Amilton da Cruz Santos

High-intensity exercise promotes postexercise hypotension greater than moderate intensity in elderly hypertensive individuals

To evaluate the effects of high‐intensity resistance exercise on postexercise hypotension (PEH) and forearm vascular resistance (FVR) in the hypertensive elderly.

Resistance exercise with different volumes: blood pressure response and forearm blood flow in the hypertensive elderly

Background The purpose of this study was to evaluate the effect of two sessions of resistance exercise with different volumes on post-exercise hypotension, forearm blood flow, and forearm vascular resistance in hypertensive elderly subjects. Methods The study was conducted with ten hypertensive elderly (65±3 years, 28.7±3 kg/m2) subjected to three experimental sessions, ie, a control session, exercise with a set (S1), and exercise with three sets (S3). For each session, the subjects were evaluated before and after intervention. In the pre-intervention period, blood pressure, forearm blood flow, and forearm vascular resistance were measured after 10 minutes of rest in the supine position. Thereafter, the subjects were taken to the gym to perform their exercise sessions or remained at rest during the same time period. Both S1 and S3 comprised a set of ten repetitions of ten exercises, with an interval of 90 seconds between exercises. Subsequently, the measurements were again performed at 10, 30, 50, 70, and 90 minutes of recovery (post-intervention) in the supine position. Results Post-exercise hypotension was greater in S3 than in S1 (systolic blood pressure, −26.5±4.2 mmHg versus −17.9±4.7 mmHg; diastolic blood pressure, −13.8±4.9 mmHg versus −7.7±5 mmHg, P<0.05). Similarly, forearm blood flow and forearm vascular resistance changed significantly in both sessions with an increase and decrease, respectively, that was more evident in S3 than in S1 (P<0.05). Conclusion Resistance exercises with higher volume were more effective in causing post-exercise hypotension, being accompanied by an increase in forearm blood flow and a reduction of forearm vascular resistance.

The influence of inspiratory muscle training on diaphragmatic mobility, pulmonary function and maximum respiratory pressures in morbidly obese individuals: a pilot study

Abstract Purpose: To investigate whether 12 week inspiratory muscle training (IMT) has any impact on pulmonary function, maximum respiratory pressures and diaphragmatic mobility (DM) in morbidly obese subjects. Method: Thirty-one morbidly obese individuals were assessed. Volunteers were randomised into two groups. The IMT group (n = 16) followed an IMT protocol for 12 weeks, with a training load of 30% of maximal inspiratory pressure (PImax). The control group (CG) (n = 15) followed the same protocol but without inspiratory load. Results: A total of 14 subjects performed IMT for 12 weeks. Significant increases in PImax (−86.86 ± −20.70 cmH2O versus −106.43 ± −32.97 cmH2O, p < 0.05) and maximal voluntary ventilation (97.84 ± 37.06 L/min versus 115.17 ± 34.17 L/min, p < 0.05) were observed in the IMT group when compared to baseline. However, only FIV1 significantly differed between the IMT group and the CG after the 12 week protocol (3.35 ± 0.96 L versus 2.22 ± 1.07 L, respectively; p < 0.05). No significant differences were found in DM after the IMT protocol was performed. Conclusion: IMT improved PImax and altered the FIV1. These results suggest that the improvements in muscular respiratory efficiency were insufficient to mobilise the diaphragm and modify ventilation mechanics. Pre-operative IMT may be a valuable approach in obese patients for preventing post-operative pulmonary complications. http://clinicaltrials.org -- NCT01449643 -- The Influence of IMT on Diaphragmatic Mobility in Morbidly Obese. Implications for Rehabilitation Morbid Obesity Morbid obesity is a disabling condition that has a serious negative impact on lung function, respiratory muscle function and quality of life. Inspiratory Muscle Training (IMT) is a technique which aims to improve pulmonary expansion and to prevent post surgery complications on morbid obese individuals. This study shows significantly increased on maximal inspiratory pressure, maximal voluntary ventilation and promoted changes on spirometric variables after IMT.

Vitamin C restores blood pressure and vasodilator response during mental stress in obese children.

FUNDAMENTO: A resposta vasodilatadora periferica tem um papel importante na fisiopatologia da obesidade e das doencas cardiacas. OBJETIVO: Avaliar o efeito cronico da suplementacao de vitamina C (VitC) sobre a pressao arterial e na resposta vasodilatadora ao estresse mental. METODOS: Neste estudo prospectivo, randomizado e duplo cego foram avaliadas criancas obesas, de ambos os generos e com idade entre 8 a 12 anos divididas em 2 grupos: 1) grupo de criancas suplementadas com 500 mg de vitamina C (n = 11) e, 2) substância placebo (n = 10) durante 45 dias. Oito criancas eutroficas, pareadas por idade tambem foram arroladas no estudo. Foi avaliada a pressao arterial media (PAM), frequencia cardiaca (ECG) e fluxo sanguineo no antebraco pela plestimografia de oclusao venosa. A condutância vascular no antebraco (CVA) foi obtida atraves da relacao entre o fluxo sanguineo no antebraco e a PAM (X100). RESULTADOS: Antes da intervencao, as criancas obesas apresentaram PAM maior e CVA menor quando comparadas as criancas eutroficas. Pos-intervencao, o Grupo VitC apresentou reducao da PAM no repouso (81 ± 2 vs 75 ± 1 mmHg, p = 0,01), enquanto no Grupo Placebo nao houve alteracao da PAM (p = 0,58). Adicionalmente, VitC promoveu um aumento da CVA no repouso (3,40 ± 0,5 vs 5,09 ± 0,6 un, p = 0,04) e durante o estresse mental (3,92 ± 0,5 vs 6,68 ± 0,9 un, p = 0,03). Alem disso, pos suplementacao com VitC, os niveis da CVA foram estatisticamente semelhantes aos das criancas eutroficas no repouso (5,09 ± 0,6 vs 5,82 ± 0,4 un, p > 0,05) e durante o estresse mental (6,68 ± 0,9 vs 7,35 ± 0,5 un, p > 0,05). CONCLUSAO: Suplementacao com VitC reduziu a pressao arterial e restabeleceu a resposta vasodilatadora periferica em criancas obesas.BACKGROUND Peripheral vasodilation response plays an important role in the pathophysiology of obesity and heart disease. OBJECTIVE To evaluate the chronic effect of vitamin C (VitC) supplementation on blood pressure and on vasodilation response to mental stress. METHODS In a double-blind, randomized and prospective study we evaluated obese children with 8 to 12 years in 2 similar groups: 1) supplemented with 500 mg VitC (n = 11) and 2) placebo (n = 10) for 45 days. Eight age-matched lean control children were also studied. We evaluated: mean blood pressure (MBP), heart rate (HR) and forearm blood flow by venous occlusion plethismography. Forearm vascular conductance (FVC) was calculated by: (forearm blood flow/PAM) X100. RESULTS On pre-intervention evaluations obese children showed higher MBP and lower FVC compared to lean control children. After intervention VitC diminished MBP at rest (81 ± 2 vs 75 ± 1 mmHg, p = 0.01), whereas placebo did not promote changes in MBP (p = 0.58). In addition, VitC promoted FVC increase at rest (3.40 ± 0.5 vs 5.09 ± 0.6 un, p = 0.04) and during the mental stress (3.92 ± 0.5 vs 6.68 ± 0.9 un, p = 0.03). Moreover, after VitC supplementation FVC levels were similar to the lean control children at rest (5.09 ± 0.6 vs 5.82 ± 0.4 un, p > 0.05) and during mental stress (6.68 ± 0.9 vs 7.35 ± 0.5 un, p > 0.05). CONCLUSION VitC supplementation reduced the MBP and restored peripheral vasodilatation response during mental stress in obese children.

Cardiac autonomic modulation in healthy elderly after different intensities of dynamic exercise.

Purpose To investigate the heart rate (HR) and its autonomic modulation at baseline and during dynamic postexercise (PEX) with intensities of 40% and 60% of the maximum HR in healthy elderly. Methods This cross-sectional study included ten apparently healthy people who had been submitted to a protocol on a cycle ergometer for 35 minutes. Autonomic modulation was evaluated by spectral analysis of HR variability (HRV). Results A relevant increase in HR response was observed at 15 minutes postexercise with intensities of 60% and 40% of the maximum HR (10±2 bpm versus 5±1 bpm, respectively; P=0.005), and a significant reduction in HRV was also noted with 40% and 60% intensities during the rest period, and significant reduction in HRV (RR variance) was also observed in 40% and 60% intensities when compared to the baseline, as well as between the post-exercise intensities (1032±32 ms versus 905±5 ms) (P<0.001). In the HRV spectral analysis, a significant increase in the low frequency component HRV and autonomic balance at 40% of the maximum HR (68±2 normalized units [nu] versus 55±1 nu and 2.0±0.1 versus 1.2±0.1; P<0.001) and at 60% of the maximum HR (77±1 nu versus 55±1 nu and 3.2±0.1 versus 1.2±0.1 [P<0.001]) in relation to baseline was observed. A significant reduction of high frequency component at 40% and 60% intensities, however, was observed when compared to baseline (31±2 nu and 23±1 nu versus 45±1 nu, respectively; P<0.001). Moreover, significant differences were observed for the low frequency and high frequency components, as well as for the sympathovagal balance between participants who reached 40% and 60% of the maximum HR. Conclusion There was an increase in the HR, sympathetic modulation, and sympathovagal balance, as well as a reduction in vagal modulation in the elderly at both intensities of the PEX.

High-Intensity Resistance Exercise Promotes Postexercise Hypotension Greater than Moderate Intensity and Affects Cardiac Autonomic Responses in Women Who Are Hypertensive

Abstract de Freitas Brito, A, Brasileiro-Santos, MdS, Coutinho de Oliveira, CV, Sarmento da Nóbrega, TK, Lúcia de Moraes Forjaz, C, and da Cruz Santos, A. High-intensity resistance exercise promotes postexercise hypotension greater than moderate intensity and affects cardiac autonomic responses in women who are hypertensive. J Strength Cond Res 29(12): 3486–3493, 2015—The purpose of this study was to evaluate the effect of high-intensity resistance exercise (RE) sessions on blood pressure (BP), heart rate (HR), cardiac autonomic modulation, and forearm blood flow (FBF). Sixteen trained hypertensive women (n = 16, 56 ± 3 years) completed the following 3 experimental sessions: control (CS), RE at 50% (EX50%), and RE at 80% (EX80%) of 1 repetition maximum (1RM). Both EX50% and EX80% comprised a set of 10 repetitions of 10 exercises, with an interval of 90 seconds between exercises. Measurements were taken preintervention and postintervention (at 10, 30, 50, 70, and 90 minutes of recovery). Reductions in systolic/diastolic BP after exercise were greater in EX80% (largest declines, −29 ± 4/−14 ± 5 mm Hg) than EX50% (largest declines, −18 ± 6/−8 ± 5 mm Hg, p ⩽ 0.05). Heart rate and cardiac sympathovagal balance (LF/HF) increased more in relation to pre-exercise values in EX80% than EX50% (largest increases 96 ± 3 vs. 90 ± 4 b·min−1, LF/HF = 1.77 ± 0.25 vs. 1.40 ± 0.20, respectively, p ⩽ 0.05). Increases in FBF and hyperemia was also higher in EX80% than EX50% compared with pre-exercise (4.97 ± 0.28 vs. 4.36 ± 0.27 ml·min−1·100 ml−1 and 5.90 ± 0.20 vs. 5.38 ± 0.25 ml·min−1·100 ml−1; p ⩽ 0.05, respectively). These results suggest that RE of higher intensity promoted greater postexercise hypotension accompanied by greater increases in FBF, vasodilator response, HR, and cardiac sympathovagal balance.

Vitamina C restaura pressão arterial e a resposta vasodilatadora no antebraço em crianças obesas

FUNDAMENTO: A resposta vasodilatadora periferica tem um papel importante na fisiopatologia da obesidade e das doencas cardiacas. OBJETIVO: Avaliar o efeito cronico da suplementacao de vitamina C (VitC) sobre a pressao arterial e na resposta vasodilatadora ao estresse mental. METODOS: Neste estudo prospectivo, randomizado e duplo cego foram avaliadas criancas obesas, de ambos os generos e com idade entre 8 a 12 anos divididas em 2 grupos: 1) grupo de criancas suplementadas com 500 mg de vitamina C (n = 11) e, 2) substância placebo (n = 10) durante 45 dias. Oito criancas eutroficas, pareadas por idade tambem foram arroladas no estudo. Foi avaliada a pressao arterial media (PAM), frequencia cardiaca (ECG) e fluxo sanguineo no antebraco pela plestimografia de oclusao venosa. A condutância vascular no antebraco (CVA) foi obtida atraves da relacao entre o fluxo sanguineo no antebraco e a PAM (X100). RESULTADOS: Antes da intervencao, as criancas obesas apresentaram PAM maior e CVA menor quando comparadas as criancas eutroficas. Pos-intervencao, o Grupo VitC apresentou reducao da PAM no repouso (81 ± 2 vs 75 ± 1 mmHg, p = 0,01), enquanto no Grupo Placebo nao houve alteracao da PAM (p = 0,58). Adicionalmente, VitC promoveu um aumento da CVA no repouso (3,40 ± 0,5 vs 5,09 ± 0,6 un, p = 0,04) e durante o estresse mental (3,92 ± 0,5 vs 6,68 ± 0,9 un, p = 0,03). Alem disso, pos suplementacao com VitC, os niveis da CVA foram estatisticamente semelhantes aos das criancas eutroficas no repouso (5,09 ± 0,6 vs 5,82 ± 0,4 un, p > 0,05) e durante o estresse mental (6,68 ± 0,9 vs 7,35 ± 0,5 un, p > 0,05). CONCLUSAO: Suplementacao com VitC reduziu a pressao arterial e restabeleceu a resposta vasodilatadora periferica em criancas obesas.BACKGROUND Peripheral vasodilation response plays an important role in the pathophysiology of obesity and heart disease. OBJECTIVE To evaluate the chronic effect of vitamin C (VitC) supplementation on blood pressure and on vasodilation response to mental stress. METHODS In a double-blind, randomized and prospective study we evaluated obese children with 8 to 12 years in 2 similar groups: 1) supplemented with 500 mg VitC (n = 11) and 2) placebo (n = 10) for 45 days. Eight age-matched lean control children were also studied. We evaluated: mean blood pressure (MBP), heart rate (HR) and forearm blood flow by venous occlusion plethismography. Forearm vascular conductance (FVC) was calculated by: (forearm blood flow/PAM) X100. RESULTS On pre-intervention evaluations obese children showed higher MBP and lower FVC compared to lean control children. After intervention VitC diminished MBP at rest (81 ± 2 vs 75 ± 1 mmHg, p = 0.01), whereas placebo did not promote changes in MBP (p = 0.58). In addition, VitC promoted FVC increase at rest (3.40 ± 0.5 vs 5.09 ± 0.6 un, p = 0.04) and during the mental stress (3.92 ± 0.5 vs 6.68 ± 0.9 un, p = 0.03). Moreover, after VitC supplementation FVC levels were similar to the lean control children at rest (5.09 ± 0.6 vs 5.82 ± 0.4 un, p > 0.05) and during mental stress (6.68 ± 0.9 vs 7.35 ± 0.5 un, p > 0.05). CONCLUSION VitC supplementation reduced the MBP and restored peripheral vasodilatation response during mental stress in obese children.

Effect of Strength Training on Oxidative Stress and the Correlation of the Same with Forearm Vasodilatation and Blood Pressure of Hypertensive Elderly Women: A Randomized Clinical Trial

The aim of the study was to evaluate the effect of strength training on oxidative stress and the correlation of the same with forearm vasodilatation and mean blood pressure of hypertensive elderly women, at rest (basal) and during a static handgrip exercise. Insufficiently active hypertensive elderly women (N = 25; mean age = 66.1 years) were randomized into a 10 week strength training group (n = 13) or control (n = 12) group. Plasma malondialdehyde (MDA), total antioxidant capacity (TAC), plasma nitrite (NO2-), forearm blood flow (FBF), mean blood pressure (MBP) and vascular conductance ([FBF / MBP] x 100) were evaluated before and after the completion of the interventions. The strength training group increased the TAC (pre: Median = 39.0; Interquartile range = 34.0–41.5% vs post: Median = 44.0; Interquartile range = 38.0–51.5%; p = 0.006) and reduced the MDA (pre: 4.94 ± 1.10 μM vs post: 3.90 ± 1.35 μM; p = 0.025; CI-95%: -1.92 –-0.16 μM). The strength training group increased basal vascular conductance (VC) (pre: 3.56 ±0.88 units vs post: 5.21 ±1.28 units; p = 0.001; CI-95%: 0.93–2.38 units) and decreased basal MBP (pre: 93.1 ±6.3 mmHg vs post: 88.9 ±5.4 mmHg; p = 0.035; CI-95%: -8.0 –-0.4 mmHg). Such changes were also observed during static handgrip exercise. A moderate correlation was observed between changes in basal VC and MBP with changes in NO2- (ΔVC → r = -0.56, p = 0.047; ΔMBP → r = -0.41, p = 0.168) and MDA (ΔVC → r = 0.64, p = 0.019; ΔMBP → r = 0.31, p = 0.305). The strength training program reduced the oxidative stress of the hypertensive elderly women and this reduction was moderately correlated with their cardiovascular benefits. Trial Registration: ensaiosclinicos.gov.br RBR-48c29w

Obesidade e testes de função pulmonar em crianças e adolescentes: uma revisão sistemática

ABSTRACT Objective : To perform a systematic review of observational studies that analyzed the relation between spirometric param -eters and the presence of obesity in children and adolescents. Data source : Data were selected without language re-striction, using the following databases: PubMed/Medline, Scopus, Lilacs, and SciELO, with no restriction as to initial date until December 2010. The descriptors were extracted from Medical Subject Headings: “respiratory function tests” and “childhood obesity”. Synthesis of data : 89 papers were initially found, but only five were selected. Observational studies reporting spirometric parameters and body mass index of the patients were included, and those that assessed pulmonary function by other methods and whose subjects were not exclusively children or enrolled patients with associated comorbidities were excluded. In order to assess the quality of these stud-ies, the scale for observational studies of the Agency for Healthcare Research and Quality was applied. All studies evaluated the forced vital capacity and the forced expiratory volume on the first second. Four papers also assessed the forced expiratory flow between 25 and 75%, forced expira -tory flow at 50%, expiratory peak flow, and the relation between forced expiratory volume on the first second and forced vital capacity

A session of resistance exercise increases vasodilation in intermittent claudication patients

No study has shown the effects of acute resistance exercise on vasodilatory capacity of patients with peripheral artery disease. The aim of this study was to analyse the effects of a single session of resistance exercise on blood flow, reactive hyperemia, plasma nitrite, and plasma malondialdehyde in patients with peripheral artery disease. Fourteen peripheral artery disease patients underwent, in a random order, 2 experimental sessions: control (rest for 30 min) and resistance exercise (8 exercises, 2 sets of 10 repetitions at an intensity of 5-7 in the OMNI Resistance Exercise Scale). Blood flow, reactive hyperemia, plasma nitrite, and malondialdehyde were measured before and 40 min after the interventions in both sessions. Data were compared between sessions by analysis of covariance, using pre-intervention values as covariates. The increases in blood flow, reactive hyperemia, and log plasma nitrite were greater (p ≤ 0.05) after resistance exercise than the control session (3.2 ± 0.1 vs. 2.7 ± 0.1 mL · 100 mL(-1) tissue · min(-1), 8.0 ± 0.1 vs. 5.7 ± 0.1 AU, and 1.36 ± 0.01 vs. 1.26 ± 0.01 μmol ∙ L(-1), respectively). On the other hand, malondialdehyde was similar between sessions (p > 0.05). In peripheral arterial disease patients, a single session of resistance exercise increases blood flow and reactive hyperemia, which seems to be mediated, in part, by increases in nitric oxide release.