Exercício físico e fatores de risco cardiovasculares em mulheres obesas na pós-menopausa

Efeitos da prática de caminhada em hipertensos: revisão integrativa

Objetivo: analisar os efeitos da prática da caminhada em hipertensos.  Métodos: revisão integrativa da literatura em língua portuguesa, efetuada nas bases de dados SciELO e Lilacs – BVS. Realizou-se uma revisão em sete artigos publicados entre os anos de 2010 e 2020.  Resultados: o estudo revelou que a prática da caminhada é efetiva para redução dos níveis pressóricos em diferentes contextos e intensidades no controle da hipertensão, seja com efeitos agudos e/ou crônicos, sendo assim considerada uma ferramenta não medicamentosa, pois condiciona o sistema cardiovascular a responder fisiologicamente com diminuição da reatividade vascular, mesmo em situações de estresse, induzindo a diminuição na pressão arterial.  Conclusão: a pesquisa apontou que a caminhada tem efeitos positivos sobre os níveis pressóricos, uma vez que a mesma contribuiu significativamente para o controle da hipertensão arterial sistêmica, especialmente naquelas que tiveram acompanhamento de um profissional de educação física.  Sugere-se a proposição de novas pesquisas que levem em consideração não só a atuação desse profissional, mas também utilize outras variáveis, como diferentes modalidades de atividade física, dieta alimentar, níveis de estresse e qualidade do sono.

Supervised training in primary care units but not self-directed physical activity lowered cardiovascular risk in Brazilian low-income patients: a controlled trial

BACKGROUND

Public health strategies to increase physical activity in low-income communities may reduce cardiovascular risk in these populations. This controlled trial compared the cardiovascular risk estimated by the Framingham Risk Score (FRS) over 12 months in formally active (FA), declared active (DA), and physically inactive (PI) patients attended by the 'Family Health Strategy' in low-income communities at Rio de Janeiro City, Brazil (known as 'favelas').

METHODS

Patients were matched for age and assigned into three groups: a) FA (supervised training, n = 53; 60.5 ± 7.7 yrs); b) DA (self-reported, n = 43; 57.0 ± 11.2 yrs); c) PI (n = 48; 57.0 ± 10.7 yrs). FA performed twice a week a 50-min exercise circuit including strength and aerobic exercises, complemented with 30-min brisk walking on the third day, whereas DA declared to perform self-directed physical activity twice a week. Comparisons were adjusted by sex, chronological age, body mass index, and use of anti-hypertensive/statin medications.

RESULTS

At baseline, groups were similar in regards to body mass, body mass index, triglycerides, and LDL-C, as well to FRS and most of its components (age, blood pressure, hypertension prevalence, smoking, HDL-C, and total cholesterol; P > 0.05). However, diabetes prevalence was 10-15% lower in DA vs. FA and PI (P < 0.05). Intention-to-treat analysis showed significant reductions after intervention (P < 0.05) in FA for total cholesterol (~ 10%), LDL-C (~ 15%), triglycerides (~ 10%), systolic blood pressure (~ 8%), and diastolic blood pressure (~ 9%). In DA, only LDL-C decreased (~ 10%, P < 0.05). Significant increases were found in PI (P < 0.05) for total cholesterol (~ 15%), LDL-C (~ 12%), triglycerides (~ 15%), and systolic blood pressure (~ 5%). FRS lowered 35% in FA (intention-to-treat, P < 0.05), remained stable in DA (P > 0.05), and increased by 20% in PI (P < 0.05).

CONCLUSIONS

A supervised multi-modal exercise training developed at primary care health units reduced the cardiovascular risk in adults living in very low-income communities. The risk remained stable in patients practicing self-directed physical activity and increased among individuals who remained physically inactive. These promising results should be considered within public health strategies to prevent cardiovascular disease in communities with limited resources.

TRIAL REGISTRATION

TCTR20181221002 (retrospectively registered). Registered December 21, 2018.

[Effects of physical exercise on cardiovascular risk and quality of life in hypertensive elderly people]

The scope of this article is to evaluate the effects of a mixed protocol of physical exercises on cardiovascular risk (CVR), quality of life and the presence of depressive symptoms in elderly hypertensive patients. It involved a longitudinal, prospective and quasi-experimental study with 48 elderly individuals. A physical exercise protocol was developed for 16 weeks according to American College of Sports Medicine, and anthropometric variables (weight, height, body mass index and waist circumference), as well as biochemical variables (total cholesterol, LDL-c, HDL-c; triglycerides) were evaluated. The mean age was 66.5±4.8 years. The frequent CVR factors were dyslipidemia (58.3%) and sedentary lifestyle (45.8%). After intervention, there was a reduction in mean values of total and LDL-cholesterol and increased HDL-cholesterol levels. The CVR and global risk score decreased significantly. The frequency of depressive symptoms decreased from 25% to 4.2%. An improvement was observed in SF-36 physical, health and vitality domains. The mixed protocol of physical exercises constituted a possible low cost and effective alternative in the improvement of the lipid profile and the quality of life related to the health of the elderly who participated in this research.