Cardiovascular risk factors in military personnel of the brazilian airforce at Alcântara (MA)

Objective: To investigate the frequency of cardiovascular risk factors in military personnel of the Brazilian Air Force in Alcântara, Brazil. Methods: A retrospective cross-sectional study was conducted with clinical records of 240 active military personnel from the Medical and Statistical Archives Service and nutritional assessment from the Nutrition Subsection Sector. The modifiable (diabetes mellitus - DM, systemic arterial hypertension - SAH, generalized obesity, abdominal obesity, hypercholesterolemia, hypertriglyceridemia, sedentarism, smoking, and alcoholism) and non-modifiable (gender and age) cardiovascular risk factors, anthropometric data, and cardiovascular diseases (CVD) were extracted. Descriptive statistics and chi-square test was applied (a=5%). Results: The sample was predominantly male (55.8%) and with a mean age of 33 (±8.4) years. The most prevalent risk factors were overweight (43.8%), abdominal obesity (42.9%), generalized obesity (21.3%), alcoholism (34.6%), and sedentary lifestyle (31.3%). Regarding the distribution of cardiovascular risk factors in relation to gender, a significant association was found with SAH, sedentarism, abdominal obesity and nutritional status (p=0.004, p=0.027, p=0.040 and p=0.018, respectively). For the sample studied, 2.7% had CVD. Conclusions: The predominant cardiovascular risk factors were overweight, abdominal obesity, generalized obesity, alcoholism and sedentary lifestyle. In men, hypertension and overweight were predominant, and in women, sedentarism and abdominal obesity.Objetivo: investigar a frequência de fatores de risco cardiovascular em  militares da Força Aérea Brasileira em Alcântara, Brasil. Metodologia: estudo transversal retrospectivo foi realizado            com registros clínicos de 240 militares ativos e oriundos de prontuários do Serviço de Arquivo Médico         e Estatístico, e de avaliação nutricional do Setor de Subseção de Nutrição. Foram extraídos os fatores de risco cardiovascular modificáveis (diabetes mellitus - DM, hipertensão arterial sistêmica - HAS, obesidade geral, obesidade abdominal, hipercolesterolemia, hipertrigliceridemia, sedentarismo, tabagismo e etilismo) e não modificáveis (sexo e idade), dados antropométricos e de doenças cardiovasculares (DCV). Estatística descritiva e teste qui-quadrado foi aplicado (a=5%). Resultados: a amostra foi predominantemente de homens (55,8%) e com média de idade de 33 (±8,4) anos. Os fatores de risco  mais prevalentes foram sobrepeso (43,8%), obesidade abdominal (42,9%), obesidade geral (21,3%), etilismo (34,6%) e   sedentarismo (31,3%). Quanto a distribuição dos fatores de risco cardiovascular em relação ao gênero, foi constatada  associação significativa com HAS, sedentarismo, obesidade abdominal e estado nutricional (p=0,004, p=0,027, p=0,040 e p=0,018, respectivamente). Para a amostra, 2,7% apresentavam DCV. Conclusão: os fatores de risco cardiovascular predominantes foram sobrepeso, obesidade abdominal, obesidade geral, etilismo e sedentarismo. Nos homens foi  predominante a hipertensão e o excesso de peso e nas mulheres, o sendentarismo e a obesidade abdominal

Dynamic resistance training improves cardiac autonomic modulation and oxidative stress parameters in chronic stroke survivors : a randomized controlled trial

Stroke survivors are at substantial risk of recurrent cerebrovascular event or cardiovascular disease. Exercise training offers nonpharmacological treatment for these subjects; however, the execution of the traditional exercise protocols and adherence is constantly pointed out as obstacles. Based on these premises, the present study investigated the impact of an 8-week dynamic resistance training protocol with elastic bands on functional, hemodynamic, and cardiac autonomic modulation, oxidative stress markers, and plasma nitrite concentration in stroke survivors. Twenty-two patients with stroke were randomized into control group (CG, n=11) or training group (TG, n=11). Cardiac autonomic modulation, oxidative stress markers, plasma nitrite concentration, physical function and hemodynamic parameters were evaluated before and after 8 weeks. Results indicated that functional parameters (standing up from the sitting position (P=0.011) and timed up and go (P=0.042)) were significantly improved in TG. Although not statistically different, both systolic blood pressure (Delta=-10.41 mmHg) and diastolic blood pressure (Delta=-8.16 mmHg) were reduced in TG when compared to CG. Additionally, cardiac autonomic modulation (sympathovagal balance-LF/HF ratio) and superoxide dismutase were improved, while thiobarbituric acid reactive substances and carbonyl levels were reduced in TG when compared to the CG subjects. In conclusion, our findings support the hypothesis that dynamic resistance training with elastic bands may improve physical function, hemodynamic parameters, autonomic modulation, and oxidative stress markers in stroke survivors. These positive changes would be associated with a reduced risk of a recurrent stroke or cardiac event in these subjects2019CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQCOORDENAÇÃO DE APERFEIÇOAMENTO DE PESSOAL DE NÍVEL SUPERIOR - CAPESFUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESPnão temnão tem2017/21320-

Autonomic dysfunction in COVID-19 patients receiving mechanical ventilation: A cross-sectional study

ABSTRACT BACKGROUND: Coronavirus disease 2019 (COVID-19) can damage cardiac tissue by increasing troponin levels and inducing arrhythmias, myocarditis, and acute coronary syndrome. OBJECTIVES: To analyze the impact of COVID-19 on cardiac autonomic control in mechanically ventilated intensive care unit (ICU) patients. DESIGN AND SETTING: This cross-sectional analytical study of ICU patients of both sexes receiving mechanical ventilation was conducted in a tertiary hospital. METHODS: Patients were divided into COVID-19-positive (COVID(+)) and COVID-19-negative (COVID(-)) groups. Clinical data were collected and heart rate variability (HRV) records obtained using a heart rate monitor. RESULTS: The study sample comprised 82 subjects: 36 (44%) in the COVID(-) group (58.3% female; median age, 64.5 years) and 46 (56%) in the COVID(+) group (39.1% females; median age, 57.5 years). The HRV indices were lower than the reference values. An intergroup comparison identified no statistically significant differences in the mean normal-to-normal (NN) interval, standard deviation of the NN interval, or root mean square of successive differences in NN intervals. The COVID(+) group had an increased low frequency (P = 0.05), reduced high frequency (P = 0.045), and increased low frequency/high frequency (LF/HF) ratio (P = 0.048). There was a weak positive correlation between LF/HF and length of stay in the COVID(+) group. CONCLUSION: Patients who received mechanical ventilation had lower overall HRV indices. COVID(+) patients who received mechanical ventilation had lower vagal HRV components. These findings likely indicate clinical applicability, as autonomic control impairments are associated with a greater risk of cardiac death

Effects of dynamic resistance training on functional, autonomic parameters and of oxidative stress in stroke survivors

Orientadores: Bruno Rodrigues, Marco Carlos UchidaTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Educação FísicaResumo: O objetivo do presente estudo foi avaliar os efeitos do treinamento resistido sobre parametros funcionais, hemodinamicos, autonomicos e de estresse oxidativo em sobreviventes ao acidente vascular cerebral (AVC). Vinte e dois sobreviventes ao AVC foram randomizados em Grupo Controle (GC) (n = 11) e Grupo Treinamento Resistido Dinamico (GTRD) (n = 11). Parametros funcionais, hemodinamicos, autonomicos e de estresse oxidativo (marcadores pro-oxidantes, antioxidantes, concentracao plasmatica de nitrito) foram avaliados antes e apos 10 semanas. GTRD realizou protocolo de treinamento resistido dinamico utilizando bandas elasticas 2 vezes por semana com intervalo de descanso de 48 horas entre cada sessao por 10 semanas. GC realizou os mesmos exercicios propostos para o GTRD, com 2 series de 6 a 8 repeticoes com frequencia de 1 sessao de treinamento a cada 2 semanas por 10 semanas. Para o GTRD, quando comparado os momentos pre e pos treinamento, foi possivel observar melhoras significativas para os testes de Caminhada de 10 metros (p=0,000; ¿¢ = -38,3%), Levantar-se da Posicao Sentada (p=0,000; ¿¢=-30,6%) e Time Up and Go (p=0,000; -23,0%). Por outro lado, para o GC ocorreu perda significativa de Forca de Preensao Palmar de Membro Paretico (p=0,017; ¿¢=-24,0%) e Forca de Preensao Palmar de Membro nao Paretico (p=0,016; ¿¢=-16,8%). Quando os grupos foram comparados, o GTRD apresentou melhor desempenho nos testes Time Up and Go (p= 0,042) e Levantar-se da Posicao Sentada (p=0,011) em comparacao ao GC. Alem disso, apos 10 semanas, foram demonstradas diferencas importantes a favor do GTRD quando comparado com GC sobre [Pressao arterial sistolica (¿¢= -10,41 mmHg) e Pressao arterial diastolica (¿¢= -8,16 mmHg)]. Houve tambem melhora do duplo produto (p = 0,011, ¿¢ = -13,1%), e nos parametros autonomicos [(SDNN (p = 0,000, ¿¢ = 39,3%), rMSSD (p = 0,014, ¿¢ = 30%) , SD1 (p = 0,014, ¿¢ = 30,4%), SD2 (p = 0,002, ¿¢ = 27,3%), Baixa Frequencia (nu) (p = 0,004, ¿¢ = -29,9%), Alta Frequencia (nu) (p = 0,003, ¿¢ = 57,0%) e Baixa Frequencia / Alta Frequencia (p = 0,004, ¿¢ = -1,56%;) quando comparados os grupos apos 10 semanas. Por outro lado, o GC demonstrou Baixa Frequencia (nu) elevado (p = 0,006, ¿¢ = 36,7%) e Alta Frequencia (nu) reduzido (p = 0,006, ¿¢ = -42,6%). Em relacao aos marcadores de estresse oxidativo, quando comparados os momentos pre e pos, foram observadas alteracoes positivas para os marcadores superoxido dismutase (p=0,003; ¿¢=9,0%) (antioxidante) e carbonilas (p=0,000; ¿¢=-32,6%) (pro-oxidante) no GC. Para o GTRD, quando comparados os momentos pre e pos, foram demonstradas alteracoes positivas sobre o marcador antioxidante superoxido dismutase (p=0,000; ¿¢=19,5%) e no marcador pro-oxidante carbonila (p=0,000; ¿¢=-30,5%). Foram observadas alteracoes positivas sobre a concentracao plasmatica de nitrito para GC (..=-1,2) e para o GTRD (..=-1,3). Apos 10 semanas de treinamento resistido dinamico foi possivel observar melhora sobre os parametros funcionais e autonomicos, alem de possiveis alteracoes positivas nos marcadores de estresse oxidativo e na concentracao plasmatica de nitrito em sobreviventes ao AVC isquemico cronicoAbstract: The present study aimed at investigating the effects of resistance training on functional, hemodynamic, autonomic and of oxidative stress in stroke survivors. Twenty-two stroke survivors were randomized into control group (CG) (n=11) and dynamic resistance training group (DRTG) (n=11). Functional parameters, hemodynamic, autonomic and of oxidative stress were evaluated before and after 10 weeks. DRTG performed dynamic resistance training protocol using elastic bands 2 times per week with a rest interval of 48 hours between each session for 10 weeks. CG performed the same exercises proposed for the dynamic resistance training group, with 2 sets of 6 to 8 repetitions,1 training session frequency every 2 weeks for 10 weeks. DRTG improved 10-meter walking speed (p=0.0001, ¿¢=-38.3%), sit-to-stand (p=0.0001, ¿¢=-30.6%), and Timed Up and Go tests (p=0.0001, ¿¢= -23.0%). On the other hand, a significant reduction in isometric handgrip of the paretic limb (p=0.017, ¿¢= -24.0%) and isometric handgrip of the non-paretic limb (p=0.016, ¿¢=-16.8%) was observed in CG. When the groups were compared, DRTG showed a better performance on Timed Up and Go (p=0.042) and sit-to-stand (P=0.011) tests in comparison to CG. Additionally, DP was significantly reduced in TG (P=0.011, ¿¢=-13.1%; ..=-1.4), when compared to the CG after 10 weeks. There was also improvement of the double product (p=0.011, ¿¢=-13.1%), and in the autonomic parameters [(SDNN (p=0.000, ¿¢=39.3%), rMSSD (p=0.014, ¿¢= 30%), SD1 (p=0.014, ¿¢= 30.4%), SD2 (p=0.002, ¿¢= 27.3%), LF (nu) (p=0.004, ¿¢= -29.9%), HF (nu) (p=0.003, ¿¢= 57.0%), and LH/HF (p=0.004, ¿¢= -1.56%;) in comparison to baseline for the GTRD when compared to the CG. On the other hand, CG demonstrated elevated LF (nu) (p=0.006, ¿¢= 36.7%) and reduced HF (nu) (p=0.006, ¿¢= -42.6%). In relation to the markers of oxidative stress, when comparing the pre and post moments, positive changes were observed for the marker superoxide dismutase (p=0.003, ¿¢= 9.0%) and carbonyls (p=0.000, ¿¢=32.6%) (pro-oxidant) in GC. For the GTRD, when the pre and post moments were compared, positive changes were observed on the antioxidant marker superoxide dismutase (p=0.000, ¿¢=19.5%) and on the pro-oxidant carbonyl marker (p=0.000, ¿¢=-30, 5%). Positive changes were observed in plasma nitrite concentration for GC (..=-1.2) and for GTRD (..=-1.3). After 10 weeks of dynamic resistance training it was possible to observe improvement on the functional and autonomic parameters, as well as possible positive changes in the markers of oxidative stress and in the plasma nitrite concentration of stroke survivorsDoutoradoAtividade Fisica AdaptadaDoutor em Educação Física140708/2016-2CNP

Exercise training on cardiovascular diseases: Role of animal models in the elucidation of the mechanisms

Abstract Cardiovascular diseases, which include hypertension, coronary artery disease/myocardial infarction and heart failure, are one of the major causes of disability and death worldwide. On the other hand, physical exercise acts in the preventionand treatment of these conditions. In fact, several experiments performed in human beings have demonstrated the efficiency of physical exercise to alter clinical signals observed in these diseases, such as high blood pressure and exercise intolerance. However, even if human studies demonstrated the clinical efficiency of physical exercise, most extensive mechanisms responsible for this phenomenon still have to be elucidated. In this sense, studies using animal models seem to be a good option to demonstrate such mechanisms. Therefore, the aims of the present study are describing the main pathophysiological characteristics of the animal models used in the study of cardiovascular diseases, as well as the main mechanismsassociated with the benefits of physical exercise

Inflammatory mechanisms associated with skeletal muscle sequelae after stroke: role of physical exercise

Inflammatory markers are increased systematically and locally (e.g., skeletal muscle) in stroke patients. Besides being associated with cardiovascular risk factors, proinflammatory cytokines seem to play a key role in muscle atrophy by regulating the pathways involved in this condition. As such, they may cause severe decrease in muscle strength and power, as well as impairment in cardiorespiratory fitness. On the other hand, physical exercise (PE) has been widely suggested as a powerful tool for treating stroke patients, since PE is able to regenerate, even if partially, physical and cognitive functions. However, the mechanisms underlying the beneficial effects of physical exercise in poststroke patients remain poorly understood. Thus, in this study we analyze the candidate mechanisms associated with muscle atrophy in stroke patients, as well as the modulatory effect of inflammation in this condition. Later, we suggest the two strongest anti-inflammatory candidate mechanisms, myokines and the cholinergic anti-inflammatory pathway, which may be activated by physical exercise and may contribute to a decrease in proinflammatory markers of poststroke patients2016CONSELHO NACIONAL DE DESENVOLVIMENTO CIENTÍFICO E TECNOLÓGICO - CNPQsem informaçã

Inflammatory Mechanisms Associated with Skeletal Muscle Sequelae after Stroke: Role of Physical Exercise

Inflammatory markers are increased systematically and locally (e.g., skeletal muscle) in stroke patients. Besides being associated with cardiovascular risk factors, proinflammatory cytokines seem to play a key role in muscle atrophy by regulating the pathways involved in this condition. As such, they may cause severe decrease in muscle strength and power, as well as impairment in cardiorespiratory fitness. On the other hand, physical exercise (PE) has been widely suggested as a powerful tool for treating stroke patients, since PE is able to regenerate, even if partially, physical and cognitive functions. However, the mechanisms underlying the beneficial effects of physical exercise in poststroke patients remain poorly understood. Thus, in this study we analyze the candidate mechanisms associated with muscle atrophy in stroke patients, as well as the modulatory effect of inflammation in this condition. Later, we suggest the two strongest anti-inflammatory candidate mechanisms, myokines and the cholinergic anti-inflammatory pathway, which may be activated by physical exercise and may contribute to a decrease in proinflammatory markers of poststroke patients

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Aim. The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH). Methods. Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session. Results. Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises. Conclusion. Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension