Cardiovascular Disease Risk Factor Modification: HBP, Exercise, Smoking

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Cardiovascular Disease Risk Factor
ModificationHBP, Exercise, Smoking

• Some Professioal and Personal Reflections
• John E. Martin
• SDSU/UCSD Research Seminar

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CV Risk FactorsTHE BIG 3

• SMOKING
• HIGH BLOOD PRESSURE
• HYPERCHOLESTEROLEMIA

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MINOR RISK FACTORSTHE LITTLE 7

• PHYSICAL INACTIVITY
• DIABETES
• OBESITY
• ALCOHOL
• STRESS/TYPE A - CPBP
• BIOLOGICAL FACTORS GENDER GENES

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DIET FACTORS
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HYPERTENSION

• HIGH BLOOD PRESSURE DIASTOLIC (gt89 MM
  HG.) SYSTOLIC (gt139 MM HG.)
• EFFECT ON BLOOD VESSELS
• HEMODYNAMICS
• DIET AND... (NA, FAT, ALCH)
• STRESS AND...
• EXERCISE AND...

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HIGH BLOOD PRESSURE

• PATHOPHYSIOLOGY
• SYMPATHETIC AROUSAL
• RENAL CONTROL MECHANISMS
• METABOLIC AUTOREGULATION
• KIDNEY DISEASE AND...
• EXERCISE AND ...
• DIET AND ...

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HBP TREATMENT

• PHARMACOLOGICAL
• PSYCHOLOGICAL
• BEHAVIORAL/LIFE STYLE CHANGE

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Exercise and HBP

• Single Subject Analysis
• Miss. Ind. Data
• (Behavior Therapy, 1985)

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HELPS Hypertension Exercise Lifestyle Program
for Seniors

• San Diego
• John E. Martin, Ph.D. Susan Caparosa,
  M.S.,
• Larry Verity, Ph.D. Diane Beach, M.P.H
• Steven Van Camp, M.D. Heidi Squier, M.A
• Donald Slymen, Ph.D. Eugenia Bastos, M.P.H.
• Christi A. Patten, M.A

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HELPS Hypertension Exercise Lifestyle Program
for Seniors

• South African Replication
• Rand Afrikaans University
• Edward Wolff, Ph.D.
• Raksha Lutschmann, M.A.
• Sinette Heys, M.A.

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SUBJECTSSAN DIEGO HELPS

• AMERICAN SUBJECTS (SO.CALIFORNIA)
• AGE 65-85 YRS
• N77
• 45 FEMALES, 32 MALES
• 87 CAUCASIAN, 5 HISPANIC, 3 BLACK
• HYPERTENSIVE
• MEDICATED

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Cross-Cultural Evaluation of Exercise Effects on
Elder Hypertensives
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South African Replication
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SUBJECTSJOHANNESBURG/SA-HELPS

• 63-87 YRS. OLD
• BLACK COLORED SOUTH AFRICANS
• N58
• 10 MALES, 48 FEMALES
• HYPERTENSIVE
• MEDICATED

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S.A. HELPS RESULTS
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FINDINGS / IMPLICATIONS

• Exercise Associated with BP Reductions in Older
  Hypertensives, Independent of Meds or Other
  Lifestyle Changes.
• Cross-Cultural Ethnic Replication of BP
  Lowering Effect.
• Intensity of Exercise Unimportant to BP
  Reduction.
• No Apparent Dose-Response Effect for BP.
  (Possible Threshold Effect?)
• Larger Reductions in BP for Africans.
• Encouraging ST and LT Exercise Adherence.