CHOICE

VISIT YOUR DOCTOR REGULARLY

Reference Riedl, David, and Gerhard Schüßler. “The Influence of Doctor-Patient Communication on Health Outcomes: A Systematic Review.” Zeitschrift für Psychosomatische Medizin und Psychotherapie 63, no. 2 (2017): 131-150.

Research Summary Researchers from the Medical University of Innsbruck, Austria systematically reviewed 17 controlled studies and eight qualitative studies on the influence of the doctor-patient relationship and communication on health outcomes, retrieved by a search of the medical literature from 2000-2015. The statistical analysis showed that building a doctor-patient relationship had a positive effect on gathering health information, and patient education in 60% of the studies. Communication skills showed improved results and enabled treatment-related emotions and behavior. Although more studies will be necessary, this systematic review revealed different domains of the doctor-patient relationship and communication positively influenced by different objectives (e.g. blood pressure) and subjective (e.g. pain scores) health outcomes.

MONITOR YOUR BLOOD PRESSURE AT HOME

Reference Tucker, Katherine L., James P. Sheppard, Richard Stevens, Hayden B. Bosworth, Alfred Bove, Emma P. Bray, Kenneth Earle et al. “Self-monitoring of blood pressure in hypertension: A systematic review and individual patient data meta-analysis.” PLoS Medicine 14, no. 9 (2017): e1002389.

Research Summary Researchers from educational institutions in the United Kingdom, Australia, Spain, Finland, Canada, and the United States completed a meta-analysis to better understand the effectiveness of blood pressure self-monitoring to lower BP and control hypertension. A search for randomized studies comparing self-monitoring to no self-monitoring in hypertensive patients (June 2016) was conducted of 2,846 articles and 36 met the eligible criteria. The results showed that self-monitoring was associated with reduced clinic systolic blood pressure compared to only checking BP during physician visits at the 12-month follow-up. The best results were seen when self-monitoring was combined with care from doctors, pharmacists, patient education, and lifestyle counseling.

CHOOSE TO STOP

Reference Ishizaka, Nobukazu, Yuko Ishizaka, Ei-Ichi Toda, Hideki Hashimoto, Ryozo Nagai, and Minoru Yamakado. “Association between cigarette smoking, metabolic syndrome, and carotid arteriosclerosis in Japanese individuals.” Atherosclerosis 181, no. 2 (2005): 381-388.

Research Summary Researchers from University of Tokyo Graduate School of Medicine, Japan investigated the prevalence of metabolic syndrome (MetS), defined as having three or more cardiovascular risk factors, including hypertension, in cigarette smokers, former smokers, and people who never smoked. Data was analyzed from 5,033 participants, between the ages of 35-65 years who had undergone a general health screening. The results revealed that both former and current smoking was associated with an increased incidence of metabolic syndrome. In both former and current smokers, the prevalence of MetS increased when the duration of cigarette smoking was greater than 10 years. The association to the risk of MetS, in former smokers, was partially reversed after five years of smoking cessation. In addition, individuals without MetS, former and current smoking was still found to be associated with build-up of plaque in the arteries.

KEEP AN EYE ON YOUR WAISTLINE

Reference Midha, Tanu, Vinay Krishna, Bhola Nath, Ranjeeta Kumari, Yashwant Kumar Rao, Umeshwar Pandey, and Samarjeet Kaur. “Cut-off of body mass index and waist circumference to predict hypertension in Indian adults.” World Journal of Clinical Cases: WJCC 2, no. 7 (2014): 272.

Research Summary Researchers from Government Medical College, India conducted a study to determine the cut-off values of body mass index (BMI) and waist circumference to predict hypertension in 801 adults in north India, aged 20 and above. The participants completed a validated questionnaire and waistline and blood pressure measurements were taken. The results showed that the cut-off values of BMI for predicting hypertension were identified as ≥ 24.5 kg/m² in men and ≥ 24.9 kg/m² in women. Similarly, the analysis for waist circumference showed that it is a good predictor of hypertension estimated as greater than 32.6 inches for men and greater than 30.7 inches for women. Adults with high BMI or high waist circumference had a higher prevalence of hypertension.

Reference Rhéaume, Caroline, Benoit J. Arsenault, Stéphane Bélanger, Louis Pérusse, Angelo Tremblay, Claude Bouchard, Paul Poirier, and Jean-Pierre Després. “Low cardiorespiratory fitness levels and elevated blood pressure.” Hypertension 54, no. 1 (2009): 91-97.

Research Summary Researchers examined how the relationship between low fitness and elevated blood pressure could be related to body fat often found among unfit individuals. Body fat was assessed by computed tomography, and fitness was measured by a physical working capacity test. Results showed that participants in with the highest body fat percentage showed the highest systolic and diastolic blood pressures, regardless of whether they had an excellent of poor fitness level.

UNDERSTAND YOUR NUMBERS

Reference Burt, Vicki L., Jeffrey A. Cutler, Millicent Higgins, Michael J. Horan, Darwin Labarthe, Paul Whelton, Clarice Brown, and Edward J. Roccella. “Trends in the prevalence, awareness, treatment, and control of hypertension in the adult US population: data from the health examination surveys, 1960 to 1991.” Hypertension 26, no. 1 (1995): 60-69.

Research Summary Researchers conducted a study to examine the blood pressure numbers that determined hypertension. The study design comprised nationally representative surveys with both an in-person interview and a medical examination that included blood pressure measurement. Between 6,530 and 13,645 adults, aged 18 through 74 years, were examined in each of four separate national surveys. Results showed the protocols for blood pressure measurements varied significantly from 1971-1991 surveys. During this time the interval threshold for defining hypertension was changed from 160/95 to 140/90 mmHg. In addition, hypertension awareness, treatment, and control also have improved tremendously during the same period, accounting for much of the shift at the upper end of the distribution.

REST

GO AHEAD AND SNOOZE

Reference Buxton, Orfeu M., and Enrico Marcelli. “Short and long sleep are positively associated with obesity, diabetes, hypertension, and cardiovascular disease among adults in the United States.” Social science & medicine 71, no. 5 (2010): 1027-1036.

Research Summary Researchers from Harvard Medical School, Division of Sleep Medicine, United States explored the relationship between short sleep (less than 7 hours) and long sleep (greater than 8 hours) and the risk of obesity, diabetes, hypertension, and cardiovascular disease; by analyzing 2004–2005 U.S. National Health Interview Survey data of 56,507 adults ages 18–85. Statistical analysis showed that more than 76% of adults on each of the outcomes studied, and sleep duration was frequently more strongly associated with these health risks. These findings suggest that a 7–8 hour sleep duration directly and indirectly reduces chronic disease risk.

RELAX WITH MUSIC

Reference Wang, Chun-Fang, Ying-Li Sun, and Hong-Xin Zang. “Music therapy improves sleep quality in acute and chronic sleep disorders: A meta-analysis of 10 randomized studies.” International journal of nursing studies 51, no. 1 (2014): 51-62.

Research Summary Researchers from the Department of Cardiovascular Surgery, Center for Cardiovascular Disease, Pingjin Hospital, Logistics University of Chinese People’s Armed Police Forces, China completed a systematic review and meta-analysis on the effectiveness of music therapy for acute and chronic sleep disorders in adults. Ten studies involving 557 participants were identified. The results showed that sleep quality was improved significantly by music. The authors concluded that music can assist in improving sleep quality of patients with acute and chronic sleep disorders.

SEE YOUR DOCTOR

Reference Bathgate, Christina J., Jack D. Edinger, James K. Wyatt, and Andrew D. Krystal. “Objective but not subjective short sleep duration associated with increased risk for hypertension in individuals with insomnia.” Sleep 39, no. 5 (2016): 1037-1045.

Research Summary Researchers investigated the relationship between hypertension prevalence in individuals with insomnia who have short total sleep duration of less than six hours or sleep duration greater than six hours. At total of 255 adults participated in this study at two large university medical centers. Two nights of polysomnography, to weeks of sleep diaries, questionnaires focused on sleep, medical, psychological, and health history were collected. The results showed that individuals with insomnia and short sleep duration less than six hours were associated with a three and a half times increased risk of hypertension compared to individuals sleeping more than six hours per night. 

Reference Mokhlesi, Babak, Laurel A. Finn, Erika W. Hagen, Terry Young, Khin Mae Hla, Eve Van Cauter, and Paul E. Peppard. “Obstructive sleep apnea during REM sleep and hypertension. Results of the Wisconsin Sleep Cohort.” American journal of respiratory and critical care medicine 190, no. 10 (2014): 1158-1167.

Research Summary Researchers from Sleep, Metabolism and Health Center, Department of Medicine examined the link between sleep apnea (difficulty breathing during sleep) with the risk of hypertension. A total of 1,451 adults were enrolled from the long-term community-based Wisconsin Sleep Cohort Study. Sonograms were taken in the laboratory during periods of at least 30 minutes of deep sleep. In addition, walking blood pressure was assessed at baseline. Assessments were repeated at four-year intervals. Long-term analysis revealed a significant association between sleep apnea interrupting deep sleep and the development of hypertension.

DEVELOP GOOD SLEEP HABITS

Reference Drake, Christopher, Timothy Roehrs, John Shambroom, and Thomas Roth. “Caffeine effects on sleep taken 0, 3, or 6 hours before going to bed.” Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 9, no. 11 (2013): 1195.

Research Summary Researchers from Wayne State College of Medicine, United States compared the potential sleep disruptive effects of a 400-mg dose of caffeine administered at 0, 3, and 6 hours prior to habitual bedtime relative to a placebo on self-reported sleep in the home. Sleep disturbance was also monitored objectively using a validated portable sleep monitor. The results demonstrated a moderate dose of caffeine at bedtime, three hours prior to bedtime, or six hours prior to bedtime each have significant effects on sleep disturbance relative to placebo group, which provides empirical support for sleep hygiene recommendations to refrain from substantial caffeine use for a minimum of six hours prior to bedtime.

Reference Bano, Milena, Federica Chiaromanni, Michela Corrias, Matteo Turco, Michele De Rui, Piero Amodio, Carlo Merkel et al. “The influence of environmental factors on sleep quality in hospitalized medical patients.” Frontiers in neurology 5 (2014).

Research Summary University of Padova, Italy and University of Fribourg, Switzerland assessed the sleep quality in 119 inpatients, in relation to environment factors, and the switch to daylight-saving time. Between March and April 2013, 118 consecutive inpatients were screened. They slept in double or quadruple rooms, facing South/South-East, and were qualified as sleeping near/far from the window. They underwent daily sleep assessment by standard questionnaires. The degree of light was measured at each patient’s eye-level, four times per day. Noise was measured at the same times each day. Information was recorded on room lighting, position of the rolling shutters and number/type of extra people in the room. The results showed a significant association between sleep quality and bed position to window light exposure. Noise levels were higher than recommended for care units but substantially comparable across times/room types, with 33% of the patients reporting one or more sleepless nights due to noise levels.

BREATHE

Reference Westman, Mina, and Dalia Etzion. “The impact of vacation and job stress on burnout and absenteeism.” Psychology & Health 16, no. 5 (2001): 595-606.

Research Summary Researchers from a Tel Aviv University, Israel examined the impact of job stress and vacation on emotional strain on 87 employees in an industrial enterprise in central Israel. The employees completed questionnaires before and after vacation and again four weeks later. The findings show that vacation alleviated perceived job stress and bum out as predicted, replicating findings that a respite from work diminishes levels of strain to lower than chronic, on-the-job levels.

Reference Hunter, Emily M., and Cindy Wu. “Give me a better break: Choosing workday break activities to maximize resource recovery.” Journal of Applied Psychology 101, no. 2 (2016): 302.

Research Summary Researchers from Baylor University, United States examined the association between workday break characteristics and well-being, in 95 employees, observed over five workdays. Results indicated that activities that were chosen by the employee, and earlier in the work shift related to more recovery following the break. In addition, break length interacted with the number of breaks per day such that longer breaks and frequent short breaks were associated with more recovery than infrequent short breaks.

Reference Kühnel, Jana, Hannes Zacher, Jessica De Bloom, and Ronald Bledow. “Take a break! Benefits of sleep and short breaks for daily work engagement.” European Journal of Work and Organizational Psychology 26, no. 4 (2017): 481-491.

Research Summary Multi-institutional researchers from Finland, Germany, and Singapore investigated the benefits of a good night’s sleep and short work breaks for employees’ daily work engagement. It was hypothesized that sleep and self-initiated short breaks help restore energy which, in turn, enable employees to experience high work engagement. A daily diary study was conducted with 107 employees who provided data twice a day (before lunch and at the end of the working day) over five workdays (453 days in total). Statistical analysis showed that sleep quality and short breaks were beneficial for employees’ daily work engagement. After nights when employees slept better, they indicated higher work engagement during the day. Moreover, taking self-initiated short breaks from work in the afternoon boosted daily work engagement.

ENVIRONMENT

WATCH OUT FOR AIR POLLUTION

Reference Babisch, Wolfgang, Kathrin Wolf, Markus Petz, Joachim Heinrich, Josef Cyrys, and Annette Peters. “Associations between traffic noise, particulate air pollution, hypertension, and isolated systolic hypertension in adults: the KORA study.” Environmental health perspectives 122, no. 5 (2014): 492.

Research Summary Researchers from Federal Environment Agency, Berlin, Germany explored the association between traffic noise (road and railway) and the incidence of hypertension in two study populations (Greater Augsbug area and the City of Augsburg, Germany) with a total of 4,166 participants 25–74 years of age. Traffic noise was determined from noise maps. Hypertension was assessed by blood pressure readings, self-reported doctor-diagnosed hypertension, and anti-hypertensive drug intake. Air pollutants were assessed in the two study areas. Statistical analysis showed that both traffic noise and air pollutants were both associated with a higher incidence of hypertension.

Reference Fuks, Kateryna B., Gudrun Weinmayr, Maria Foraster, Julia Dratva, Regina Hampel, Danny Houthuijs, Bente Oftedal et al. “Arterial blood pressure and long-term exposure to traffic-related air pollution: an analysis in the European Study of Cohorts for Air Pollution Effects (ESCAPE).” Environmental health perspectives 122, no. 9 (2014): 896.

Research Summary Researchers from IUF-Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany. investigated the association of long-term traffic-related air pollution with blood pressure and the incidence of hypertension. Data was analyzed from 15 population-based studies, participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exposure to particulate matter and nitrogen oxides was assessed. Blood pressure from 113,926 residents medicated and nonmedicated with BP lowering medication was assessed. The statistical analysis showed that the residents living within 300 feet was associated with increased systolic and diastolic blood pressure in the nonmedicated participants.

TURN DOWN THE VOLUME

Reference Foraster, Maria, Nino Künzli, Inmaculada Aguilera, Marcela Rivera, David Agis, Joan Vila, Laura Bouso et al. “High blood pressure and long-term exposure to indoor noise and air pollution from road traffic.” Environmental health perspectives 122, no. 11 (2014): 1193.

Research Summary Researchers from Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain analyzed associations between long-term exposure to indoor traffic noise in the bedrooms of 1,926 participants and the incidence of hypertension. Outdoor annual average levels of nighttime traffic noise and nitrogen oxide were estimated at postal addresses with a detailed traffic noise model. Individual indoor traffic levels were measured. The results showed that long-term exposure to indoor traffic noise was associated with a high incidence of hypertension.

GET OUTSIDE

Reference Yu, Chia-Pin, Chia-Min Lin, Ming-Jer Tsai, Yu-Chieh Tsai, and Chun-Yu Chen. “Effects of short forest bathing program on autonomic nervous system activity and mood states in middle-aged and elderly individuals.” International journal of environmental research and public health 14, no. 8 (2017): 897.

Research Summary Researchers from National Taiwan University, Taiwan investigated changes in the nervous system and mood after 128 middle-aged and elderly participants spent two hours taking a bath in a forest, in Taiwan. Physiological responses, pulse rate, systolic and diastolic blood pressure, heart rate variability (HRV), and emotions were measured before and after the program. The results showed that pulse rate, systolic, and diastolic blood pressure were significantly lower after the program, which indicated physiological benefits from stress recovery. The Profile of Mood States negative mood subscale scores of “tension-anxiety,” “anger-hostility,” “fatigue-inertia,” “depression-dejection,” and “confusion-bewilderment” were significantly lower, whereas the positive mood subscale score of “vigor-activity” was higher. Furthermore, participants exhibited significantly lower anxiety levels according to the State-Trait Anxiety Inventory.

Reference van den Bosch, Matilda, and Å. Ode Sang. “Urban natural environments as nature-based solutions for improved public health–A systematic review of reviews.” Environmental research 158 (2017): 373-384.

Research Summary Researchers from University of British Columbia, Canada and Swedish University of Agricultural Sciences, Sweden conducted a systematic review on associations between public health and natural environments. The results show that there is strong evidence for improved mood as well as on heat from exposure to natural environments.

Reference Anderson, Allison P., Michael D. Mayer, Abigail M. Fellows, Devin R. Cowan, Mark T. Hegel, and Jay C. Buckey. “Relaxation with immersive natural scenes presented using virtual reality.” Aerospace medicine and human performance 88, no. 6 (2017): 520-526.

Research Summary Researchers evaluated virtual reality (VR) presented natural settings for reducing stress and improving mood. There were 18 participants (9 men, 9 women), ages 32±12 years, who viewed three 15-min 360° scenes (an indoor control, rural Ireland, and remote beaches). Participants were mentally stressed before scenes. Electrodermal activity (EDA) and heart rate variability measured psycho-physiological arousal. The Positive and Negative Affect Schedule and the 15-question Modified Reality Judgment and Presence Questionnaire (MRJPQ) measured mood and scene quality. The results showed that natural scene VR provided relaxation both objectively and subjectively, and scene preference had a significant effect on mood and perception of scene quality.

BRING NATURE INSIDE

Reference Ikei, Harumi, Misako Komatsu, Chorong Song, Eri Himoro, and Yoshifumi Miyazaki. “The physiological and psychological relaxing effects of viewing rose flowers in office workers.” Journal of physiological anthropology 33, no. 1 (2014): 6.

Research Summary Researchers from Chiba University, Japan examined the effects of exposure to roses in the workplace on stress levels biomarkers, like heart rate variability, and pulse rate) of office workers. The experimental site was Mizuho Information & Research Institute, Inc., in the Tokyo metropolitan area. A total of 31 male office workers were recruited. The participants were exposed to thirty unscented pink roses (Rosa, Dekora) arranged in a cylindrical glass vase for four minutes. The control group was not exposed to flowers. After the experiments, the subjects completed a questionnaire. The results showed that participants exposed to the roses reported being more “comfortable and relaxed” and “natural feelings” than those not exposed. In addition, the heart rates of those exposed to roses were less variable through their work day, than those not exposed.

Reference Aghaie, Bahman, Nahid Rejeh, Majideh Heravi-Karimooi, Abbas Ebadi, Seyed Tayeb Moradian, Mojtaba Vaismoradi, and Melanie Jasper. “Effect of nature-based sound therapy on agitation and anxiety in coronary artery bypass graft patients during the weaning of mechanical ventilation: A randomised clinical trial.” International journal of nursing studies 51, no. 4 (2014): 526-538.

Research Summary Researchers from Department of Nursing, Faculty of Nursing and Midwifery, Shahed University, Tehran, Iran, Swansea University, United Kingdom, and University of Nordland, Bodø, Norway studied the effects of nature-based sound therapy on agitation and anxiety on 120 coronary artery bypass graft patients, aged 45-65, when weaning from ventilators. The patients were randomly assigned to one of two intervention groups: 1) listened to nature-based sounds through headphones and 2) wore headphones with no sound. Anxiety levels and agitation were assessed using the Faces Anxiety Scale and Richmond Agitation Sedation Scale, respectively. Patients in both groups had vital signs recorded after the first trigger, at 20-minute intervals throughout the procedure, immediately after the procedure, 20 minutes, and 30 minutes after being removed. Data were collected over five months from December 2012 to April 2013. The results showed that the intervention group had significantly lower anxiety and agitation levels than the control group. A significant difference was also found between the anxiety and agitations.

GET A LITTLE SUNSHINE

Reference Liu, Donald, Bernadette O. Fernandez, Alistair Hamilton, Ninian N. Lang, Julie MC Gallagher, David E. Newby, Martin Feelisch, and Richard B. Weller. “UVA irradiation of human skin vasodilates arterial vasculature and lowers blood pressure independently of nitric oxide synthase.” Journal of Investigative Dermatology 134, no. 7 (2014): 1839-1846.

Research Summary Researchers from University of Edinburgh, and University of Southampton, United Kingdom conducted a study to test whether exposure to Ultraviolet Rays (UVA) may mobilize nitrate skin activity into the circulation to exert beneficial cardiovascular effects. Results showed in 24 healthy volunteers, irradiation of the skin with two standard doses of UVA lowered blood pressure (BP), with concurrent decreases in circulating nitrate and rises in nitrite concentrations. In addition, UVA exposure of the forearm caused increased blood flow, suggesting the release of pre-stored nitric oxide stores in the skin.

ACTIVITY

EXERCISE REGULARLY

Reference Guidry, Margaux A., Bruce E. Blanchard, Paul D. Thompson, Carl M. Maresh, Richard L. Seip, Amy L. Taylor, and Linda S. Pescatello. “The influence of short and long duration on the blood pressure response to an acute bout of dynamic exercise.” American heart journal 151, no. 6 (2006): 1322-e5.

Research Summary Researchers from University of Connecticut, United States compared the effects of short and long duration on the blood pressure (BP) response to one session of aerobic exercise. Participants were 45 men with elevated BP. The men were randomly assigned to 40% or 60% aerobic intensity of maximal oxygen consumption. Following assignment, they completed three experiments: a no-exercise control, a 15-minute SHORT, and 30-minute LONG cycle session. The participants left the laboratory wearing an ambulatory BP monitor. Repeated BP measurements were analyzed. The results showed, over nine hours after the exercise activity, systolic and diastolic BP reduced after SHORT and LONG duration exercise compared with the no-exercise group.  The conclusion was that the immediate BP-lowering effects of short-duration, lower intensity exercise are comparable to those of higher amounts of exercise.

BREAK UP THE SITTING

eference Larsen, R. N., B. A. Kingwell, P. Sethi, E. Cerin, N. Owen, and D. W. Dunstan. “Breaking up prolonged sitting reduces resting blood pressure in overweight/obese adults.” Nutrition, Metabolism and Cardiovascular Diseases 24, no. 9 (2014): 976-982.

Research Summary Researchers from Baker IDI Heart and Diabetes Institute, Australia, School of Exercise and Nutrition Sciences, Deakin University, Australia, Institute of Human Performance, and the University of Hong Kong, China examined the effects of seven hours of prolonged sitting on resting blood pressure with a similar duration of sitting combined with intermittent brief bouts of light-intensity or moderate-intensity physical activity. A total of 19 overweight adults, aged 45-65, were recruited for this study and randomly assigned to one of three activities: 1) uninterrupted sitting; 2) sitting with two minutes of light-intensity walking every 20 minutes; and 3) sitting with two minutes of moderate-activity every 20 minutes. After an initial two-hour period seated, participants consumed a test meal (75g carbohydrate, 50g fat) and completed each activity over the next five hours. Resting blood pressure was assessed every hour as a single measurement, five minutes prior to each activity session. The results found that breaking up prolonged sitting with light and moderate intensity activity breaks was associated with lower systolic and diastolic blood pressure compared to uninterrupted sitting.

BE CONSISTENT

Reference Kaushal, Navin, and Ryan E. Rhodes. “Exercise habit formation in new gym members: a longitudinal study.” Journal of behavioral medicine 38, no. 4 (2015): 652-663.

Research Summary Researchers from University of Victoria, Canada conducted a study to: 1) investigate the behaviour changes required for exercise habit formation and 2) what predicts habit. A total of 111 participants (new gym members) completed surveys across 12 weeks on exercise practices. The results found that exercising for at least four bouts per week for six weeks was the minimum requirement to establish an exercise habit. Additionally, consistency, low complexity (simple, and fun), supportive, non-judgmental environment all significantly predicted changes in habit formation over time. The conclusion is trainers should keep exercises fun and simple for new clients and focus on consistency which could lead to habit formation in nearly six weeks.

Reference Royer, Heather, Mark Stehr, and Justin Sydnor. “Incentives, commitments, and habit formation in exercise: evidence from a field experiment with workers at a fortune-500 company.” American Economic Journal: Applied Economics 7, no. 3 (2015): 51-84.

Research Summary Researchers analyzed the results of a largescale workplace field experiment to examine whether self- commitment contracts improve the long-term effects of incentive programs. The results showed the workers that combined the incentive program with a commitment contract showed significant long- lasting behavior change toward exercise, persisting at the one year follow up after the program ended.

HAVE FUN

Reference Kaushal, Navin, and Ryan E. Rhodes. “Exercise habit formation in new gym members: a longitudinal study.” Journal of behavioral medicine 38, no. 4 (2015): 652-663.

Research Summary Researchers from University of Victoria, Canada conducted a study to: 1) investigate the behaviour changes required for exercise habit formation and 2) what predicts habit. A total of 111 participants (new gym members) completed surveys across 12 weeks on exercise practices. The results found that exercising for at least four bouts per week for six weeks was the minimum requirement to establish an exercise habit. Additionally, consistency, low complexity (simple, and fun), supportive, non-judgmental environment all significantly predicted changes in habit formation over time. The conclusion is trainers should keep exercises fun and simple for new clients and focus on consistency which could lead to habit formation in nearly six weeks.

GET INTENSE

Reference Brito, Aline de F., Caio Victor C. Oliveira, Maria do Socorro B. Santos, and Amilton da C. Santos. “High‐intensity exercise promotes postexercise hypotension greater than moderate intensity in elderly hypertensive individuals.” Clinical physiology and functional imaging 34, no. 2 (2014): 126-132.

Research Summary Researchers from Federal University of Paraiba, Brazil evaluated the effects of high-intensity resistance exercise on post-exercise hypotension (lowering of blood pressure) in 10 older adults (65 and over) with hypertension. The participants were assigned to three experimental sessions: 1) control no exercise group; 2) exercise at 50% maximal capacity; and 3) 80% of maximal capacity. For each session, the volunteers were evaluated pre- and postintervention. In the preintervention, the blood pressure (BP) was taken after 10 minutes of rest. Afterwards, they were taken to the gym to perform the exercise sessions or remained at rest. Both 50% and 80% training sessions were composed of a set of 10 repetitions of 10 exercises, with an interval of a 90 second rest between exercises. Subsequently, BP measurements were again performed at 10, 30, 50, 70 and 90 minutes after the exercise session. The results showed that post-exercise hypotension was much greater in 80% compared with the 50% group (systolic BP 115 mmHg after exercise versus 124 mmHg before exercise, diastolic 75 mmHg after exercise versus 86 mmHg before exercise).   

Reference Cote, Anita T., Shannon SD Bredin, Aaron A. Phillips, Michael S. Koehle, and Darren ER Warburton. “Greater autonomic modulation during post-exercise hypotension following high-intensity interval exercise in endurance-trained men and women.” European journal of applied physiology 115, no. 1 (2015): 81-89.

Research Summary Researchers from University of British Columbia assessed the effect of high-intensity interval exercise on post training blood pressure. Cardiac volumes and function via echocardiography (ECG) were measured in two groups of men and women, endurance training versus normally active men and women, average age of 30 years, following high-intensity interval cycle exercise. Continuous measurements of ECG and beat-by-beat blood pressure were collected before and 30 minutes post-exercise for analysis of heart rate and systolic blood pressure. Results showed that post-exercise systolic BP was significantly reduced from baseline, occurring to a greater degree in endurance trained people compared with normally active individuals, while over-all pressure was similarly reduced in all groups.

TRUST IN GOD

FORGIVE

Reference Quenstedt-Moe, Gretchen, and Sue Popkess. “Forgiveness and health in Christian women.” Journal of religion and health 53, no. 1 (2014): 204-216.

Research Summary Researchers from Missouri Western State University, United States studied the influence of forgiveness on the both the emotional and physical health of individuals. The participants willingness to forgive was measured using four validated questionnaires and body mass index was calculated. One on one interviews revealed that Christian woman expresses very severe unjust violations involving sexual, physical, emotional, and even financial abuse. Statistical analysis suggested an important relationship among willingness to forgive and overall health measures.

Reference May, Ross W., Marcos A. Sanchez-Gonzalez, Kirsten A. Hawkins, Wayne B. Batchelor, and Frank D. Fincham. “Effect of anger and trait forgiveness on cardiovascular risk in young adult females.” The American journal of cardiology 114, no. 1 (2014): 47-52.

Research Summary Researchers from Florida State University, Tallahassee College of Medicine, and the Department of Biomedical Sciences conducted a study to determine if anger and willingness to forgive is associated with improved blood pressure and other cardiovascular markers in heart disease patients. A total of 308 health female volunteers were recruited for the study. Tendency to anger and forgiveness was identified using validated questionnaires and the participants were assigned to one of three studies assessing heart protective biomarkers. Statistical analysis demonstrated that anger was significantly associated with higher walking BP and BP variability. In contrast, tendency to forgive was associated with a reduction in blood pressure and decreased ventricular work and heart oxygen consumption.

LIVE A PURPOSE-DRIVEN LIFE

Reference Hill, Patrick L., and Nicholas A. Turiano. “Purpose in life as a predictor of mortality across adulthood.” Psychological science 25, no. 7 (2014): 1482-1486.

Research Summary Researchers from Carleton University and the University of Rochester Medical Center, United States examined whether purpose in life promotes longevity (live longer) across the adult years, using data from the longitudinal Midlife in the United States (MIDUS) sample. Analysis demonstrated that purposeful individuals lived longer than their counterparts without a life purpose did during a 14 year follow-up. Moreover, these longevity benefits were not conditional on the participants’ age, how long they lived during the follow-up period, or whether they had retired from the workforce.  

TAKE COMFORT IN YOUR FAITH

Reference Papazisis, Georgios, Panagiotis Nicolaou, Evangelia Tsiga, Theodora Christoforou, and Despina Sapountzi‐Krepia. “Religious and spiritual beliefs, self‐esteem, anxiety, and depression among nursing students.” Nursing & health sciences 16, no. 2 (2014): 232-238.

Research Summary Researchers from School of Medicine, Aristotle University of Thessaloniki, Greece conducted a study to determine the relationship between religious beliefs, self-esteem, anxiety, and depression in nursing students in Cyprus. A total of 123 students were asked to complete a survey consisting of four self-report questionnaires. The results revealed that the 98% of the students stated a strong religious and or a spiritual belief that was strongly associated with increased self-esteem, decreased depression, and perceived mild stress levels.

Reference Laurin, Kristin, Aaron C. Kay, and David A. Moscovitch. “On the belief in God: Towards an understanding of the emotional substrates of compensatory control.” Journal of Experimental Social Psychology 44, no. 6 (2008): 1559-1562.

Research Summary Researchers investigated the role of Jewish religiousness in anxiety, depression, and happiness, in 565 Jewish community members. Several facets of global Jewish religiousness were examined, as well as a theoretically based Jewish religious trust in God. A self-report measure of trust and mistrust in God. The results found that higher levels of trust in God was associated with less anxiety and depression, and greater personal happiness.  

GO TO CHURCH

Reference Banerjee, Ananya Tina, Michael H. Boyle, Sonia S. Anand, Patricia H. Strachan, and Mark Oremus. “The relationship between religious service attendance and coronary heart disease and related risk factors in Saskatchewan, Canada.” Journal of religion and health 53, no. 1 (2014): 141-156.

Research Summary Researchers from McMaster University, Canada examined the association between frequency of religious service attendance and self-reported frequency of heart disease, diabetes, and hypertension in Canada. Data was collected from 5,442 records from the Canadian Community Health Survey. Statistical analysis found that people who attended religious services more than once a week had lower odds of developing diabetes and hypertension compared to persons who attended less than once a year.

Reference Sørensen, Torgeir, Lars J. Danbolt, Lars Lien, Harold G. Koenig, and Jostein Holmen. “The relationship between religious attendance and blood pressure: the HUNT study, Norway.” The International Journal of Psychiatry in Medicine 42, no. 1 (2011): 13-28.

Research Summary Researchers from MF Norwegian School of Theology, Norway explored the possible relationship between religious service attendance and blood pressure, in the United States and Norway. Data from the Nord-Trøndelag Health Study’s third wave, HUNT 3 (2006–2008), was used. The associations between religious attendance and diastolic and systolic blood pressure in 20,066 women and 15,898 men were investigated in this study. Statistical analysis revealed the lowest blood pressure was found in men and women attending church more than three times per month compared to individuals who never attended religious services.  

LET GO OF WORRY

Reference Ferguson, Jane K., Eleanor W. Willemsen, and MayLynn V. Castañeto. “Centering prayer as a healing response to everyday stress: A psychological and spiritual process.” Pastoral psychology 59, no. 3 (2010): 305-329.

Research Summary Researchers explored the outcome of prayer on everyday stress and on Christians’ approach to communicating with God. The impact of 10 weekly two-hour group sessions and individual practice of prayer two-times daily by 15 Roman Catholic congregants. The results showed that daily prayer decreased participants’ stress and increase their collaborative relationship with God. 

INTERPERSONAL RELATIONSHIPS

ASK FOR HELP

Reference Hu, H. H., Gang Li, and Takashi Arao. “The association of family social support, depression, anxiety and self-efficacy with specific hypertension self-care behaviours in Chinese local community.” Journal of human hypertension 29, no. 3 (2015): 198-203.

Research Summary Researchers from Waseda University, Japan, Beijing Center for Diseases Control and Prevention, and Institute of Chronic Diseases Control and Prevention, China conducted a study aimed to test the role of family social support, depression, anxiety, and self-confidence on specific self-care behaviors. In a local community health center, 318 patients with hypertension completed a validated questionnaire assessing family support, depression, anxiety, and self-confidence in 2012. Analysis showed that family social support was positively associated with medication adherence and regular blood pressure measurement.

AVOID DRAMA

Reference Yang, Yang Claire, Courtney Boen, and Kathleen Mullan Harris. “Social relationships and hypertension in late life: evidence from a nationally representative longitudinal study of older adults.” Journal of aging and health 27, no. 3 (2015): 403-431.

Research Summary Researchers from University of North Carolina at Chapel Hill conducted a study using data of older adults from the National Social Life, Health, and Aging Project (2005-2011) to examine the potential associations between social support, social connectedness, and change in systolic blood pressure and hypertension risk over time. Analysis showed that low social support was predictive of increase in systolic blood pressure, whereas low social connectedness was predictive of an increase in risk of hypertension.

Reference Shankar, Aparna, Anne McMunn, James Banks, and Andrew Steptoe. “Loneliness, social isolation, and behavioral and biological health indicators in older adults.” Health Psychology 30, no. 4 (2011): 377.

Research Summary Researchers from University College London, United Kingdom analyzed the impact of social isolation and loneliness, on health-related behaviors and biological factors using data from the English Longitudinal Study of Ageing (ELSA). Data on health behaviors (smoking and physical activity) were analyzed from 8,688 participants and data on blood pressure, cholesterol, and inflammatory markers were analyzed from over 5,000 of these participants who were eligible for a nurse visit and blood sampling. Loneliness was measured using a validated questionnaire and an index of social isolation was computed incorporating marital status; frequency of contact with friends, family, and children; and participation in social activities. The results showed that fewer than 2% of participants reported being lonely all the time, while nearly 7% had the highest possible scores on social isolation. Both social isolation and loneliness were associated with a greater risk of being inactive, smoking, as well as reporting multiple health-risk behaviors. Social isolation was also positively associated with blood pressure, C-reactive protein, and fibrinogen levels.

Reference Hawkley, Louise C., Ronald A. Thisted, Christopher M. Masi, and John T. Cacioppo. “Loneliness predicts increased blood pressure: 5-year cross-lagged analyses in middle-aged and older adults.” Psychology and aging 25, no. 1 (2010): 132.

Research Summary Researchers from University of Chicago studied whether loneliness may contribute to greater increases in systolic blood pressure over a four-year period than were observed in less lonely individuals. A population-based sample of 229 50- to 68-year-old White, Black, and Hispanic men and women in the Chicago Health, Aging, and Social Relations Study was tested annually for each of the five consecutive years. Statistical analysis revealed that loneliness at the start of the study predicted significant increases in systolic blood pressure 2, 3, and 4 years later.

Reference Sneed, Rodlescia S., and Sheldon Cohen. “Negative social interactions and incident hypertension among older adults.” Health psychology 33, no. 6 (2014): 554.

Research Summary Researchers from Carnegie Mellon University, United States explored the association between negative social interaction and hypertension among older adults. Data was used from the 2006 and 2010 waves of the Health and Retirement Study, a survey of community-dwelling older adults over 50. Total average negative social interactions were assessed at baseline by averaging the frequency of negative interactions with partners, children, other family, and friends. Blood pressure was measured at both waves. Individuals were considered to have hypertension if they reported use of antihypertensive medications, had measured average resting systolic blood pressure of 140 mmHg or higher, or measured average resting diastolic blood pressure of 90 mmHg or higher. Statistical analysis showed that 29% of participants developed hypertension over the four-year follow up. Each one-unit increase in the total average negative social interaction score was associated with a 38% increased chance of developing hypertension.

SEEK PROFESSIONAL SUPPORT

Reference Dye, Cheryl J., Joel E. Williams, and Janet Hoffman Evatt. “Improving hypertension self-management with community health coaches.” Health promotion practice 16, no. 2 (2015): 271-281.

Research Summary Researchers from Clemson University, conducted a study to observe the effectiveness of a professional program called “Health Coaches for Hypertension Control,” designed to improve hypertension self-management among rural residents older than 60 years through education and support offered by trained Health Coaches. Participants received baseline and follow-up health risk appraisals with blood work, educational materials, and items such as blood pressure monitors and pedometers. Data were collected at baseline, eight weeks, and 16 weeks on 146 participants who demonstrated statistically significant increases in hypertension-related knowledge and readiness to change behaviors. The results showed statistically significant decreases in systolic blood pressure by on average 5.7 mmHg, 2.5- pound weight loss, and reduction of blood glucose by 5 mg/dl. Additionally, although 40.4% of participants met the Healthy People 2020 definition of controlled hypertension at baseline, the proportion of participants meeting this definition at 16 weeks postintervention increased to 51.0%.

LOVE AN ANIMAL

Reference Friedmann, Erika, Sue A. Thomas, Heesook Son, Deborah Chapa, and Sandra McCune. “Pet’s presence and owner’s blood pressures during the daily lives of pet owners with pre- to mild-hypertension.” Anthrozoös 26, no. 4 (2013): 535-550.

Research Summary Researchers evaluated the impact of the presence of pet dogs and cats on ambulatory blood pressure on 32 pet owners with pre- to mild-hypertension. Owner’s ambulatory blood pressure were recorded every 20 minutes for one day during waking hours at study entry, one month, and three months. Activity monitors and diaries were used to obtain information about activity, mood, and whether the pet and/or another person was present in the room (indoors) or in close proximity (outdoors) with the owner at each assessment. Statistical analysis revealed that the presence of a dog or cat was associated with lower systolic and diastolic blood pressure during their owners’ normal daily lives.

GIVE BACK TO THE COMMUNITY

Reference Sneed, Rodlescia S., and Sheldon Cohen. “A prospective study of volunteerism and hypertension risk in older adults.” Psychology and aging 28, no. 2 (2013): 578.

Research Summary Researchers from Carnegie Mellon University explored the relationship between volunteering and the risk of hypertension among older adults. Participants provided data during the 2006 and 2010 waves of the Health and Retirement Study, a validated survey utilizing a nationally representative sample of community-dwelling adults over the age of 50. Volunteerism and blood pressure were measured at baseline and again four years later. The results revealed that the participants who had volunteered at least 200 hours in the 12 months prior to baseline were 40% less likely to develop hypertension than non-volunteers. There was no association between volunteerism and hypertension risk at less than 200 hours of volunteer participation. Volunteering at least 200 hours was also associated with greater increases in psychological well-being and physical activity compared to non-volunteers.

OUTLOOK

EXPRESS GRATITUDE

Reference Jackowska, Marta, Jennie Brown, Amy Ronaldson, and Andrew Steptoe. “The impact of a brief gratitude intervention on subjective well-being, biology and sleep.” Journal of health psychology 21, no. 10 (2016): 2207-2217.

Research Summary Researchers from University College London, United States conducted an experiment to test whether gratitude was linked to feelings of happiness, and well-being. A total of 119 young women were observed for two weeks of a gratitude intervention with an active control (everyday events reporting) and no treatment conditions. The results showed that the gratitude intervention increased feelings of happiness, optimism, and sleep quality along with decreases in diastolic blood pressure.  

START LAUGHING

Reference Ponraj, M. “Effectiveness of Laughter Therapy on Blood Pressure Among Patients with Primary Hypertension.” TNNMC Journal of Medical & Surgical Nursing 4, no. 2 (2016): 12-13.

Research Summary Researchers conducted a study to assess the effectiveness of laughter therapy on levels of blood pressure among 60 patients with hypertension. Laughter therapy was administered and blood pressure was assessed by using Med India Blood pressure tool. The findings revealed that systolic blood pressure, diastolic blood pressure was found to be statistically highly significant in the control group compared to the experimental group.

TAKE THE TENSION OUT OF HYPERTENSION

Reference Bono, Joyce E., Theresa M. Glomb, Winny Shen, Eugene Kim, and Amanda J. Koch. “Building positive resources: Effects of positive events and positive reflection on work stress and health.” Academy of Management Journal 56, no. 6 (2013): 1601-1627.

Research Summary Researchers conducted a three-week field study to examine the relationships between employee stress and health, with a specific focus on positive events. The results suggest that both naturally occurring positive work events and an end of day reflection intervention are associated with reduced stress and improved health. These findings show that a brief, end-of-workday reflection led to decreased stress and improved health in the evening.  

FOCUS ON HAPPINESS

Reference Blanchflower, David G., and Andrew J. Oswald. “Hypertension and happiness across nations.” Journal of health economics 27, no. 2 (2008): 218-233.

Research Summary Researchers from Dartmouth College, United States analyzed data from 16 countries, including Denmark, Netherlands, Germany, and Italy assessing the potential association between happiness and hypertension. Statistical analysis reveals that happier nations reported systematically lower level of hypertension. 

Reference Trudel-Fitzgerald, Claudia, Julia K. Boehm, Mika Kivimaki, and Laura D. Kubzansky. “Taking the tension out of hypertension: a prospective study of psychological well-being and hypertension.” Journal of hypertension 32, no. 6 (2014): 1222.

Research Summary Researchers from Laval University, Canada, Chapman University, United States, University College London, United Kingdom, and Harvard School of Public Health, United States examined the possible relationship between emotional vitality (happiness) and optimism and incident hypertension. Participants were 6,384 healthy British civil servants age 39 to 63 from the Whitehall II cohort. Psychological well-being (emotional vitality and optimism) and cardiovascular risk factors (demographic characteristics, health status, health behaviors, and psychological ill-being) were assessed during the 1991-1994 baseline. Incident hypertension was defined by clinical measures of systolic or diastolic blood pressure >140/90 mmHg, self-reported physician-diagnosed hypertension, or treatment for hypertension. The results showed there were 2,304 cases of incident hypertension during the follow-up period. High (happiness) versus low (unhappiness) emotional vitality was associated with a significantly reduced risk of hypertension.  

BE KIND

Reference Pressman, Sarah D., Tara L. Kraft, and Marie P. Cross. “It’s good to do good and receive good: The impact of a ‘pay it forward’ style kindness intervention on giver and receiver well-being.” The Journal of Positive Psychology 10, no. 4 (2015): 293-302.

Research Summary Researchers tested the effectiveness of a brief, one-time “pay it forward” act of kindness on the well-being on the giver and receiver. A total of 83 undergraduates (‘givers’) performed random kind acts for 1.5 hours. The results showed a wide range of well-being benefits for givers for example, felt much happier, and less depressed after the act of kindness. Receivers also benefited as evidenced by greater smiling behavior and more sincere smiles vs the control group that did not give or receive kindness. Of the 48 receivers who completed a follow-up online questionnaire, the majority indicated that they would also participate in “pay it forward” kind acts, with almost 40% indicating that they already had. 

NUTRITION

EAT WITH YOUR HEALTH IN MIND

Reference Liu, Lihua, Shan Wang, and Jianchao Liu. “Fiber consumption and all‐cause, cardiovascular, and cancer mortalities: A systematic review and meta‐analysis of cohort studies.” Molecular nutrition & food research 59, no. 1 (2015): 139-146.

Research Summary Researchers from Institute of Hospital Management, United States conducted a meta-analysis aimed to investigate fiber consumption and death from heart disease and other medical conditions. MEDLINE and web of science database were searched for published medical studies that met the criteria of fiber consumption and death from multiple medical conditions. Statistical analysis found that, compared with those who consumed lowest fiber, for individuals who ate highest fiber, death rate was lower by 23% from heart disease, by 17% for cancer, and by 23% for other medical conditions.

Reference Orlich, Michael J., and Gary E. Fraser. “Vegetarian diets in the Adventist Health Study 2: a review of initial published findings.” The American journal of clinical nutrition 100, no. Supplement 1 (2014): 353S-358S.

Research Summary Researchers from the Adventist Health Study 2 study reviewed the impact of vegetarian (do not eat meat, including fish and minimal dairy and poultry) dietary patterns to health and disease risk. The initial review of published findings showed a strong association between vegetarian dietary patterns and lower body mass index, lower risk and prevalence of diabetes, lower prevalence of hypertension, and in some instances, lower risk of cancer.

Reference Yokoyama, Yoko, Kunihiro Nishimura, Neal D. Barnard, Misa Takegami, Makoto Watanabe, Akira Sekikawa, Tomonori Okamura, and Yoshihiro Miyamoto. “Vegetarian diets and blood pressure: a meta-analysis.” JAMA internal medicine 174, no. 4 (2014): 577-587.

Research Summary Researchers from multiple universities from the United States and Japan conducted a systematic review and meta-analysis exploring the link between vegetarian diets and blood pressure management. MEDLINE and Web of Science were searched for articles published in English from 1946, that explored consumption of vegetarian dietary patterns and systolic and diastolic blood pressure outcomes. Of the 258 studies identified, seven clinical and 32 observational studies were included. The analysis of the seven clinical studies, with 311 participants, showed that consumption of vegetarian diets was associated with a reduction of average systolic BP by 4.8 mmHg and diastolic BP by 2.2 mmHg compared to the consumption of a meat diet. The 32 observational studies, with 21,604 participants, showed that consumption of vegetarian diets was associated with an average lower mean systolic BP by 6.9 mmHg and diastolic BP by 4.7 mmHg compared to eating a meat diet.

Reference Ashworth, Ann, Klaus Mitchell, Jamie R. Blackwell, Anni Vanhatalo, and Andrew M. Jones. “High-nitrate vegetable diet increases plasma nitrate and nitrite concentrations and reduces blood pressure in healthy women.” Public health nutrition 18, no. 14 (2015): 2669-2678.

Research Summary Researchers from University of Exeter, United Kingdom explored whether diets containing high-nitrate (HN) green leafy vegetables, would increase plasma nitrate and reduce blood pressure in young women. A total of 19 participants either received HN vegetables (HN diet) or avoided HN vegetables (Control diet) for one week. Before and after each intervention, resting BP and plasma nitrate and nitrite concentrations were measured. The results showed that diets high in green leafy vegetables significantly increased nitrate concentrations and reduced resting systolic blood pressure. These was no significant change in the control group.

GET A HEALTHY DOSE

Reference Khalesi, Saman, Christopher Irwin, and Matt Schubert. “Flaxseed consumption may reduce blood pressure: a systematic review and meta-analysis of controlled trials.” The Journal of nutrition 145, no. 4 (2015): 758-765.

Research Summary Researchers from Menzies Health Institute, and Griffith University, Australia clarified the effects of flaxseed consumption on blood pressure. PubMed (MEDLINE), Cumulative Index to Nursing and Allied Health Literature, and Cochrane Library (Central) were searched through July 2014 for studies in which humans supplemented their habitual diet with flaxseed or its extracts for a minimum of a two-week study duration. A total of 11 studies (14 trials) were included in the analysis. A statistical analysis revealed that flaxseed supplementation (oil) reduced systolic and diastolic blood pressure by close to 2 mmHg, which is a significant reduction. Individuals consuming whole flaxseeds had a greater reduction than those taking flaxseed oil. The authors concluded that the beneficial potential of flaxseed to reduce blood pressure may be greater when it is consumed as a whole seed and for a duration of greater than 12 weeks.

Reference Ndanuko, Rhoda N., Linda C. Tapsell, Karen E. Charlton, Elizabeth P. Neale, and Marijka J. Batterham. “Dietary patterns and blood pressure in adults: a systematic review and meta-analysis of randomized controlled trials.” Advances in Nutrition: An International Review Journal 7, no. 1 (2016): 76-89.

Research Summary Researchers from the School of Medicine and School of Mathematics and Applied Statistics, and University of Wollongong, Australia conducted a systematic review to assess the effect of dietary patterns on blood pressure in adults. Studies that were published between January 1999 and June 2014 were retrieved using Scopus, Web of Science, and the MEDLINE database. A total of 17 randomized studies were included in the meta-analysis. The results suggest that healthy dietary patterns such as the Dietary Approaches to Stop Hypertension diet, Nordic diet, and Mediterranean diet significantly lowered systolic BP and diastolic BP by 4.26 mmHg and 2.38 mmHg, respectively. These diets are rich in fruit, vegetables, whole grains, legumes, seeds, and nuts, and low in meat, sweets, and alcohol.

BE A SMART SHOPPER

Reference Te Morenga, Lisa A., Alex J. Howatson, Rhiannon M. Jones, and Jim Mann. “Dietary sugars and cardiometabolic risk: systematic review and meta-analyses of randomized controlled trials of the effects on blood pressure and lipids.” The American journal of clinical nutrition (2014): ajcn-081521.

Research Summary Researchers from University of Otago, New Zealand conducted a systematic review and meta-analysis that examined effects of the modification of dietary added sugars on blood pressure and cholesterol. Systematic searches were conducted in OVID Medline, Embase, Scopus, Cumulative Index to Nursing and Allied Health Literature, and Web of Science databases (to August 2013) to identify studies that reported intakes of added sugars and at least one cholesterol or blood pressure outcome. The minimum study duration was two-week. A total of 39 of 11,517 studies identified were included; 37 reported cholesterol outcomes, and 12 reported blood pressure outcomes. Statistical analysis showed higher compared with lower sugar intakes significantly raised cholesterol and triglyceride levels. In addition, added sugar intake in studies lasting at least eight weeks showed a significant increase in systolic and diastolic blood pressure.

ADD FLAVOR WITH HERBS

Reference Shouk, Reem, Aya Abdou, Kalidas Shetty, Dipayan Sarkar, and Ali H. Eid. “Mechanisms underlying the antihypertensive effects of garlic bioactives.” Nutrition Research 34, no. 2 (2014): 106-115.

Research Summary Researchers from United Arab Emirates University, United Arab Emirates, North Dakota State University, United States and Qatar University, Qatar systematically reviewed the biochemicals underlying the blood pressure lowering effects of eating garlic. Key studies, largely from PubMed, were selected and screened to develop a comprehensive understanding of the specific role of garlic in the management of hypertension. The review suggests that garlic and garlic derived biochemicals have significant medicine like properties with the potential for eliminating hypertension and other heart disease symptoms; however, further clinical studies are required to determine completely the specific biochemical mechanisms involved in disease prevention and management.

Reference Mente, Andrew, Martin J. O’donnell, Sumathy Rangarajan, Matthew J. McQueen, Paul Poirier, Andreas Wielgosz, Howard Morrison et al. “Association of urinary sodium and potassium excretion with blood pressure.” N Engl J Med 2014, no. 371 (2014): 601-611.

Research Summary Researchers explored the link between salt intake and hypertension in 102,216 adults from 18 countries. Estimates of 24-hour sodium and potassium excretion were made from a single fasting morning urine specimen. We assessed the relationship between electrolyte excretion and blood pressure, measured with an automated device. Statistical analysis showed increases of 2.11 mmHg in systolic blood pressure and .78 mmHg in diastolic blood pressure for each one gram increase in estimated sodium excretion. The BP increases were greater in individuals with hypertension than for those without hypertension. CHANGE YOUR DRINKING HABITS

Reference Dennis, Elizabeth A., Ana Laura Dengo, Dana L. Comber, Kyle D. Flack, Jyoti Savla, Kevin P. Davy, and Brenda M. Davy. “Water consumption increases weight loss during a hypocaloric diet intervention in middle‐aged and older adults.” Obesity 18, no. 2 (2010): 300-307.

Research Summary Researchers from Virginia Tech, United States examined whether pre-meal water consumption facilitates weight loss among overweight middle-aged and older adults to determine if the ability of pre-meal water consumption to reduce meal calorie intake after a 12-week period of increased water consumption. A total of 48 adults, 55–75 years old, were assigned to one of two groups: 1) low calorie diet + 500 ml water prior to each daily meal (water group) or 2) low calorie diet alone (non-water group). At baseline and week 12, meal calorie intake was assessed at two test meals and body weight was assessed weekly for 12 weeks. The results showed that weight loss was four and a half pounds greater in the water group than in the non-water group and showed a 44% greater decline in weight over 12 weeks than the non-water group.

Reference Fuchs, Flávio Danni, Lloyd E. Chambless, Paul Kieran Whelton, F. Javier Nieto, and Gerardo Heiss. “Alcohol consumption and the incidence of hypertension.” Hypertension 37, no. 5 (2001): 1242-1250.

Research Summary Researchers explored the relationship between alcohol consumption and hypertension. In a medical study, 8,334 of the Atherosclerosis Risk in Communities (ARIC) Study participants, aged 45 to 64 years at baseline, who were free of hypertension and coronary heart disease, had their blood pressures ascertained after six-years of follow-up. Alcohol consumption was assessed by dietary interviews. The results showed an increased risk of hypertension in those who consumed large amounts of alcohol (greater than 210 grams per day = 7.4 ounces) compared with those who did not consume alcohol over the six-years of follow-up. Reference Malik, Aaqib Habib, Yasir Akram, Suchith Shetty, Senada Senda Malik, and Valentine Yanchou Njike. “Impact of sugar-sweetened beverages on blood pressure.” The American journal of cardiology 113, no. 9 (2014): 1574-1580.

Research Summary Researchers from Connecticut, Yale-Griffin Prevention Research Center, and University of New England conducted a systematic review exploring the relationships between the consumption of sugar-sweetened beverages (SSBs) and blood pressure. A comprehensive search in five electronic databases along with a bibliography search was performed. The keywords “sugar sweetened beverages,” “sugary drinks,” “added sugars,” “blood pressure,” and “hypertension” were indexed in all combinations. Studies were included that reported the effects of intake of SSBs on BP. Of 605 potentially relevant studies, a total of 12 studies (409,707 participants) met the criteria. Statistical significance between increased SSB intake and higher BP leading to the increased incidence of hypertension was found in 10 of the studies.