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1.
Arch. cardiol. Méx ; 91(3): 289-298, jul.-sep. 2021. tab, graf
Article in Spanish | LILACS | ID: biblio-1345167

ABSTRACT

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.


Subject(s)
Humans , Female , Pregnancy , Adult , Blood Pressure/physiology , Hypertension, Pregnancy-Induced/diagnosis , Hypertension/complications , Pre-Eclampsia/diagnosis , Reference Values , Cross-Sectional Studies , Gestational Weight Gain , Mexico
2.
Rev. bras. med. esporte ; 27(3): 278-281, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1288578

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Sports/physiology , Blood Cell Count , Blood Pressure/physiology , Hemoglobins/analysis , Heart Rate/physiology , Lipids/blood
3.
Rev. bras. med. esporte ; 27(5): 481-484, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1288613

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Sports/physiology , Blood Pressure/physiology , Body Constitution/physiology , Dancing/physiology , Heart Rate/physiology , Surveys and Questionnaires
4.
Article in English | WPRIM | ID: wpr-878325

ABSTRACT

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).


Subject(s)
Adult , Blood Pressure/physiology , China/epidemiology , Environmental Exposure/statistics & numerical data , Female , Humans , Male , Middle Aged , Prospective Studies , Risk Factors , Seasons , Temperature
5.
Chinese Medical Journal ; (24): 920-926, 2021.
Article in English | WPRIM | ID: wpr-878086

ABSTRACT

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.


Subject(s)
Aged , Asian Continental Ancestry Group , Blood Pressure/physiology , Cardiovascular Diseases/etiology , China/epidemiology , Cohort Studies , Humans , Hypertension/epidemiology , Incidence , Male , Middle Aged , Risk Factors
6.
Gac. méd. Méx ; 156(5): 432-437, sep.-oct. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1249942

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Young Adult , Blood Pressure/physiology , Renal Insufficiency, Chronic/diagnosis , Blood Pressure Determination/methods , Predictive Value of Tests , ROC Curve , Sensitivity and Specificity , Area Under Curve , Renal Insufficiency, Chronic/physiopathology , Glomerular Filtration Rate/physiology
7.
Arq. neuropsiquiatr ; 78(10): 651-659, Oct. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131690

ABSTRACT

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.


Subject(s)
Humans , Cerebral Hemorrhage , Stroke , Blood Pressure/physiology , Brain , Minimally Invasive Surgical Procedures/methods
8.
Rev. bras. ter. intensiva ; 32(3): 374-380, jul.-set. 2020. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1138513

ABSTRACT

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.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Shock, Septic/therapy , Blood Pressure/physiology , Positive-Pressure Respiration , Fluid Therapy/methods , Respiration, Artificial , Shock, Septic/physiopathology , Prospective Studies , Sensitivity and Specificity
9.
Arq. bras. cardiol ; 114(6): 1040-1048, Jun., 2020. tab, graf
Article in English, Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131242

ABSTRACT

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)


Subject(s)
Humans , Adult , Aged , Blood Pressure/physiology , Hypotension, Orthostatic/epidemiology , Blood Pressure Determination , Brazil/epidemiology , Prevalence , Longitudinal Studies , Middle Aged
10.
Rev. méd. Chile ; 148(5): 611-617, mayo 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1139345

ABSTRACT

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.


Subject(s)
Humans , Middle Aged , Aged , Aged, 80 and over , Hand Strength/physiology , High-Intensity Interval Training , Hypertension/physiopathology , Hypertension/therapy , Blood Pressure/physiology , Treatment Outcome , Isometric Contraction/physiology
11.
Arq. bras. cardiol ; 114(5): 755-761, maio 2020. tab
Article in Portuguese | SES-SP, LILACS, SES-SP | ID: biblio-1131234

ABSTRACT

Resumo Fundamento A atividade física, em diferentes dimensões (ocupacional, doméstica e de lazer), pode ter papel relevante sobre a hipertensão arterial (HA). Praticar atividade física apenas no lazer, ou isoladamente nas outras dimensões, pode ser insuficiente para o controle efetivo da HA. Objetivo Analisar o efeito isolado e cumulativo das dimensões da atividade física sobre a ocorrência de hipertensão arterial em trabalhadores. Métodos Estudo transversal com 1.070 trabalhadores de Limpeza Urbana e Indústria de Calçados, na Bahia, utilizando questionário aplicado por entrevistador acerca de aspectos sociodemográficos, ocupacionais, de estilo de vida e morbidade hipertensiva. Foram medidos peso, altura, circunferência abdominal e pressão arterial. Caso de HA: pressão arterial sistólica ≥140 ou diastólica ≥90, ou tratamento regular de Hipertensão. Foram investigadas as dimensões ocupacional, doméstica e de lazer da atividade física. Realizou-se análise multivariada com Regressão de Cox para estudos transversais. Resultados A prevalência de HA foi de 24%, sendo 37% dentre pacientes com idades entre 35 e 44 anos, e 51% entre 45 e 54 anos. O modelo multivariado evidenciou que ativos em uma dimensão ou em nenhuma tiveram 62% mais HA, e um valor 25% mais elevado de HA foi observado dentre aqueles trabalhadores ativos em duas das três dimensões, na comparação com os ativos nas três dimensões. Sexo masculino, maior idade (> 31 anos) e excesso de peso se associaram à HA, com razões de prevalência de 1,62, 2,10 e 2,26, respectivamente. Conclusões Verificou-se efeito cumulativo das dimensões da atividade física sobre a ocorrência de HA. Classificar sujeitos ativos no trabalho ou no ambiente doméstico como inativos ao se basear apenas na dimensão do lazer pode implicar em erro metodológico. (Arq Bras Cardiol. 2020; 114(5):755-761)


Abstract Background Physical activity, each type in its own manner, whether occupational, domestic or leisure, can play a significant role regarding high blood pressure (HBP). However, practicing physical activity only at leisure time, or in specific situations, can be insufficient to achieve the effective control of HBP. Objective To analyze the isolated and cumulative effect of different types of physical activity and the prevalence of HBP among workers. Methods A cross-sectional study with 1,070 Urban Cleaning and Footwear Industry workers in Bahia, who answered a survey, conducted by an interviewer on sociodemographic, occupational, lifestyle and hypertensive morbidity aspects. Weight, height, waist circumference and blood pressure were measured. Case of HBP: Systolic blood pressure ≥140 or diastolic blood pressure ≥90, or regular treatment for HBP. The occupational, domestic and leisure aspects of Physical Activity were studied. A multivariate analysis with Cox Regression was performed for cross-sectional studies. Results The prevalence of HBP was 24%, being 37% among workers aged between 35-44 years, and 51% among workers aged between 45-54 years. The multivariate model showed that workers who were active in one form of physical activity only or no forms had 62% higher BP levels and that these levels were 25% higher among workers who were active in two out of three physical activity forms. Being a male, being older (> 31 years old) and being overweight were characteristics associated with HBP, with prevalence ratios of 1.62, 2.10 and 2.26, respectively. Conclusions There was a cumulative effect of the form of physical activity on the occurrence of HBP. Classifying active subjects at work or at home as inactive persons by relying only on the leisure form can lead to methodological errors. (Arq Bras Cardiol. 2020; 114(5):755-761)


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Blood Pressure/physiology , Exercise/physiology , Hypertension/epidemiology , Brazil/epidemiology , Sex Factors , Prevalence , Cross-Sectional Studies , Age Factors
12.
Rev. méd. Chile ; 148(4): 496-499, abr. 2020. tab
Article in English | LILACS | ID: biblio-1127090

ABSTRACT

ABSTRACT Background The ambulatory arterial stiffness index (AASI), derived from 24 h ambulatory blood pressure monitoring (ABPM) can be a good indicator of arterial stiffness. Aim To assess the correlation between AASI and brachial-ankle pulse wave velocity (baPWV), ankle-brachial index (ABI) and cardio-ankle vascular index (CAVI) in patients with type 2 diabetes mellitus without hypertension. Material and Methods Cross sectional study in 28 diabetic patients aged 49 ± 7 years (40% women). AASI was calculated as 1 minus the regression slope of diastolic on systolic blood pressure, using ABPM data. ABPM was measured in the arm using an oscillometric device. ABI was calculated as the ratio between ankle and brachial systolic blood pressure. CAVI was derived from pulse wave velocity using the Vasera VS-1000 device. Correlations were calculated using a bivariate Spearman correlation. Results The mean values for AASI, ABI, baPWV and CAVI were 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s and 7.60 ± 1.90, respectively. There was a significant negative correlation between AASI and ABI (r = -0.491, p < 0.01). Conclusions In these diabetic patients, there was an association between AASI, an arterial stiffness marker and ABI, an indicator for the presence of atherosclerosis.


Antecedentes El índice de rigidez arterial ambulatorio (AASI), derivado del monitoreo ambulatorio de presión arterial de 24 h (MAPA), puede ser un buen indicador de rigidez arterial. Objetivo Evaluar la correlación entre el AASI y la velocidad de onda de pulso braquial (VOP), el índice tobillo-brazo (ITB) y el índice vascular cardio-tobillo (CAVI) en pacientes con diabetes mellitus tipo 2 sin hipertensión arterial. Material y Métodos Estudio transversal en 28 pacientes con diabetes de 49 ± 7 años (40% mujeres). El AASI se calculó como 1 menos la pendiente de regresión de la presión arterial diastólica sobre la sistólica, usando datos del MAPA de 24 h, el cual se midió en el brazo, usando un dispositivo oscilométrico. El ITB se calculó como la razón entre la presión arterial sistólica del tobillo sobre la del brazo. El CAVI se derivó de la velocidad de onda de pulso medida con el dispositivo Vasera VS-1000. Para el análisis estadístico se utilizó el coeficiente de correlación bivariada de Spearman. Resultados Los valores de AASI, VOP, ITB y CAVI fueron 0.39 ± 0.14, 1.14 ± 0.09, 15.15 ± 2.71 m/s y 7.60 ± 1.90, respectivamente. Hubo una correlación negativa significativa entre AASI e ITB (r = -0.491, p < 0.01). Conclusiones Hay una asociación entre AASI, un marcador de rigidez arterial e ITB, un indicador de aterosclerosis, en estos pacientes con diabetes mellitus tipo 2.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Arteries/physiopathology , Blood Pressure/physiology , Brachial Artery/physiopathology , Diabetes Mellitus, Type 2/complications , Vascular Stiffness/physiology , Ankle/blood supply , Carotid Arteries/diagnostic imaging , Cross-Sectional Studies , Predictive Value of Tests , Blood Pressure Monitoring, Ambulatory , Diabetes Mellitus, Type 2/blood , Ankle Brachial Index , Pulse Wave Analysis
13.
Arq. bras. med. vet. zootec. (Online) ; 72(2): 419-430, Mar./Apr. 2020. ilus, tab
Article in Portuguese | LILACS, VETINDEX | ID: biblio-1128360

ABSTRACT

A ultrassonografia convencional e o Doppler espectral nas artérias carótidas comuns em equinos e muares são considerados escassos, diferentemente do que ocorre na medicina humana. Este trabalho propôs comparar as artérias carótidas comuns de equinos e muares por ultrassonografia modo-B e Doppler espectral, além de verificar as diferenças dessas variáveis entre os gêneros desses animais e a relação com a massa corpórea. Foram avaliados os seguintes parâmetros: massa corpórea, diâmetros das artérias, espessura da camada íntima-média (EIM), índice de resistividade (IR), índice de pulsatilidade (IP), velocidade sistólica (VS), velocidade diastólica (VD) e velocidade média (VM). Salvo a massa corpórea, esses parâmetros foram obtidos de três regiões (cranial, médio e caudal) e submetidos à análise conjuntamente. Os diâmetros das artérias carótidas comuns são diferentes entre equinos e muares, com valores menores nos equinos. O IR, o IP, a VS e a VM diferiram entre equinos e muares, sendo maiores nos equinos, e a VD superior nos muares. Não foi observada diferença das variáveis do modo-B e Doppler entre gêneros nos equinos, diferentemente dos muares, cujos machos apresentaram valores maiores do diâmetro, do IR e do IP, mas menores da VS e da VM. A massa corpórea não influenciou as variáveis do modo-B, independentemente do gênero, mas apresenta correlação significativa nas variáveis do modo Doppler. As artérias carótidas comuns de equinos e muares são diferentes pelos exames ultrassonográficos modo-B e Doppler espectral. O gênero não influencia no modo-B e no Doppler nos equinos, porém influencia parcialmente nos muares. A massa corpórea de equinos e de muares, independentemente do gênero, não tem associação com as variáveis do modo-B, apenas com o Doppler.(AU)


Conventional ultrasound and spectral Doppler in the common carotid arteries in horses and mules are considered scarce, different from human medicine. The aim of this study was to compare the common carotid arteries of horses and mules by B-mode ultrasonography and spectral Doppler ultrasonography, as well as to verify the differences of these variables between their genders and the relation with body mass. The following parameters were evaluated: body mass, artery diameter, intima-media thickness (EIM), resistivity index (IR), pulsatility index (IP), systolic velocity (VS), diastolic velocity (VD) and average velocity (VM). Besides the body mass, the other variables were obtained from three regions (cranial, medium and caudal) and analyzed together. The diameters of the common carotid arteries are different between horses and mules, being smaller in horses. The IR, IP, VS and VM differed between horses and mules, being higher in the horses, but the VD was higher in mules. No difference in the variables in B-mode and Doppler between gender were observed in horses, different from mules, in which the diameters, IR and IP values were higher in males and the VS and VM was higher in females. Body mass did not influence B-Mode, both for horses and mules. A significant correlation was observed for Doppler. The common carotid arteries of horses and mules are different by ultrasound scans B-mode and spectral Doppler. Gender does not influence the B-Mode and Doppler variables in horses, but can in mules. The body mass of horses and mules, regardless of gender, is not associated with B-mode variables, but with Doppler variables.(AU)


Subject(s)
Animals , Carotid Arteries/physiology , Carotid Arteries/diagnostic imaging , Equidae/anatomy & histology , Horses/anatomy & histology , Blood Pressure/physiology , Body Weights and Measures/veterinary , Ultrasonography/veterinary , Ultrasonography, Doppler/veterinary
15.
Arch. cardiol. Méx ; 90(1): 17-23, Jan.-Mar. 2020. tab, graf
Article in English | LILACS | ID: biblio-1131001

ABSTRACT

Abstract Introduction: Central blood pressure (CBP) is considered a measure of prognostic value for cardiovascular risk. In turn, the aortic pulse wave velocity (PWVAo) and augmentation index (Aix) have been related to arterial stiffness and cardiovascular risk. Controversies exist regarding the reference values in different ethnic groups, ages, and anthropometrics. The objective of this study is to evaluate the CBP and arterial stiffness parameters in a Mexican population by age, gender, and anthropometry. Methods: Between 2015 and 2016, 1009 apparently healthy subjects were recruited in the Instituto Nacional de Cardiología Ignacio Chávez. Using the Arteriograph (TensioMed) equipment with an oscillometric technique, CBP, central pulse pressure (cPP), PWVAo, and Aix were acquired. All results were automatically obtained by computer software version 3.0.0.4. Results: Female sex was prevalent (72%), mean age was 47 ± 12 years; 26% had normal weight, 43% were overweight, and 30% had obesity. The reference values were higher than those reported in other populations. PWVAo and Aix were always found to be higher in females. A central-brachial pressure gradient was observed in < 40 years with lower CBP. Body mass index (BMI) presented a direct and positive correlation with CBP (p < 0.001); however, PWVAo and Aix were not modified. Conclusion: CBP, cPP, PWVAo, and Aix parameters should be considered based on age, gender, and BMI. In Mexican population, CBP and cPP values were higher compared with other previously reported values, especially in women, the elderly, and obese. PWVAo and Aix are higher in older women; however, they are not modified by BMI.


Resumen Introducción: La presión central aórtica (PCA) se considera una medida del valor pronóstico. A su vez, la velocidad de la onda del pulso aórtico (VOPA) y el índice de aumento (IA) se han relacionado con la rigidez arterial y riesgo cardiovascular. Existen controversias sobre los valores de referencia en diferentes grupos. El objetivo de este estudio es evaluar estos parámetros en una población mexicana por edad, género y antropometría. Métodos: Entre 2015 y 2016 se reclutaron 1,009 sujetos aparentemente sanos en el Instituto Nacional de Cardiología Ignacio Chávez. Usando el equipo de Arteriograph (TensioMed) con técnica oscilométrica, se adquirieron: PCA, presión de pulso central, VOPA e IA. Todos los resultados fueron obtenidos automáticamente. Resultados: El sexo femenino fue prevalente (72%), edad de 47 ± 12 años; 26% con peso normal, 43% con sobrepeso y 30% con obesidad. Todos los valores fueron superiores a los reportados en otras poblaciones. VOPA e IA siempre fueron más altos en mujeres. Se observó un gradiente de presión central-braquial en < 40 años, con menor PCA. El IMC presentó una correlación directa y positiva con la PCA (p < 0,001), sin embargo, VOPA e IA no se modificaron. Conclusión: Los parámetros de PCA, VOPA e IA deben considerarse en función de edad, género e IMC. En una población mexicana, los valores de PCA fueron más altos en comparación con informados previamente (Europa y Asia), especialmente en mujeres, ancianos y obesos. VOPA e IA son más altos en mujeres mayores; sin embargo, no son modificados por el IMC.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Blood Pressure/physiology , Overweight/epidemiology , Vascular Stiffness/physiology , Obesity/epidemiology , Reference Values , Cross-Sectional Studies , Age Factors , Mexico
16.
Ciênc. Saúde Colet ; 25(2): 645-654, Feb. 2020. tab
Article in English | LILACS | ID: biblio-1055836

ABSTRACT

Abstract The hormonal changes in climacteric women may affect the vestibular system; however, it is not clear in the literature whether the presence of vestibular dysfunction associated with climacteric is related to poorer quality of life. The study sample was composed of 374 women (40-65 years). Socioeconomic and demographic data, menopausal status, practice of physical exercises, presence or absence of vestibular dysfunction, hypertension and diabetes, anthropometric measurements and quality of life (using the Utian Quality of Life Scale - UQoL) were collected. Statistical analyses were performed using the Pearson test, Anova, T-test, and multiple regression considering a significance level of 5%. A significant relationship was found between vestibular dysfunction and health (p = 0.02) and emotional (p = 0.01) domains of the UQoL. In addition, physical activity, menopausal status, body mass index (BMI), waist-hip ratio (WHR), household income and diastolic blood pressure (DBP) mean also remained significantly related to quality of life. A relationship between vestibular dysfunction and quality of life for health and emotional domains in climacteric women was observed.


Resumo Mudanças hormonais em mulheres climatéricas podem afetar o sistema vestibular, porém, não está claro na literatura se a presença da disfunção vestibular associada ao climatério está relacionada à pior qualidade de vida. O objetivo deste artigo é analisar a relação entre disfunção vestibular e qualidade de vida em mulheres climatéricas. Amostra composta por 374 mulheres (40 a 65 anos). Foram coletados dados socioeconômicos e demográficos, status menopausal, prática de exercício físico, presença ou ausência de disfunção vestibular, hipertensão e diabetes, medidas antropométricas e qualidade de vida (por meio do Utian Quality of Life Scale - UQoL). Na análise estatística foi utilizado teste de Pearson, Anova, teste t e regressão múltipla, considerando nível de significância de 5%. Verificou-se relação significativa entre a disfunção vestibular e os domínios saúde (p = 0,02) e emocional (p = 0,01) do UQoL. Além disso, atividade física, status menopausal, IMC (índice de massa corporal), RCQ (relação cintura-quadril), renda familiar e média da PAD (pressão arterial diastólica) também permaneceram significantemente relacionadas à qualidade de vida. Observou-se relação entre disfunção vestibular e qualidade de vida para os domínios saúde e emocional em mulheres climatéricas.


Subject(s)
Humans , Female , Adult , Aged , Quality of Life , Menopause/physiology , Vestibular Diseases/epidemiology , Blood Pressure/physiology , Exercise/psychology , Body Mass Index , Cross-Sectional Studies , Waist-Hip Ratio , Income , Middle Aged
17.
Cienc. act. fís. (Talca, En línea) ; 21(1): 1-13, ene. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1123685

ABSTRACT

OBJETIVO: Investigar o efeito do treinamento de força (TF) com distintas intensidades sobre a cocorrência e magnitude da hipotensão pós-exercício (HPE). MÉTODOS: sete homens normotensos foram submetidos a duas sessões de TF, com intensidades de 60% e 85% de 1RM, respectivamente. A pressão arterial sistólica (PAS) e diastólica (PAD) foram monitoradas em cada sessão nos momentos: antes, imediatamente após, e a cada 10' durante uma hora. RESULTADOS: Após a primeira sessão, houve redução (p=0,001) da PAS a partir de 20' pós-exercício, sem alterações em relação aos níveis basais; a PAD demonstrou redução (p=0,03) em relação ao repouso apenas nos momentos 20' e 30' pós-exercício. Na segunda sessão, a PAS apresentou redução (p=0,01) a partir do momento 30' pós-exercício até a última mensuração; a PAD não apresentou alterações. Não houve alterações entre as sessões com 60 e 85% de 1RM para PAS e PAD. CONCLUSÃO: Apesar de ser observada tendência à redução nos níveis das variáveis em ambas as sessões, não foram observadas significâncias que pudessem caracterizar a HPE. Entretanto, observou-se que a manipulação da intensidade produziu respostas similares entre as sessões para PAS e PAD.


OBJECTIVE: To investigate the effect of strength training (ST) with distinct intensity characteristics, on post exercise hypotension (PEH) occurrence and magnitude. METHODS: Seven normotensive men were submitted to two ST sessions, with intensities of 60% and 85% of 1RM, respectively. Systolic (SBP) and diastolic blood pressure (DBP) were measured at distinct moments of each session: before, immediately after, and each 10' for one hour. RESULTS: After the first session, there was a reduction (p=0.001) on SBP since 20' post-exercise, without changes compared to the basal levels; DBP showed reduction (p=0.03) compared to rest only at 20' post and 30' post-exercise. In the second session, SBP showed reduction (p=0.01) since 30' post-exercise until the last measure; DBP did not show any changes. There were no changes between the session with 60 and 85% of 1RM for SBP or DBP. CONCLUSION: Despite the trend of reduction of the variables at both sessions, there were no significance that could characterize the PEH. However, it was observed that the intensity manipulation has produced similar of SBP and DBP response for both exercise sessions.


OBJETIVO: Investigar el efecto del entrenamiento de fuerza (TF) con distintas intensidades sobre la ocurrencia y magnitud de la hipotensión post-ejercicio (HPE). MÉTODOS: siete hombres normotensos fueron sometidos a dos sesiones de TF, con intensidades de 60% y 85% de 1RM, respectivamente. La presión arterial sistólica (PAS) y diastólica (PAD) fue monitoreada en cada sesión en los momentos: antes, inmediatamente después, y cada 10 'durante una hora. RESULTADOS: Después de la primera sesión, hubo reducción (p = 0,001) de la PAS a partir de 20 'post-ejercicio, sin alteraciones en comparación con los niveles basales; la PAD demostró reducción (p = 0,03) en relación al reposo sólo en los momentos 20 'y 30' post-ejercicio. En la segunda sesión, la PAS presentó reducción (p = 0,01) a partir del momento 30 'post-ejercicio hasta la última medición; la PAD no presentó cambios. No hubo cambios entre las sesiones con 60 y 85% de 1RM para PAS y PAD. CONCLUSIÓN: Aunque se observó tendencia a la reducción en los niveles de las variables en ambas sesiones, no se observaron significaciones que pudieran caracterizar la HPE. Sin embargo, se observó que la manipulación de la intensidad produjo respuestas similares entre las sesiones para PAS y PAD.


Subject(s)
Humans , Male , Young Adult , Blood Pressure/physiology , Resistance Training , Post-Exercise Hypotension , Exercise , Analysis of Variance , Arterial Pressure/physiology
18.
Braz. j. med. biol. res ; 53(1): e8645, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055484

ABSTRACT

Data about the feasibility and safety of thoracoscopic surgery under non-intubated anesthesia and regional block are limited. In this prospective study, 57 consecutive patients scheduled for thoracoscopic surgery were enrolled. Patients were sedated with dexmedetomidine and anesthetized with propofol and remifentanil. Ropivacaine was used for intercostal nerve and paravertebral block. Lidocaine was used for vagal block. The primary outcomes were mean arterial pressure (MAP), heart rate (HR), oxygen saturation, and end-tidal carbon dioxide partial pressure (ETCO2) at T0 (pre-anesthesia), T1 (immediately after laryngeal mask/nasopharyngeal airway placement), T2 (immediately after skin incision), T3 (10 min after opening the chest), T4 (end of surgery), and T5 (immediately after laryngeal mask/nasopharyngeal airway removal). One patient required conversion to intubation, 15 developed intraoperative hypotension, and two had hypoxemia. MAP at T0 and T5 was higher than at T1-T4; MAP at T3 was lower (P<0.05 vs other time points). HR at T0 and T5 was higher (P<0.05 vs other time points). ETCO2 at T2 and T3 was higher (P<0.05 vs other time points). Arterial pH, PCO2, and lactic acid at T1 differed from values at T0 and T2 (P<0.05). The Quality of Recovery-15 (QoR-15) score at 24 h was lower (P<0.05). One patient experienced dysphoria during recovery. Thoracoscopic surgery with regional block under direct thoracoscopic vision is a feasible and safe alternative to conventional surgery under general anesthesia, intubation, and one-lung ventilation.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Young Adult , Thoracoscopy/methods , Laryngeal Masks , Anesthesia, General/methods , Nerve Block/methods , Blood Pressure/drug effects , Blood Pressure/physiology , Propofol/administration & dosage , Feasibility Studies , Prospective Studies , Dexmedetomidine/administration & dosage , Remifentanil/administration & dosage , Heart Rate/drug effects , Heart Rate/physiology
19.
Arq. bras. cardiol ; 114(1): 109-117, Jan. 2020. tab, graf
Article in English | LILACS | ID: biblio-1055081

ABSTRACT

Abstract Background: Non-dipper blood pressure (NDBP) is one of the important causes of hypertension-related target organ damage and future cardiovascular events. Currently, there is no practical tool to predict NDBP pattern. Objectives: The aim of this study was to investigate the relationship between aortic arch calcification (AAC) on chest radiography and NDBP pattern. Methods: All patients referred for ambulatory BP monitoring test were approached for the study participation. NDBP was defined as the reduction of ≤10% in nighttime systolic BP as compared to the daytime values. AAC was evaluated with chest radiography and inter-observer agreement was analyzed by using kappa statistics. Univariate and multivariate logistic regression analysis was conducted to assess the association of AAC and NDBP pattern. A 2-tailed p-value < 0.05 was considered statistically significant. Results: A total of 406 patients (median age: 51.3) were included. Of these, 261(64%) had NDBP pattern. Overall, the prevalence of AAC was 230 (57%). Non-dipper group had significantly higher prevalence of AAC (70% vs. 33%, p < 0.0001) as compared to the dipper group. Presence of AAC was a strong and independent predictor of NDBP pattern (OR 3.919, 95%CI 2.39 to 6.42) in multivariate analysis. Conclusions: Presence of AAC on plain chest radiography is strongly and independently associated with the presence of NDBP pattern.


Resumo Fundamento: A pressão arterial não-dipper é uma das causas mais importantes de lesão de órgão-alvo da hipertensão e de eventos cardiovasculares futuros. Atualmente, não há uma ferramenta prática para prever o padrão não-dipper de pressão arterial. Objetivos: O objetivo deste estudo foi investigar a relação entre a calcificação no arco aórtico detectada no raio de tórax e o padrão não-dipper de pressão arterial. Métodos: Todos os pacientes encaminhados para monitorização ambulatorial da pressão arterial foram abordados para participação no estudo. A pressão arterial não-dipper foi definida como a redução de ≤10% da pressão arterial sistólica noturna quando comparada com os valores diários. A calcificação no arco aórtico foi avaliada através de radiografia do tórax e a concordância interobservador foi analisada utilizando a estatística kappa. Análises de regressão logística uni e multivariada foram realizadas para avaliar a associação entre a calcificação no AA e o padrão PADV. Valores de p bicaudais < 0,05 foram considerados estatisticamente significativos. Resultados: Ao todo, 406 pacientes (idade mediana: 51,3) foram incluídos. Desses, 261(64%) apresentavam padrão não-dipper de pressão arterial. De modo geral, a prevalência de calcificação no arco aórtico foi de 230 (57%). O grupo não-dipper apresentou prevalência significativamente maior de calcificação no arco aórtico (70% vs. 33%, p < 0,0001) em relação ao grupo dipper. A presença de calcificação no arco aórtico foi um preditor forte e independente de padrão não-dipper de pressão arterial (OR = 3,919; IC: 95% 2,39-6,42) em análise multivariada. Conclusões: A presença de calcificação no arco aórtico em raio-x de tórax simples está forte e independentemente associada à presença de padrão não-dipper de pressão arterial.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aortic Diseases/diagnostic imaging , Blood Pressure/physiology , Vascular Calcification/diagnostic imaging , Aortic Diseases/physiopathology , Severity of Illness Index , Radiography, Thoracic , Risk Factors , Circadian Rhythm , Blood Pressure Monitoring, Ambulatory , Vascular Calcification/physiopathology
20.
Einstein (Säo Paulo) ; 18: eAO5227, 2020. tab, graf
Article in English | LILACS | ID: biblio-1056054

ABSTRACT

ABSTRACT Objective To investigate the efficacy of a behavior change program named Vida Ativa Melhorando a Saúde on cardiovascular parameters in hypertensive patients. Methods Ninety hypertensive patients aged over 40 years were randomly allocated to one of two groups: Vida Ativa Melhorando a Saúde or Control (n=45 respectively). Patients in the Vida Ativa Melhorando a Saúde group took part in a behavior change program aimed to encourage changes in physical activity levels and eating habits, according to the Social Cognitive Theory. The program consisted of 90-minute weekly group meetings conducted by a physical therapist and a dietitian. One chapter of the educational material (workbook) provided was discussed per meeting. Participants in the Control Group attended a single educative lecture on lifestyle changes. Brachial and central blood pressure, arterial stiffness and endothelial function parameters were measured pre- and post-intervention. Results Vida Ativa Melhorando a Saúde led to reduction of brachial (131.3±15.8mmHg to 125.1±17.3mmHg; p<0.01) and central (123.6±16.3mmHg to 119.0±20.6mmHg; p=0.02) systolic and brachial diastolic (123.6±16.3mmHg to 119.0±20.6mmHg; p<0.01) blood pressure values, and improvement of post-occlusive reactive hyperemia (from 5.7±2.5mL·100mL−1 to 6.5±2.1mL·100mL−1 tissue·min−1; p=0.04). No changes in body composition, heart rate and arterial stiffness parameters were detected in both groups (p>0.05). Conclusion Vida Ativa Melhorando a Saúde program improved blood pressure and microvascular reactivity in hypertensive patients. Trial registration: ClinicalTrials.gov: NCT02257268


RESUMO Objetivo Analisar a eficácia do programa de mudança de comportamento Vida Ativa Melhorando a Saúde sobre parâmetros cardiovasculares em pacientes hipertensos. Métodos Noventa pacientes hipertensos ≥40 anos foram aleatoriamente randomizados em dois grupos: Vida Ativa Melhorando a Saúde (n=45) e Controle (n=45). O Grupo Vida Ativa Melhorando a Saúde participou de um programa de mudança de comportamento que objetiva motivar mudanças na atividade física e nos hábitos alimentares, de acordo com a teoria sociocognitiva. O programa foi conduzido em grupos, durante 12 semanas consecutivas, em encontros semanais (~90 minutos), conduzidos por um profissional de edução física e um nutricionista. Um capítulo do material didático era discutido em cada um desses encontros. O Grupo Controle participou de uma única palestra educativa sobre mudanças de estilo de vida. Medidas de pressão arterial braquial e central, rigidez arterial, e de função endotelial foram realizadas nos momentos pré e pós-intervenção. Resultados O Grupo Vida Ativa Melhorando a Saúde reduziu a pressão arterial sistólica braquial (de 131,3±15,8mmHg a 125,1±17,3mmHg; p<0,01) e central (de 123,6±16,3mmHg a 119,0±20,6mmHg; p=0,02) e a pressão arterial diastólica braquial (123,6±16,3mmHg a 119,0±20,6mmHg; p<0,01) e apresentou melhora na hiperemia reativa pós-oclusão (de 5,7±2,5mL·100mL−1a 6,5±2,1mL·100mL−1tecido·min−1; p=0,04). Não houve modificação na composição corporal, na frequência cardíaca e nem nos parâmetros de rigidez arterial em ambos os grupos (p>0,05). Conclusão O Programa Vida Ativa Melhorando a Saúde melhorou a pressão arterial e a reatividade microvascular em pacientes hipertensos. Registro do estudo: ClinicalTrials.gov: NCT02257268


Subject(s)
Humans , Male , Female , Aged , Health Behavior/physiology , Hypertension/physiopathology , Blood Pressure/physiology , Body Composition , Exercise/physiology , Program Evaluation , Treatment Outcome , Feeding Behavior/physiology , Vascular Stiffness/physiology , Heart Rate/physiology , Hyperemia/physiopathology , Hypertension/psychology , Life Style , Middle Aged
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