Different classes of antihypertensives may have different responses when associated with exercise. Thus, this study aims to compare the responses of the association of 12 weeks of aerobic exercise and weightlifting with different classes of medications in 45 postmenopausal hypertensive women.
Cardiovascular diseases are the leading causes of death and postmenopausal women. Physical exercise, in turn, is a strategy to reduce cardiovascular stress, by decreasing the blood pressure (BP) at rest and several risk factors associated with sedentary lifestyle, thus improving the quality and life expectancy of these women. However, different classes of antihypertensives may have different responses when associated with exercise. Thus, this study aims to compare the responses of the association of 12 weeks of aerobic exercise and weightlifting with different classes of medications in 45 postmenopausal hypertensive women. The volunteers will do cardiovascular and biochemistry evaluations before and after the intervention.
Study Type
INTERVENTIONAL
Allocation
NON_RANDOMIZED
Purpose
PREVENTION
Masking
NONE
Enrollment
30
The program consisted of 36 sessions of combined aerobic and resistance exercises training during 12 consecutive weeks. Each session lasted 60 minutes and consisted of 30 minutes of resistance exercise and 30 minutes of aerobic exercise. The resistance training was performed in two sets of 8 to 12 repetitions in five exercises of weight training (Based on 1 repetition maximum test - 1RM). The aerobic exercise was performed on a treadmill, at a speed of 5.5 km/h and intensity (imposed by treadmill inclination and heart rate) between 65 and 75% of maximun heart rate measured in maximum incremental test. Every week the resistance load and aerobic intensity was readjusted by determined training zone (8 to 12 maximum repetitions) and heart rate predicted in the incremental respectively.
Guilherme Morais Puga
Uberlândia, Minas Gerais, Brazil
Changes in Ambulatorial Blood Pressure
All volunteers were submitted to a 24-hour Blood Pressure (BP; systolic and diastolic measurements) assessment by Ambulatorial Blood Pressure Monitoring (ABPM) before and after 10 weeks of combined exercise training, with a minimum of 48 hours after the last training session. A device was used associated with a diary of examination to self-report of activities of daily living (sleep, work, food) or any event that could interfere abnormally with BP or device measurements. The device was always placed 7am and the measurements were made every 15 minutes from 7h to 23h and every 30 minutes from 23h to 7h. The monitoring was considered valid when it happened for a period of 24 hours. The following results were evaluated: systolic blood pressure; diastolic blood pressure, mean blood pressure and heart rate in awake, sleep and 24-hour periods. Before the use ABPM during daily activities, resting blood pressure were measured using the same equipment after 15 min of rest in siting position.
Time frame: Before and within 72 hours after 12 weeks of exercise training
Changes in Ambulatorial Blood Pressure Variability
Based on Ambulatorial Blood Pressure data, were calculated Blood Pressure Variability by: 24-hour standard deviation weighted by the time interval between consecutive readings; the mean diurnal and nocturnal deviations weighted for the duration of the daytime and nighttime interval; the average real variability weighted for the time interval between consecutive readings; the ambulatory arterial stiffness index calculated by the slope of the trend curve of the dispersion of pressure data; the morning surge that represents the dynamic daytime variation in morning pressure that tends to increase, being assessed from the point of least pressure during sleep in relation to the first two hours after waking; and nocturnal dipping, that represents the average percentage drop of sleep pressure in relation to wakefulness, and individuals with falls of 10% or more are considered dippers and below that are considered nom-dippers.
Time frame: Before and within 72 hours after 12 weeks of exercise training
Changes in Heart Rate Variability
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Heart Rate (HR) was recorded using a heart rate monitor in a beat-by-beat basis. HR was registered in a seat position for 20 min of rest. Prior to the HR Variability (HRV) analysis, the RR intervals (RRi) were visually inspected and filtered using a moving average filter. The HRV was analyzed in both time-, frequency- and nonlinear-domain. Being that for frequency-domain analysis, firstly the RRi series were interpolated at 4 Hz and then the signal linear trend component removal was performed using the smooth priors approach.
Time frame: Before and within 72 hours after 12 weeks of exercise training
Changes in salivary oxidative stress
The salivary was collected after 12-hours fasting and the total antioxidant capacity was evaluated using the Ferric-Ability of Plasma (FRAP) methodology and calculated from the standard trolox curve. The activity of the enzyme superoxide dismutase (SOD) was determined based on the auto oxidation capacity of pyrogallol and catalase activity (CAT) by monitoring the consumption of hydrogen peroxide at 240 nm. Lipid peroxidation levels were determined by the TBARS method (thiobarbituric acid reactive substances), using as standard a curve of 1,1,3,3-tetraethoxypropane (TMP). The total protein concentration was obtained using bovine serum albumin (BSA) as standard. The amounts of nitric oxide (NO) were estimated by the determination of total nitrite by the Griess colorimetric method.
Time frame: Before and within 72 hours after 12 weeks of exercise training
Changes of blood pressure reactivity
To evaluate reactivity of blood pressure under mental stress, the Stroop protocol will be used. The test consists of a video on a computer screen facing the volunteer that changes the image every 2 seconds. Then the volunteers should speak as quickly as possible the color of the letters present on the screen, and in each image there is dissonance between the background color, the color of the letters and the word formed (which is always the name of another color). Each minute of the test the blood pressure (systolic and diastolic) will be measured by auscultatory method. To evaluate the reactivity of blood pressure under physical stress will be used the Cold pressor test. The test consists of immersing the volunteers' right hand for 1 minute in water maintained at 4ºC. Blood pressure is then assessed in the left arm after 30 and 60 seconds of immersion and after 2 minutes after the end of immersion in water. The blood pressure measurements will be done by auscultatory method.
Time frame: Before and within 72 hours after 12 weeks of exercise training
Changes of Biochemical markers on blood
Venous blood samples will be collected with 12 hours of fasting. After local asepsis, 10 ml of blood will be obtained at each collection through the puncture of the ulnar or radial ulnar vein, using a syringe and disposable needles. The blood samples will be deposited in test tubes containing ethylenediamine tetraacetic acid (EDTA) and dried tubes with separator gel for collection of serum. The samples will then be centrifuged at 2000 rpm for 15 minutes to separate plasma and serum aliquots and stored at -80 ° C for further biochemical analysis. Thus, the samples will be analyzed in the following variables: Lipid Profile, Superoxide Dismutase (SOD), Catalase (CAT), Thiobarbituric Acid (TBARS), Nitrite/nitrate (NOx-), Interleukin-6 (IL-6), Interleukin-10 IL-10), Interleukin-1 beta (IL-1b), Tumor Necrosis Factor alpha (TNFa), Creatine Kinase (CK), C-reactive protein (P-CR) and Adiponectin.
Time frame: Before and within 72 hours after 12 weeks of exercise training