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Published in: Health and Quality of Life Outcomes 1/2018

Open Access 01-12-2018 | Research

Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial

Authors: Victoria Arija, Felipe Villalobos, Roser Pedret, Angels Vinuesa, Dolors Jovani, Gabriel Pascual, Josep Basora

Published in: Health and Quality of Life Outcomes | Issue 1/2018

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Abstract

Background

Physical activity (PA) promotes cardiovascular health and health related quality of life (HRQoL), although the effect of that on blood pressure (BP) control has rarely been studied in hypertensive subjects. Our aim was to evaluate the effectiveness of a PA intervention programme on cardiovascular disease (CVD) risk, HRQoL and BP control in hypertensive subjects.

Methods

A randomized clinical trial, with a PA intervention programme of 9 months duration, comprising a walking group of 120 min/week, supervised, and with socio-cultural activities. Participants were 207 hypertensive subjects (68.2 years, 76.8% women). PA (IPAQ-s), diet, CVD risk, BP, BMI, smoking, and HRQoL (SF-36) were assessed at baseline and at the end of the intervention. Changes in CVD risk and in HRQoL during the intervention was calculated (end-baseline score). Multivariate models were applied.

Results

In multivariate models, the PA intervention programme, with no modification of the diet, decreased CVD risk (− 1.19 points) and the systolic BP (− 8.68 mmHg), and increased some areas of HRQoL (4.45 to 14.62 points). An increase in the percentage of subjects with controlled BP was observed by the PA programme itself (OR 5.395 to 5.785 according to multivariate models), and by the changes during the intervention in the decrease in CVD risk (OR 0.609) and in the increase in the HRQoL in physical component summary (OR 1.041), role physical (OR 1.010), and bodily pain (OR 1.014), independently of controlled BP at baseline.

Conclusions

This PA intervention programme improved cardiovascular health and HRQoL, and favoured BP control in primary care users with hypertension.

Trial registration

Clinicaltrials.gov ID NCT02767739; Trial registered on May 5th, 2016. Retrospectively registered.
Literature
1.
go back to reference Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. Guía de práctica clínica de la ESH/ESC para el manejo de la hipertensión arterial (2013). Rev. Española Cardiol. 2013;66:880.e1–880.e64. Mancia G, Fagard R, Narkiewicz K, Redon J, Zanchetti A, Böhm M, et al. Guía de práctica clínica de la ESH/ESC para el manejo de la hipertensión arterial (2013). Rev. Española Cardiol. 2013;66:880.e1–880.e64.
2.
go back to reference Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009;27:963–75.CrossRefPubMed Pereira M, Lunet N, Azevedo A, Barros H. Differences in prevalence, awareness, treatment and control of hypertension between developing and developed countries. J Hypertens. 2009;27:963–75.CrossRefPubMed
3.
go back to reference Menéndez E, Delgado E, Fernández-Vega F, Prieto MA, Bordiú E, Calle A, et al. Prevalencia, diagnóstico, tratamiento y control de la hipertensión arterial en España. Resultados del estudio Di@bet.es. Rev. Española Cardiol. 2016;69:572–8.CrossRef Menéndez E, Delgado E, Fernández-Vega F, Prieto MA, Bordiú E, Calle A, et al. Prevalencia, diagnóstico, tratamiento y control de la hipertensión arterial en España. Resultados del estudio Di@bet.es. Rev. Española Cardiol. 2016;69:572–8.CrossRef
4.
go back to reference Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37:3232–45.CrossRef Townsend N, Wilson L, Bhatnagar P, Wickramasinghe K, Rayner M, Nichols M. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J. 2016;37:3232–45.CrossRef
6.
go back to reference Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens. 2011;29:179–88.CrossRefPubMed Trevisol DJ, Moreira LB, Kerkhoff A, Fuchs SC, Fuchs FD. Health-related quality of life and hypertension: a systematic review and meta-analysis of observational studies. J Hypertens. 2011;29:179–88.CrossRefPubMed
7.
go back to reference Youssef RM, Moubarak II, Kamel MI. Factors affecting the quality of life of hypertensive patients. East Mediterr Health J. 2005;11:109–18.PubMed Youssef RM, Moubarak II, Kamel MI. Factors affecting the quality of life of hypertensive patients. East Mediterr Health J. 2005;11:109–18.PubMed
8.
go back to reference Bardage C, Isacson DGL. Hypertension and health-related quality of lifean epidemiological study in Sweden. J Clin Epidemiol. 2001;54:172–81.CrossRefPubMed Bardage C, Isacson DGL. Hypertension and health-related quality of lifean epidemiological study in Sweden. J Clin Epidemiol. 2001;54:172–81.CrossRefPubMed
9.
go back to reference Tüzün H, Aycan S, İlhan MN. Impact of comorbidity and socioeconomic status on quality of life in patients with chronic diseases who attend primary health care centres. Cent Eur J Public Health. 2015;23:188–94.CrossRefPubMed Tüzün H, Aycan S, İlhan MN. Impact of comorbidity and socioeconomic status on quality of life in patients with chronic diseases who attend primary health care centres. Cent Eur J Public Health. 2015;23:188–94.CrossRefPubMed
10.
go back to reference Tsai J, Yang H, Wang W, Hsieh M, Chen P, Kao C, et al. The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension. Clin Exp Hypertens. 2004;26:255–65.CrossRefPubMed Tsai J, Yang H, Wang W, Hsieh M, Chen P, Kao C, et al. The beneficial effect of regular endurance exercise training on blood pressure and quality of life in patients with hypertension. Clin Exp Hypertens. 2004;26:255–65.CrossRefPubMed
11.
go back to reference Sun J, Buys N. Community-based mind–body meditative tai chi program and its effects on improvement of blood pressure, weight, renal function, serum lipoprotein, and quality of life in Chinese adults with hypertension. Am J Cardiol. 2015;116:1076–81.CrossRefPubMed Sun J, Buys N. Community-based mind–body meditative tai chi program and its effects on improvement of blood pressure, weight, renal function, serum lipoprotein, and quality of life in Chinese adults with hypertension. Am J Cardiol. 2015;116:1076–81.CrossRefPubMed
12.
go back to reference Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ. 2008;337:a2509.CrossRefPubMedPubMedCentral Lawton BA, Rose SB, Elley CR, Dowell AC, Fenton A, Moyes SA. Exercise on prescription for women aged 40-74 recruited through primary care: two year randomised controlled trial. BMJ. 2008;337:a2509.CrossRefPubMedPubMedCentral
13.
go back to reference Elley CR, Kerse N, Arroll B, Robinson E. Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ. 2003;326:793.CrossRefPubMedPubMedCentral Elley CR, Kerse N, Arroll B, Robinson E. Effectiveness of counselling patients on physical activity in general practice: cluster randomised controlled trial. BMJ. 2003;326:793.CrossRefPubMedPubMedCentral
14.
go back to reference Kinmonth A-L, Wareham NJ, Hardeman W, Sutton S, Prevost AT, Fanshawe T, et al. Efficacy of a theory-based behavioural intervention to increase physical activity in an at-risk group in primary care (ProActive UK): a randomised trial. Lancet. 2008;371:41–8.CrossRefPubMed Kinmonth A-L, Wareham NJ, Hardeman W, Sutton S, Prevost AT, Fanshawe T, et al. Efficacy of a theory-based behavioural intervention to increase physical activity in an at-risk group in primary care (ProActive UK): a randomised trial. Lancet. 2008;371:41–8.CrossRefPubMed
15.
go back to reference Olsson SJ, Börjesson M, Ekblom-Bak E, Hemmingsson E, Hellénius M-L, Kallings LV. Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial. BMC Public Health. 2015;15:687.CrossRefPubMedPubMedCentral Olsson SJ, Börjesson M, Ekblom-Bak E, Hemmingsson E, Hellénius M-L, Kallings LV. Effects of the Swedish physical activity on prescription model on health-related quality of life in overweight older adults: a randomised controlled trial. BMC Public Health. 2015;15:687.CrossRefPubMedPubMedCentral
16.
go back to reference Dechamps A, Diolez P, Thiaudière E, Tulon A, Onifade C, Vuong T, et al. Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: a randomized controlled trial. Arch. Intern. Med. 2010;170:162–9.CrossRefPubMed Dechamps A, Diolez P, Thiaudière E, Tulon A, Onifade C, Vuong T, et al. Effects of exercise programs to prevent decline in health-related quality of life in highly deconditioned institutionalized elderly persons: a randomized controlled trial. Arch. Intern. Med. 2010;170:162–9.CrossRefPubMed
17.
go back to reference Battaglia G, Bellafiore M, Alesi M, Paoli A, Bianco A, Palma A. Effects of an adapted physical activity program on psychophysical health in elderly women. Clin Interv Aging. 2016;11:1009–15.CrossRefPubMedPubMedCentral Battaglia G, Bellafiore M, Alesi M, Paoli A, Bianco A, Palma A. Effects of an adapted physical activity program on psychophysical health in elderly women. Clin Interv Aging. 2016;11:1009–15.CrossRefPubMedPubMedCentral
18.
go back to reference Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med. Sci. Sports Exerc. 2008;39:1423–34.CrossRef Haskell WL, Lee I-M, Pate RR, Powell KE, Blair SN, Franklin BA, et al. Physical activity and public health: updated recommendation for adults from the American College of Sports Medicine and the American Heart Association. Med. Sci. Sports Exerc. 2008;39:1423–34.CrossRef
19.
go back to reference Arija V, Villalobos F, Pedret R, Vinuesa A, Timón M, Basora T, et al. Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: the “pas-a-pas” community intervention trial. BMC Public Health. 2017;17:576.CrossRefPubMedPubMedCentral Arija V, Villalobos F, Pedret R, Vinuesa A, Timón M, Basora T, et al. Effectiveness of a physical activity program on cardiovascular disease risk in adult primary health-care users: the “pas-a-pas” community intervention trial. BMC Public Health. 2017;17:576.CrossRefPubMedPubMedCentral
20.
go back to reference Domingo A, Marcos J. Propuesta de un indicador de la «clase social» basado en la ocupación. Gac Sanit. 1989;3:320–6.CrossRef Domingo A, Marcos J. Propuesta de un indicador de la «clase social» basado en la ocupación. Gac Sanit. 1989;3:320–6.CrossRef
21.
go back to reference Román Viñas B, Ribas Barba L, Ngo J, Serra ML. Validación en población catalana del cuestionario internacional de actividad física. Gac Sanit. 2013;27:254–7.CrossRefPubMed Román Viñas B, Ribas Barba L, Ngo J, Serra ML. Validación en población catalana del cuestionario internacional de actividad física. Gac Sanit. 2013;27:254–7.CrossRefPubMed
23.
go back to reference Rodríguez IT, Ballart JF, Pastor GC, Jordà EB, Val VA. Validation of a short questionnaire on frequency of dietary intake: reproducibility and validity. Nutr Hosp. 2008;23:242–52.PubMed Rodríguez IT, Ballart JF, Pastor GC, Jordà EB, Val VA. Validation of a short questionnaire on frequency of dietary intake: reproducibility and validity. Nutr Hosp. 2008;23:242–52.PubMed
24.
go back to reference Arija V, Salas Salvado J, Fernández-Ballart J, Cuco GM-H. Consumo alimentario, hábitos, y estado nutricional de la población de Reus (VIII). Evolución de la ingesta energética y nutricional desde 1983 a 1993. Med Clin (Barc). 1996;20:45–50. Arija V, Salas Salvado J, Fernández-Ballart J, Cuco GM-H. Consumo alimentario, hábitos, y estado nutricional de la población de Reus (VIII). Evolución de la ingesta energética y nutricional desde 1983 a 1993. Med Clin (Barc). 1996;20:45–50.
25.
go back to reference Marrugat J, Solanas P, D’Agostino R, Sullivan L, Ordovas J, Cordón F, et al. Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada. Rev Española Cardiol. 2003;56:253–61.CrossRef Marrugat J, Solanas P, D’Agostino R, Sullivan L, Ordovas J, Cordón F, et al. Estimación del riesgo coronario en España mediante la ecuación de Framingham calibrada. Rev Española Cardiol. 2003;56:253–61.CrossRef
26.
go back to reference Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney M-T, et al. Guía ESC 2016 sobre prevención de la enfermedad cardiovascular en la práctica clínica. Rev. Española Cardiol. 2016;69:939.e1–939.e87.CrossRef Hoes AW, Agewall S, Albus C, Brotons C, Catapano AL, Cooney M-T, et al. Guía ESC 2016 sobre prevención de la enfermedad cardiovascular en la práctica clínica. Rev. Española Cardiol. 2016;69:939.e1–939.e87.CrossRef
27.
go back to reference Alonso J, Prieto L, Anto J. La version espanola del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de resultados clinicos. Med Clínica. 1995;104:771–6. Alonso J, Prieto L, Anto J. La version espanola del SF-36 Health Survey (Cuestionario de Salud SF-36): un instrumento para la medida de resultados clinicos. Med Clínica. 1995;104:771–6.
28.
go back to reference Kassavou A, Turner A, French DP. Do interventions to promote walking in groups increase physical activity? A meta-analysis. Int J Behav Nutr Phys Act. 2013;10:18.CrossRefPubMedPubMedCentral Kassavou A, Turner A, French DP. Do interventions to promote walking in groups increase physical activity? A meta-analysis. Int J Behav Nutr Phys Act. 2013;10:18.CrossRefPubMedPubMedCentral
29.
go back to reference Kouvonen A, De Vogli R, Stafford M, Shipley MJ, Marmot MG, Cox T, et al. Social support and the likelihood of maintaining and improving levels of physical activity: the Whitehall II study. Eur J Pub Health. 2012;22:514–8.CrossRef Kouvonen A, De Vogli R, Stafford M, Shipley MJ, Marmot MG, Cox T, et al. Social support and the likelihood of maintaining and improving levels of physical activity: the Whitehall II study. Eur J Pub Health. 2012;22:514–8.CrossRef
30.
go back to reference Tiessen AH, Smit AJ, Broer J, Groenier KH, van der Meer K. Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care. BMC Fam Pract. 2012;13:90.CrossRefPubMedPubMedCentral Tiessen AH, Smit AJ, Broer J, Groenier KH, van der Meer K. Randomized controlled trial on cardiovascular risk management by practice nurses supported by self-monitoring in primary care. BMC Fam Pract. 2012;13:90.CrossRefPubMedPubMedCentral
31.
go back to reference Picorelli AMA, Pereira LSM, Pereira DS, Felício D, Sherrington C. Adherence to exercise programs for older people is influenced by program characteristics and personal factors: a systematic review. J Physiother. 2014;60:151–6.CrossRefPubMed Picorelli AMA, Pereira LSM, Pereira DS, Felício D, Sherrington C. Adherence to exercise programs for older people is influenced by program characteristics and personal factors: a systematic review. J Physiother. 2014;60:151–6.CrossRefPubMed
32.
go back to reference 2018 Physical Activity Guidelines Advisory Committee. 2018 physical activity guidelines committee scientific report. 2018. 2018 Physical Activity Guidelines Advisory Committee. 2018 physical activity guidelines committee scientific report. 2018.
33.
go back to reference Blumenthal JA, Sherwood A, Gullette ECD, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension. Arch Intern Med. 2000;160:1947.CrossRefPubMed Blumenthal JA, Sherwood A, Gullette ECD, Babyak M, Waugh R, Georgiades A, et al. Exercise and weight loss reduce blood pressure in men and women with mild hypertension. Arch Intern Med. 2000;160:1947.CrossRefPubMed
34.
go back to reference Friedberg JP, Rodriguez MA, Watsula ME, Lin I, Wylie-Rosett J, Allegrante JP, et al. Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial. Hypertension. 2015;65:440–6.CrossRefPubMed Friedberg JP, Rodriguez MA, Watsula ME, Lin I, Wylie-Rosett J, Allegrante JP, et al. Effectiveness of a tailored behavioral intervention to improve hypertension control: primary outcomes of a randomized controlled trial. Hypertension. 2015;65:440–6.CrossRefPubMed
35.
go back to reference Boraita PA. Ejercicio, piedra angular de la prevención cardiovascular. Rev Esp Cardiol. 2008;61:514–28.CrossRef Boraita PA. Ejercicio, piedra angular de la prevención cardiovascular. Rev Esp Cardiol. 2008;61:514–28.CrossRef
36.
go back to reference Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol. 2006;33:853–6.CrossRefPubMed Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clin Exp Pharmacol Physiol. 2006;33:853–6.CrossRefPubMed
37.
go back to reference Larsen MK, Matchkov VV. Hypertension and physical exercise : the role of oxidative stress. Medicina (B Aires). 2016;52:1–9. Larsen MK, Matchkov VV. Hypertension and physical exercise : the role of oxidative stress. Medicina (B Aires). 2016;52:1–9.
38.
go back to reference Smith JK. Long-term exercise and atherogenic activity of blood mononuclear cells in persons at risk of developing ischemic heart disease. JAMA. 1999;281:1722.CrossRefPubMed Smith JK. Long-term exercise and atherogenic activity of blood mononuclear cells in persons at risk of developing ischemic heart disease. JAMA. 1999;281:1722.CrossRefPubMed
39.
go back to reference Casillas JM, Gremeaux V, Damak S, Feki A, Pérennou D. Exercise training for patients with cardiovascular disease. Ann Réadaptation Médecine Phys. 2007;50:403–18.CrossRef Casillas JM, Gremeaux V, Damak S, Feki A, Pérennou D. Exercise training for patients with cardiovascular disease. Ann Réadaptation Médecine Phys. 2007;50:403–18.CrossRef
40.
go back to reference Bowen DJ, Fesinmeyer MD, Yasui Y, Tworoger S, Ulrich CM, Irwin ML, et al. Randomized trial exercise in sedentary middle aged women: effects on quality of life. Int J Behav Nutr Phys Act. 2006;3:34.CrossRefPubMedPubMedCentral Bowen DJ, Fesinmeyer MD, Yasui Y, Tworoger S, Ulrich CM, Irwin ML, et al. Randomized trial exercise in sedentary middle aged women: effects on quality of life. Int J Behav Nutr Phys Act. 2006;3:34.CrossRefPubMedPubMedCentral
41.
go back to reference Imayama I, Alfano CM, Cadmus LA, Wang C, Xiao L, Duggan C, et al. Effects of 12-month exercise on health-related quality of life: a randomized controlled trial. Prev. Med (Baltim). 2011;52:344–51.CrossRef Imayama I, Alfano CM, Cadmus LA, Wang C, Xiao L, Duggan C, et al. Effects of 12-month exercise on health-related quality of life: a randomized controlled trial. Prev. Med (Baltim). 2011;52:344–51.CrossRef
42.
go back to reference Chin A, Paw MJ, van Poppel MN, Twisk JW, van Mechelen W. Effects of resistance and all-round, functional training on quality of life, vitality and depression of older adults living in long-term care facilities: a “randomized” controlled trial. BMC Geriatr. 2004;4:5.CrossRef Chin A, Paw MJ, van Poppel MN, Twisk JW, van Mechelen W. Effects of resistance and all-round, functional training on quality of life, vitality and depression of older adults living in long-term care facilities: a “randomized” controlled trial. BMC Geriatr. 2004;4:5.CrossRef
43.
go back to reference Conradsson M, Littbrand H, Lindelöf N, Gustafson Y, Rosendahl E. Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial. Aging Ment Health. 2010;14:565–76.CrossRefPubMed Conradsson M, Littbrand H, Lindelöf N, Gustafson Y, Rosendahl E. Effects of a high-intensity functional exercise programme on depressive symptoms and psychological well-being among older people living in residential care facilities: a cluster-randomized controlled trial. Aging Ment Health. 2010;14:565–76.CrossRefPubMed
44.
go back to reference Arruza JA, Arribas S, Gil De Montes L, Irazusta S, Romero S, Cecchini JA. Repercusiones de la duracion de la actividad físico-deportiva sobre el bienestar psicologico. Rev Int Med y Ciencias la Act Fis y del Deport. 2008;8:171–83. Arruza JA, Arribas S, Gil De Montes L, Irazusta S, Romero S, Cecchini JA. Repercusiones de la duracion de la actividad físico-deportiva sobre el bienestar psicologico. Rev Int Med y Ciencias la Act Fis y del Deport. 2008;8:171–83.
45.
go back to reference Guallar-Castillón P, Santa-Olalla P, Ramón J, López E, Rodríguez-Artalejo F. Actividad física y calidad de vida de la población adulta mayor en España. Med Clin (Barc). 2004;123:606–10. Guallar-Castillón P, Santa-Olalla P, Ramón J, López E, Rodríguez-Artalejo F. Actividad física y calidad de vida de la población adulta mayor en España. Med Clin (Barc). 2004;123:606–10.
46.
go back to reference De Frias CM, Whyne E. Stress on health-related quality of life in older adults: the protective nature of mindfulness. Aging Ment Heal. 2015;19:201–6.CrossRef De Frias CM, Whyne E. Stress on health-related quality of life in older adults: the protective nature of mindfulness. Aging Ment Heal. 2015;19:201–6.CrossRef
47.
go back to reference Kahana E, Kelley-Moore J, Kahana B. Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life. Aging Ment Heal. 2012;16:438–51.CrossRef Kahana E, Kelley-Moore J, Kahana B. Proactive aging: a longitudinal study of stress, resources, agency, and well-being in late life. Aging Ment Heal. 2012;16:438–51.CrossRef
48.
go back to reference Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009;10:434–45.CrossRefPubMed Lupien SJ, McEwen BS, Gunnar MR, Heim C. Effects of stress throughout the lifespan on the brain, behaviour and cognition. Nat Rev Neurosci. 2009;10:434–45.CrossRefPubMed
49.
go back to reference Pohjavaara P, Telaranta T, Väisänen E. The role of the sympathetic nervous system in anxiety: Is it possible to relieve anxiety with endoscopic sympathetic block? Nord J Psychiatry. 2003;57:55–60.CrossRef Pohjavaara P, Telaranta T, Väisänen E. The role of the sympathetic nervous system in anxiety: Is it possible to relieve anxiety with endoscopic sympathetic block? Nord J Psychiatry. 2003;57:55–60.CrossRef
50.
go back to reference Hassoun L, Herrmann-Lingen C, Hapke U, Neuhauser H, Scheidt-Nave C, Meyer T. Association between chronic stress and blood pressure. Psychosom Med. 2015;77:575–82.CrossRefPubMed Hassoun L, Herrmann-Lingen C, Hapke U, Neuhauser H, Scheidt-Nave C, Meyer T. Association between chronic stress and blood pressure. Psychosom Med. 2015;77:575–82.CrossRefPubMed
51.
go back to reference Sacchetti A, Mattei G, Bursi S, Padula MS, Rioli G, Ferrari S. Association of blood pressure with anxiety and depression in a sample of primary care patients. Eur Psychiatry. 2017;41:S496.CrossRef Sacchetti A, Mattei G, Bursi S, Padula MS, Rioli G, Ferrari S. Association of blood pressure with anxiety and depression in a sample of primary care patients. Eur Psychiatry. 2017;41:S496.CrossRef
52.
go back to reference López MPS, García MEA, Dresch V. Ansiedad, autoestima y satisfactión autopercibida como predictores de la salud: Diferencias entre hombres y mujeres. Psicothema. 2006;18:584–90. López MPS, García MEA, Dresch V. Ansiedad, autoestima y satisfactión autopercibida como predictores de la salud: Diferencias entre hombres y mujeres. Psicothema. 2006;18:584–90.
Metadata
Title
Physical activity, cardiovascular health, quality of life and blood pressure control in hypertensive subjects: randomized clinical trial
Authors
Victoria Arija
Felipe Villalobos
Roser Pedret
Angels Vinuesa
Dolors Jovani
Gabriel Pascual
Josep Basora
Publication date
01-12-2018
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2018
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/s12955-018-1008-6

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