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)

Respiratory muscle endurance is limited by lower ventilatory efficiency in post-myocardial infarction patients

Background: Reduced respiratory muscle endurance (RME) contributes to increased dyspnea upon exertion in patients with cardiovascular disease. Objective: The objective was to characterize ventilatory and metabolic responses during RME tests in post-myocardial infarction patients without respiratory muscle weakness. Method: Twenty-nine subjects were allocated into three groups: recent myocardial infarction group (RG, n=9), less-recent myocardial infarction group (LRG, n=10), and control group (CG, n=10). They underwent two RME tests (incremental and constant pressure) with ventilatory and metabolic analyses. One-way ANOVA and repeated measures one-way ANOVA, both with Tukey post-hoc, were used between groups and within subjects, respectively. Results: Patients from the RG and LRG presented lower metabolic equivalent and ventilatory efficiency than the CG on the second (50± 06, 50± 5 vs. 42± 4) and third part (50± 11, 51± 10 vs. 43± 3) of the constant pressure RME test and lower metabolic equivalent during the incremental pressure RME test. Additionally, at the peak of the incremental RME test, RG patients had lower oxygen uptake than the CG. Conclusions : Post-myocardial infarction patients present lower ventilatory efficiency during respiratory muscle endurance tests, which appears to explain their inferior performance in these tests even in the presence of lower pressure overload and lower metabolic equivalent. .

Reference equations for the six-minute walk distance based on a Brazilian multicenter study

BACKGROUND: It is important to include large sample sizes and different factors that influence the six-minute walking distance (6MWD) in order to propose reference equations for the six-minute walking test (6MWT). OBJECTIVE: To evaluate the influence of anthropometric, demographic, and physiologic variables on the 6MWD of healthy subjects from different regions of Brazil to establish a reference equation for the Brazilian population. METHOD: In a multicenter study, 617 healthy subjects performed two 6MWTs and had their weight, height, and body mass index (BMI) measured, as well as their physiologic responses to the test. Delta heart rate (∆HR), perceived effort, and peripheral oxygen saturation were calculated by the difference between the respective values at the end of the test minus the baseline value. RESULTS: Walking distance averaged 586±106m, 54m greater in male compared to female subjects (p<0.001). No differences were observed among the 6MWD from different regions. The quadratic regression analysis considering only anthropometric and demographic data explained 46% of the variability in the 6MWT (p<0.001) and derived the equation: 6MWDpred=890.46-(6.11×age)+(0.0345×age2)+(48.87×gender)-(4.87×BMI). A second model of stepwise multiple regression including ∆HR explained 62% of the variability (p<0.0001) and derived the equation: 6MWDpred=356.658-(2.303×age)+(36.648×gender)+(1.704×height)+(1.365×∆HR). CONCLUSION: The equations proposed in this study, especially the second one, seem adequate to accurately predict the 6MWD for Brazilians. .

Testes de tolerância ao exercício em pregrama de fisioterapia hospitalar após exarcebação da doença pulmonar obstrutiva crônica / Tolerance tests ti the exercise in a hospital physical therapy program in the exacerbation of the chronic pbstructive pulmonary disease

Na exacerbação da Doença Pulmonar Obstrutiva Crônica (DPOC) há uma redução da tolerância ao exercício. A avaliação da tolerancia ao exercício com o emprego do Teste da Caminhada de Seis minutoos (TC6min) é amplamente empregada, e o uso de Testes de Degrau vem sendo incentivado. O objetivo geral desta pesquisa foi avaliar a tolerânncia ao exercício de pacientes hospitalizados devido à exacerbação da DPOC por meiodo TC6min e do Teste de Degrau com Cadência Livre (TDCL). Oito pacientes do sexo masculino (57,9 +-9,02 anos) executaram os dois testes, durante 6 minutos, em ordem aleatória. Os parâmetros cardiorrespiratórios (frequência cardíaca, saturação periférica de oxigênio, pressão arterial e frequência respiratória) bem como os índices de percepção de esforço (dispnéia e fadiiga em membros inferiores) foram monitorados. Os resultados mostram que os testes produziram efeitos equivalentes quanto às variáveis cardiorrespiratórias e de percepção de esforço. Houve uma boa correlação (r=0,706 e p<0,001) entre a quantidade de passos completos no TDCL e a distãncia percorrida no TC6 min. Portanto, além do TC6min ou em substituição a este, principalmente na ausêñcia de espaço físico adequado, pode-se oferecer aos pacientes com DPOC hospitalizados outra metodologia simples, barata e segura, o TDCL.