Health and lifestyle parameters in peripheral artery disease at two periods of the COVID-19 pandemic: comparison between men and women

ABSTRACT Objective: This study analyzed the impact of sex on self-reported health and lifestyle parameters in peripheral artery disease patients at two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 patients with peripheral artery disease (53 men and 46 women) were evaluated during two periods of the COVID-19 pandemic ( i.e ., at onset: May to August 2020, and on follow-up: May to August 2021). Patients were interviewed via telephone, and information regarding lifestyle and health parameters was obtained. Results: At the onset of the COVID-19 pandemic, health and habit parameters were similar between women and men, with 63.0% and 45.3% indicating frequent fatigue, 73.9% and 84.9% reporting increased sitting time, and 23.9% and 39.6% practicing physical activity, respectively. At follow-up, difficulties in physical mobility (women: from 26.1% to 73.9%, p<0.001; men: from 39.6% to 71.7%, p=0.001) and the frequency of hospitalization for reasons other than COVID-19 increased similarly in women and men (women: from 4.3% to 21.7%, p=0.013; men: from 9.4% to 24.5%, p=0.038). The other parameters were similar between the periods. Conclusion: Self-reported physical mobility difficulties and hospitalization frequency increased in women and men with peripheral artery disease.

Impacto do câncer em pacientes com doença arterial periférica / Impact of cancer in patients with peripheral artery disease

Introdução e Objetivo: O impacto do câncer em pacientes com DAP sobre nível de atividade física diária, capacidade funcional, função cardiovascular e qualidade de vida ainda não é conhecido, sendo, portanto, o objetivo deste presente estudo. Métodos: Estudo transversal com 299 pacientes. Nível de Atividade física (acelerômetro), capacidade funcional (teste de caminhada de 6 minutos, Handgrip, Short Physical Performance Battery, Walking Impairment Questionnaire-WIQ e o Walking Estimated-Limitation Calculated by History), função cardiovascular (pressão arterial braquial, variabilidade da frequência cardíaca e rigidez arterial) e qualidade de vida (WHOQOL-bref) foram comparados entre os pacientes com DAP com e sem histórico de câncer. Resultados: Pacientes com DAP e câncer (N=27) apresentaram melhor desempenho no domínio da distância e da velocidade do WIQ (21±37 vs 14±26, p=0.036; 29±18 vs 22±15, p=0.022, respectivamente) comparado aos pacientes com DP sem câncer. Os outros parâmetros foram similares entre os grupos. Conclusão: Os pacientes com DAP e câncer apresentaram

Introduction and Objective: The impact of cancer in patients with PAD on the level of daily physical activity, functional capacity, cardiovascular function and quality of life is not yet known, thus being the objective of this present study. Methods: Cross-sectional study with 299 patients. Physical activity level (accelerometer), functional capacity (6-minute walk test, Handgrip, Short Physical Performance Battery, Walking Impairment Questionnaire-WIQ and the Walking Estimated-Limitation Calculated by History), cardiovascular function (brachial blood pressure, variability of heart rate and arterial stiffness) and quality of life (WHOQOL-bref) were compared between patients with PAD with and without a history of cancer. Results: Patients with PAD and cancer (N=27) performed better in the distance and speed domains of the WIQ (21±37 vs 14±26, p=0.036; 29±18 vs 22±15, p=0.022, respectively) compared to PD patients without cancer. The other parameters were similar between groups. Conclusion: Patients with PAD and cancer had better results for subjectively assessed functional capacity.

Association between mental health and sleep quality in peripheral artery disease patients: a longitudinal study / Associação entre saúde mental e qualidade do sono em pacientes com doença arterial periférica: estudo longitudinal

Objective: To analyze the longitudinal association between mental health and sleep quality in peripheral artery disease (PAD) patients in two periods of the COVID-19 pandemic. Methods: In this longitudinal study, 99 PAD patients were evaluated in two years of COVID-19 pandemic (2020 and 2021). Patients were interviewed by telephone call, and information regarding mental health (anxiety, unhappiness, stress and depression) and sleep quality (sleep change, difficulty to sleep and sleep improvement) were obtained. Patients were divided into: no symptoms (patients that reported no mental health symptoms, n=31, 68.2±9.4 y.o.) and one or more symptoms (patients with at least one mental health symptom, n=68, 68.1±9.4 y.o.). Results: In 2020, mental health symptoms were associated with sleep change (OR=5.018; p=0.020), difficulty to sleep (OR=12.250; p=0.003) and sleep improvement (OR=0.104; p=0.003). In 2021, mental health was associated only with sleep change (OR=3.522; p=0.035). Conclusion: The impact of mental health symptoms on sleep quality of PAD patients was attenuated along the coronavirus pandemic.

Objetivo: Analisar a associação longitudinal entre saúde mental e qualidade do sono em pacientes com doença arterial periférica (DAP) em dois períodos da pandemia de COVID-19. Métodos: Neste estudo longitudinal, 99 pacientes com DAP foram avaliados em dois anos de pandemia de COVID-19 (2020 e 2021). Os pacientes foram entrevistados por telefone, obtendo-se informações sobre saúde mental (ansiedade, infelicidade, estresse e depressão) e qualidade do sono (alteração do sono, dificuldade para dormir e melhora do sono). Os pacientes foram divididos em: sem sintomas (pacientes que não relataram sintomas de saúde mental, n=31, 68,2±9,4 anos) e um ou mais sintomas (com pelo menos um sintoma de saúde mental, n=68, 68,1±9,4 anos). Resultados: Em 2020, os sintomas de saúde mental foram associados à alteração do sono (OR=5,018; p=0,020), dificuldade para dormir (OR=12,250; p=0,003) e melhora do sono (OR=0,104; p=0,003). Em 2021, a saúde mental esteve associada apenas à alteração do sono (OR=3,522; p=0,035). Conclusão: O impacto dos sintomas de saúde mental na qualidade do sono de pacientes com DAP foi atenuado durante a pandemia de coronavírus.

Effects of isometric handgrip training on blood pressure among hypertensive patients seen within public primary healthcare: a randomized controlled trial

ABSTRACT BACKGROUND: Meta-analyses have demonstrated that isometric handgrip training (IHT) decreases blood pressure in hypertensive individuals. Nonetheless, most studies were conducted in laboratory settings and its effects in real-world settings remain unclear. OBJECTIVE: To analyze the effects of IHT on office and ambulatory blood pressure in hypertensive patients attended within primary healthcare. DESIGN AND SETTING: Randomized controlled trial conducted in primary healthcare units within the Family Health Program, Petrolina, Pernambuco, Brazil. METHODS: 63 hypertensive patients (30-79 years old; 70% female) were randomly allocated into IHT or control groups. IHT was performed three times per week (4 x 2 minutes at 30% of maximal voluntary contraction, one-minute rest between bouts, alternating the hands). Before and after the 12-week training period, office and ambulatory blood pressure and heart rate variability were obtained. The significance level was set at P < 0.05 (two-tailed testing) for all analyses. RESULTS: IHT significantly decreased office systolic blood pressure (IHT: 129 ± 4 versus 121 ± 3 mmHg, P < 0.05; control: 126 ± 4 versus 126 ± 3 mmHg, P > 0.05), whereas there was no effect on diastolic blood pressure (IHT: 83 ± 3 versus 79 ± 2 mmHg, P > 0.05; control: 81 ± 3 versus 77 ± 3 mmHg, P > 0.05). Heart rate variability and ambulatory blood pressure were not altered by the interventions (P > 0.05 for all). CONCLUSION: IHT reduced office systolic blood pressure in hypertensive patients attended within primary care. However, there were effects regarding diastolic blood pressure, ambulatory blood pressure or heart rate variability. CLINICALTRIALS.GOV IDENTIFIER: NCT03216317.

Isometric handgrip training does not improve quality of life in hypertensives / Treinamento isométrico com handgrip não melhora qualidade de vida em hipertensos

Hypertensive patients have high blood pressure and poor cardiovascular health and it is known that hypertension negatively affects people's health-related quality of life. Meta-analyses have shown that isometric handgrip training (IHT) reduces blood pressure in hypertensives, but the effects of IHT on health-related quality of life is unknown. Therefore, we tested the hypotheses that the IHT improves health-related quality of life in hypertensives. In this randomized controlled trial, 48 hypertensive individuals were randomly assigned to two groups: IHT and control. IHT was completed thrice weekly (4 × 2 min at 30% of maximal voluntary contraction). Before and after 12 weeks healthrelated quality of life was assessment through Medical Outcomes Study Questionnaire Short Form 36 (SF36). No significant effect was observed for physical function (IHT: 85.6±4.6 vs. 81.1±7.2; Control: 78.6±76.7±4.9), physical problems (IHT: 71.4±10.1vs. 83.9±8.1; Control: 73.8±8.2 vs. 64.3±8.0), general health (IHT: 56.1±3.7 vs. 57.1±1.9; Control: 54.3±1.6 vs. 57.6±2.1), pain (IHT: 23.6±4.6 vs. 30.7±5.8; Control: 32.9±4.5 vs. 31.9±4.3), social aspects (IHT: 46.4±3.6 vs. 50.0±2.3; Control: 48.8±2.7 vs. 48.8±1.7), emotional problems (IHT: 85.7±8.4 vs. 92.9±5.2; Control: 79.4±7.8 vs. 71.4±6.6), mental health (IHT: 61.7±2.8 vs. 58.0±2.5; Control: 54.5±2.4 ± 55.6±1.9), and vitality (IHT: 60.0±4.3 vs. 58.6±4.0; Control: 50.7±2.9 vs. 53.6±3.0) after 12-weeks of supervised IHT (p>0.05 for all). In conclusion, 12-weeks of IHT does not improve health-related quality of life in hypertensives. Therefore, in order to improve quality of life, other exercises should be an indicated for hypertensive patients...(AU)

Pacientes hipertensos têm pressão arterial elevada e saúde cardiovascular prejudicada, e, sabese que a hipertensão também afeta negativamente a qualidade de vida relacionada a saúde. Meta-análises têm demonstrado que o treinamento de exercício isométrico com handgrip (IHT) reduz pressão arterial, mas os efeitos do IHT na qualidade de vida relacionada a saúde são esconhecidos. Portanto, foi testado a hipótese que o IHT melhora a qualidade de vida relacionada a saúde em hipertensos. Nesse ensaio clínico controlado randomizado, 48 hipertensos foram randomizados em IHT e controle. IHT foi realizado três vezes semanais (4 x 2 minutos a 30% da contração voluntária máxima). Antes e após 12 semanas, a qualidade de vida relacionada a saúde foi avaliada pelo Medical Outcomes Study Questionnaire Short Form 36. Nenhum efeito significante foi observado para função física (IHT: 85,6±4,6 vs. 81,1±7,2; Controle: 78,6±76,7±4,9), problemas físicos (IHT: 71,4±10,1 vs. 83,9±8,1; Controle: 73,8±8,2 vs. 64,3±8,0), estado geral de saúde (IHT: 56,1±3,7 vs. 57,1±1,9; Controle: 54,3±1,6 vs. 57,6±2,1), dor (IHT: 23,6±4,6 vs. 30,7±5,8; Controle: 32,9±4,5 vs. 31,9±4,3), aspectos sociais (IHT: 46,4±3,6 vs. 50,0±2,3; Controle: 48,8±2,7 vs. 48,8±1,7), problemas emocionais (IHT: 85,7±8,4 vs. 92,9±5,2; Controle: 79,4±7,8 vs. 71,4±6,6), saúde mental (IHT: 61,7±2,8 vs. 58,0±2,5; Controle: 54,5±2,4 ± 55,6±1,9), e vitalidade (IHT: 60,0±4,3 vs. 58,6±4,0; Controle: 50,7±2,9 vs. 53,6±3,0) após 12 semanas de IHT (p>0.05 para todos). Em conclusão, 12 semanas de IHT não melhora a qualidade de vida relacionada a saúde em hipertensos. Portanto, para melhorar a qualidade de vida, outras modalidades de exercício deveriam ser indicadas para pacientes hipertensos...(AU)