Wellness
Aerobic exercise performed in the evening benefits elderly hypertensives more than morning exercise
Evening training was more effective in terms of improving cardiovascular autonomic regulation and lowering blood pressure. This can be partly explained as due to an improvement in baroreflex sensitivity and a reduction of muscle sympathetic nerve activity, which increased in the evening.

Aerobic training is known to regulate blood pressure more effectively when practiced in the evening than in the morning. Now, researchers conducted a study of elderly patients at the University of São Paulo’s School of Physical Education and Sports (EEFE-USP) in Brazil, and they concluded that evening exercise is better for blood pressure regulation thanks to improved cardiovascular control by the autonomic nervous system via a mechanism known as baroreflex sensitivity.
An article on this study, “Evening but not morning aerobic training improves sympathetic activity and baroreflex sensitivity in elderly patients with treated hypertension”, was published in the The Journal of Physiology.
“There are multiple mechanisms to regulate blood pressure, and although morning training was beneficial, only evening training improved short-term control of blood pressure by enhancing baroreflex sensitivity. This is important because baroreflex control has a positive effect on blood pressure regulation, and there aren’t any medications to modulate the mechanism,” Leandro Campos de Brito, first author of the article, said.
In the study, 23 elderly patients diagnosed and treated for hypertension were randomly allocated into two groups: morning training and evening training. Both groups trained for ten weeks on a stationary bicycle at moderate intensity, with three 45-minute sessions per week.
Key cardiovascular parameters were analyzed, such as systolic and diastolic blood pressure, and heart rate after ten minutes’ rest. The data was collected before and at least three days after the volunteers completed the ten weeks of training.
The researchers also monitored mechanisms pertaining to the autonomic nervous system (which controls breathing, heart rate, blood pressure, digestion, and other involuntary bodily functions), such as muscle sympathetic nerve activity (which regulates peripheral blood flow via contraction and relaxation of blood vessels in muscle tissue) and sympathetic baroreflex sensitivity (assessing control of blood pressure via alterations to muscle sympathetic nerve activity).
In the evening training group, all four parameters analyzed were found to improve: systolic and diastolic blood pressure, sympathetic baroreflex sensitivity, and muscle sympathetic nerve activity. In the morning training group, no improvements were detected in muscle sympathetic nerve activity, systolic blood pressure or sympathetic baroreflex sensitivity.
Evening training was more effective in terms of improving cardiovascular autonomic regulation and lowering blood pressure. This can be partly explained as due to an improvement in baroreflex sensitivity and a reduction of muscle sympathetic nerve activity, which increased in the evening.
“For now, all we know is that baroreflex control is the decisive factor, from the cardiovascular standpoint at least, to make evening training more beneficial than morning training, since it induces the other benefits analyzed. However, much remains to be done in this regard in order to obtain a better understanding of the mechanisms involved,” said Brito.
Baroreflex sensitivity regulates each heartbeat interval and controls autonomic activity throughout the organism.
“It’s a mechanism that involves sensitive fibers and deformations in the walls of arteries in specific places, such as the aortic arch and carotid body. When blood pressure falls, this region warns the brain region that controls the autonomic nervous system, which in turn signals the heart to beat faster and tells the arteries to contract more strongly. If blood pressure rises, it warns the heart to beat more slowly and tells the arteries to contract less. In other words, it modulates arterial pressure beat by beat,” Brito said.
In previous studies, the EEFE-USP research group showed that evening aerobic training reduced blood pressure more effectively than morning training in hypertensive men (read more at agencia.fapesp.br/34194), and that the more effective response to evening training in terms of blood pressure control was accompanied by a greater reduction in systemic vascular resistance and systolic pressure variability (read more at agencia.fapesp.br/37432).
“Replication of the results obtained in previous studies and in different groups of hypertensive patients, associated with the use of more precise techniques to evaluate the main outcomes, has strengthened our conclusion that aerobic exercise performed in the evening is more beneficial to the autonomic nervous system in patients with hypertension. This can be especially important for those with resistance to treatment with medication,” Brito ended.
Wellness
Keeping fit and building muscle could increase survival rates in cancer patients
Anyone can benefit from higher muscle strength and cardiorespiratory fitness to have reduced mortality. But there are especially positive findings for those patients living with lung cancer and digestive cancer.

Physical fitness and increasing muscle strength could reduce the mortality rate for cancer patients by between 31% to 46%, new research from Edith Cowan University (ECU) has found.
Around 20 million new cancer cases were reported in 2022, with 9.7 million cancer deaths reported world-wide during the same period, with experts expecting the trend to increase in the coming decades.
ECU PhD student Mr Francesco Bettariga noted that in healthy adults, physical fitness and muscle strength has been associated with a 21% reduction in all-cause mortality, as well as a 15% reduction for cardiovascular disease mortality, and a 27% reduction for chronic obstructive pulmonary disease mortality.
Mr Bettariga’s research has found that both muscle strength and cardiorespiratory fitness had a significant impact to lower the risk of all-cause and cancer-specific mortality in patients with any form of cancer and stage.
“Our research found that anyone can benefit from higher muscle strength and cardiorespiratory fitness to have reduced mortality. But when we did our sub-group analysis, we found especially positive findings for those patients living with lung cancer and digestive cancer,” Mr Bettariga said.
“Increased muscle strength and cardiorespiratory fitness had also significant potential to extend the lives of people living with advanced stage of cancer.”
Mr Bettariga said that while physical fitness was beneficial to everyone, increased muscle strength and cardiorespiratory fitness after a cancer diagnosis would still deliver results.
“In practical terms, if a person is diagnosed with cancer and only starts exercising to increase their muscle strength or cardiorespiratory fitness levels after that diagnosis, they will potentially extend their survival and reduce their mortality risk.”
He noted that cardiorespiratory fitness could be particularly increased by aerobic exercises like brisk walking, running, swimming or cycling, while muscle strength could be enhanced by the adoption of resistance exercise programs, including the use of dumbbells, barbell and weight-machine.
“The guidelines are that people should be exercising at least three to five days per week. They can do between 75 minutes and 150 minutes of vigorous-intensity exercise a week, or around 300 minutes of moderate-intensity exercise.
“Resistance exercise training can be done at least twice a week, and would need to incorporate at least two or three sets of each resistance exercise, consisting of around 8 to 15 repetitions each at moderate intensity at least.”
Mr Bettariga said the results from his research underscored the importance of clinical practitioners assessing the physical fitness of cancer patients as part of the process of predicting survival.
“Moreover, from a practical perspective, implementing tailored exercise prescriptions to enhance muscle strength and cardiorespiratory fitness throughout the cancer continuum may contribute to reducing cancer-related mortality.”
Wellness
Physical activity boosts mental health in women with chronic pelvic pain disorders
By using innovative data modeling techniques, we can better understand how lifestyle factors like physical activity interact with health conditions and pave the way for more personalized treatment approaches.

A Mount Sinai study provides compelling evidence that exercise can significantly help the mental well-being of millions of women living with chronic pelvic pain disorders (CPPDs), such as endometriosis and uterine fibroids.
The researchers at the Icahn School of Medicine at Mount Sinai found that activities like brisk walking or aerobic exercise can lead to measurable improvements in mental well-being, regardless of pain levels or history of anxiety or depressive disorders. Their findings were reported in the February 26 online issue of the Journal of Pain Research.
CPPDs affect millions of women worldwide, leading to increased health care costs, reduced quality of life, and a higher risk of anxiety and depression, yet effective management strategies remain limited. This study highlights the potential of physical activity as a simple and accessible way to enhance mental well-being, say the investigators.
“Chronic pelvic pain disorders are incredibly complex and burdensome for those affected, yet we still have very few effective treatment strategies,” says lead corresponding author Ipek Ensari, PhD, an Assistant Professor in the Windreich Department of Artificial Intelligence and Human Health at the Icahn School of Medicine and a member of the Hasso Plattner Institute of Digital Health at Mount Sinai. “Our research suggests that physical activity could be an important tool for improving mental health in these patients, offering them a proactive way to enhance their well-being.”
The study tracked 76 women with CPPDs over 14 weeks using mobile health technology, collecting more than 4,200 days’ worth of data. Participants reported their mental health, physical functioning, and pain levels weekly via an app (ehive), while Fitbit devices recorded their daily physical activity. The researchers used advanced statistical modeling to analyze how movement patterns influenced mental health outcomes over time.
One key finding was that the benefits appear to accumulate over time rather than provide immediate relief. “We were particularly intrigued to find that the positive effects of exercise seem to lag by a few days, meaning the mental health benefits may build up gradually,” says Dr. Ensari. “This insight is vital for both patients and health care providers, as it underscores the importance of consistency in physical activity.”
Beyond its implications for patient care, the study also highlights the growing role of artificial intelligence and mobile health technologies in chronic disease management.
“This study showcases the power of wearable technology and AI-driven analysis to uncover valuable insights about health and behavior in real time,” says Girish N. Nadkarni, MD, Chair of the Windreich Department of Artificial Intelligence and Human Healthat the Icahn School of Medicine, Director of the Hasso Plattner Institute for Digital Health, Irene and Dr. Arthur M. Fishberg Professor of Medicine, and Director of The Charles Bronfman Institute for Personalized Medicine. Dr. Nadkarni is also the inaugural System Chief of the Division of Data-Driven and Digital Medicine within Mount Sinai’s Department of Medicine and Co-Director of the Mount Sinai Clinical Intelligence Center. “By using innovative data modeling techniques, we can better understand how lifestyle factors like physical activity interact with health conditions and pave the way for more personalized treatment approaches.”
While the findings are encouraging, the researchers emphasize that physical activity should not be viewed as a replacement for medical treatment but rather as a complementary strategy. Future research will explore how different types and intensities of exercise impact mental health, pain, and fatigue, with the ultimate goal of developing personalized interventions using wearable technology and mobile apps.
The paper is titled “Trajectories of mHealth-tracked mental health and their predictors in female chronic pelvic pain disorders.”
The remaining authors, all with the Icahn School of Medicine except where indicated, are Emily L. Leventhal, BA: Nivedita Nukavarapu, PhD; Noemie Elhadad, PhD (Columbia University Irving Medical Center); Suzanne R. Bakken, PhD, RN, FAAN, FACMI, FIAHSI (Columbia University School of Nursing); Michal A. Elovitz, MD; Robert P. Hirten, MD; Jovita Rodrigues, MS; Matteo Danieletto, PhD; and Kyle Landell, BA.
Wellness
Move more, age well: Prescribing physical activity for older adults as a recipe for healthy aging
150 minutes of moderate physical activity every week reduced risk of death from all causes by 31%. Physical activity is essential for aging well and can help prevent or reduce disease in more than 30 chronic conditions, such as coronary artery disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, depression, dementia, and cancer.

Can physical activity extend the lifespans of older adults? A review article published in CMAJ (Canadian Medical Association Journal) summarizes the considerable evidence supporting the important role physical activity plays in preventing or reducing the effects of diseases and discusses how to prescribe effective exercise for older adults.
Canada’s population is aging, with at least 1 in 5 people aged 65 years or older in 2025, and the number of people older than age 85 years is expected to triple in the next 20 years. However, for many people, these added years do not mean healthy years. More than 80% of adults do not meet the recommendations for physical activity from the Canadian Physical Activity Guidelines.
“Physical activity is one of the most important ways to preserve or improve functional independence, including among older adults who are frail or deemed to be at increased risk of falling,” writes Dr. Jane Thornton, associate professor at Schulich School of Medicine & Dentistry, Western University, London, Ontario, and director of health, medicine and science at the International Olympic Committee. “Higher levels of physical activity in older age are associated with improvements in cognition, mental health, and quality of life.”
A 2023 meta-analysis of several large studies found that 150 minutes of moderate physical activity every week reduced risk of death from all causes by 31%. Physical activity is essential for aging well and can help prevent or reduce disease in more than 30 chronic conditions, such as coronary artery disease, heart failure, type 2 diabetes mellitus, chronic obstructive pulmonary disease, osteoporosis, depression, dementia, and cancer.
Benefits of activity include the following:
- Protection against risk of death from any cause
- Falls prevention through increased muscle strength and better balance
- Bone and joint health, including improved bone density and alleviation of some osteoarthritis symptoms
- Improved cognitive function, and better mood and mental health
- Ability to engage in daily activities and improved quality of life
The World Health Organization (WHO) recommends 150–300 minutes weekly of moderate-to-intense physical activity for adults, including older adults.
How can clinicians prescribe physical activity?
“As many older adults live with chronic health conditions or reduced mobility, clinicians should tailor and encourage them to take a gradual approach to increasing their physical activity, which should include resistance training (muscle strengthening) as an essential component,” said Dr. Samir Sinha, professor of medicine at the University of Toronto and director of health policy research, National Institute on Ageing.
The WHO 5-step framework — called the “5As” — can provide clinicians with a roadmap to promote activity in their patients. The authors also suggest inputting physical activity in patient records as a vital sign to follow over time.
“Physical activity is underused as a health intervention both in the community and in the delivery of health care for older adults. Age, frailty, or existing functional impairments should not be viewed as absolute contraindications to physical activity but rather key reasons to prescribe it, considering the benefits of physical activity interventions for older adults. Older adults who become more physically active can potentially add years to their lives as well as higher quality of life to those years,” the authors conclude.
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