (T12). The primary endpoint was change in a CVD risk score (average z-score of waist circumference, blood pressure, fasting glucose, inverted high-density lipoprotein cholesterol, triglycerides, and inverted cardiorespiratory fitness) from baseline to T12. We performed intention-to-treat (ITT, primary) and 3 per protocol analyses.

We randomised 151 survivors (44% females, 30.4 ± 8.6 years). We found a significant and robust reduction of the CVD risk score in the intervention compared to the control group at T6 and T12 across all analyses; with a difference in the reduction of the CVD risk z-score of -0.18 (95% confidence interval -0.29 to -0.06, P = 0.003) at T12 in favour of the intervention group (ITT analysis).

This RCT showed that a long-term PA intervention can reduce CVD risk in long-term survivors of childhood cancer.

Clinicaltrials.gov: NCT02730767.

Aerobic exercise is a leading strategy for the prevention/management of systemic arterial hypertension, but other modalities of exercise have also been explored. Thus, we examined the acute effect of isometric handgrip exercise (IHGE) and the chronic effect of isometric handgrip training (IHGT) on systolic blood pressure (SBP) and diastolic blood pressure (DBP) in individuals with hypertension without comorbid conditions. We conducted a systematic review with meta-analysis of randomized controlled trials (RCTs) involving adults with hypertension. We searched the electronic databases MEDLINE (PubMed), Cochrane, Web of Science, LILACS, EMBASE and PEDro. We used random-effects model for the analyses, RoB2 tool to assess the risk of bias, and GRADE to assess the strength of evidence. A total of 9 RCTs (2 for IHGE and 7 for IHGT) were selected. Compared to a control condition, IHGE did not have any effect on SBP/DBP. Unlike, the pooled mean effect of IHGT showed SBP was reduced by 6.7 mmHg (95% CI -10.3 to -3.4 mmHg) and DBP by 4.5 mmHg (95% CI -7.3 to -1.7 mmHg) in individuals with hypertension. Also, the 95% prediction interval (95% PI) of IGHT was -10.9 to -2.5 mmHg for SBP and -10.2 to +1.2 mmHg for DBP. In conclusion, while IHGE did not produce post-exercise hypotension in the population studied, IHGT reduced SBP/DBP in individuals with hypertension with clinically important reductions in SBP (-6.7 mmHg) and DBP (-4.5 mmHg). This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (CRD 42021217958).

Current guidelines suggest that regular aerobic training might lower blood pressure in hypertensive individuals. However, evidence linking resistant hypertension (RH) with total daily physical activity (PA), including work-, transport-, and recreation-related PA, is limited. Therefore, this study assessed the association between daily PA and RH.

A cross-sectional study was conducted using data acquired from a nationwide survey in the US (the National Health and Nutrition Examination Survey, NHANES). The weighted prevalence of RH was calculated, and moderate and vigorous daily PA was assessed using the Global Physical Activity Questionnaire (GPAQ). A multivariate logistic regression model determined the association between daily PA and RH.

A total of 8,496 treated hypertension patients were identified, including 959 RH cases. The unweighted prevalence of RH among treated hypertension cases was 11.28%, while the weighted prevalence was 9.81%. Participants with RH had a low rate of recommended PA levels (39.83%), and daily PA and RH were significantly associated. PA exhibited significant dose-dependent trends with a low probability of RH (p-trends < 0.05). Additionally, participants with sufficient daily PA had a 14% lower probability of RH than those with insufficient PA [fully adjusted odds ratio (OR) = 0.86; 95% confidence interval (CI) = 0.74-0.99).

The present study revealed that RH has an incidence of up to 9.81% in treated hypertension patients. Hypertensive patients tended to be physically inactive, and insufficient PA and RH were significantly associated. Sufficient daily PA should be recommended to reduce the RH probability among treated hypertension patients.

Elevated sympathetic activity and chronic inflammation are known contributory factors observed in hypertension. We have observed that sympathoinhibitory electroacupuncture (SI-EA) at acupoints ST36-37 alleviates sympathetic activity and hypertension. Additionally, EA at acupoints SP6-7 exerts anti-inflammatory (AI-EA) effects. However, it is not known whether simultaneous stimulation of this combination of acupoints attenuates or enhances individual effects. A 2 × 2 factorial design was used to test the hypothesis that combining SI-EA and AI-EA (cEA) leads to greater reduction of hypertension by decreasing sympathetic activity and inflammation in hypertensive rats than either set of acupoints alone. Dahl salt-sensitive hypertensive (DSSH) rats were treated with four EA regimens including cEA, SI-EA, AI-EA, and sham-EA twice weekly for five weeks. A group of normotensive (NTN) rats served as control. Systolic and diastolic BP (SBP and DBP) and heart rate (HR) were measured non-invasively by tail-cuff. Plasma norepinephrine (NE), high-sensitivity C-reactive protein (hs-CRP) and interleukin 6 (IL-6) concentrations were determined with ELISA at the completion of treatments. DSSH rats on high salt diet progressively developed moderate hypertension within five weeks. DSSH rats treated with sham-EA showed continuous increase in SBP and DBP and elevations in plasma NE, hs-CRP, and IL-6 levels relative to NTN control. Both SI-EA and cEA decreased SBP and DBP, and had corresponding changes in biomarkers (NE, hs-CRP, and IL-6) compared with sham-EA. AI-EA prevented SBP and DBP elevation and decreased IL-6 and hs-CRP relative to sham-EA. Importantly in DSSH rats that received repetitive cEA treatment, SI-EA interacted positively with AI-EA leading to greater reduction of SBP, DBP, NE, hs-CRP, and IL-6 than SI-EA or AI-EA alone. These data suggest that by targeting both elevated sympathetic activity and chronic inflammation, cEA regimen results in a greater reduction of BP effects in treating hypertension compared to using individual SI-EA or AI-EA alone.

Hypertension is the primary risk factor for cardiovascular disease and adequate blood pressure control is often elusive. The objective of this work was to conduct a meta-analysis of trial data of isometric resistance training (IRT) studies in people with hypertension, to establish if IRT produced an anti-hypertensive effect. A database search (PubMed, CINAHL, Cochrane Central Register of Controlled Trials, and MEDLINE) identified randomised controlled and crossover trials of IRT versus a sedentary or sham control group in adults with hypertension.

We included 12 studies (14 intervention groups) in the meta-analyses, with an aggregate of 415 participants. IRT reduced systolic blood pressure (SBP), mean difference (MD) - 7.47 mmHg (95%CI - 10.10, - 4.84), P < 0.01; diastolic blood pressure (DBP) MD - 3.17 mmHg (95%CI - 5.29, - 1.04), P < 0.01; and mean arterial blood pressure (MAP) MD - 7.19 mmHg (95%CI - 9.06, - 5.32), P < 0.0001. Office pulse pressure and resting heart rate was not significantly reduced, neither were 24-h or day-time ambulatory blood pressures (SBP, DBP). Night-time blood pressures, however, were significantly reduced with SBP MD - 4.28 mmHg (95%CI - 7.88, - 0.67), P = 0.02, and DBP MD - 2.22 mmHg (95%CI - 3.55, - 0.88), P < 0.01. IRT does lower SBP, DBP and MAP office and night-time ambulatory SBP and DBP, but not 24-h mean ambulatory blood pressures in people with hypertension.

Foam rolling (FR) has recently become very popular among athletes and recreational exercisers and is often used during warm up prior to strength training (ST) to induce self-myofascial release. The purpose was to examine the acute effects of ST and FR performed in isolation or in combination on blood pressure (BP) responses during recovery in normotensive women. Sixteen normotensive and strength trained women completed four interventions: 1) rest control (CON), 2) ST only, 3) FR only, and 4) ST immediately followed by FR (ST + FR). ST consisted of three sets of bench press, back squat, front pull-down, and leg press exercises at 80% of 10RM. FR was applied unilaterally in two sets of 120 s to each of the quadriceps, hamstring, and calf regions. Systolic (SBP) and diastolic (DBP) BP were measured before (rest) and every 10 min, for 60 min, following (Post 10-60) each intervention. Cohen's d effect sizes were calculated to indicate the magnitude effect by the formula d = Md/Sd, where Md is the mean difference and Sd is the standard deviation of differences. Cohen's d effect-sizes were defined as small (≥0.2), medium (≥0.5), and large (≥0.8). There were significant reductions in SBP for ST at Post-50 (p < 0.001; d = -2.14) and Post-60 (p < 0.001; d = -4.43), for FR at Post-60 (p = 0.020; d = -2.14), and for ST + FR at Post-50 (p = 0.001; d = -2.03) and Post-60 (p < 0.001; d = -2.38). No change in DBP was observed. The current findings suggest that ST and FR performed in isolation can acutely reduce SBP but without an additive effect. Thus, ST and FR can both be used to acutely reduce SBP and, importantly, FR can be added to a ST regimen without furthering the SBP reduction during recovery.

More than 30 randomized controlled trials, supported by individual patient-level and group-level meta-analyses and a Delphi analysis of expert opinion, unequivocally show isometric resistance training (IRT) elicits antihypertensive benefits in healthy people and those with chronic illness. We aim to provide efficacy and safety evidence, and a guide for IRT prescription and delivery. Recommendations are made for the use of IRT in specific patient populations and appropriate methods for IRT delivery. Published data suggest IRT consistently elicits mean blood pressure reductions of 7.4/3.3 mmHg systolic blood pressure/diastolic blood pressure, equivalent to antihypertensive medication monotherapy. Blood pressure reductions of this size are associated with an approximate 13% to 22% reduction in major cardiovascular events. Moreover, IRT is safe in a range of patient populations. We suggest that IRT has the greatest potential benefit when used as an antihypertensive therapy in individuals unwilling and/or unable to complete aerobic exercise, or who have had limited adherence or success with it; individuals with resistant or uncontrolled hypertension, already taking at least two pharmacological antihypertensive agents; and healthy or clinical populations, as an adjunct to aerobic exercise and dietary intervention in those who have not yet attained control of their hypertension. IRT is efficacious and produces clinically meaningful blood pressure reductions (systolic blood pressure, 7 mmHg; diastolic blood pressure, 3 mmHg). IRT is safe and typical program delivery requires only about 17 min weekly. IRT should be used as an adjunct to other exercise modalities, in people unable to complete other types of exercise, or in resistant hypertension.

There isevidence that device-guided slow breathing using biofeedback acutely reduces blood pressure (BP) and pulse wave velocity [i.e. increased pulse arrival time (PAT)].

The objectives of the study presented here were to test whether the results of changes observed in PAT in earlier studies are reproducible over 1 week and how changes in pulse wave velocity/PAT translate into absolute self-measured BP changes.

Patients with a systolic BP 130-160 mmHg or treated essential hypertension (21 females/23 males) were trained to perform unattended device-guided slow breathing exercises for 10 min daily over 5 days. Furthermore, they were skilled to perform self-measurement of BP before and after the breathing exercise using a validated upper-arm device.

Office BP at screening [median (1, 3. Q)] was 137 (132, 142)/83 (79, 87) mmHg. We observed a significant ( P  < 0.05) increase in PAT of 5 ms (SD 12.5 ms) on average after 10 min of guided breathing and an additional 1 ms ( P  < 0.05, SD 8 ms) during the following 5 min of spontaneous breathing compared to baseline. PAT before the exercise remained constant over 5 days paralleled by constant self-measured BP before the exercise. Device-guided breathing was associated with a significant reduction of self-measured SBP of 5 mmHg ( P  < 0.01, SD 8 mmHg). Data furthermore demonstrated that these changes were highly reproducible over 1 week.

Device-guided slow breathing and biofeedback lead to reproducible and favorable changes (increase) in PAT and SBP (decrease).

Yoga has been increasingly popular yet has shown inconsistent benefits on cardiovascular disease (CVD) risk factors. We aimed to systematically analyze the effect of yoga on modifiable CVD risk factors. We systematically searched Ovid MEDLINE, Ovid Embase, Ovid Cochrane Database of Systematic Reviews, Scopus, and Web of Science from database inception in 1966 through June 2022 for studies evaluating the association between yoga and blood pressure, lipid profile, HbA1c and body mass index (BMI). Two investigators independently reviewed data. Conflicts were resolved through consensus. Random-effects meta-analyses were used. 64 RCTs including a total of 16,797 participants were eligible for inclusion in the meta-analysis. Yoga therapy improved both systolic as well as diastolic blood pressure (weight mean difference [WMD] (95% Confidence interval [CI]) of -4.56 [-6.37, -2.75] mm Hg, WMD [95% CI] - 3.39 [-5.01, -1.76] mm Hg respectively). There was also an improvement in BMI as well as hemoglobin A1c (HbA1c) (WMD [95% CI] of -0.57 [-1.05, -0.10] kg/m², WMD [95% CI] of -0.14 [-0.24, -0.030] mmol/L respectively) . In addition, all parameters of the lipid profile, including low-density lipoprotein cholesterol (LDL-C) showed a significant improvement with yoga therapy (WMD [95% CI] -7.59 [-12.23, -2.95] mg/dL for LDL-C). Yoga has a modest yet positive effect on blood pressure, BMI, lipid profile and HbA1c and, therefore, may play an ancillary role in primary prevention of CVD.

This article reports the results of Smart Walk: a randomized pilot trial of an 8-month culturally tailored, smartphone-delivered physical activity (PA) intervention for African American women with obesity. Sixty participants (age range = 24−49 years; BMI range = 30−58 kg/m2) were randomized to the Smart Walk intervention (n = 30) or a wellness comparison intervention (n = 30). Results supported the acceptability and feasibility of the intervention, as demonstrated by participant retention (85% at 4 months and 78% at 8 months), Smart Walk app use, and intervention satisfaction (i.e., 100% of PA participants completing the intervention [n = 24] reported they would recommend it to friend). Smart Walk participants also reported greater increases in moderate-to-vigorous PA (4-month between-arm difference in change [b] = 43.3 min/week; p = 0.018; Cohen’s d = 0.69; 8-month b = 56.6 min/week; p = 0.046; d = 0.63) and demonstrated clinically relevant, although not statistically significant (p-values > 0.05), baseline to 4 months improvements in cardiorespiratory fitness (b = 1.67 mL/kg/min; d = 0.40), systolic blood pressure (b = −3.33 mmHg; d = 0.22), diastolic blood pressure (b = −4.28 mmHg; d = 0.37), and pulse wave velocity (b = −0.46 m/s; d = 0.33). Eight-month cardiometabolic outcomes followed similar trends, but had high rates of missing data (45−53%) due to COVID-19 restrictions. Collectively, findings demonstrated favorable outcomes for acceptability and feasibility, while also highlighting key areas for refinement in future research.

Hypertension (HTN) is a common and growing public health challenge with severe risk factors. Hence, this study aimed to assess the effect of Om chanting and Yoga Nidra on depression, anxiety, stress, sleep quality and autonomic functions on individuals with hypertension.

This prospective randomized controlled study was conducted in patients with hypertension at Little Flower Medical Research Center. A total of 80 patients with diagnosed hypertension were recruited and randomized equally to either the experimental group or control group. The experimental group received a combination of Om chanting and Yoga Nidra for five days a week for two months. The control group participants continued with their regular conventional medications. Depression anxiety stress scale (DASS), Pittsburgh sleep quality index (PSQI) and heart rate variability (HRV) scores were assessed at baseline, 30 and 60 day for both the groups.

A total of 34 subjects in the experimental group and 31 subjects in the control group were included in the analysis. There was a significant (p<0.001) reduction in depression, anxiety, stress, and a significant (p<0.001) improvement in PSQI and HRV parameters in the experimental group was observed as compared to the control group. No adverse events were reported during the trial period.

The current study validates the effectiveness of Om chanting and Yoga Nidra in reducing depression, anxiety, stress and improving sleep quality and autonomic functions in hypertensive patients. These interventions could thus be considered a safer form of complementary therapy in managing stress and hypertension.