Multicomponent exercise decreases blood pressure, heart rate and double product in normotensive and hypertensive older patients with high blood pressure / El ejercicio multicomponente disminuye los parámetros hemodinámicos en pacientes ancianos normotensos e hipertensos no controlados

Abstract Objective: The present study aimed to investigate the effects of a 6-month multicomponent exercise program on blood pressure, heart rate, and double product of uncontrolled and controlled normotensive and hypertensive older patients. Methods: The study included 183 subjects, 97 normotensives, of which 53 were controlled normotensives (CNS), and 44 uncontrolled normotensives (UNS), as well as 86 hypertensives, of which 43 were controlled hypertensives (CHS), and 43 uncontrolled hypertensives (UHS). Volunteers were recruited and blood pressure and heart rate measurements were made before and after a 6-month multicomponent exercise program. The program of physical exercise was performed twice a week for 26 weeks. The physical exercises program was based on functional and walking exercises. Exercise sessions were performed at moderate intensity. Results: The results indicated that UHS showed a marked decrease in systolic (−8.0 mmHg), diastolic (−11.1 mmHg), mean (−10.1 mmHg), and pulse pressures, heart rate (−6.8 bpm), and double product (−1640 bpm mmHg), when compared to baseline. Similarly, diastolic (−5.5 mmHg) and mean arterial (−4.8 mmHg) pressures were significantly decreased in UNS. Concomitantly, significant changes could be observed in the body mass index (−0.9 kg/m2;−1.5 kg/m2) and waist circumference (−3.3 cm; only UHS) of UNS and UHS, which may be associated with the changes observed in blood pressure. Conclusions: In conclusion, the data of the present study indicate that a 6-month multicomponent exercise program may lead to significant reductions in blood pressure, heart rate, and double product of normotensive and hypertensive patients with high blood pressure values.

Resumen Objetivo: El presente estudio tuvo como objetivo investigar los efectos de un programa de ejercicios multicomponente de 6 meses sobre la presión arterial, la frecuencia cardíaca y el doble producto de pacientes mayores hipertensos y normotensos (incontrolados y controlados). Método: 183 sujetos, 97 normotensos - 53 normotensos controlados (SNC) y 44 normotensos no controlados (SNU) - y 86 hipertensos - 43 hipertensos controlados (CHS) y 43 hipertensos no controlados (UHS) -, fueron reclutados y sometidos a evaluaciones (presión arterial y frecuencia cardíaca) antes y después de un programa de ejercicios multicomponente de 6 meses. El programa de ejercicio se realizó dos veces por semana durante 26 semanas. El programa de ejercicios físicos se basó en ejercicios funcionales y de caminar. Las sesiones de ejercicio se realizaron a intensidad moderada. Resultados: Los resultados indicaron que UHS presentó una marcada disminución en presión sistólica (−8.0 mmHg), diastólica (−11.1 mmHg), media (−10.1 mmHg) y de pulso, frecuencia cardíaca (−6.8 lpm) y doble producto (−1640 lpm mmHg) cuando se compara con la línea base. De manera similar, las presiones diastólica (−5.5 mmHg) y arterial media (−4.8 mmHg) se redu- jeron significativamente en los SNU. Concomitantemente, fue posible observar alteraciones significativas en el índice de masa corporal (−0.9 kg/m2; −1.5 kg/m2) y circunferencia de cintura (−3.3 cm, solo UHS) de UNS y UHS, lo que puede estar asociado con los cambios observados en la presión arterial. Conclusiones: En conclusión, los datos del presente estudio indican que un programa de ejercicio multicomponente de 6 meses puede provocar reducciones significativas en la presión arterial, frecuencia cardíaca y doble producto de pacientes normotensos e hipertensos con valores de presión arterial alta.

Cutoffs and cardiovascular risk factors associated with neck circumference among community-dwelling elderly adults: a cross-sectional study / Pontos de corte e fatores de risco cardiovascular associados com a circunferência do pescoço em idosos da comunidade: um estudo transversal

ABSTRACT CONTEXT AND OBJECTIVE: In elderly people, measurement of several anthropometric parameters may present complications. Although neck circumference measurements seem to avoid these issues, the cutoffs and cardiovascular risk factors associated with this parameter among elderly people remain unknown. This study was developed to identify the cutoff values and cardiovascular risk factors associated with neck circumference measurements among elderly people. DESIGN AND SETTING: Cross-sectional study conducted in two community centers for elderly people. METHODS: 435 elderly adults (371 women and 64 men) were recruited. These volunteers underwent morphological evaluations (body mass index and waist, hip, and neck circumferences) and hemodynamic evaluations (blood pressure values and heart rate). Receiver operating characteristic curve analyses were used to determine the predictive validity of cutoff values for neck circumference, for identifying overweight/obesity. Multivariate analysis was used to identify cardiovascular risk factors associated with large neck circumference. RESULTS: Cutoff values for neck circumference (men = 40.5 cm and women = 35.7 cm), for detection of obese older adults according to body mass index, were identified. After a second analysis, large neck circumference was shown to be associated with elevated body mass index in men; and elevated body mass index, blood pressure values, prevalence of type 2 diabetes and hypertension in women. CONCLUSION: The data indicate that neck circumference can be used as a screening tool to identify overweight/obesity in older people. Moreover, large neck circumference values may be associated with cardiovascular risk factors.

RESUMO CONTEXTO E OBJETIVO: Em idosos, diversas ferramentas antropométricas podem apresentar complicações durante a mensuração. Embora a circunferência do pescoço pareça evitar tais problemas, os pontos de corte e fatores de risco cardiovascular associados a essa ferramenta em idosos permanecem desconhecidos. Este estudo foi desenvolvido para identificar os valores de ponto de corte e fatores de risco cardiovascular associados à circunferência do pescoço em idosos. DESENHO E LOCAL: Estudo transversal, realizado em dois centros comunitários para idosos. MÉTODOS: 435 idosos (371 mulheres e 64 homens) foram recrutados. Os voluntários foram submetidos a avaliação morfológica (índice de massa corporal e cintura, quadril, e circunferência do pescoço) e hemodinâmica (valores da pressão arterial e frequência cardíaca). A análise pela curva receiver operating characteristic foi usada para determinar o valor preditivo dos valores de ponto de corte da circunferência do pescoço para identificação de sobrepeso/obesidade. Análise multivariada foi usada para identificar os fatores de risco cardiovascular associados com circunferência do pescoço larga. RESULTADOS: Os valores de corte para circunferência do pescoço (homens = 40,5 cm e mulheres = 35,7 cm) para detectar adultos idosos obesos, de acordo com o índice de massa corporal, foram identificados. Depois da segunda análise, circunferência do pescoço larga foi associada com elevado índice de massa corporal em homens e mulheres e elevados valores de pressão arterial, prevalência de diabetes mellitus tipo II e hipertensão em mulheres. CONCLUSÃO: Os dados indicam que a circunferência do pescoço pode ser utilizada como ferramenta de rastreio para identificar sobrepeso/obesidade em idosos. Ademais, altos valores de circunferência do pescoço podem estar associados com fatores de risco cardiovascular.