Suchergebnisse

OBJECTIVES: To determine the feasibility of a low sodium meal plan intervention aimed at reducing seated blood pressure (BP) in residents of a government-subsidized congregate, senior living facility. METHODS: The Satter House Trial of Reduced Sodium Meals (SOTRUE) was an individual-level, masked, randomized, controlled pilot study, testing the feasibility of administering a low versus typical sodium meal plan to adult residents of Jack Satter House, a section 202 congregate living facility in Revere, MA, subsidized by the Federal Department of Housing and Urban Development (HUD). Adults over age 60 years received 3 isocaloric meals with two snacks daily over a 14-day period. Both meal plans were equivalent in potassium and macronutrients, but differed in sodium density ( 2 mg/kcal). The primary outcome was seated systolic BP (SBP) averaged over 2 visits (days 10 and 14) using an Omron HEM-907XL automated cuff. Our objective measure of compliance was morning urine sodium-creatinine ratio. RESULTS: We randomized 20 participants (95% women, 95% white, and mean age 78 +/− 8 years), beginning in October 7, 2019. Baseline characteristics were evenly distributed between groups. Dietary compliance was high (only 2 discontinued meals) and follow-up was 100% with the last participant ending November 4, 2019. Baseline SBP changed from 121 to 116 mm Hg on the typical sodium meal plan (N = 9; mean difference of −5 mm Hg; 95% CI: −18, 8) and 123 to 112 mm Hg on the low sodium meal plan (N = 11; mean difference of −11 mm Hg; 95% CI: −15.2, −7.7). Compared to the typical sodium meal plan, the low sodium meal plan non-significantly reduced SBP by 5 mm Hg (95% CI: −14, 4) and non-significantly reduced urine sodium-creatinine ratio (%-difference −36.0; 95% CI: −60.3, 3.4). Effects on SBP were greater in the subgroup using hypertension medications at baseline (−13 mm Hg; 95% CI: −26, −0) and changes in SBP from baseline were correlated with changes in urine sodium-creatinine ratio (Pearson's r = 0.31). ...

Abstract

Background
Dysfunction in blood vessel dynamics may contribute to changes in muscle measures. Therefore, we examined associations of vascular health measures with grip strength and gait speed in adults from the Framingham Heart Study.


Methods
The cross-sectional study (1998–2001) included participants with 1 measure of grip strength (kg, dynamometer) or gait speed (4-m walk, m/s) and at least 1 measure of aortic stiffness (carotid–femoral pulse wave velocity, brachial pulse pressure, and brachial flow pulsatility index) or brachial artery structure and function (resting flow velocity, resting brachial artery diameter, flow-mediated dilation %, hyperemic brachial blood flow velocity, and mean arterial pressure [MAP]) assessed by tonometry and brachial artery ultrasound. The longitudinal study included participants with ≥1 follow-up measurement of gait speed or grip strength. Multivariable linear regression estimated the association of 1 standard deviation (SD) higher level of each vascular measure with annualized percent change in grip strength and gait speed, adjusting for covariates.


Results
In cross-sectional analyses (n = 2 498, age 61 ± 10 years; 56% women), higher resting brachial artery diameter (β ± standard error [SE] per 1 SD: 0.59 ± 0.24, p = .01) and MAP (β ± SE: 0.39 ± 0.17, p = .02) were associated with higher grip strength. Higher brachial pulse pressure (β ± SE: −0.02 ± 0.01, p = .07) was marginally associated with slower gait speed. In longitudinal analyses (n = 2 157), higher brachial pulse pressure (β ± SE: −0.19 ± 0.07, p = .005), was associated with slowing of gait speed but not with grip strength.


Conclusions
Higher brachial artery pulse pressure (measure of aortic stiffness) was associated with loss of physical function over ~11 years, although we found no evidence that microvascular function contributed to the relation.