OBJECTIVE:To provide scientific evidence supporting the efficacy of forest bathing as a natural therapy for human hypertension.

METHODS:Twenty-four elderly patients with essential hypertension were randomly divided into two groups of 12. One group was sent to a broad-leaved evergreen forest to experience a 7-day/7-night trip, and the other was sent to a city area in Hangzhou for control. Blood pressure indicators, cardiovascular disease-related pathological factors including endothelin-1, homocysteine, renin, angiotensinogen, angiotensin II, angiotensin II type 1 receptor, angiotensin II type 2 receptor as well as inflammatory cytokines interleukin-6 and tumor necrosis factorα were detected. Meanwhile, profile of mood states (POMS) evaluation was used to assess the change of mood state of subjects. In addition, the air quality in the two experimental sites was monitored during the 7-day duration, simultaneously.

RESULTS:The baselines of the indicators of the subjects were not significantly different. Little alteration in the detected indicators in the city group was observed after the experiment. While subjects exposed to the forest environment showed a significant reduction in blood pressure in comparison to that of the city group. The values for the bio-indicators in subjects exposed to the forest environment were also lower than those in the urban control group and the baseline levels of themselves. POMS evaluation showed that the scores in the negative subscales were lowered after exposure to the forest environment. Besides, the air quality in the forest environment was much better than that of the urban area evidenced by the quantitative detection of negative ions and PM10 (particulate matter<10μm in aerodynamic diameter).

CONCLUSION:Our results provided direct evidence that forest bathing has therapeutic effects on human hypertension and induces inhibition of the renin-angiotensin system and inflammation, and thus inspiring its preventive efficacy against cardiovascular disorders.

BACKGROUND:Hypertension, a chronic medical condition of increased blood pressure, is a serious public health problem. Environmental and genetic risk factors are known to predispose to hypertension. The present study was designed to investigate the association of glutathione S-transferase (GST) gene polymorphism with oxidative stress in hypertensive patients and the possible beneficial effect of yoga on them.

MATERIALS AND METHODS:Sixty (60) hypertensive individuals, between 30 and 60 years of age, were divided into two groups of 30 each. The yoga group was subjected to 50-60 minutes of yogic practices daily for 42 days, while the control group included the remaining 30 age- and sex-matched hypertensive individuals. GST gene polymorphism was analyzed using multiple allele specific polymerase chain reaction, and oxidative stress parameters were assessed biochemically.

RESULTS:Assessment of blood pressure showed a statistically significant though modest reduction (p<0.05) in the yoga group as compared to the control group. Malondialdehyde was observed to be significantly low (p<0.05), while antioxidant capacity in the form of GST showed an increasing trend and ferric-reducing ability of plasma was significantly increased (p<0.05) in the subjects who practiced yoga.

CONCLUSIONS:In conclusion, yoga has been found to decrease blood pressure as well as the levels of oxidative stress in patients with hypertension.

BACKGROUND:Transcendental meditation (TM) is a stress reduction technique that can potentially lower blood pressure (BP) safely. The American Heart Association recommends that TM may be considered in clinical practice.

OBJECTIVE:To provide an overview of all systematic reviews and meta-analyses of TM on BP for evidence-informed clinical decision making.

METHOD:Systematic searches of PubMed, EBSCOhost, Cochrane Library, Web of Science, Embase, and PsycINFO for all systematic reviews and/or meta-analyses of randomized controlled trials (RCTs) with TM as an intervention, and outcome measures include systolic BP (SBP) and diastolic BP (DBP). Qualitative and quantitative data were synthesized. The methodological quality of the selected reviews was assessed using the AMSTAR checklist.

RESULTS:Eight systematic reviews and meta-analyses are included. Among them is an Agency for Healthcare Research and Quality report, a Cochrane systematic review, 4 independent reviews, and 2 reviews from a TM related institution. The quality of most of the included reviews is fair with a mean score of 5.75/11 on the AMSTAR scale. Overall, there exists a clear trend of increasing evidence over the years supporting the efficacy of TM in lowering BP. However, some conflicting findings remain across reviews and potential risk of bias exists in many of the RCTs included in these reviews.

CONCLUSION:Practising TM may potentially reduce the SBP by∼4mm Hg and DBP by ∼2mm Hg. Such effect is comparable with other lifestyle interventions such as weight-loss diet and exercise. Further evidence from long-term well-designed RCTs conducted by independent researchers is needed.

BACKGROUND:Vitamin D3 can be metabolized in the skin to 25(OH)D and 1,25(OH)2D because the skin expresses vitamin D-25-hydroxylase, 25(OH)D-1-alpha-hydroxylase, and the vitamin D receptor. The aim of this review was to discuss the pleiotropic effects after serial suberythemal UVB irradiation with a sun-simulating UV spectrum in end-stage kidney disease patients.

PATIENTS AND METHODS:Fourteen hemodialysis patients, with a mean age of 51 (range 41-57) years, were whole-body UV irradiated over 6 months.

RESULTS:Patients demonstrated an increase in their hematocrit and required less erythropoietin. An increase in maximal oxygen uptake and workload capacity was associated with decreased lactic acid production. The patients demonstrated a decreased heart rate and systolic and diastolic blood pressure with an increase in the R-R-interval and the beat-to-beat-differences.

CONCLUSION:Cardiovascular disease is the most important comorbidity. Exposure to simulated sunlight that contains both UVB and UVA reduce cardiovascular risk factors and improve quality of life.

Objective:Previous studies have reported that a vegetarian diet may lower blood pressure (BP), but the effect of diet on BP in asymptomatic participants with proteinuria is unknown. We examined the association of diet and BP in individuals with or without proteinuria.

Materials and Methods:This cross-sectional study analyzed data from participants who were more than 40 years old and received physical checkups at Taipei Tzu Chi Hospital from September 5, 2005, to December 31, 2016. Diets were assessed at baseline by a self-reported questionnaire and categorized as vegan, lacto-ovo vegetarian, or omnivore. There were 2818 (7.7%) vegans, 5616 (15.3%) lacto-ovo vegetarians, and 28,183 (77.0%) omnivores. The effect of different parameters on BP was determined using a multivariate multiple linear regression model with no intercept, with control for important characteristics and lifestyle confounders.

Results:The vegan group had a lower mean systolic BP (-3.87 mmHg,<0.001) and diastolic BP (-2.48 mmHg,<0.001) than the omnivore group. Participants with proteinuria had a higher systolic BP (4.26 mmHg,<0.001) and diastolic BP (2.15 mmHg,<0.001) than those without proteinuria. Interaction analysis indicated that vegan participants with proteinuria had a lower systolic BP (-2.73 mmHg,= 0.046) and diastolic BP (-2.54 mmHg,= 0.013) than other participants with proteinuria. However, individuals in the lacto-ovo group with proteinuria had a BP similar to other participants with proteinuria.

Conclusions:A vegan diet was associated with lower BP in asymptomatic participants with proteinuria. This diet could be a nonpharmacologic method to reduce BP.

OBJECTIVES:A vegetarian diet may prevent elevation of blood pressures and lower the risk for hypertension through lower degrees of obesity, inflammation, and insulin resistance. This study investigated the association between a vegetarian diet and hypertension incidence in a cohort of Taiwanese adult nonsmokers and examined whether this association was mediated through inflammation, abdominal obesity, or insulin resistance (using fasting glucose as a proxy).

METHODS:This matched cohort study was from the 1994-2008 MJ Health Screening Database. Each vegetarian was matched with five nonvegetarians by age, sex, and study site. The analysis included 4109 nonsmokers (3423 nonvegetarians and 686 vegetarians), followed for a median of 1.61 years. The outcome includes hypertension incidence, as well as SBP and DBP levels. Regression analysis was performed to assess the association between vegetarian diet and hypertension incidence or future blood pressure levels in the presence/absence of potential mediators.

RESULTS:Vegetarians had a 34% lower risk for hypertension, adjusting for age and sex (odds ratio: 0.66, 95% confidence interval: 0.50-0.87; SBP: -3.3 mmHg, P < 0.001; DBP: -1.5 mmHg, P < 0.001). The results stay statistically significant after further adjustment for C-reactive protein, waist circumference, and fasting glucose (odds ratio: 0.72, 95% confidence interval: 0.55-0.86; SBP: -2.4 mmHg, P < 0.05; DBP: -1.1 mmHg, P < 0.05). The protective association between vegetarian diet and hypertension appeared to be consistent across age groups.

CONCLUSION:Taiwanese vegetarians had lower incidence of hypertension than nonvegetarians. Vegetarian diets may protect against hypertension beyond lower abdominal obesity, inflammation, and insulin resistance.

We investigated the effects of walking 10,000 steps/day or more on blood pressure and cardiac autonomic nerve activity in mild essential hypertensive patients. All subjects were males aged 47.0+/-1.0 (mean+/-SEM) years old. The original cohort consisted of 730 people in a manufacturing industry who measured the number of steps they walked each day using a pedometer. Eighty-three of these subjects walked 10,000 steps/day or more for 12 weeks. Thirty-two of these were hypertensives with systolic blood pressure (SBP) greater than 140 mmHg and/or diastolic blood pressure (DBP) greater than 90 mmHg. Thirty of these hypertensive subjects (HT) were examined twice, once during the pre- and once during the post-study period, for body mass index (BMI), maximal oxygen intake (Vo2max), blood pressure, heart rate (HR), and autonomic nerve activity by power spectral analysis of SBP and HR variability. In the HT group, walking 13,510+/-837 steps/day for 12 weeks lowered blood pressure (from 149.3+/-2.7/98.5+/-1.4 to 139.1+/-2.9/90.1+/-1.9 mmHg; p<0.01, respectively). In both the 34 normotensive controls and 17 hypertensive sedentary controls, blood pressure did not change. Walking also significantly lowered low-frequency fluctuations in SBP as an index of sympathetic nerve activity, from 1.324+/-0.192 to 0.738+/-0.154 mmHg2/Hz (p<0.05). VO2max rose significantly from 26.1+/-2.4 to 29.5+/-2.5 ml/kg/min (p<0.05). There were no changes in parasympathetic nerve activity, baroreceptor reflex sensitivity, or BMI. Our results indicate that walking 10,000 steps/days or more, irrespective of exercise intensity or duration, is effective in lowering blood pressure, increasing exercise capacity, and reducing sympathetic nerve activity in hypertensive patients.

OBJECTIVE:High ankle systolic blood pressure (SBP;≥175 mm Hg) is associated with arterial stiffness (pulse wave velocity [PWV]) and cardiac events. This study aims to investigate the effects of whole-body vibration (WBV) training on ankle SBP and its associations with changes in PWV and aortic SBP in postmenopausal women.

METHODS:Thirty-six postmenopausal women were randomized to a control group (n = 12) or a WBV training group (3 d/wk) that was stratified by ankle SBP into WBV-high (n = 12) and WBV-normal (n = 12). Ankle SBP, brachial SBP, aortic SBP, femoral-ankle PWV (legPWV), carotid-femoral PWV, and brachial-ankle PWV (baPWV) were examined before and after 12 weeks.

RESULTS:Baseline ankle SBP was higher (P<0.05) in the WBV-high group compared with the WBV-normal group. WBV-high reduced mean (SEM) ankle SBP (-24 [7] mm Hg, P<0.05) compared with WBV-normal and control. Both WBV groups decreased (P<0.05) mean (SEM) brachial SBP (-11 [2] mm Hg), aortic SBP (-11 [3] mm Hg), legPWV (-0.80 [0.17] m/s), and baPWV (-1.18 [0.27] m/s) compared with the control group. Reductions in legPWV were correlated (P<0.05) with decreases in ankle SBP (r = 0.43), brachial SBP (r = 0.42), aortic SBP (r = 0.42), and baPWV (r = 0.75).

CONCLUSIONS:WBV training decreases ankle SBP in postmenopausal women with high ankle SBP. WBV training reduces aortic SBP, legPWV, and baPWV, but not carotid-femoral PWV, in postmenopausal women independently of ankle SBP. Therefore, reductions in peripheral and central SBP induced by WBV training are explained by a reduction in peripheral PWV.

Objective People living with HIV infection are at increased risk for developing cardiovascular disease (CVD). Safe and effective interventions for lowering CVD risk in HIV infection are high priorities. We conducted a prospective, randomized, controlled study to evaluate whether a yoga lifestyle intervention improves CVD risk factors, virological or immunological status, or quality of life (QOL) in HIV-infected adults relative to standard of care treatment in a matched control group. Methods Sixty HIV-infected adults with mild-moderate CVD risk were assigned to 20 weeks of supervised yoga practice or standard of care treatment. Baseline and week 20 measures were: 2-h oral glucose tolerance test with insulin monitoring, body composition, fasting serum lipid/lipoprotein profile, resting blood pressures, CD4 T-cell count and plasma HIV RNA, and the Medical Outcomes Study Short Form (SF)-36 health-related QOL inventory. Results Resting systolic and diastolic blood pressures improved more (P=0.04) in the yoga group (-5 +/- 2 and -3 +/- 1 mmHg, respectively) than in the standard of care group (+1 +/- 2 and+2 +/- 2 mmHg, respectively). However, there was no greater reduction in body weight, fat mass or proatherogenic lipids, or improvements in glucose tolerance or overall QOL after yoga. Immune and virological status was not adversely affected. Conclusion Among traditional lifestyle modifications, yoga is a low-cost, simple to administer, nonpharmacological, popular behavioural intervention that can lower blood pressure in pre-hypertensive HIV-infected adults with mild-moderate CVD risk factors.

BACKGROUND:Yoga, an ancient Indian system of exercise and therapy is an art of good living or an integrated system for the benefit of the body, mind, and inner spirit. Regular practice of yoga can help to increase blood flow to the brain, reduce stress, have a calming effect on the nervous system, and greatly help in reducing hypertension.

AIM:Aim of the present study is to evaluate the effect of 1-month yoga practice on body mass index (BMI), and blood pressure (BP).

MATERIALS AND METHODS:The present study was conducted to determine the effect of yoga practice on 64 participants (age 53.6± 13.1 years) (experimental group) whereas the results were compared with 26 healthy volunteers (control group). We examined the effects of yoga on physiological parameters in a 1-month pilot study. Most of the participants were learner and practiced yoga for 1 h daily in the morning for 1 month. BMI and BP (systolic and diastolic) were studied before and after 1 month of yoga practice.

RESULTS:Yoga practice causes decreased BMI (26.4± 2.5-25.22 ± 2.4), systolic BP (136.9 ± 22.18 mmHg to 133 ± 21.38 mmHg), and diastolic BP (84.7 ± 6.5 mmHg to 82.34 ± 7.6 mmHg). On the other hand, no significant changes were observed in BMI and BP of control group.

CONCLUSION:This study concludes that yoga practice has potential to control BMI and BP without taking any medication.

OBJECTIVES:Metabolic syndrome (MetS) is associated with diabetes mellitus and cardiovascular diseases. Our previous study indicated that people with MetS showed a decrease in waist circumference and a decreasing trend in blood pressure after 1 year of yoga. This study investigated the effect of yoga on MetS people with high-normal blood pressure by exploring modulations in pro-inflammatory adipokines (leptin, chemerin, visfatin and plasminogen activator inhibitor-1 or PAI-1) and an anti-inflammatory adipokine (adiponectin).

DESIGN & METHODS:A total of 97 Hong Kong Chinese individuals aged 57.6± 9.1 years with MetS and high-normal blood pressure were randomly assigned to control (n = 45) and yoga groups (n = 52). Participants in the control group were not given any intervention but were contacted monthly to monitor their health status. Participants in the yoga group underwent a yoga training programme with three 1-hour yoga sessions weekly for 1 year. The participants' sera were harvested and assessed for adipokines. Generalized estimating equation (GEE) was used to examine the interaction effect between 1 year of time (pre vs. post) and intervention (control vs. yoga).

RESULTS:GEE analyses revealed significant interaction effects between 1-year of time and yoga intervention for the decreases in leptin and chemerin and the increase in adiponectin concentration in the sera examined.

CONCLUSION:These results demonstrated that 1 year of yoga training decreased pro-inflammatory adipokines and increased anti-inflammatory adipokine in adults with MetS and high-normal blood pressure. These findings support the beneficial role of yoga in managing MetS by favourably modulating adipokines. This article is protected by copyright. All rights reserved.

Background Many clinical trials have evaluated the oxidative stress reduction and enhancement of antioxidant status following yogic practices, but a review has not been reported earlier. Present study is designed to systematically review the effect of yogic practices on oxidative stress and antioxidant status. Content Using the MEDLINE, EMBASE SCOPEMED, and Indian database electronic searches were performed through August 2016 using the keywords yoga AND oxidative stress OR antioxidant which yielded 97 studies. Selections were made to include only experimental studies written in English, published in peer-reviewed journals and investigating the effects of regular yogic practices on oxidative stress and antioxidant status in these studies. Summary and outlook Search yielded a total of 97 trials, 11 met rigorous criteria for final systematic review. Healthy population showed overall enhancement of antioxidant status and reduced oxidative stress following yogic practices. Diabetic patients showed increased glutathione, vitamin C content and superoxide dismutase activity and decreased malondialdehyde content following yogic practices. Prediabetic and hypertensive patients showed reduced malondialdehyde content following yogic practices. Renal disease patients showed decreased protein oxidation, and increased superoxide dismutase activity following yogic practices. Regular yogic practices can improve antioxidants and reduce oxidative stress in healthy, diabetic, prediabetic, hypertensive and renal disease patients. Studies on other disease population have rarely been reported and studies are very few to conclude strongly.