Efeitos agudos e crônicos do exercício de força na pressão arterial ambulatorial: uma revisão sistemática e metanálise

Abstract

Resistance exercise has been used as a strategy to control clinical blood pressure, however its effect, both acute and chronic, on ambulatory blood pressure remains uncertain. Thus, the objective of the present study was to summarize, through a systematic review and meta-analysis, the acute and chronic effects of resistance exercise on ambulatory blood pressure (BP) in healthy individuals and those with chronic non-communicable diseases (NCDs). Data searches were performed in PubMed and Web of Science by two independent investigators for studies published up to April 2023. Acute or chronic studies reporting the effects of resistance exercise on ambulatory BP parameters (ambulatory blood pressure of 24 hours, period of wakefulness, period of sleep, nocturnal decrease and morning rise of BP). Mean differences (MDs) with 95% confidence intervals (95% CI) were calculated using an inverse variance method with a random effects model. Twenty-four studies were included, of which 17 investigated the acute effects (338 participants) and seven the chronic effects (326 participants) of resistance exercise on ambulatory BP. The result of the meta-analysis for acute studies showed a reduction in sleep systolic BP in participants with NCDs (MD: -1.31; 95% CI: -2.27, -0.34; p=0.008) and a reduction in waking diastolic BP in healthy subjects (MD: -0.77; 95% CI: 1.51, -0.03; p=0.04) compared to the control condition.). Meta-analysis for chronic studies showed a significant reduction in 24-hour systolic BP for chronic diseases (MD: -4.00; 95% CI: -7.90, -0.09; p = 0.05). Also, resistance training decreased diastolic BP in chronic diseases (MD: -1.34; 95% CI: -2.54, -0.14; p = 0.03), and overall (MD: -1.32; 95% CI: -2.29, -0.35; p = 0.008). The meta-analysis revealed reductions in awake systolic and diastolic BP in chronic diseases (Systolic - MD: -5.63; 95% CI: -9.24, -2.03; p = 0.002; Diastolic - MD: -1.60; 95% CI: -2.77, -0.43; p = 0.007) and overall (Systolic - MD: -4.32; 95% CI: -7.09, -1.55; p = 0.002; Diastolic - MD: -1.33; 95% CI: -2.31, -0.35; p = 0.008). In conclusion, the results of this systematic review and meta-analysis indicate that there is heterogeneity of results between studies. Despite this, there is evidence that resistance exercise acutely reduces systolic BP during sleep in individuals with CNCDs and diastolic BP during wakefulness in healthy individuals, while chronically it can lead to reductions in 24-hour systolic and diastolic BP and mainly in systolic and diastolic BP. in individuals with CNCD.