Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 27
Filtrar
1.
Arq Bras Cardiol ; 117(2): 309-316, 2021 08.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34495225

RESUMO

BACKGROUND: Although maximal and submaximal walking are recommended for patients with peripheral artery disease (PAD), performing these exercises may induce different physiological responses. OBJECTIVES: To compare the acute effects of maximal and submaximal walking on post-exercise cardiovascular function, regulation, and associated pathophysiological processes in patients with symptomatic PAD. METHODS: Thirty male patients underwent 2 sessions: maximal walking (Gardner's protocol) and submaximal walking (15 bouts of 2 minutes of walking separated by 2 minutes of upright rest). In each session, blood pressure (BP), heart rate (HR), cardiac autonomic modulation (HR variability), forearm and calf blood flows (BF), vasodilatory capacity (reactive hyperemia), nitric oxide (NO), oxidative stress (lipid peroxidation), and inflammation (four markers) were measured pre- and post-walking. ANOVAs were employed, and p < 0.05 was considered significant. RESULTS: Systolic and mean BP decreased after the submaximal session, but they increased after the maximal session (interactions, p < 0.001 for both). Diastolic BP did not change after the submaximal session (p > 0.05), and it increased after maximal walking (interaction, p < 0.001). HR, sympathovagal balance, and BF increased similarly after both sessions (moment, p < 0.001, p = 0.04, and p < 0.001, respectively), while vasodilatory capacity, NO, and oxidative stress remained unchanged (p > 0.05). Vascular and intercellular adhesion molecules increased similarly after both maximal and submaximal walking sessions (moment, p = 0.001). CONCLUSIONS: In patients with symptomatic PAD, submaximal, but not maximal walking reduced post-exercise BP, while maximal walking maintained elevated cardiac overload during the recovery period. On the other hand, maximal and submaximal walking sessions similarly increased post-exercise HR, cardiac sympathovagal balance, and inflammation, while they did not change post-exercise NO bioavailability and oxidative stress.


Assuntos
Doença Arterial Periférica , Caminhada , Pressão Sanguínea , Teste de Esforço , Frequência Cardíaca , Humanos , Claudicação Intermitente , Masculino
2.
Arq Bras Cardiol ; 117(1): 74-81, 2021 07.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34320072

RESUMO

BACKGROUND: Resting heart rate (RHR) may be a useful screening tool for cardiovascular risk. However, RHR cutoff points, an interesting clinical approach, have never been described in young populations. OBJECTIVE: To establish RHR cutoff points in Brazilian adolescents and to analyze whether cutoff points are associated with cardiovascular risk factors. METHODS: The sample was composed of 6,794 adolescents (10 to 19 years old). Blood pressure and RHR were assessed by oscillometric device. Body mass index and waist circumference were also assessed. Receiver operating characteristic curve was adopted to analyze the sensitivity and specificity, and associations of high RHR with cardiovascular risk factors were analyzed by binary logistic regression. A p value < 0.05 was considered statistically significant for all the analyses. RESULTS: Mean RHR values were higher among participants ages 10 to 14 years than 15 to 19 years, for boys (p < 0.001) and girls (< 0.001). The proposed RHR cutoff points for cardiovascular risk factors detection were significant for boys ages 10 to 14 (> 92 bpm) and 15 to 19 years (> 82 bpm), as well as for girls ages 15 to 19 years (> 82 bpm) (p < 0.05 for all), whereas no cutoff point was identified for girls ages 10 to 14 years (p > 0.05). Proposed RHR cutoff points were associated with abdominal obesity, overweight, and high blood pressure in boys in girls. RHR cutoff points were associated with the cluster of cardiovascular risk factors in adolescents ages 15 to 19 years. CONCLUSION: The proposed RHR cutoff points were associated with cardiovascular risk factors in adolescents.


Assuntos
Doenças Cardiovasculares , Adolescente , Adulto , Índice de Massa Corporal , Doenças Cardiovasculares/diagnóstico , Criança , Estudos Transversais , Feminino , Frequência Cardíaca , Humanos , Masculino , Fatores de Risco , Circunferência da Cintura , Adulto Jovem
3.
Arq. bras. cardiol ; 117(1): 74-81, July. 2021. tab, graf
Artigo em Português | LILACS-Express | LILACS | ID: biblio-1285232

RESUMO

Resumo Fundamento A frequência cardíaca em repouso (FCR) pode ser uma ferramenta útil de triagem para o risco cardiovascular. Porém, os pontos de corte para FCR nunca foram descritos em populações jovens. Objetivo Estabelecer os pontos de corte para FCR em adolescentes brasileiros e analisar se há associação entre pontos de corte e fatores de risco cardiovascular. Métodos A amostra foi composta por 6.794 adolescentes (de 10 a 19 anos). A pressão arterial e a FCR foram avaliadas por dispositivo oscilométrico. Também foram avaliados o índice de massa corporal e a circunferência da cintura. Foi adotada a curva ROC para analisar a sensibilidade e especificidade, e as associações de FCR elevada com os fatores de risco cardiovascular foram analisadas por regressão logística binária. Foi considerado estatisticamente significante um valor de p < 0,05 para todas as análises. Resultados Os valores médios da FCR eram mais altos entre os participantes de 10 a 14 anos do naqueles de 15 a 19 anos, em meninos (p < 0,001) e meninas (< 0,001). Os pontos de corte de FCR propostos para detecção de fatores de risco cardiovascular foram significativos para meninos de 10 a 14 (> 92 bpm) e de 15 a 19 anos (> 82 bpm) e para meninas de 15 a 19 anos (> 82 bpm) (p < 0,05 para todos), enquanto nenhum ponto de corte foi identificado para as meninas de 10 a 14 anos (p > 0,05). Os pontos de corte propostos para a FCR foram associados com obesidade abdominal, sobrepeso e pressão arterial elevada em meninos e meninas. Os pontos de corte da FCR foram associados ao conjunto de fatores de risco cardiovascular em adolescentes de 15 a 19 anos. Conclusões Os pontes de corte propostos para a FCR foram associados com os fatores de risco cardiovascular em adolescentes.


Abstract Background Resting heart rate (RHR) may be a useful screening tool for cardiovascular risk. However, RHR cutoff points, an interesting clinical approach, have never been described in young populations. Objective To establish RHR cutoff points in Brazilian adolescents and to analyze whether cutoff points are associated with cardiovascular risk factors. Methods The sample was composed of 6,794 adolescents (10 to 19 years old). Blood pressure and RHR were assessed by oscillometric device. Body mass index and waist circumference were also assessed. Receiver operating characteristic curve was adopted to analyze the sensitivity and specificity, and associations of high RHR with cardiovascular risk factors were analyzed by binary logistic regression. A p value < 0.05 was considered statistically significant for all the analyses. Results Mean RHR values were higher among participants ages 10 to 14 years than 15 to 19 years, for boys (p < 0.001) and girls (< 0.001). The proposed RHR cutoff points for cardiovascular risk factors detection were significant for boys ages 10 to 14 (> 92 bpm) and 15 to 19 years (> 82 bpm), as well as for girls ages 15 to 19 years (> 82 bpm) (p < 0.05 for all), whereas no cutoff point was identified for girls ages 10 to 14 years (p > 0.05). Proposed RHR cutoff points were associated with abdominal obesity, overweight, and high blood pressure in boys in girls. RHR cutoff points were associated with the cluster of cardiovascular risk factors in adolescents ages 15 to 19 years. Conclusion The proposed RHR cutoff points were associated with cardiovascular risk factors in adolescents.

4.
Eur J Vasc Endovasc Surg ; 61(6): 954-963, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-33875324

RESUMO

OBJECTIVE: This study examined the impact of submaximal walking training (WT) on local and systemic nitric oxide (NO) bioavailability, inflammation, and oxidative stress in patients with intermittent claudication (IC). METHODS: The study employed a randomised, controlled, parallel group design and was performed in a single centre. Thirty-two men with IC were randomly allocated to two groups: WT (n = 16, two sessions/week, 15 cycles of two minutes walking at an intensity corresponding to the heart rate obtained at the pain threshold interspersed by two minutes of upright rest) and control (CO, n = 16, two sessions/week, 30 minutes of stretching). NO bioavailability (blood NO and muscle nitric oxide synthase [eNOS]), redox homeostasis (catalase [CAT], superoxide dismutase [SOD], lipid peroxidation [LPO] measured in blood and muscle), and inflammation (interleukin-6 [IL-6], C-reactive protein [CRP], tumour necrosis factor α [TNF-α], intercellular adhesion molecules [ICAM], vascular adhesion molecules [VCAM] measured in blood and muscle) were assessed at baseline and after 12 weeks. RESULTS: WT statistically significantly increased blood NO, muscle eNOS, blood SOD and CAT, and muscle SOD and abolished the increase in circulating and muscle LPO observed in the CO group. WT decreased blood CRP, ICAM, and VCAM and muscle IL-6 and CRP and eliminated the increase in blood TNF-α and muscle TNF-α, ICAM and VCAM observed in the CO group. CONCLUSION: WT at an intensity of pain threshold improved NO bioavailability and decreased systemic and local oxidative stress and inflammation in patients with IC. The proposed WT protocol provides physiological adaptations that may contribute to cardiovascular health in these patients.


Assuntos
Exercício Físico/fisiologia , Inflamação , Claudicação Intermitente , Músculo Esquelético/metabolismo , Estresse Oxidativo , Caminhada/fisiologia , Adaptação Fisiológica/fisiologia , Proteína C-Reativa/análise , Teste de Esforço/métodos , Fatores de Risco de Doenças Cardíacas , Humanos , Claudicação Intermitente/sangue , Claudicação Intermitente/fisiopatologia , Claudicação Intermitente/terapia , Masculino , Pessoa de Meia-Idade , Óxido Nítrico/análise , Avaliação de Resultados em Cuidados de Saúde , Superóxido Dismutase/análise , Molécula 1 de Adesão de Célula Vascular/análise
5.
J Phys Act Health ; 18(4): 426-432, 2021 03 05.
Artigo em Inglês | MEDLINE | ID: mdl-33668017

RESUMO

BACKGROUND: To examine the associations between physical activity (PA) and sedentary behavior (SB) with walking capacity and the effects of reallocating time from SB to PA in patients with symptomatic peripheral artery disease (PAD) using compositional data analysis. METHODS: This cross-sectional study included 178 patients (34% females, mean age = 66 [9] y, body mass index = 27.8 [5.0] kg/m2, and ankle-brachial index = 0.60 [0.18]). Walking capacity was assessed as the total walking distance (TWD) achieved in a 6-minute walk test, while SB, light-intensity PA, and moderate to vigorous-intensity PA (MVPA) were measured by a triaxial accelerometer and conceptualized as a time-use composition. Associations between time reallocation among wake-time behaviors and TWD were determined using compositional isotemporal substitution models. RESULTS: A positive association of MVPA with TWD (relative to remaining behaviors) was found in men (ßilr = 66.9, SE = 21.4, P = .003) and women (ßilr = 56.5, SE = 19.8; P = .005). Reallocating 30 minutes per week from SB to MVPA was associated with higher TWD in men (6.7 m; 95% confidence interval, 2.6-10.9 m) and women (4.5 m; 95% confidence interval, 1.5-7.5 m). CONCLUSIONS: The findings highlight, using a compositional approach, the beneficial and independent association of MVPA with walking capacity in patients with symptomatic PAD, whereas SB and light-intensity PA were not associated.


Assuntos
Acelerometria/métodos , Doença Arterial Periférica , Comportamento Sedentário , Idoso , Estudos Transversais , Análise de Dados , Exercício Físico , Feminino , Humanos , Masculino , Caminhada/fisiologia
6.
Ann Vasc Surg ; 74: 382-388, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-33549795

RESUMO

BACKGROUND: Exercise program has been recommended for the treatment of symptomatic peripheral artery disease (PAD) patients. However, whether exercise promotes reduction in arterial stiffness in these patients, who exhibit high arterial stiffness, is poor known. AIM: To analyze the effects of a single session of resistance, walking, and combined exercises on arterial stiffness in symptomatic PAD patients and to describe individual responses and identify clinical predictors of arterial stiffness responses after exercises. METHODS: Twelve patients with symptomatic PAD underwent four experimental sessions in random order: walking exercise (W - 10 bouts of 2-min walking at the speed corresponding to the onset of claudication pain with 2-min interval among sets), resistance exercise (R - 2 sets of 10 reps in eight resistance exercises), combined exercise (CO - 1 set of 10 reps in eight resistance exercises + 5 bouts of 2-min walking with 2-min interval between) and control session (C - resting in exercise room). Ambulatory arterial stiffness index (AASI) was obtained during ambulatory period after each session. Body mass index, ankle brachial index, sex and age also were evaluated. RESULTS: AASI was lower in R compared to other sessions (R - 0.52 ± 0.05; W - 0.59 ± 0.05; CO - 0.64 ± 0.05; C - 0.60 ± 0.05, P < 0.001), with 75% of patients presenting lower AASI after R session. No difference was found between W, CO and C sessions (P> 0.05). Ankle brachial index was negatively correlated with R and W sessions net effect (r = -0.618 and -0.750, respectively; P< 0.05 for both), no correlation was found with CO. CONCLUSION: A single bout of resistance exercise acutely reduces arterial stiffness in symptomatic PAD, while walking and combined exercise did not alter this variable. This response is more likely to occur in individuals with less severe disease.

7.
Ann Vasc Surg ; 71: 9-18, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32800891

RESUMO

BACKGROUND: Walking is recommended for patients with peripheral arterial disease (PAD). It has been shown that patients with PAD present sharper increases in blood pressure (BP) and heart rate (HR) during maximal walking when compared with healthy subjects. Additionally, women with PAD present a worse physiological profile, and it is possible that they may present higher cardiovascular load during and after a bout of maximal walking than men. Thus, the objective of this study was to compare cardiovascular and autonomic responses during and after maximal walking between men and women with PAD and intermittent claudication (IC). METHODS: Forty patients with PAD and IC (20 men and 20 women) underwent, in random order, 2 sessions: control (standing on treadmill) and exercise (maximal treadmill walking test with Gardner's protocol). During the exercise, HR and BP were measured. Before and after the sessions, cardiovascular variables (BP HR, cardiac output, peripheral vascular resistance, and stroke volume) and autonomic modulation (HR and BP variabilities and baroreflex sensitivity) were assessed. In addition, an ambulatory BP monitoring was recorded after each session. RESULTS: Men and women presented similar maximal walking capacity. During the walking test, HR and systolic BP increased similarly in men and women. After the maximal walking, cardiovascular and autonomic responses did not differ between the genders. In addition, postintervention ambulatory BP parameters were also similar in men and women. Therefore, in men and women, maximal walking similarly reduced clinic systolic BP and stroke volume, and increased HR and total power of HR variability during the recovery period. CONCLUSIONS: Men and women with PAD and IC present similar cardiovascular and autonomic responses during and after maximal walking.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Sistema Cardiovascular/inervação , Hemodinâmica , Claudicação Intermitente/fisiopatologia , Doença Arterial Periférica/fisiopatologia , Caminhada , Idoso , Barorreflexo , Pressão Sanguínea , Débito Cardíaco , Teste de Esforço , Feminino , Frequência Cardíaca , Humanos , Claudicação Intermitente/diagnóstico , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/diagnóstico , Fatores Sexuais , Fatores de Tempo , Resistência Vascular
8.
J Aging Phys Act ; 29(2): 225-232, 2020 09 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887851

RESUMO

This study aimed to compare the effects of resistance training performed with low versus moderate loads on systemic resting blood pressure (BP) in older women. A total of 29 women (72.6 ± 5.1 years) were randomized into two groups: low load (LOW, n = 15) and moderate load (MOD, n = 14). An 8-week whole-body resistance training program was carried out 3 days/week (eight exercises, three sets, 10 or 15 repetition maximum). The LOW and MOD groups trained with a relative load of 15 and 10 repetition maximum, respectively. Outcome measures included resting systolic and diastolic BP. After 8 weeks, both groups presented significant changes (p < .05) in systolic BP (LOW = -3.0%; MOD = -4.6%) and mean BP (LOW = -1.9%; MOD = -3.1%). There was no change for diastolic BP in the posttest in both groups. The results suggest that low and moderate loads are equally effective for promoting decreases in resting BP in older women.


Assuntos
Treinamento de Força , Idoso , Pressão Sanguínea , Exercício Físico , Terapia por Exercício , Feminino , Humanos , Descanso
9.
J Psychosom Res ; 134: 110122, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32403057

RESUMO

OBJECTIVE: Depression is commonly associated to physical multimorbidity and there is an urgent need to identify modifiable risk factors. Physical activity (PA) is good for health, but the association between PA and multimorbidity with depressive symptoms is unclear. Thus, we investigated whether meeting weekly recommended PA guidelines influences the association between multimorbidity and depressive symptoms. METHODS: Data were used from a national survey conducted in Brazil in 2013 with 60,202 adults (≥ 18 years). Information regarding depressive symptoms (PHQ-9), PA, and chronic disease was collected via interview-administered questionnaires. Data on covariates (age, educational status, employment status, tobacco smoking, alcohol consumption, and TV-viewing) were also assessed. Adjusted logistic regression models were used. RESULTS: Overall, men and women with one or more chronic conditions who were inactive (engaging in <150 min PA per week) had higher odds of elevated depressive symptoms than active individuals with no chronic condition. However, only in men, physical inactivity interacts with heart disease (OR: 2.59; 95%CI: 1.10 to 6.09), cancer (OR: 21.54; 95%CI: 2.67 to 173.94) and chronic obstructive pulmonary disease (COPD) (OR: 8.26; 95%CI: 2.20 to 31.01) regarding elevated depressive symptoms. CONCLUSION: Our data suggest that engaging in weekly recommended PA targets may attenuate association of heart disease, cancer and COPD with depressive symptoms among men.


Assuntos
Depressão/epidemiologia , Depressão/fisiopatologia , Exercício Físico , Inquéritos Epidemiológicos , Multimorbidade , Adulto , Idoso , Brasil/epidemiologia , Doença Crônica/psicologia , Estudos Transversais , Depressão/complicações , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Adulto Jovem
10.
J Cardiovasc Nurs ; 2020 May 14.
Artigo em Inglês | MEDLINE | ID: mdl-32427794

RESUMO

OBJECTIVE: The aim of this study was to assess the effects of a single bout of maximal walking on blood and muscle nitric oxide (NO) bioavailability, oxidative stress, and inflammation in symptomatic peripheral artery disease (PAD) patients. METHODS: A total of 35 men with symptomatic PAD performed a graded maximal exercise test on a treadmill (3.2 km/h, 2% increase in grade every 2 minutes). Plasma samples and gastrocnemius muscle biopsies were collected preexercise and postexercise for assessment of NO bioavailability (plasma NO and muscle, endothelial NO synthase), oxidative stress and antioxidant function (lipid peroxidation [LPO], catalase [CAT], and superoxide dismutase), and inflammation (interleukin-6, C-reactive protein, tumor necrosis factor-α, intercellular adhesion molecules, and vascular adhesion molecules). The effects of the walking exercise were assessed using paired t tests or Wilcoxon tests. RESULTS: After maximal walking, plasma NO and LPO were unchanged (P > .05), plasma CAT decreased, and all blood inflammatory markers increased (all P ≤ .05). In the disease-affected skeletal muscle, endothelial NO synthase, CAT, LPO, and all inflammatory markers increased, whereas superoxide dismutase decreased (all P ≤ .05). CONCLUSION: In patients with symptomatic PAD, maximal exercise induces local and systemic impairments, which may play a key role in atherogenesis. Exercise strategies that avoid maximal effort may be important to reduce local and systemic damage and enhance clinical benefits.

11.
J Cardiopulm Rehabil Prev ; 40(1): 24-28, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31348126

RESUMO

PURPOSE: To compare functional and cardiovascular variables of men and women with peripheral artery disease (PAD). METHODS: This observational, cross-sectional study included 67 women and 144 men (age 66 ± 9 and 67 ± 10 yr, respectively) with PAD. Patients were submitted to a clinical evaluation, 6-min walk test (6MWT) and cardiovascular evaluation, including blood pressure, arterial stiffness variables, and heart rate variability. RESULTS: Women had lower claudication onset distance (P = .033) and 6MWT distance (P < .001), and similar percentage of the predicted 6MWT distance (P > .05). Women had higher pulse pressure (P = .002), augmentation index (P < .001), augmentation index corrected by 75 bpm (P < .001), and brachial and central systolic blood pressure (P = .041 and P = .029). Diastolic blood pressure, pulse wave velocity, and heart rate variability were similar between sexes (P > .05). CONCLUSION: Although predicted 6MWT performance was similar between sexes, women had higher blood pressure and wave reflection variables compared with men. Interventions to reduce blood pressure and wave reflection should be emphasized in women with PAD.


Assuntos
Pressão Sanguínea/fisiologia , Frequência Cardíaca/fisiologia , Doença Arterial Periférica/fisiopatologia , Rigidez Vascular/fisiologia , Teste de Caminhada/estatística & dados numéricos , Idoso , Brasil , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores Sexuais
12.
Ann Vasc Surg ; 61: 72-77, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31336162

RESUMO

BACKGROUND: The objective of this study was to analyze the association between cardiac autonomic modulation and arterial stiffness in patients with peripheral artery disease (PAD). METHODS: This cross-sectional study included one hundred fourteen patients with symptomatic PAD (67.5% men; 65 ± 7 years; body mass index: 26.8 ± 4.5 kg/m2). Heart rate variability (HRV) was measured within time (standard deviation of all RR intervals [beat to beat heart interval] [SDNN], root mean square of the successive differences between adjacent normal RR intervals [RMSSD], and the proportion of successive RR intervals that differed by more than 50 msec [pNN50]) and frequency (low frequency [LF] and high frequency [HF]) domains. Arterial stiffness was assessed by carotid-femoral pulse wave velocity (cfPWV). Crude and adjusted linear regression analyses examined the relationship between HRV and cfPWV. RESULTS: Nonsignificant crude associations were identified among cfPWV and RMSSD (P = 0.181), SDNN (P = 0.105), pNN50 (P = 0.087), LF (P = 0.376), HF (P = 0.175), and LF/HF ratio (P = 0.426). After adjustments for age, sex, smoking, body mass index, ankle-brachial index, and use of beta-blockers, significant associations were identified among cfPWV and RMSSD (P = 0.037), SDNN (P = 0.049), and pNN50 (P = 0.049). CONCLUSIONS: Cardiac autonomic modulation was significantly associated with arterial stiffness in patients with PAD after adjustment for confounding factors. This relationship may contribute to the enhanced cardiovascular disease risk for PAD patients and provides a target for strategies to improve patient clinical outcomes.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Frequência Cardíaca , Coração/inervação , Doença Arterial Periférica/fisiopatologia , Rigidez Vascular , Idoso , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/complicações , Doença Arterial Periférica/diagnóstico , Prognóstico , Análise de Onda de Pulso , Fatores de Risco
13.
Ann Vasc Surg ; 61: 78-82, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31352085

RESUMO

BACKGROUND: The aim of this study was to identify the clinical factors associated with arterial stiffness in patients with symptomatic peripheral artery disease. METHODS: In this cross-sectional study, 181 patients (67% men; mean aged 66 ± 9 years) were recruited and had their central arterial stiffness assessed by carotid-femoral pulse wave velocity (cf-PWV). Clinical characteristics are sociodemographic data, body mass index, comorbid conditions, and walking capacity. RESULTS: Multiple linear regression analysis showed that age (b = 0.182, P = 0.032), body mass index (b = 0.254, P = 0.002), and mean blood pressure (b = 0.249, P = 0.021) were positively associated with cf-PWV. CONCLUSIONS: Our results showed that the aging, elevated body mass index, and higher blood pressure are clinical factors associated with increased arterial stiffness in patients with peripheral artery disease.


Assuntos
Doença Arterial Periférica/fisiopatologia , Rigidez Vascular , Adiposidade , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Pressão Sanguínea , Índice de Massa Corporal , Comorbidade , Estudos Transversais , Tolerância ao Exercício , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/complicações , Doença Arterial Periférica/diagnóstico , Prognóstico , Análise de Onda de Pulso , Fatores de Risco
14.
Expert Rev Cardiovasc Ther ; 17(1): 65-73, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30481076

RESUMO

Introduction: Patients with symptomatic peripheral artery disease (PAD) exhibit reduced functional capacity and increased mortality due to cardiovascular disease. Although exercise has been a cornerstone for clinical treatment to improve walking capacity in patients with symptomatic PAD, its effects on cardiovascular parameters have been poorly explored. Areas covered: This review examines the role of exercise in improving blood pressure in patients with symptomatic PAD and summarizes the current evidence on the acute (single bout of exercise) and chronic effects of walking and resistance exercise on blood pressure and its determinants. Expert commentary: In patients with symptomatic PAD, exercise promotes acute and chronic reductions in blood pressure. These effects were observed particularly after walking and resistance exercise. Future studies are necessary to investigate the effects of other exercise modalities, especially non-painful exercises, on cardiovascular function in patients with symptomatic PAD.


Assuntos
Terapia por Exercício , Hipertensão/terapia , Doença Arterial Periférica/terapia , Pressão Sanguínea/fisiologia , Humanos , Hipertensão/etiologia , Hipertensão/fisiopatologia , Doença Arterial Periférica/complicações , Doença Arterial Periférica/fisiopatologia , Caminhada/fisiologia
15.
Ann Vasc Surg ; 57: 144-151, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30476599

RESUMO

BACKGROUND: The aim of this study is to identify, in patients with peripheral artery disease and intermittent claudication (IC), the reproducibility of heart rate (HR), blood pressure (BP), rate pressure product, heart rate variability (HRV), and forearm and calf blood flow (BF) and vasodilatory assessments. METHODS: Twenty-nine patients with IC underwent test and retest sessions, 8-12 days apart. During each session, HR, BP, HRV, BF, and vasodilatory responses were measured by electrocardiogram, auscultation, spectral analysis of HRV (low frequency, LFR-R; high frequency, HFR-R), and strain gauge plethysmography (baseline BF, post-occlusion BF, post-occlusion area under the curve). Reproducibility was determined by intra-class correlation coefficient (ICC), typical error, coefficient of variation (CV), and limits of agreement. RESULTS: The ICC for HR and BP was >0.8 with CV <9%. For most HRV measures, ICC was >0.9 while CV was <7%, except for LF/HF (ICC = 0.737, CV = 93.8%). The ICC for forearm and calf baseline BF assessments was >0.9 while CV was <19%; variable ICC and CV for vasodilatory responses were exhibited for calf (0.653-0.770, 35.2-37.7%) and forearm (0.169-0.265, 46.2-55.5%). CONCLUSIONS: In male patients with IC, systemic hemodynamics (HR and BP), cardiac autonomic modulation (LFR-R and HFR-R), and forearm and calf baseline BF assessments exhibited excellent reproducibility, whereas the level of reproducibility for vasodilatory responses were moderate to poor. Assessment reproducibility has highlighted appropriate clinical tools for the regular monitoring of disease/intervention progression in patients with IC.


Assuntos
Sistema Nervoso Autônomo/fisiopatologia , Eletrocardiografia , Antebraço/irrigação sanguínea , Coração/inervação , Hemodinâmica , Claudicação Intermitente/diagnóstico , Perna (Membro)/irrigação sanguínea , Pletismografia , Idoso , Pressão Sanguínea , Frequência Cardíaca , Humanos , Claudicação Intermitente/fisiopatologia , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Valor Preditivo dos Testes , Fluxo Sanguíneo Regional , Reprodutibilidade dos Testes , Vasodilatação
16.
Clin Exp Hypertens ; 41(7): 692-695, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30409054

RESUMO

Background: Increased handgrip strength has been associated with lower cardiovascular and non-cardiovascular mortality in different populations. In patients with hypertension, arterial stiffness relates to cardiovascular mortality. However, whether muscle strength is associated with arterial stiffness in hypertensives is unknown. Thus, the objective of this study was to analyze the association between handgrip strength and arterial stiffness parameters in hypertensive patients. Methods: Seventy-two hypertensive patients completed all evaluations and were included in the analysis. The ambulatory arterial stiffness index (AASI) was obtained based on 24-h ambulatory blood pressure monitoring. Carotid-femoral pulse wave velocity (cfPWV), and reflected wave indicator (AIx and AIx@75) were estimated using applanation tonometry technique, whereas handgrip strength test was performed using a digital dynamometer. Crude and adjusted linear regression models were performed. Results: The crude analysis revealed a negative association between handgrip strength and AASI (b = -0.41, p = 0.002) and AIx (b = -0.49, p < 0.001), and AIx@75 (b = -0.54, p < 0.001) which remained significant after adjustments for age, sex, and body mass index, mean blood pressure, and heart rate only for AASI (b = -0.46, p = 0.028) and AIx@75 (b = -0.24, p- = 0.040). Handgrip strength was not associated with cfPWV (p > 0.05). Conclusion: Handgrip strength is negatively associated with AASI and AIx@75, but not with AIx and cfPWV in hypertensive patients.


Assuntos
Força da Mão , Hipertensão/fisiopatologia , Rigidez Vascular , Idoso , Pressão Sanguínea/fisiologia , Monitorização Ambulatorial da Pressão Arterial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Onda de Pulso
17.
J Am Soc Hypertens ; 12(12): e59-e64, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-30425018

RESUMO

After an exercise session, a reduction of blood pressure (BP) is expected, a phenomenon called postexercise hypotension (PEH). PEH as a predictor of chronic training responses for BP has been broadly explored. It suggests that when PEH occurs after each exercise sessions, its benefits may summate over time, contributing to the chronic adaptation. Thus, PEH is an important clinical tool, acting as a "single brick" in the wall, and building the chronic effect of decreasing BP. However, there is large variation in the literature regarding methodology and results, creating barriers for understanding comparisons among PEH studies. Thus, the differences among subjects' and exercise protocols' characteristics observed in the studies investigating PEH must be considered when readers interpret the results. Furthermore, understanding of these factors of influence might be useful for avoiding misinterpretations in future comparisons and how the subjacent mechanisms contribute to the BP reduction after exercise.

18.
Clinics (Sao Paulo) ; 73: e373, 2018 10 18.
Artigo em Inglês | MEDLINE | ID: mdl-30365821

RESUMO

OBJECTIVE: The present study analyzed blood pressure responses after a single session of isometric handgrip exercise performed with different volumes and intensities by patients with hypertension. METHODS: This randomized crossover trial submitted 12 hypertensive patients (58±5 years old) to four isometric handgrip exercise sessions in a random order: 4 x 2 min at 30% of the maximal voluntary contraction (S30%); 4 x 2 min at 50% of the maximal voluntary contraction (S50%2min); 4 x 3 min at 30% of the maximal voluntary contraction (S30%3min); and a control session. The systolic and diastolic blood pressure, heart rate, and rate-pressure product were measured pre- and post-exercise (30th min). RESULTS: No significant changes were observed in cardiovascular variables after any session (p>0.05 for all comparisons). Similarly, individual analyses revealed heterogeneity in the responses, including increases in blood pressure observed in some sessions. Patients with reduced blood pressure after an isometric handgrip exercise session exhibited a higher body mass index, diastolic blood pressure and heart rate (p<0.05). They also tended to be younger (p=0.07). CONCLUSION: Isometric handgrip exercise performed with different intensities and volumes did not reduce the blood pressure of hypertensive patients.


Assuntos
Terapia por Exercício/métodos , Frequência Cardíaca/fisiologia , Hipertensão/terapia , Estudos Cross-Over , Feminino , Força da Mão/fisiologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
19.
Pediatr Cardiol ; 39(7): 1397-1403, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29766226

RESUMO

A low heart rate variability (HRV) has been associated with cardiovascular risk factors in adolescents. However, no cut-off points are known for HRV parameters in this age group, making it difficult to use in clinical practice. Thus, the aims of the current study were to establish cutoffs of HRV parameters and to examine their association with cardiovascular risk in Brazilian adolescents male. For this reason, this cross-sectional study included 1152 adolescent boys (16.6 ± 1.2 years old). HRV measures of time (SD of all RR intervals, root mean square of the squared differences between adjacent normal RR intervals, and the percentage of adjacent intervals over 50 ms), frequency domains [low (LF) and high (HF) frequency], and Poincaré plot (SD1, SD2 and SD1/SD2 ratio) were assessed. Cardiovascular risk was assessed by sum of abdominal obesity, high blood pressure, overweight, and low physical activity level. The proposed cutoffs showed moderate to high sensitivity, specificity, and area under curve values (p < 0.05). HRV frequency parameters were statistically superior when compared to time-domain and Poincaré plot parameters. The binary logistic regression analysis indicated that all proposed HRV cutoffs were independently associated with a clustering of cardiovascular risk factors, with greater magnitude of HF and SD1/SD2 ratio (two or more risk factors: OR = 3.59 and 95% CI 1.76-7.34). In conclusion, proposed HRV cutoffs have moderate to high sensitivity in detecting of the cardiovascular risk factor and HRV frequency-domain were better discriminants of cardiovascular risk than time-domain and Poincaré plot parameters.


Assuntos
Doenças Cardiovasculares/etiologia , Frequência Cardíaca/fisiologia , Medição de Risco/métodos , Adolescente , Área Sob a Curva , Brasil , Estudos Transversais , Humanos , Masculino , Fatores de Risco , Sensibilidade e Especificidade , Adulto Jovem
20.
Ann Vasc Surg ; 52: 147-152, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29793014

RESUMO

BACKGROUND: Impaired microcirculation is associated with poor walking capacity in symptomatic peripheral artery disease (PAD) patients during treadmill test; however, this test does not simulate the efforts of daily walking of these patients. Thus, the aim of the study was to describe the microcirculation responses during a 6-minute walk test (6MWT) and to analyze the relationship between microcirculation indicators and walking impairment in symptomatic PAD patients. METHODS: Thirty-four patients were included (mean age = 67.6 ± 11.2 years). Their clinical characteristics were collected, and they performed a 6MWT, in which the initial claudication distance (ICD) and total walking distance (TWD) were recorded. During and after the 6MWT, calf muscle oxygen saturation (StO2) parameters were monitored continuously to measure microcirculation behavior. The association between calf muscle StO2 parameters and walking impairment were analyzed by Pearson or Spearman correlations. RESULTS: Walking impairment was not associated with any StO2 parameters during exercise. In contrast, after 6MWT, recovery time of StO2 (r = -0.472, P = 0.008) and recovery time to maximal StO2 (r = -0.402, P = 0.019) were negatively correlated with ICD. Furthermore, the distance walked under claudication symptoms (ΔTWD-ICD) was positively correlated with recovery time to maximal StO2 (r = 0.347, P = 0.048). CONCLUSIONS: In symptomatic PAD patients, shorter ICD values during a 6MWT are associated with a delayed recovery in calf muscle StO2 after exercise. Calf muscle StO2 parameters decrease subtly during 6MWT, suggesting that the degree of ischemia in the calf muscle during ground walking, simulating efforts of the daily walking, is relatively low.


Assuntos
Claudicação Intermitente/diagnóstico , Microcirculação , Contração Muscular , Músculo Esquelético/irrigação sanguínea , Músculo Esquelético/metabolismo , Consumo de Oxigênio , Doença Arterial Periférica/diagnóstico , Teste de Caminhada , Caminhada , Idoso , Tolerância ao Exercício , Feminino , Humanos , Claudicação Intermitente/metabolismo , Claudicação Intermitente/fisiopatologia , Perna (Membro) , Masculino , Pessoa de Meia-Idade , Doença Arterial Periférica/metabolismo , Doença Arterial Periférica/fisiopatologia , Valor Preditivo dos Testes , Fatores de Tempo
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...