4. Discussion
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ELEVATED BLOOD PRESSURE, HYPERTENSION
The ANKER-Study was conducted before and during the COVID-19 pandemic and investigated the effects of two different types of nature-based therapies in couples with a sedentary lifestyle. Effects of mountain hiking and forest therapy on health-related quality of life, relationship quality, and other psychological and physiological parameters were investigated. The COVID-19 theme was taken up in this paper, as this pandemic influenced not only organizational aspects, but it also changed the perspective towards gender-specific implications, as the impact of this pandemic is esteemed meaningfully higher for women than for men. Women, especially working women, are disproportionately responsible for most domestic tasks, including care for children and elderly [Current research on COVID-19 and human-nature relationships, indicates that women are more likely to attribute higher values to nature and recreation than men [The results with regard to physiological parameters, on the other hand, were different regarding gender: Since both interventions took place in altitudes of ~1500 m, their hematopoietic system was stimulated; as this exposed the subjects to the interactions between low barometric pressure and partial-pressure of OVital signs were kept as physiological control parameters in this study, whereby a very positive trend was observed for blood pressure in both gender groups: In our study, persons with sedentary lifestyle initially showed a slightly elevated blood pressure (HG: 135.40 ± 19.07/83.38 ± 10.20 bpm, FTG:132.30 ± 16.80/82.83 ± 10.66 bpm), which already approached the recommended range immediately after the one-week intervention (HG: 130.74 ± 13.36/81.90 ± 8.01bpm, FTG:129.80 ± 16.27/81.50 ± 9.63bpm), so a clinically relevant change can be assumed. Gatterer et al. stated that in elderly persons with hypertension, moderate intensity hiking only at weekends may reduce systolic blood pressure; otherwise, it did not improve cardiovascular risk factors in healthy older people. They did not find gender-specific differences [Forest therapy in the ANKER-study was professionally guided by a specialized psychologist. Findings exhibited that guided forest therapy programs promote positive emotional changes and social bonding through interaction with others [Moreover, there are also differences in the gender-specific influence of COVID-19: Amplified risk for developing mental health problems for women during the pandemic is experienced with pregnancy or intimate partner violence [During the COVID-19 pandemic, concerned women, older persons, college-educated respondents, and white-collar workers noted the greatest use of the forest as a recreation site. Nonetheless, women and people with elementary education expressed the most fears related to visiting the forest. In contrast, men and people who lived in rural areas and small towns, as well as respondents who performed activities related to the forest, were most involved in exploring and working in the forest and [