Modulação do sistema autonômico em pacientes hipertensos submetidos ao treinamento aeróbico

Abstract

Systemic arterial hypertension (SAH) is a major risk factor for cardiovascular disease (CVD), affecting approximately one billion people worldwide. It is the most important cause of morbidity and mortality. The blood pressure control has its SNA (sympathetic and parasympathetic). Studies on hypertension have shown that increased sympathetic activity is related to the blood pressure lowering effect, conditioning the most severe forms of the disease. The objective was to verify the SNA behavior through the analysis of Heart Rate Variability - HRV in hypertensive patients undergoing an aerobic training protocol (PPRCV) developed for cardiac rehabilitation. The study hypertensive patients of both genders, age 54.43 ± 8.25. The patients underwent series of tests and pre and post appraisal (medical appraisal; anthropometric measurements; TC6’, biochemical blood tests; measures of HRV, answered the IPAQ). Performed exercises for cardiac and neuromuscular adaptation (PACRNM) for 4 weeks. After adaptation PPRCV applied for 12 weeks. Reviewed anthropometric, biochemical and physiological variables and blood was found to decrease the circumference of the abdomen: 0.99 ± 0.01 (m), to 0.95 ± 0.02 (m); p <0.0001. The TC6’: 398.0 ± 82.0 (m); to 467.0 ± 61.0 (m), p = 0.0052. VO2: 19.7 ± 4.5 and 25.4 ± 5.5, with p = 0.0011. SpO2 showed an increase to 96.9 ± 0.7 97.5 ± 0.3, p = 0.0054. In the biochemistry of blood, with p <0.0001, all variables: Triglycerides: 224.90 ± 41.97 to 174.05 ± 25,24; Total cholesterol: 212.24 ± 13.59; 189.36 ± 12.01; HDL: 35.43 ± 8.55; 45.26 ± 5.55; LDL: 150.70 ± 11.73; 105.77 ± 14.16; VLDL: 26.11 ± 5.57; 38,35 ± 2 29; Fasting Glucose: ± 9.08 107.76; 84.14 ± 9.76. HRV in% AF: 43.5 ± 11.3; to 53.1 ± 14.5 p 0.0276; and % BF: 56.4 ± 11.3; to 46.8 ± 14.5; p 0.0276; in LF / HF ratio: 2.3 ± 1.6; to 1.3 ± 1.0, p 0.0364. The hemodynamic analysis: SBP 128.8 ± 5.0; 118.8 ± 0.7, p <0.0001, 83.9 ± 5.4 DBP; 76.3 ± 0.9 p <0.0001, 98.9 ± 5.1 MBP; 89.3 ± 1.6 p <0.0001; HR: 77.5 ± 2.3; to 75.0 ± 1.5 p <0.0005. DP: 10919.5 ± 1862.06 to 8027.6 ± 353.8, p = 0.0002. Regarding the IPAQ vigorous activity per week (4,1> 6-Km.h-1, 4-11 MET) at the beginning and only 0.095 ± 0 3.85 ± 0 at the end, and a day ± 0.33 0 to 38.57 ± 0.7. The results affirm that there is evidence of improvement in aspects related to physical fitness, quality of life, which showed positive changes, such as in cardiovascular variables, physiological, proposing improvement in cardiovascular function. HRV, the frequency domain, we observed changes in the percentage of AF% (-9.6%) and an increase in LF% (9.6%), which indicates improvement in autonomic modulation and allows us to state that there is a reduction in hyperactivity the sympathetic nervous system, with increased vagal parasympathetic function. These changes reflected beneficially in cardiac autonomic modulation of hypertensive patients.