Impacto da pandemia da COVID-19 sobre o tratamento medicamentoso dos pacientes com doença arterial periférica: um estudo observacional transversal

Contexto: A pandemia do Coronavírus 2019 (COVID-19) tem afetado negativamente o comportamento dapopulação. Nesse contexto, o impacto da pandemia da COVID-19 no tratamento medicamentoso dos pacientes comdoença arterial periférica (DAP) e claudicação intermitente (CI) permanece obscuro. Objetivos: Analisar o impactoda pandemia da COVID-19 no tratamento medicamentoso dos pacientes com DAP e CI. Métodos: Neste estudoobservacional transversal, 136 pacientes com DAP e CI, recrutados do nosso banco de dados, responderam por telefoneum questionário envolvendo as seguintes questões: a) cuidados com a COVID-19; b) saúde global; c) tratamento dasdoenças. Posteriormente, os pacientes foram divididos em dois grupos, de acordo com a dificuldade para a aquisiçãodos medicamentos (DAM: dificuldade e SDAM: sem dificuldade), para a comparação da saúde global entre os doisgrupos. Resultados: Dezessete porcento dos pacientes reportaram dificuldades para a aquisição dos medicamentosdurante a pandemia. Uma maior prevalência desses pacientes reportou estar mais triste (56,5% versus 24,8%, p 0,05). Conclusões: Uma maior prevalência de pacientes do grupo DAM reportou estar mais triste e com maisdificuldade para dormir em comparação ao grupo SDAM durante a pandemia da COVID-19. = Background: The Coronavirus 2019 (COVID-19) pandemic has had a negative impact on the population’s behavior. In this context, the effect of the COVID-19 pandemic on drug treatment of patients with peripheral arterial disease (PAD) and intermittent claudication (IC) remains unclear. Objectives: To analyze the impact of the COVID-19 pandemic on drug treatment of patients with PAD and IC. Methods: In this cross-sectional, observational study, 136 patients with PAD and IC were recruited from our database and answered a questionnaire by telephone involving the following questions: a) precautions related to COVID-19; b) general health status; and c) treatment of diseases. Subsequently, patients were divided into two groups according to difficulty in obtaining their drugs (DOD: difficulty obtaining drugs, or NDOD: no difficulty obtaining drugs) and overall health was compared between groups. Results: Seventeen percent of patients reported difficulties with obtaining drugs during the pandemic. A higher proportion of these patients reported being sadder (56.5% vs. 24.8%, P < 0.01) and having more difficulty sleeping (56.5% vs. 24.8%, P < 0.01) than of the patients in the NDOD group (P <0.01). The groups did not differ in terms of impairment of walking capability, anxiety, stress, or depression (P> 0.05). Conclusions: A higher proportion of patients in the DOD group reported being sadder and having greater difficulty sleeping compared to the NDOD group during the COVID-19 pandemic

Physical activity practice during COVID-19 pandemic in patients with intermittent claudication

OBJECTIVE: To describe physical activity habits and barriers for physical activity practice in patients with peripheral artery disease and claudication symptoms during Coronavirus 2019 (COVID-19) pandemic. METHODS: In this cross-sectional survey study, 127 patients with peripheral artery disease (59.8% men; 68±9 years old; and 81.9% had the peripheral artery disease diagnosis ≥5 years old) were included. The physical activity habits and barriers for physical activity practice were assessed through telephone interview using a questionnaire with questions related to: (a) COVID-19 personal care; (b) overall health; (c) physical activity habits; (d) for those who were inactive, the barriers for physical activity practice. RESULTS: Only 26.8% of patients reported practicing physical activity during the COVID-19 pandemic. Exercise characteristics more common among these patients include walking, performed at least 5 days a week, during 31–60 min at light intensity. In contrast, among physically inactive patients, pain, injury or disability (55%), the COVID-19 pandemic (50%), the need to rest due to leg pain (29%), and lack of energy (27%) were the most frequent barriers to physical activity practice. CONCLUSION: The physical activity level of patients with peripheral artery disease is impacted by the COVID-19 pandemic

Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women

ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease

Impact of the COVID-19 pandemic on health lifestyle in patients with peripheral artery disease: A cross-sectional study

Background: Social isolation has been one of the main strategies to prevent the spread of Coronavirus 2019 (COVID-19). However, the impact of social isolation on the lifestyle of patients with peripheral artery disease (PAD) and claudication symptoms remains unclear. Objectives: To analyze the perceptions of patients with PAD of the impact of social isolation provoked by COVID-19 pandemic on health lifestyle. Design: Cross-sectional. Setting: The database of studies developed by our group involving patients with PAD from public hospitals in São Paulo. Methods: In this cross-sectional survey study, 136 patients with PAD (61% men, 68 ± 9 years old, 0.55 ± 0.17 ankle-brachial index, 82.4% with a PAD diagnosis ≥5 years old) were included. Health lifestyle factors were assessed through a telephone interview using a questionnaire containing questions related to: (a) COVID-19 personal care; (b) mental health; (c) health risk habits; (d) eating behavior; (e) lifestyle; (f) physical activity; (g) overall health; and (h) peripheral artery disease health care. Results: The majority of patients self-reported spending more time watching TV and sitting during the COVID-19 pandemic and only 28.7% were practicing physical exercise. Anxiety and unhappiness were the most prevalent feelings self-reported among patients and 43.4% reported a decline in walking capacity. Conclusion: Most patients with PAD self-reported increased sedentary behavior, lower physical activity level, and worse physical and mental health during the COVID-19 pandemic. Thus, it is necessary to adopt strategies to improve the quality of life of these patients during this period

Acute and training effects of dynamic resistance exercise on ambulatory blood pressure: A systematic review and meta-analysis

Objective: This systematic review/meta-analysis aimed to verify the acute (24-hour) and training effects of resistance exercise on ambulatory blood pressure (ABP). Methods: PubMed, Web of Science, and Scielo databases were searched for crossover and/or controlled trials of resistance exercise in adults compared to a control group/condition, monitoring ABP. Mean differences (MDs) with 95% confidence intervals (95% CI) were calculated (p≤0.05 significant). Results: Twenty-four studies were included, 17 investigating acute (338 participants) and seven training effects (326 participants). Acutely we verified lower nighttime systolic BP in chronic disease (MD: -1.31; 95% CI: -2.27, -0.34; p=0.008), and lower daytime diastolic BP in healthy participants (MD: -0.77; 95% CI: -1.51, -0.03; p=0.040). Long-term effect revealed reductions in 24-hour systolic (MD: -4.00; 95% CI: -7.90, -0.09; p=0.050) and diastolic BP in chronic disease (MD: -1.34; 95% CI: -2.54, -0.14; p=0.03), and pooling groups (MD: -1.32; 95% CI: -2.29, -0.35; p=0.008). Meta-analysis revealed significant reductions in daytime systolic and diastolic BP in chronic disease (Systolic - MD: -5.63; 95% CI: -9.24, -2.03; p = 0.002; Diastolic - MD: -1.60; 95% CI: -2.77, -0.43; p=0.007) and pooling groups (Systolic - MD: -4.32; 95% CI: -7.09, -1.55; p=0.002; Diastolic - MD: -1.33; 95% CI: -2.31, -0.35; p=0.008). Conclusion: Resistance exercise acutely leads to lower nighttime systolic and daytime diastolic BP in healthy participants and chronic disease, while resistance training decreases 24-hour systolic and diastolic BP, daytime systolic and diastolic BP in chronic disease