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The effect of grape (Vitis vinifera) seed extract supplementation on flow-mediated dilation, blood pressure, and heart rate: A systematic review and meta-analysis of controlled trials with duration- and dose-response analysis.
Foshati, S, Nouripour, F, Sadeghi, E, Amani, R
Pharmacological research. 2022;:105905
Abstract
The objective of this systematic review and meta-analysis of controlled trials was to assess the long-term effect of grape seed extract (GSE) supplementation on flow-mediated dilation (FMD), systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) in adults. Web of Science, Scopus, Medline, Cochrane Library, and Google Scholar were searched up to May 24, 2021. Nineteen trials were included in this study. Weighted mean difference (WMD) and 95% confidence interval (CI) were calculated using a random-effects model. GSE supplementation significantly reduced DBP (WMD: -2.20 mmHg, 95% CI: -3.79 to -0.60, I2 = 88.8%) and HR (WMD: -1.25 bpm, 95% CI: -2.32 to -0.19, I2 = 59.5%) but had no significant effects on FMD (WMD: 1.02%, 95% CI: -0.62 to 2.66, I2 = 92.0%) and SBP (WMD: -3.55 mmHg, 95% CI: -7.59 to 0.49, I2 = 97.4%). Subgroup analysis revealed that the dose and duration of GSE administration and the characteristics of study participants could be sources of between-study heterogeneity. Significant non-linear relationships were found between DBP and the duration of GSE supplementation (P = 0.044) and its dose (P = 0.007). In conclusion, GSE may be beneficial for individuals with or at risk of cardiovascular disease because it may have hypotensive and HR-lowering properties.
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The effect of high Intensity interval training versus moderate intensity continuous training on arterial stiffness and 24h blood pressure responses: A systematic review and meta-analysis.
Way, KL, Sultana, RN, Sabag, A, Baker, MK, Johnson, NA
Journal of science and medicine in sport. 2019;(4):385-391
Abstract
OBJECTIVES Greater arterial stiffness and poor 24h blood pressure (BP) are recognized as indicators of poor cardiovascular health. Evidence has shown that high intensity interval training (HIIT) may be a superior alternative to moderate intensity continuous training (MICT) for improving cardiovascular disease risk factors such as cardiorespiratory fitness and vascular function. However, there are limited data comparing the effect of HIIT to MICT on central arterial stiffness and/or 24h BP response. The purpose of this study was to compare HIIT versus MICT on central arterial stiffness and 24h BP outcomes by systematic review and meta-analysis. DESIGN A systematic review and meta-analysis was conducted. METHODS Eligible studies were exercise training interventions (≥4weeks) that included both HIIT and MICT and reported central arterial stiffness, as measured by pulse wave velocity and augmentation index and/or 24h BP outcome measures. RESULTS HIIT was found to be superior to MICT for reducing night-time diastolic BP (ES: -0.456, 95% CI: -0.826 to -0.086mmHg; P=0.016). A near-significant greater reduction in daytime systolic (ES: -0.349, 95% CI: -0.740 to 0.041mmHg; p=0.079) and diastolic BP was observed with HIIT compared to MICT (ES: -0.349, 95% CI: -0.717 to 0.020mmHg; p=0.063). No significant difference was found for other BP responses or arterial stiffness outcomes. CONCLUSIONS HIIT leads to a superior reduction in night-time diastolic BP compared to MICT. Furthermore, a near-significant greater reduction in daytime BP was found with HIIT compared to MICT. No significant difference was observed for changes to central arterial stiffness between HIIT and MICT.
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3.
Monitoring Athletic Training Status Through Autonomic Heart Rate Regulation: A Systematic Review and Meta-Analysis.
Bellenger, CR, Fuller, JT, Thomson, RL, Davison, K, Robertson, EY, Buckley, JD
Sports medicine (Auckland, N.Z.). 2016;(10):1461-86
Abstract
BACKGROUND Autonomic regulation of heart rate (HR) as an indicator of the body's ability to adapt to an exercise stimulus has been evaluated in many studies through HR variability (HRV) and post-exercise HR recovery (HRR). Recently, HR acceleration has also been investigated. OBJECTIVE The aim of this systematic literature review and meta-analysis was to evaluate the effect of negative adaptations to endurance training (i.e., a period of overreaching leading to attenuated performance) and positive adaptations (i.e., training leading to improved performance) on autonomic HR regulation in endurance-trained athletes. METHODS We searched Ovid MEDLINE, Embase, CINAHL, SPORTDiscus, PubMed, and Academic Search Premier databases from inception until April 2015. Included articles examined the effects of endurance training leading to increased or decreased exercise performance on four measures of autonomic HR regulation: resting and post-exercise HRV [vagal-related indices of the root-mean-square difference of successive normal R-R intervals (RMSSD), high frequency power (HFP) and the standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) only], and post-exercise HRR and HR acceleration. RESULTS Of the 5377 records retrieved, 27 studies were included in the systematic review and 24 studies were included in the meta-analysis. Studies inducing increases in performance showed small increases in resting RMSSD [standardised mean difference (SMD) = 0.58; P < 0.001], HFP (SMD = 0.55; P < 0.001) and SD1 (SMD = 0.23; P = 0.16), and moderate increases in post-exercise RMSSD (SMD = 0.60; P < 0.001), HFP (SMD = 0.90; P < 0.04), SD1 (SMD = 1.20; P = 0.04), and post-exercise HRR (SMD = 0.63; P = 0.002). A large increase in HR acceleration (SMD = 1.34) was found in the single study assessing this parameter. Studies inducing decreases in performance showed a small increase in resting RMSSD (SMD = 0.26; P = 0.01), but trivial changes in resting HFP (SMD = 0.04; P = 0.77) and SD1 (SMD = 0.04; P = 0.82). Post-exercise RMSSD (SMD = 0.64; P = 0.04) and HFP (SMD = 0.49; P = 0.18) were increased, as was HRR (SMD = 0.46; P < 0.001), while HR acceleration was decreased (SMD = -0.48; P < 0.001). CONCLUSIONS Increases in vagal-related indices of resting and post-exercise HRV, post-exercise HRR, and HR acceleration are evident when positive adaptation to training has occurred, allowing for increases in performance. However, increases in post-exercise HRV and HRR also occur in response to overreaching, demonstrating that additional measures of training tolerance may be required to determine whether training-induced changes in these parameters are related to positive or negative adaptations. Resting HRV is largely unaffected by overreaching, although this may be the result of methodological issues that warrant further investigation. HR acceleration appears to decrease in response to overreaching training, and thus may be a potential indicator of training-induced fatigue.
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Impact of Acute Energy Drink Consumption on Blood Pressure Parameters: A Meta-analysis.
Shah, SA, Chu, BW, Lacey, CS, Riddock, IC, Lee, M, Dargush, AE
The Annals of pharmacotherapy. 2016;(10):808-15
Abstract
OBJECTIVE Hospitalizations associated with energy drinks have increased in the past decade. Whereas energy drinks are suspected to cause hemodynamic effects, the magnitude of risk remains controversial. We evaluated the effects of acute energy drink consumption on systolic and diastolic blood pressure (SBP and DBP) and heart rate (HR). DATA SOURCES A search in PubMed, Cumulative Index of Nursing and Allied Health Literature, and Cochrane database through December 31, 2015, was performed. STUDY SELECTION AND DATA EXTRACTION Prospective clinical studies assessing the effects of commercially available energy drinks on BP and HR were included. A weighted mean change from baseline was calculated using the DerSimonian and Laird random-effects model for all end points. DATA SYNTHESIS In all, 15 studies were included, encompassing a total of 340, 322, and 340 individuals for SBP, DBP, and HR, respectively. SBP and DBP increased significantly by 4.44 mm Hg (95% CI = 2.71 to 6.17; Cochrane Q P = 0.001) and 2.73 mm Hg (95% CI = 1.52 to 3.95; Cochrane Q P = 0.050), respectively. HR changed nonsignificantly by 0.80 beats per minute (95% CI = -1.26 to 2.87; Cochrane Q P < 0.001). The largest change in SBP was seen with drinks administering ≥200 mg of caffeine (6.44 mm Hg, 95% CI = 4.62 to 8.27). CONCLUSIONS Our results indicate that acute consumption of caffeinated energy drinks significantly raises SBP and DBP. Further investigation of the ingredients in energy drinks and the impact of chronic energy drink consumption is warranted.
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Resting heart rate and risk of incident heart failure: three prospective cohort studies and a systematic meta-analysis.
Khan, H, Kunutsor, S, Kalogeropoulos, AP, Georgiopoulou, VV, Newman, AB, Harris, TB, Bibbins-Domingo, K, Kauhanen, J, Gheorghiade, M, Fonarow, GC, et al
Journal of the American Heart Association. 2015;(1):e001364
Abstract
BACKGROUND The relationship between resting heart rate (RHR) and incident heart failure (HF) has been questioned. METHODS AND RESULTS RHR was assessed at baseline in 7073 participants in 3 prospective cohorts (Cardiovascular Health Study, Health ABC study and Kuopio Ischemic Heart Disease Study) that recorded 1189 incident HF outcomes during 92 702 person-years of follow-up. Mean age of participants was 67 (9.9) years and mean RHR was 64.6 (11.1) bpm. Baseline RHR correlated (P<0.001) positively with body mass index (r=0.10), fasting glucose (r=0.18), and C-reactive protein (r=0.20); and inversely with serum creatinine (r=-0.05) and albumin (r=-0.05). Baseline RHR was non-linearly associated with HF risk. The age and sex-adjusted hazard ratio for HF comparing the top (>72 bpm) versus the bottom (<57 bpm) quartile of baseline RHR was 1.48 (95% confidence interval [CI] 1.26 to 1.74) and was modestly attenuated (1.30, 95% CI 1.10 to 1.53) with further adjustment for body mass index, history of diabetes, hypertension, smoking status, serum creatinine, and left ventricular hypertrophy. These findings remained consistent in analyses accounting for incident coronary heart disease, excluding individuals with prior cardiovascular events, or those taking beta-blockers; and in subgroups defined by several individual participant characteristics. In a pooled random effects meta-analysis of 7 population-based studies (43 051 participants and 3476 HF events), the overall hazard ratio comparing top versus bottom fourth of RHR was 1.40 (95% CI: 1.19 to 1.64). CONCLUSIONS There is a non-linear association between RHR and incident HF. Further research is needed to understand the physiologic foundations of this association.
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Losmapimod concentration-QT relationship in healthy volunteers: meta-analysis of data from six clinical trials.
Yang, S, Beerahee, M
European journal of clinical pharmacology. 2013;(6):1261-7
Abstract
PURPOSE The objective of this work was to describe the losmapimod concentration-QT relationship using meta-analysis of data from clinical trials with healthy volunteers and to evaluate the covariates that have significant impact on the QT prolongation. METHODS Losmapimod plasma concentration and QT interval data were collected from six early clinical studies with healthy volunteers. The electrocardiograms (ECGs) were collected at baseline and at a number of post-dose time points (losmapimod or placebo). The population pharmacokinetic/pharmacodynamic (PK/PD) modelling approach was applied to investigate the relationship between losmapimod concentration and QT prolongation. RESULTS The dataset for analysis comprised 190 healthy adults who took at least one dose of losmapimod or placebo. Of the 2,494 QT observations collected, 1,532 observations had matched QT and losmapimod plasma concentration data. Population PK/PD analyses indicated that the model with the individual heart rate correction factor (α) fitted the data better than those using fixed α (0.33 for Fridericia's correction or 0.5 for Bazett's correction) and that there was no relationship between losmapimod concentration and QT interval. Female volunteers had about a 3 % higher QT interval at baseline than the male volunteers. No other covariates had a significant effect on the QT interval. CONCLUSIONS It is appropriate to apply population PK/PD analysis to investigate the effect of drug concentration on QT prolongation. Our meta-analysis of healthy volunteer data indicated no relationship between systemic losmapimod concentration and QT interval in healthy volunteers.