Does Hypertension Knowledge Influence Levels of Physical Activity in Hypertensive Patients From a Southern Brazilian Community?

Abstract Background: Increased level of physical activity (PA) and health education are known as non-pharmacological treatments of hypertension (HP). There is a lack of studies investigating the influence of HP knowledge on the level of PA among hypertensive patients. Objective: To examine the influence of patient's knowledge about HP on PA level and the relationship between these variables. Methods: A cross-sectional study was conducted in in a primary care center located in a city in the southern Brazil. A total of 199 hypertensive patients (median 61.2 [13] years; body mass index (BMI) 21.9 (7.5) kg/m2; 72.4% women) were included. The level of PA was assessed by measuring the number of steps taken daily. The knowledge about HP was assessed by a standardized questionnaire (HIPER-Q). The Kruskall-Wallis test was used to compare age, BMI and PA level between HP knowledge categories, and the Spearman test was used to assess correlations (p <0.05). Results: The median score of knowledge about HP for patients categorized as insufficient (n=6, 3%), poor (n=24; 12.1%), acceptable (n=101; 50.8%) and good (n=68; 34.2%) was 11.0 (8.0), 20.0 (4.0), 26.0 (5.0) and 38.0 (2.0), respectively. No patient has achieved an "excellent" level of knowledge. There was no significant difference in PA level (p = 0.341), BMI (p = 0.510) or age (p = 0.073) between these categories. Age was negatively correlated with knowledge about HP (p <0.05 and rho = 0.02). Conclusions: Patient's knowledge about HP did not influence the level of PA in hypertensive patients. Age, number of steps per day and BMI were not significantly different between the categories of knowledge. Public policies and organizational strategy should be addressed to improve health education and avoid sedentary behavior in this population. (Int J Cardiovasc Sci. 2020; [online].ahead print, PP.0-0)

Utilização da escala de dificuldade percebida na produção da fala na avaliação aeróbia em cicloergometro (Talk Test) / Use the scale of perceived difficulty in production of speech in the assessment aerobic cycle ergometer (Talk Test)

O Talk Test (TT) é uma ferramenta que avalia subjetivamente a intensidade ótima para a prática de exercício com base na capacidade de manter uma conversa confortável durante o esforço. O objetivo do presente estudo foi obter evidências de validade (concorrente e de constructo) do TT. Quatorze sujeitos, 7 mulheres e 7 homens (22 ± 8 anos, 69 ± 15 Kg, 169 ± 10 cm, 21 ± 12 %G) foram submetidos a um teste progressivo em cicloergmetro, carga inicial de 25 watts e incremento de 25 watts a cada 2 minutos (60-70 RPM) até a exaustão. Ao final dos estágios o avaliado recitava três vezes uma frase conhecida, indicando a sua Dificuldade Percebida na Produção da Fala (DPPF) de acordo com a escala proposta por Rotstein et al. (2004). A carga com valor 7, correspondente à “difícil” (L7DPPF) foi utilizada como indicadora do segundo limiar fisiológico, assim como o do Ponto de Deflexão da Freqüência Cardíaca (PDFC), identificado pelo Dmáx positivo da diferença entre um ajuste polinomial de terceira ordem e ajuste linear de todos os pontos da relação FC / Carga. Para as análises foram empregados os testes Kolmogorov-Smirnov, Kruskall-Wallis, post-hoc de Dunn’s, e o método de Bland- Altman, além da correlação de Spearman (p<0,05). Não foram identificadas iferenças significativas entre L7DPPF e PDFC (p=0,03), além de serem associados à carga máxima atingida no teste (r=0,90 e r=0,81). As duas técnicas de identificação do LTF2 – PDFC e o L7DPPF – se mostraram semelhante pelo método Bland-Altman, (IC 95% = 0,41 – 1,46). Sendo o TT um indicador de aptidão aeróbia, o L7DPPF pode ser considerado um método para predizer LTF2.

Talk Test is a tool used to to evaluate by a subjective manner the optimal exercise intensity. It is based on individual capacity to maintain a confortable speech during the effort. The aim of the study was to verify evidence of validitiy (concurrent and constructo) of the Talk Test. Fourteen subjects (7 males and 7 females) volunteered to a cicle ergometer progressive test with intial load of 25 Watts and increments of 25 Watts each 2 minutes until exhaustion. Subjects should recite a known sentence for three times at the end of each stage and indicate their Perceived Speech Production Difficult (DPPF) accoding to the scale of Rotstein et al., (2004) where the load at the level 7 which is “difficult” was taken as a physiological threshold indicator. The Second Physiological Threshold (LT2) was considered the Heart Rate Deflection Point (PDFC) identified by the positive Dmax method. For analyzes were employed olmogorov-Smirnov test, Kruskal-Wallis post hoc Dunn's, and Bland- Altman, beyond the Spearman correlation (p <0.05). No significant differences were identified between L7DPPF and PDFC (p = 0.03), and are associated with the maximum load reached in the test (r = 0.90 and r = 0.81). Both techniques of identification of LTF2 - PDFC and L7DPPF - were similar by Bland- Altman method (95% CI = 0.41 to 1.46). TT being an indicator of aerobic fitness, the L7DPPF could be considered a method to predict LTF2.