Avaliação da variabilidade da frequência cardíaca, do perfil inflamatório e de estresse oxidativo em policiais militares do sexo feminino com histórico familiar de hipertensão: papel da atividade física

Abstract

Cardiovascular diseases (CVD) are the leading cause of death, with systemic arterial hypertension (SAH) playing a significant role in this scenario. SAH is associated with dysfunctions in the autonomic nervous system, increased systemic inflammation and an imbalance in oxidative stress. Studies show that male military police officers (PMESP) have a CVD mortality rate 2 to 3.5 times higher than that of the civilian population in the same age group. Although Brazilian women have high rates of SAH diagnosis and CVD deaths, there is a lack of specific data on this condition in the female PMESP population. This dissertation investigated the comparison between heart rate variability (HRV), inflammation and oxidative stress in female military police officers with a positive family history of systemic arterial hypertension (SAH), comparing them to a group without this history. It also assessed the impact of physical activity on this condition. 72 female police officers took part and were divided into two groups: those with a positive family history (HFP, n=45), with an average age of 35.9± 6.3 years, and those with a negative family history (HFN, n=27), with an average age of 33.6± 4.7 years. Physical activity and psychological questionnaires were administered, and anthropometric, hemodynamic and HRV measurements were taken (linear and non-linear methods), as well as assessments of inflammatory mediators (TNF-alpha, IL-6 and IL-10) and systemic oxidative stress (pro-oxidant, antioxidant and cell damage markers). There were no differences between the groups in terms of body composition, psychological assessments and level of physical activity, with most of the women classed as physically active. The HFP group had higher DBP (72.96±5.89 vs. 68.51±7.69 mmHg) and HR (70.70±8.94 vs. 64.99±7.61 bpm), as well as lower total variability and parasympathetic modulation (RMSSD and HF band) and higher cardiac sympathovagal balance (LF/HF: 1.6 (0.3-4.5) vs. 0.8 (0.2-4.7) and SD2/SD1: 1.9 (1.2-3.5) vs. 1.5 (1.0 -2.8)). In addition, the HFP group showed a reduction in IL-10 and an increase in TNF-alpha and the TNF-alpha/IL-10 and IL-6/IL-10 ratios, as well as an increase in hydrogen peroxide, NADPH oxidase activity and lipoperoxidation, as assessed by TBARS. In the HFP group, there was a significant correlation between RMSSD and LF/HF (r=-0.48/ p=0.0024); LF/HF with IL6/IL-10 (r=0.44/ p=0.006) and with TNF-alpha/IL-10 (r=0.42/ p=0.017); IL6/IL-10 ratio with TBARS (r=0.44/ p= 0.005); LF/HF and physical activity time (r=-0.34/ p=0.043); RMSSD with physical activity time (r=0.57/ p=0.001) and with sitting time per day (r=-0.52/ p=0.0012).In conclusion, the findings reinforce that a family history of hypertension is related to early neuroinflammatory and oxidative stress dysfunctions in female police officers with a positive family history of hypertension, and that higher levels of physical activity seem to mitigate these impairments, possibly impacting the risk of developing hypertension.