Impacto do nível de atividade física e do sobrepeso em filhos de pais normotensos ou hipertensos: avaliações cardiovasculares, autonômicas, de estresse oxidativo e de adesão

Abstract

The objective of the present study was to evaluate the impact of the level of physical activity and overweight in offspring of normotensives or hypertensives, as well as to validate a scale of prediction of adherence to physical activity. This thesis was divided into two studies. In Study I, we observed that among the twenty items on the adherence scale, ten presented good reproducibility (Kappa> 0.70, Pearson's correlation> 0.81), good internal consistency (Cronbach's Alpha 0.84), good clarity and discriminant validity (p = 0.0006 vs sedentary, t = 4.12), correlation between the sum of the scale and the Mets (metabolic equivalent) evaluated by IPAQ with r = 0.073 and p = 0.048. In Study II, 114 males, young, physically active and insufficiently active adults, offspring of normotensives or hypertensives, overweight or eutrophic were selected. The IPAQ was used for the level of physical activity, the PSS-10 for perceived stress, the WHOQOL for quality of life analysis. Anthropometric, hematological and biochemical analyzes and systemic oxidative stress evaluations were performed. In addition, blood pressure (BP) recording beat-to-beat using the Finometer® was used for evaluation of hemodynamic parameters and of heart rate (HRV) and BP variability (BPV). The results showed a higher BMI and % of fat, both by folds and Bioelectrical impedance analysis, in the overweight groups compared to the eutrophic groups, as well as higher weekly caloric expenditure among the active groups in relation to the sedentary groups, independently of the familial history of hypertension (FHH). In the hematological and biochemical profile all groups presented values within the normal range. The BP values were similar between the studied groups, but a lower heart rate was observed in the active groups with a negative FHH. There was no difference in perceived stress levels, but the quality of life was better in the active groups, with lower benefits in the group with a positive FHH. In relation to HRV, the active eutrophic groups, both with a positive and negative FHH, had higher values of RMSSD (cardiac parasympathetic modulation) and lower sympatho/vagal balance in relation to their respective eutrophic sedentary groups, which was not observed in overweight groups. The groups with a positive FHH presented higher values of both simpato/vagal balance (eutrophic and overweight), SAP variance (just overweight) and vascular sympathetic modulation (LF) (eutrophic and overweight) compared to the group with negative FHH, and these differences were attenuated in the physically active group with FHH and overweight. The active eutrophic group with a negative FHH presented better baroreflex sensitivity in relation to their respective sedentary group, which was not observed in the group with a FHH. With regard to oxidative stress, active groups with a negative FHH had lower levels of hydrogen peroxide and nitrites and greater activity of the antioxidant enzyme glutathione peroxidase (just eutrophic) when compared to their respective sedentary groups, which was not observed for the offspring of hypertensives (sedentary vs actives). In addition, these two parameters and the oxidation of proteins (carbonyls) were increased in the overweight and non-overweight groups with a FHH in relation to the eutrophic group with a negative FHH, being attenuated in the active group with FHH and overweight. In conclusion, the scale of adherence to the physical active developed in this study showed good reproducibility, good internal consistency, clarity and discriminating validity. In addition, our results showed that even under normal clinical conditions, a positive FHH, regardless of the presence of overweight, induced autonomic dysfunction and increases in oxidative stress markers that may be precursors of cardiometabolic diseases in this genetically predisposed population. On the other hand, a physically active lifestyle improves HRV, baroreflex and parameters related to redox status in individuals with a negative FHH. Such benefits seem to be attenuated by the positive FHH, but a physically active lifestyle seems to prevent/attenuate the dysfunctions observed in this condition.