BACKGROUND: Physical exercise promotion is one of the main global goals of innumerous health and medical societies for preventing and managing noncommunicable chronic diseases (NCDs), being one of the main therapeutic for the patient with hypertension. Exercise in heated swimming pool has emerged as a potential alternative to physical exercise on the ground for the reduction of blood pressure (BP) of hypertensive patients, however, its effects on BP, as well as hemodynamic, metabolic, inflammatory and functional variables of older individuals with hypertension have not been investigated. PURPOSE: To evaluate the effects of heated water-based exercise (HEx) versus land-based exercise (LEx) on BP, arterial stiffness, endothelial function, metabolic, inflammatory and functional variables of older individuals with hypertension. METHODS: 60 older individuals (male and female) with hypertension (age \> 60 years) will be randomized in 2:2:1 ratio to HEx, LEx or control (CON) intervention. The feasibility and physiological adaptations (physical capacity, musculoskeletal and cardiovascular responses to stress, biological and biochemical markers associated with the pathophysiology of the disease and vascular adaptations) will be assessed before, after 12 weeks and after 24 weeks of follow-up. HEx and LEx training programs will be performed three times per week and will be performed for the firs 12 weeks of follow-up.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
SUPPORTIVE_CARE
Masking
SINGLE
Enrollment
60
Warm Up - 5 minutes of stretching and heating of the joints and muscle groups to be worked; Aerobic exercise - 30 minutes of aerobic exercise (following the same control parameter of the experimental session); Resistance exercises - 20 minutes of resisted exercises, which will be divided into 6 exercises with 2 sets of 10 to 15 repetitions (following the same control parameter of the experimental session); Calm back - 5 minutes of stretching.
Warm up - 5 minutes of stretching and heating of the joints and muscle groups to be worked; Aerobic exercise - 30 minutes of aerobic exercise performed on treadmill and / or exercise bike (following the same control parameter of the experimental session); Endurance Exercises - 20 minutes of exercises resisted, also divided into 6 exercises with 2 sets of 10 to 15 repetitions. The large muscle groups of the upper limbs, lower limbs and trunk will be exercised in fitness machine and with free weights (following the same control parameter of the experimental session); Calm back - 5 minutes of stretching.
Guidance to maintain the usual level of physical activity and not to enter physical exercise programs during the 12 weeks of follow-up.
Universidade Estadual Paulista Julio de Mesquita Filho
Bauru, São Paulo, Brazil
RECRUITINGBlood pressure change
24-hour systolic and diastolic ambulatory blood pressure change from baseline
Time frame: baseline, 3 month and 6 month
Arterial stiffness
Carotid-femoral pulse wave velocity change from baseline
Time frame: baseline, 3 month and 6 month
Brachial artery flow-mediated dilation (FMD)
Change from baseline in brachial artery flow-mediated dilation (FMD) (%), calculated as: (peak diameter - baseline diameter) / baseline diameter × 100, measured via ultrasound (SonoSite M-Turbo™) after 5-minute artery occlusion.
Time frame: baseline, 3 month and 6 month
Maximal oxygen consumption
Change from baseline of maximal oxygen consumption during a progressive cardiopulmonary exercise testing
Time frame: baseline, 3 month and 6 month
First ventilatory threshold (anaerobic threshold)
Change from baseline in the first ventilatory threshold (anaerobic threshold) will be measured by the V-slope method during a progressive cardiopulmonary exercise testing.
Time frame: baseline, 3 month and 6 month
Change from baseline in the second ventilatory threshold (respiratory compensation point)
Change from baseline in the second ventilatory threshold (respiratory compensation point) will be determined determined as the point at which a rapid rise in ventilation/carbon dioxide output, and a fall in partial pressure of carbon dioxide output during a progressive cardiopulmonary exercise testing.
Time frame: baseline, 3 month and 6 month
Exercise tolerance
Change from baseline of exercie duration (minutes) during a progressive cardiopulmonary exercise testing
Time frame: baseline, 3 month and 6 month
Handgrip strength
Change from baseline of maximum isometric strength measured during handgrip strength testing (dynamometry)
Time frame: baseline, 3 month and 6 month
Flexibility
Change from baseline of the seat-and-reach test performance
Time frame: baseline, 3 month and 6 month
Lower-limb strength
Change from baseline of the five time sit-to stand performance
Time frame: baseline, 3 month and 6 month
Agility and balance
Change from baseline of the timed-up and go test performance
Time frame: baseline, 3 month and 6 month
Endurance performance
Six-minute walking test performance change from baseline
Time frame: baseline, 3 month and 6 month
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