ABSTRACT
Ao se recomendar atividade física e esporte, o médico deve considerar as característica da atividade proposta, associada ao tipo de valvopatia e sua gravidade. Uma das formas de se classificar esporte,atividade física é pelo tipo de exercício e pela intensidade empregados em sua prática. Assim, os exercícios podem ser classificados em dinâmicos e estáticos leves, moderados e intensos. A avaliação da doença valvar, por outro lado, inicia-se pelo diagnóstico, com anamnese, exame físico e exames complementares, acrescentada pela estratificação de gravidade que leva em conta parâmetros anatômicos e funcionais das valvas, alterações anatômicas do coração e presença de síntomas, principalemnte dispnéia aos esforços. Dessa forma, baseado no diagnóstico tanto anatômico como funcional da valvopatia, e com a caracterização da gravidade, o médico pode recomendar atividade física e/ou esporte de forma individualizada para o paciente.
Subject(s)
Male , Female , Humans , Motor Activity/physiology , Mitral Valve Stenosis/etiology , Exercise/physiologyABSTRACT
OBJECTIVE: To assess the prevalence of white-coat normortension, white-coat hypertension, and white-coat effect. METHODS: We assessed 670 medical records of patients from the League of Hypertension of the Hospital das Clínicas of the Medical School of the University of Säo Paulo. White-coat hypertension (blood pressure at the medical office: mean of 3 measurements with the oscillometric device ³140 or ³90 mmHg, or both, and ambulatory blood pressure monitoring mean during wakefulness < 135/85) and white-coat normotension (office blood pressure < 140/90 and blood pressure during wakefulness on ambulatory blood pressure monitoring ³ 135/85) were analyzed in 183 patients taking no medication. The white-coat effect (difference between office and ambulatory blood pressure > 20 mmHg for systolic and 10 mmHg for diastolic) was analyzed in 487 patients on treatment, 374 of whom underwent multivariate analysis to identify the variables that better explain the white-coat effect. RESULTS: Prevalence of white-coat normotension was 12 percent, prevalence of white-coat hypertension was 20 percent, and prevalence of the white-coat effect was 27 percent. A significant correlation (p<0.05) was observed between white-coat hypertension and familial history of hypertension, and between the white-coat effect and sex, severity of the office diastolic blood pressure, and thickness of left ventricular posterior wall. CONCLUSION: White-coat hypertension, white-coat normotension, and white-coat effect should be considered in the diagnosis of hypertension