Volcanic smog and cardiometabolic health: Hawaiian hypertension?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/149349/1/jch13500.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/149349/2/jch13500_am.pd

Arm Position During Ambulatory Blood Pressure Monitoring: A Review of the Evidence and Clinical Guidelines

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/106696/1/jch12255.pd

The 2017 ACC/AHA Hypertension Guidelines: Should they have included proven nonpharmacological blood pressure‐lowering strategies such as Transcendental Meditation?

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/148410/1/jch13488_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/148410/2/jch13488.pd

“Environmental Hypertensionology” The Effects of Environmental Factors on Blood Pressure in Clinical Practice and Research

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/88111/1/j.1751-7176.2011.00543.x.pd

Is Acute High-Dose Secondhand Smoke Exposure Always Harmful to Microvascular Function in Healthy Adults?

Prev Cardiol.Long-term exposure to secondhand smoke (SHS) is associated with impaired vascular function. The authors investigated the vascular and blood pressure (BP) reactions to acute SHS exposure. Twenty-five healthy nonsmoking adults underwent a 1-hour exposure to SHS (mean fine particulate matter <2.5 μm level=315±116 μg/m 3 ). Microvascular endothelial-dependent vasodilatation (EDV) (EndoPAT, Itamar Medical, Caesarea, Israel) and aortic hemodynamics/compliance (SphygmoCor, AtCor Medical, West Ryde, Australia) were measured before and after the SHS exposure with BP measured every 15 minutes during and for a 24-hour period before and after the exposure. SHS exposure did not change EDV, aortic hemodynamics, arterial compliance, or 24-hour BP. However, diastolic BP significantly increased during the SHS exposure period by 3.4±5.6 mm Hg. Our brief SHS exposure did not impair microvascular endothelial function or arterial compliance in healthy nonsmoking adults, but brachial diastolic BP increased.Prev Cardiol. 2010;13:175–179. © 2010 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79199/1/j.1751-7141.2010.00074.x.pd

Acute Blood Pressure Responses in Healthy Adults During Controlled Air Pollution Exposures

Exposure to air pollution has been shown to cause arterial vasoconstriction and alter autonomic balance. Because these biologic responses may influence systemic hemodynamics, we investigated the effect of air pollution on blood pressure (BP). Responses during 2-hr exposures to concentrated ambient fine particles (particulate matter < 2.5 μm in aerodynamic diameter; PM(2.5)) plus ozone (CAP+O(3)) were compared with those of particle-free air (PFA) in 23 normotensive, non-smoking healthy adults. Mean concentrations of PM(2.5) were 147 ± 27 versus 2 ± 2 μg/m(3), respectively, and those of O(3) were 121 ± 3 versus 8 ± 5 ppb, respectively (p < 0.0001 for both). A significant increase in diastolic BP (DBP) was observed at 2 hr of CAP+O(3) [median change, 6 mm Hg (9.3%); binomial 95% confidence interval (CI), 0 to 11; p = 0.013, Wilcoxon signed rank test] above the 0-hr value. This increase was significantly different (p = 0.017, unadjusted for basal BP) from the small 2-hr change during PFA (median change, 1 mm Hg; 95% CI, −2 to 4; p = 0.24). This prompted further investigation of the CAP+O(3) response, which showed a strong association between the 2-hr change in DBP (and mean arterial pressure) and the concentration of the organic carbon fraction of PM(2.5) (r = 0.53, p < 0.01; r = 0.56, p < 0.01, respectively) but not with total PM(2.5) mass (r ≤ 0.25, p ≥ 0.27). These findings suggest that exposure to environmentally relevant concentrations of PM(2.5) and O(3) rapidly increases DBP. The magnitude of BP change is associated with the PM(2.5) carbon content. Exposure to vehicular traffic may provide a common link between our observations and previous studies in which traffic exposure was identified as a potential risk factor for cardiovascular disease

Accuracy of Wrist-worn Physical Activity Monitors to Measure Energy Expenditure

IIn recent years, the popularity and demand of physical activity monitors has drastically risen with the need and want to improve physical fitness. Newer devices worn on the wrist measure both heart rate and energy expenditure but the accuracy of these measurements is unclear. PURPOSE: To measure the accuracy of three separate wrist-worn activity monitors to estimate energy expenditure during structured periods of aerobic exercise. METHODS: Twelve men and three women (22 ± 3 years, 25 ± 3 kg/m2) consented to participate in this study. Three different physical activity monitors, TomTom Cardio (TT), Microsoft Band (MB), and Fitbit Surge (FB), were randomly assigned to either the left or right wrist of each participant. The instructions for the testing procedure were thoroughly explained to every participant at the start of each trial. The treadmill started at a speed of 2 mph and increased by 1 mph every three minutes up to a max speed of 6 mph. Energy expenditure was estimated through direct measurement of oxygen consumed and carbon dioxide produced through a metabolic cart (MC, Parvo Medics True One ®2400). The mean bias in energy expenditure between MC and each device was calculated. Pearson product-moment correlations and 95% equivalence testing were also calculated. Statistical significance was set at an alpha level of 0.05. RESULTS: The mean bias between the MC and devices at 2 mph varied from -1.9 ± 1.1 kcal/min (FB) to 0.7 ± 1.0 kcal/min (MB) while the mean bias at 6 mph varied from -1.7 ± 2.1 kcal/min (MB) to 5.2 ± 1.7 kcal/min (TT). For total energy expenditure, all devices were significantly correlated with the MC (FB: r=0.66, p=0.007; TomTom: r=0.77, p\u3c0.001; MB: r=0.59, p=0.02). The mean bias for total energy expenditure was -25 ± 16 kcal for the FB, 26 ± 13 kcal for the TT, and -11 ± 17 kcal for the MB. The equivalence zone for MC was 88 kcal to 108 kcal but 90% confidence intervals of devices did not fall within this zone. CONCLUSION: The wrist-worn physical activity monitors used in this study that measure heart rate and energy expenditure tend to either underestimate or overestimate total energy expenditure from treadmill walking and running

Valsartan Improves Insulin Sensitivity without Altering Vascular Function in Healthy Overweight Adults without the Metabolic Syndrome

Background. We investigated hyperactivity of the renin-angiotensin system (RAS) as a cause of endothelial dysfunction in obese humans. Methods. Thirty five healthy overweight (BMI = 33.6 ± 6.6 kg m −2) adults (33 ± 10 years old) without cardiovascular risk factors received valsartan (160 mg) orally daily or a matching placebo for 6 weeks each. Results. Baseline flow-mediated dilatation (FMD) and nitroglycerin-mediated dilatation (NMD) were not altered by placebo or valsartan. However, fasting plasma insulin was significantly decreased by valsartan compared to placebo (−4.6 ± 16.0 μUmL−1 versus −0.4 ± 11.6 μUmL−1, P = 0.032) with no changes in glucose. A secondary analysis in patients with elevated waist to hip ratios (ÿ0.85, n = 18) showed an increase in FMD with valsartan. Conclusions. Our findings suggest that angiotensin 2 receptor blockade may aid in the prevention of diabetes even at the earliest stages of risk due solely to uncomplicated obesity. The lack of an improvement in FMD does not support a central role of RAS-hyperactivity in the etiology of the vascular dysfunction due solely to obesity. However, it is possible that obese patients with central adiposity may improve FMD with RAS blockade, and future investigation is warranted in this subgroup.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/63259/1/met.2007.0002.pd