Efeito de uma sessão de beach tennis sobre variabilidade de pressão arterial de curto prazo em indivíduos com hipertensão : um ensaio clínico randomizado cruzado

Introdução: A variabilidade da pressão arterial (PA) é um importante fator de risco cardiovascular, independentemente dos valores médios de PA. Diferentes modalidades de atividade física, em especial os esportes recreativos, tem ganhado importância no cenário clínico como estratégia não-farmacológica para prevenção e tratamento da hipertensão. No entanto, o benefício dos esportes recreativos sobre a variabilidade da PA permanece desconhecido. Objetivo: Avaliar o efeito de uma sessão de beach tennis sobre a variabilidade de PA de curto prazo em indivíduos com hipertensão. Métodos: Trata-se de um ensaio clínico randomizado cruzado, no qual 24 indivíduos hipertensos (12 homens e 12 mulheres, média de idade de 48 anos) foram randomizados em ordem aleatória (1:1) a duas sessões experimentais: sessão beach tennis (BT) e sessão controle, sem exercício (Con). BT iniciou com aquecimento padronizado de 5-min, composto por exercícios técnicos da modalidade, seguido de 3 minijogos com duração de 12-min e intervalos de 2-min entre eles. Durante Con, os participantes permaneceram em repouso sentado. Ambas as intervenções tiveram duração de 45-min. PA e frequência cardíaca foram aferidas no consultório, imediatamente após cada um dos sets em BT e nos intervalos de tempo equivalentes em C (15-min), e no período de recuperação, em intervalos de 15-min por 45-min, após finalizar as intervenções. A variabilidade de curto prazo da PA sistólica e diastólica foi calculada através da variabilidade real média (VRM) nos períodos diurno, noturno e 24 horas. Para estimar a demanda cardiovascular de BT, o duplo produto foi calculado através das medidas de PA e frequência cardíaca registradas durante as sessões experimentais e durante o monitoramento ambulatorial. Resultados: Reduções significativas foram observadas após a sessão BT na variabilidade de PA, expressa pela VRM diastólica no período de 24 horas (Δ -0.9 ± 0.4; p = 0.049) e no período diurno (-1.4 ± 0.5; p = 0.004), quando comparado a sessão Con. Não foram observadas reduções significativas na VRM sistólica durante a monitorização ambulatorial e diastólica durante o período noturno (p > 0,05). Durante a sessão BT, o duplo-produto (10331 ± 750; p < 0.001) permaneceu significativamente elevado, quando comparado a sessão Con. Durante o monitoramento ambulatorial, o duplo produto permaneceu em níveis semelhantes após a sessão BT, quando comparado com a sessão Con (8491 ± 297 vs. 8603 ± 270; p = 0,493). Conclusão: Uma sessão de BT reduz a variabilidade de curto prazo da PA diastólica pelo período de 24 horas e no período diurno em indivíduos com hipertensão

Effects of a single bout of power exercise training on ambulatory blood pressure in older adults with hypertension : a randomized controlled crossover study

Objective: To evaluate the effect of a single bout of power exercise training (PT) on office and ambulatory blood pressure (BP). Methods: Twenty-four older adults with essential hypertension participated in two experimental sessions in a randomized order: the PT composed of 3 sets of 8–10 repetitions in 5 power training exercises and the non- exercise control at seated rest (Con). Both experimental sessions lasted 40 min. Office BP was measured continuously for 1 h in the laboratory and 24 h BP through ambulatory blood pressure monitoring. Results: Compared with Con, office systolic/diastolic BP decreased after PT (Systolic BP: 10 mmHg, p<0.001; Diastolic BP: 4 mmHg, p=0.015). A trend toward decrease (p=0.06) was found in diastolic ambulatory BP during daytime (2 mmHg; p=0.062) and nighttime (3 mmHg; p=0.063) after PT. No differences were found between PT and Con sessions for systolic and mean ambulatory BP. Conclusion: A single bout of PT decreases office BP but this hypotensive effect is not sustained under ambulatory conditions in older patients with essential hypertension

Sex differences in post-exercise hypotension, ambulatory blood pressure variability, and endothelial function after a power training session in older adults

Background: The efficacy of power training (PT) to acutely reduce blood pressure (BP) in participants with hypertension is controversial, and no studies have assessed the influence of sex on post-exercise hypotension and its mechanisms in older adults. Purpose: The aims of this secondary, exploratory analysis were to compare the effects of a single bout of PT on post-exercise hypotension, BP variability, and endothelial function between older men and women with hypertension. Methods: Twenty-four participants with hypertension (12 men and 12 women aged to >60 years old) took part in this crossover study and randomly performed two experimental sessions: power exercise training (PT) and non-exercising control session (Con). The PT protocol was composed of 3 sets of 8–10 repetitions of five exercises performed in the following order: leg press, bench press, knee extension, upright row, and knee flexion, using an intensity corresponding to 50% of one repetition maximal test (1RM) and 2-min intervals between sets and exercises. The concentric phase of exercises during each repetition was performed “as fast as possible,” while the eccentric phase lasted 1 to 2 s. During Con, the participants remained at seated rest on the same exercise machines, but without any exercise. Each protocol lasted 40 min. Office BP, flow-mediated dilatation (FMD), 24-h ambulatory BP, and the average real variability (ARV) of systolic and diastolic BP were assessed before and after experimental sessions. Results: Comparing PT with Con, a reduced office BP after exercise was found in men (systolic BP—average post 1 h: −14 mmHg, p < 0.001; diastolic BP—average post 1 h: −8 mmHg, p < 0.001) and only a reduced systolic BP in women (average post 1 h: −7 mmHg, p = 0.04). Comparing men and women, a reduced systolic BP (post 60': −15 mmHg, p = 0.048; average post 1 h: −7 mmHg, p = 0.046) and diastolic BP (post 60': −9 mmHg, p = 0.049) after the first hour were found in men. In relation to 24-h ambulatory BP, ARV, and FMD, no statistically significant differences were found between men and women. Conclusion: In older adults with hypertension, the office BP response after the experimental sessions was different in men and women, showing that the PT protocol is more effective to acutely reduce BP in men. Additionally, the mechanisms behind this reduction remain unclear. This finding suggests that sex cannot be combined to analyze post-exercise hypotension

Effect of recreational beach tennis on ambulatory blood pressure and physical fitness in hypertensive individuals (BAH study) : rationale and study protocol

Background: Different physical activities are widely recommended as non-pharmacological therapies to reduce blood pressure. However, the effectiveness of exercise programs is associated with its continuity and regularity, and the long-term adherence to traditional exercise interventions is often low. Recreational sports emerge as an alternative, being more captivating and able to retain individuals for longer periods. Besides, sport interventions have demonstrated improvements in physical fitness components that are associated with a lower incidence of hypertension. However, no studies have investigated the effects of recreational sports on 24 h ambulatory blood pressure. The aim of the present study is to evaluate the effect of beach tennis training on ambulatory blood pressure and physical fitness in individuals with hypertension. Methods: This study will be a randomized, single-blinded, two-arm, parallel, and superiority trial. Forty-two participants aged 35–65 years with previous diagnosis of hypertension will be randomized to 12 weeks of beach tennis training group (two sessions per week lasting 45–60 min) or a non-exercising control group. Ambulatory (primary outcome) and office blood pressures, cardiorespiratory fitness, muscle strength/power and quality of life will be assessed at baseline and after the intervention period. Discussion: Our conceptual hypothesis is that beach tennis training will reduce ambulatory blood pressure and improve fitness parameters in middle-aged individuals with hypertension. The results of this trial are expected to provide evidences of efficacy of recreational beach tennis practice on blood pressure management and to support sport recommendations for clinical scenario in higher risk populations

Effects of combined training performed two or four times per week on 24-h blood pressure, glycosylated hemoglobin and other health-related outcomes in aging individuals with hypertension : rationale and study protocol of a randomized clinical trial

Background: Acute blood pressure lowering after exercise seems to predict the extent of blood pressure reduction after chronic exercise training interventions. Based on that, the same weekly amount of exercise performed more frequently could be more beneficial for controlling blood pressure. Purpose: To compare the effects of a combined training program (resistance plus aerobic exercise) performed four or two times per week on 24-h ambulatory blood pressure and other healthrelated outcomes in middle-aged and older individuals with hypertension. Methods: This study will be a randomized, parallel group, two-arm, superiority trial. Ninety-eight participants aged 50–80 years with a previous physician diagnosis of hypertension will be randomized to perform two or four sessions per week of combined training using the same total weekly overload. Primary outcomes will be 24-h ambulatory blood pressure and glycosylated hemoglobin; secondary outcomes will be endothelial function, physical fitness and quality of life. The outcomes will be assessed at baseline and at the end of 12 weeks period. Results: Our conceptual hypothesis is that a combined exercise program performed four or two times per week with equalized weekly volume/overload will improve all outcomes in comparison to the baseline values, and that reductions in 24-h blood pressure and glycosylated hemoglobin will be more pronounced in the group that trained four times a week than twice. The results of this trial are expected to provide evidences to support that higher weekly frequency of combined training should be emphasized in aging adults with hypertension