Combined effect of physical exercise and hormone replacement therapy on cardiovascular and metabolic health in postmenopausal women: A systematic review and meta-analysis

The cardioprotective effect of postmenopausal hormone replacement therapy (HRT) has been demonstrated in several studies. Similarly, physical exercise has yielded positive results. However, the effects of their combination remain inconclusive. This review describes the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We searched the Scopus, Web of Science, PubMed, and Embase databases and included randomized controlled trials published up to December 2021 on the combined effects of physical exercise and hormone therapy on cardiovascular and metabolic health in postmenopausal women. We identified 148 articles, of which only seven met the inclusion criteria (386 participants; 91 [23%] HRT + exercise; 104 [27%] HRT; 103 [27%] exercise; 88 [23%] placebo). The combined treatment further decreased systolic blood pressure (SBP) compared to the isolated effect of aerobic training (AT) (mean difference [MD]=-1.69; 95% confidence interval [CI]=-2.65 to -0.72, n=73). Nevertheless, it attenuated the decrease in diastolic blood pressure (DBP) (MD=0.78; 95%CI: 0.22-1.35, n=73), and the increase in peak oxygen consumption (VO2 peak) promoted by exercise (AT + HRT=2.8±1.4 vs AT + placebo=5.8±3.4, P=0.02). The combination of AT and oral HRT improved SBP. However, AT alone seemed to have a better effect on physical fitness and DBP in postmenopausal women.

Thyrotropin and free thyroxine levels and coronary artery disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)

Data on the association between subclinical thyroid dysfunction and coronary artery disease (CAD) is scarce. We aimed to analyze the association between thyroid function and CAD using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). We included subjects with normal thyroid function (0.4-4.0 mIU/L, and normal free thyroxine, FT4, or 0.8 to 1.9 ng/dL), subclinical hypothyroidism (SCHypo; TSH>4.0 mIU/L and normal FT4), and subclinical hyperthyroidism (SCHyper; TSH<0.4 mIU/L and normal FT4) evaluated by coronary computed tomography angiography. We excluded individuals using medications that interfere in thyroid function or with past medical history of cardiovascular disease. Logistic regression models evaluated the presence of CAD, segment involvement score (SIS) >4, and segment severity score (SSS) >4 of coronary arteries as the dependent variables, and quintiles of TSH and FT4 as the independent variables, adjusted for demographical data and cardiovascular risk factors. We included 767 subjects, median age 58 years (IQR=55-63), 378 (49.3%) women, 697 euthyroid (90.9%), 57 (7.4%) with SCHypo, and 13 (1.7%) with SCHyper. No association between TSH and FT4 quintiles and CAD prevalence was noted. Similarly, no association between TSH levels and the extent or severity of CAD, represented by SIS>4 and SSS>4 were seen. Restricting analysis to euthyroid subjects did not alter the results. TSH levels were not significantly associated with the presence, extent, or severity of CAD in a middle-aged healthy population.

Anthropization on the Cerrado biome in the Brazilian Uruçuí-Una Ecological Station estimated from orbital images / Antropização do bioma Cerrado na Estação Ecológica Uruçuí-Una estimada a partir de imagens orbitais

In this study we analysed the dynamics of deforestation and burnings during the dry seasons from 2003 to 2008 in the Uruçuí-Una Ecological Station (UUES) and its buffer zone, located in the Cerrado biome of the southwest of Piauí, a Brazil's State, based on images from the orbital sensors CCD/CBERS-2 and TM/Landsat-5. Two dates from each of the years were interpreted and analysed: one in the middle of the dry season and one at the end. The deforested areas were expanded through the period analysed and were larger in the buffer zone, suggesting a relative protection of the UUES. New cut-offs were predictable because of the early opening of roads that would become their limits. The burning scars were larger at the end of the dry season as a consequence of the management and implementation of agricultures and pastures. In 2004 and 2007 these scars were larger probably because of the increase of dry phytomass that every three years is big enough to spread the fire originated in the anthropogenic burnings through the native vegetation. This scenario reaffirms the need for: stronger enforcement in order to stop anthropisation in the UUES and a management plan, absent for this unit so far. These proceedings are urgent also because the UUES is located in one of the most preserved regions of the Cerrado and controversially where intense anthropisation in ongoing, which stresses the lack, need and urgency of biological conservation proceedings for the Piauí's southeastern Cerrado.

Neste estudo, analisamos a dinâmica dos desmatamentos e queimadas do bioma Cerrado na Estação Ecológica Uruçuí-Una e sua zona tampão, localizada no sudoeste do Piauí, durante as estações secas de 2003 a 2008, com base em imagens dos sensores orbitais CCD/CBERS-2 e TM/Landsat-5. Duas datas de cada ano foram interpretadas e analisadas: uma em meados da estação seca e outra no final. A área desmatada expandiu-se no período analisado e foi maior na zona tampão, sugerindo uma proteção relativa da Estação Ecológica. Novos desmatamentos foram previsíveis devido a prévias aberturas de estradas e aceiros que posteriormente tornaram-se os limites das áreas exploradas. As queimadas foram maiores no período final do que no meio da estação seca em função da implantação e manejo das áreas agropecuárias. Em 2004 e 2007, as queimadas foram maiores provavelmente devido ao acúmulo de fitomassa seca que, a cada três anos, espalha facilmente pela vegetação nativa o fogo originado nas atividades antrópicas. Este cenário enfatiza a necessidade de reforçar a fiscalização para interromper a antropização na Estação Ecológica e de um plano de manejo, ainda ausente nesta Estação. Estas medidas são ainda mais urgentes pelo fato da Estação estar localizada em uma das regiões mais conservadas do Cerrado, mas, paradoxalmente, é onde está ocorrendo intensa antropização, o que realça a ausência, necessidade e urgência de medidas de conservação biológica para o Cerrado do sudoeste do Piauí.

Anthropization on the Cerrado biome in the Brazilian Uruçuí-Una Ecological Station estimated from orbital images

In this study we analysed the dynamics of deforestation and burnings during the dry seasons from 2003 to 2008 in the Uruçuí-Una Ecological Station (UUES) and its buffer zone, located in the Cerrado biome of the southwest of Piauí, a Brazil's State, based on images from the orbital sensors CCD/CBERS-2 and TM/Landsat-5. Two dates from each of the years were interpreted and analysed: one in the middle of the dry season and one at the end. The deforested areas were expanded through the period analysed and were larger in the buffer zone, suggesting a relative protection of the UUES. New cut-offs were predictable because of the early opening of roads that would become their limits. The burning scars were larger at the end of the dry season as a consequence of the management and implementation of agricultures and pastures. In 2004 and 2007 these scars were larger probably because of the increase of dry phytomass that every three years is big enough to spread the fire originated in the anthropogenic burnings through the native vegetation. This scenario reaffirms the need for: stronger enforcement in order to stop anthropisation in the UUES and a management plan, absent for this unit so far. These proceedings are urgent also because the UUES is located in one of the most preserved regions of the Cerrado and controversially where intense anthropisation in ongoing, which stresses the lack, need and urgency of biological conservation proceedings for the Piauí's southeastern Cerrado.

Neste estudo, analisamos a dinâmica dos desmatamentos e queimadas do bioma Cerrado na Estação Ecológica Uruçuí-Una e sua zona tampão, localizada no sudoeste do Piauí, durante as estações secas de 2003 a 2008, com base em imagens dos sensores orbitais CCD/CBERS-2 e TM/Landsat-5. Duas datas de cada ano foram interpretadas e analisadas: uma em meados da estação seca e outra no final. A área desmatada expandiu-se no período analisado e foi maior na zona tampão, sugerindo uma proteção relativa da Estação Ecológica. Novos desmatamentos foram previsíveis devido a prévias aberturas de estradas e aceiros que posteriormente tornaram-se os limites das áreas exploradas. As queimadas foram maiores no período final do que no meio da estação seca em função da implantação e manejo das áreas agropecuárias. Em 2004 e 2007, as queimadas foram maiores provavelmente devido ao acúmulo de fitomassa seca que, a cada três anos, espalha facilmente pela vegetação nativa o fogo originado nas atividades antrópicas. Este cenário enfatiza a necessidade de reforçar a fiscalização para interromper a antropização na Estação Ecológica e de um plano de manejo, ainda ausente nesta Estação. Estas medidas são ainda mais urgentes pelo fato da Estação estar localizada em uma das regiões mais conservadas do Cerrado, mas, paradoxalmente, é onde está ocorrendo intensa antropização, o que realça a ausência, necessidade e urgência de medidas de conservação biológica para o Cerrado do sudoeste do Piauí.