Awareness and education about cardiovascular events and sport are essential Results of a French multicenter survey [Sensibilisation et éducation concernant les accidents cardio-vasculaires à l'effort sont indispensables résultats d'une enquête française multi-centrique]

International audienceAims Cardiovascular events occurring during physical activity are becoming a public health problem. Besides medical exams screening for cardiac abnormalities, better prevention could make such accidents less frequent. This study assessed the lack of awareness of cardiovascular risk factors and behaviors in the general sporting population. Methods A survey was conducted by questionnaire in 3590 regular sports practitioners in 6 sport medicine centers. Results Among the 3590 practitioners, mean age was 30.7 ± 16 years, 71% were men, 9.5% were smokers, 5.5% had hypercholesterolemia, 4.4% had high blood pressure and 0.9% were diabetics. In subjects 40 years old, only 54% had undergone a pre-participation exercise test. Among the entire sample, 17% were not aware of the danger of smoking before and just after exercising, and 67%, 47% and 32% did not know the risks of training with fever, exercising in low or high temperature, respectively. The risks of doping, lack of warm-up or proper hydration were unknown to 22%, 2% and 3%, respectively. Finally, the need to report palpitation, dizziness and chest pain related to exercise was unknown to 18%, 7% and 11%, respectively. Recreational athletes had a higher correct response rate than competitive ones, especially those training < 9 h/week. Conclusion The lack of awareness about cardiovascular events remains significant among sports practitioners. Better education about such risks seems necessary to reduce the rate of accidents in the future. © 2018 Elsevier Masson SA

The ambulatory hypotensive effect of aerobic training: a reappraisal through a meta-analysis of selected moderators

International audienceThe effectiveness of regular exercise in decreasing both systolic and diastolic blood pressure (BP) is well-established. Our purpose was to assess the impact of both subject and physical activity program characteristics on ambulatory BP through a meta-analysis of the existing literature. Three databases (PubMed, Embase, Web of Science) were searched using relevant terms and strategies. From 637 identified records, 37 studies met inclusion criteria: details about training intervention and participant characteristics, pre- and post-training ambulatory BP measurements, at home (HBPM) or during 24-h (ABPM). The weighted mean difference was for 24-h systolic/diastolic ABPM (n = 847 participants): -4.06/-2.77 mmHg (95%CI: -5.19 to -2.93/-3.58 to -1.97; P < 0.001), for daytime (ABPM or HBPM, n = 983): -3.78/-2.73 mmHg (95%CI: -5.09 to -2.47/-3.57 to -1.89; P < 0.001) and nighttime ABPM periods (n = 796): -2.35/-1.70 mmHg (95%CI: -3.26 to -1.44/-2.45 to -0.95; P < 0.001). Characteristics significantly influencing BP improvement were: an initial office BP ≥130/85 mmHg and diet-induced weight-loss. We found no differences according to sex, age, or training characteristics (intensity, number of sessions, training duration). Antihypertensive effects of aerobic training assessed by ambulatory BP measurements appear significant and clinically relevant for both daytime and nighttime periods, in particular for participants with an office BP ≥130/85 mmHg

Ambulatory blood pressure reduction following 2 weeks of high-intensity interval training on an immersed ergocycle.

Hypertension guidelines recommend moderate-intensity continuous training (MICT) for the primary or secondary prevention of hypertension. However, alternative modalities, such as high-intensity interval training (HIIT) on dry land or in water, have been studied less widely. To assess chronic blood pressure (BP) response to a 2-week training programme involving six sessions of either MICT or HIIT performed on dry land or HIIT performed in an immersed condition, in participants with baseline office systolic/diastolic BP (SBP/DBP)≥130/85mmHg. We randomly assigned 42 individuals (mean age 65±7 years; 52% men) with baseline office SBP/DBP≥130/85mmHg to perform six 24-minute sessions on an ergocycle (three times a week for 2 weeks) of either MICT on dry land, HIIT on dry land or HIIT in a swimming pool, and assessed BP responses using 24-hour ambulatory BP monitoring. While 2-week MICT and HIIT on dry land modified none of the 24-hour average haemodynamic variables significantly, immersed HIIT induced a significant decrease in 24-hour BP (SBP -5.1±7.3 [P=0.02]; DBP -2.9±4.1mmHg [P=0.02]) and daytime BP (SBP -6.2±8.3 [P=0.015]; DBP -3.4±4.0mmHg [P=0.008]), and slightly improved 24-hour and daytime pulse wave velocity (PWV) (24-hour PWV -0.17±0.23m/s [P=0.015]; daytime PWV -0.18±0.24m/s [P=0.02]). HIIT on an immersed stationary ergocycle is an innovative method that should be considered as an efficient non-pharmacological treatment of hypertension. As such, it should now be implemented in a larger cohort to study its long-term effects on the cardiovascular system