Efeito agudo do exercício aeróbio, de força e concorrente sobre a pressão arterial, o controle autonômico cardíaco e a função endotelial de pré-hipertensos com sobrepeso

Abstract

Prehypertension is an independent risk factor for atherosclerosis and cardiovascular disease. This condition can alter the morphology of the arterial reflected wave and cause impaired vascular function. The acute impact of different kinds of exercise (aerobic, resistance or concurrent) on the pulse wave reflection are scarce and scientific evidence is still needed. The aim of this study was to evaluate the acute effect of aerobic, resistance and concurrent exercise on endothelial function, blood pressure, pulse wave reflection and cardiac autonomic modulation in overweight prehypertensive subjects. Fifteen sedentary, overweight and prehypertensive men were selected for a non-randomized clinical trial to participate in three exercise sessions, one aerobic, one resistance and another concurrent exercise. Blood pressure, reactive hyperemia index, heart rate variability and aortic pressures were assessed before and after exercise sessions. Compared to pre-exercise data, the results showed that aerobic and concurrent exercise reduced systolic blood pressure (-4.32.0mmHg and -6.01.5mmHg, respectively, p <0.050) during 25 and 30 minutes of the recovery period, respectively. A reduction of vagal activity was verified mainly after the resistance exercise verified by the rised sympathovagal balance (+1.20.6, p <0.050). Peripheral vascular resistance remained significantly low (-0.070.1mmHg.min / L, p <0.001) and cardiac output remained statistically high (+0.80.3L / min, p <0.01) only after resistance exercise. Pulse wave reflection parameters decreased after aerobic and concurrent exercise (AIx = -5.11.7%, p = 0.030, and -7.62.4%, p = 0.002, respectively). There was no significant change in the reactive hyperemia index after exercise sessions (F = 0.68, p = 0.51). Despite this, after concurrent exercise, RHI correlated to systemic vascular resistance (r = -0.53, p = 0.043) and with heart rate (r = 0.68, p = 0.005), while changes in augmentation indexes (AIx and AIx 75) were associated with a predominance of sympathetic activity (r = -0.71, p = 0.015; and r = -0.70, p = 0.016, respectively). In conclusion, aerobic and concurrent exercise were shown to be effective in reducing blood pressure and pulse wave reflection parameters in prehypertensive patients. The pronounced transient vagal suppression seen after resistance exercise seems to be attenuated when followed by an aerobic exercise, in a concurrent session. For prehypertensive patients, after a concurrent exercise session, the possibility of improvement in microvascular endothelial function seems to be associated with the reduction of peripheral vascular resistance and an elevation of the cardiac effort, possibly mirroring the shear stress of the session. Likewise, the results suggest that the reduction of pulse wave parameters is also associated with the level of cardiac effort performed in the concurrent session.