***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Regular physical exercise is broadly recommended by current European and American hypertension guidelines . It remains elusive , however , whether exercise leads to a reduction of blood pressure in resistant hypertension as well . The present r and omized controlled trial examines the cardiovascular effects of aerobic exercise on resistant hypertension . Resistant hypertension was defined as a blood pressure ≥140/90 mm Hg in spite of 3 antihypertensive agents or a blood pressure controlled by ≥4 antihypertensive agents . Fifty subjects with resistant hypertension were r and omly assigned to participate or not to participate in an 8- to 12-week treadmill exercise program ( target lactate , 2.0±0.5 mmol/L ) . Blood pressure was assessed by 24-hour monitoring . Arterial compliance and cardiac index were measured by pulse wave analysis . The training program was well tolerated by all of the patients . Exercise  significantly decreased systolic and diastolic daytime ambulatory blood pressure by 6±12 and 3±7 mm Hg , respectively ( P=0.03 each ) . Regular exercise  reduced blood pressure on exertion and increased physical performance as assessed by maximal oxygen uptake and lactate curves . Arterial compliance and cardiac index remained unchanged . Physical exercise is able to decrease blood pressure even in subjects with low responsiveness to medical treatment . It should be included in the therapeutic approach to resistant hypertension Objectives The aim of the study was to examine the additive effect of resistance training ( RT ) to a dietary education ( DE ) intervention on emerging coronary heart disease ( CHD ) risk factors , concentration of apolipoproteins B ( apoB ) and A-I ( apoA-I ) , and Dietary Approaches to Stop Hypertension ( DASH ) Diet Index scores in overweight and obese older adults . Patients and methods This was an ancillary study of a r and omized clinical trial held in the Fall of 2008 at the University of Rhode Isl and . Participants were overweight or obese subjects ( mean body mass index [ BMI ] of 31.7 kg/m2 ) r and omized into two groups , one participating in DE only ( n = 12 ) and the other participating in DE plus RT ( DERT ) ( n = 15 ) . The intervention involved all subjects participating in 30 minutes of DE per week for 10 weeks . Subjects in the DERT group participated in an additional 40 minutes of RT three times per week for 10 weeks . Measurements taken were anthropometric ( height , weight , waist circumference , and body composition using the BOD POD ® [ Body Composition System , v 2.14 ; Life Measurement Instruments , Concord , CA ] ) , clinical ( blood pressure ) , and biochemical ( lipid profile and apoB and apoA-I concentrations ) , and the DASH Diet Index was used to measure diet quality . Results 27 subjects ( 11 males , 16 females ) , with a mean age of 66.6 ± 4.3 years , were included in analyses . The DERT subjects had significantly better triacylglycerol and apoB concentrations and DASH Diet Index scores than the DE subjects post-intervention . Improvements were seen within the DE group in energy intake , fat-free mass , and systolic blood pressure and within the DERT group in body weight , percentage of body fat , BMI , diastolic blood pressure , and oxidized low-density lipoprotein ( all P < 0.05 ) . Conclusion The addition of RT effectively reduced CHD risk factors , body composition , and diet quality in overweight and obese older adults ; DERT was more effective than DE alone in improving DASH Diet Index scores and lowering apoB concentrations but was not more effective in increasing apoA-I concentrations . Future research is needed to determine if apolipoproteins are superior to lipoprotein cholesterol concentrations in predicting CHD risk Objective : To determine the blood pressure responses in elderly normotensive men and women to dietary sodium and to the diunsaturated fatty acid dihomogammalinolenic acid ( DGLA ) , which is derived from linoleic acid Design : Blood pressure responses were assessed in 66 subjects ( 36 male , 30 female ; mean age 65 years ) on two diets differing by approximately 70mmol/day sodium , combined with daily supplements of either 1 g DGLA or 1 g safflower oil  , giving a four-group parallel design . After a common period of salt restriction and salt supplementation , two sets of parallel groups continued with either salt or placebo tablets . The study was blinded , except for dietary adjustments based on 24-h urinary sodium excretion values measured once every 2 weeks . Blood pressures were also measured automatically once every 2 weeks Results : Urinary sodium excretion ( sodium intake ) correlated significantly with systolic and diastolic blood pressures . A strong interaction with sex ( P < 0.001 for systolic blood pressure ) reflected greater responsiveness in women to changing sodium intake . A second major determinant of blood pressure responsiveness was the waist : hip ratio , an index of central obesity ; this correlation was independent of the initial sodium intake , initial blood pressure or body mass index . The waist : hip ratio was a powerful predictor of blood pressure changes with sodium intake in women only ; women with and roid fat distribution were , similarly to men , less sensitive to dietary sodium . Daily supplements of 1 g DGLA doubled the concentration of DGLA in plasma but did not influence blood pressure Conclusions : Among elderly normotensive subjects , women responded to changes in sodium intake with greater changes in blood pressure than men did . Furthermore , this response was strongly related to the gynaecoid distribution of body OBJECTIVE We evaluated the effects of exercise on neurobehavioral function in healthy older people more than 75 years of age . DESIGN A r and omized controlled trial with 6-month follow-up was conducted . SETTING The study was performed in the rural town of Kahoku , Japan , the population of which is considered representative of the older population of Japan . PARTICIPANTS We studied 42 healthy volunteers ( 18 men and 24 women ; mean age , 79 years ( range 75 to 87 years ) ) who were r and omly assigned to one of two groups , exercise or control . INTERVENTION Subjects assigned to the exercise group were instructed to exercise for 60 minutes twice a week for 6 months . Subjects in the control group were not instructed to engage in an specific exercise regimen . MEASUREMENTS The following measurements were recorded for both groups at baseline and at 6-month follow-up : ( 1 ) Neurobehavioral function as determined by the following tests : Mini-Mental State Exam ( MMSE ) , Hasegawa Dementia Scale Revised ( HDSR ) , Visuospatial Cognitive Performance Test ( VCP-test ) , Button score , Up & Go test , and Functional Reach ; and ( 2 ) Body mass index and blood pressure . RESULTS The effects of exercise were shown in the Up & Go test , and Functional Reach ( ANOVA with repeated measures ) . CONCLUSION This study demonstrates the acceptability and effectiveness of exercise on neurobehavioral function , even in older people more than 75 years of age Objective : To describe the contribution of changes in fitness and fatness result ing from exercise training on changes in submaximal exercise blood pressure ( BP ) during treadmill testing . Design and setting : Prospect i ve , r and omised , controlled trial . Participants : Sedentary older adults ( n = 115 ) with untreated prehypertension or mild hypertension . Intervention : Six-month supervised aerobic and strength training . Main outcome measurement : Systolic BP ( SBP ) was assessed at rest and during each stage of a maximal grade d exercise test ( GXT ) that determined Vo2peak . General and regional fatness was assessed by anthropometry , dual-energy x-ray absorptiometry and MRI . BP changes were calculated for each GXT stage , and multivariate regression models were used to describe the association of changes in exercise BP with changes in fitness and fatness . Results : After training , exercisers versus controls had significantly increased Vo2peak and significantly lower measures of general and regional fatness . Also , stage-specific SBP was significantly lower at stage 3 ( −9.4 vs −1.6 mm Hg , p = 0.03 ) and stage 4 ( −7.9 vs −1.2 mm Hg , p = 0.03 ) . Pooled regression analysis across all stages showed that exercisers had a 7.1 mm Hg reduction in SBP , but this reduction fell short of statistical significance ( p = 0.12 ) compared with controls . A 1.0 ml/kg/min increase in Vo2peak and a 1.0 cm decrease in waist circumference independently predicted a 1.0 mm Hg decrease in exercise SBP ( p = 0.04 and p = 0.001 , respectively ) . Conclusions : Decreased exercise SBP was independently associated with decreased waist circumference , a marker of abdominal obesity and increased fitness . These findings suggest that exercise training improves multiple factors that have an independent influence on SBP Background Synthesis of multiple r and omized controlled trials ( RCTs ) in a systematic review can summarize the effects of individual outcomes and provide numerical answers about the effectiveness of interventions . Filtering of search es is time consuming , and no single method fulfills the principal requirements of speed with accuracy . Automation of systematic review s is driven by a necessity to expedite the availability of current best evidence for policy and clinical decision-making . We developed Rayyan ( http://rayyan.qcri.org ) , a free web and mobile app , that helps expedite the initial screening of abstract s and titles using a process of semi-automation while incorporating a high level of usability . For the beta testing phase , we used two published Cochrane review s in which included studies had been selected manually . Their search es , with 1030 records and 273 records , were uploaded to Rayyan . Different features of Rayyan were tested using these two review s. We also conducted a survey of Rayyan ’s users and collected feedback through a built-in feature . Results Pilot testing of Rayyan focused on usability , accuracy against manual methods , and the added value of the prediction feature . The “ taster ” review ( 273 records ) allowed a quick overview of Rayyan for early comments on usability . The second review ( 1030 records ) required several iterations to identify the previously identified 11 trials . The “ suggestions ” and “ hints , ” based on the “ prediction model , ” appeared as testing progressed beyond five included studies . Post rollout user experiences and a reflexive response by the developers enabled real-time modifications and improvements . The survey respondents reported 40 % average time savings when using Rayyan compared to others tools , with 34 % of the respondents reporting more than 50 % time savings . In addition , around 75 % of the respondents mentioned that screening and labeling studies as well as collaborating on review s to be the two most important features of Rayyan . As of November 2016 , Rayyan users exceed 2000 from over 60 countries conducting hundreds of review s totaling more than 1.6 M citations . Feedback from users , obtained mostly through the app web site and a recent survey , has highlighted the ease in exploration of search es , the time saved , and simplicity in sharing and comparing include-exclude decisions . The strongest features of the app , identified and reported in user feedback , were its ability to help in screening and collaboration as well as the time savings it affords to users . Conclusions Rayyan is responsive and intuitive in use with significant potential to lighten the load of review ers BACKGROUND there have been few population -based , r and omized controlled trials on the effects of strength or endurance training on cardiovascular fitness in older women . OBJECTIVE to study the effects of strength or endurance training on cardiovascular fitness in women aged 76 - 78 years . DESIGN a population -based , r and omized controlled trial . SETTING exercise laboratory in a university faculty of sport and health sciences . SUBJECTS we r and omly assigned 42 medically-screened women aged 76 - 78 years , drawn from the population register to strength ( n=16 ) , endurance ( n=15 ) or control ( n=11 ) groups . METHODS subjects in the two exercise groups performed a supervised , individually tailored 18-week strength or endurance training programme . Controls continued with physical activity at their normal level . RESULTS the strength training group showed an increase in cycle ergometer peak power from 68.1 to 70.3 W ( P=0.035 compared with controls ) . Their peak power per kg body weight increased from 1.02 to 1.05 , while that of the endurance training group increased from 0.91 to 0.93 ( P=0.027 and P=0.049 respectively ) . Peak oxygen uptake increased from 18.1 to 19.7 ml x kg(-1 ) x min(-1 ) in the strength and from 17.1 to 18.2 in the endurance group ( non-significant ) . Six subjects ( 19 % ) in the exercise groups withdrew from the study because of health problems . CONCLUSIONS even with its limitations , the study suggests that the effect of 18-week strength or endurance training on cardiovascular fitness among women aged > /=75 is relatively small . Furthermore , health problems can emerge during training programmes in medically-screened elderly women The purpose of this study was to investigate the effect of resistance training on resting blood pressure and heart rate variability in elderly postmenopausal women . 29 untrained , non-hypertensive elderly women were r and omly assigned to 2 groups : an intervention group  ( n=15 , 65.5±5.0 years , 57.3±6.5 kg , 156.7±5.1 cm ) that underwent a supervised resistance training program ( 8 exercises , 2 sets , 10 - 15 repetitions , 3 times/week ) or a control group  ( n=14 , 66.2±4.1 years , 61.1±11.7 kg , 157.5± 
    Output:
    
Aerobic exercise training , dynamic resistance exercise training , COM , and isometric exercise training all elicited significant reductions in both systolic and diastolic BP , with no additional benefit of COM compared with single modality exercise training .
Three months of traditional exercise-based lifestyle intervention may produce a reduction in BP of approximately 5 mmHg systolic and 3 mmHg diastolic in older individuals , similar to that expected in younger individuals