RESUMO
In recent years, the world's aging population has increased, contributing to the development of age-related pathologies, which have been aggravated by physical inactivity and excessive fat intake. This study aimed to evaluate the effect of implementing a nutritional program (control group-CG) combined with exercise (intervention group-IG) on the inflammatory profile, MMPs, and TIMPs in a group of 34 elderly participants (IG, n = 18; CG, n = 16). Participants underwent a full multidisciplinary diagnostic evaluation (T0), with the gathering of clinical information and biochemical and hematological determinations being re-evaluated eight weeks later (T1). A diet manual was made, which provided a selection of different types of diets resulting from the nutritional needs of the different users at the center. The aerobic exercise consisted of two sessions per week with a total duration of 1 h. The laboratory evaluation was performed by slot blot. Statistical analysis included a paired sample t-test and Spearman's correlation coefficient. We observed that in the IG, there was a significant increase at T1 of TNF-α (p < 0.05) and MMP-2 (p < 0.05), without changes in IL-6 and MMP-9, showing that the intervention did not cause an exacerbated inflammatory response in exercised elderly people. The intervention program implemented showed potential to contribute to better active aging strategies, taking advantage of the known benefits of exercise without inducing a harmful inflammatory response in elderly participants.
RESUMO
BACKGROUND: Since the Randomized Aldactone Evaluation Study (RALES), the use of spironolactone is recommended in systolic heart failure (HF) patients that have been in New York Heart Association (NYHA) class III or IV. There is limited information on the use, side effects, and withdrawal rate of spironolactone in routine clinical practice. HYPOTHESIS: Side effects related to spironolactone use are more common than reported in clinical trials. METHODS: Patients who had moderate to severe left ventricular systolic dysfunction (LVSD) under optimized medical therapy were included. We introduced spironolactone in those with serum potassium (K+) < or = 5 meq/L, and serum creatinine (Cr) < or = 2.5 mg/dL. Spironolactone was withdrawn if serum K + > or = 5.5 meq/L, serum Cr increased more than 30%- 50% of the baseline value, and/or if the patient had gynecomastia. RESULTS: We selected 134 patients followed in an HF clinic. In our sample, 56.7% of the patients (76 out of 134) were currently or had formerly been on spironolactone therapy. The rate of spironolactone withdrawal was 25% (19 out of 76). Reasons for suspension were hyperkalemia (17.1%), renal function deterioration (14.5%), gynecomastia (5.3% of males), and other reasons (1.3%). CONCLUSION: Spironolactone side effects are common and are mostly related to effects on the angiotensin-aldosterone axis. Our results reinforce the need to closely monitor serum K+ and Cr levels in patients treated with spironolactone, as its side effects are more common than reported in clinical trials.