The "Hypertension Approaches in the Elderly: a Lifestyle study" multicenter, randomized trial (HAEL Study): rationale and methodological protocol.

BACKGROUND: Hypertension is a clinical condition highly prevalent in the elderly, imposing great risks to cardiovascular diseases and loss of quality of life. Current guidelines emphasize the importance of nonpharmacological strategies as a first-line approach to lower blood pressure. Exercise is an efficient lifestyle tool that can benefit a myriad of health-related outcomes, including blood pressure control, in older adults. We herein report the protocol of the HAEL Study, which aims to evaluate the efficacy of a pragmatic combined exercise training compared with a health education program on ambulatory blood pressure and other health-related outcomes in older individuals. METHODS: Randomized, single-blinded, multicenter, two-arm, parallel, superiority trial. A total of 184 subjects (92/center), ≥60 years of age, with no recent history of cardiovascular events, will be randomized on a 1:1 ratio to 12-week interventions consisting either of a combined exercise (aerobic and strength) training, three times per week, or an active-control group receiving health education intervention, once a week. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness and endothelial function, together with quality of life, functional fitness and autonomic control will be measured in before and after intervention. DISCUSSION: Our conceptual hypothesis is that combined training intervention will reduce ambulatory blood pressure in comparison with health education group. Using a superiority framework, analysis plan prespecifies an intention-to-treat approach, per protocol criteria, subgroups analysis, and handling of missing data. The trial is recruiting since September 2017. Finally, this study was designed to adhere to data sharing practices. TRIAL REGISTRATION: NCT03264443 . Registered on 29 August, 2017.

Supersets do not change energy expenditure during strength training sessions in physically active individuals.

BACKGROUND/OBJECTIVE: The energy expenditure (EE) in strength training (ST) is analyzed both during and after each training session. However, little information exists about the influence of strength exercises supersets on EE. We aimed to determine whether supersets of ST exercises influenced EE during and after one strength exercise session. METHODS: Twenty men were randomly divided to perform either a session with grouped exercises for the same muscle (GE: 26.6 ± 3.4 years; 17.4 ± 3.4 body fat) or a session with separated exercises (SE: 24.9 ± 2.6 years; 15.4 ± 5.9 body fat). Four exercises (5 sets of 8-10 maximum repetitions) for knee extensor muscles and shoulder horizontal flexor muscles were executed in both training sessions. The EE of each experimental session was obtained through the analysis of oxygen uptake during and after exercise (60 minutes postsession). RESULTS: Total work during the session and increases in lactate concentrations were similar between the GE and SE Groups. During exercise, EE was greater in the SE Group when compared with the GE Group (GE: 123.8 ± 14.36 kcal vs. SE: 131.77 ± 20.91 kcal). During the postexercise period, GE induced greater EE when compared with SE (GE: 25.12 ± 7.86 kcal vs. SE: 19.76 ± 5.53 kcal). However, the exercise sequence did not influence overall EE (GE: 148.92 ± 18.72 kcal vs. SE: 151.53 ± 17.97 kcal, p = 0.920). CONCLUSION: Our findings indicate that, in physically active men, ST supersets do not influence total EE during and 60 minutes after a single session.

Prevalence of diabetic retinopathy in Brazil: a systematic review with meta-analysis.

AIMS: To evaluate the prevalence of diabetic retinopathy (DR) in Brazilian adults with diabetes mellitus via a systematic review with meta-analysis. METHODS: A systematic review using PubMed, EMBASE, and Lilacs was conducted, searching for studies published up to February 2022. Random effect meta-analysis was performed to estimate the DR prevalence. RESULTS: We included 72 studies (n = 29,527 individuals). Among individuals with diabetes in Brazil, DR prevalence was 36.28% (95% CI 32.66-39.97, I2 98%). Diabetic retinopathy prevalence was highest in patients with longer duration of diabetes and in patients from Southern Brazil. CONCLUSION: This review shows a similar prevalence of DR as compared to other low- and middle-income countries. However, the high heterogeneity observed-expected in systematic reviews of prevalence-raises concerns about the interpretation of these results, suggesting the need for multicenter studies with representative samples and standardized methodology.

Análise da situação de saúde dos idosos usuários de uma política municipal de atividades físicas / Analysis of health status of older adults users of a municipal physical activity program / Análisis de la situación de salud de los adultos ancianos de una política municipal de actividad física

Introdução: Políticas públicas intersetoriais em saúde são intervenções populacionais (e de cunho ecológico) muito utilizadas para a redução da carga global de doença e otimização de recursos tanto financeiros quanto humanos. Objetivo: O objetivo deste estudo foi analisar a situação de saúde de usuários idosos de uma política municipal de atividades físicas. Métodos: Trata-se de um estudo transversal com amostragem baseada em centros comunitários (N dispositivos comunitários=11), que disponibilizam práticas de movimentos corporais e outros, subsidiados pela Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). A amostragem de usuários foi ponderada para o total de usuários atendidos por centro, adotando seleção aleatória simples. A coleta de dados ocorreu entre abril de 2018 e fevereiro de 2019, em que a equipe de coleta se deslocou ao território adscrito dos usuários para a condução de inquérito de saúde autoaplicado e a avaliação funcional; de forma contrária, os usuários compareceram a um centro de coleta para a série laboratorial (sem jejum). Resultados: Foram incluídos e analisados 351 usuários (média±desvio padrão, 70±6 anos). Para fatores de risco cardiovasculares, a prevalência de hipercolesterolemia foi de 54,2% e de 49,3% para hipertensão arterial sistêmica ­ as mais elevadas. O transtorno de sono foi prevalente em 55,3% da amostra. Entre as doenças autorrelatadas, os participantes listaram as cardiovasculares (14,3%), câncer prévio (14,6%), diabetes (13,2%), artrite reumatoide/ reumatismo (29,6%) e depressão (sem discriminador de depressão maior/ menor) (18,6%). A capacidade funcional, estimada pelo teste de caminhada em 6 minutos e a força de preensão manual, preditores de mortalidade cardiovascular e agravos, tiveram valores médios encontrados de 498,05±78,96 m e 27,08±8,14 kg, respectivamente. Conclusão: Os achados do presente estudo permitem contrastar prevalências estimadas em idosos participantes de um programa público de atividades físicas com outras estimativas em grupos de comparação, possibilitando a análise de situação de saúde com base em diferentes comportamentos e fatores de risco. Por fim, o trabalho viabilizou a monitorização de intervenções públicas para idosos em nível comunitário, sendo um ponto de base para acompanhamento futuro.

Introduction: Intersectoral public policies on health are population (and ecological) interventions widely used to reduce the global burden of disease and optimize both financial and human resources. Objective: The objective of this study was to analyze the health status of older adults users of a municipal policy on physical activities. Methods: This is a cross-sectional study with a sample based on community centers (N community centers=11), which provide body movement practices and others, funded by the Municipal Department of Social Development and Sports (SMDSE), City Hall of Porto Alegre (state of Rio Grande do Sul ­ RS, Brazil). The users' sample was weighted by the number of users of each center, by simple random sampling. Data collection took place between April 2018 and February 2019, in which the collection team went to the users' assigned territory to conduct a self-administered health survey and functional assessment; conversely, the users attended a collection center for laboratory tests (without fasting). Results: A total of 351 users (mean±SD, 70±6 years old) were included. For cardiovascular risk factors, the prevalence of hypercholesterolemia was 54.2% and 49.3% for systemic arterial hypertension ­ the highest levels. Sleep disorder was prevalent in 55.3% of the sample. Among the self-reported diseases, participants listed cardiovascular (14.3%), previous cancer (14.6%), diabetes (13.2%), rheumatoid arthritis/rheumatism (29.6%), and depression (without major/minor depression discrimination) (18.6%). Functional capacity, estimated by the six-minute walk test, and handgrip strength, predictors of cardiovascular mortality and injuries, had mean values of 498.05±78.96 m and 27.08±8.14 kg, respectively. Conclusions: The findings of this study allow contrasting prevalence rates estimated in older adults participants of a public physical activity program with other estimates in comparison groups, enabling the analysis of health status based on different behaviors and risk factors. All in all, our study enabled to monitor public interventions for older adults at the community level, serving as a baseline for future monitoring.

Introducción: Las políticas de salud pública intersectoriales tienen el potencial de destacar la reducción de la carga global de enfermedad y la optimización de los recursos financieros y humanos. Objetivo: El objetivo de este estudio fue analizar la situación de salud de los usuarios, ancianos, de una política municipal de actividades físicas. Métodos: Se trata de un estudio transversal con muestreo a partir de centros comunitarios (N dispositivos comunitarios=11), que brindan prácticas de movimiento corporal y otras, subsidiadas por la Secretaria Municipal de Desenvolvimento Social e Esporte (SMDSE), Prefeitura Municipal de Porto Alegre (RS). El muestreo de usuarios fue ponderado por el total de usuarios atendidos por centro, adoptando selección aleatoria simple. La recolección de datos ocurrió entre abril/2018 y febrero/2019, cuando el equipo de recolección viajó al territorio asignado de los usuarios para realizar una encuesta de salud auto aplicada y evaluación funcional; por el contrario, los usuarios acudían a un centro de recogida de series de laboratorio (sin ayuno). Resultados: Se incluyeron y analizaron 351 usuarios (media±DP, 70±6 años). Para los factores de riesgo cardiovascular, la prevalencia de hipercolesterolemia fue de 54,2% y de hipertensión arterial sistémica de 49,3%, la más alta. El trastorno del sueño fue prevalente en el 55,3% de la muestra. Entre las enfermedades auto informadas, los participantes enumeraron enfermedades cardiovasculares (14,3%), cáncer previo (14,6%), diabetes (13,2%), artritis reumatoide/reumatismo (29,6%) y depresión (sin discriminación de depresión mayor/menor) (18,6%). La capacidad funcional, estimada por la prueba de la marcha de 6 minutos, y la fuerza de prensión manual, predictores de mortalidad y lesiones cardiovasculares, tuvieron valores medios de 498,05±78,96 m y 27,08±8,14 kg, respectivamente. Conclusiones: Los hallazgos de este estudio permiten contrastar las prevalencias estimadas en participantes ancianos de un programa público de actividades físicas con otras estimaciones en grupos de comparación, lo que permite el análisis de la situación de salud basado en diferentes comportamientos y factores de riesgo. Por último, el trabajo ha facilitado la monitorización de intervenciones públicas para personas mayores a nivel comunitario, sirviendo como punto de partida para un seguimiento futuro.

Avaliação da atividade física e qualidade de vida da enfermagem / Physical activity assessment and quality of life in nursing

Objetivo:avaliar o nível de atividade física, índice de massa corporal e a qualidade de vida dos acadêmicos de enfermagem e enfermeiros do Rio Grande do Sul. Método: trata-se de um estudo transversal, com aplicação de questionários digitais de anamnese e para levantamento donível de atividade física, pelo International Physical Activity Questionnaire,e da qualidade de vida,por meio do Short Form-36. Os dados foram coletados e analisados pelossoftwaresSurveyMonkeye SPSS (teste de Mann-Whitney e qui-quadrado).Resultados: os resultados do questionário de atividade físicamostraram que um total de 22(25%) indivíduos apresentava nível de atividade física insuficiente, 33 (37%) eram suficientemente ativose 34 (38%) muito ativos. O índice de massa corporaldos enfermeiros e acadêmicos apresentou uma média de 24,7 (22-29) kg/m².Avaliando a qualidade devida segundo os domínios do questionário, observou-se que osenfermeiros e acadêmicosapresentam alta capacidade funcional (90% do máximo), porém osdemais domínios da qualidade de vida apresentam-se com valores abaixo de 75% do máximo possível. Conclusão: amaioria dos enfermeiros e acadêmicos possuem níveis satisfatórios de atividade física, índice de massa corporal dentro dos parâmetros recomendados e qualidade de vida parcialmente adequada.

Objective: evaluate the level of physical activity, body mass index and quality of life of nursing students and nurses in Rio Grande do Sul. Method:this was a cross-sectional study, with application of digital questionnaires for anamnesis and for survey of the level of physical activity, by the International Physical Activity Questionnaire, and of the quality of life, by means of the Short Form-36.Data were collected and analyzed by SurveyMonkey and SPSS software(Mann-Whitney and chi-square test). Results:the results of the physical activity questionnaire showed that a total of 22 (25%) individuals had insufficient level of physical activity, 33 (37%) were sufficiently active and 34(38%) were very active. The body massindex of the nurses and students had a mean of 24.7 (22-29) kg/m². Evaluating the quality of life according to the domains of the questionnaire, it was observed that the nurses and academics had high functional capacity (90% of the maximum), but the otherdomains of quality of life presented values below 75% of the maximum possible.Conclusion:most nurses and students have satisfactory levels of physical activity, body mass index within the recommended parameters and partially adequate quality of life