Preditores de transtornos na excitação sexual de participantes de reabilitação cardiopulmonar / Predictors of sexual aurousal disorders in participants of cardiopulmonary rehabilitation program

Objetivo do estudo foi verificar o perfil da função sexual e quais fatores melhor predizem os transtornos na resposta de excitação sexual de participantes de programa de reabilitação cardiopulmonar e metabólica. Participaram 61 homens e 53 mulheres. Para investigar a função sexual foi aplicado Índice Internacional de Função Erétil e Female Sexual Function Índex. Utilizou-se estatística descritiva, teste t student, Quiquadrado e regressão linear, considerando p<0,05. 71,9% dos homens apresentaram disfunção erétil, sendo 28,1% de grau leve, 15,6% moderadamente leve, 9,4% moderada e 18,8% grave. Transtornos de excitação sexual foram preditos para os homens pelos domínios: satisfação sexual (ß:0,445), satisfação geral (ß:0,229) e função orgásmica (ß:0,309). Para as mulheres: orgasmo (ß: 0,440), dor (ß:0,312) e excitação (ß:0,338). Porcentagem significativa da amostra apresentou disfunção sexual e os preditores para transtornos de excitação masculina foram satisfação sexual, satisfação geral e função orgásmica e para as mulheres orgasmo, dor e excitação.

Qualidade de vida e função sexual de participantes de programa de reabilitação cardiopulmonar e metabólica / Quality of life and sexual function of participants from cardiopulmonary and metabolic rehabilitation program

A disfunção sexual está correlacionada às doenças cardiovasculares e metabólicas, sendo considerado um importante problema de saúde relacionado à qualidade de vida. O objetivo deste estudo foi traças o perfil da qualidade de vida e função sexual de indivíduos de ambos os sexos, participantes há mais de seis meses de Programa de Rehabilitação Cardiopulmonar e Metabólica. Foram entrevistados 46 homens e 45 mulheres com média de idade 62,80 e 63,88 anos, respectivamente. Para avaliar a qualidade de vida, foi utilizado o questionário de qualidade de vida SF-36; a função sexual masculina foi avaliada por meio do Índice Internacional de Função Erétil e a feminina pelo Índice de Função Sexual Feminino (IFSF). Os dados obtidos foram analisados com uso da estatística descritiva. Os indivíduos apresentaram qualidade de vida moderada nos domínios dor, estado geral de saúde, vitalidade, aspectos sociais e da saúde mental. Os domínios capacidade funcional, limitações por aspectos físicos e aspectos emocionais representaram bons índices. A disfunção erétil representou 60.9%, sendo que 39,2% dos homens com disfunção apresentaram grau leve, 14,2% leve a moderado, 10,7% moderado e 35,7% grave. O escore total do IFSF leve a moderado, 10,02 sendo que os domínios mais comprometidos foram dor, excitação, lubrificação e orgasmo. Os participantes do Programa de Reabilitação Cardiopulmonar e Metabólica, referem uma qualidade de vida moderada para boa, apesar de a disfunção erétil ser prevalente e o resultado da função sexual feminina ser menos satisfatório.

Sexual dysfunction is related to cardiovascular and metabolic diseases and is considered a major health-related quality of life. The objective of this study was to profile the quality of life and sexual function in individual of both sexes, participating for more than six months of Cardiopulmonary and Metabolic Rehabilitation Program. Interviews took place with 46 men and 45 women with mean age 63,88 years and 62.80, respectively. The SF-36 questionnaire was applied to assess the quality of life, male sexual function was assessed using the International Index of Erectile Function and female the Female Sexual Function Index (FSFI). Data was analyzed using descriptive statistics. The subjects had moderate quality of life in the domains of pain, general health, vitality, social functioning and mental health. The functional capacity, limitations on physical and emotional aspects represented good rates. Already, the erectile dysfunction accounted for 60.9% whereas 39.2% from those had low dysfunction, 14.29% moderately light, 10.7% moderate and 35.7% severe. The total score was 10.02 FSFI being that the areas most affected were pain, arousal, lubrication and orgasm. Participants of Cardiopulmonary and Metabolic Rehabilitation Program report a moderatte to good quality of life, in spite of the prevalent erectile dysfunction and the less satisfactory result of female sexual function.

Equações de predição da aptidão cardiorrespiratória de adultos sem teste de exercícios físicos / A non-exercise prediction model for estimation of cardiorespiratory fitness in adults

A ferramenta mais precisa para avaliação da aptidão cardiorrespiratória é o teste cardiopulmonar de esforço. Entretanto, para sua utilização, são necessários equipamentos de custo elevado, técnicos bem treinados e tempo, restringindo sua utilização em estudos populacionais. Desta forma, o objetivo do estudo foi desenvolver modelos de predição da aptidão cardiorrespiratória de adultos, por meio de variáveis de simples mensuração. Foram utilizados os dados de 8.293 sujeitos, sendo 5.291 homens e 3.235 mulheres. A amostra constituiu-se de dados retrospectivos da cidade de Florianópolis - SC, abrangendo sujeitos entre 18 e 65 anos. Para estimar o consumo de oxigênio de pico (VO2pico), mensurado de maneira direta, foram associados os dados de: idade, massa corporal, condicionamento, estatura, frequência cardíaca pré-esforço, dislipidemia, hipertensão arterial, tabagismo, diabetes. Após a realização dos procedimentos estatísticos por intermédio de regressão linear múltipla, foram desenvolvidas duas equações para o sexo masculino e duas para o sexo feminino. O modelo completo para o sexo masculino apresenta R² ajustado de 0,531 e erro padrão de estimativa (EPE) de 7,15 ml-1∙ kg-1∙ min, enquanto que o modelo completo para o sexo feminino apresenta R² ajustado de 0,436 e EPE de 5,68 ml-1∙ kg-1∙ min. Conclui-se que o modelo desenvolvido de predição da aptidão cardiorrespiratória é uma alternativa viável e prática para predição do VO2pico em estudos epidemiológicos ou quando um teste cardiopulmonar de esforço não for possível ou acessível.

The most accurate tool for assessment of cardiorespiratory fitness is cardiopulmonary exercise testing (CPET). However, CPET requires expensive equipment, trained technicians and time, which limits their use in population studies. In view of this issue, the present study aims to develop regression equations for predicting the cardiorespiratory fitness of adults using simple measurement variables. The study used data from 8,293 subjects, 5,291 male and 3,235 female (age range, 18 to 65 years). The sample was recruited in Florianopolis, Santa Catarina. To develop equations for prediction of peak oxygen uptake (VO2peak), the data associated were: fitness, age, body mass, height, resting heart rate, hypertension, diabetes, dyslipidemia and smoking. After statistical analyses, two equations for men and two for women were developed. The complete equations showed an adjusted R² = 0.531 and a standard error of estimate (SEE) = 7.15 ml-1∙ kg-1∙ min for men and R² = 0.436 and SEE = 5.68 ml-1∙ kg-1∙ min for women. We conclude that the model developed for prediction of cardiorespiratory fitness is feasible and practical for prediction of VO2peak in epidemiological studies or when CPET cannot be performed.

Redução dos níveis pressóricos em indivíduos hiper-reativos após treinamento físico aeróbio / Blood pressure reduction in hyper-reactive individuals after aerobic exercise

FUNDAMENTO: Alguns indivíduos normotensos sedentários têm aumento exagerado da pressão arterial (PA) durante a atividade física, comportamento esse chamado hiper-reatividade pressórica (HP). OBJETIVO: Verificar o efeito de um programa de exercício físico (PEF) aeróbio sobre a pressão arterial de indivíduos com hiper-reatividade pressórica. MÉTODOS: Dez homens voluntários com HP, 45 ± 10 anos, chamados grupo experimental (GE), foram submetidos a um PEF em esteira, 3x/semana, durante dois meses, comparados a 14 homens com HP, 48 ± 8 anos, chamados grupo controle (GC), que se mantiveram sedentários. Os indivíduos foram avaliados antes e depois do PEF por teste de esforço para fins comparativos. Foram avaliadas as pressões arteriais sistólica (PAS) e diastólica (PAD) e as frequências cardíacas (FC) inicial, de pico e final de teste. RESULTADOS: Houve importante diminuição da PAS inicial (-5 por cento; p=0,01), da PAD inicial (-4,6 por cento; p=0,01), da PAS de pico (-12,4 por cento; p=0,001), da PAD de pico (-14,7 por cento; p=0,03), e da PAS final (-4,6 por cento; p=0,03) no GE. O GC permaneceu com comportamento hiper-reativo, tendo evoluído com níveis mais exagerados quando comparados pré e pós-estudo (p < 0,04). Na FC, somente a final apresentou aumento de 11,3 bpm após treinamento (p=0,02). O VO2pico do teste aumentou 4,4 ml.kg-1.min-1 no GE (p=0,01) e manteve-se semelhante no GC. CONCLUSÃO: O PEF normalizou o comportamento da hiper-reatividade pressórica em homens sedentários.

BACKGROUND: Some normotensive sedentary individuals have an exaggerated increase in blood pressure (BP) during physical activity, which is a behavior that is called blood pressure hyper-reactivity. OBJECTIVE: To investigate the effect of an aerobic exercise program (AEP) on blood pressure in individuals with blood pressure hyper-reactivity (BPH). METHODS: Ten male volunteers with BPH, aged 45 ± 10 years, referred to as the experimental group (EG), took part in an AEP on a treadmill, 3 times a week for two months. They were compared to 14 men with BPH, aged 48 ± 8 years, referred to as the control group (CG), who remained sedentary. The subjects were evaluated before and after the AEP by stress test for comparison purposes. We evaluated the initial, peak and test-end heart rates (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP). RESULTS: There a significant decrease in the initial SBP (-5 percent; p=0.01), initial DBP (-4.6 percent; p=0.01), peak SBP (-12.4 percent; p=0.001), peak DBP (-14.7 percent; p=0.03), final SBP (-4.6 percent, p=0.03) in the EG. The CG continued with its hyper-reactive behavior, which evolved to more exaggerated levels when the results before and after the study were compared (p<0.04). In the HR, there was an increase only in the final HR, of 11.3 bpm, after training (p=0.02). The test-peak VO2 increased by 4.4 ml.kg-1 .min-1 in the EG (p=0.01) and remained similar in the CG. CONCLUSION: The AEP normalized the behavior of the blood pressure hyper-reactivity in sedentary men. (Arq Bras Cardiol. 2010; [online]. ahead print, PP.0-0).

Blood pressure reduction in hyper-reactive individuals after aerobic exercise.

BACKGROUND: Some normotensive sedentary individuals have an exaggerated increase in blood pressure (BP) during physical activity, which is a behavior that is called blood pressure hyper-reactivity. OBJECTIVE: To investigate the effect of an aerobic exercise program (AEP) on blood pressure in individuals with blood pressure hyper-reactivity (BPH). METHODS: Ten male volunteers with BPH, aged 45 ± 10 years, referred to as the experimental group (EG), took part in an AEP on a treadmill, 3 times a week for two months. They were compared to 14 men with BPH, aged 48 ± 8 years, referred to as the control group (CG), who remained sedentary. The subjects were evaluated before and after the AEP by stress test for comparison purposes. We evaluated the initial, peak and test-end heart rates (HR), systolic blood pressure (SBP) and diastolic blood pressure (DBP). RESULTS: There a significant decrease in the initial SBP (-5%; p=0.01), initial DBP (-4.6%; p=0.01), peak SBP (-12.4%; p=0.001), peak DBP (-14.7%; p=0.03), final SBP (-4.6%, p=0.03) in the EG. The CG continued with its hyper-reactive behavior, which evolved to more exaggerated levels when the results before and after the study were compared (p<0.04). In the HR, there was an increase only in the final HR, of 11.3 bpm, after training (p=0.02). The test-peak VO2 increased by 4.4 ml.kg(-1) x min(-1) in the EG (p=0.01) and remained similar in the CG. CONCLUSION: The AEP normalized the behavior of the blood pressure hyper-reactivity in sedentary men.

Ausência de influência da massa corporal na redução da pressão arterial após exercício físico / Lack of influence of body mass on blood pressure reduction after exercising

FUNDAMENTO: A hipertensão arterial (HA) é associada com um grande número de comorbidades, dentre elas, a obesidade. A correlação entre essas duas variáveis tem sido alvo de investigação. OBJETIVO: Analisar a correlação entre a perda de massa corporal e redução pressórica em hipertensos submetidos a programa de exercícios físicos (PEF). MÉTODOS: Cento e onze hipertensos com sobrepeso ou obesidade, divididos aleatoriamente em um grupo experimental (GE), com 57 (58 ± 8,9 anos) que participaram de um PEF de três meses, três vezes por semana, em sessões de exercício aeróbio de 50 por cento a 70 por cento do VO2pico, por 30 a 60 minutos, além de exercícios resistidos; e um grupo controle (GC), com 54 (60 ± 7,7 anos) que não participaram do PEF. No GE, a pressão arterial (PA) foi aferida antes de cada sessão e a mensuração das variáveis antropométricas (VA) no início do programa e após três meses. No GC a PA e as VA foram avaliadas em consultório médico no início e fim do estudo. Os dados foram expressos por média ± desvio padrão (DP), usou-se teste t e correlação de Pearson. Considerou-se significativo p < 0,05. RESULTADOS: No GC não ocorreu diferença significativa nas VA e PA no início e fim do estudo. No GE não ocorreu alteração significativa nas VA, no entanto, a redução pressórica de 12 por cento na PA Sistólica (-17,5 mmHg; p = 0,001) e de 9 por cento na PA Diastólica (-8,1 mmHg; p = 0,01) ao final do estudo. Não houve correlação entre as VA e queda da PA (r = 0,1). CONCLUSÃO: A redução pressórica não se correlacionou com redução das medidas antropométricas após período de exercício físico.

BACKGROUND: Hypertension (H) is associated with a large number of co-morbidities, including obesity. The correlation between two variables has been investigated. OBJECTIVE: To analyze the correlation between the loss of body mass and blood pressure reduction in hypertensive patients undergoing exercising programs (EP). METHODS: One hundred eleven hypertensive patients with overweight or obesity were randomly divided into an experimental group (EG). Out of these, 57 (58 ± 8.9 years old) participated in a three-month EP conducted three times a week in aerobic exercise sessions from 50 percent to 70 percent of VO2 peak for 30 to 60 minutes and resistance exercises; and a control group (CG) with 54 (60 ± 7.7 years old) who did not participate in the EP. In the EG, blood pressure (BP) was measured before each session and the measurement of anthropometric variables (AV) at the beginning of the program and after three months. In the CG the BP and the VA were evaluated in the doctor's office at the beginning and at the end of the study. Data were expressed as mean ± standard deviation (SD). Pearson correlation and t test were used. A value of p < 0.05 was considered significant. RESULTS: In the CG there was no significant difference in AV and BP at the beginning and at the end of the study. In the EG, there was no significant alteration in the AV, however, there was blood pressure reduction of 12 percent in systolic BP (-17.5 mmHg, p = 0.001) and 9 percent in Diastolic BP (-8.1 mmHg, p = 0. 01) at the end of the study. There was no correlation between the AV and decrease in BP (r = 0.1). CONCLUSION: The blood pressure reduction was not correlated with reduction of anthropometric measures after the exercising period.

[Lack of influence of body mass on blood pressure reduction after exercising]. / Ausência de influência da massa corporal na redução da pressão arterial após exercício físico.

BACKGROUND: Hypertension (H) is associated with a large number of co-morbidities, including obesity. The correlation between two variables has been investigated. OBJECTIVE: To analyze the correlation between the loss of body mass and blood pressure reduction in hypertensive patients undergoing exercising programs (EP). METHODS: One hundred eleven hypertensive patients with overweight or obesity were randomly divided into an experimental group (EG). Out of these, 57 (58 +/- 8.9 years old) participated in a three-month EP conducted three times a week in aerobic exercise sessions from 50% to 70% of VO2 peak for 30 to 60 minutes and resistance exercises; and a control group (CG) with 54 (60 +/- 7.7 years old) who did not participate in the EP. In the EG, blood pressure (BP) was measured before each session and the measurement of anthropometric variables (AV) at the beginning of the program and after three months. In the CG the BP and the VA were evaluated in the doctor's office at the beginning and at the end of the study. Data were expressed as mean +/- standard deviation (SD). Pearson correlation and t test were used. A value of p < 0.05 was considered significant. RESULTS: In the CG there was no significant difference in AV and BP at the beginning and at the end of the study. In the EG, there was no significant alteration in the AV, however, there was blood pressure reduction of 12% in systolic BP (-17.5 mmHg, p = 0.001) and 9% in Diastolic BP (-8.1 mmHg, p = 0. 01) at the end of the study. There was no correlation between the AV and decrease in BP (r = 0.1). CONCLUSION: The blood pressure reduction was not correlated with reduction of anthropometric measures after the exercising period.

Effects of Campomanesia xanthocarpa on biochemical, hematological and oxidative stress parameters in hypercholesterolemic patients.

ETHNOPHARMACOLOGICAL RELEVANCE: In Southern Brazil, the plant Campomanesia xanthocarpa Berg. (Myrtaceae), popularly known as "guavirova", has been empirically used for its potential effect in reducing blood cholesterol levels. AIM OF THE STUDY: Since there are no scientific data confirming its popular use, the aim of the present study was to investigate the effect of Campomanesia xanthocarpa on biochemical, hematological, anthropometrical and oxidative stress parameters in hypercholesterolemic patients. MATERIALS AND METHODS: Thirty three patients were selected according to total cholesterol (TC) levels: 200-240 mg/dL, undesirable level (UL), and >240 mg/dL, hypercholesterolemic level (HL). UL or HL patients were randomly divided into control group (CG), which received placebo capsules, and experimental group 250 (EG 250) or 500 (EG 500), which received either 250 or 500 mg of encapsulated Campomanesia xanthocarpa. All groups received a cholesterol restriction diet and capsules once a day. The biochemical (TC, triglycerides, HDL, LDL and VLDL), hematological (hematocrit and hemoglobin), anthropometrical (weight and abdominal circumference) and oxidative stress (protein carbonyl) parameters were measured before, 45 and 90 days after the treatment started. RESULTS: There was no alteration on biochemical, hematological, anthropometric or oxidative stress parameters in UL patients of all groups. However, a significant decrease in TC and LDL levels was observed in HL patients from EG 500 group (reduction of 28+/-3% and 45+/-4% to levels before treatment) in relation to CG group patients (reduction of 12+/-2% and 29+/-4%). Moreover, a significant reduction in oxidative stress was observed in HL patients of EG 250 (51+/-12%) and EG 500 groups (34+/-18%) when compared to levels before treatment. A positive correlation between plasma oxidative stress PC and TC levels was observed. Finally, we found that Campomanesia xanthocarpa extract possesses anti-oxidant properties and 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitory activity in vitro. CONCLUSION: Confirming its popular use, the treatment with Campomanesia xanthocarpa encapsulated reduced blood TC and LDL levels in hypercholesterolemic patients.

Dose-response curve to exercise in hypertensive individuals: analysis of the number of sessions to the hypotensive effect.

BACKGROUND: The effect of exercise on blood pressure (BP) is already known; however, the dose-response curve of the hypotensive effect of exercise in hypertensive individuals is yet to be clarified. OBJECTIVE: To evaluate the dose-response curve of the number of sessions that are necessary to cause a hypotensive effect in hypertensive individuals. METHODS: 88 individuals, aged 58 +/- 11 years, divided in Experimental group (EG), with 48 that participated in a physical exercise program (PEP), which consisted of 40 minutes of aerobic exercises performed 3x/week, for 3 months, at 70% of the VO2max, and muscular exercises at 40% of the maximal voluntary contraction (MVC) and Control Group (CG) with 40 individuals that did not participate in the PEP. The systolic (SAP) and diastolic (DAP) arterial pressures were measured before each of the 36 sessions in the EG and assessed by ambulatory blood pressure monitoring (ABPM) in the CG. Differences in BP, the variation rate (D%) and the maximum hypotensive effect (MHE%) were observed between sessions. The data were expressed as means +/- SD; the t test and correlation were used, with p<0.05 being considered significant. RESULTS: There was no difference regarding BP values in the CG. The EG showed an important decrease of 15 mmHg in SAP and 7 mmHg in DAP, with a large part of this effect occurring as early as the first session and the majority up to the 5th session. There was a strong inverse correlation (R:-0.66) with the number of sessions. CONCLUSION: An important hypotensive effect was observed from the 1st session on and it was observed that the dose-response curve can be abrupt and decrescent, instead of flat.

Curva dose-resposta do exercício em hipertensos: análise do número de sessões para efeito hipotensor / Dose-response curve to exercise in hypertensive individuals: analysis of the number of sessions to the hypotensive effect / Curva dosis-respuesta del ejercicio en hipertensos: análisis del número de sesiones para efecto hipotensor

Fundamento: O efeito do exercício na pressão arterial já é conhecido, entretanto a curva dose-resposta do efeito hipotensor do exercício em hipertensos ainda não está clara. Objetivo: Avaliar a curva dose-resposta do número de sessões necessárias para causar efeito hipotensor em indivíduos hipertensos. Métodos: Participaram deste estudo 88 indivíduos, com 58 ± 11 anos, divididos em grupo experimental (GE) – composto de 48 integrantes de um programa de exercício físico (PEF) de 3 meses, 3 vezes por semana, com 40’ de exercício aeróbio a 70% do VO2máx e exercícios musculares a 40% da CVM – e grupo-controle (GC) – 40 indivíduos que não realizaram PEF. As pressões arteriais sistólica (PAS) e diastólica (PAD) foram mensuradas antes de cada uma das 36 sessões no GE e avaliadas por MAPA no GC. Observaram-se as diferenças na PA, o índice de variação (D%) e o efeito hipotensor máximo (EHM%) entre as sessões. Os dados foram expressos por M ± DP, e usou-se teste t e correlação, considerando p < 0,05 significativo.Resultados: No GC não houve diferença nos valores pressóricos. No GE, após o PEF, ocorreu uma queda importante de 15 mmHg na PAS e de 7 mmHg na PAD, e uma grande parte desse efeito ocorreu já na primeira sessão, e a maior parte até a quinta. Houve uma forte correlação inversa (R: -0,66) com o número de sessões. Conclusão: Na primeira sessão, já ocorreu efeito hipotensor importante, e observou-se que a curva dose-resposta pode ser abrupta e decrescente em vez de achatada.

Background: The effect of exercise on blood pressure (BP) is already known; however, the dose-response curve of the hypotensive effect of exercise in hypertensive individuals is yet to be clarified. Objective: To evaluate the dose-response curve of the number of sessions that are necessary to cause a hypotensive effect in hypertensive individuals. Methods: 88 individuals, aged 58 ± 11 years, divided in Experimental group (EG), with 48 that participated in a physical exercise program (PEP), which consisted of 40 minutes of aerobic exercises performed 3x/week, for 3 months, at 70% of the VO2max, and muscular exercises at 40% of the maximal voluntary contraction (MVC) and Control Group (CG) with 40 individuals that did not participate in the PEP. The systolic (SAP) and diastolic (DAP) arterial pressures were measured before each of the 36 sessions in the EG and assessed by ambulatory blood pressure monitoring (ABPM) in the CG. Differences in BP, the variation rate (D%) and the maximum hypotensive effect (MHE%) were observed between sessions. The data were expressed as means ± SD; the t test and correlation were used, with p<0.05 being considered significant. Results: There was no difference regarding BP values in the CG. The EG showed an important decrease of 15 mmHg in SAP and 7 mmHg in DAP, with a large part of this effect occurring as early as the first session and the majority up to the 5th session. There was a strong inverse correlation (R:-0.66) with the number of sessions. Conclusion: An important hypotensive effect was observed from the 1st session on and it was observed that the dose-response curve can be abrupt and decrescent, instead of flat.

Fundamento: Ya se conoce el efecto del ejercicio en la presión arterial, sin embargo, la curva dosis-respuesta del efecto hipotensor del ejercicio en hipertensos no está aclarada aún. Objetivo: Evaluar la curva dosis-respuesta del número de sesiones necesarias para causar efecto hipotensor en individuos hipertensos.Métodos: El estudio estaba conformado por 88 individuos, con 58 ± 11 años, divididos en grupo experimental (GE) –conformado por 48 integrantes de un programa de ejercicio físico (PEF) de tres meses, tres veces por semana, con 40’ de ejercicio aerobio al 70% del VO2máx y ejercicios musculares al 40% de la capacidad voluntaria máxima (CVM); y grupo-control (GC) con 40 individuos que no realizaron el PEF. Se midieron las presiones arteriales sistólica (PAS) y diastólica (PAD) del GE antes de cada una de las 36 sesiones y en el GC se las evaluaron por monitoreo ambulatorio de presión arterial (MAPA). Se observaron las diferencias en la PA, el índice de variación (D%) y el efecto hipotensor máximo (EHM%) entre las sesiones. Los datos estaban expresados por promedio ± desviación estándar, y se utilizó la prueba t y correlación, tomando p < 0,05 como valor significativo. Resultados: En el GC no hubo diferencia en los valores de presión arterial. En el GE, luego del PEF, ocurrió un descenso importante de 15 mmHg en la PAS y de 7 mmHg en la PAD; y una gran parte de ese efecto tuvo lugar ya en la primera sesión, y la mayor parte sucedió hasta la quinta sesión. Hubo una fuerte correlación inversa (R: -0,66) con el número de sesiones. Conclusión: En la primera sesión, ya ocurrió efecto hipotensor importante. También se evidenció que la curva dosis-respuesta pode ser abrupta y decreciente en lugar de achatada.