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5-minute workout lowers blood pressure as much as exercise, drugs

The ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) could play a key role in helping aging adults fend off cardiovascular disease.

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Working out just five minutes daily via a practice described as “strength training for your breathing muscles” lowers blood pressure and improves some measures of vascular health as well as, or even more than, aerobic exercise or medication, new CU Boulder research shows.

The study, published in the Journal of the American Heart Association, provides the strongest evidence yet that the ultra-time-efficient maneuver known as High-Resistance Inspiratory Muscle Strength Training (IMST) could play a key role in helping aging adults fend off cardiovascular disease.

In the United States alone, 65% of adults over age 50 have above-normal blood pressure – putting them at greater risk of heart attack or stroke. Yet fewer than 40% meet recommended aerobic exercise guidelines.

“There are a lot of lifestyle strategies that we know can help people maintain cardiovascular health as they age. But the reality is, they take a lot of time and effort and can be expensive and hard for some people to access,” said lead author Daniel Craighead, an assistant research professor in the Department of Integrative Physiology. “IMST can be done in five minutes in your own home while you watch TV.”

Developed in the 1980s as a way to help critically ill respiratory disease patients strengthen their diaphragm and other inspiratory (breathing) muscles, IMST involves inhaling vigorously through a hand-held device which provides resistance. Imagine sucking hard through a tube that sucks back.

Initially, when prescribing it for breathing disorders, doctors recommended a 30-minute-per-day regimen at low resistance. But in recent years, Craighead and colleagues have been testing whether a more time-efficient protocol–30 inhalations per day at high resistance, six days per week–could also reap cardiovascular, cognitive and sports performance improvements.

For the new study, they recruited 36 otherwise healthy adults ages 50 to 79 with above normal systolic blood pressure (120 millimeters of mercury or higher). Half did High-Resistance IMST for six weeks and half did a placebo protocol in which the resistance was much lower.

After six weeks, the IMST group saw their systolic blood pressure (the top number) dip nine points on average, a reduction which generally exceeds that achieved by walking 30 minutes a day five days a week. That decline is also equal to the effects of some blood pressure-lowering drug regimens.

Even six weeks after they quit doing IMST, the IMST group maintained most of that improvement.

“We found that not only is it more time-efficient than traditional exercise programs, the benefits may be longer lasting,” Craighead said.

The treatment group also saw a 45% improvement in vascular endothelial function, or the ability for arteries to expand upon stimulation, and a significant increase in levels of nitric oxide, a molecule key for dilating arteries and preventing plaque buildup. Nitric oxide levels naturally decline with age.

Markers of inflammation and oxidative stress, which can also boost heart attack risk, were significantly lower after people did IMST.

And, remarkably, those in the IMST group completed 95% of the sessions.

“We have identified a novel form of therapy that lowers blood pressure without giving people pharmacological compounds and with much higher adherence than aerobic exercise,” said senior author Doug Seals, a Distinguished Professor of Integrative Physiology. “That’s noteworthy.”

The practice may be particularly helpful for postmenopausal women.

In previous research, Seals’ lab showed that postmenopausal women who are not taking supplemental estrogen don’t reap as much benefit from aerobic exercise programs as men do when it comes to vascular endothelial function. IMST, the new study showed, improved it just as much in these women as in men.

“If aerobic exercise won’t improve this key measure of cardiovascular health for postmenopausal women, they need another lifestyle intervention that will,” said Craighead. “This could be it.”

Preliminary results suggest MST also improved some measures of brain function and physical fitness. And previous studies from other researchers have shown it can be useful for improving sports performance.

“If you’re running a marathon, your respiratory muscles get tired and begin to steal blood from your skeletal muscles,” said Craighead, who uses IMST in his own marathon training. “The idea is that if you build up endurance of those respiratory muscles, that won’t happen and your legs won’t get as fatigued.”

Seals said they’re uncertain exactly how a maneuver to strengthen breathing muscles ends up lowering blood pressure, but they suspect it prompts the cells lining blood vessels to produce more nitric oxide, enabling them to relax.

The National Institutes of Health recently awarded Seals $4 million to launch a larger follow-up study of about 100 people, comparing a 12-week IMST protocol head-to-head with an aerobic exercise program.

Meanwhile, the research group is developing a smartphone app to enable people to do the protocol at home using already commercially available devices.

Those considering IMST should consult with their doctor first. But thus far, IMST has proven remarkably safe, they said.

“It’s easy to do, it doesn’t take long, and we think it has a lot of potential to help a lot of people,” said Craighead.

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Wellness

Top 5 heat tips for those with medical-based heat intolerance

Prolonged exposure to routine summer weather is a persistent issue for those with chronic diseases. But the recent record-breaking temperatures are causing ripple effects, sparking symptom flareups, inflammation, and debilitating fatigue.

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The current and seemingly relentless heat waves are dangerous to a growing, but often overlooked community, people with medically-caused heat intolerance, often associated with neurological and autoimmune diseases.

Prolonged exposure to routine summer weather is a persistent issue for those with chronic diseases. But the recent record-breaking temperatures are causing ripple effects, sparking symptom flareups, inflammation, and debilitating fatigue.

“The general public doesn’t really understand what fatigue means,” said Kim Klein, 63. “It causes overwhelming brain fog and I can’t think straight — it gets the best of me. Trying to stay ahead of my multiple sclerosis-related fatigue is the best thing I can do.”

“Extreme heat unfortunately impacts Kim Klein and many of our clients disproportionately,” says Kurtis Kracke, ThermApparel CEO. “But people without chronic disease need to be vigilant as well since many common medications for blood pressure, allergies, and depression, are compounding these issues for all of us. This is a recipe for disaster.”

ThermApparel’s Top Five Tips to Battle Unprecedented Heat Waves:

  1. Limit your exposure: reduce activity, stay indoors, find air conditioning, drink fluids, avoid caffeine, and liquor.
  2. Using a cooling vest can reduce symptom flareups, shorten fatigue, and increase recovery times.
  3. Inflammation and fatigue are your worst enemies: If you must be active, know that heat can aggravate inflammation, and increase corresponding fatigue.
  4. Understand your medications and which can increase your risk to heat-related illness: antidepressants, blood pressure meds, antihistamines, etc.
  5. Know that when it is over 85 degrees, your heart is working double or triple than normal to cool your body down.
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Fitness

Study finds moderate-vigorous physical activity is the most efficient at improving fitness

Dedicated exercise (moderate-vigorous physical activity) was the most efficient at improving fitness. Specifically, exercise was three times more efficient than walking alone and more than 14 times more efficient than reducing the time spent sedentary. Additionally, they found that the greater time spent exercising and higher steps/day could partially offset the negative effects of being sedentary in terms of physical fitness.

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In the largest study performed to date to understand the relationship between habitual physical activity and physical fitness, researchers from Boston University School of Medicine (BUSM) have found that higher amount of time spent performing exercise (moderate-vigorous physical activity) and low-moderate level activity (steps) and less time spent sedentary, translated to greater physical fitness.

“By establishing the relationship between different forms of habitual physical activity and detailed fitness measures, we hope that our study will provide important information that can ultimately be used to improve physical fitness and overall health across the life course,” explained corresponding author Matthew Nayor, MD, MPH, assistant professor of medicine at BUSM.

He and his team studied approximately 2,000 participants from the community-based Framingham Heart Study who underwent comprehensive cardiopulmonary exercise tests (CPET) for the “gold standard” measurement of physical fitness. Physical fitness measurements were associated with physical activity data obtained through accelerometers (device that measures frequency and intensity of human movement) that were worn for one week around the time of CPET and approximately eight years earlier.

They found dedicated exercise (moderate-vigorous physical activity) was the most efficient at improving fitness. Specifically, exercise was three times more efficient than walking alone and more than 14 times more efficient than reducing the time spent sedentary. Additionally, they found that the greater time spent exercising and higher steps/day could partially offset the negative effects of being sedentary in terms of physical fitness.

According to the researchers, while the study was focused on the relationship of physical activity and fitness specifically (rather than any health-related outcomes), fitness has a powerful influence on health and is associated with lower risk of cardiovascular disease, diabetes, cancer and premature death. “Therefore, improved understanding of methods to improve fitness would be expected to have broad implications for improved health,” said Nayor, a cardiologist at Boston Medical Center.

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Fitness

Tips to avoid common running injuries

Injuries are very common among runners. Recent research estimates that 82% of runners will become injured during their running career and up to 90% will experience injury while training for a marathon. Some of the most common include a stress fracture, plantar fasciitis, hamstring tendinitis, ankle sprain, runners’ knee, and Achilles’ tendonitis.

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Whether training for a marathon or preparing for your first community race, being knocked off course with pain can be hard to handle mentally and physically.

Injuries are very common among runners. Recent research estimates that 82% of runners will become injured during their running career and up to 90% will experience injury while training for a marathon. Some of the most common include a stress fracture, plantar fasciitis, hamstring tendinitis, ankle sprain, runners’ knee, and Achilles’ tendonitis.

Injury prevention is critical. Here are some safety tips from Dr. Joshua Blomgren, a 15-time Chicago Marathon team physician and sports medicine physician, Midwest Orthopaedics at Rush:

Don’t over-train

Don’t increase weekly mileage or intensity by more than 10 percent each week. Build up slowly and let a good training schedule determine how much you run.

Invest in good shoes

Go to a specialty running shop to be properly fitted for running shoes and/or orthotics. Replace them every 350-500 miles. Incorrect shoes can affect your gait, leading to injuries in your feet, legs, knees, or hips.

Choose the best running surface

Look for running surfaces that absorb shock. Opt for asphalt over concrete. Find grass or dirt trails, especially for higher mileage. Avoid uneven surfaces and seek paths with slow curves.

Stretch!

Training causes tight muscles, leading to strain and changes in your gait. Commit to a stretching program. Just 5 -10 minutes after each workout can make a big difference.

Strengthen muscles

Runners have tight hip flexors because their quads are overtrained. Strengthen your hamstrings and glutes to reduce chance of injury and abductors, adductors, and core to create stability.

Watch out for heel striking

Heel striking occurs when your feet land in front of you and your heel hits the ground first. This is common among new runners but can lead to injuries such as shin splints, stress fractures, and joint pain. Land mid-sole with your foot directly underneath your body.

Prioritize posture

Good form means staying upright and keeping your shoulders back and relaxed. Work core exercises into your training and do posture checks every so often. Hold your head right above your shoulders and hips.

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