Efeito do treinamento aeróbio de leve intensidade sobre a pressão arterial em hipertensos resistentes: avaliação da variabilidade cardiovascular

• Autor(a) principal: Moura, Stephanney Karolinne Mercer Souza Freitas de
• Data de Publicação: 2019
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Biblioteca Digital de Teses e Dissertações da UFPB
• Texto Completo: https://repositorio.ufpb.br/jspui/handle/123456789/20214
• topic: Hipertensão resistente; Pressão arterial; Exercício aeróbio; Mecanismos; Resistant hypertension; Blood pressure; Aerobic exercise; Mechanisms; CNPQ::CIENCIAS DA SAUDE::EDUCACAO FISICA

Introduction: Resistant arterial hypertension is characterized by uncontrolled blood pressure (BP), despite the use of three or more antihypertensive drugs, or controlled BP under the use of four or more antihypertensive drugs. In order to assist and enhance the BP reduction in these patients with RAH, non-drug strategies such as aerobic exercise have been recommended. Studies have shown that aerobic training is able to reduce BP in resistant hypertensive patients (HR), however evidence has shown that light intensity aerobic exercise is able to manage BP levels in a similar way to moderate intensity exercise and exercise less cardiac overload in these hypertensive patients. Objectives: To evaluate the effect of light intensity aerobic training on BP in HR, as well as the modulation of cardiac autonomic mechanisms and the 24-hour BP variability. Methods: This is a randomized controlled clinical trial in which seventeen HR, of both sexes, insufficiently active, with a mean age of 52.6 ± 12.2 years, participated, who were randomly allocated into 2 groups: aerobic training mild intensity (GT) (n = 8) and control without exercise (CG) (n = 9). The patients allocated in the GT for 8 weeks underwent three weekly sessions of light aerobic physics with a duration of 40 minutes distributed in 5 minutes of warm-up at 2.5 km / h + 30 minutes at 10% below the anaerobic threshold to the anaerobic threshold point + 5 minutes at 2 km / h, while the CG did the clinical follow-up without physical exercise during the same period. Before and after the intervention program, participants underwent a cardiopulmonary test of maximum exercise to determine aerobic capacity (VO2peak), as well as assessing ambulatory BP and cardiac autonomic modulation by ECG and pressure control by BP variability in 24h. Results: the light intensity training program was able to reduce SBP, MAP and DBP in 24h periods (-11.6mmHg, d = 1.19 / -8,7mmHg, d = 1.18 / -7,7mmHg, d = 0.98 , respectively), wakefulness (-12,1mmHg, d = 1.29 / -10,7mmHg, d = 1.37 / -8,6mmHg, d = 1.15, respectively) and sleep (- 13,1mmHg, d = 1.40 / -10, 6mmHg, d = 1.57 / and -11,6mmHg, d = 1.49, respectively). In addition, there were reductions in the variability indices reported for the standard deviation of SBP (-3,0mmHg; d = 1.39), MAP (-1,1mmHg; d = 0.76) and DBP (- 0,5mmHg; d = 0.36 ) and the mean real variability of SBP (-1,2 mmHg; d = 0.83), MAP (-0,9 mmHg; d = 0.59) and DBP (-0,04 mmHg; d = 0.22). There was also an increase in vagal modulation (d> 0.90). Conclusion: Light intensity aerobic training was able to reduce ambulatory BP in hypertensive patients not responding to drug treatment, and this adjustment seems to have been generated by improved pressure control with increased cardiac vagal modulation. Thus, it is suggested that aerobic exercise at light intensity can be considered an effective strategy to reduce cardiovascular risk in these patients with resistant hypertension.