Therapeutic effect of a moderate intensity interval training program on the lipid profile in men with hypertension: A randomized controlled trial

Objective: Physical inactivity has been established as a major primary risk factor for the development of hypertension. Also, factors such as elevated total cholesterol (TC) and reduced high density lipoprotein cholesterol (HDL) have been implicated as risk factors for coronary events in hypertension. The purpose of the present study was to investigate the effect of interval training program on blood pressure and lipid profile of subjects with hypertension. Materials and Methods: A total of 245 male patients with mild‑to‑moderate hypertension (systolic blood pressure [SBP] between 140 and 180 mmHg and diastolic blood pressure [DBP] between 90 and 109 mmHg) were age matched and grouped into interval and control groups. The interval (n=140; 58.90 ± 7.35 years) group was involved in an 8‑week interval training (60–79% HR max reserve) program of between 45 minutes and 60 minutes at a work/rest ratio of 1:1 of 6 minutes each, while the control hypertensive (n=105; 58.27 ± 6.24 years) group remained sedentary during this period. Cardiovascular parameters (SBP and DBP), VO2 max, TC, HDL, and artrogenic index (AI) were assessed. Student’s t‑test and Pearson correlation test were used in data analysis. Results: Findings of the study revealed significant decreased effects of the interval training program on SBP, DBP, TC AI, and significant increased effects on VO2 max and HDL level at P<0.05. There was also a significant correlation between changes VO2 max and changes in AI. Conclusions: It was concluded that the interval training program is an effective adjunct nonpharmacological management of hypertension and a means of upregulation of HDL.Keywords: Blood pressure, hypertension, interval exercise, lipid profileNigerian Journal of Clinical Practice •Jan-Mar 2012 • Vol 15 • Issue

Effect of low intensity continuous training programme on serum uric acid in the non pharmacological management of hypertension: a randomized controlled trial

Elevated serum uric acid (SUA) is considered to be positively associated with cardiovascular event risk factor in hypertension. Also, the positive role of exercise in the management of Hypertension has been well and long established. However the relationship between SUA level and hypertensive management particularly in non pharmacological technique is ambiguous and unclear. Therefore the purpose of the present study was to determine the effect of continuous low intensity training programme on SUA level and cardiovascular parameters in male subjects with hypertension. Twohundred and seventeen male patients with mild to moderate (systolic blood pressure [SBP] between 140-180 & diastolic blood pressure [DBP] between 90-109 mmHg) essential hypertension were age matched and grouped into continuous and control groups. The continuous (n=112; 58.63 ± 7.22years) group involved in an 8 weeks interval training (35-9% HR max reserve) programme of between 45minutes to 60 minutes, while agematched controls hypertensive (n=105; 58.27± 6.24 years) group remain sedentary during this period. Cardiovascular parameters (SBP, DBP & VO2max) and SUA were assessed. Students't and Pearson correlation tests were used in data analysis. Findings of the study revealed significant effect of interval training programme on VO2 max, SBP, and DBP and SUA concentration at p< 0.05 and changes in VO2max negatively correlated with SUA (r= -.266) at

Effect of aerobic exercise training on maternal weight gain in pregnancy: A meta-analysis of randomized controlled trials

BACKGROUND: Weight gains in pregnancy within the recommended guidelines are associated with healthy fetal and maternal outcomes; higher weight gains are associated with fetal macrosomia. This study was a systemic review of randomized controlled trials on the effect of aerobic training on maternal weight in pregnancy.METHODS: The study data source was publications through May 2012 in the MEDLINE (PubMed) database. The citation lists of randomized controlled trials on the effect of aerobic training and maternal weight were extracted. Data on participants’ characteristics, study quality, population, intervention, treatment outcome (maternal weight gain) were collected and analyzed.RESULTS: There were 11 randomized controlled studies using body weight (kg) as measure of treatment outcome. A total of 1177 subjects were recruited in the 11 studies. The mean± SD weight gain (kg) for the exercise (11.31± 7.44kg) and control (14.42± 6.60kg) groups; Meta-analysis result indicated significant effect of aerobic training on maternal weight (t= -7.580, p= .000) at p&lt; 0.05.CONCLUSION: It was concluded that aerobic training is an effective tool in maternal weight gain control in pregnancy. More randomized controlled trials are warranted.KEYWORDS: Aerobic exercise, Pregnancy, Maternal weight, Meta-analysi

Influence of Menstrual Cycle on Maximal Aerobic Power of Young Female Adults

The purpose of this study was to determine the exercise response to various stages of the menstrual cycle in young female African adults. Fifteen volunteer, sedentary young female adults with a regular 28-day menstrual cycle and no history of premenstrual syndrome or abnormality participated in this study. A repeated measure and three counter balanced cross over order design was used in data collection. The subjects engaged in a 20-metre shuttle run test (20-MST) at the 3rd (early follicular phase), 14th (ovulation) and 26th (late luteal phase) days of their menstrual 2 cycle. Maximal aerobic endurance performance indexes (VO2 max, run time & number of exercise laps) were recorded. One way ANOVA with repeated measures was used in data analysis. 2 The result revealed no significant differences in the short maximum endurance performance (VO2 max) [F=.554, p=0.581], run laps [F=.483, p=0.622], and run time [F=.554, p=0.581]) recorded in the various phases of the menstrual cycle at

Effect of neuro-developmental therapy (NDT) on disability level of subjects with cerebral palsy receiving physiotherapy at the University of Nigeria Teaching Hospital, Enugu, Nigeria

Aim and Objective: Cerebral palsy (CP) describes a group of disorders causing activity limitation which is attributed to non-progressive disturbances that occur in the developing fetal or infant brain. The rehabilitation of children with CP has focused on increasing functionality in their daily activities. The objective of this study was to assess the disability levels of cerebral palsy patients receiving physiotherapy treatment at Physiotherapy department, University of Nigeria Teaching Hospital, Enugu, Nigeria.Methods: The study is a retrospective-repeated measures design, involving the use of Gross Motor Function Classification System (GMFCS) and the medical records of the patients. The duration and frequency of treatment were obtained from the patients’ folders. They were initially assessed on the first visit and re-assessed after 3, 6 and ≥ 12 months of physiotherapy (Neuro-developmental therapy [NDT]) exercises using GMFCS. Simple percentage (%), Kruskal Wallis and Mann-Whitney tests were used in data analyses.Results: The highest number of disability recovery cases are in the treatment frequency group of &gt; 2 treatment per week 17(56.68%) and the first 3-6 months of treatment duration15 (50%) of NDTPhysiotherapy. However, Disability level reduces with longer (&gt;12 months) treatment duration. Results also showed significant frequency and duration treatment effects on disability level following NDT-Physiotherapy at p&lt; 0.05.Conclusion: It was concluded that both duration and frequent of treatment were important factors in the management of CP using NDTPhysiotherapy.Key words: Cerebral palsy, Disability, Gross Motor Function, Neuro-developmental therapy

Effect of aerobic exercise training on cardiovascular parameters and CD4 cell count of people living with Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome: A randomized controlled trial

Objective: Despite the significant positive effect of Highly Active  Antiretroviral Therapy on physical and psychosocial well.being of people living with human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) (PLWHA); decreased physical activity and its associated cardiovascular risk still pose some consequences for health and general well.being. This study investigated the effect of an 8 week aerobic exercise training on cardiovascular parameters and CD4 cell (T.cells) count of PLWHA.Materials and Methods: This randomized controlled trial recruited 30 age matched PLWHA who were randomly assigned into exercise group (EG) (n = 15) and control group (CG) (n = 15) respectively. The PLWHA were patients receiving treatment in Presidentfs Emergency Plan for AIDS relief at the HIV clinic of the University of Nigeria Teaching Hospital, Nigeria. The EG in addition to conventional therapy received moderate intensity continuous exercise training (60.79% of the maximum heart rate [max]) of between 45 and 60 min, 3 times/week for 8 weeks, while the CG received conventional therapy involving antiretroviral therapy and counseling only. Systolic blood pressure (SBP), diastolic blood pressure (DBP), maximum oxygen uptake (VO2 max) and CD4 cell count were assessed at baseline (week 1) and week 8 respectively. Analysis of co.variance and Pearson correlation tests were used in data analysis.Results: Findings of the study revealed a significant effect (ANCOVA test) of moderate intensity continuous exercise training program on, SBP, DBP, VO2 max and CD4 cell count at P &lt; 0.05. Changes in VO2 max significantlycorrelated (Pearson correlation test) with changes in CD4 cell count (r = 0.528) at P &lt; 0.05.Conclusion: Moderate intensity aerobic exercise is an effective  complementary therapy in lowering blood pressure and increasing CD4 cell count in PLWHA.Key words: Aerobic exercise, cardiovascular parameters, CD4 count, human immunodeficiency virus/acquired immune deficiency syndrome, Nigeri

Evaluating the Causal Relation of ApoA-IV with Disease-Related Traits - A Bidirectional Two-sample Mendelian Randomization Study

Apolipoprotein A-IV (apoA-IV) has been observed to be associated with lipids, kidney function, adiposity- and diabetes-related parameters. To assess the causal relationship of apoA-IV with these phenotypes, we conducted bidirectional Mendelian randomization (MR) analyses using publicly available summary-level datasets from GWAS consortia on apoA-IV concentrations (n = 13,813), kidney function (estimated glomerular filtration rate (eGFR), n = 133,413), lipid traits (HDL cholesterol, LDL cholesterol, triglycerides, n = 188,577), adiposity-related traits (body-mass-index (n = 322,206), waist-hip-ratio (n = 210,088)) and fasting glucose (n = 133,010). Main analyses consisted in inverse-variance weighted and multivariable MR, whereas MR-Egger regression and weighted median estimation were used as sensitivity analyses. We found that eGFR is likely to be causal on apoA-IV concentrations (53 SNPs; causal effect estimate per 1-SD increase in eGFR = −0.39; 95% CI = [−0.54, −0.24]; p-value = 2.4e-07). Triglyceride concentrations were also causally associated with apoA-IV concentrations (40 SNPs; causal effect estimate per 1-SD increase in triglycerides = −0.06; 95% CI = [−0.08, −0.04]; p-value = 4.8e-07), independently of HDL-C and LDL-C concentrations (causal effect estimate from multivariable MR = −0.06; 95% CI = [−0.10, −0.02]; p-value = 0.0014). Evaluating the inverse direction of causality revealed a possible causal association of apoA-IV on HDL-cholesterol (2 SNPs; causal effect estimate per one percent increase in apoA-IV = −0.40; 95% CI = [−0.60, −0.21]; p-value = 5.5e-05).</p

Digging into the extremes: a useful approach for the analysis of rare variants with continuous traits?

The common disease/rare variant hypothesis predicts that rare variants with large effects will have a strong impact on corresponding phenotypes. Therefore it is assumed that rare functional variants are enriched in the extremes of the phenotype distribution. In this analysis of the Genetic Analysis Workshop 17 data set, my aim is to detect genes with rare variants that are associated with quantitative traits using two general approaches: analyzing the association with the complete distribution of values by means of linear regression and using statistical tests based on the tails of the distribution (bottom 10% of values versus top 10%). Three methods are used for this extreme phenotype approach: Fisher’s exact test, weighted-sum method, and beta method. Rare variants were collapsed on the gene level. Linear regression including all values provided the highest power to detect rare variants. Of the three methods used in the extreme phenotype approach, the beta method performed best. Furthermore, the sample size was enriched in this approach by adding additional samples with extreme phenotype values. Doubling the sample size using this approach, which corresponds to only 40% of sample size of the original continuous trait, yielded a comparable or even higher power than linear regression. If samples are selected primarily for sequencing, enriching the analysis by gathering a greater proportion of individuals with extreme values in the phenotype of interest rather than in the general population leads to a higher power to detect rare variants compared to analyzing a population-based sample with equivalent sample size

Lipoprotein(a) plasma levels are not associated with incident microvascular complications in type 2 diabetes mellitus

Aims/hypothesis: Microvascular disease in type 2 diabetes is a significant cause of end-stage renal disease, blindness and peripheral neuropathy. The strict control of known risk factors, e.g. lifestyle, hyperglycaemia, hypertension and dyslipidaemia, reduces the incidence of microvascular complications, but a residual risk remains. Lipoprotein (a) [Lp(a)] is a strong risk factor for macrovascular disease in the general population. We hypothesised that plasma Lp(a) levels and the LPA gene SNPs rs10455872 and rs3798220 are associated with the incident development of microvascular complications in type 2 diabetes. Methods: Analyses were performed of data from the DiaGene study, a prospective study for complications of type 2 diabetes, collected in the city of Eindhoven, the Netherlands (n = 1886 individuals with type 2 diabetes, mean follow-up time = 6.97 years). To assess the relationship between plasma Lp(a) levels and the LPA SNPs with each newly developed microvascular complication (retinopathy n = 223, nephropathy n = 246, neuropathy n = 236), Cox proportional hazards models were applied and adjusted for risk factors for microvascular complications (age, sex, mean arterial pressure, non-HDL-cholesterol, HDL-cholesterol, BMI, duration of type 2 diabetes, HbA1c and smoking). Results: No significant associations of Lp(a) plasma levels and the LPA SNPs rs10455872 and rs3798220 with prevalent or incident microvascular complications in type 2 diabetes were found. In line with previous observations the LPA SNPs rs10455872 and rs3798220 did influence the plasma Lp(a) levels. Conclusions/interpretation: Our data show no association between Lp(a) plasma levels and the LPA SNPs with known effect on Lp(a) plasma levels with the development of microvascular complications in type 2 diabetes. This indicates that Lp(a) does not play a major role in the development of microvascular complications. However, larger studies are needed to exclude minimal effects of Lp(a) on the development of microvascular complications

A genome-wide association meta-analysis on lipoprotein (a) concentrations adjusted for apolipoprotein (a) isoforms.

High lipoprotein (a) [Lp(a)] concentrations are an independent risk factor for cardiovascular outcomes. Concentrations are strongly influenced by apo(a) kringle IV repeat isoforms. We aimed to identify genetic loci associated with Lp(a) concentrations using data from five genome-wide association studies (n = 13,781). We identified 48 independent SNPs in the &lt;i&gt;LPA&lt;/i&gt; and 1 SNP in the &lt;i&gt;APOE&lt;/i&gt; gene region to be significantly associated with Lp(a) concentrations. We also adjusted for apo(a) isoforms to identify loci affecting Lp(a) levels independently from them, which resulted in 31 SNPs (30 in the &lt;i&gt;LPA&lt;/i&gt; , 1 in the &lt;i&gt;APOE&lt;/i&gt; gene region). Seven SNPs showed a genome-wide significant association with coronary artery disease (CAD) risk. A rare SNP (rs186696265; MAF ∼1%) showed the highest effect on Lp(a) and was also associated with increased risk of CAD (odds ratio = 1.73, &lt;i&gt;P&lt;/i&gt; = 3.35 × 10 &lt;sup&gt;-30&lt;/sup&gt; ). Median Lp(a) values increased from 2.1 to 91.1 mg/dl with increasing number of Lp(a)-increasing alleles. We found the &lt;i&gt;APOE2&lt;/i&gt; -determining allele of rs7412 to be significantly associated with Lp(a) concentrations ( &lt;i&gt;P&lt;/i&gt; = 3.47 × 10 &lt;sup&gt;-10&lt;/sup&gt; ). Each &lt;i&gt;APOE2&lt;/i&gt; allele decreased Lp(a) by 3.34 mg/dl corresponding to ∼15% of the population's mean values. Performing a gene-based test of association, including suspected Lp(a) receptors and regulators, resulted in one significant association of the &lt;i&gt;TLR2&lt;/i&gt; gene with Lp(a) ( &lt;i&gt;P&lt;/i&gt; = 3.4 × 10 &lt;sup&gt;-4&lt;/sup&gt; ). In summary, we identified a large number of independent SNPs in the &lt;i&gt;LPA&lt;/i&gt; gene region, as well as the &lt;i&gt;APOE2&lt;/i&gt; allele, to be significantly associated with Lp(a) concentrations