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Pereira LCC, Chagas P, Barbosa ECD, Barroso WKS, Oliveira AC, Hillesheim SF, Kohlrausch VC, Chemello D. The usefulness of SAGE score in predicting high pulse wave velocity in hypertensive patients: a retrospective cohort study. Front Cardiovasc Med 2024; 11:1227906. [PMID: 38596694 PMCID: PMC11002898 DOI: 10.3389/fcvm.2024.1227906] [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: 05/24/2023] [Accepted: 02/29/2024] [Indexed: 04/11/2024] Open
Abstract
Introduction Aortic stiffness assessed by pulse wave velocity (PWV) is an important predictor to evaluate the risk of hypertensive patients. However, it is underutilized in clinical practice. We aimed to identify the optimal cutoff SAGE score that would indicate a risk PWV ≥ 10 m/s in Brazilian ambulatory hypertensive patients. Materials and methods A retrospective cohort study. Patients underwent central blood pressure measurement using a validated oscillometric device from August 2020 to December 2021. A ROC curve was constructed using the Youden statistic to define the best score to identify those at high risk for PWV ≥ 10 m/s. Results A total of 212 hypertensive individuals were selected. The mean age was 64.0 ± 12.4 years and 57.5% were female. The following comorbidities were present: overweight (47.6%), obesity (34.3%), and diabetes (25.0%). Most of the sample (68.9%) had PWV < 10 m/s. According to Youden's statistic, a cutoff point of 6 provided the optimal combination of sensitivity and specificity for identifying patients with a PWV ≥ 10 m/s. This cutoff achieved sensitivity of 97.0%, and specificity of 82.9%. In clinical practice, however, a cutoff point of 7 (where score values of at least 7 were considered to indicate high risk) had a positive likelihood ratio of 8.2 and a negative likelihood ration of 0.346, making this the ideal choice by accurately excluding patients who are less likely to have PWV ≥ 10 m/s. Conclusion A SAGE score ≥7 identified Brazilian hypertensive patients with a high risk of PWV ≥ 10 m/s.
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Affiliation(s)
| | - Patrícia Chagas
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
- Department of Food and Nutrition, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | - Eduardo Costa Duarte Barbosa
- Department of Cardiology, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre – Cardiologia, Porto Alegre, Brazil
| | - Weimar Kunz Sebba Barroso
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Adriana Camargo Oliveira
- Department of Cardiology, Universidade Federal de Goiás – Liga de Hipertensão Arterial, Goiânia, Brazil
| | - Suélen Feijó Hillesheim
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
| | | | - Diego Chemello
- Postgraduate Program in Gerontology, Universidade Federal de Santa Maria (UFSM), Santa Maria, Brazil
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Dos Santos Carvalho Schiavon M, de Moraes LHO, de Moraes TF, Buzinari TC, Neto JCRM, Rodrigues GJ. Chronic red laser treatment induces hypotensive effect in two-kidney one-clip model of renovascular hypertension in rat. Lasers Med Sci 2023; 38:252. [PMID: 37919476 DOI: 10.1007/s10103-023-03918-8] [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: 04/24/2023] [Accepted: 10/22/2023] [Indexed: 11/04/2023]
Abstract
To evaluate whether the chronic effect of photobiomodulation therapy (PBM) on systolic arterial pressure (SAP) from two kidneys one clip (2 K-1C) hypertension animal models can cause a hypotensive effect. Serum levels of nitric oxide were also analyzed and the assessment of lipid peroxidation of the thoracic aorta artery. Male Wistar rats were used. Hypertensive animals (2 K-1C) with Systolic arterial pressure (SAP) greater than or equal to 160 mmHg were used. Systolic arterial pressure (SAP) was determined by the tail plethysmography technique. Normotensive (2 K) and hypertensive (2 K-1C) rats were treated to PBM for 4 weeks using a laser whose irradiation parameters were: red wavelength (λ) = 660 nm: operating continuously; 56 s per point (3 points) spot size = 0.0295 cm2; average optical power of 100 mW; energy of 5.6 J per point; irradiance of 3.40 W/cm2; fluency of 190 J/cm2 per point. The application was on the animals tails, at 3 different points simultaneously, in contact with the skin. To assess serum nitrite and nitrate (NOx) levels, blood collection was performed after chronic PBM treatment, 24 h after the last laser application. The evaluation of the lipid peroxidation of the thoracic aorta artery was performed by measuring the concentration of hydroperoxide by the FOX method. Chronic photobiomodulation therapy (PBM) by red laser (660 nm) can induce a hypotensive effect in 64% of 2 K-1C hypertensive animals, which we say responsive animals. There was no difference in serum NO levels 24 h after the last red laser application, between treated and non-treated groups. Aortic rings from 2 K-1C hypertensive animals present a higher lipid peroxidation. The chronic PBM treatment by red laser decreased aortic rings lipid peroxidation in hypertensive responsive groups, compared to control. our results indicate that chronic PBM made by red laser has an important hypotensive effect in renovascular hypertensive models, by a mechanism that involves decrease in oxidative stress from vascular beds.
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Affiliation(s)
| | | | - Thiago Francisco de Moraes
- Departamento de Ciências Fisiológicas, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | - Tereza Cristina Buzinari
- Departamento de Ciências Fisiológicas, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | - José Carlos Rapozo Mazulo Neto
- Departamento de Ciências Fisiológicas, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, Brazil
| | - Gerson Jhonatan Rodrigues
- Departamento de Ciências Fisiológicas, Universidade Federal de São Carlos (UFSCar), São Carlos, SP, CEP 13565-905, 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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Rodrigues JAL, Ferrari GD, Trapé ÁA, de Moraes VN, Gonçalves TCP, Tavares SS, Tjønna AE, de Souza HCD, Júnior CRB. β 2 adrenergic interaction and cardiac autonomic function: effects of aerobic training in overweight/obese individuals. Eur J Appl Physiol 2020; 120:613-624. [PMID: 31915906 DOI: 10.1007/s00421-020-04301-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Accepted: 01/03/2020] [Indexed: 12/20/2022]
Abstract
PURPOSE To verify the influence of different volumes and intensities of aerobic exercise on cardiac autonomic function (CAF) through heart rate variability (HRV) analysis as well the influence of β2 adrenergic receptor (ADRB2) variants in overweight/obese individuals. METHODS 70 physically inactive adults were randomly allocated into the following 16-week training: 1-high-intensity interval training (HIIT) (n = 25, 1 × 4 min bout at 85-95%HR peak, 3×/week), 4-HIIT (n = 26, 4 × 4 min bouts at 85-95%HR peak, interspersed with 3 min of recovery at 50-70%HR peak, 3×/week), and moderate continuous training (MCT) (n = 19, 30 min at 60-70%HR peak, 5×/week). Before and after the exercise training, anthropometric, BP, cardiorespiratory fitness, and HRV measures were evaluated. R-R intervals recorded for 10 min in a supine position at pre- and post-intervention were used to analyze HRV in the plot-Poincare indexes (SD1, SD2), and frequency-domain (LF, HF, LF/HF). Full blood samples were used for genotyping. RESULTS 4-HIIT and MCT showed positive outcomes for almost all variables while 1-HIIT had a positive influence only on SBP and SD2 index. No associations were observed between isolated ADRB2 variants and changes in HRV. In the analysis of the interaction genotypes, all groups responded positively for the SD1 index of HRV and only the H1 (GG and CC) and H2 (GG and CG + GG) groups presented increases in the RMSSD index. Furthermore, there was an increase in the LF index only in the H3 (CC and AA + AG) and H4 (AA + AG and CG + GG) groups. CONCLUSIONS ADRB2 variants and aerobic exercise training are important interacting variables to improve autonomic function and other health variables outcomes in overweight or obese individuals.
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Affiliation(s)
- Jhennyfer Aline Lima Rodrigues
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil.
- Laboratory of Physiology and Metabolism, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, Bandeirantes AvenueCEP 14.040-907, Ribeirão Preto, SP, 3900, Brazil.
| | - Gustavo Duarte Ferrari
- Department of Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-903, Brazil
| | - Átila Alexandre Trapé
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil
| | - Vitor Nolasco de Moraes
- Ribeirão Preto Medical School, Department of Medical Clinic, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil
| | - Thiago Correa Porto Gonçalves
- Ribeirão Preto Medical School, Department of Medical Clinic, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil
| | - Simone Sakagute Tavares
- Department of Physics and Chemistry, Faculty of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-903, Brazil
| | - Arnt Erik Tjønna
- K.G. Jebsen Center of Exercise in Medicine at Department of Circulation and Medical Imaging, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hugo Celso Dutra de Souza
- Ribeirão Preto Medical School, Exercise Physiology Laboratory, Department of Health Science, University of São Paulo (USP), Bandeirantes Avenue, 3900Vila Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil
| | - Carlos Roberto Bueno Júnior
- School of Nursing of Ribeirão Preto, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil
- Ribeirão Preto Medical School, Department of Medical Clinic, University of São Paulo (USP), Bandeirantes Avenue 3900, Ribeirão Preto, SP, 14040-907, Brazil
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Affiliation(s)
- José Geraldo Mill
- Departamento de Ciências Fisiológicas do Centro de Ciências da Saúde - Universidade Federal do Espírito Santo, Vitória, ES - Brazil.,Hospital Universitário Cassiano Antônio Moraes - Universidade Federal do Espírito Santo, Vitória, ES - Brazil
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Oliveira AND, Simões MM, Simões R, Malachias MVB, Rezende BA. Cardiovascular Risk in Psoriasis Patients: Clinical, Functional and Morphological Parameters. Arq Bras Cardiol 2019; 113:242-249. [PMID: 31340236 PMCID: PMC6777896 DOI: 10.5935/abc.20190123] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 11/21/2018] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Psoriasis correlates with metabolic disorders, early atheromatosis and increased cardiovascular risk. OBJECTIVES To assess markers of cardiovascular disease in psoriatic patients. METHODS Cross-sectional, observational study involving 11 psoriatic participants and 33 controls. Anthropometric, biochemical, hemodynamic and imaging parameters were evaluated. Arterial stiffness was assessed by oscillometric measurement of the brachial artery. Intima-media thickness (IMT) and left ventricular diastolic function were assessed by Doppler echography and echocardiography. Between-group comparisons of numerical variables were performed by the Student's t-test or Wilcoxon Mann-Whitney test for independent samples. Significance level was set at 5%. RESULTS Psoriatic patients showed increased pulse wave velocity (PWV) (9.1 ± 1.8 vs 8.0 ± 2 m/s, p = 0.033), IMT of the left common carotid artery (p = 0.018) and a higher percentage of patients above the 75th percentile according to the ELSA table when compared with controls (54.5 vs 18.2%, p = 0.045). Psoriatic patients also showed an increase in peripheral/central systolic blood pressure (137.1 ± 13.2 vs 122.3 ± 11.6 mmHg, p = 0.004)/(127 ± 13 vs 112.5 ± 10.4 mmHg, p = 0.005), peripheral/central diastolic blood pressure (89.9 ± 8.9 vs 82.2 ± 8, p = 0.022)/(91 ± 9.3 vs 82.2 ± 8.3, p = 0.014), total cholesterol (252 ± 43.5 vs 198 ± 39.8 mg/dL, p < 0.001), LDL cholesterol (167 ± 24 vs 118 ± 40.8 mg/dL, p < 0.001) and C-reactive protein (7.6 ± 35.4 vs 1 ± 1.2 mg/L p < 0.001) compared with controls. CONCLUSION Psoriasis patients show increased PWV, IMT, peripheral and central blood pressures, and serum cholesterol and C-reactive protein levels, denoting a higher cardiovascular risk.
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Affiliation(s)
| | - Marcela M Simões
- Faculdade de Ciências Medicas de Minas Gerais - Instituto de Pós-Graduação, Belo Horizonte, MG - Brazil
| | - Ricardo Simões
- Faculdade de Ciências Medicas de Minas Gerais - Instituto de Pós-Graduação, Belo Horizonte, MG - Brazil
| | | | - Bruno Almeida Rezende
- Faculdade de Ciências Medicas de Minas Gerais - Instituto de Pós-Graduação, Belo Horizonte, MG - Brazil
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