Physical activity and medication in the control of blood pressure: secondary analysis of the Brazilian national health research / Atividade física e medicação no controle da pressão sanguínea: análise secundária da pesquisa nacional de saúde

AIM: To test the effectiveness of different physical activities (PA) in controlling blood pressure. The dependent variable was controlled and uncontrolled blood pressure (BP). METHODS: This is a secondary analysis of a cross-sectional, observational, descriptive and analytical study from the Brazilian National Health Research (PNS) database. The PNS was conducted by the Brazilian Institute of Geography and Statistics (IBGE) in 2013, in partnership with the Ministry of Health. Total PA was calculated in minutes per week (MPS) with the sum of 3 activities, physical exercise, time spent walking to work, and heavy work activity. Sociodemographic variables and the use of hypertension medications were analyzed as possible associated factors. RESULTS: The chances of having controlled BP were calculated by logistic regression. Among the 10199 participants aged 40 years and older, who reported hypertension, 5398 (53%) had controlled BP, being higher among the women (56%), within the age range of 40-59 years-old (56%), and on medication for hypertension (54%). The controlled-BP group performed 64 ± 146.1 MPW of PA while the uncontrolled-BP spent 46 ± 150.7 MPW in PA (p < 0.001). Work activity was also higher among the controlled-BP group (p = 0.019). Participants who performed total PA between 90-149 MPW had 21% higher odds of controlled-BP (p = 0.024) and those who performed 150 MPW or more, 22% (p = 0.001). Medication increased the chance of BP control by 18% (p = 0.003). The odds of having controlled-BP were higher in physical exercise: 42% on 90-149 MPW (p = 0.001) and 40% on 150 MPW or more (p < 0.001). CONCLUSION: Physical exercise was significantly associated with better BP control than just total PA. Both exercise and total physical activity were significantly associated with better BP control than medication.

OBJETIVO: Testar a efetividade de diferentes atividades físicas (AF) no controle da pressão arterial. A variável dependente foi a pressão arterial (PA) controlada e não controlada. MÉTODOS: Trata-se de uma análise secundária de um estudo transversal, observacional, descritivo e analítico de um banco de dados da Pesquisa Nacional de Saúde (PNS). A PNS foi conduzida pelo Instituto Brasileiro de Geografia e Estatística (IBGE), no ano de 2013, em parceria com o Ministério da Saúde. A AF total foi calculada em minutos por semana (MPS) com a soma de três atividades, exercício físico, tempo gasto na caminhada para o trabalho e atividade laboral pesada. As variáveis sociodemográficas e o uso de medicamentos para hipertensão foram analisados como possíveis fatores associados. RESULTADOS: As chances de controlar a PA foram calculadas por regressão logística. Entre os 10.199 participantes, com 40 anos ou mais, que relatam hipertensão, 5.398 (53%) controlavam a PA, sendo maior entre as mulheres (56%), com idade entre 40 e 59 anos (56%) e em uso de medicamentos para hipertensão (54%). O grupo PA controlado realizou 64 ± 146,1 MPS de AF, enquanto o PA não controlado passou 46 ± 150,7 MPS em AF (p < 0,001). A atividade laboral também foi maior no grupo PA controlado (p = 0,019). Os participantes que executaram AF total entre 90-149 MPS tiveram chances 21% mais altas de pressão controlada (p = 0,024) e 150 MPS ou mais, essa probabilidade foi de 22% (p = 0,001). A medicação aumentou a chance de controle da PA em 18% (p = 0,003). As chances de ter PA controlada foram maiores no exercício físico: 42%, em 90-149 MPS (p = 0,001) e 40% em 150 MPS ou mais (p < 0,001). CONCLUSÃO: O exercício físico esteve significativamente associado a um melhor controle da PA do que somente a prática de AF total. Tanto o exercício físico quanto a atividade física total mostraram-se significativamente associados a um melhor controle da PA do que a medicação.

Physical activity level and hypoglycemia in type 1 diabetes patients

Introduction: The recommended management for individuals with type 1 diabetes (T1D) includes an intensive treatment with insulin therapy and the practice of regular exercise. However, this association is related with hypoglycemia episodes. Objective: The aim of this study was to perform a cross-sectional evaluation of the association between the physical activity (PA) level and hypoglycemia episodes reported in patients with T1D. Methods: Adult outpatients with T1D had their PA level assessed by the International Physical Activity Questionnaire (long form), considering the intensity of the physical activity (vigorous, moderate and/or walks) in daily activities, such as at work, means of transport, domestic activities and at leisure, and answered questions about self-care and hypoglycemia episodes. Results: The study included 126 patients who presented the following characteristics: mean age of 35 (28-47) years old and 16 (11-24) years of diabetes duration, 55% women, HbA1c=9.3 ± 2.1%, and body mass index = 25.0 ± 4.2 kg/m2 . Very active patients had lower values of glucose and LDL-cholesterol when compared with the less active group. A greater proportion of active (48.1%) and very active patients (66.7%) reported practicing exercise regularly when compared with the less active subjects (13.3%; P=0.003). Less active patients had a three-fold chance of reporting hypoglycemia episodes when compared with very active patients (OR=3.49; CI 95%: 1.26-9.70; P=0.016). Conclusions: Less active adults with T1D presented more hypoglycemia, probably due to the practice of informal moderate and/or vigorous activities without specific self-care.