The acute and chronic effects of exercise therapy on blood pressure in non-Caucasians living in a multi-ethnic country
BACKGROUND Worldwide, cardiovascular diseases are the leading cause of death with a higher burden in low- and middle-income countries, including Suriname. Hypertension, the leading prevalent risk factor for the development of cardiovascular disease, is responsible for approximately 45% of the cases of stroke and 50% of the cases of coronary artery disease and attributes to almost 19% of all global deaths. Over the last four decades the prevalence of raised blood pressure (BP) almost doubled. Present national and international guidelines recommend regular physical activity and exercise as the number one (IA class recommendation) intervention in the prevention of hypertension, lowering the risk of developing hypertension with 28% and cardiovascular disease with 35%. These exercise guidelines, which to date are uniform across all ethnic groups, are based on meta-analytic research performed in mainly Caucasian populations demonstrating clinically significant reductions in systolic and diastolic BP following aerobic exercise or resistance training. It is well known that a great variability exists in the response to pharmacological anti-hypertensive treatments among ethnic groups, resulting in ethnic-specific pharmacological anti-hypertensive recommendations. Yet, whether the BP responses to lifestyle interventions, and in particular exercise therapy, also differ among non-Caucasian ethnic groups have been scarcely investigated. Additionally, the mechanisms that are associated with the BP changes following exercise remain understudied in non-Caucasian populations. Therefore, this doctoral research project will investigate exercise as a viable BP-lowering therapy in non-Caucasian populations and aims to increase our understanding on the mechanisms that are related with the BP responses (acute and chronic) to exercise in non-Caucasian populations. GENERAL AIMS AND OBJECTIVES This doctoral research project will: i) Objective 1: Systematically review and summarize the available literature on the effectiveness of exercise interventions on blood pressure in adults of African or Asian origin; and to compare the efficacy of exercise interventions between both ethnic groups, ii) Objective 2: Investigate and compare the acute response (post-exercise hypotension) to exercise on blood pressure and blood pressure regulating mechanisms in adults with high blood pressure or hypertension (stage 1) of African or Asian origin, and iii) Objective 3: Evaluate the chronic response of blood pressure and blood pressure regulating mechanisms to the currently recommended dose of exercise for blood pressure management in adults with high blood pressure or hypertension (stage 1) of African or Asian origin.