Heart of Hypertension Project: Development of a Community-Based Prevention Program for Young African American Men

Background: Early-onset hypertension (HTN) is a major contributor to shortened life expectancy of African American men. Lifestyle changes are known to reduce blood pressure (BP); however, interventions tailored for young African American men have not been developed.Objectives: With a community partner, we developed and assessed a HTN education and lifestyle intervention for young African American men.Methods: A preliminary plan was presented to experts and to 18- to 22-year-old African American men, and revised based on their feedback. The revised plan (health screening and 6-week intervention) was tested with the focal group.Lessons Learned: Participants were enthusiastic about the program and suggested improvements included increasing individualized guidance, building on relationships, and defining the Heart of Hypertension community.Conclusions: The Heart of Hypertension Project holds promise for HTN prevention among young African American men. The next steps are to incorporate feedback from participants into the approach and evaluate the effectiveness of the intervention on lifestyle change and BP in young African American men with pre-HTN

Accuracy of Calendar-Based Methods for Assigning Menstrual Cycle Phase in Women

Background: Sex steroid hormone fluctuations during the menstrual cycle are considered a risk factor for noncontact anterior cruciate ligament injuries.Objective: To determine whether self-reported menstrual history data can be used to accurately categorize menstrual cycle events using calendar-based counting methods.Study Design: Descriptive laboratory study.Methods: Seventy-three women completed a menstrual history questionnaire and submitted to blood sampling for the first 6 days of menses and 8 to 10 days after a positive ovulation test over 2 consecutive months. Frequency counts determined whether appropriate criterion hormone (progesterone) levels were achieved at predefined calendar days.Results: For the criterion of progesterone >2 ng/mL, 18% and 59% of women attained it when counting forward 10 to 14 days after the onset of menses and counting back 12 to 14 days from the end of the cycle, respectively. Most women (76%) attained the criterion for ovulation 1 to 3 days after a positive urinary ovulation test. Regardless of the counting method employed, the criterion of progesterone >4.5 ng/mL for identifying midluteal phase was attained in 67% of cases. Serial blood sampling for 3 to 5 days after the positive urinary ovulation test captured 68% to 81% of the hormone values indicative of ovulation and 58% to 75% indicative of the luteal phase.Conclusion: These data suggest that self-reported menstrual history and calendar-based counting methods should not be used alone if accurate identification of ovulation is essential. A urinary ovulation test and serial blood samples for verification of progesterone postovulation enhance the proper identification of menstrual cycle events.Clinical Relevance: Given the cost of serial blood sampling on numerous days, the use of urinary ovulation kits and strategically selected serial blood sampling could significantly reduce participant burden and provide cost-effective measures for clinical studies related to anterior cruciate ligament injury epidemiology

Changes in serum collagen markers, IGF-I, and Knee joint laxity across the menstrual cycle

Variations in serum markers of collagen production (CICP) and degradation (ICTP), insulin-like growth factor I (IGF-I) and anterior knee laxity (AKL) were measured in 20 women [10 with spontaneous cycles (eumenorrheic), 10 using oral contraceptives] over 5 consecutive days at menses (M1–M5, 1st pill week), the initial estrogen rise near ovulation (O1–O5, 2nd pill week), the initial progesterone rise of the early luteal phase (EL1–EL5, 3rd pill week) and post-progesterone peak of the late luteal phase (LL1–LL5, 4th pill week). ICTP was higher in oral contraceptive women (5.3±1.7 vs. 3.7±1.3µg/L; p=0.030), primarily during days near ovulation and the early luteal phase when concentrations decreased in eumenorrheic women (p=0.04). IGF-I concentrations increased during menses then decreased and remained lower during the early and late luteal phase in oral contraceptive women, resulting in lower concentrations compared to eumenorrheic women at EL2 and LL1 (p=0.03). CICP decreased in early and late luteal days (p<0.01), and there was a trend toward lower concentrations in eumenorrheic versus oral contraceptive women (85.7±35.7ng/ml vs. 123.2±49.8ng/ml; p=0.07). Lower CICP and greater IGF-I concentrations predicted greater AKL across the 20 cycle days in both groups (R2=0.310 and 0.400). Sex hormone concentration changes across the menstrual cycle are of sufficient magnitude to influence collagen metabolism, and may indirectly influence knee structure and function

Some Sex Hormone Profiles are Consistent over Time in Normal Menstruating Women: Implications for Sports Injury Epidemiology

Purpose-It is unclear whether sex hormone profiles obtained in two consecutive months are consistent within women. Month-to-month consistency in daily, nadir, peak and mean hormone concentrations during the early follicular and luteal phases in recreationally active, young eumenorrheic women was prospectively examined. Methods-60 healthy, non-smoking women who reported normal and consistent menstrual cycles lasting 26–32 days for the past 6 months were followed prospectively to obtain serum samples for the first 6 days of menses and for 8 days after a positive ovulation test over two consecutive months. Month-to-month consistency of daily concentrations of oestradiol (pg/ml), progesterone (ng/ml), testosterone (ng/dl), sex hormone-binding globulin (nmol/l) and free androgen index were determined using linear mixed models. Month-to-month consistency in nadir, peak and mean concentrations were then assessed using intraclass correlation coefficients and SEM to more precisely examine intraindividual consistency. Results-Linear mixed models revealed stable hormone concentrations across cycles and cycles by day. Reliability estimates for nadir, peak, mean menses and mean postovulatory concentrations range from 0.56 to 0.86 for oestradiol, 0.44 to 0.91 for progesterone, 0.60 to 0.86 for testosterone, 0.88 to 0.97 for sex hormone-binding globulin and 0.78 to 0.91 for free androgen index. Conclusions-Hormone profiles were reproducible over two consecutive months. To reduce month-to-month intraindividual variations and improve measurement consistency, it is recommended that multiple samples be taken over consecutive days as opposed to a single sample

Influence of Lean Body Mass and Strength on Landing Energetics

Purpose: Less lean body mass may limit one’s ability to produce adequate muscle forces to safely control landing from a jump, thus increasing the risk for injury. The primary objective of this study was to determine the effect of lower extremity lean mass (LELM) and eccentric muscle strength on lower extremity energy absorption (EA) during a drop jump landing.Methods: Seventy athletic subjects (35 men and 35 women) were measured for LELM with dual-energy x-ray absorptiometry, maximal eccentric strength of the quadriceps (QuadECC) and hamstrings (HamECC), and lower extremity joint energetics during the initial landing of a drop jump. A mediation analysis examined the extent to which LELM predicted EA at each lower extremity joint (EAHIP, EAKNEE, and EAANK) and subsequently whether these relationships were mediated by each subject’s maximal eccentric strength capabilities.Results: LELM was a significant predictor of EAKNEE (R2 = 0.22, P < 0.01) in females but not in males (R2 = 0.03, P = 0.16). In females, QuadECC was a significant mediator of the effect of LELM on EA at the knee (ab = 179.72, 95% confidence interval [CI] = 10.43–423.42) and ankle (ab = 1.71, 95% CI = [0.16, 3.94]), whereas HamECC was a significant mediator of the relationship between LELM and EAHIP (ab = 4.89, 95% CI = 2.05–8.40). No significant relationships were observed in males.Conclusions: LELM was a significant factor in energetic capabilities for females but not males. For females, this relationship was evident secondary to the stronger underlying relationship between maximal strength and EA. Thus, the maximal eccentric strength capabilities may be a more important determinant of energetic behaviors compared with the available quantity of lean mass alone. More work is needed to investigate these relationships and to reveal the underlying sex-specific mechanisms that determine EA capabilities

Collagen Gene Variants Previously Associated With Anterior Cruciate Ligament Injury Risk Are Also Associated With Joint Laxity

Background: Genetic association studies demonstrate a relationship between several collagen gene variants and anterior cruciate ligament (ACL) injury, yet the mechanism of these relationships is still unclear. Joint laxity is a heritable trait; increased magnitudes of anterior knee laxity (AKL), genu recurvatum (GR), and general joint laxity (GJL) have been consistently associated with a greater risk of ACL injury. Joint laxity may constitute an important intermediate phenotype for the genetic association with ACL injury that can be measured clinically.Hypothesis: To determine if genetic variants within the COL1A1, COL5A1, and COL12A1 genes, previously associated with ACL injury, were also associated with greater magnitudes of AKL, GR, and GJL.Study Design: Descriptive laboratory study.Methods: Blood samples and measures of AKL, GR, and GJL were obtained from 124 (50 male, 74 female) healthy, recreationally active subjects. Genomic DNA was extracted from the blood samples and genotyped for single-nucleotide polymorphisms previously examined relative to ACL injury. Univariate analyses of variance compared the magnitude of each laxity variable across the 3 genotypes for each single-nucleotide polymorphism in both sex-combined and sex-specific models.Results: Specific genotypes were associated with greater GR in all subjects. Some genotypes were associated with greater magnitudes of GR, AKL, and GJL in females only.Conclusions: Gene variants previously associated with ACL injury risk were in large part also associated with joint laxity. Sex-specific genetic associations with joint laxity were consistent with those previously reported for ACL injury.Clinical Relevance: These data provide insight into potential pathways through which genotypic variants in collagen genes have the potential to alter ligament structure and behavior and, thus, ACL injury risk

The Relationship Between Physical Activity and Perceived Health Status in Older Women: Findings from the Woman’s College Alumni Study

Using data collected from the Woman’s College (WC) Alumni Study, the purpose of this study was to determine whether perceived health status is related to physical activity in older women. A multiple linear regression analysis was conducted to examine the relationship between amounts of physical activity and self-reported health status. The results of the current study reveal that the level of physical activity is significantly correlated with perceived health status. The findings of this study have implications for the assessment of older individuals’ health and may lead to interventions that are tailored to increase physical activity among older women

Effects of an Individualized Soccer Match Simulation on Vertical Stiffness and Impedance

An observed relationship between soccer match duration and injury has led to research examining the changes in lower extremity mechanics and performance with fatiguing exercise. Because many fatigue protocols are designed to result in substantial muscular deficits, they may not reflect the fatigue associated with sport-specific demands that have been associated with the increasing incidence of injury as the match progresses. Thus, the aim of this study was to systematically analyze the progressive changes in lower extremity mechanics and performance during an individualized exercise protocol designed to simulate a 90-minute soccer match. Previous match analysis data were used to systematically develop a simulated soccer match exercise protocol that was individualized to the participant's fitness level. Twenty-four National Collegiate Athletic Association Division I soccer players (12 men, 12 women) participated in 2 testing sessions. In the first session, the participants completed the Yo-Yo Intermittent Recovery Test Level 1 to assess their fitness level and determine the 5 submaximal running intensities for their soccer match simulation. In the second test session, progressive changes in the rating of perceived exertion (RPE), lower extremity performance (vertical jump height, sprint speed, and cutting speed), and movement mechanics (jumping vertical stiffness and terminal landing impedance) were measured during the soccer match simulation. The average match simulation running distance was 10,165 ± 1,001 m, consistent with soccer match analysis research. Time-related increases in RPE, and decrements in sprinting, and cutting speed were observed, suggesting that fatigue increased as the simulation progressed. However, there were no time-related decreases in vertical jump height, changes in lower extremity vertical stiffness in jumping, or vertical impedance during landing. Secondary analyses indicated that the coordinative changes responsible for the maintenance of stiffness and impedance differed between the dominant and nondominant limbs. Despite an increase in RPE to near exhaustive levels, and decrements in sprint and cutting performance, the participants were able to maintain jump performance and movement mechanics. Interestingly, the coordinative changes that allowed for the maintenance of vertical stiffness and impedance varied between limbs. Thus, suggesting that unilateral training for performance and injury prevention in soccer-specific populations should be considered

The development and initial validation of the Health and Reproductive Survey (HeRS).

Due to the diversity in profiles associated with the female reproductive cycle and their potential physiological and psychological effects, monitoring the reproductive status of exercising females is important from a practical and research perspective. Moreover, as physical activity can influence menstrual function, the effects of physical activity energy expenditure on reproductive function should also be considered. The aim of this study was to develop and establish initial face and content validity of the Health and Reproductive Survey (HeRS) for physically active females, which is a retrospective assessment of menstrual function from menarche (first menstruation) to menopause (cessation of menstruation). Face validity was evaluated qualitatively, and the initial content validity was established through a principal component analysis. The face validity process was completed by 26 females aged 19-67 years and the content validity was established through a survey sent to a convenience sample of 392 females, of which 230 females (57.9% and aged 18-49 years) completed the survey. The revisions made following the face validation improved the understanding, flow, and coherence of the survey. The principal component analysis indicated that, at a minimum, the survey measures these constructs: menstrual cessation and associated moderators, athletic participation and performance levels (as associated with menstruation change and the menstrual cycle), age and menstrual cessation, hormonal contraception ("birth control"), and menarche and associated moderators. The Health and Reproductive Survey (HeRS) is a partially validated tool that can be used by researchers to characterize the menstrual status of physically active females relative to their physical activity status

Menstrual cycle phase does not predict political conservatism

Recent authors have reported a relationship between women's fertility status, as indexed by menstrual cycle phase, and conservatism in moral, social and political values. We conducted a survey to test for the existence of a relationship between menstrual cycle day and conservatism. 2213 women reporting regular menstrual cycles provided data about their political views. Of these women, 2208 provided information about their cycle date, 1260 provided additional evidence of reliability in self-reported cycle date, and of these, 750 also indicated an absence of hormonal disruptors such as recent hormonal contraception use, breastfeeding or pregnancy. Cycle day was used to estimate day-specific fertility rate (probability of conception); political conservatism was measured via direct self-report and via responses to the "Moral Foundations” questionnaire. We also recorded relationship status, which has been reported to interact with menstrual cycle phase in determining political preferences. We found no evidence of a relationship between estimated cyclical fertility changes and conservatism, and no evidence of an interaction between relationship status and cyclical fertility in determining political attitudes. Our findings were robust to multiple inclusion/exclusion criteria and to different methods of estimating fertility and measuring conservatism. In summary, the relationship between cycle-linked reproductive parameters and conservatism may be weaker or less reliable than previously thought