Hypertension

Essential hypertension is the chronic elevation in blood pressure of unknown origin, which is prevalent in 15-25% of the adult population and estimated to cause 4.5% of current global disease burden. The fundamental question of whether psychosocial stress (including subacute and chronic stressors and chronic psychological states such as depression) causes hypertension has been investigated using observational studies, natural experiments, and laboratory studies to show whether acute stress modifies disease relevant biological processes. There is consistent evidence for an association between psychosocial factors and hypertension, and biologically plausible mechanisms have been established. Acute and enduring stressors directly impact on blood pressure control. However, one intriguing question that remains partly unanswered is why a similar level of stress exposure might lead to the development of sustained hypertension in some individuals but not in others. In summary, lifestyle approaches that encompass stress reduction and health behaviour promotion should therefore be considered in the treatment of hypertension and identifying those at high risk

Psychosocial stress and cardiovascular disease risk: the role of physical activity

Chronic stress and depression are associated with increased risk of cardiovascular disease and poorer prognosis, and physical (in)activity may be a key underlying biobehavioral mechanism. Physical activity has antidepressant effects and physically fitter, more active individuals appear to be more biologically resilient to psychosocial stressors. This paper will present data from a series of population cohort studies and laboratory based psychophysiological studies to explore the role of physical activity as a protective factor against the effects of psychosocial stress on cardiovascular disease. These mechanisms may improve treatment and prevention of stress-related illnesses, and thus has important implications for public health and clinical care of high-risk patients

The association between leisure-time physical activity and lung function in older adults: The English longitudinal study of ageing

The longitudinal association between physical activity and lung function is unclear. Therefore, we examined said association over eight years. This study included data from 2,966 participants in English Longitudinal Study of Ageing (63±7 years [mean±SD]), a prospective study of initially healthy, community dwelling adults. Physical activity was assessed using an interview and lung function using a spirometer at baseline (2004-5) and follow-up (2012-13). General linear regression was used to assess associations between activity and lung function. Logistic regression was used to assess the odds of new cases of abnormal lung function. Some 14% of participants were defined as physically inactive at baseline, 50% were classified into the moderate group, and 36% into the vigorous group. In comparison with remaining inactive at follow-up, remaining active was positively associated with forced vital capacity (FVC) (β=0.09, 95% confidence interval [CI]: 0.01, 0.17; p=0.02) and forced expiratory volume in one second (FEV-1) (β=0.09, 95% CI: 0.02, 0.15; p=0.01) after adjustment for baseline lung function score and other covariates. Using the fifth centile to define the lower limit of normal (that is, -1.64 z scores), there were lower odds of incident abnormal lung function in participants who remained physically active compared to those who remained inactive (FVC odds ratio=0.31, 95% CI: 0.17, 0.55. FEV-1 odds ratio=0.43, 95% CI: 0.26, 0.72). Similar associations were observed in those who became active. This study suggests that remaining physically active or becoming active in older age are positively associated with lung function and reduced odds of abnormal lung function

Sarcopenic obesity, weight loss, and mortality: The English Longitudinal Study of Ageing

Background: Age-related sarcopenia describes loss of muscle strength and often accompanies an increase in adiposity in elderly participants. Objectives: We examined the association of sarcopenic obesity, and changes in muscle strength and weight with risk of mortality. Design: Participants were 6,864 community dwelling men and women (mean±SD age 66.2 ± 6 9.5 years, 45.6% men) from the English Longitudinal Study of Ageing. Handgrip strength and body mass index were measured at baseline and at four years follow-up. Individual participant data were linked with death records from National Health Service registries. Sarcopenic obesity was defined as obese individuals (body mass index [BMI] ≥ 30 kg/m2) in the lowest tertile of sex specific grip strength (<35.3 kg men; < 19.6kg women). Results: Over an average follow up of 8 years there were 906 deaths. Compared with the reference group (normal BMI and highest hand grip tertile), the risk of all-cause mortality increased with reducing grip strength within each BMI category. For participants in the lowest hand grip tertile there was little difference in risk between normal BMI (Hazard ratio=3.25; 95% CI, 1.86, 5.65), overweight (2.50;1.44, 4.35), and obese (2.66; 1.86, 3.80), after adjustment for covariates. Compared to participants with stable weight and grip strength, risk of all-cause mortality was significantly greater in those experiencing weight loss over 4 years (2.21;1.32, 3.71) and reduced hand grip strength (1.53;1.07, 2.17), with the highest risk in those with weight loss and reduced strength (3.77; 2.54, 5.60). Conclusion: Sarcopenic obesity did not confer any greater risk than sarcopenia alone. Weight loss in combination with sarcopenia presented the greatest risk of mortality

Are interventions to promote physical activity in children a waste of time?

Are interventions to promote physical activity in children a waste of time

Screen-based sedentary behavior, physical activity, and muscle strength in the English longitudinal study of ageing

Background: Sarcopenia is associated with loss of independence and ill-health in the elderly although the causes remain poorly understood. We examined the association between two screen-based leisure time sedentary activities (daily TV viewing time and internet use) and muscle strength. Methods and Results: We studied 6228 men and women (aged 64.969.1 yrs) from wave 4 (2008-09) of the English Longitudinal Study of Ageing, a prospective study of community dwelling older adults. Muscle strength was assessed by a hand grip test and the time required to complete five chair rises. TV viewing and internet usage were inversely associated with one another. Participants viewing TV $6hrs/d had lower grip strength (Men, B =21.20 kg, 95% CI, 22.26, 20.14; Women, 20.75 kg, 95% CI, 21.48, 20.03) in comparison to ,2hrs/d TV, after adjustment for age, physical activity, smoking, alcohol, chronic disease, disability, depressive symptoms, social status, and body mass index. In contrast, internet use was associated with higher grip strength (Men, B = 2.43 kg, 95% CI, 1.74, 3.12; Women, 0.76 kg, 95% CI, 0.32, 1.20). These associations persisted after mutual adjustment for both types of sedentary behaviour. Conclusions: In older adults, the association between sedentary activities and physical function is context specific (TV viewing vs. computer use). Adverse effects of TV viewing might reflect the prolonged sedentary nature of this behavior

U-shaped association between body mass index and psychological distress in a population sample of 114,218 British adults

U-shaped association between body mass index and psychological distress in a population sample of 114,218 British adult

Television viewing time and risk of incident diabetes mellitus: the English Longitudinal Study of Ageing

Aim To investigate the longitudinal association between television viewing time and risk of incident diabetes mellitus in an elderly sample of adults in England. Methods Analyses of data from the English Longitudinal Study of Ageing. At baseline (2008), participants reported their television viewing time and physical activity level. Diabetes mellitus was recorded from self-reported physician diagnosis at 2-year follow-up. Associations between television viewing time and combined television viewing time and physical activity level with risk of incident diabetes mellitus at follow-up were examined using adjusted logistic regression models. Results A total of 5964 participants (mean ± sd age 65 ± 9 years at baseline, 44% male) were included in the analyses. There was an association between baseline television viewing time and risk of incident diabetes mellitus at 2-year follow-up (≥ 6 h/day compared with <2 h/day; odds ratio 4.27, 95% CI 1.69, 10.77), although the association was attenuated to the null in final adjusted models that included BMI. Participants who were inactive/had high television viewing time at baseline were almost twice as likely to have diabetes mellitus at 2-year follow-up than those who were active/had low television viewing time (fully adjusted odds ratio 1.94, 95% CI 1.02, 3.68), although active participants reporting high television viewing were not at risk. Conclusion Interventions to reduce the incidence of diabetes in the elderly that focus on both increasing physical activity and reducing television viewing time might prove useful

Relative proportion of vigorous physical activity, total volume of moderate to vigorous activity, and body mass index in youth: the Millennium Cohort Study

The present physical activity guidelines suggest that when the overall activity energy expenditure is held constant, moderate and vigorous intensity activities (MVPA) provide equivalent health benefits. We explored associations between vigorous physical activity on body mass index whilst controlling for volume of MVPA. In a longitudinal study with 7 years follow up (n=4,770; aged 7 yrs old at baseline), physical activity was measured objectively at baseline. Body mass index (BMI) was measured at baseline and follow up. Vigorous activity was expressed as the percentage of total MVPA. Participants in the highest vigorous activity tertile at baseline were at lower odds (odds ratio=0.70; 95% CI, 0.55, 0.88) of overweight /obesity at follow up compared with those in the lowest vigorous activity tertile after adjustment for total volume of MVPA, BMI at baseline, sex, ethnicity, and social status. The results suggest vigorous activity, regardless of volume, is important in preventing excessive weight gain in young people

Reply to Wang: chronic disease and handgrip strength

Reply to Wang: chronic disease and handgrip strengt