Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients. / Associação entre Hipertensão Arterial Sistêmica com Marcadores Laboratoriais, Composição Corporal, Apneia Obstrutiva do Sono e Variabilidade da Frequência Cardíaca em Adultos Obesos.

BACKGROUND: Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks. OBJECTIVE: The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association. METHODS: Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted. RESULTS: The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804). CONCLUSIONS: Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.

FUNDAMENTO: A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde. OBJETIVO: O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação. MÉTODOS: Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05. RESULTADOS: A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804). CONCLUSÃO: Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.

Molecular aspects of COVID-19 and its relationship with obesity and physical activity: a narrative review

Abstract BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE: The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING: Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS: We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: "covid-19," "physical activity," and "obesity". The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS: We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION: This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.

Perfil de dor e cinesiofobia em atletas de judô da categoria master / Pain profile and kinesiophobia in judo athletes of the master category

INTRODUÇÃO: Atletas de contato estão sujeitos a lesões musculoesqueléticas devido às técnicas repetitivas aplicadas durante treinos e campeonatos. Isso pode levá-los a apresentar dores agudas e crônicas, e, a depender da técnica aplicada, diferentes regiões do corpo podem ser acometidas. Estudos nesta área focam na descrição da lesão ou trauma, no entanto, a presença de cinesiofobia nesta população é uma lacuna a ser investigada. OBJETIVO: Descrever o perfil de dor e cinesiofobia em atletas de Judô da categoria master. MÉTODO: Estudo observacional, descritivo, de corte transversal, realizado com 29 atletas de judô master inscritos na Federação Baiana. Para descrição da dor, foram utilizados o Inventário Breve de Dor (IBD) e Doleur Neuropathique Questionnaire (DN4) e a Escala de Cinesiofobia de Tampa (ECT). Os dados foram tabulados e analisados descritivamente através do software Excel for Windows® utilizando valor absoluto ou média (desvio padrão). RESULTADOS: Os dados do IBD mostraram que a média geral de dor foi de 5,1 ± 1,8, o tratamento optado foi majoritariamente o farmacológico e a região mais acometida foi a face anterior do joelho. Dos 29 participantes, 9 (31%) apresentavam o escore ≥3, indicando presença de dor neuropática e cinesiofobia leve com média geral de 33,8 ± 6,7 no escore da ECT. CONSIDERAÇÕES FINAIS: Os atletas apresentaram dor moderada com pouco impacto na vida pessoal e as regiões com maior incidência foram os joelhos. Cinesiofobia leve esteve presente em mais da metade dos participantes e um terço apresentou dor neuropática.

INTRODUCTION: Contact athletes are subject to musculoskeletal injuries due to repetitive techniques applied during training and championships. This can lead to acute and chronic pain, and depending on the technique applied, different regions of the body may be affected. Studies in this area focus on the description of injury or trauma, however, the presence of kinesiophobia in this population is a gap to be investigated. OBJECTIVE: To describe the profile of pain and kinesiophobia in judo athletes of the master category. METHOD: An observational, descriptive, cross-sectional study conducted with 29 judo master athletes enrolled in the Bahia Federation. For pain description, the Brief Pain Inventory (BPI) and Doleur Neuropathique Questionnaire (DN4) and the Tampa Scale for Kinesiophobia (TSK) were used. The data were tabulated and analyzed descriptively through the software Excel for Windows® using absolute or mean value (standard deviation). RESULTS: The BPI data showed that the overall pain mean was 5.1 ± 1.8, the treatment chosen was mostly pharmacological and the region most affected was the anterior knee. Of the 29 participants, 9 (31%) had score 3, indicating the presence of neuropathic pain and mild kinesiophobia with an overall mean of 33.8 ± 6.7 on the TSK score. FINAL CONSIDERATIONS: The athletes presented moderate pain with little impact on personal life and the regions with the highest incidence were the knees. Mild kinesiophobia was present in more than half of the participants and one third presented neuropathic pain.

Molecular aspects of COVID-19 and its relationship with obesity and physical activity: a narrative review.

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 has several mechanisms of action related to inflammatory responses, especially in individuals diagnosed with obesity. This hyperinflammatory clinical profile resulting from the association between obesity and coronavirus disease 2019 (COVID-19) may be attenuated by regular physical activity. OBJECTIVE: The aim of this study was to review the evidence on the consequences of physical inactivity and physical activity on COVID-19 in patients with obesity. DESIGN AND SETTING: Narrative review at the Bahiana School of Medicine and Public Health in Salvador, Brazil. METHODS: We searched evidence on the association of COVID-19 with physical activity and obesity using the following keywords: "covid-19," "physical activity," and "obesity". The databases used were MEDLINE (PubMed), ScienceDirect, and Virtual Health Library. Studies published from 2019 to 2021 and available in Portuguese, English, and Spanish were included. The final search was conducted on September 26, 2021. RESULTS: We identified 661 studies in the database, among which 71 were considered for inclusion in the narrative review of the molecular aspects of COVID-19 and its relationship with physical activity and obesity. CONCLUSION: This literature review enabled the perception of the relationship between the molecular mechanisms of COVID-19 and obesity. Regular physical activity had various benefits for the inflammatory condition of the studied population, highlighting moderate-intensity.

Associação entre Hipertensão Arterial Sistêmica com Marcadores Laboratoriais, Composição Corporal, Apneia Obstrutiva do Sono e Variabilidade da Frequência Cardíaca em Adultos Obesos / Association between Arterial Hypertension and Laboratory Markers, Body Composition, Obstructive Sleep Apnea and Autonomic Parameters in Obese Patients

Resumo Fundamento A hipertensão arterial sistêmica (HAS) é uma doença multifatorial, altamente prevalente e associada a riscos à saúde. Objetivo O objetivo deste estudo foi investigar a associação entre HAS e marcadores laboratoriais, antropométricos, de variabilidade da frequência cardíaca (VFC) e de apneia obstrutiva do sono e, em segundo plano, analisar a sensibilidade e especificidade das variáveis que são fatores independentes na associação. Métodos Estudo transversal com 95 pacientes obesos atendidos em um ambulatório de referência em obesidade em Salvador, BA, Brasil. Os dados da HAS foram obtidos dos prontuários eletrônicos. A amostra foi estratificada em Grupo Normotenso (GN) e Grupo Hipertenso (GH), sendo medidos marcadores laboratoriais, composição corporal, polissonografia e VFC para avaliar a associação da HAS com as variáveis preditoras. Para as análises, adotou-se p<0,05. Resultados A média da idade do GN foi de 36,3 ± 10,1 e GH 40,4 ± 10,6 anos, 73,7% eram mulheres no GN e 57,9% no GH; 82,4% no GH apresentavam resistência à insulina. No modelo de regressão logística multivariado com ajustes para idade, sexo, altura e saturação de oxi-hemoglobina, a HAS foi inversamente associada à glicose plasmática em jejum mg/dL (odds ratio [OR] = 0,96; intervalo de confiança de 95% [IC] = 0,92-0,99) e área de gordura visceral (AGV) cm2 (OR = 0,98; IC 95% = 0,97-0,99). A área sob a curva AGV foi de 0,728; IC 95% (0,620-0,836) e glicemia de jejum 0,693; IC 95% (0,582-0,804). Conclusão Menores concentrações de AGV e glicemia de jejum foram inversamente associadas à HAS. Além disso, tanto a glicemia de jejum quanto o AGV mostraram alta sensibilidade para triagem de HAS.

Abstract Background Systemic arterial hypertension (SAH) is a multifactorial disease, highly prevalent and associated with health risks. Objective The purpose of this study was to investigate the association between SAH and laboratory, anthropometric, heart rate variability (HRV), and obstructive sleep apnea markers and, secondarily, to analyze the sensitivity and specificity of the variables that are independent factors in the association. Methods Cross-sectional study with 95 obese patients treated at an obesity referral clinic in Salvador, BA, Brazil. SAH data were obtained from electronic medical records. The sample was stratified in the Normotensive Group (NG) and the Hypertensive Group (HG), and laboratory markers, body composition, polysomnography, and HRV were measured to evaluate the association of SAH with the predictor variables. For the analysis, p<0.05 was adopted. Results The average age of the NG was 36.3 ± 10.1 and HG 40.4 ± 10.6 years; 73.7% were women in the NG and 57.9% in HG; 82.4% in HG had insulin resistance. In the multivarious logistics regression model with adjustments in age, sex, height, and oxyhemoglobin saturation, SAH was inversely associated with fasting plasma glucose mg/dL (odds ratio [OR] = 0.96; 95% confidence interval [CI] = 0.92-0.99) and visceral fat area (VFA) cm2(OR = 0.98; 95% CI = 0.97-0.99). The area under the VFA curve was 0.728; CI 95% (0.620-0.836); fasting plasma glucose 0.693;CI 95% (0.582-0.804). Conclusions Lower VFA and fasting plasma glucose concentrations were inversely associated with SAH. In addition, fasting plasma glucose and VFA showed a high sensitivity for SAH screening.

Anthropometric Measures for the Prognosis of Obstructive Sleep Apnea in Obese.

OBJECTIVE: The objective of this study was to identify, among the different anthropometric indicators, the one that shows higher discriminatory power for the prognosis of Obstructive Sleep Apnea Syndrome (OSAS). DESIGN: Observational cross-sectional study PARTICIPANTS: Obese individuals elective to bariatric surgery METHODS: A study based on data of 758 patients aged ≥ 21 years old, of both sexes, in the pre-operatory stage of the surgical procedure of gastric bypass. Obstructive sleep apnea and obstructive sleep hypopnea were evaluated and classified through the apnea-hypopnea index, which was obtained through the examination of polysomnography. Variables were divided into two groups: individuals with and without OSAS. As predictors, measures of body mass index (BMI), neck circumference (NC), and waist circumference (WC) were used. RESULTS: The area under the ROC curve was used to check the sensitivity and specificity. All evaluated anthropometric indicators showed statistical significance. WC: area of 0.62 (CI 95%: 0.58 - 0.67), NC: area of 0,68 (CI 95%: 0.64 - 0.72) and BMI: area of 0.58 (CI 95%: 0.54 - 0.63). CONCLUSION: The investigated anthropometric indicators performed as good predictors of OSAS. However, NC seems to be the best anthropometric indicator for the prognosis of OSAS in obese individuals when compared to BMI and WC.

Acute Blood Pressure Response to Different Resistance Programs in Trained Men

Abstract Background Resistance training is used in different exercise programs, with different objectives and different levels of physical fitness. Training-related variables, such as volume, rest time and intensity, can affect the response of blood pressure (BP), but studies on the effect of these variables on BP are still needed. Objective To evaluate the acute response of BP in trained individuals undergoing two different methods of resistance training. Methods The sample was divided into three groups: (1) the German volume training (GVT) (n= 15), which consisted of 10 series of 10 repetitions at 50% of 1-repetition maximum (RM) with intervals of 30 seconds; (2) the sarcoplasm stimulating training (SST) (n= 16), performed at 8 RM and 85% of 1-RM and interval of 10 seconds until failure, followed by removal of 20% of weight and repetition of the whole series (total of three sets), and the control group (CG) (n= 15) who underwent BP measurements only. The two-way repeated measures ANOVA was used for analysis of variations, and a p< 0.05 was considered statistically significant. Results In the within-group analysis, a significant lowering of systolic blood pressure (SBP) was found at 10 minutes (125.4±10.8 mmHg, p= 0.045) and 20 minutes (124.5±8.5 mmHg, p= 0.044) post-training compared with immediately after training. In the between-group comparison, higher SBP values were observed immediately after training in the SST group (142.1±28.2, p= 0.048) compared with the CG. Conclusion High-volume and high-intensity resistance training programs did not cause abnormal changes in blood pressure. (Int J Cardiovasc Sci. 2021; [online].ahead print, PP.0-0)

Effect of sodium bicarbonate supplementation on two different performance indicators in sports: a systematic review with meta-analysis.

PURPOSE: Sodium bicarbonate shows ergogenic potential in physical exercise and sports activities, although there is no strong evidence which performance markers show the greatest benefit from this supplement. This study evaluated the effects of sodium bicarbonate supplementation on time trial performance and time to exhaustion in athletes and sports practitioners. METHODS: A systematic review was conducted using three databases, including 17 clinical trials. Among these clinical trials, 11 were considered eligible for the meta-analysis according to the criteria for the assessment of methodological quality using the PEDro Scale. Time to exhaustion was assessed in six studies, while time trial performance was evaluated in five studies. RESULTS: A significant beneficial effect of supplementation on time to exhaustion was found in a random effects model (1.48; 95% confidence interval [CI], 0.49 to 2.48). There was no significant effect of supplementation on time trial performance in a fixed effects model (slope = -0.75; 95% CI, -2.04 to 0.55) relative to a placebo group. CONCLUSION: Sodium bicarbonate has the potential to improve sports performance in general, especially in terms of time to exhaustion.

Modulação da variabilidade da frequência cardíaca em praticantes de CrossFit® / Modulation of heart rate variability in CrossFit® practitioners

INTRODUÇÃO: O CrossFit® é um tipo de exercício físico que afeta a homeostase do corpo exigindo ajustes pela via autonômica. Devido sua intensidade de treino ocorre uma modificação no tônus vagal e adaptações fisiológicas cardiovasculares. OBJETIVO: Verificar a variabilidade da frequência cardíaca em praticantes de CrossFit®. MATERIAIS E MÉTODOS: Corte transversal em praticantes de CrossFit® no período de março a junho de 2017, com idade ≥18 anos, tempo de prática ≥3 meses e uma frequência ≥2 vezes na semana. Excluídos: fumantes, gestantes, comorbidades auto referidas (Diabetes Mellitus, hipertensão, doenças cardiorrespiratórias e disfunção na tireoide), mulheres no período menstrual, menopausa, ou aqueles que tiveram dificuldade na compreensão do teste proposto. Para a mensuração da variabilidade da frequência cardíaca (VFC) foi utilizado o cardiofrequencimetro da marca Polar® modelo V800 heart rate monitor, para a sua análise foi utilizado KUBIOS HRV versão 2.0. Aprovação do CEP-BAHIANA (CAAE 46685415.0.0000.5544). RESULTADOS: Foram pesquisados 16 participantes, com idade média de 32,11 ± 6,44 anos, 10 (62, 5%) homens. O IMC encontrado foi de 26,39±3,80 kg/m², classificando 9 (56,3%) indivíduos como sobrepeso e 6 (37,5%)com peso normal. Os valores obtidos da VFC no domínio do tempo:VLFms2: 1544(859-3640); LFms2:827(550-2115); HFms2:661(335-1577);LF/ HF:1,18(0,86-1,8). CONCLUSÃO: Na amostra estudada, observou-se que praticantes de CrossFit® possuem leve predomínio da atividade simpática, especialmente o sexo masculino e naqueles que praticam atividade física cinco ou mais vezes por semana.

INTRODUCTION: CrossFit® is a type of physical exercise that affects the homeostasis of the body requiring adjustments through the autonomic pathway. Due to its intensity of training there is a modification in vagal tone and cardiovascular physiological adaptations. OBJECTIVE: To verify heart rate variability in CrossFit® practitioners. MATERIALS AND METHODS: Cross-section in CrossFit® practitioners from March to June 2017, aged ≥18 years, practice time ≥3 months and a frequency ≥2 times in the week. Excluded: smokers, pregnant women, self-referenced comorbidities (Diabetes Mellitus, hypertension, cardiorespiratory diseases and thyroid dysfunction), women in the menstrual period, menopause, or those who had difficulty understanding the proposed test. For the measurement of heart rate variability (HRV), the heart rate monitor model V800 heart rate monitor was used for its analysis was KUBIOS HRV version 2.0. Approval of CEP-BAHIANA (CAAE 46685415.0.0000.5544). 5544. RESULTS: 16 participants were studied, with a mean age of 32.11 ± 6.44 years, 10 men (62.5%). The mean BMI found was 26.39 ± 3.80 kg/ m², classifying 9 (56.3%) individuals as overweight and 6 (37.5%) with normal weight. The values obtained from HRV in the time domain: VLF:1544 (859-3640), LF: 827 (550-2115), HF: 661 (335-1577), LF / HF: 1.18 (0.86-1,8). CONCLUSION: In the studied sample, it was observed that CrossFit® practitioners have a slight predominance of sympathetic activity, especially males and those who practice physical activity five or more times per week.

Effects of Exercise Training on Cardiovascular and Autonomic Parameters in Stroke Survivors: A Systematic Review

Negative changes in cardiovascular and autonomic variables in stroke survivors have encouraged the global scientific community to focus on investigating therapeutic strategies to mitigate stroke damage. The objective of the present study was to describe the effects of exercise training on cardiovascular and autonomic variables in stroke survivors. We used the PICO (population, intervention, control/comparison, and outcome variables) model for the search of articles in PubMed and Physiotherapy Evidence Databases from 2009 to December 2018. The following data were also recorded: type of study, author, year of publication, participants (time after stroke, sample size, and age) and benefits of exercise training. A total of 544 articles were initially selected, of which nine peer-reviewed articles met the search criteria. These nine studies enrolled 611 participants (middle-aged or elderly), and pointed to positive effects of training on maximal oxygen uptake, peak aerobic capacity, 6-minute walk test and resting heart rate. However, more well-controlled studies are needed to confirm the benefits of exercise training on cardiovascular and autonomic variables in this population