Effects of the cessation of an aerobic exercise program with nutritional intervention in adults with primary hypertension, overweight/obesity and physically inactive: EXERDIET-HTA study

176 p.Esta tesis doctoral la componen distintos estudios que se centran en la relación de la capacidad cardiorespiratoria (CCR) con el perfil bioquímico y en los efectos del cese de una intervención de 16 semana con ejercicio físico (EF) aeróbico supervisado y dieta hipocalórica, 6 meses (6M) después de la misma, en participantes con hipertensión arterial primaria (HTA), sobrepeso u obesidad y físicamente inactivas. Por ello, los objetivos principales de este trabajo fueron: 1) establecer ,en esta población, las asociaciones entre la CCR y el perfil bioquímico; 2) determinar si las mejoras obtenidas después de una intervención de 16 semanas con dieta hipocalórica y EF aeróbico supervisado en CCR, presión arterial (PA) y composición corporal son mantenidas tras un periodo de 6M sin supervisión; y 3) determinar las diferencias en el perfil metabólico después de una intervención de 16 semanas con dieta hipocalórica y EF aeróbico supervisado y analizar si los cambios observados tras ese periodo son mantenidos tras un periodo de 6M sin supervisión

Effects of the cessation of an aerobic exercise program with nutritional intervention in adults with primary hypertension, overweight/obesity and physically inactive: EXERDIET-HTA study

176 p.Esta tesis doctoral la componen distintos estudios que se centran en la relación de la capacidad cardiorespiratoria (CCR) con el perfil bioquímico y en los efectos del cese de una intervención de 16 semana con ejercicio físico (EF) aeróbico supervisado y dieta hipocalórica, 6 meses (6M) después de la misma, en participantes con hipertensión arterial primaria (HTA), sobrepeso u obesidad y físicamente inactivas. Por ello, los objetivos principales de este trabajo fueron: 1) establecer ,en esta población, las asociaciones entre la CCR y el perfil bioquímico; 2) determinar si las mejoras obtenidas después de una intervención de 16 semanas con dieta hipocalórica y EF aeróbico supervisado en CCR, presión arterial (PA) y composición corporal son mantenidas tras un periodo de 6M sin supervisión; y 3) determinar las diferencias en el perfil metabólico después de una intervención de 16 semanas con dieta hipocalórica y EF aeróbico supervisado y analizar si los cambios observados tras ese periodo son mantenidos tras un periodo de 6M sin supervisión

Actigraphy-based sleep analysis in sedentary and overweight/obese adults with primary hypertension: data from the EXERDIET-HTA study

Purpose: The aim of this study was to analyze actigraphy-based sleep quantity and quality in sedentary and overweight/obese adults with primary hypertension (HTN) divided by sex and cardiorespiratory fitness (CRF) and to assess the association of sleep parameters with body composition, blood pressure (BP), and CRF. Methods: This is a cross-sectional design utilizing data from the EXERDIET-HTA study conducted in 154 non-physically, obese adults with HTN (53.3 ± 7.8 years). Sleep parameters (total bedtime; total sleep time, TST; and sleep efficiency = (TST/total bedtime) × 100)) were calculated from raw accelerometer data (ActiGraph GT3X+). Peak oxygen uptake (V̇O2peak) determined the CRF. Blood pressure was assessed with the 24-h ambulatory BP monitoring. The distributions of V̇O2peak were divided into tertiles (low, medium, and high CRF) in each sex. Series of linear regression analyses were conducted between sleep, fitness, and health-related variables. Results: Short sleep duration (6.2 h) both on weekdays and weekends, poor sleep quality (< 85% of efficiency), and no significant differences in sleep variables between women and men, nor among CRF groups, were observed. The short sleeping pattern was negatively associated (P < 0.05) with mean and night systolic BP (mmHg, β = - 0.2), and sleep efficiency with waist circumference (cm, β = - 0.08, P = 0.05). Conclusions: Actigraphy-based sleep analysis reinforces that sleep disorders, such as short sleep duration and poor sleep quality, are associated with high BP and abdominal obesity in sedentary adults with overweight/obesity and HTN. Sleep pattern did not appear to be related with CRF level in this population.The University of the Basque Country (EHU14/08, PPGA18/15) supported this study and The Basque Government to AMAB, PC and IGAwith predoctoral grants

Effects of different aerobic exercise programmes with nutritional intervention in sedentary adults with overweight/obesity and hypertension: EXERDIET-HTA study

Background Both exercise training and diet are recommended to prevent and control hypertension and overweight/obesity. Purpose The purpose of this study was to determine the effectiveness of different 16-week aerobic exercise programmes with hypocaloric diet on blood pressure, body composition, cardiorespiratory fitness and pharmacological treatment. Methods Overweight/obese, sedentary participants ( n = 175, aged 54.0 ± 8.2 years) with hypertension were randomly assigned into an attention control group (physical activity recommendations) or one of three supervised exercise groups (2 days/week: high-volume with 45 minutes of moderate-intensity continuous training (MICT), high-volume and high-intensity interval training (HIIT), alternating high and moderate intensities, and low-volume HIIT (20 minutes)). All variables were assessed pre- and post-intervention. All participants received the same hypocaloric diet. Results Following the intervention, there was a significant reduction in blood pressure and body mass in all groups with no between-group differences for blood pressure. However, body mass was significantly less reduced in the attention control group compared with all exercise groups (attention control -6.6%, high-volume MICT -8.3%, high-volume HIIT -9.7%, low-volume HIIT -6.9%). HIIT groups had significantly higher cardiorespiratory fitness than high-volume MICT, but there were no significant between-HIIT differences (attention control 16.4%, high-volume MICT 23.6%, high-volume HIIT 36.7%, low-volume HIIT 30.5%). Medication was removed in 7.6% and reduced in 37.7% of the participants. Conclusions The combination of hypocaloric diet with supervised aerobic exercise 2 days/week offers an optimal non-pharmacological tool in the management of blood pressure, cardiorespiratory fitness and body composition in overweight/obese and sedentary individuals with hypertension. High-volume HIIT seems to be better for reducing body mass compared with low-volume HIIT. The exercise-induced improvement in cardiorespiratory fitness is intensity dependent with low-volume HIIT as a time-efficient method in this population.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: this study was supported by the University of the Basque Country (GIU14/21 and EHU14/08). The Basque government with predoctoral grants supported IGA, PC and AMAB. BH Fitness Company has supported the study with the donation of treadmills and bikes as equipment to conduct the exercise intervention

Multidisciplinary Prehabilitation and Postoperative Rehabilitation for Avoiding Complications in Patients Undergoing Resection of Colon Cancer: Rationale, Design, and Methodology of the ONCOFIT Study

ONCOFIT is a randomized clinical trial with a two-arm parallel design aimed at determining the influence of a multidisciplinary Prehabilitation and Postoperative Program (PPP) on post-surgery complications in patients undergoing resection of colon cancer. This intervention will include supervised physical exercise, dietary behavior change, and psychological support comparing its influence to the standard care. Primary and secondary endpoints will be assessed at baseline, at preoperative conditions, at the end of the PPP intervention (after 12 weeks) and 1-year post-surgery, and will include: post-surgery complications (primary endpoint); prolonged hospital length of stay; readmissions and emergency department call within 1-year after surgery; functional capacity; patient reported outcome measures targeted; anthropometry and body composition; clinical/tumor parameters; physical activity levels and sedentariness; dietary habits; other unhealthy habits; sleep quality; and fecal microbiota diversity and composition. Considering the feasibility of the present intervention in a real-life scenario, ONCOFIT will contribute to the standardization of a cost-effective strategy for preventing and improving health-related consequences in patients undergoing resection of colon cancer with an important clinical and economic impact, not only in the scientific community, but also in clinical practice.This study was funded by the University of Granada, Plan Propio de Investigación 2016-Excellence actions: Unit of Excellence on Exercise and Health (UCEES). P.C. was supported by the Margarita Salas postdoctoral grant, convened by de University of the Basque Country (UPV/EHU), funded by the Ministry of Universities of Spain and the European Union-Next Generation EU

Contemporary use of cefazolin for MSSA infective endocarditis: analysis of a national prospective cohort

Objectives: This study aimed to assess the real use of cefazolin for methicillin-susceptible Staphylococcus aureus (MSSA) infective endocarditis (IE) in the Spanish National Endocarditis Database (GAMES) and to compare it with antistaphylococcal penicillin (ASP). Methods: Prospective cohort study with retrospective analysis of a cohort of MSSA IE treated with cloxacillin and/or cefazolin. Outcomes assessed were relapse; intra-hospital, overall, and endocarditis-related mortality; and adverse events. Risk of renal toxicity with each treatment was evaluated separately. Results: We included 631 IE episodes caused by MSSA treated with cloxacillin and/or cefazolin. Antibiotic treatment was cloxacillin, cefazolin, or both in 537 (85%), 57 (9%), and 37 (6%) episodes, respectively. Patients treated with cefazolin had significantly higher rates of comorbidities (median Charlson Index 7, P <0.01) and previous renal failure (57.9%, P <0.01). Patients treated with cloxacillin presented higher rates of septic shock (25%, P = 0.033) and new-onset or worsening renal failure (47.3%, P = 0.024) with significantly higher rates of in-hospital mortality (38.5%, P = 0.017). One-year IE-related mortality and rate of relapses were similar between treatment groups. None of the treatments were identified as risk or protective factors. Conclusion: Our results suggest that cefazolin is a valuable option for the treatment of MSSA IE, without differences in 1-year mortality or relapses compared with cloxacillin, and might be considered equally effective