Long-term anabolic steroids in male bodybuilders induce cardiovascular structural and autonomic abnormalities.

OBJECTIVE: The aims of this study were to examine the hypothesis that users of anabolic androgenic steroids (AAS) would have cardiac autonomic disorders and that there is a correlation between sympathetic modulation, high blood pressure (BP) and alterations to cardiac dimensions. METHODS: Forty-five male subjects were enrolled in the study. They were categorized into three groups comprising bodybuilders actively using AAS (AAS users; n = 15), bodybuilders who had never used AAS (nonusers; n = 15) and age-paired healthy sedentary controls (n = 15). Hemodynamic parameters, linear and nonlinear analyses of heart rate variability and electrocardiography and echocardiography analyses were performed at rest. RESULTS: Bodybuilders in the AAS group had a higher mean BP than those in the ASS nonuser group (p < 0.05) and the sedentary controls (p < 0.001). Cardiac sympathetic modulation was higher in AAS users than in AAS nonusers (p < 0.05) and the sedentary controls (p < 0.001), and parasympathetic modulation was lower in AAS users than in nonusers and the sedentary controls (p < 0.05). Shannon entropy was lower in AAS users than in the sedentary (p < 0.05) controls, and the corrected QT interval and QT dispersion were higher in AAS users than in the sedentary controls (p < 0.05). The interventricular septal thickness, left ventricle posterior wall thickness and relative diastolic wall thickness were higher in AAS users than in AAS nonusers and the sedentary controls (p < 0.001). AAS users showed a positive correlation between increased sympathetic modulation and high BP (r = 0.48, p < 0.005), as well as sympathetic modulation and cardiac hypertrophy (r = 0.66, p < 0.001). CONCLUSION: There was a marked cardiac autonomic alteration in AAS users, with a shift toward sympathetic modulation predominance and vagal attenuation. The high BP observed in our group of bodybuilders using AAS was associated with increased sympathetic modulation, and this increased sympathetic modulation was associated with structural alterations in the heart. This association may constitute an important mechanism linking AAS abuse to increased cardiovascular risk.

[Perceived barriers and coping strategies developed by patients with type 2 diabetes mellitus to join to walking]. / Barreiras percebidas e estratégias de enfrentamento desenvolvidas por portadores do diabetes mellitus tipo II para adesão à caminhada.

OBJECTIVE: To investigate the perceived barriers and coping strategies for the practice of walking identified among patients with diabetes mellitus (DM) in the scope of the Unified Health System (SUS). METHODOLOGY: A sample of 83 individuals with DM, SUS users, was asked to reflect on the obstacles that prevented them from walking, as well as to formulate coping plans to overcome them. The obstacles raised and plans developed were categorized for similarity and subjected to frequency analysis. RESULTS: The main obstacle reported was the feeling of "dismay" (36.1%). The most frequent coping plan to overcome the barriers found was 'social support from family members', 'neighbors' and 'friends'. CONCLUSION: The results made it possible to know the difficulties and potential of the subjects related to self-care for DM regarding the practice of walking, knowledge that can help the multidisciplinary teams of the SUS.

Barreiras percebidas e estratégias de enfrentamento desenvolvidas por portadores do diabetes mellitus tipo II para adesão à caminhada / Perceived barriers and coping strategies developed by patients with type 2 diabetes mellitus to join to walking / Barreras percibidas y estrategias de afrontamiento desarrolladas por pacientes con diabetes mellitus tipo II para la adherencia a la marcha

RESUMO Objetivo Investigar as barreiras percebidas e as estratégias de enfrentamento para a efetivação da prática de caminhada identificadas entre portadores do diabetes mellitus (DM) no âmbito do Sistema Único de Saúde (SUS). Metodologia Uma amostra de 83 portadores do DM, usuários do SUS, foi inquirida a refletir sobre os obstáculos que os impediam de praticar a caminhada, e formular planos de enfretamento para superar tais obstáculos. Foram categorizados os obstáculos levantados e os planos desenvolvidos quanto à similaridade e submetidos à análise de frequência. Resultados O principal obstáculo relatado foi o sentimento de "desânimo" (36,1%). O plano de enfrentamento mais frequente para superar as barreiras encontradas foi o 'apoio social de familiares', 'vizinhos' e 'amigos'. Conclusão Os resultados possibilitaram conhecer as dificuldades e as potencialidades dos sujeitos relativas ao autocuidado para o DM no que se refere à prática da caminhada, conhecimento que pode auxiliar as equipes multidisciplinares do SUS.

ABSTRACT Objective To investigate the perceived barriers and coping strategies for the practice of walking identified among patients with diabetes mellitus (DM) in the scope of the Unified Health System (SUS). Methodology A sample of 83 individuals with DM, SUS users, was asked to reflect on the obstacles that prevented them from walking, as well as to formulate coping plans to overcome them. The obstacles raised and plans developed were categorized for similarity and subjected to frequency analysis. Results The main obstacle reported was the feeling of "dismay" (36.1%). The most frequent coping plan to overcome the barriers found was 'social support from family members', 'neighbors' and 'friends'. Conclusion The results made it possible to know the difficulties and potential of the subjects related to self-care for DM regarding the practice of walking, knowledge that can help the multidisciplinary teams of the SUS.

RESUMEN Objetivo Investigar las barreras percibidas y las estrategias de afrontamiento para la práctica de la marcha identificadas en pacientes con diabetes mellitus (DM) en el ámbito del Sistema Único de Salud (SUS). Metodología Se solicitó les solicitó a 83 personas con DM, usuarias del SUS, que reflexionaran sobre los obstáculos que les impedían caminar, así como que formularan planes de afrontamiento para superarlos. Los obstáculos planteados y los planes desarrollados se clasificaron por similitud y se sometieron a análisis de frecuencia. Resultados El principal obstáculo reportado fue el sentimiento de "consternación" (36,1%). El plan de afrontamiento más frecuente para superar las barreras encontradas fue el "apoyo social de familiares", "vecinos" y "amigos". Conclusión Los resultados permitieron conocer las dificultades y potencialidades de los sujetos relacionados con el autocuidado de la DM con respecto a la práctica de la marcha, conocimiento que puede ayudar a los equipos multidisciplinarios del SUS.