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Moura EG, Bedoya-Castaño J, de Andrade Barboza C, Silva G, Dias G, Ribeiro Ministro da Costa G, Moreno H, Rodrigues B. Duration of Water-Based Exercise on Hemodynamic and Sleep Quality: An of Hypertensives and Normotensives Subanalysis. RESEARCH QUARTERLY FOR EXERCISE AND SPORT 2024:1-9. [PMID: 38980799 DOI: 10.1080/02701367.2024.2363464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/29/2024] [Indexed: 07/11/2024]
Abstract
Purpose: This study aimed to determine whether a better hemodynamic profile and a better sleep quality are associated with the duration of physical exercise in the water; secondly, it aims to determine whether better sleep quality is associated with a more favorable hemodynamic profile. Methods: 97 subjects (85 women, age 59.46 ± 10.62) were included in the study. Groups were divided into normotensive (n = 46) and hypertensive individuals, (n = 51) duration of water aerobics (1-6 (n = 18), 7-11 (n = 11), 12-35 (n = 26), and > 36 months (n = 42), respectively), and sleep quality (Good, Poor, and Sleep Disordered). The peripheral (brachial), central (through applanation tonometry), and arterial blood pressure were assessed, and the Pittsburgh Sleep Quality Index questionnaire was collected. Results: We found that the groups practicing water-based exercise for a more extended period (>6 months) did not present improved pressure values and sleep quality. The best (though still weak) relationship between the water-based exercise time and the sleep quality values occurred between the group of 7-11 exercising for over 36 months (r = - 0.29 for both). When multivariate regression analysis was performed, there was interaction between AIx@75bpm and sleep quality score, as well as between AIx@75bpm and the age of subjects (p = .006 and 0.003, respectively). Conclusion: The data from the present study reported that subjects who participated for a longer time in the water aerobics training protocol had no additional hemodynamic and sleep quality benefits compared to volunteers with shorter duration groups (<6 months).
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Brito L, Sahade V, Marcadenti A, Torreglosa CR, Weber B, Bersch-Ferreira ÂC, Rodrigues IG, Sousa ACS, Gomes AB, Pinheiro JMF, Vasconcelos SML, Carlos DMDO, de Figueiredo JA, Dantas CDF, Daltro C. Dietary Adequacy of Individuals with Cardiovascular Disease According to Clinical Guidelines in the Brazilian Cardioprotective Nutritional (BALANCE). Arq Bras Cardiol 2024; 121:e20230705. [PMID: 39166563 PMCID: PMC11341214 DOI: 10.36660/abc.20230705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 02/24/2024] [Accepted: 03/13/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Achieving nutritional goals established by scientific societies is a constant challenge and not always achieved. OBJECTIVE To investigate the dietary adequacy of individuals with cardiovascular disease (CVD), participants in the Cardioprotective Brazilian Food Program residing in the Northeast region of Brazil, according to the recommendations of the Brazilian Society of Cardiology (SBC). METHODS Cross-sectional analysis with data from the study implementing the Brazilian Cardioprotective Diet (DICA BR), which evaluated individuals with CVD treated in specialized cardiovascular health centers in eight states in the Northeast region. Food consumption was obtained by 24-hour dietary records and dietary adequacy followed SBC recommendations. Values of p < 0.05 were considered significant. RESULTS 647 patients were studied, with a mean (standard deviation) age of 63.1 (9.4) years, 50.2% of whom were female. When evaluating food intake, a low adequacy of carbohydrates (52.3%), proteins (70.9%), lipids (38.8%), and fiber (22.4%) was observed. It was observed that the majority of women consumed a low-protein diet (59.2%) and the elderly had a greater inadequacy in carbohydrate consumption (52.6%). Regarding sodium intake, men had a higher intake (72.9%), while the elderly showed a 13% reduction. Furthermore, it was shown that men ate more fiber (28.1%) and individuals with higher education had a high consumption of saturated fatty acids (70.5%). CONCLUSIONS Most individuals did not achieve the recommended dietary therapy goals for secondary cardiovascular prevention. The findings of the present study reinforce the need to implement structured strategies to encourage healthy eating habits in these individuals.
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Affiliation(s)
- Luciana Brito
- Programa de Pós-Graduação em Medicina e Saúde da UFBAHospital Universitário Professor Edgard SantosUniversidade Federal da BahiaSalvadorBABrasilPrograma de Pós-Graduação em Medicina e Saúde da UFBA - Hospital Universitário Professor Edgard Santos - Universidade Federal da Bahia (UFBA), Salvador, BA – Brasil
- Empresa Brasileira de Serviços HospitalaresSalvadorBABrasilEmpresa Brasileira de Serviços Hospitalares (EBSERH), Salvador, BA – Brasil
| | - Viviane Sahade
- Universidade Federal da BahiaDepartamento de NutriçãoEscola de NutriçãoSalvadorBABrasilUniversidade Federal da Bahia - Departamento de Nutrição da Escola de Nutrição da UFBA, Salvador, BA – Brasil
| | - Aline Marcadenti
- Instituto de Pesquisa do HcorSão PauloSPBrasilInstituto de Pesquisa do Hcor, São Paulo, SP – Brasil
| | - Camila Ragne Torreglosa
- Instituto de Pesquisa do HcorSão PauloSPBrasilInstituto de Pesquisa do Hcor, São Paulo, SP – Brasil
| | - Bernardete Weber
- Real e Benemérita Associação Portuguesa de BeneficênciaSão PauloSPBrasilReal e Benemérita Associação Portuguesa de Beneficência, São Paulo, SP – Brasil
| | - Ângela Cristine Bersch-Ferreira
- Real e Benemérita Associação Portuguesa de BeneficênciaSão PauloSPBrasilReal e Benemérita Associação Portuguesa de Beneficência, São Paulo, SP – Brasil
| | - Isa Galvão Rodrigues
- Pronto Socorro Cardiológico Universitário de PernambucoRecifePEBrasilPronto Socorro Cardiológico Universitário de Pernambuco, Recife, PE – Brasil
| | | | - Adriana Barros Gomes
- Universidade Federal de SergipeAracajuSEBrasilUniversidade Federal de Sergipe, Aracaju, SE – Brasil
| | | | | | | | | | - Clenise de Farias Dantas
- Hospital Universiário Alcides CarneiroUniversidade de Campina GrandeCampina GrandePBBrasilHospital Universiário Alcides Carneiro - Universidade de Campina Grande, Campina Grande, PB – Brasil
| | - Carla Daltro
- Programa de Pós-Graduação em Medicina e Saúde da UFBA Departamento de Nutrição da Escola de Nutrição da UFBAUniversidade Federal da BahiaSalvadorBABrasilPrograma de Pós-Graduação em Medicina e Saúde da UFBA - Departamento de Nutrição da Escola de Nutrição da UFBA – Universidade Federal da Bahia, Salvador, BA – Brasil
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Kogure GS, Verruma CG, Santana BA, Calado RT, Ferriani RA, Furtado CLM, Dos Reis RM. Obesity contributes to telomere shortening in polycystic ovary syndrome. Reprod Sci 2024; 31:1601-1609. [PMID: 38393627 DOI: 10.1007/s43032-024-01485-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 02/07/2024] [Indexed: 02/25/2024]
Abstract
Polycystic ovary syndrome (PCOS) is a multifactorial disorder and obesity occurs in 38% to 88% of these women. Although hyperandrogenism may contribute to telomere lengthening, increased body mass index (BMI) is associated with telomere erosion. We sought to compare leukocyte telomere length (LTL) in PCOS women with normal, overweight, and obese BMI. We evaluated the relationship between LTL and clinical variables of PCOS and inflammatory biomarkers independent of BMI. A total of 348 women (243 PCOS and 105 non-PCOS) were evaluated for anthropometric measures, total testosterone, androstenedione, estradiol (E2), follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), free androgen index (FAI), fasting insulin and glycemia, lipid profile, homocysteine, C-reactive protein (CRP) and homeostatic model of insulin resistance (HOMA-IR). LTL was measured by qPCR. The PCOS group presented higher weight, waist circumference, BMI, testosterone, LH, fasting insulin, FAI, and HOMA-IR, and lower E2, SHBG, and fasting glycemia measures compared with the non-PCOS. When stratified by BMI, LTL was increased in all subgroups in PCOS compared to non-PCOS. However, in the PCOS group, LTL was lower in overweight (P = 0.0187) and obese (P = 0.0018) compared to normal-weight women. The generalized linear model showed that BMI, androstenedione, homocysteine, and CRP were associated with telomere biology. Women with PCOS had longer LTL, however, overweight or obesity progressively contributes to telomere shortening and may affect reproductive outcomes of PCOS, while androstenedione may increase LTL.
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Affiliation(s)
- Gislaine Satyko Kogure
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Carolina Gennari Verruma
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Barbara A Santana
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rodrigo T Calado
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, 14049-900, Brazil
| | - Rui Alberto Ferriani
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil
| | - Cristiana Libardi Miranda Furtado
- Experimental Biology Center, Universidade de Fortaleza (UNFOR), Fortaleza, Brazil.
- Graduate Program in Medical Sciences, Universidade de Fortaleza, Fortaleza, Brazil.
- Postgraduate Program in Translational Medicine, Drug Research and Development Center, Federal University of Ceará, Fortaleza, Brazil.
| | - Rosana Maria Dos Reis
- Department of Gynecology and Obstetrics, Ribeirao Preto Medical School, University of Sao Paulo (FMRP-USP), Ribeirao Preto, Brazil.
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Palmeirim MS, Baxter YC, Silveira M, Maggion RV, Aquino B, Avezum Á, Saric J, Morgan L, Drager LF, Bortolotto LA, Rollemberg SMS, de Lima MMC, Albuquerque EPR, Jones O, Steinmann P, Reiker T, Boch J. Situational analysis of hypertension management at primary health care level in São Paulo, Brazil: population, healthcare professional and health system perspectives. BMC Health Serv Res 2024; 24:668. [PMID: 38807206 PMCID: PMC11134720 DOI: 10.1186/s12913-024-10978-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 04/10/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Government-led, population-wide initiatives are crucial for advancing the management of hypertension - a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control. METHODS First, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city- Itaquera and Penha- which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents. RESULTS Data gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans. CONCLUSIONS This situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.
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Affiliation(s)
- Marta S Palmeirim
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.
- University of Basel, Basel, Switzerland.
| | | | | | | | | | - Álvaro Avezum
- Hospital Alemão Oswaldo Cruz, São Paulo, Brazil
- São Paulo University, São Paulo, Brazil
- McMaster University, Hamilton, Canada
- World Heart Federation, Geneva, Switzerland
| | - Jasmina Saric
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
| | | | - Luciano F Drager
- Sociedade de Cardiologia do Estado de São Paulo (SOCESP), São Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
| | - Luiz A Bortolotto
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas, University of São Paulo, São Paulo, Brazil
- Sociedade Brasileira de Hipertensão, São Paulo, Brazil
| | | | | | | | | | - Peter Steinmann
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland
- University of Basel, Basel, Switzerland
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Baudson FRS, de Menezes-Júnior LAA, de Freita SN, Pimenta FAP, Machado-Coelho GLL, de Oliveira FLP, do Nascimento Neto RM, Ribeiro SMLT. Rotating shift work time is directly associated with excess body adiposity. Sleep Breath 2024; 28:531-537. [PMID: 37770792 DOI: 10.1007/s11325-023-02928-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023]
Abstract
OBJECTIVE To analyze the association between changes in body adiposity and length of service on a schedule of rotating shifts. METHODS The study was a cross-sectional investigation conducted during the years 2012, 2015, and 2018, involving individuals engaged in rotating shifts at a company involved in iron ore extraction situated within the Iron Quadrangle region of Minas Gerais and the southeastern region of Pará, Brazil. Sociodemographic and behavioral data were collected along with anthropometric parameters in order to calculate body mass index (BMI) and the waist-to-height ratio (WHtR). For data analysis, a multivariate logistic regression was employed to explore potential associations between indicators of body adiposity and the duration of shift work, employing a hierarchical determination model. RESULTS The findings showed that in the multivariate model, controlling for confounding factors, workers with 5 to 10, 10 to 15, and more than 15 years of shift work had 41 to 96% greater odds of being overweight (BMI > 25.0 kg/m2), 71 to 82% of having altered neck circumference (> 40 cm), 33 to 120% of altered WC (>102 cm), and 57 to 214% of having altered WHtR (> 0.5 cm). CONCLUSION The findings suggest that time spent in work has a significant effect on anthropometric indicators of body adiposity, especially if the worker has a previously established comorbidity such as dyslipidemia or hypertension and is frequently exposed to night work.
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Affiliation(s)
- Felipe Reis Stavaux Baudson
- Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
| | | | | | | | - George Luiz Lins Machado-Coelho
- Post-graduate Program in Health and Nutrition, Nutrition School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
- Medical School, Federal University of Ouro Preto, Ouro Preto, Minas Gerais, Brazil
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Oliveira-Silva L, Fecchio RY, Silva Junior NDD, Pio-Abreu A, Silva GVD, Drager LF, Silva de Sousa JC, Forjaz CLDM. Post-dynamic, isometric and combined resistance exercise responses in medicated hypertensive men. J Hum Hypertens 2024; 38:52-61. [PMID: 37670145 DOI: 10.1038/s41371-023-00859-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 08/23/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
This study investigated the effects of dynamic resistance exercise (DRE), isometric handgrip exercise (IHE) and combined resistance exercise (DRE+IHE) on post-exercise hypotension (PEH) and its hemodynamic, autonomic, and vascular mechanisms. For that, 70 medicated hypertensives men (52 ± 8 years) were randomly allocated to perform one of the following interventions: DRE (3 sets, 8 exercises, 50% of 1RM), IHE (4 sets, 2 min, 30% of MVC), CRE (DRE+IHE) and control (CON, seated rest). Before and after the interventions, blood pressure (BP), systemic hemodynamics, cardiovascular autonomic modulation and brachial vascular parameters were evaluated. After the DRE and CRE, systolic and mean BP decreased (SBP = -7 ± 6 and -8 ± 8 mmHg; MBP -4 ± 5 and -5 ± 5 mmHg, respectively, all P < 0.05), vascular conductance increased (+ 0.47 ± 0.61 and +0.40 ± 0.47 ml.min-1.mmHg-1, respectively, both P < 0.05) and baroreflex sensitivity decreased (-0.15 ± 0.38 and -0.29 ± 0.47 ms/mmHg, respectively, both P < 0.05) in comparison to pre-exercise values. No variable presented any significant change after IHE. The responses observed after CRE were similar to DRE and significantly different from CON and IHE. In conclusion, DRE, but not IHE, elicits PEH, which happens concomitantly to skeletal muscle vasodilation and decreased baroreflex sensitivity. Moreover, adding IHE to DRE does not potentiate PEH and neither changes its mechanisms.Clinical Trial Registration: Data from this study derived from an ongoing longitudinal clinical trial approved by the Institution's Ethics Committee of Human Research (process 2.870.688) and registered at the Brazilian Clinical Trials (RBR-4fgknb) at http://www.ensaiosclinicos.gov.br .
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Affiliation(s)
- Laura Oliveira-Silva
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Rafael Yokoyama Fecchio
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Natan Daniel da Silva Junior
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
| | - Andrea Pio-Abreu
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Giovânio Vieira da Silva
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Luciano Ferreira Drager
- Unidade de Hipertensão, Disciplina de Nefrologia, Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
- Unidade de Hipertensão, Instituto do Coração (InCor), Hospital das Clínicas, HCFMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Julio Cesar Silva de Sousa
- Exercise Hemodynamic Laboratory, School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil
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Westphal-Nardo G, Chaput JP, Faúndez-Casanova C, Fernandes CAM, de Andrade Gonçalves EC, Utrila RT, Oltramari K, Grizzo FMF, Nardo-Junior N. Exploring New Tools for Risk Classification among Adults with Several Degrees of Obesity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6263. [PMID: 37444110 PMCID: PMC10341139 DOI: 10.3390/ijerph20136263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 06/27/2023] [Accepted: 06/27/2023] [Indexed: 07/15/2023]
Abstract
The epidemic of obesity worldwide has been recognized as a very important challenge. Within its complexity, the identification of higher-risk patients is essential, as it is unsustainable to offer access to treatment to all people with obesity. Several new approaches have recently been presented as important tools for risk stratification. In this research, we applied several of these tools in a cross-sectional study involving adults with obesity classes I, II, III, and super-obesity. The participants had their cardiometabolic risk profiles assessed. The study included adults with obesity aged 18 to 50 years (n = 404), who were evaluated using anthropometric, body composition, hemodynamic, physical fitness, and biochemical assessments. These variables were used to identify the prevalence of risk factors for cardiometabolic diseases according to the classes of obesity by gender and age group. The results showed high prevalence of risk factors, especially among the upper classes of obesity (BMI > 35 kg/m2) using single parameters as the waist circumference, with almost 90% above the cut-off point. For smaller numbers such as Glycated Hemoglobin, however, the prevalence was around 30%. Indexes such as the atherogenic index of plasma (AIP) had the highest prevalence, with 100% of the male participants identified as being at increased risk for cardiovascular disease.
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Affiliation(s)
- Greice Westphal-Nardo
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Jean-Philippe Chaput
- Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, ON K1H 8L1, Canada;
| | - César Faúndez-Casanova
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
- Faculty of Education Sciences, Catholic University of Maule, Talca 34809112, Maule, Chile
| | - Carlos Alexandre Molena Fernandes
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Eliane Cristina de Andrade Gonçalves
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Raquel Tomiazzi Utrila
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Karine Oltramari
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Felipe Merchan Ferraz Grizzo
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
| | - Nelson Nardo-Junior
- Department of Physical Education, Associate Graduate Program in Physical Education UEM/UEL, Health Sciences Center, State University of Maringa, Maringa 87020-900, Parana, Brazil; (C.F.-C.); (N.N.-J.)
- Center for Multiprofessional Studies on Obesity—NEMO/HUM/UEM, University Hospital of Maringa, State University of Maringa, Maringa 87083-240, Parana, Brazil; (C.A.M.F.); (E.C.d.A.G.); (R.T.U.); (K.O.); (F.M.F.G.)
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Trainotti GO, Mariúba JV, Bertanha M, Sobreira ML, Yoshida RDA, Jaldin RG, de Camargo PAB, Yoshida WB. Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease. J Vasc Bras 2023; 22:e20200053. [PMID: 36794171 PMCID: PMC9925060 DOI: 10.1590/1677-5449.202000531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 08/05/2022] [Indexed: 02/12/2023] Open
Abstract
Background Diabetics are at 5-15 times greater risk of developing peripheral arterial disease (PAD) and few studies have compared risk factors and distribution and severity of arterial changes in diabetics compared with non-diabetics. Objectives To compare angiographic changes between diabetic and non-diabetic patients with advanced PAD and correlate them with risk factors. Methods A retrospective cross-sectional study was conducted of consecutive patients undergoing lower limb arteriography for PAD (Rutherford 3-6) using TASC II and Bollinger et al. angiographic scores. Exclusion criteria were upper limb angiographies, unclear images, incomplete laboratory test results, and previous arterial surgeries. Statistical analyses included chi-square tests, Fisher's test for discrete data, and Student's t test for continuous data (significance level: p < 0.05). Results We studied 153 patients with a mean age of 67 years, 50.9% female and 58.2% diabetics. A total of 91 patients (59%) had trophic lesions (Rutherford 5 or 6) and 62 (41%) had resting pain or limiting claudication (Rutherford 3 and 4). Among diabetics, 81.7% were hypertensive, 29.4% had never smoked, and 14% had a history of acute myocardial infarction. According to the Bollinger et al. score, infra-popliteal arteries were more affected in diabetics, especially the anterior tibial artery (p = 0.005), while the superficial femoral artery was more affected in non-diabetics (p = 0.008). According to TASC II, the most severe angiographic changes in the femoral-popliteal segment occurred in non-diabetic patients (p = 0.019). Conclusions The most frequently affected sectors were the infra-popliteal sectors in diabetics and the femoral sector in non-diabetics.
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Affiliation(s)
- Giovanni Ortale Trainotti
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | - Jamil Victor Mariúba
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | - Matheus Bertanha
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | - Marcone Lima Sobreira
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | - Ricardo de Alvarenga Yoshida
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | - Rodrigo Gibin Jaldin
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
| | | | - Winston Bonetti Yoshida
- Universidade Estadual Paulista - UNESP, Faculdade de Medicina de Botucatu, Hospital das Clínicas, Botucatu, SP, Brasil.
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Trainotti GO, Mariúba JV, Bertanha M, Sobreira ML, Yoshida RDA, Jaldin RG, Camargo PABD, Yoshida WB. Comparative study of angiographic changes in diabetic and non-diabetic patients with peripheral arterial disease. J Vasc Bras 2023. [DOI: 10.1590/1677-5449.202000532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023] Open
Abstract
Abstract Background Diabetics are at 5-15 times greater risk of developing peripheral arterial disease (PAD) and few studies have compared risk factors and distribution and severity of arterial changes in diabetics compared with non-diabetics. Objectives To compare angiographic changes between diabetic and non-diabetic patients with advanced PAD and correlate them with risk factors. Methods A retrospective cross-sectional study was conducted of consecutive patients undergoing lower limb arteriography for PAD (Rutherford 3-6) using TASC II and Bollinger et al. angiographic scores. Exclusion criteria were upper limb angiographies, unclear images, incomplete laboratory test results, and previous arterial surgeries. Statistical analyses included chi-square tests, Fisher's test for discrete data, and Student’s t test for continuous data (significance level: p < 0.05). Results We studied 153 patients with a mean age of 67 years, 50.9% female and 58.2% diabetics. A total of 91 patients (59%) had trophic lesions (Rutherford 5 or 6) and 62 (41%) had resting pain or limiting claudication (Rutherford 3 and 4). Among diabetics, 81.7% were hypertensive, 29.4% had never smoked, and 14% had a history of acute myocardial infarction. According to the Bollinger et al. score, infra-popliteal arteries were more affected in diabetics, especially the anterior tibial artery (p = 0.005), while the superficial femoral artery was more affected in non-diabetics (p = 0.008). According to TASC II, the most severe angiographic changes in the femoral-popliteal segment occurred in non-diabetic patients (p = 0.019). Conclusions The most frequently affected sectors were the infra-popliteal sectors in diabetics and the femoral sector in non-diabetics.
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Cangussú LR, Sartori Alho EA, Silva AL, Fonsêca DV, Lopes JM, Barbosa RHDA, Lopes MR. Low health literacy and quality of life in patients with systemic arterial hypertension. DIALOGUES IN HEALTH 2022; 1:100036. [PMID: 38515897 PMCID: PMC10953978 DOI: 10.1016/j.dialog.2022.100036] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 07/07/2022] [Accepted: 08/09/2022] [Indexed: 03/23/2024]
Abstract
Purpose Evaluate the level of health literacy and quality of life of patients with hypertension. Methods A cross-sectional, observational study was carried out in the Northeast region of Brazil with 105 patients with hypertension through the SAHLPA-18, S-TOFHLA and MINICHAL tests. Results For both literacy tests applied, it can be observed that about 60% of the interviewed patients did not present adequate health literacy. It was found that factors such as increasing age, lower economic class and lower education were associated with a lower level of health literacy. In the evaluation of the quality of life by the MINICHAL, 46.7% of the patients reported that hypertension interferes with quality of life. It was also possible to show that the time of diagnosis (p = 0.04) and the economic class (p = 0.008) influence the quality of life. Conclusion Hypertension is a chronic condition that requires continuous treatment and has potential risks of evolving with fatal and non-fatal complications that can affect the patients' quality of life. The data presented reflect the difficulty in understanding and processing health information, which may directly impact on the therapeutic management of hypertension.
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De Moraes JA, De Barcelos GT, Coneglian JC, Do Espírito Santo BCDR, Delevatti RS, Gerage AM. Combined Training with Aerobic Exercise Performed Outdoors Can Promote Better Blood Pressure and Affective Responses in Individuals with Cardiovascular Risk Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16009. [PMID: 36498081 PMCID: PMC9737698 DOI: 10.3390/ijerph192316009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/18/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
The purpose of the study was to compare the effects of two models of combined training (CT) (aerobic and resistance exercise realized in the same training session), with aerobic training performed in different environments (indoor or outdoor), on blood pressure (BP), heart rate (HR), and affective response in individuals with cardiovascular risk factors. Twenty-six participants were allocated, in a non-randomized design, into CT with aerobic exercise performed indoors (ICT) or outdoors (OCT). Both groups were submitted to three weekly CT sessions, with aerobic exercises performed on ergometers or an athletics track. Before and after nine weeks of training, BP and HR at rest were measured. In the last session of the training, the affective response was collected. The individuals were 65.8 ± 7.8 (ICT) and 67.3 ± 8.2 (OCT) years. Lower values of diastolic BP were observed for the OCT group at post-training (p < 0.001). Moreover, in OCT, a significant inverse correlation was identified between the affective response to training and changes in systolic BP (r = −0.60; p = 0.03) and mean BP (r = −0.62; p = 0.02). In conclusion, CT, with aerobic exercise performed outdoors, seems to be more effective in reducing BP with better affective responses to training.
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Affiliation(s)
| | | | | | | | | | - Aline Mendes Gerage
- Post-Graduate Program of Physical Education—UFSC, Federal University of Santa Catarina, Florianopolis 88040-900, Brazil
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Bezerra PT, Santiago LM, Silva IA, Souza AA, Pegado CL, Damascena CM, Ribeiro TS, Lindquist AR. Action observation and motor imagery have no effect on balance and freezing of gait in Parkinson's disease: a randomized controlled trial. Eur J Phys Rehabil Med 2022; 58:715-722. [PMID: 36052889 PMCID: PMC10019482 DOI: 10.23736/s1973-9087.22.07313-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 06/14/2022] [Accepted: 08/25/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND Combining action observation (AO) and motor imagery (MI) training may induce greater brain activity in areas usually involved in Parkinson's disease (PD) and lead to greater behavioral and neurophysiological effects than when used separately. AIM To determine the effects of combining AO, MI, and gait training on balance and freezing of gait in individuals with PD. DESIGN This is a single-blinded, randomized controlled clinical trial. SETTING Laboratory of Intervention and Analysis of Movement (LIAM) from the Department of Physical Therapy of a Brazilian University. POPULATION Study sample consisted of individuals diagnosed with idiopathic PD by a neurologist specialized in movement disorders. METHODS 39 individuals with PD were divided into experimental (EG=21) and control groups (CG=18). EG performed 12 sessions of AO, MI, and gait training, whereas CG watched PD-related educational videos and performed 12 sessions of gait training. Balance (measured using the Mini Balance Evaluation Systems Test [MiniBESTest]) and freezing of gait (measured using the Freezing of Gait Questionnaire) were reassessed one day after the end of the intervention. RESULTS We did not observe significant intra- and intergroup differences in freezing of gait. For the EG, we observed a significant intragroup difference in the total score of MiniBESTest (F=5.2; P=0.02), and sensory orientation (F=4.5; P=0.04) and dynamic gait (F=3.6; P=0.03) domains. MiniBESTest domains were not different between groups. CONCLUSIONS Combining AO, MI, and gait training was not more effective than isolated gait training for balance and freezing of gait in individuals with PD. CLINICAL REHABILITATION IMPACT MI training can moderate AO effects and enhance motor learning when both therapies are combined. Therefore, this approach may still have the potential to be included in the treatment of PD. New studies should investigate whether the factors that influence these results are related to the protocol's sensitivity in changing the evaluated parameters or to the time and intensity of AO and MI training.
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Affiliation(s)
- Paula T Bezerra
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Lorenna M Santiago
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
- Anita Garibaldi Education and Health Research Center, Santos Dumont Institute, Macaíba, Rio Grande do Norte, Brazil
| | - Isaíra A Silva
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Aline A Souza
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Camila L Pegado
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Clécia M Damascena
- University of Estácio do Rio Grande do Norte (Fatern), Natal, Rio Grande do Norte, Brazil
| | - Tatiana S Ribeiro
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil
| | - Ana R Lindquist
- Department of Physical Therapy, Rio Grande do Norte Federal University, Natal, Rio Grande do Norte, Brazil -
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Almeida IDS, Andrade LDS, de Sousa AMM, Junior GC, Catai AM, Mota YL, Durigan JLQ. Is the Combination of Aerobic Exercise with Mat Pilates Better than Mat Pilates Training Alone on Autonomic Modulation Related to Functional Outcomes in Hypertensive Women? Secondary Analysis of a Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10577. [PMID: 36078292 PMCID: PMC9518527 DOI: 10.3390/ijerph191710577] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/09/2022] [Accepted: 08/11/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Although mat Pilates (MP) has become popular, the effects of MP in hypertensive women (HW) are not entirely clear. Here, we investigated the effects of 16 weeks of MP training contrasted with MP supplemented with aerobic exercise (MP+AE) and compared with a non-intervention group on autonomic modulation, cardiorespiratory fitness, strength, flexibility, performance of functional tasks, QOL, anthropometric variables, clinical BP, and heart rate. METHODS This is a three-arm, secondary analysis of an RCT. Sixty HW, aged 30 to 59 years, were allocated into: MP only (MP), MP+AE on a treadmill (MP+AE), and Control Group, without exercises. Assessments were performed before and after 16 weeks of training. RESULTS The ANOVA shows differences in between-group comparisons in the SDNN, rMSSD, and SD1 in the heart rate variability analysis, with increases in rMSSD, SDNN, and SD1 only in the MP, and this result was not found in the MP+AE group (p < 0.05). Differences were observed in the between-group comparisons in time in the cardiorespiratory exercise test (CPX), flexibility, and the waist-to-hip ratio, with changes in the MP+AE, differences in QOL, and increments in the MP and MP+AE (p < 0.05). CONCLUSIONS MP increased the indices that reflect vagal and global cardiac autonomic modulation. MP+AE improved the CPX performance, flexibility, QOL, and anthropometric variables. These results suggest that MP supplemented or not with AE has promising effects in HW.
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Affiliation(s)
- Isabella da Silva Almeida
- Laboratory of Muscle and Tendon Plasticity, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 72220-275, Brazil
| | - Letícia de Souza Andrade
- Physiotherapy School Clinic, Physiotherapy Department, Universidade Católica de Brasília, Distrito Federal, Brasília 71966-700, Brazil
| | - Alessandra Martins Melo de Sousa
- Laboratory of Muscle and Tendon Plasticity, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 72220-275, Brazil
| | - Gerson Cipriano Junior
- Laboratory of Exercise Physiology, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 72220-275, Brazil
| | - Aparecida Maria Catai
- Physiotherapy Department, Universidade Federal de São Carlos, São Paulo 13565-905, Brazil
| | - Yomara Lima Mota
- Health Education and Consultancy Department, PROCER Health Education and Consultancy, São Paulo 12916-398, Brazil
| | - João Luiz Quagliotti Durigan
- Laboratory of Muscle and Tendon Plasticity, Graduate Program in Rehabilitation Science, Faculdade de Ceilândia, Universidade de Brasília, Distrito Federal, Brasília 72220-275, Brazil
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Valente HB, Gervazoni NDL, Laurino MJL, Vanzella LM, Stoco-Oliveira MC, Rodrigues MV, André LB, Ribeiro F, de Carvalho AC, Vanderlei LCM. Autonomic and cardiorespiratory responses to the active tilt test in individuals with Parkinson disease: cross-sectional study. ARQUIVOS DE NEURO-PSIQUIATRIA 2022; 80:689-698. [PMID: 36254441 PMCID: PMC9685817 DOI: 10.1055/s-0042-1755225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
BACKGROUND The Parkinson disease (PD) is frequently associated with autonomic dysfunctions. However, data regarding the influence of PD on the autonomic responses to postural changes is limited. OBJECTIVE To analyze and compare the autonomic responses, evaluated through linear and non-linear methods of heart rate variability, and cardiorespiratory parameters in two groups: Parkinson disease (PDG) and control (CG), at rest and during the active tilt test. METHODS A total of 48 participants were analyzed (PDG: n = 25;73.40 ± 7.01 years / CG: n = 23;70.17 ± 8.20 years). The autonomic modulation and cardiorespiratory parameters were evaluated at rest and during the active tilt test. To assess the autonomic modulation the linear indices, at the time (rMSSD, SDNN) and frequency (LF, HF, LF/HF) domains, and the non-linear indices, obtained through the Poincaré plot (SD1, SD2, SD1/SD2), were calculated. The cardiorespiratory parameters evaluated were heart rate (HR), systolic (SBP), and diastolic blood pressure (DBP), peripheral oxygen saturation (SpO2), and respiratory rate. RESULTS At rest, the PDG presented significantly lower values of rMSSD, SDNN, LF, HF, SD1, SD2, and DBP, and higher values of SpO2. During test, in the PD group, modifications were observed in HR, and SBP, besides a reduced parasympathetic response, and an increased global modulation. The qualitative analysis of the Poincaré plot showed that the PDG has a lower dispersion of the RR intervals during rest and the active tilt test. CONCLUSION Individuals with PD present reduced global variability and parasympathetic modulation at rest, and reduced parasympathetic response and damage in HR regulation when performing the active tilt test, compared with controls.
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Affiliation(s)
- Heloisa Balotari Valente
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Natacha de Lima Gervazoni
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Maria Júlia Lopez Laurino
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Laís Manata Vanzella
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Mileide Cristina Stoco-Oliveira
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Mariana Viana Rodrigues
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Larissa Borba André
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Felipe Ribeiro
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Augusto Cesinando de Carvalho
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
| | - Luiz Carlos Marques Vanderlei
- Universidade Estadual Paulista “Júlio de Mesquita Filho”, Faculdade de Ciências e Tecnologia, Departamento de Fisioterapia, Presidente Prudente SP, Brazil
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Dos Santos PA, de Oliveira AM, Alves CQ, Souza Filho CF, Ladeia AMT, Petto J. Renin-Angiotensin-Aldosterone System in Women Using Combined Oral Contraceptive: A Systematic Review. REVISTA BRASILEIRA DE GINECOLOGIA E OBSTETRICIA : REVISTA DA FEDERACAO BRASILEIRA DAS SOCIEDADES DE GINECOLOGIA E OBSTETRICIA 2022; 44:710-718. [PMID: 35724684 PMCID: PMC9948294 DOI: 10.1055/s-0042-1745790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To describe the effects of combined oral contraceptives (COC) on the renin-angiotensin-aldosterone system (RAAS). DATA SOURCES This is a systematic review according to the criteria of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), registered in PROSPERO under the ID: CRD42020200019. Searches were performed between August 2020 and December 2021, in the following databases: Medline via Pubmed, Cochrane Central Library, Scientific Electronic Library Online, and Latin American and Caribbean Literature in Health Sciences via Virtual Health Library. The effects of the combined oral contraceptive on plasma renin activity values, plasma renin values, angiotensinogen values- also known as plasma renin substrate- angiotensin, and/or aldosterone values. STUDY SELECTION A total of 877 studies were selected and, of these, 10 articles met the eligibility criteria and were included in this review. DATA COLLECTION Data were combined through qualitative synthesis and included in a spreadsheet previously prepared by the authors. DATA SYNTHESIS The collected samples ranged from 18 to 137 participants, totaling 501 women aged between 18 and 49 years throughout all studies. The studies showed increased activity of plasma renin, plasma renin substrate, angiotensin II, and aldosterone in this population. CONCLUSION The findings of this study suggest that the COC promotes greater activation of the RAAS. Supporting the idea that its use is related to an increased risk of cardiovascular events, including systemic arterial hypertension.
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Affiliation(s)
| | | | | | | | | | - Jefferson Petto
- Escola Bahiana de Medicina e Saúde Pública, Salvador, BA, Brazil.,Actus Cordios Reabilitação Cardiovascular, Respiratória e Metabólica, Salvador, BA, Brazil.,Centro Universitário UniFTC, Salvador, BA, Brazil
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Serum Ferritin and NAFLD in Patients Undergoing Bariatric Surgery. Obes Surg 2022; 32:2658-2663. [PMID: 35670949 DOI: 10.1007/s11695-022-06127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 05/17/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Non-alcoholic fatty liver disease (NAFLD) has become a challenge in public health, as the prevalence of obesity and overweight has been increasing. It has been observed that serum ferritin (SF) levels are commonly elevated in NAFLD patients. PURPOSE To assess the relationship between SF levels and NAFLD, exploring the role of SF as a non-invasive marker of NAFLD. METHODS Clinical, anthropometric, laboratory, and histological data of patients with obesity who underwent bariatric surgery in a reference center in Brazil were retrospectively evaluated. Data were collected in the preoperative period up to the first year postoperatively. RESULTS A total of 431 patients were analyzed. The prevalence of hyperferritinemia was 18% in the preoperative period and 14% 1 year after the surgery. After multiple regression analysis, elevated SF was not an independent predictor of steatosis, non-alcoholic steatohepatitis (NASH), or liver fibrosis. CONCLUSIONS Increased SF levels are common in patients with NAFLD; however, SF was not considered an independent predictor of steatosis, NASH, or fibrosis.
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Gyuricza JV, Brodersen J, Machado LBM, D'Oliveira AFPL. ‘People say it is dangerous’. REVISTA BRASILEIRA DE MEDICINA DE FAMÍLIA E COMUNIDADE 2022. [DOI: 10.5712/rbmfc17(44)3052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Introduction: Mild hypertension is a common asymptomatic condition present in people at low risk of future cardiovascular events. These people represent approximately two-thirds of those diagnosed with hypertension. The best available evidence does not support pharmacological treatment for mild hypertension to reduce cardiovascular mortality. Additionally, overdetection of hypertension also occurs, and this practice is supported by public awareness campaigns, screening, easy access to testing, and poor clinical practice, enhancing the overdiagnosis potential. Moreover, sparse qualitative patient-oriented evidence that diagnosing hypertension has harmful consequences is observed. Therefore, evidence regarding the potential for unintended psychosocial effects of diagnosing mild hypertension is required. Objective: The aim of this study was to investigate if diagnosing low-risk people with mild hypertension has unintended psychosocial consequences. Methods: Eleven semi-structured single interviews and four focus groups were conducted in São Paulo, Brazil, among people diagnosed with mild hypertension without comorbidities. Informants were selected among the general population from a list of patients, a primary healthcare clinic, or a social network. The informants had a broad range of characteristics, including sex, age, education level, race/skin colour, and time from diagnosis. Data were subjected to qualitative thematic content analysis by three of the authors independently, followed by discussions, to generate categories and themes. Results: The informants confirmed that the hypertension diagnosis was a label for psychosomatic reactions to stress, medicalised illness experiences, and set a biographical milestone. We observed unintended consequences of the diagnosis in a broad range of psychosocial dimensions, for example, fear of death, disabilities, or ageing; pressure and control from significant others; and guilt, shame, and anxiety regarding work and leisure. Although informants had a broad range of characteristics, they shared similar stories, understandings, and labelling effects of the diagnosis. Conclusion: The diagnosis of hypertension is a significant event and affects daily life. Most of the impact is regarded as negative psychosocial consequences or harm; however, sometimes the impact might be ambiguous. Patients’ explanatory models are key elements in understanding and changing the psychosocial consequences of the diagnosis, and healthcare providers must be aware of explanatory models and psychosocial consequences when evaluating blood pressure elevations.
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Effectiveness of Strategies for Nutritional Therapy for Patients with Type 2 Diabetes and/or Hypertension in Primary Care: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074243. [PMID: 35409925 PMCID: PMC8998242 DOI: 10.3390/ijerph19074243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 03/05/2022] [Accepted: 03/07/2022] [Indexed: 02/04/2023]
Abstract
A central aspect to the management of type 2 Diabetes Mellitus (T2DM) and hypertension is promoting a healthy lifestyle, and nutritional therapy (NT) can support patients achieving glycemic control and blood pressure targets. This systematic review aimed to evaluate the effectiveness of NT in the management of patients with T2DM and/or hypertension in primary care. Primary outcomes were HbA1c, systolic blood pressure (SBP) and diastolic blood pressure (DBP). Thirty-nine studies were included, thirty on T2DM and nine on hypertension. With a moderate quality of evidence, educational/counseling programs and food replacement programs in primary care likely reduce HbA1c on patients with T2DM (mean difference (MD): −0.37, 95% CI: −0.57 to −0.17, 7437 patients, 27 studies; MD: −0.54, 95% CI: −0.75 to −0.32, 440 patients, 2 studies, respectively). Mediterranean diet for T2DM was accessed by one study, and no difference between the groups was found. Educational and counseling programs likely reduce DBP in patients with hypertension (MD: −1.79, 95% CI: −3.46, −0.12, 2840 patients, 9 studies, moderate quality of the evidence), but the effect in SBP was unclear due to risk of bias and imprecision. Nutritional therapy strategies (i.e., educational/counseling programs and food replacement programs) in primary care improved HbA1c in patients with T2DM and DBP in individuals with hypertension.
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Maciel EDS, Silva BKR, Figueiredo FWDS, Pontes-Silva A, Quaresma FRP, Adami F, Fonseca FLA. Physical inactivity level and lipid profile in traditional communities in the Legal Amazon: a cross-sectional study : Physical inactivity level in the Legal Amazon. BMC Public Health 2022; 22:542. [PMID: 35303858 PMCID: PMC8932679 DOI: 10.1186/s12889-022-12973-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 03/14/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The practice of regular physical activity can alter the lipid profile in populations according to diverse demographic characteristics. OBJECTIVE To evaluate the association of physical inactivity with the lipid profile among vulnerable populations. METHODS A cross-sectional study was conducted among 349 vulnerable individuals from Tocantins state, northern Brazil. The International Physical Activity Questionnaire 7 Day short form was used to measure self-reported physical activity levels. Venous blood samples were drawn to evaluate lipid profile. Logistic regression adjusted by the socioeconomic variables was used to analyse the effects of physical inactivity on the lipidic profile. The level of significance was 5% and Stata® (StataCorp, LC) version 11 was used. RESULTS We observe an inverse relationship between physical inactivity and HDL-C-that is, those who were sedentary or below the WHO Recommendations for physical activity were at 2.6 greater odds (IC95% 1.21, 5.67; p = 0.015) of having a lower HDL compared with those meeting or exceeding WHO physical activity recommendations. CONCLUSION On the vulnerable populations studied, the insufficiently active or sedentary individuals (called the physical inactivity individuals) have more risk of the altered HDL-C.
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Affiliation(s)
| | | | | | - André Pontes-Silva
- Programa de Pós-Graduação em Fisioterapia (PhD Program), Universidade Federal de São Carlos (UFSCar), Rod. Washington Luiz, Km 235, São Carlos, SP CEP 13565-905 Brazil
| | | | - Fernando Adami
- Centro Universitário FMABC (FMABC), Santo André, SP Brazil
| | - Fernando Luiz Affonso Fonseca
- Centro Universitário FMABC (FMABC), Santo André, SP Brazil
- Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil
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Abreu JM, Nogueira ABB, Villela MM, Módolo DM, Panaro TC, Setubal S, Velarde LGC, Lima GAB, da Cruz Filho RA, Soares DV. Low bone mass and vitamin D in Brazilian people living with HIV under antiretroviral therapy. Arch Osteoporos 2022; 17:40. [PMID: 35247128 DOI: 10.1007/s11657-022-01088-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 02/26/2022] [Indexed: 02/03/2023]
Abstract
We performed a cross-sectional study in 212 PLHIV under antiretroviral therapy. Bone mass was compromised in 36.5% of relatively young sample and associated with hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was present in 85%, especially those on NNRTI. PURPOSE Previous studies have reported an increased prevalence of bone demineralization among people living with the human immunodeficiency virus (PLHIV). We aimed to assess bone mineral density (BMD), vitamin D levels, and associated risk factors in Brazilian PLHIV. METHODS Cross-sectional study with 212 patients in a specialized assistance service. Clinical and demographic information were registered. Laboratory tests were performed, and BMD was measured at the lumbar spine, total hip/femoral neck, and forearm by dual-energy X-ray absorptiometry. Participants were classified into "with low bone mass (wLBM)" and "without low bone mass (woLBM)." Those wLBM encompasses osteoporosis, osteopenia, and below the expected range for age as recommended by the World Health Organization. RESULTS One hundred and eighty-seven patients were included. Median age was 46.3 years (interquartile range (IQR) 40-52) and duration of HAART exposure was 11.2 years (IQR 7-15). Plasma viral load was undetectable in 79%. Hypovitaminosis D (< 30 ng/mL) was present in 85% and LBM in 36.5%. Men wLBM were more likely to have testosterone deficiency and had higher PTH levels than those woLBM. LBM in women was associated with older age, menopause, and metabolic syndrome. CONCLUSION This study showed a high frequency of LBM in a relatively young sample, and suggests a detrimental effect of hypogonadism, older age, higher PTH levels, and metabolic syndrome. Hypovitaminosis D was frequent, especially those on non-nucleoside reverse transcriptase inhibitor, higher body mass index, and abdominal circumference.
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Affiliation(s)
- Juliana Mendes Abreu
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil.
| | - Amanda B B Nogueira
- Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Mariana M Villela
- Postgraduate Program in Medical Sciences, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Denise M Módolo
- Scientific Initiation Program of the Medical Graduation Course, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Thaís C Panaro
- Scientific Initiation Program of the Medical Graduation Course, Universidade Federal Fluminense, Niterói, Rio de Janeiro, Brazil
| | - Sérgio Setubal
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | | | - Giovanna A B Lima
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | - Rubens A da Cruz Filho
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
| | - Debora V Soares
- Department of Internal Medicine, Universidade Federal Fluminense, Rua Alvares de Azevedo 121, bl2 apt 806, Icaraí, Niterói, Rio de Janeiro, 24220-020, Brazil
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Intervenção educativa na qualidade de vida e conhecimento da síndrome metabólica. ACTA PAUL ENFERM 2022. [DOI: 10.37689/acta-ape/2022ao02982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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22
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Chaves ZJL, Silva LS, Nascimento RCRMD. Public Programs for Essential Medicine Access in a Small Municipality: A Cross-Sectional Analysis. INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2022. [DOI: 10.36660/ijcs.20200287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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23
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Effect of Combined Endurance Training and MitoQ on Cardiac Function and Serum Level of Antioxidants, NO, miR-126, and miR-27a in Hypertensive Individuals. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8720661. [PMID: 35071600 PMCID: PMC8776465 DOI: 10.1155/2022/8720661] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/24/2021] [Accepted: 12/17/2021] [Indexed: 12/27/2022]
Abstract
Objectives Hypertension (HTN) is one of the most important risk factors for cardiovascular diseases. Despite advances in treatment and control of HTN, the prevalence of HTN is still increasing. MitoQ is a supplement that acts on mitochondria and attenuates reactive oxygen species (ROS), which plays an important role in cardiovascular health. miRNAs play an important role in the pathophysiology of HTN. We evaluated the effects of MitoQ supplementation and endurance training (ET), alone and in combination, on functional indices of the heart and serum levels of miR-126, miR-27a, antioxidants, and NO, in patients with HTN. Methods In a double-blind randomized clinical trial, 52 male participants (age 40-55 years) were randomly divided into four groups (n = 13) of placebo, MitoQ (20 mg/day, oral), ET (cycle ergometer, moderate intensity, 40-60% VO2 peak, heart rate 120-140 b/min, 45 min a day, three days/week for six weeks), and MitoQ+ET. Cardiac function indices were assessed by echocardiography before and after interventions. Results Systolic blood pressure (SBP) significantly decreased in all intervention groups (P < 0.001) while DBP (P < 0.01) and LV hypertrophy (P < 0.05) were significantly decreased only in the MitoQ+ET group. Serum levels of SOD, GPx, and NO and the level of miR-126 significantly increased in all treatment groups, while miR-27a reduced in the ET (P < 0.05) and MitoQ+ET (P < 0.01) groups. Conclusions Compared to MitoQ and ET alone, their combination has more prominent improving effects on cardiac health and amelioration of BP in the patients with HTN. These effects are through miR-126 and miR-27a modulation and ameliorating mitochondrial ROS production.
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Guimarães MCDLP, Coelho JC, da Silva GV, Drager LF, Gengo e Silva Butcher RDC, Butcher HK, Pierin AMG. Blood Pressure Control and Adherence to Drug Treatment in Patients with Hypertension Treated at a Specialized Outpatient Clinic: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:2749-2761. [PMID: 34916785 PMCID: PMC8670885 DOI: 10.2147/ppa.s336524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/21/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate and identify variables associated with the control of hypertension and adherence to antihypertensive drug treatment in a group of patients with hypertension monitored in a specialized, highly complex outpatient service. METHODS A prospective, cross-sectional study was carried out in the hypertension unit of a tertiary teaching hospital. Patients diagnosed with hypertensive aged 18 years and over and accompanied for at least six months were included in the study. Patients with secondary hypertension and pregnant women were excluded. The sample consisted of 253 patients. Adherence/concordance to antihypertensive treatment was assessed using the Morisky Green Levine Scale. Blood pressure control was set for values less than 140/90 mmHg. Variables with p≤0.20 in univariate analysis were included in multiple logistic regression. The level of significance adopted was p ≤0.05. RESULTS Most of patients were white, married and women, with a mean age of 65 (13.3) years old, low income, and education levels. Blood pressure control and adherence were observed in 69.2% and 90.1% of the patients, respectively. Variables that were independently associated with blood pressure control were (OR, odds ratio; CI, 95% confidence interval): married marital status (OR 2.3; CI 1.34-4.28), use of calcium channel blockers (OR 0.4; CI 0.19-0.92) and number of prescribed antihypertensive drugs (OR 0.78; CI 0.66-0.92). Adherence was not associated with any of the variables studied. CONCLUSION There was a high frequency of patients with satisfactory adherence to antihypertensive drug treatment. Blood pressure control was less frequent and was associated with social and treatment-related factors.
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Affiliation(s)
| | - Juliana Chaves Coelho
- Graduate Program in Adult Health Nursing (PROESA), University of São Paulo Nursing School, São Paulo, SP, Brazil
| | - Giovanio Vieira da Silva
- Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Luciano Ferreira Drager
- Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, SP, Brazil
- Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | | | - Howard K Butcher
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Angela Maria Geraldo Pierin
- Graduate Program in Adult Health Nursing (PROESA), University of São Paulo Nursing School, São Paulo, SP, Brazil
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Is resistance training alone an antihypertensive therapy? A meta-analysis. J Hum Hypertens 2021; 35:769-775. [PMID: 34321596 DOI: 10.1038/s41371-021-00582-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 11/08/2022]
Abstract
Evidence concerning the prescription of isolated resistance training (RT) to hypertensive individuals is limited. Guidelines are divergent concerning RT inclusion for prehypertensive and hypertensive persons. A meta-analysis investigating data with larger sample sizes provides more robust effect size estimates and allows for inferences on clinical choices concerning the effectiveness of RT alone. In this context, the aim of this meta-analysis was to assess the effects of RT alone on the systolic (SBP) and diastolic (DBP) blood pressures in prehypertensive and hypertensive individuals. Data from 13 studies involving 417 participants (207 assigned to RT and 210 controls) were obtained. The results indicate significant reductions in SBP (-6.16 mmHg CI -8.27 to -4.04; I2: 31.0% P value for heterogeneity = 0.136 and effect size = -0.59) and DBP (-3.70 mmHg CI -5.19 to -2.21; I2: 18.3% P value for heterogeneity = 0.106 and effect size = -0.55) when compared to control groups. In conclusion, RT alone is able to reduce SBP and DBP in prehypertensive and hypertensive subjects, especially in elderly individuals.
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26
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Costa-Ribeiro A, Andrade SMMDS, Férrer MLV, Silva OAPD, Salvador MLS, Smaili S, Lindquist ARR. Can Task Specificity Impact tDCS-Linked to Dual Task Training Gains in Parkinson's Disease? A Protocol for a Randomized Controlled Trial. Front Aging Neurosci 2021; 13:684689. [PMID: 34276344 PMCID: PMC8281034 DOI: 10.3389/fnagi.2021.684689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Patients with Parkinson's disease (PD) have difficulties while performing dual-task activities, a condition present in everyday life. It is possible that strategies such as transcranial Direct Current Stimulation (tDCS) can be associated with motor training enriched with dual-task training to improve the performance of two concurrent tasks. Currently, it is unclear whether specific tasks and clinical conditions of PD patients have different results after the intervention. Therefore, the proposed randomized controlled trial will examine task-dependency in enhancing the effects of tDCS-linked rehabilitation training on PD and the relationships between baseline outcomes in responders and non-responders to therapy. Fifty-six patients with Parkinson's disease will be recruited to participate in this controlled, double-blind randomized multicentric clinical trial. Patients in modified Hoehn & Yahr stage 1.5-3, age between 40 and 70 years will be included. Subjects will be randomly assigned to an experimental group (EG) and a control group (CG). The EG will perform treadmill gait training associated with dual task exercises+tDCS, while the CG will only engage in treadmill gait training+tDCS. Blinded testers will assess patients before and after 12 intervention sessions and after a 4-week follow-up period. All patients will undergo a screening and an initial visit before being assessed for primary and secondary outcomes. The primary outcome measure is functional mobility measured by Timed Up and Go Test. Secondary outcomes include cognitive function, participation, motor function and body function and structure. This study will evaluate the effectiveness of an intervention protocol with tDCS, dual-task training and gait training in patients with PD. The study will also highlight the clinical factors and variability between individuals that could interfere in the training of a specific task and influence the therapeutic effect. Clinical Trial registration: www.ClinicalTrials.gov, identifier NCT04581590.
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Affiliation(s)
- Adriana Costa-Ribeiro
- NeuroMove Laboratory, Department of Physiotherapy, Federal University of Paraíba, Campus I Cidade Universitária, Joao Pessoa, Brazil
| | | | - Mayane Laís Veloso Férrer
- NeuroMove Laboratory, Department of Physiotherapy, Federal University of Paraíba, Campus I Cidade Universitária, Joao Pessoa, Brazil
| | - Ozair Argentille Pereira Da Silva
- Laboratory of Intervention and Analysis of Movement, Department of Physiotherapy, Federal University of Rio Grande do Norte, Campus Universitário, Natal, Brazil
| | - Maiara Llarena Silva Salvador
- Neuroscience and Aging Laboratory, Federal University of Paraíba, Campus I Cidade Universitária, Joao Pessoa, Brazil
| | - Suhaila Smaili
- Department of Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Ana Raquel Rodrigues Lindquist
- Laboratory of Intervention and Analysis of Movement, Department of Physiotherapy, Federal University of Rio Grande do Norte, Campus Universitário, Natal, Brazil
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Miranda VIA, Schäfer AA, Tomasi CD, Soratto J, de Oliveira Meller F, Silveira MPT. "Inequalities in access to medicines for diabetes and hypertension across the capitals in different regions of Brazil: a population-based study". BMC Public Health 2021; 21:1242. [PMID: 34182965 PMCID: PMC8240304 DOI: 10.1186/s12889-021-11279-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/27/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To guarantee prevention and adequate treatment, as required for the population to have access to health services and technologies, including medicines. The purpose of this study is to analyse the economic and regional inequalities in access to medicines for diabetes and hypertension among the adult population in Brazil. METHODS This was a cross-sectional study with adults aged 18 and over from the VIGITEL study conducted in 2019 in all Brazilian regions. Non-access to antidiabetic and antihypertensive drugs was assessed according to formal education and housing macro-region. The slope index of inequality (SII) was used to analyse absolute inequalities. RESULTS The total number of individuals interviewed was 52,443. Approximately 10.0% of the people with diabetes and/or hypertension reported not having access to drug treatment. The major means for having access to antihypertensive drugs, in all regions, was private pharmacies; for antidiabetics, in the North region, people had greater access through private pharmacies, while in the Northeast, Southeast and South, they had greater access through the public sector. Inequalities were found in the lack of access to medicines according to the region of residence, especially in the North region. CONCLUSION The lack of access to medicines showed regional disparities, particularly in the most economically vulnerable regions.
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Affiliation(s)
- Vanessa Iribarrem Avena Miranda
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Av. Universitária, 1105, Criciúma, Santa Catarina, CEP: 88806-000, Brazil.
| | - Antônio Augusto Schäfer
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Av. Universitária, 1105, Criciúma, Santa Catarina, CEP: 88806-000, Brazil
| | - Cristiane Damiani Tomasi
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Av. Universitária, 1105, Criciúma, Santa Catarina, CEP: 88806-000, Brazil
| | - Jacks Soratto
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Fernanda de Oliveira Meller
- Postgraduate Program in Public Health, University of Southern Santa Catarina, Av. Universitária, 1105, Criciúma, Santa Catarina, CEP: 88806-000, Brazil
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Santos RZD, Korbes AS, Martins ETC, Lucca MD, Lucca LD, Karsten M, Benetti M. Does Hypertension Knowledge Influence Levels of Physical Activity in Hypertensive Patients From a Southern Brazilian Community? INTERNATIONAL JOURNAL OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.36660/ijcs.20200141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Antioxidant Responses in Hypertensive Postmenopausal Women after Acute Beetroot Juice Ingestion and Aerobic Exercise: Double Blind and Placebo-Controlled Crossover Trial. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021. [DOI: 10.1155/2021/5579864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study is aimed to analyze the effect of different nitrate concentrations [NO3-] present in beetroot juice (BJ) on salivary oxidative stress markers after acute exercise performance in hypertensive postmenopausal women. Thirteen hypertensive postmenopausal women participated in three experimental sessions, taking different beverages: noncaloric orange flavored drink (OFD), low nitrate (low-NO3-) BJ, and high nitrate (high-NO3-) BJ. The participants performed aerobic exercise on a treadmill, at 65–70% of heart rate reserve (HRR), for 40 min. Saliva samples were collected after an overnight fast, 10 minutes before BJ ingestion at 7 : 20 am (0
), 120 minutes after beverages ingestion (130
), immediately after exercise (170
), and 90 min after exercise (260
). Salivary total protein (TP), catalase activity (CAT), reduced glutathione (GSH), and total antioxidant capacity by ferric-reducing antioxidant power (FRAP) concentrations were analyzed. No interaction (session
time) was found among three sessions over time. Catalase area under the curve (AUC) was lower after both low-NO3- and high-NO3- consumption (
), and GSH AUC was lower after high-NO3- (
) compared with OFD. So, the acute intake of BJ with aerobic exercise seems to decrease catalase (in high-NO3- and low-NO3-) and GSH (in high-NO3-), besides not interfering with FRAP in hypertensive postmenopausal women.
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Pondofe K, Fregonezi GAF, Brito O, Dourado Júnior ME, Torres-Castro R, Resqueti VR. Effects of an optimised approach to home-based respiratory care in individuals with amyotrophic lateral sclerosis: a study protocol for a randomised controlled trial. BMJ Open 2021; 11:e042780. [PMID: 33837098 PMCID: PMC8043034 DOI: 10.1136/bmjopen-2020-042780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/22/2021] [Accepted: 03/23/2021] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION This study aims to investigate the effects of an optimal home-based respiratory care protocol in individuals with amyotrophic lateral sclerosis (ALS). METHODS AND ANALYSIS This is a randomised, blinded controlled trial involving patients diagnosed with ALS, both sexes, age between 18 and 80 years. Patients will be randomly allocated into the conventional respiratory care (CRC) group and the optimised respiratory care home-based (ORC) group. Primary outcomes will be peak cough flow, the number of exacerbations and ALS Functional Rating Scale Revised. Secondary outcomes will include chest wall volumes, maximal respiratory pressures, sniff nasal inspiratory pressure, nasal expiratory pressure and forced vital capacity (FVC), forced expiratory volume in the 1st second (FEV1) and FEV1/FVC. The CRC group will receive educational information about respiratory care at the clinic. The ORC group will receive conventional care and home-based care. The clinical status of all individuals will be monitored weekly through telephone calls. A 6-month intervention is planned, the outcomes will be assessed every 3 months and 3 and 6 months follow-up after final evaluation. The primary and secondary results will be described as average or median for continuous variables and absolute and relative frequencies for qualitative variables. Treatment effects or differences between the outcomes (baseline, 3 months and 6 months) of the study groups will be analysed using an analysis of variance. The level of significance will be set as p≤0.05. ETHICS AND DISSEMINATION The research ethics committee approved the study. It is expected to evaluate respiratory function in patients with ALS in the short, medium and long terms with home-based care protocol applied. The disease's rapid progression is a limitation for performing a long-term clinical study. TRIAL REGISTRATION NUMBER RBR-3z23ts; Pre-results.
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Affiliation(s)
- Karen Pondofe
- Departamento de Fisioterapia, PneumoCardioVascular Lab/HUOL e Laboratório de Inovação Tecnológica em Reabilitação, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Guilherme A F Fregonezi
- Departamento de Fisioterapia, PneumoCardioVascular Lab/HUOL e Laboratório de Inovação Tecnológica em Reabilitação, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Ozana Brito
- Departamento de Fisioterapia, PneumoCardioVascular Lab/HUOL e Laboratório de Inovação Tecnológica em Reabilitação, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | - Mario Emilio Dourado Júnior
- Medicina Integrada, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil
| | | | - Vanessa R Resqueti
- Departamento de Fisioterapia, PneumoCardioVascular Lab/HUOL e Laboratório de Inovação Tecnológica em Reabilitação, Hospital Universitário Onofre Lopes, Empresa Brasileira de Serviços Hospitalares (EBSERH), Universidade Federal do Rio Grande do Norte, Natal, Brazil
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Silva AP, Araujo EV, Machado IP, Alves LF, DA Silva Mello MF, Silva PHDEA, Dias IR, Soares V. Rating of Perceived Exertion in Three-Minute Step Test in Children with Cystic Fibrosis. INTERNATIONAL JOURNAL OF EXERCISE SCIENCE 2021; 14:177-186. [PMID: 34055158 PMCID: PMC8136547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The purpose of the study was to assess whether there are differences in cardiorespiratory fitness between children with and without cystic fibrosis (CF). Ten children with CF attended at a referral center for the treatment of CF and 13 children without CF were evaluated. The average age of the children with CF was 10.40 (3.13) years and those without CF was 9.39 (3.25) years. The children performed the three-minute step test with monitoring of hemodynamic parameters and the rating of perceived exertion (RPE) every minute. Oxygen desaturation of 4% during the test occurred in three children with CF and none of the children reached a SatO2 percentage < 75%. After the step test, the findings showed that children with CF presented higher RPE scores during the test (p = 0.002) when compared to children without CF (p < 0.001). The RPE was the only parameter that changed during the test and demonstrated that children with cystic fibrosis tired more during the test when compared to children without CF despite the lack of changes in hemodynamic variables.
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Affiliation(s)
- Amanda P Silva
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
| | - Erika V Araujo
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
| | - Igor P Machado
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
| | - Livia F Alves
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
| | - Marcos F DA Silva Mello
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
| | | | - Isabella R Dias
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
- PostGraduate Program in Human Movement and Rehabilitation, University Center of Anápolis-UniEVANGELICA, Anápolis, GO, BRAZIL
| | - Viviane Soares
- Department of Physical Therapy, University Center of Anápolis - UniEVANGELICA, Anápolis, GO, BRAZIL
- PostGraduate Program in Human Movement and Rehabilitation, University Center of Anápolis-UniEVANGELICA, Anápolis, GO, BRAZIL
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Seguro CS, Rebelo ACS, Silva AG, Santos MMAD, Cardoso JS, Apolinário V, Jardim PCV, Gentil P. Use of low volume, high effort resistance training to manage blood pressure in hypertensive patients inside a public hospital: a proof of concept study. Eur J Transl Myol 2021; 31. [PMID: 33709656 PMCID: PMC8056164 DOI: 10.4081/ejtm.2021.9547] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 12/19/2020] [Indexed: 12/15/2022] Open
Abstract
Physical exercise has been shown to have an important role in the prevention and treatment of arterial hypertension. However, the general exercise recommendations are time consuming, which might be detrimental to exercise adoption. Based on this, minimal doses of exercise have been suggested as an alternative approach and this report investigates the feasibility and effects of low volume and high effort resistance training for hypertensive patients in a hospital setting. This is a pilot non-randomized prospective study where 15 sedentary hypertensive patients (11 women and 4 men) performed 24 resistance training sessions over 12 weeks at a public hospital. The resistance training sessions consisted of two sets of four exercises, with a rest interval of two minutes between sets. Systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured 10 minutes before and 10 minutes after each training. No injuries or intercurrence were reported during the study. SBP decreased significantly when compared the first and last sessions, when the measures were performed at rest (152 ± 16 mmHg vs. 122 ± 9 mmHg vs, p<0.05), and after (137 ± 13 mmHg vs. 115 ± 5 mmHg, p<0.05) the resistance training session. Similarly, DBP also decreased significantly when the values from the last session were compared with the first session, when measured at rest (83 ± 14 mmHg vs 73 ± 9 mmHg, p<0.05). Low volume and high effort resistance training seems to be a feasible non-pharmacological strategy to help controlling blood pressure in hypertensive patients within a hospital.
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Affiliation(s)
| | | | | | | | | | | | | | - Paulo Gentil
- Faculty of Physical Education and Dance, Federal University of Goiás, Goiânia; Hypertension League, Federal University of Goiás, Goiânia.
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Carpes L, Jacobsen A, Domingues L, Jung N, Ferrari R. Recreational beach tennis reduces 24-h blood pressure in adults with hypertension: a randomized crossover trial. Eur J Appl Physiol 2021; 121:1327-1336. [PMID: 33590342 DOI: 10.1007/s00421-021-04617-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 02/05/2021] [Indexed: 01/23/2023]
Abstract
PURPOSE To evaluate the effect of a beach tennis session on 24-h ambulatory blood pressure in adults with hypertension. METHODS In this randomized crossover trial, 24 participants (12 men and 12 women) randomly performed two experimental sessions: a beach tennis session and a non-exercise control session. The beach tennis session started with a standardized 5-min warm-up consisting of basic techniques, followed by three 12-min beach tennis matches with 2-min intervals between them. Heart rate was continuously recorded and rating of perceived exertion was assessed in the middle and at the end of each set during the beach tennis session. Enjoyment was also assessed after the beach tennis session. The control session was performed in seated rest. Both experimental sessions lasted 45 min. Ambulatory blood pressure was measured continuously for 24 h after sessions. RESULTS Systolic blood pressure (24-h: 6 mmHg, P = 0.008; daytime: 6 mmHg, P = 0.031; nighttime: 6 mmHg, P = 0.042) and diastolic blood pressure (24-h: 3 mmHg, P = 0.021; daytime: 3 mmHg, P = 0.036; nighttime: 4 mmHg, P = 0.076) decreased after beach tennis when compared with control. The participants presented a reserve heart rate of 59-68%, and a rating of perceived exertion score of 3.4-4.7 using Borg's CR10 Scale. The enjoyment scores after beach tennis session were higher than 90%. CONCLUSION A single session of recreational beach tennis reduces 24-h ambulatory blood pressure in adults with hypertension. Additionally, the participants can achieve a high physiological stress but perceive less effort during the practice. TRIAL REGISTRATION Date: April 10, 2019; identifier number NCT03909308 (Clinicaltrials.gov).
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Affiliation(s)
- Leandro Carpes
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Alexandre Jacobsen
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Lucas Domingues
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Nathalia Jung
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil
| | - Rodrigo Ferrari
- Graduate Program in Cardiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
- Sports and Exercise Training Study Group, Hospital de Clínicas de Porto Alegre, Rua Ramiro Barcelos 2350, Porto Alegre, RS, 90035-903, Brazil.
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Zanatta JMDM, Cosenso-Martin LN, da Silva Lopes V, Roma Uyemura JR, Polegati Santos AM, Paz Landim MI, Yugar-Toledo JC, Vilela-Martin JF. Evidence of Nonadherence in Cases of Pseudoresistant Hypertension. Integr Blood Press Control 2021; 14:9-17. [PMID: 33603455 PMCID: PMC7887157 DOI: 10.2147/ibpc.s264057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/26/2020] [Indexed: 11/23/2022] Open
Abstract
Resistant hypertension (RH) is characterized by the use of three or more antihypertensive drugs without reaching the goal of controlling blood pressure (BP). For a definitive diagnosis of RH, it is necessary to exclude causes of pseudoresistance, including the white-coat effect, errors in BP measurement, secondary hypertension, therapeutic inertia, and poor adherence to lifestyle changes and pharmacological treatment. Herein, we report the history of a patient with long-standing uncontrolled BP, even when using seven antihypertensive drugs. Causes of secondary hypertension that justified the high BP levels were investigated, in addition to the other causes of pseudo-RH. In view of the difficult-to-control BP situation, it was decided to hospitalize the patient for better investigation. After 5 days, he had BP control with practically the same medications previously used. Finally, all factors related to the presence of pseudo-RH are discussed, especially poor adherence to treatment. Poor adherence to antihypertensive treatment is common in daily medical practice, and its investigation is of fundamental importance for better management of BP.
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Affiliation(s)
- João Marcos de Menezes Zanatta
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Luciana Neves Cosenso-Martin
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Valquíria da Silva Lopes
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Jéssica Rodrigues Roma Uyemura
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Aleandra Marton Polegati Santos
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Manoel Ildefonso Paz Landim
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - Juan Carlos Yugar-Toledo
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
| | - José Fernando Vilela-Martin
- Internal Medicine Department, State Medical School at Sao Jose Do Rio Preto (FAMERP), Sao Jose Do Rio Preto, Sao Paulo, Brazil
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Mantovanil MDF, Kalinke LP, da Silva ÂTM, Perez Arthur J, Radovanovic CAT, Bortolato-Major C. Effectiveness of nursing case management versus usual care for blood pressure control in adults with hypertension: a systematic review. INVESTIGACION Y EDUCACION EN ENFERMERIA 2021; 39:e04. [PMID: 33687808 PMCID: PMC7987286 DOI: 10.17533/udea.iee.v39n1e04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES To synthesize the best available evidence regarding the effectiveness of nursing case management in primary health care, compared to usual care, in improving blood pressure in adults over 18 years with hypertension. METHODS Systematic review that includes studies carried out with adult patients diagnosed with hypertension, with or without other concomitant chronic diseases, followed-up by a case manager nurse, who evaluated the effectiveness of case management in the improvement of blood pressure. A critical evaluation of the studies was made and the results of interest were described using the instruments and tools from the Joanna Briggs Institute. Due to the heterogeneity of the included studies, the results of similar measures were not grouped in statistical meta-analysis. A narrative and tabular format was used to synthesize and present them. RESULTS Six randomized controlled trials were critically evaluated and included in the review. The total sample was 1963 participants. The results showed the outcomes compared at baseline and at the end of follow-up (six or twelve months). Regarding the main outcome, systolic and diastolic blood pressure, there was some reduction in the group followed-up through case management in studies lasting six months; however, the impossibility of comparing the findings poses limitations to answering the questions in this review. CONCLUSIONS Despite the heterogeneity of the studies, the narrative and tabular analysis demonstrated that short-term case management in primary care (six-month studies) helped to reduce blood pressure levels, although the level of evidence for these results is low or very low.
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Philbois SV, Facioli TP, Gastaldi AC, Rodrigues JAL, Tank J, Fares TH, Rodrigues KP, Souza HCD. Important differences between hypertensive middle-aged women and men in cardiovascular autonomic control-a critical appraisal. Biol Sex Differ 2021; 12:11. [PMID: 33430973 PMCID: PMC7802327 DOI: 10.1186/s13293-020-00355-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/26/2020] [Indexed: 11/17/2022] Open
Abstract
Background Normotensive premenopausal women show a vagal predominance of cardiac autonomic modulation, whereas age-matched men show a predominance of sympathetic modulation. However, some women develop systemic arterial hypertension (SAH) even with preserved ovarian function. Our hypothesis is that these women may have cardiovascular autonomic parameters similar to those of hypertensive men, even when subjected to pharmacological treatment. We aimed to investigate cardiovascular autonomic control and baroreflex sensitivity (BRS) in hypertensive premenopausal women and age-matched men. Methods One hundred volunteers between 18 and 45 years of age were assigned to two groups (50 participants each): a hypertensive group including patients with a history of SAH for at least 6 months (25 men and 25 women), who were under treatment with monotherapy (losartan, 25–50 mg/kg); and a normotensive group (25 men and 25 women). Anthropometric, hemodynamic, metabolic, and autonomic cardiovascular assessments were performed focusing on BRS, autonomic modulation of heart rate variability (HRV), and blood pressure variability (BPV). Results On HRV analysis, women showed higher values of high-frequency (HF) oscillations in absolute and normalized units, lower values of low-frequency (LF) in normalized units, and lower LF/HF ratio, as compared with men. When the normotensive and hypertensive groups were compared, hypertensive groups showed lower values of total variance and of LF and HF bands in absolute units. On BRS, hypertensive groups showed lower values than the normotensive group. Conclusion Regardless of blood pressure control through pharmacological treatment, hypertensive patients continued to have reduced HRV compared to normotensive, and hypertensive men had more autonomic impairment than hypertensive premenopausal women.
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Affiliation(s)
- Stella V Philbois
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Tábata P Facioli
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Ada C Gastaldi
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Jhennyfer A L Rodrigues
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Jens Tank
- Institute of Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Thauane H Fares
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Karine P Rodrigues
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Hugo C D Souza
- Laboratory of Exercise Physiology and Cardiovascular Physiotherapy, Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900, Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
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Marcolino MS, Oliveira JAQ, Cimini CCR, Maia JX, Pinto VSOA, Sá TQV, Amancio K, Coelho L, Ribeiro LB, Cardoso CS, Ribeiro AL. Development and Implementation of a Decision Support System to Improve Control of Hypertension and Diabetes in a Resource-Constrained Area in Brazil: Mixed Methods Study. J Med Internet Res 2021; 23:e18872. [PMID: 33427686 PMCID: PMC7834943 DOI: 10.2196/18872] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND The low levels of control of hypertension and diabetes mellitus are a challenge that requires innovative strategies to surpass barriers of low sources, distance, and quality of health care. OBJECTIVE The aim of this study is to develop a clinical decision support system (CDSS) for diabetes and hypertension management in primary care, to implement it in a resource-constrained region, and to evaluate its usability and health care practitioner satisfaction. METHODS This mixed methods study is a substudy of HealthRise Brazil Project, a multinational study designed to implement pilot programs to improve screening, diagnosis, management, and control of hypertension and diabetes among underserved communities. Following the identification of gaps in usual care, a team of clinicians established the software functional requirements. Recommendations from evidence-based guidelines were reviewed and organized into a decision algorithm, which bases the CDSS reminders and suggestions. Following pretesting and expert panel assessment, pilot testing was conducted in a quasi-experimental study, which included 34 primary care units of 10 municipalities in a resource-constrained area in Brazil. A Likert-scale questionnaire evaluating perceived feasibility, usability, and utility of the application and professionals' satisfaction was applied after 6 months. In the end-line assessment, 2 focus groups with primary care physicians and nurses were performed. RESULTS A total of 159 reminders and suggestions were created and implemented for the CDSS. At the 6-month assessment, there were 1939 patients registered in the application database and 2160 consultations were performed by primary care teams. Of the 96 health care professionals who were invited for the usability assessment, 26% (25/96) were physicians, 46% (44/96) were nurses, and 28% (27/96) were other health professionals. The questionnaire included 24 items on impressions of feasibility, usability, utility, and satisfaction, and presented global Cronbach α of .93. As for feasibility, all professionals agreed (median scores of 4 or 5) that the application could be used in primary care settings and it could be easily incorporated in work routines, but physicians claimed that the application might have caused significant delays in daily routines. As for usability, overall evaluation was good and it was claimed that the application was easy to understand and use. All professionals agreed that the application was useful (score 4 or 5) to promote prevention, assist treatment, and might improve patient care, and they were overall satisfied with the application (median scores between 4 and 5). In the end-line assessment, there were 4211 patients (94.82% [3993/4211] with hypertension and 24.41% [1028/4211] with diabetes) registered in the application's database and 7960 consultations were performed by primary health care teams. The 17 participants of the focus groups were consistent to affirm they were very satisfied with the CDSS. CONCLUSIONS The CDSS was applicable in the context of primary health care settings in low-income regions, with good user satisfaction and potential to improve adherence to evidence-based practices.
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Affiliation(s)
- Milena Soriano Marcolino
- Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - João Antonio Queiroz Oliveira
- Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Junia Xavier Maia
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Thábata Queiroz Vivas Sá
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Kaique Amancio
- Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Lissandra Coelho
- Medical School, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Teófilo Otoni, Brazil
| | - Leonardo Bonisson Ribeiro
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Antonio Luiz Ribeiro
- Medical School, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Telehealth Center, University Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Costa MVGD, Lima LRD, Silva ICRD, Rehem TCMSB, Funghetto SS, Stival MM. Risco cardiovascular aumentado e o papel da síndrome metabólica em idosos hipertensos. ESCOLA ANNA NERY 2021. [DOI: 10.1590/2177-9465-ean-2020-0055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
RESUMO Objetivo avaliar a síndrome metabólica e o risco cardiovascular de idosos hipertensos atendidos na atenção primária. Métodos estudo transversal realizado com 154 idosos hipertensos de uma Unidade Básica de Saúde do Distrito Federal. Um instrumento estruturado investigou o perfil dos idosos. Para a classificação da síndrome metabólica, consideraram-se os critérios propostos pela National Cholesterol Education Program – Adult Treatment Panel III. Para análise do risco cardiovascular, utilizou-se o escore de risco de Framingham. Foi realizada análise estatística e inferencial com a utilização da ANOVA, teste qui-quadrado e exato de Fisher, além da odds ratio e seu intervalo de confiança de 95% para estimar o risco cardiovascular entre os grupos. Resultados 64,9% dos idosos hipertensos eram obesos. Síndrome metabólica foi evidenciada em 70,8%. Observou-se que 27,2% apresentaram baixo, 46,8% moderado e 26,0% elevado risco cardiovascular, sendo que o sexo feminino e a idade avançada influenciaram negativamente o risco. Idosos com síndrome metabólica apresentaram 7,19 vezes mais chances de terem elevado risco cardiovascular. Considerações finais e implicações para a prática os idosos hipertensos apresentaram uma elevada prevalência de síndrome metabólica que aumentou significativamente o risco cardiovascular. Este resultado possibilita um melhor planejamento da assistência de enfermagem pelo enfermeiro da atenção primária à saúde.
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Cezar MDM, Oliveira Junior SAD, Damatto RL. Moderate-Intensity Resistance Training Improves Oxidative Stress in Heart. Arq Bras Cardiol 2021; 116:12-13. [PMID: 33566959 PMCID: PMC8159501 DOI: 10.36660/abc.20200561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
| | | | - Ricardo Luiz Damatto
- Faculdade de Ciências Sociais e Agrárias de Itapeva (FAIT), Itapeva, SP - Brasil
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de Oliveira JVB, Lima RPA, Pordeus Luna RC, da Silva Diniz A, de Almeida ATC, de Oliveira NFP, Gonçalves MDCR, de Lima RT, de Lima Ferreira FEL, Diniz SCPDOR, Silva AS, Andrade e Silva AH, Persuhn DC, de Carvalho Costa MJ. The direct correlation between oxidative stress and LDL-C levels in adults is maintained by the Friedewald and Martin equations, but the methylation levels in the MTHFR and ADRB3 genes differ. PLoS One 2020; 15:e0239989. [PMID: 33326437 PMCID: PMC7743960 DOI: 10.1371/journal.pone.0239989] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 09/16/2020] [Indexed: 12/16/2022] Open
Abstract
Low-density lipoprotein (LDL-C) concentrations are a standard of care in the prevention of cardiovascular disease and are influenced by different factors. This study compared the LDL-C concentrations estimated by two different equations and determined their associations with inflammatory status, oxidative stress, anthropometric variables, food intake and DNA methylation levels in the LPL, ADRB3 and MTHFR genes. A cross-sectional population-based study was conducted with 236 adults (median age 37.5 years) of both sexes from the municipality of João Pessoa, Paraíba, Brazil. The LDL-C concentrations were estimated according to the Friedewald and Martin equations. LPL, ADRB3 and MTHFR gene methylation levels; malondialdehyde levels; total antioxidant capacity; ultra-sensitive C-reactive protein, alpha-1-acid glycoprotein, homocysteine, cobalamin, and folic acid levels; usual dietary intake; and epidemiological variables were also determined. For each unit increase in malondialdehyde concentration there was an increase in the LDL-C concentration from 6.25 to 10.29 mg/dL (p <0.000). Based on the Martin equation (≥70 mg/dL), there was a decrease in the DNA methylation levels in the ADRB3 gene and an increase in the DNA methylation levels in the MTHFR gene (p <0.05). There was a positive relation of homocysteine and cholesterol intake on LDL-C concentrations estimated according to the Friedewald equation and of waist circumference and age based on the two estimates. It is concluded the LDL-C concentrations estimated by the Friedewald and Martin equations were different, and the Friedewald equation values were significantly lower than those obtained by the Martin equation. MDA was the variable that was most positively associated with the estimated LDL-C levels in all multivariate models. Significant relationships were observed based on the two estimates and occurred for most variables. The methylation levels of the ADRB3 and MTHFR genes were different according to the Martin equation at low LDL-C concentrations (70 mg/dL).
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Affiliation(s)
- Jéssica Vicky Bernardo de Oliveira
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
- * E-mail:
| | - Raquel Patrícia Ataíde Lima
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | - Rafaella Cristhine Pordeus Luna
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | - Alcides da Silva Diniz
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Pernambuco (Universidade Federal de Pernambuco—UFPE), Recife, Pernambuco, Brazil
| | - Aléssio Tony Cavalcanti de Almeida
- Postgraduate Program in Applied Economics, Department of Economics, Centre for Applied Social Sciences, UFPB, João Pessoa, Paraíba, Brazil
| | | | - Maria da Conceição Rodrigues Gonçalves
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | - Roberto Texeira de Lima
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | - Flávia Emília Leite de Lima Ferreira
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | | | - Alexandre Sergio Silva
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
| | | | - Darlene Camati Persuhn
- Department of Molecular Biology, Centre for Exact and Natural Sciences, UFPB, João Pessoa, Paraíba, Brazil
| | - Maria José de Carvalho Costa
- Postgraduate Program in Nutrition Sciences, Department of Nutrition, Health Sciences Centre, Federal University of Paraíba (Universidade Federal da Paraíba–UFPB), João Pessoa, Paraíba, Brazil
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Stolt LROG, Kolish DV, Cardoso MRA, Tanaka C, Vasconcelos EFS, Pereira EC, Dellú MC, Pereira WMP, Aldrighi JM, Schmitt ACB. Accidental falls in middle-aged women. Rev Saude Publica 2020; 54:141. [PMID: 33331487 PMCID: PMC7726919 DOI: 10.11606/s1518-8787.2020054002579] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 06/05/2020] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVE To estimate the prevalence of accidental falls in women and to identify possible associations of sociodemographic, clinical and lifestyle variables with falls, in 2007 and 2014. METHODS Two cross-sectional studies were performed, in 2007 and 2014, within the Projeto de Saúde de Pindamonhangaba (PROSAPIN – Pindamonhangaba Health Project), with women aged between 35 to 75 years. Probabilistic samples were selected among women living in the municipality and participating in the Health Family Strategy. Data collection included: face-to-face interview, anthropometric examination and blood test. The outcome variable “have you fallen in the last six months?” was raised during the interview. The prevalence of falls in 2007 and 2014 were estimated by score with a 95% confidence interval (95%CI). Multiple logistic regression models were constructed to identify the association of independent variables with the occurrence of falls for each year based on the odds ratio (OR). We used the Stata 14.0 software for statistical analysis. RESULTS The prevalence of accidental falls were: 17.6% (95%CI 14.9–20.5) in 2007 and 17.2% (95%CI 14.8–19.8) in 2014. In 2007, factors associated with falls were: aged 50–64 years (OR = 1.81; 95%CI 1.17–2.80), high school (OR = 1.76; 95%CI 1.06–2.93), hyperuricemia (OR = 3.74; 95%CI 2.17–6.44), depression (OR = 2.07; 95%CI 1.31–3.27), poor sleep (OR = 1.78; 95%CI 1.12–2.82) and daytime sleepiness (OR = 1.86; 95%CI 1.16–2.99). In 2014, they were: aged 50–64 years (OR = 1.64; 95%CI 1.04–2.58), hyperuricemia (OR = 1.91; 95%CI 1.07–3.43) and depression (OR = 1.56; 95%CI 1.02–2.38), plus metabolic syndrome (OR = 1.60; 95%CI 1.03–2.47) and musculoskeletal pain (OR = 1.81; 95%CI 1.03–3.18). CONCLUSIONS Falls occur significantly in women aged 50 years or over, indicating that they are not restricted to older adults and that there is a need to initiate preventive measures earlier. Both studies showed similar magnitudes of occurrence of accidental falls and reinforced their multifactorial nature. In addition, hyperuricemia may be a potential new factor associated with falls.
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Affiliation(s)
- Lígia Raquel Ortiz Gomes Stolt
- Universidade Federal da Paraíba. Departamento de Fisioterapia. João Pessoa, PB, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil
| | - Daniel Vieira Kolish
- Articulab - Ortopedia Moderna Especializada. Fisioterapeuta em reabilitação ortopédica e facilitador de processos de trabalho e desenvolvimento de projetos. São Paulo, SP, Brasil
| | - Maria Regina Alves Cardoso
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Epidemiologia. São Paulo, SP, Brasil
| | - Clarice Tanaka
- Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Hospital das Clínicas. Laboratório de Investigação em Fisioterapia. São Paulo, SP, Brasil
| | | | | | | | | | - José Mendes Aldrighi
- Universidade de São Paulo. Faculdade de Saúde Pública. Departamento de Saúde Materno-Infantil. São Paulo, SP, Brasil
| | - Ana Carolina Basso Schmitt
- Universidade de São Paulo. Faculdade de Medicina. Programa de Pós-Graduação em Ciências da Reabilitação. São Paulo, SP, Brasil.,Universidade de São Paulo. Faculdade de Medicina. Departamento de Fisioterapia, Fonoaudiologia e Terapia Ocupacional. São Paulo, SP, Brasil
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42
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de Oliveira Vieira A, Nascentes GAN, de Morais Oliveira AC, Correia D, Cabrine-Santos M. Biomarkers assessment in patients with Chagas disease and systemic arterial hypertension. Parasitol Res 2020; 120:1429-1435. [PMID: 33174073 DOI: 10.1007/s00436-020-06954-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Accepted: 11/01/2020] [Indexed: 10/23/2022]
Abstract
Chagas disease (ChD) and systemic arterial hypertension (SAH) are two severe comorbidities that lead to mortality and a reduction in people's quality of life, with an impact on public health. The aim of this study was to quantify the biomarkers of cardiac injury in patients with ChD and SAH. Eighty patients were divided into four groups: 20 hypertensive patients, 20 ChD-hypertensive patients, 20 ChD patients, and 20 normotensive volunteers; all of them came from outpatient's public health services. Among the evaluated markers for cardiac lesions (creatine kinase, creatine kinase-MB isoform, myoglobin, high-sensitive cardiac troponin T[hs-cTnT], B-type natriuretic peptide [BNP], and C-reactive protein), hs-cTnT and BNP were the most appropriate. Importantly, our results showed that the cut off point for hs-cTnT could be < 0.007 ng/mL, which could lead to the early detection of myocardial lesions. The BNP and hs-cTnT levels were high only in the ChD and ChD-hypertensive patient groups, suggesting that Chagas' disease may play an important role in the increase of these biomarkers. ChD patients, hypertensive or not, with cardiac or cardiodigestive involvement presented significantly higher values of hs-cTnT (p < 0.001) and BNP (p = 0.001) than ChD patients with indeterminate and digestive forms, which strengthens the validation of these markers for the follow-up of clinical cardiac form of ChD. This study suggests that the BNP and hs-cTnT can be used as possible indirect biomarkers of cardiac damage. In addition, the reference values of these biomarkers in Chagas and hypertensive cardiomyopathies should be better understood with further studies.
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Affiliation(s)
- Anderson de Oliveira Vieira
- Clinical Pathology Service at the Hospital de Clínicas/Ebserh, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil
| | - Gabriel Antônio Nogueira Nascentes
- Program of Microbiology and Immunology, Federal Institute of Education, Science and Technology of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil
| | | | - Dalmo Correia
- Infectious Diseases Division, Internal Medicine Department, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil
| | - Marlene Cabrine-Santos
- Internal Medicine Department, Federal University of Triângulo Mineiro, Uberaba, Minas Gerais State, Brazil. .,Universidade Federal do Triângulo Mineiro, Av. Getúlio Guaritá, 130, Abadia, Uberaba, Minas Gerais, 38025-440, Brazil.
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43
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Whole-Body Vibration as Antihypertensive Non-Pharmacological Treatment in Hypertensive Individuals with Knee Osteoarthritis: Randomized Cross-Over Trial. SUSTAINABILITY 2020. [DOI: 10.3390/su12218944] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
(1) Background: Hypertension is a serious medical condition characterized by a persistent increase in blood pressure (BP), which is prevalent in individuals with knee osteoarthritis (KOA). Pharmacological interventions are normally used to treat both hypertension and KOA; however, a more sustainable form of treatment is desirable for these clinical conditions. Whole-body vibration (WBV) exercise has been proposed as a non-pharmacological therapy for reducing both BP and KOA symptomatology. This study aimed to evaluate the antihypertensive effect of WBV in hypertensive individuals with KOA. (2) Methods: Nineteen hypertensive individuals with KOA were randomly allocated to either a control (CG) (n = 9) or a WBV group (WBVG) (n = 10). Subjects in the WBVG were positioned sitting in a chair in front of a vibrating platform (VP) with the feet on the base (peak-to-peak displacement 2.5, 5.0 and 7.5 mm; frequencies 5 to 14 Hz). In the CG, subjects assumed the same position with the VP turned off. The protocols in the CG and WBVG were performed 2 days/week for a total of 5 weeks. (3) Results: No baseline differences (age, anthropometrics, BP parameters and medications) between the groups were found (p > 0.05). WBV exercise reduced systolic BP (SBP: 126.1 ± 2.7 versus 119.1 ± 3.2 mmHg; p = 0.001; post hoc: p = 0.02; F = 23.97) and mean BP (MBP: 82.6 ± 1.8 versus 78.7 ± 1.8, p = 0.001, post hoc: p = 0.02; F = 23.97), while no significant changes were found in diastolic BP (DBP: 68.5 ± 2.2 versus 64.4 ± 2.3; p = 0.11; F = 2.68). (4) Conclusions: WBV might be considered a sustainable therapy for exerting an antihypertensive effect in medicated hypertensive individuals with KOA. This decline in BP might translate to a reduction in pharmacological need, although further studies are necessary to understand the mechanisms underlying the described effect.
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Lidani KCF, Sandri TL, Castillo-Neyra R, Andrade FA, Guimarães CM, Marques EN, Beltrame MH, Gilman RH, de Messias-Reason I. Clinical and epidemiological aspects of chronic Chagas disease from Southern Brazil. Rev Soc Bras Med Trop 2020; 53:e20200225. [PMID: 33111908 PMCID: PMC7580281 DOI: 10.1590/0037-8682-0225-2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/31/2020] [Indexed: 01/15/2023] Open
Abstract
INTRODUCTION Patients with Chagas disease (CD), caused by Trypanosoma cruzi, present a higher risk of developing other chronic diseases, which may contribute to CD severity. Since CD is underreported in the southern state of Paraná, Brazil, we aimed to characterize clinical and epidemiological aspects of individuals chronically infected with T. cruzi in Southern Brazil. METHODS A community hospital-based study was performed, recording clinical/demographic characteristics of 237 patients with CD from Southern Brazil. To estimate the association between different forms of CD and sociodemographic and clinical variables, multiple logistic regression models were built using the Akaike information criterion. RESULTS Mean age was 57.5 years and 59% were females. Most patients' (60%) place of origin/birth was within Paraná and they were admitted to the CD outpatient clinic after presenting with cardiac/digestive symptoms (64%). The predominant form of CD was cardiac (53%), followed by indeterminate (36%), and digestive (11%). The main electrocardiographic changes were in the right bundle branch block (39%) and left anterior fascicular block (32%). The average number of comorbidities per patient was 3.9±2.3; systemic arterial hypertension was most common (64%), followed by dyslipidemia (34%) and diabetes (19%); overlapping comorbidities were counted separately. Male sex was associated with symptomatic cardiac CD (OR=2.92; 95%CI: 1.05-8.12; p=0.040). CONCLUSIONS This study provided greater understanding of the distribution and clinical profile of CD patients in Southern Brazil, indicating a high prevalence of comorbidities among these patients who are a vulnerable group due to advanced age and substantial risk of morbidity.
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Affiliation(s)
| | - Thaisa Lucas Sandri
- University of Tübingen, Institute of Tropical Medicine, Tübingen,
BW, Germany
| | - Ricardo Castillo-Neyra
- University of Pennsylvania, Perelman School of Medicine, Department
of Biostatistics, Epidemiology & Informatics, Philadelphia, PA, USA
| | - Fabiana Antunes Andrade
- Universidade Federal do Paraná, Departamento de Patologia Médica,
Hospital de Clínicas, Curitiba, PR, Brasil
| | - Cesar Maistro Guimarães
- Universidade Federal do Paraná, Hospital de Clínicas, Unidade de
Terapia Intensiva, Curitiba, PR, Brasil
| | - Eduardo Nunes Marques
- Universidade Federal do Paraná, Departamento de Patologia Médica,
Hospital de Clínicas, Curitiba, PR, Brasil
| | - Marcia Holsbach Beltrame
- Universidade Federal do Paraná, Departamento de Genética,
Laboratório de Genética Molecular Humana, Curitiba, PR, Brasil
| | - Robert Hugh Gilman
- Johns Hopkins Bloomberg School of Public Health, Department of
International Health, Baltimore, MD, USA
| | - Iara de Messias-Reason
- Universidade Federal do Paraná, Departamento de Patologia Médica,
Hospital de Clínicas, Curitiba, PR, Brasil
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Nascimento BR, Brant LCC, Yadgir S, Oliveira GMM, Roth G, Glenn SD, Mooney M, Naghavi M, Passos VMA, Duncan BB, Silva DAS, Malta DC, Ribeiro ALP. Trends in prevalence, mortality, and morbidity associated with high systolic blood pressure in Brazil from 1990 to 2017: estimates from the "Global Burden of Disease 2017" (GBD 2017) study. Popul Health Metr 2020; 18:17. [PMID: 32993676 PMCID: PMC7526365 DOI: 10.1186/s12963-020-00218-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/10/2020] [Indexed: 11/10/2022] Open
Abstract
Background Hypertension remains the leading risk factor for cardiovascular disease (CVD) worldwide, and its impact in Brazil should be assessed in order to better address the issue. We aimed to describe trends in prevalence and burden of disease attributable to high systolic blood pressure (HSBP) among Brazilians ≥ 25 years old according to sex and federal units (FU) using the Global Burden of Disease (GBD) 2017 estimates. Methods We used the comparative risk assessment developed for the GBD study to estimate trends in attributable deaths and disability-adjusted life-years (DALY), by sex, and FU for HSBP from 1990 to 2017. This study included 14 HSBP-outcome pairs. HSBP was defined as ≥ 140 mmHg for prevalence estimates, and a theoretical minimum risk exposure level (TMREL) of 110–115 mmHg was considered for disease burden. We estimated the portion of deaths and DALYs attributed to HSBP. We also explored the drivers of trends in HSBP burden, as well as the correlation between disease burden and sociodemographic development index (SDI). Results In Brazil, the prevalence of HSBP is 18.9% (95% uncertainty intervals [UI] 18.5–19.3%), with an annual 0.4% increase rate, while age-standardized death rates attributable to HSBP decreased from 189.2 (95%UI 168.5–209.2) deaths to 104.8 (95%UI 94.9–114.4) deaths per 100,000 from 1990 to 2017. In spite of that, the total number of deaths attributable to HSBP increased 53.4% and HSBP raised from 3rd to 1st position, as the leading risk factor for deaths during the period. Regarding total DALYs, HSBP raised from 4th in 1990 to 2nd cause in 2017. The main driver of change of HSBP burden is population aging. Across FUs, the reduction in the age-standardized death rates attributable to HSBP correlated with higher SDI. Conclusions While HSBP prevalence shows an increasing trend, age-standardized death and DALY rates are decreasing in Brazil, probably as results of successful public policies for CVD secondary prevention and control, but suboptimal control of its determinants. Reduction was more significant in FUs with higher SDI, suggesting that the effect of health policies was heterogeneous. Moreover, HSBP has become the main risk factor for death in Brazil, mainly due to population aging.
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Affiliation(s)
- Bruno Ramos Nascimento
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil. .,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil.
| | - Luísa Campos Caldeira Brant
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil
| | - Simon Yadgir
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Gregory Roth
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Scott Devon Glenn
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Meghan Mooney
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | - Mohsen Naghavi
- Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
| | | | - Bruce Bartholow Duncan
- Programa de Pós-graduação em Epidemiologia e Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Diego Augusto Santos Silva
- Federal University of Santa Catarina, Research Center in Kinanthropometry and Human Performance, Florianópolis, SC, Brazil
| | - Deborah Carvalho Malta
- Escola de Enfermagem, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Departamento de Vigilância de Doenças e Agravos Não Transmissíveis e Promoção da Saúde, Ministério da Saúde, Brasília, Brazil
| | - Antonio Luiz Pinho Ribeiro
- Faculdade de Medicina, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil.,Hospital das Clínicas, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 110, Belo Horizonte, MG, Brazil
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Ferrari F, Martins VM. High-intensity Interval Training versus Continuous Exercise: Is There a Difference Regarding the Magnitude of Blood Pressure Reduction? Arq Bras Cardiol 2020; 115:15-16. [PMID: 32785495 PMCID: PMC8384329 DOI: 10.36660/abc.20200261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Filipe Ferrari
- Programa de Pós-Graduação em Cardiologia e Ciências Cardiovasculares, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
| | - Vítor Magnus Martins
- Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brasil
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Yugar-Toledo JC, Moreno Júnior H, Gus M, Rosito GBA, Scala LCN, Muxfeldt ES, Alessi A, Brandão AA, Moreira Filho O, Feitosa ADDM, Passarelli Júnior O, Souza DDSMD, Amodeo C, Barroso WKS, Gomes MAM, Paiva AMGD, Barbosa ECD, Miranda RD, Vilela-Martin JF, Nadruz Júnior W, Rodrigues CIS, Drager LF, Bortolotto LA, Consolim-Colombo FM, Sousa MGD, Borelli FADO, Kaiser SE, Salles GF, Azevedo MDFD, Magalhães LBNC, Póvoa RMDS, Malachias MVB, Nogueira ADR, Jardim PCBV, Jardim TDSV. Brazilian Position Statement on Resistant Hypertension - 2020. Arq Bras Cardiol 2020; 114:576-596. [PMID: 32267335 PMCID: PMC7792719 DOI: 10.36660/abc.20200198] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Affiliation(s)
| | - Heitor Moreno Júnior
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP - Brasil
| | - Miguel Gus
- Hospital Moinhos de Vento, Porto Alegre, RS - Brasil
| | | | | | - Elizabeth Silaid Muxfeldt
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil
| | | | | | | | | | | | | | - Celso Amodeo
- Instituto Dante Pazzanese de Cardiologia,São Paulo, SP - Brasil
| | | | | | | | | | | | | | - Wilson Nadruz Júnior
- Faculdade de Ciências Médicas da Universidade Estadual de Campinas, Campinas, SP - Brasil
| | - Cibele Isaac Saad Rodrigues
- Faculdade de Ciências Médicas e da Saúde Pontifícia Universidade Católica de são Paulo, São Paulo, SP - Brasil
| | - Luciano Ferreira Drager
- Instituto do Coração do Hospital das Clínicas da Faculdade Medicina Universidade de São Paulo,São Paulo, SP - Brasil
| | - Luiz Aparecido Bortolotto
- Instituto do Coração do Hospital das Clínicas da Faculdade Medicina Universidade de São Paulo,São Paulo, SP - Brasil
| | | | | | | | | | - Gil Fernando Salles
- Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ - Brasil
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Cezar MDM, Lima ARR, Pagan LU, Damatto RL. Environmental Enrichment Effect on Oxidative Stress in Hypertensive Rats. Arq Bras Cardiol 2020; 113:913-914. [PMID: 31800716 PMCID: PMC7020971 DOI: 10.5935/abc.20190221] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
| | | | | | - Ricardo Luiz Damatto
- Faculdade de Ciências Sociais e Agrárias de Itapeva (FAIT), Itapeva, SP - Brazil
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49
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Ginoza M, Fernandes GAB, Corrêa MF, Fernandes JPS. Novel potent vasodilating agents: Evaluation of the activity and potency of LINS01005 and derivatives in rat aorta. Eur J Pharm Sci 2020; 143:105171. [PMID: 31805391 DOI: 10.1016/j.ejps.2019.105171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Revised: 11/23/2019] [Accepted: 11/29/2019] [Indexed: 10/25/2022]
Abstract
Cardiovascular diseases (CVDs) present high prevalence rates in the current world. It is estimated that approximately one-third of the global deaths are related to CVDs, and thus there is still a need for novel drugs to treat these disorders. We serendipitously discovered that LINS01005 (5a) is a potent vasodilating agent in rat aorta, and therefore a set of analogues were evaluated for the vasodilating potency in Wistar and SHR rat thoracic aorta precontracted with norepinephrine, with endothelium intact (E+) or denuded (E-) aortic rings. Compounds 5a and 5b were the most potent, showing submicromolar potency for endothelium intact vessels (EC50 853 and 941 nM, respectively) and micromolar values for E- vessels (EC50 2.4 and 7.1 µM, respectively). These compounds were indeed significantly more potent vasodilating agents in SHR-derived aortic rings (p < 0.001), showing nanomolar potency for 5a [EC50 2.4 nM (E+) 9.0 nM (E-)] and 5b [EC50 20 nM (E+) 2.1 µM (E-)]. SAR analysis though PCA and HCA were performed, suggesting that N-phenylpiperazine is essential to the activity, while increasing volume in the substituted aromatic moiety is detrimental to the potency. This is the first report of the vasodilating properties of such compounds, and studies regarding the mechanism of action are in progress in our group.
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Affiliation(s)
- Milton Ginoza
- Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau 210, Diadema, SP 09913-030, Brazil
| | - Gustavo A B Fernandes
- Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau 210, Diadema, SP 09913-030, Brazil
| | - Michelle F Corrêa
- Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau 210, Diadema, SP 09913-030, Brazil
| | - João Paulo S Fernandes
- Departamento de Ciências Farmacêuticas, Universidade Federal de São Paulo, Rua São Nicolau 210, Diadema, SP 09913-030, Brazil.
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50
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de Oliveira LS, Fontes AMGG, Vitor ALR, Vanderlei FM, Garner DM, Valenti VE. Lower Systolic Blood Pressure in Normotensive Subjects is Related to Better Autonomic Recovery Following Exercise. Sci Rep 2020; 10:1006. [PMID: 31969683 PMCID: PMC6976706 DOI: 10.1038/s41598-020-58031-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Accepted: 09/13/2019] [Indexed: 02/07/2023] Open
Abstract
Blood pressure (BP) is a cardiovascular parameter applied to detect cardiovascular risk. Recently, the pre-hypertension state has received greater consideration for prevention strategies. We evaluated autonomic and cardiorespiratory recovery following aerobic exercise in normotensive individuals with different systolic BP (SBP) values. We investigated 30 healthy men aged 18 to 30 years divided into groups according to systolic BP (SBP): G1 (n = 16), resting SBP <110 mmHg and G2 (n = 14), resting SBP between 120-110 mmHg. The groups endured 15 minutes seated at rest, followed by a submaximal aerobic exercise on a treadmill and then remaining seated for 60 minutes also at rest, during recovery from the exercise. Cardiorespiratory parameters and heart rate (HR) variability (HRV) (rMSSD, SD1, HF [ms2]) were evaluated before and during recovery from exercise. G2 displayed slower return of SBP, rMSSD and SD1 HRV indices during recovery from exercise compared to G1. In conclusion, normotensive subjects with higher resting SBP (110 to 120 mmHg) offered delayed autonomic recovery following moderate exercise. We suggest that this group may be less physiologically optimized leading to cardiac risks.
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Affiliation(s)
- Letícia Santana de Oliveira
- Autonomic Nervous System Center, Post-Graduate Program in Physical Therapy, São Paulo State University, UNESP, Presidente Prudente, SP, Brazil
| | - Anne Michelli G G Fontes
- Autonomic Nervous System Center, Post-Graduate Program in Physical Therapy, São Paulo State University, UNESP, Presidente Prudente, SP, Brazil
| | - Ana Laura Ricci Vitor
- Autonomic Nervous System Center, Post-Graduate Program in Physical Therapy, São Paulo State University, UNESP, Presidente Prudente, SP, Brazil
| | - Franciele M Vanderlei
- Autonomic Nervous System Center, Post-Graduate Program in Physical Therapy, São Paulo State University, UNESP, Presidente Prudente, SP, Brazil
| | - David M Garner
- Cardiorespiratory Research Group, Department of Biological and Medical Sciences, Faculty of Health and Life Sciences, Oxford Brookes University, Headington Campus, Gipsy Lane, Oxford, OX3 0BP, United Kingdom
| | - Vitor E Valenti
- Autonomic Nervous System Center, Post-Graduate Program in Physical Therapy, São Paulo State University, UNESP, Presidente Prudente, SP, Brazil.
- Autonomic Nervous System Center (CESNA), São Paulo State University, UNESP, Marilia, SP, Brazil.
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