Non-Targeted Self-Measured Blood Pressure and Hypertension Control in Public and Private Health Systems in Brazil

Abstract Background: It is estimated that more than 30% of the Brazilian population has systemic arterial hypertension (SAH), and mostly as an uncontrolled disease. The most recent Brazilian Guideline of Hypertension recommends the practice of self-measurement of blood pressure (BP) as one of the strategies for a better control of SAH, but there is no consensus about the efficiency of this tool. Objective: To assess the control of SAH and the practice of non-targeted self-measured BP (SMBP) among hypertensive users of the Unified Health System (SUS) and the Supplementary Network (SN). Methods: This is a cross-sectional, observational, analytical study, with a stratified probability sample. One thousand volunteers were investigated, being 500 from SUS and 500 from the SN. Uni and multivariate analyses were performed considering a 5% significance level. Results: Patients from SUS presented inferior sociodemographic data (schooling, social status) in relation to those of the SN (p < 0.001), and showed lower control of SAH (p = 0.014), as well as more visits to the emergency room in the past year due to hypertension (p = 0.002), and fewer regular appointments with the cardiologist (p = 0.004). SMBP was equally present in both assessed groups (p = 0.567), even though users of the SN have been more advised to not conduct such a practice (p = 0.002). SMBP (p < 0.001) was an independent factor for uncontrolled SAH both in SUS (OR = 3.424) and in the SN (OR = 3.474). Conclusion: Patients in SUS presented lower SAH control. The practice of SMBP, mostly practiced with an uncalibrated digital device, was equally present in both groups and became an independent factor of uncontrolled SAH.

Changes in body composition of Wistar rats: effects of high-intensity interval training

The present study aimed to investigate the effectiveness of high-intensity interval training (HIIT) in the body composition of Wistar rats. The HIIT protocol consisted of high-intensity swimming three times a week for four weeks. There were no differences between groups as to the Lee index. However, the weights of the perigonadal (p=0.001) and retroperitoneal (p=0.026) fats were significantly different between the Control Group (CG, n=10) vs. Trained Group (TG, n=10), respectively. There was also a significant increase in the body weight of the animals in TG (16.43%) and CG (7.19%) at the end of the experiment. These findings suggested that HIIT was not sufficient to improve significantly the body composition of rats.

Short-term hiit does not promote oxidative stress or muscle damage / Hiit de corto plazo no promueve estrés oxidativo o daños musculares / Hiit de curto prazo não promove estresse oxidativo ou danos musculares

ABSTRACT Introduction: High intensity interval training (HIIT) is a method that is widely used today. Objective: The present study aimed to evaluate the effects of HIIT on markers of oxidative stress and muscle damage in rats. Methods: The sample consisted of 60-day-old Wistar rats, divided into two groups: a control group (n=8) and an HIIT group (n=8). The training consisted of fourteen 20-second swimming sessions (loaded with weights equivalent to 14% of their body weight) with 10-second intervals between each session, performed for 12 consecutive days. Results: HIIT induced a reduction (−17.75%) in thiobarbituric acid reactive substances (an oxidative stress marker) in hepatic tissue (p=0.0482). There was also a reduction (−31.80%) in the HIIT group in the level of superoxide dismutase enzyme activity in the liver (p=0.0375). However, there were no differences between the groups in catalase, glutathione peroxidase, glutathione reductase, the total content of SH sulfhydryls, hydroperoxides, or carbonylated proteins in the hepatic tissue. No significant differences were found in any of these markers in the gastrocnemius muscle. The muscle damage markers creatinine kinase and lactate dehydrogenase were also similar between the groups in the gastrocnemius. Conclusion: The conclusion was that that short-term HIIT does not cause oxidative stress or muscle damage. Level of evidence I; High-quality randomized clinical trial with or without statistically significant difference, but with narrow confidence intervals.

RESUMEN Introducción: El entrenamiento en intervalos de alta intensidad (HIIT) es un método muy utilizado actualmente. Objetivo: El presente estudio tuvo como objetivo evaluar los efectos del HIIT en corto plazo sobre marcadores de estrés oxidativo y daño muscular en ratones. Métodos: La muestra consistió en ratones Wistar con 60 días de edad, divididos en dos grupos: grupo control (n = 8) y grupo HIIT (n = 8). El entrenamiento consistió en catorce sesiones de natación de 20 segundos (con cargas equivalentes a 14% del peso corporal) con intervalos de 10 segundos entre cada sesión, realizadas durante 12 días consecutivos. Resultados: El HIIT indujo una reducción (-17,75%) de las sustancias reactivas al ácido tiobarbitúrico (un marcador de estrés oxidativo) en el tejido hepático (p = 0,0482). También hubo reducción (~31,80%) en el grupo HIIT en el nivel de enzima superóxido dismutasa en el hígado (p=0,0375). Sin embargo, no hubo diferencias entre los grupos con relación a catalasa, glutatión peroxidasa, glutatión reductasa, tenor total de sulfhidrilos SH, hidroperóxidos o proteínas carboniladas en el tejido hepático. No fue encontrada ninguna diferencia significativa en ninguno de esos marcadores en el músculo gastrocnemio. Los marcadores de lesión muscular, creatinina quinasa y lactato deshidrogenasa también fueron similares entre los grupos en el gastrocnemio. Conclusión: Fue posible concluir que el HIIT de corta duración no causa estrés oxidativo o daño muscular. Nivel de evidencia I; Estudio clínico aleatorizado de alta calidad con o sin diferencia estadísticamente significativa, pero con intervalos de información estrechos.

RESUMO Introdução: O treinamento intervalado de alta intensidade (HIIT) é um método muito utilizado atualmente. Objetivo: O presente estudo objetivou avaliar os efeitos do HIIT em curto prazo sobre marcadores de estresse oxidativo e dano muscular em ratos. Métodos: A amostra consistiu em ratos Wistar com 60 dias de idade, divididos em dois grupos: grupo controle (n = 8) e grupo HIIT (n = 8). O treinamento consistiu em quatorze sessões de natação de 20 segundos (com cargas equivalentes a 14% do peso corporal) com intervalos de 10 segundos entre cada sessão, realizadas por 12 dias consecutivos. Resultados: O HIIT induziu uma redução (-17,75%) das substâncias reativas ao ácido tiobarbitúrico (um marcador de estresse oxidativo) no tecido hepático (p = 0,0482). Houve também redução (-31,80%) no grupo HIIT no nível de enzima superóxido dismutase no fígado (p = 0,0375). No entanto, não houve diferenças entre os grupos com relação a catalase, glutationa peroxidase, glutationa redutase, teor total de sulfidrilas SH, hidroperóxidos ou proteínas carboniladas no tecido hepático. Nenhuma diferença significativa foi encontrada em qualquer um desses mascadores no músculo gastrocnêmio. Os marcadores de lesão muscular, creatinina quinase e lactato desidrogenase, também foram semelhantes entre os grupos no gastrocnêmio. Conclusão: Foi possível concluir que o HIIT de curta duração não causa estresse oxidativo ou dano muscular. Nível de evidência I; Estudo clínico randomizado de alta qualidade com ou sem diferença estatisticamente significante, mas com intervalos de informação estreitos.

The stretch-shortening cycle efficiency is dependent on the maturational stage / A eficiência do ciclo alongamento-encurtamento é dependente do estágio maturacional

Abstract Maturation interferes with physiological and mechanical aspects of muscle contraction. The aim of the present study was to compare the efficiency of the stretch-shortening cycle (SSC) between different maturation stages. One hundred forty six young people, with 72 boys and 74 girls, were recruited to participate in the study. Sexual maturation was measured and the group was stratified into adolescents (> 3 auto-tanner) and children (<2 auto-tanner). Squat jump (SJ) and countermovement jump (CMJ) performance were measured to measure reactive force (RF) capacity, eccentric utilization ratio (EUR) and pre-stretch augmentation (PSAP). The children did not present statistical difference between SJ and CMJ (t(55)= -1.93; ∆ = -0.61; 95% CI = -1.24 to -0.02; p = 0.058), while the adolescents presented higher performance of CMJ (t(89)= -12.28; ∆ = -2.44; 95% CI = -2.84 to -2.05; p <0.001). In addition, adolescents had higher RF performance (t(144)= 5.18; p <0.0001; 95% CI = 2.53 to 1.13), PSAP (t(144)= 4.38; p <0.0001; 95% CI = 14.00 to 5.29) and EUR (t(144)= 4.38; p <0.0001; 95% CI = 0.14 to 0.05). We conclude that more mature young people have better SSC utilization.

Resumo Maturação interfere em aspectos fisiológicos e mecânicos da contração muscular. O objetivo do estudo foi comparar a eficiência do ciclo alongamento-encurtamento (SSC) em diferentes estágios maturacionais. Cento e quarenta e seis jovens, sendo 72 meninos e 74 meninas, foram recrutados para participar do estudo. Maturação sexual foi mensurada e o grupo foi estratificado em adolescentes (≥ 3 e crianças (< estágio 2). Salto estático (SJ) e o salto contramovimento (CMJ) foram utilizados para mensurar a força reativa (RF), razão de utilização da excêntrica (EUR) e aumento do pré-estiramento (PSAP). As crianças não apresentaram diferença significante entre SJ e CMJ (t(55)= -1.93; ∆ = -0.61; 95% CI = -1.24 to -0.02; p = 0.058), Enquanto que os adolescentes apresentaram maior desempenho de CMJ (t(89)= -12.28; ∆ = -2.44; 95% CI = -2.84 to -2.05; p <0.001). Em adição, adolescentes apresentaram maior RF (t(144)= 5.18; p <0.0001; 95% CI = 2.53 to 1.13), PSAP (t(144)= 4.38; p <0.0001; 95% CI = 14.00 to 5.29) e EUR (t(144)= 4.38; p <0.0001; 95% CI = 0.14 to 0.05). Nós concluímos que jovens com mais maturados apresentam maior capacidade de utilização do SSC.