Intervención educativa realizada por enfermeros para el control de la presión arterial: revisión sistemática con metaanálisis / Educational intervention performed by nurses for blood pressure control: a systematic review with meta-analysis / Intervenção educativa realizada por enfermeiros para controle da pressão arterial: revisão sistemática com metanálise

Objetivo: evaluar el efecto de la intervención educativa que realizan los enfermeros para controlar la presión arterial en personas con hipertensión arterial, en comparación con los cuidados habituales. Método: revisión sistemática con metaanálisis de ensayos clínicos aleatorizados realizada en seis bases de datos. Se incluyeron estudios en los cuales el enfermero llevó a cabo la intervención educativa en la persona con hipertensión arterial. El riesgo de sesgo se evaluó mediante la herramienta Risk of Bias Tool, el metaanálisis se hizo utilizando el software Review Manager y la certeza de la evidencia se calculó usando el sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: se encontraron 1692 estudios revisados por pares y se incluyeron ocho artículos en el metaanálisis. El metaanálisis se calculó para el resultado presión arterial sistólica y presión arterial diastólica, subagrupados por tiempo y tipo de implementación de la intervención. Para la intervención educativa presencial, realizada d forma individual combinada con actividad grupal, la estimativa del efecto fue -12,41 mmHg (Intervalo de Confianza 95%, -16,91 a -7,91, p<0,00001) para la presión sistólica y -5,40 mmHg (Intervalo 95% Confianza, -7,98 a -2,82, p<0,0001) para la presión diastólica, con certeza de evidencia alta. Conclusión: a intervención educativa realizada por el enfermero, de forma individual combinada con la actividad grupal, tiene efecto clínico y estadísticamente significativo. Registro PROSPERO: CRD42021282707.

Objetivo: to assess the effect of an educational intervention performed by nurses for blood pressure control in people with arterial hypertension, when compared to usual care. Método: a systematic review with meta-analysis of randomized clinical trials, conducted in six databases. The studies included were those in which an educational intervention was performed by nurses on people with arterial hypertension. The risk of bias was assessed by means of the Risk of Bias Tool, the meta-analysis was performed in the Review Manager software and certainty of the evidence was calculated in the Grading of Recommendations Assessment, Development and Evaluation system. Resultados: a total of 1,692 studies were found, which were peer-reviewed, including eight of them in the meta-analysis. The meta-analysis was calculated for the "systolic blood pressure" and diastolic blood pressure" outcomes, in subgroups by time and by intervention performance type. For the in-person educational intervention, performed individually combined with a group activity, the effect estimate was -12.41 mmHg (95% Confidence Interval: from -16.91 to -7.91, p<0,00001) for systolic pressure and -5.40 mmHg (95% Confidence Interval: from -7.98 to -2.82, p<0,00001) for diastolic pressure, with high certainty of evidence. Conclusión: the educational intervention performed by nurses, individually and combined with a group activity, presents a statistically significant clinical effect. PROSPERO registration No.: CRD42021282707.

Objetivo: avaliar o efeito da intervenção educativa realizada por enfermeiros para controle da pressão arterial em pessoas com hipertensão arterial, comparada com cuidado habitual. Método: revisão sistemática com metanálise de ensaios clínicos randomizados realizada em seis bases de dados. Foram incluídos estudos em que a intervenção educativa foi realizada pelo enfermeiro à pessoa com hipertensão arterial. O risco de viés foi avaliado pela Risk of Bias Tool, a metanálise no software Review Manager e a certeza da evidência no sistema Grading of Recommendations Assessment, Development and Evaluation. Resultados: foram encontrados 1692 estudos, revisados por pares, e oito artigos foram incluídos na metanálise. A metanálise foi calculada para o desfecho pressão arterial sistólica e pressão arterial diastólica, em subgrupo por tempo e por tipo de execução da intervenção. Para a intervenção educativa presencial, realizada de modo individual combinada com atividade de grupo, a estimativa de efeito foi de -12.41 mmHg (Intervalo de Confiança 95%, -16.91 a -7.91, p<0.00001) para pressão arterial sistólica e -5.40 mmHg (Intervalo de Confiança 95%, -7.98 a -2.82, p<0.0001) para pressão arterial diastólica, com certeza da evidência alta. Conclusão: a intervenção educativa realizada pelo enfermeiro, de modo individual combinada com atividade de grupo, apresenta efeito clínico e estatisticamente significativo. Registro PROSPERO: CRD42021282707.

The distribution of blood pressure and associated factors of the elderly with type 2 diabetes in Jiangsu Province / 中华预防医学杂志

Objective: To investigate the distribution of blood pressure and analyze the associated factors of blood pressure of the elderly with type 2 diabetes in Jiangsu Province. Methods: The elderly over 60 years old participants with type 2 diabetes in the communities of Huai'an City and Changshu City, Jiangsu Province were selected in this study. They were divided into two groups: taking antihypertensive drugs and not taking antihypertensive drugs. The demographic characteristics, such as age and sex, and relevant factors were collected by questionnaire. The systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured by physical examination. The percentile of SBP and DBP in each age group of men and women were described. The kernel density estimation curve was used to show the blood pressure distribution. The trend of blood pressure with age was fitted by locally weighted regression. The logistic regression model was used to analyze relevant factors of blood pressure. Results: A total of 12 949 participants were included in this study, including 7 775 patients in the antihypertensive drug group and 5 174 patients in the group without antihypertensive drugs. The SBP of participants was concentrated at 140-160 mmHg, and their DBP was concentrated at 75-85 mmHg. There were significant differences in the distribution of blood pressure among the subgroups of body mass index (BMI) and rural areas whether taking antihypertensive drugs and not. For participants aged under 80 years old, the SBP showed an increasing trend with age and the DBP showed a decreasing trend with age. Age, BMI ≥24 kg/m2, fasting blood glucose ≥7.0 mmol/L, living in rural areas and no smoking were influencing factors of the elevated SBP; BMI ≥24 kg/m2, male, living in rural areas, no smoking, drinking alcohol and not receiving drug hypoglycemic treatment were influencing factors of the elevated DBP. Conclusion: The SBP of older diabetic adults in Jiangsu Province is at a high level, and the distribution of blood pressure is significantly different between men and women in taking antihypertensive drugs group. The SBP presents a rising trend and the DBP is decreasing at the age of 60-80 years. The blood pressure level of this population are mainly affected by age, BMI, urban and rural areas, smoking.

A non-contact continuous blood pressure measurement method based on video stream / 生物医学工程学杂志

Hypertension is the primary disease that endangers human health. A convenient and accurate blood pressure measurement method can help to prevent the hypertension. This paper proposed a continuous blood pressure measurement method based on facial video signal. Firstly, color distortion filtering and independent component analysis were used to extract the video pulse wave of the region of interest in the facial video signal, and the multi-dimensional feature extraction of the pulse wave was preformed based on the time-frequency domain and physiological principles; Secondly, an integrated feature selection method was designed to extract the universal optimal feature subset; After that, we compared the single person blood pressure measurement models established by Elman neural network based on particle swarm optimization, support vector machine (SVM) and deep belief network; Finally, we used SVM algorithm to build a general blood pressure prediction model, which was compared and evaluated with the real blood pressure value. The experimental results showed that the blood pressure measurement results based on facial video were in good agreement with the standard blood pressure values. Comparing the estimated blood pressure from the video with standard blood pressure value, the mean absolute error (MAE) of systolic blood pressure was 4.9 mm Hg with a standard deviation (STD) of 5.9 mm Hg, and the MAE of diastolic blood pressure was 4.6 mm Hg with a STD of 5.0 mm Hg, which met the AAMI standards. The non-contact blood pressure measurement method based on video stream proposed in this paper can be used for blood pressure measurement.

Comparison between different exercises on the health and physical conditioning of the elderly / Comparação entre diferentes exercícios sobre a saúde e o condicionamento físico dos idosos / Comparación entre diferentes ejercicios sobre la salud y el acondicionamiento físico de los ancianos

ABSTRACT Introduction Research on scientific fitness exercises for the elderly has an important practical significance and can improve the physical fitness and health of the elderly. Chinese research on scientific conditioning exercises for the elderly is still lacking, especially when comparing results between different sports approaches in the elderly. Objective To study the effects of different types of exercise on the physical performance and health of the elderly. Methods 329 healthy elderly volunteers (161 men) with a mean age of 64.5 years from 6 different sports activities were selected. The following indicators of body shape and physical function were evaluated before and after training: height, weight, waist circumference, hip circumference, vital capacity, heart rate, systolic blood pressure, and diastolic blood pressure. All indicators were collected following the standardized methods of China's national fitness monitoring system. Exercise intensity was monitored with the subject's target heart rate. Physical exercises were performed for 30 to 40 minutes, 3 to 4 times a week. Results The type of physical exercise has a significant association with human performance and health. Conclusion Exercise and fitness programs positively correlate with human performance and health. Evidence level II; Therapeutic Studies - Investigating the results.

RESUMO Introdução A pesquisa sobre exercícios de aptidão científica para idosos tem um importante significado prático, podendo melhorar a aptidão física e a saúde dos idosos. Atualmente, a pesquisa chinesa sobre exercícios de condicionamento científico para idosos ainda é deficiente, principalmente ao comparar resultados entre diferentes abordagens esportivas nos idosos. Objetivo Estudar os efeitos de diferentes tipos de exercícios no desempenho físico e na saúde dos idosos. Métodos 329 idosos voluntários saudáveis (161 homens) com idade média de 64,5 anos, de 6 diferentes atividades esportivas foram selecionados. Os seguintes indicadores de forma corporal e função física foram avaliados antes e após os treinos: altura, peso, circunferência da cintura, circunferência do quadril, capacidade vital, frequência cardíaca, pressão arterial sistólica e pressão arterial diastólica. Todos os indicadores foram coletados seguindo os métodos padronizados do sistema nacional de monitoramento de condicionamento físico da China. A intensidade do exercício foi monitorada com a frequência cardíaca alvo do indivíduo. Os exercícios físicos foram executados entre 30 a 40 minutos, 3 a 4 vezes por semana. Resultados O tipo de exercício físico tem uma associação significativa com o desempenho humano e a saúde. Conclusão Os programas de exercícios e condicionamento físico têm uma correlação positiva com o desempenho humano e a saúde. Nível de evidência II; Estudos terapêuticos - Investigação de resultados.

RESUMEN Introducción La investigación sobre ejercicios científicos de acondicionamiento físico para ancianos tiene un significado práctico importante y puede mejorar la condición física y la salud de las personas mayores. Actualmente, aún falta investigación china sobre ejercicios de acondicionamiento científico para personas mayores, especialmente cuando se comparan los resultados entre diferentes enfoques deportivos en ancianos. Objetivo Estudiar los efectos de diferentes tipos de ejercicio sobre el rendimiento físico y la salud de los adultos mayores. Métodos Se seleccionaron 329 voluntarios adultos mayores sanos (161 hombres) con una edad media de 64,5 años, de 6 actividades deportivas diferentes. Se evaluaron los siguientes indicadores de forma corporal y función física antes y después del entrenamiento: altura, peso, circunferencia de la cintura, circunferencia de la cadera, capacidad vital, frecuencia cardíaca, presión arterial sistólica y presión arterial diastólica. Todos los indicadores se recopilaron siguiendo los métodos estandarizados del sistema nacional de seguimiento del estado físico de China. La intensidad del ejercicio se controló con la frecuencia cardíaca objetivo del sujeto. Los ejercicios físicos se realizaron durante 30 a 40 minutos, 3 a 4 veces por semana. Resultados El tipo de ejercicio físico tiene una asociación significativa con el rendimiento humano y la salud. Conclusión Los programas de ejercicio y acondicionamiento físico tienen una correlación positiva con el rendimiento y la salud humana. Nivel de evidencia II; Estudios terapéuticos - Investigación de resultados.

Oxygen use in Atacama large millimeter and submillimeter (ALMA) arrays in Chajnantor valley at 5050 m / Uso de oxígeno en Atacama large millimeter and submillimeter (ALMA) en el valle de Chajnantor a 5050 m

The Chilean workforce has over 200,000 people that are intermittently exposed to altitudes over 4000 m. In 2012, the Ministry of Health provided a technical guide for high altitude workers that included a series of actions to mitigate the effects of hypoxia. Previous studies have shown the positive effect of oxygen enrichment at high altitudes. The Atacama Large Millimeter / submillimeter Arrays (ALMA) radiotelescope operate at 5,050 m (Array Operation Site, AOS) and is the only place in the world where Pressure Swing Adsorption (PSA) and Liquid Oxygen technologies have been installed at a large scale. Here we discuss our experience using oxygen supplementation at ALMA, to prevent the malaise and/or risks associated with exposure at 5,050 m. Antenna operators experienced chronic intermittent hypobaric hypoxia (CIHH, shiftwork 8 days HA*6 days rest SL) over 4 years. Studies to define normal O2 saturation values were performed in OSF and AOS by continuous recording during the shift. The outcomes showed no differences between production procedures (PSA or Liquid oxygen) in regulating oxygen availability at AOS facilities. As a result, big-scale installations have difficulties reaching the appropriate oxygen concentration due to leaks in high mobility areas. In addition, the PSA plant requires adequation and maintenance to operate at a very high altitude.

La fuerza laboral chilena cuenta con más de 200.000 personas que están expuestas intermitentemente a altitudes superiores a los 4000 m. En 2012, el Ministerio de Salud entregó una guía técnica para trabajadores de altura que incluía una serie de acciones para mitigar los efectos de la hipoxia. Estudios anteriores han demostrado el efecto positivo del enriquecimiento de oxígeno en altitudes elevadas. El radiotelescopio Atacama Large Millimeter/submillimeter Arrays (ALMA) opera a 5.050 m (Array Operation Site, AOS) y es el único lugar en el mundo donde se han instalado tecnologías de adsorción por cambio de presión (PSA) y oxígeno líquido a gran escala. Aquí discutimos nuestra experiencia usando suplementos de oxígeno en ALMA, para prevenir el malestar y/o los riesgos asociados con la exposición a 5.050 m. Los operadores de antena experimentaron hipoxia hipobárica intermitente crónica (CIHH, trabajo por turnos 8 días HA*6 días descanso SL) durante 4 años. Se realizaron estudios para definir valores normales de saturación de O2 en OSF y AOS mediante registro continuo durante el turno. Los resultados no mostraron diferencias entre los procedimientos de producción (PSA u oxígeno líquido) en la regulación de la disponibilidad de oxígeno en las instalaciones de AOS. Como resultado, las instalaciones a gran escala tienen dificultades para alcanzar la concentración de oxígeno adecuada debido a fugas en áreas de alta movilidad. Además, la planta de PSA requiere de adecuación y mantenimiento para operar a gran altura.

Adaptation to university studies affects on functional state of freshmen

According to different researches, 30% of university graduates have a low level of health, and studying at university is one of the factors of its deterioration, besides the first year is considered critical. The purpose of research is to study the dynamics of physical development, physical fitness and functional state of young men during the first year of university studies. For the survey we used standard measurements and index calculations for 11 indicators of physical development, 9 indicators of physical fitness and 15 indicators of functional status. We calculated the arithmetic mean (M), the standard error of the mean (m), then evaluated differences by the Student criterion (t) for independent samples and considered them as reliable atр < 0.05. It is shown that during the first year of studies, young men have an increase in the Erismann index, the corpulence (Rohrer's) index, the body mass index and a decrease in the Pignet index. There is also an increase in the coefficient of endurance, adaptive capacity and diastolic pressure, while vital capacity of the lungs, the vital index, time of hanging on the bar and the speed of running 1000 m decrease. The dynamics of physical development is expressed in a change in mass-growth indices and indicates an increase in body weight. The dynamics of physical fitness is expressed in a decrease of the time of hanging on the bar and the speed of running 1000 m. The dynamics of the functional state is expressed in a decrease of vital capacity of the lungs, vital index, increase in the coefficient of endurance, adaptive capacity and diastolic blood pressure.

Miniature Non-invasive Blood Pressure Measurement and Verification System / 中国医疗器械杂志

Mercury sphygmomanometer based on traditional auscultation method is widely used in primary medical institutions in China, but a large amount of blood pressure data can not be directly recorded and applied in scientific research analysis, meanwhile auscultation data is the clinical standard to verify the accuracy of non-invasive electronic sphygmomanometer. Focusing on this, we designed a miniature non-invasive blood pressure measurement and verification system, which can assist doctors to record blood pressure data automatically during the process of auscultation. Through the data playback function,the software of this system can evaluate and verify the blood pressure algorithm of oscillographic method, and then continuously modify the algorithm to improve the measurement accuracy. This study introduces the hardware selection and software design process in detail. The test results show that the system meets the requirements of relevant standards and has a good application prospect.

Role of blood pressure on stroke-related mortality: a 45-year follow-up study in China / 中华医学杂志(英文版)

BACKGROUND@#Hypertension is associated with stroke-related mortality. However, the long-term association of blood pressure (BP) and the risk of stroke-related mortality and the influence path of BP on stroke-related death remain unknown. The current study aimed to estimate the long-term causal associations between BP and stroke-related mortality and the potential mediating and moderated mediating model of the associations.@*METHODS@#This is a 45-year follow-up cohort study and a total of 1696 subjects were enrolled in 1976 and 1081 participants died by the latest follow-up in 2020. COX proportional hazard model was used to explore the associations of stroke-related death with baseline systolic blood pressure (SBP)/diastolic blood pressure (DBP) categories and BP changes from 1976 to 1994. The mediating and moderated mediating effects were performed to detect the possible influencing path from BP to stroke-related deaths. E value was calculated in the sensitivity analysis.@*RESULTS@#Among 1696 participants, the average age was 44.38 ± 6.10 years, and 1124 were men (66.3%). After a 45-year follow-up, a total of 201 (11.9%) stroke-related deaths occurred. After the adjustment, the COX proportional hazard model showed that among the participants with SBP ≥ 160 mmHg or DBP ≥ 100 mmHg in 1976, the risk of stroke-related death increased by 217.5% (hazard ratio [HR] = 3.175, 95% confidence interval [CI]: 2.297-4.388), and the adjusted HRs were higher in male participants. Among the participants with hypertension in 1976 and 1994, the risk of stroke-related death increased by 110.4% (HR = 2.104, 95% CI: 1.632-2.713), and the adjusted HRs of the BP changes were higher in male participants. Body mass index (BMI) significantly mediated the association of SBP and stroke-related deaths and this mediating effect was moderated by gender.@*CONCLUSIONS@#In a 45-year follow-up, high BP and persistent hypertension are associated with stroke-related death, and these associations were even more pronounced in male participants. The paths of association are mediated by BMI and moderated by gender.

Quantitative analysis of the effect of contact pressure on the reflection characteristics of radial pressure wave / 生物医学工程学杂志

The radial artery pulse wave contains a wealth of physiological and pathological information about the human body, and non-invasive studies of the radial artery pulse wave can assess arterial vascular elasticity in different age groups.The piezoelectric pulse wave transducers were used to non-invasively acquire radial artery pulse waves at different contact pressures in young and middle-aged and elderly populations. The radial artery waveforms were decomposed using a triangular blood flow model fitting method to obtain forward and reflected waves and calculate reflection parameters. Finally a correlation analysis and regression analysis of the contact pressure Psensor with the reflection parameters was carried out. The results showed that the reflection parameters RM, RI and Rd had a strong negative correlation with Psensor in both types of subjects, and the correlation coefficients and slopes of the regression curves were significantly different between the two types of subjects (P<0.05). Based on the results of this study, excessive contact pressure on the transducer should be avoided when detecting radial artery reflection waves in clinical practice. The results also show that the magnitude of the slope of the regression curve between the reflection parameters and the transducer contact pressure may be a potentially useful indicator for quantifying the elastic properties of the vessel.

Improvement of cardiovascular function health level by regular sports / Melhoria do nível de saúde da função cardiovascular por meio de esportes regulares / Mejora del nivel de salud de la función cardiovascular mediante deportes regulares

ABSTRACT Introduction Regular physical activity helps improve cardiovascular and cerebrovascular skills. How to evaluate the nervous tension of the cardiovascular and cerebrovascular vessels through sports is a hot topic. Objective The paper discusses the influence of regular participation in sports on people's cardiovascular function and blood-related indicators. Methods We select 30 healthy older adults who regularly participate in sports, record their ECG changes, blood pressure, heart rate and other related cardiovascular function indicators, and analyze the blood function of the elderly. Detection of blood cell count (RBC), red blood cell volume (MCV) and hemoglobin (Hb), serum creatinine (Cr), blood glucose (BGS), triglycerides (TG), cholesterol (TC), low-density lipoprotein (LDL) and high-Density lipoprotein (HDL) is measured. Results Older adults who persist in exercise for a long time have better indicators than those who do not exercise. Conclusions Appropriate aerobic exercise can reduce the stiffness of blood vessels in the elderly. Exercise can help the elderly increase heart rate variability and improve the heart's autonomic nerve function's blood indicators, and body mass. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução A atividade física regular ajuda a melhorar as habilidades cardiovasculares e cerebrovasculares. Como avaliar a tensão nervosa dos vasos cardiovasculares e cerebrovasculares por meio de esportes é um assunto quente. Objetivo o artigo discute a influência da participação regular em esportes sobre a função cardiovascular das pessoas e indicadores relacionados ao sangue. Métodos Selecionamos 30 idosos saudáveis que participam regularmente de esportes, registramos suas alterações no ECG, pressão arterial, frequência cardíaca e outros indicadores relacionados à função cardiovascular e analisamos a função sanguínea dos idosos. Detecção de contagem de células sanguíneas (RBC), volume de glóbulos vermelhos (MCV) e hemoglobina (Hb), creatinina sérica (Cr), glicose no sangue (BGS), triglicerídeos (TG), colesterol (TC), lipoproteína de baixa densidade (LDL ) e a lipoproteína de alta densidade (HDL) é medida. Resultados Idosos que persistem por muito tempo nos exercícios têm melhores indicadores do que aqueles que não praticam. Conclusão O exercício aeróbio adequado pode reduzir a rigidez dos vasos sanguíneos em idosos. O exercício pode ajudar os idosos a aumentar a variabilidade da frequência cardíaca e melhorar os indicadores sanguíneos da função nervosa autonômica do coração e a massa corporal. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción La actividad física regular ayuda a mejorar las habilidades cardiovasculares y cerebrovasculares. Cómo evaluar la tensión nerviosa de los vasos cardiovasculares y cerebrovasculares a través del deporte es un tema candente. Objetivo El artículo analiza la influencia de la participación regular en deportes sobre la función cardiovascular de las personas y los indicadores relacionados con la sangre. Métodos Seleccionamos a 30 adultos mayores sanos que participan regularmente en deportes, registramos sus cambios en el ECG, presión arterial, frecuencia cardíaca y otros indicadores relacionados con la función cardiovascular, y analizamos la función sanguínea de los ancianos. Detección del recuento de glóbulos rojos (RBC), volumen de glóbulos rojos (MCV) y hemoglobina (Hb), creatinina sérica (Cr), glucosa en sangre (BGS), triglicéridos (TG), colesterol (TC), lipoproteínas de baja densidad (LDL) ) y se mide la lipoproteína de alta densidad (HDL). Resultados Los adultos mayores que persisten en el ejercicio durante mucho tiempo tienen mejores indicadores que los que no lo hacen. Conclusión El ejercicio aeróbico adecuado puede reducir la rigidez de los vasos sanguíneos en los ancianos. El ejercicio puede ayudar a los ancianos a aumentar la variabilidad de la frecuencia cardíaca y mejorar los indicadores sanguíneos y la masa corporal de la función nerviosa autónoma del corazón. Nivel de evidencia II; Estudios terapéuticos: investigación de los resultados del tratamiento.

Research on the influence of sport dance on physical health in national fitness exercise / Pesquisa sobre a influência da dança esportiva na saúde física no exercício de condicionamento físico nacional / Investigación sobre la influencia de la danza deportiva en la salud física en el ejercicio de acondicionamiento físico nacional

ABSTRACT Introduction: Sports dance is widely known as a competitive game, but as a leisure activity, there is little research on the efficacy of human health and fitness. Sports dance, as a popular national fitness exercise, has sound health promotion effects. At present, domestic and foreign researches mostly focus on the impact of sports dance on young men and women. Objective: This study will explore the influence of regular physical dance exercises on the body shape, function, and quality of middle-aged and older adults, provide a scientific basis for the role of physical dance in national fitness. Methods: This study recruited 20 healthy middle-aged and elderly members of a leisure sports dance club without professional dance experience for three months of dance training. The first two weeks are pre-experiments five times a week. Each exercise time is 60 minutes. The last ten weeks are formal experiments, two times a week, 90 minutes each time, and no other physical exercises are involved in everyday life. By comparing part of the body shape, physical function, and physical fitness index before and after the experiment, the impact of sports dance on middle-aged and older adults' healthy physical fitness is evaluated. Results: After three months of physical dance exercise with different dance styles, in male, BMI index, body fat percentage, waist circumference, hip circumference, and thigh circumference indicators all decreased, but there was no significant difference. In women, BMI index, body fat percentage (P<0.01), waist circumference (P<0.05), diastolic blood pressure (P<0.01), sitting body forward bending (P<0.05), and standing with one foot and closed eyes all increased. In women, the indexes of grip strength (P<0.01), forward bending in sitting position (P<0.055), and standing with eyes closed on one foot all increased. Conclusions: It is suggested that long-term moderate-intensity aerobic sport dance exercise can improve the body shape of middle-aged and older adults and help increase physical fitness; meanwhile, sports dance can effectively improve the cardiovascular function of middle-aged and elderly subjects. Level of evidence II; Therapeutic studies - investigation of treatment results.

RESUMO Introdução: A dança esportiva é amplamente conhecida como um jogo competitivo, mas como atividade de lazer, existem poucas pesquisas sobre sua eficácia na saúde e forma física humana. A dança esportiva, como exercício físico popular em âmbito nacional, tem importantes efeitos na promoção da saúde. Atualmente, a pesquisa nacional e estrangeira está focada principalmente no impacto da dança esportiva em jovens de ambos os sexos. Objetivo: Este estudo irá explorar a influência dos exercícios regulares de dança física na forma, função e qualidade do corpo de adultos mais velhos e de meia-idade, e fornecerá uma base científica para o papel da dança física no fitness nacional. Métodos: Este estudo recrutou 20 pessoas saudáveis, de meia-idade e idosos de um clube esportivo sem experiência profissional em dança durante três meses de treinamento. As primeiras duas semanas foram pré-experimentos cinco vezes por semana. Cada tempo de exercício foi de 60 minutos. As últimas dez semanas foram experimentos formais, duas vezes por semana, 90 minutos cada vez, sem nenhum outro exercício físico na vida cotidiana. Ao comparar a forma corporal, a função física e o índice de aptidão física antes e depois do experimento, o impacto da dança esportiva na aptidão física saudável de adultos mais velhos e de meia-idade é avaliado. Resultados: Após três meses de exercício físico de dança com diferentes estilos de dança, nos homens, o índice de IMC, o percentual de gordura corporal, a circunferência da cintura, a circunferência do quadril e a circunferência da coxa diminuíram, mas não houve diferença significativa. Nas mulheres, o índice de IMC, o percentual de gordura corporal (P <0,01), a circunferência da cintura (P <0,05), a pressão arterial diastólica (P <0,01), o corpo sentado inclinado para frente (P <0,05) e com um pés e olhos fechados aumentaram. Nas mulheres, os índices de força de preensão (P <0,01), de inclinação para a frente na posição sentada (P <0,055) e com um pé com os olhos fechados aumentaram. Conclusões: Sugere-se que o exercício de dança esportiva aeróbica de intensidade moderada de longa duração pode melhorar a forma corporal de adultos mais velhos e de meia idade e ajudar a aumentar a aptidão física; enquanto isso, a dança esportiva pode efetivamente melhorar a função cardiovascular de indivíduos de meia-idade e idosos. Nível de evidência II; Estudos terapêuticos: investigação dos resultados do tratamento.

RESUMEN Introducción: La danza deportiva es ampliamente conocida como un juego competitivo, pero como actividad de ocio hay poca investigación sobre la eficacia en la salud y el estado físico humanos. La danza deportiva, como ejercicio físico popular a nivel nacional, tiene importantes efectos en la promoción de la salud. En la actualidad, las investigaciones nacionales y extranjeras se centran principalmente en el impacto de la danza deportiva en hombres y mujeres jóvenes. Objetivo: Este estudio explorará la influencia de los ejercicios regulares de danza física en la forma, función y calidad del cuerpo de los adultos mayores y de mediana edad, y proporcionará una base científica para el papel de la danza física en la aptitud nacional. Métodos: Este estudio reclutó a 20 miembros sanos de mediana edad y ancianos de un club deportivo sin experiencia profesional en danza durante tres meses de entrenamiento. Las dos primeras semanas eran experimentos previos cinco veces por semana. Cada tiempo de ejercicio fue de 60 minutos. Las últimas diez semanas eran experimentos formales, dos veces por semana, 90 minutos cada vez, sin otros ejercicios físicos en la vida cotidiana. Al comparar la forma del cuerpo, la función física y el índice de aptitud física antes y después del experimento, se evalúa el impacto de la danza deportiva en la aptitud física saludable de los adultos mayores y de mediana edad. Resultados: Después de tres meses de ejercicio físico de baile con diferentes estilos de baile, en los hombres, el índice de IMC, el porcentaje de grasa corporal, la circunferencia de la cintura, la circunferencia de la cadera y la circunferencia del muslo disminuyeron, pero no hubo diferencia significativa. En las mujeres, el índice de IMC, el porcentaje de grasa corporal (P <0.01), la circunferencia de la cintura (P <0.05), la presión arterial diastólica (P <0.01), el cuerpo sentado inclinado hacia adelante (P <0.05) y con un pie y ojos cerrados aumentaron. En las mujeres, aumentaron los índices de fuerza de agarre (P <0.01), de inclinación hacia adelante en posición sentada (P <0.055) y con un pie con los ojos cerrados. Conclusiones: Se sugiere que el ejercicio de danza deportiva aeróbica de intensidad moderada a largo plazo puede mejorar la forma del cuerpo de los adultos mayores y de mediana edad y ayudar a aumentar la aptitud física; mientras tanto, la danza deportiva puede mejorar eficazmente la función cardiovascular de sujetos de mediana edad y ancianos. Nivel de evidencia II;Estudios terapéuticos: investigación de los resultados del tratamiento.

Presión arterial en embarazos normales de la Ciudad de México / Blood pressure in normal pregnancies from Mexico City

Resumen Objetivo: Determinar la presión arterial (PA) normal en embarazadas en la Ciudad de México. Método: Estudio transversal descriptivo de la PA en embarazos normales de feto único en la Ciudad de México. Las mediciones siguieron un método estandarizado con uso de dispositivos electrónicos automatizados. Se construyeron valores de referencia de las presiones sistólica (PS), diastólica (PD) y arterial media (PAM). Se probaron los efectos de las características maternas y de la gestación sobre la PA. Los intervalos de referencia de la PA se ajustaron para las variables significativas. Resultados: En 1,056 mujeres con edad media de 33 años y 160 cm medios de estatura se realizaron 1,915 mediciones entre las 5 y 41 semanas de edad gestacional (EG) con peso medio de 65 kg. La PA durante el embarazo fue de 102.7/67.2 ± 9.3/7.4 DE mmHg y 79.0 ± 7.4 DE mmHg la PAM. La PA tuvo una relación cuadrática con la EG, la más baja en el segundo trimestre. La PS y la PD mostraron una correlación lineal (r = 0.71). El peso materno tuvo el efecto más significativo sobre PS y PAM; la estatura sobre la PD. La edad, etnia, paridad, consumo de tabaco y antecedente familiar ejercieron efectos diferentes en cada PA. La gestación no tuvo efecto significativo en el modelo multivariado de la PS. Conclusiones: La PA se halló por debajo de la norma convencional en embarazadas. Los criterios diagnósticos para hipertensión en el embarazo deben revisarse; los valores de referencia pueden ajustarse a características maternas y gestacionales.

Abstract Objective: To determine the normal blood pressure (BP) in pregnancy, Mexico City. Methods: A cross-sectional observational study was carried out of BP on singleton normal pregnancies in Mexico City. Measurements followed a standardised methodology using automated electronic devices. Reference values of systolic (SBP), diastolic (DBP) and mean arterial pressure (MAP) were constructed. Maternal and gestation characteristics effects on BP were tested. The reference ranges of BP were adjusted for significant variables. Results: On 1,056 women of 33 years old mean age and 160.0 cm mean height, 1,915 measurements were made between 5 and 41 weeks of gestational age (GA) with 65.0 kg of mean weight. The median BP throughout pregnancy was 102.7/67.2 ± 9.3/7.4 SD mmHg, and 79.0 ± 7.4 SD mmHg the MAP. BP had a quadratic relationship with GA, being the lowest in 2nd trimester. SBP and DBP had a r = 0.71 linear correlation. Maternal weight had the most significant effect on SBP and MAP; height, on DBP. Maternal age, ethnic origin, parity, tobacco habit and family history had differential effects on BP. Gestation had no significant effect on SBP multivariate model. Conclusions: BP resulted lower than conventional standard for pregnant women. Diagnostic criteria for hypertension in pregnancy must be revised; reference values can be adjusted by maternal and gestation characteristics.

Evidence of the association between sleep duration and blood pressure in adolescents: a systematic review / Evidências da associação entre duração do sono e pressão arterial em adolescentes: revisão sistemática

ABSTRACT Objective: To review the epidemiological evidence of the association between sleep duration and blood pressure in adolescents. Data sources: We performed a systematic review of observational studies in Medline, Scopus, Lilacs, Web of Science, Science Direct databases and Virtual Libraries in English, Spanish and Portuguese published until September 2018. Studies were selected first by title and abstract, then by complete reading, according to the eligibility criteria. The reference list of selected articles was evaluated in order to retrieve relevant studies. Data synthesis: Initially, 1,455 articles were retrieved. After exclusion due to duplicity or not meeting the eligibility criteria, 13 articles were included in the review. Studies varied greatly in sample size (143 to 6,940 patients), methods of measuring blood pressure and sleep duration, cutoff points, categorization and adjustment of variables. The main evidence from the studies is that short sleep duration is associated with high blood pressure in adolescence, although the presence of association between high blood pressure and long sleep duration is possible, but not clear in the literature. Conclusions: Sleep duration, especially short duration, is associated with high blood pressure in adolescents. Such evidence draws attention to implications on cardiovascular health in this age group.

RESUMO Objetivo: Discutir as principais evidências epidemiológicas da associação entre duração do sono e pressão arterial em adolescentes relatadas na literatura científica. Fonte de dados: Foi realizada uma revisão sistemática de estudos observacionais nas bases de dados do Sistema Online de Busca e Análise de Literatura Médica (MEDLINE), Scopus, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Web of Science, ScienceDirect e bibliotecas virtuais nos idiomas inglês, espanhol e português para todo o período anterior a setembro de 2018. Foram selecionados trabalhos primeiramente pelo título e pelo resumo, em seguida pela leitura completa, conforme os critérios de elegibilidade. A lista de referência dos artigos selecionados foi avaliada a fim de recuperar estudos relevantes. Síntese dos dados: Inicialmente, foram recuperados 1.455 artigos. Após exclusões por duplicidade ou por não se enquadrarem nos critérios de elegibilidade, resultaram 13 artigos, que foram incluídos na revisão. Os estudos variaram bastante em tamanho de amostra (143 a 6.940), métodos de mensuração da pressão arterial e duração do sono, pontos de corte, categorização e ajuste de variáveis. As principais evidências trazidas pelos estudos são de que a curta duração do sono está associada à pressão arterial elevada na adolescência, embora não se descarte a possibilidade da relação entre pressão arterial elevada e longa duração do sono, que ainda não está clara na literatura. Conclusões: A duração do sono, principalmente a curta duração, está associada à pressão arterial elevada em adolescentes. Tais evidências chamam atenção para implicações sobre a saúde cardiovascular nessa faixa etária.

Effects of Outdoor Temperature on Blood Pressure in a Prospective Cohort of Northwest China / 生物医学与环境科学（英文）

Objective@#The relationship between outdoor temperature and blood pressure (BP) has been inconclusive. We analyzed data from a prospective cohort study in northwestern China to investigate the effect of outdoor temperature on BP and effect modification by season.@*Methods@#A total of 32,710 individuals who participated in both the baseline survey and the first follow-up in 2011-2015 were included in the study. A linear mixed-effect model and generalized additive mixed model (GAMM) were applied to estimate the association between outdoor temperature and BP after adjusting for confounding variables.@*Results@#The mean differences in systolic blood pressure (SBP) and diastolic blood pressure (DBP) between summer and winter were 3.5 mmHg and 2.75 mmHg, respectively. After adjusting for individual characteristics, meteorological factors and air pollutants, a significant increase in SBP and DBP was observed for lag 06 day and lag 04 day, a 0.28 mmHg (95% @*Conclusions@#This study demonstrated a significant negative association between outdoor temperature and BP in a high-altitude environment of northwest China. Moreover, BP showed a significant seasonal variation. The association between BP and temperature differed by season and individuals' demographic characteristics (age, gender, BMI), unhealthy behaviors (smoking and alcohol consumption), and chronic disease status (CVDs, hypertension, and diabetes).

Association between cumulative blood pressure and long-term risk of cardiovascular disease: findings from the 26-year Chinese Multi-provincial Cohort Study-Beijing Project / 中华医学杂志(英文版)

BACKGROUND@#Cumulative blood pressure (BP), a measure incorporating the level and duration of BP exposure, is associated with the risk of cardiovascular disease (CVD). However, the level at which cumulative BP could significantly increase the risk remains unclear. This study aimed to investigate the association of 15-year cumulative BP levels with the long-term risk of CVD, and to examine whether the association is independent of BP levels at one examination.@*METHODS@#Data from a 26-year follow-up of the Chinese Multi-provincial Cohort Study-Beijing Project were analyzed. Cumulative BP levels between 1992 and 2007 were calculated among 2429 participants free of CVD in 2007. Cardiovascular events (including coronary heart disease and stroke) occurring from 2007 to 2018 were registered. Adjusted hazard ratios (HRs) for CVD incidence associated with quartiles of cumulative systolic blood pressure (SBP) and diastolic blood pressure (DBP) were calculated.@*RESULTS@#Of the 2429 participants, 42.9% (1042) were men, and the mean age in 2007 was 62.1 ± 7.9 years. Totally, 207 CVD events occurred during the follow-up from 2007 to 2018. Participants with higher levels of cumulative SBP or DBP exhibited a higher incidence rate of CVD (P < 0.001). Compared with the lowest quartile of cumulative SBP, the HR for CVD was 1.03 (95% confidence interval [CI]: 0.59-1.81), 1.69 (95% CI: 0.99-2.87), and 2.20 (95% CI: 1.21-3.98) for the second to the fourth quartile of cumulative SBP, and 1.46 (95% CI: 0.86-2.48), 1.99 (95% CI: 1.18-3.35), and 2.08 (95% CI: 1.17-3.71) for the second to the fourth quartile of cumulative DBP, respectively. In further cross-combined group analyses with BP measurements in 2007, 15-year cumulative BP levels higher than the median, that is, 1970.8/1239.9 mmHg·year for cumulative SBP/DBP, which were equivalent to maintaining SBP/DBP levels of 131/83 mmHg or above on average in 15 years, were associated with higher risk of CVD in subsequent years independent of BP measurements at one-time point.@*CONCLUSION@#Cumulative exposure to moderate elevation of BP is independently associated with increased future cardiovascular risk.

Sensibilidad y especificidad de la presión de pulso ampliada como prueba diagnóstica de IRC estadio K/DOQI III-b / Sensitivity and specificity of increased pulse pressure as a diagnostic test for K/DOQI III-b

Resumen Introducción: La presión de pulso ampliada (PPA) se asocia a un filtrado glomerular calculado ≤ 60/mL/minuto/1.73 m2, por lo que puede ser útil como prueba diagnóstica para identificar a personas con insuficiencia renal crónica (IRC) estadio K/DOQI III-b. Objetivo: Determinar la utilidad de la PPA como prueba diagnóstica de IRC estadio K/DOQI III-b. Método: Estudio de prueba diagnóstica que incluyó a pacientes adultos sin comorbilidades, registrados en la Cohorte de Trabajadores de la Salud. Se utilizó la fórmula CKD-EPI para calcular la filtración glomerular. Se determinó la presión de pulso restando la presión arterial diastólica a la presión arterial sistólica. Se calculó sensibilidad, especificidad, valor predictivo positivo, valor predictivo negativo y prevalencia. Se elaboró una curva ROC para determinar el área bajo la curva. Resultados: Se incluyeron 6215 pacientes. Se observó que una PPA ≥ 50 mm Hg tuvo sensibilidad de 74 %, especificidad de 70 %, valor predictivo positivo de 1 %, valor predictivo negativo de 100 % y prevalencia de 1 %. El punto de inflexión en la curva ROC para identificar IRC K/DOQI III-b fue de 0.71. Conclusión: La PPA ≥ 50 mm Hg es útil como prueba diagnóstica para identificar a personas con IRC estadio K/DOQI III-b.

Abstract Introduction: Increased pulse pressure (IPP) is associated an estimated glomerular filtration ≤ 60/mL/min/1.73 m2; thus, it can be useful as a diagnostic test to identify people with K/DOQI stage III-b chronic kidney disease (CKD). Objective: To determine the usefulness of IPP as a diagnostic test for K/DOQI stage III-b CKD. Method: Diagnostic test study that included adult patients without comorbidities, registered in the Health Workers Cohort. The CKD-EPI formula was used to calculate glomerular filtration. Pulse pressure was determined by subtracting diastolic from systolic blood pressure. Sensitivity, specificity, positive predictive value, negative predictive value and prevalence were calculated using standard formulas. A ROC curve was generated to determine the area under the curve. Results: A total of 6,215 patients were included. An IPP ≥ 50 mmHg was observed to have a sensitivity of 74 %, specificity of 70 %, positive predictive value of 1 %, negative predictive value of 100 % and a prevalence of 1 %. The inflection point in the ROC curve to identify K/DOQI III-b CKD was 0.71. Conclusion: An IPP ≥ 50 mmHg is useful as a diagnostic test to identify people with K/DOQI stage III-b CKD.

Intracerebral hemorrhage: update and future directions / Hemorragia intracerebral: atualização e direções futuras

ABSTRACT Intracerebral hemorrhage (ICH), defined as bleeding into the brain parenchyma, is a significant public health issue. Although it accounts for only 10 to 15% of strokes, it is associated with the highest morbidity and mortality rates. Despite advances in the field of stroke and neurocritical care, the principles of acute management have fundamentally remained the same over many years. The main treatment strategies include aggressive blood pressure control, early hemostasis, reversal of coagulopathies, clot evacuation through open surgical or minimally invasive surgical techniques, and the management of raised intracranial pressure.

RESUMO A hemorragia cerebral é definida como um sangramento no parênquima cerebral e representa um importante problema de saúde pública. Ela corresponde a 10 a 15% das causas de AVC e está associada a altas taxas de morbimortalidade. Apesar dos avanços no campo do AVC e dos cuidados neurocríticos, os princípios do manejo agudo permaneceram fundamentalmente os mesmos por muitos anos. As principais estratégias de tratamento incluem controle agressivo da pressão arterial, hemostasia precoce, reversão de coagulopatias, evacuação do coágulo por meio de técnicas cirúrgicas abertas ou cirúrgicas minimamente invasivas e gerenciamento da pressão intracraniana elevada.

O comportamento da pressão arterial após elevação da pressão parcial positiva final pode auxiliar na determinação do status de fluido-responsividade em pacientes com choque séptico? / Can the behavior of blood pressure after elevation of the positive end-expiratory pressure help to determine the fluid responsiveness status in patients with septic shock?

RESUMO Objetivo: Avaliar se a diminuição da pressão arterial provocada pela elevação da pressão parcial positiva final corresponde à variação da pressão de pulso como indicador de fluido-responsividade. Métodos: Estudo de caráter exploratório que incluiu prospectivamente 24 pacientes com choque séptico ventilados mecanicamente e submetidos a três etapas de elevação da pressão parcial positiva final: de 5 para 10cmH2O (nível da pressão parcial positiva final 1), de 10 para 15cmH2O (nível da pressão parcial positiva final 2) e de 15 para 20cmH2O (nível da pressão parcial positiva final 3). Alterações da pressão arterial sistólica, da pressão arterial média e da variação da pressão de pulso foram avaliadas durante as três manobras. Os pacientes foram classificados como responsivos (variação da pressão de pulso ≥ 12%) e não responsivos a volume (variação da pressão de pulso < 12%). Resultados: O melhor desempenho para identificar pacientes com variação da pressão de pulso ≥ 12% foi observado no nível da pressão parcial positiva final 2: variação de pressão arterial sistólica de -9% (área sob a curva de 0,73; IC95%: 0,49 - 0,79; p = 0,04), com sensibilidade de 63% e especificidade de 80%. A concordância foi baixa entre a variável de melhor desempenho (variação de pressão arterial sistólica) e a variação da pressão de pulso ≥ 12% (kappa = 0,42; IC95%: 0,19 - 0,56). A pressão arterial sistólica foi < 90mmHg no nível da pressão parcial positiva final 2 em 29,2% dos casos e em 41,6,3% no nível da pressão parcial positiva final 3. Conclusão: Variações da pressão arterial em resposta à elevação da pressão parcial positiva final não refletem de modo confiável o comportamento da variação da pressão de pulso para identificar o status da fluido-responsividade.

Abstract Objective: To evaluate whether the decrease in blood pressure caused by the increase in the positive end-expiratory pressure corresponds to the pulse pressure variation as an indicator of fluid responsiveness. Methods: This exploratory study prospectively included 24 patients with septic shock who were mechanically ventilated and subjected to three stages of elevation of the positive end-expiratory pressure: from 5 to 10cmH2O (positive end-expiratory pressure level 1), from 10 to 15cmH2O (positive end-expiratory pressure level 2), and from 15 to 20cmH2O (positive end-expiratory pressure level 3). Changes in systolic blood pressure, mean arterial pressure, and pulse pressure variation were evaluated during the three maneuvers. The patients were classified as responsive (pulse pressure variation ≥ 12%) or unresponsive to volume replacement (pulse pressure variation < 12%). Results: The best performance at identifying patients with pulse pressure variation ≥ 12% was observed at the positive end-expiratory pressure level 2: -9% systolic blood pressure variation (area under the curve 0.73; 95%CI: 0.49 - 0.79; p = 0.04), with a sensitivity of 63% and specificity of 80%. Concordance was low between the variable with the best performance (variation in systolic blood pressure) and pulse pressure variation ≥ 12% (kappa = 0.42; 95%CI: 0.19 - 0.56). The systolic blood pressure was < 90mmHg at positive end-expiratory pressure level 2 in 29.2% of cases and at positive end-expiratory pressure level 3 in 41.63% of cases. Conclusion: Variations in blood pressure in response to the increase in positive end-expiratory pressure do not reliably reflect the behavior of the pulse pressure as a measure to identify the fluid responsiveness status.

A Prevalência da Hipotensão Ortostática e a Distribuição da Variação Pressórica no Estudo Longitudinal da Saúde do Adulto / Prevalence of Orthostatic Hypotension and the Distribution of Pressure Variation in the Longitudinal Study of Adult Health

Resumo Fundamento A hipotensão ortostática (HO) tem sido negligenciada na clínica não havendo estudos sobre sua prevalência na população brasileira. Objetivo Determinar a prevalência de HO e a variação da pressão arterial (PA) após manobra postural no Estudo Longitudinal da Saúde do Adulto. Métodos No presente estudo descritivo da linha de base (N = 14.833 indivíduos, 35-74 anos), os participantes ficavam deitados por 20 minutos e então levantavam ativamente, com a medida da PA em supino e aos 2, 3, e 5 minutos de ortostase. A HO foi definida por queda ≥ 20 mmHg na PA sistólica e/ou queda ≥ 10 mmHg na PA diastólica aos 3 minutos, sendo determinada a sua prevalência com intervalo de confiança de 95% (IC95%). A distribuição da variação da PA após a manobra postural foi determinada numa subamostra (N = 8.011) após remoção de participantes com morbidade cardiovascular e/ou diabetes. Resultados A prevalência de HO foi de 2,0% (IC95%: 1,8 - 2,3), crescente com a idade. Se o critério for a mesma queda pressórica em qualquer das medidas, a prevalência aumenta para 4,3% (IC95%: 4,0 - 4,7). Em presença de HO houve relato de sintomas (tontura, escotomas, náuseas, etc.) em 19,7% dos participantes (IC95%: 15,6 - 24,6) e em apenas 1,4% (IC95%: 1,2 - 1,6) dos sem HO. Os escores-Z −2 das variações da PA antes e após manobra postural na subamostra foram de −14,1 mmHg na PA sistólica e −5,4 mmHg na diastólica. Conclusão A prevalência de HO varia em função do momento da aferição da PA. Os pontos de corte atuais podem subestimar a ocorrência de HO na população. (Arq Bras Cardiol. 2020; 114(6):1040-1048)

Abstract Background Orthostatic hypotension (OH) has been neglected in clinical practice, and there are no studies on its prevalence in the Brazilian population. Objective To determine the prevalence of OH and blood pressure (BP) changes after the postural change maneuver in participants of the Longitudinal Study of Adult Health. Methods In this descriptive study of baseline data (N = 14,833 adults, ages 35 - 74 years), participants remained lying down for 20 minutes and subsequently stood up actively. BP measurements were taken while the participants were supine and at 2, 3, and 5 minutes after standing. OH was defined as a reduction of ≥ 20 mmHg in systolic BP and/or a reduction of ≥ 10 mmHg in diastolic BP at 3 minutes, and its prevalence was determined with a 95% confidence interval (CI). The distribution of BP variation after the postural change maneuver was determined in a subsample (N = 8,011) obtained by removing patients with cardiovascular morbidity and/or diabetes. Results The prevalence of OH was 2.0% (95% CI: 1.8 - 2.3), increasing with age. If the criterion applied were a BP reduction during any measurement, the prevalence would increase to 4.3% (95% CI: 4.0 - 4.7). Symptoms (dizziness, scotoma, nausea, etc.) were reported by 19.7% of participants (95% CI: 15.6 - 24.6) with OH and 1.4% (95% CI: 1.2 - 1.6) of participants without OH. The −2 Z-scores of BP variation before and after the postural change maneuver in the subsample were −14.1 mmHg for systolic BP and −5.4 mmHg for diastolic BP. Conclusion Prevalence of OH varies depending on when BP is measured. Current cutoff points may underestimate the actual occurrence of OH in the population. (Arq Bras Cardiol. 2020; 114(6):1040-1048)

Entrenamiento de handgrip isométrico de alta intensidad en adultos mayores pre-hipertensos y con diagnóstico de hipertensión arterial sistémica etapa I / Effects high intensity isometric handgrip training on blood pressure of hypertensive older people

Background: Moderate isometric handgrip exercise is an effective tool in the management of systemic hypertension. Aim: To evaluate the effectiveness of a high intensity isometric handgrip exercise protocol for the reduction of blood pressure in older people with pre or stage-1 hypertension. Material and Methods: Twenty-three participants aged 73.8 ± 6.6 years (range 61-90) completed eight weeks of high intensity isometric handgrip training 2 times per week, performing 32 contractions maintained for 5 seconds, with breaks of 5 seconds. Blood pressure (BP) was measured at baseline and at the end of the intervention. Results: Systolic blood pressure decreased from 141 ± 11 to 127 ± 10 mmHg (p < 0.01). The decrease in diastolic blood pressure was from 79 ± 7 to 74 ± 6 mmHg (p < 0.01). Conclusions: A blood pressure reduction was recorded in these participants after a period of high intensity isometric handgrip exercise.