Karla Fabiana Goessler

Effect of exercise training on the renin–angiotensin–aldosterone system in healthy individuals: a systematic review and meta-analysis

The aim of this systematic review and meta-analysis was to evaluate the effect of exercise training on parameters of the renin–angiotensin–aldosterone system (RAAS) in healthy adults, and to investigate the relation with training induced changes in blood pressure. A systematic search was conducted and we included randomized controlled trials lasting ⩾4 weeks investigating the effects of exercise on parameters of the RAAS in healthy adults (age ⩾18 years) and published in a peer-reviewed journal up to December 2013. Fixed effects models were used and data are reported as weighted means and 95% confidence limits (CL). Eleven randomized controlled trials with a total of 375 individuals were included. Plasma renin activity was reduced after exercise training (n= 7 trials, standardized mean difference −0.25 (95% CL −0.5 to −0.001), P=0.049), whereas no effect was observed on serum aldosterone ((n= 3 trials; standardized mean difference −0.79 (−1.97 to +0.39)) or angiotensin II (n=3 trials; standardized mean difference −0.16 (−0.61 to +0.30). Significant reductions in systolic blood pressure −5.65 mm Hg (−8.12 to −3.17) and diastolic blood pressure −3.64 mm Hg (−5.4 to −1.91) following exercise training were observed. No relation was found between net changes in plasma renin activity and net changes in blood pressure (P>0.05). To conclude, although we observed a significant reduction in plasma renin activity following exercise training this was not related to the observed blood pressure reduction. Given the small number of studies and small sample sizes, larger well-controlled randomized studies are required to confirm our results and to investigate the potential role of the RAAS in the observed improvements in blood pressure following exercise training.

Direct renin inhibitor therapy and swimming training: hemodynamic and cardiac effects in hypertensive and normotensive rats.

Abstract Purpose: This study aimed to analyze the hemodynamic and cardiac effects of direct renin inhibitor (DRI) treatment and swimming training in hypertensive rats. Methods: Seventy-seven rats were divide into eight groups: sedentary normotensive (SN), trained normotensive (TN), sedentary normotensive treated with DRI (SN_DRI), trained normotensive treated with DRI (TN_DRI), sedentary hypertensive (SH), trained hypertensive (TH), sedentary hypertensive treated with DRI (SH_DRI), trained hypertensive treated with DRI (TH_DRI). Swimming training occurred for up to 60 min, five times a week for four weeks. The hypertensive animals were treated with 20 mg ċ kg−1 ċ day−1 L-NAME for four weeks. Groups treated with DRI received 10 mg ċ kg−1 ċ day−1 of aliskiren for four weeks. After the treatment period, all the animals underwent femoral artery catheterization surgery for direct measurement of cardiovascular variables. Results: The SH group presented hypertension (136.4 ± 5.0 mmHg) compared to the SN (107.1 ± 1.7 mmHg). The TH group showed lower mean arterial pressure (MAP) than the SH (121.1 ± 1.3 mmHg), but the treatment with DRI did not attenuate hypertension (128.2 ± 4.9 mmHg). The analysis of collagen areas demonstrated that treatment with DRI may attenuate cardiac remodeling in situations of hypertension, in the condition of treatment alone or combined with physical training. Conclusion: Both interventions in combination may be more effective at reducing cardiovascular risk in hypertensive subjects.

Blood Pressure and Hemodynamic Adaptations after a Training Program in Young Individuals with Down Syndrome

Background Cardiovascular diseases affect people worldwide. Individuals with Down Syndrome (DS) have an up to sixteen-time greater risk of mortality from cardiovascular diseases. Objective To evaluate the effects of aerobic and resistance exercises on blood pressure and hemodynamic variables of young individuals with DS. Methods A total of 29 young individuals with DS participated in the study. They were divided into two groups: aerobic training (AT) (n = 14), and resistance training (TR) (n = 15). Their mean age was 15.7 ± 2.82 years. The training program lasted 12 weeks, and had a frequency of three times a week for AT and twice a week for RT. AT was performed in treadmill/ bicycle ergometer, at an intensity between 50%-70% of the HR reserve. RT comprised nine exercises with three sets of 12 repetition-maximum. Systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MBP) and hemodynamic variables were assessed beat-to-beat using the Finometer device before/after the training program. Descriptive analysis, the Shapiro-Wilk test to check the normality of data, and the two-way ANOVA for repeated measures were used to compare pre- and post-training variables. The Pearson’s correlation coefficient was calculated to correlate hemodynamic variables. The SPSS version 18.0 was used with the significance level set at p < 0.05. Results After twelve weeks of aerobic and/or resistance training, significant reductions in variables SBP, DBP and MBP were observed. Conclusion This study suggests a chronic hypotensive effect of moderate aerobic and resistance exercises on young individuals with DS.

The influence of physical training status on postexercise hypotension in patients with hypertension: a cross-sectional study

Background To date, few studies have analyzed postexercise hypotension (PEH) in hypertensive patients with different levels of physical fitness. Aim Therefore, this study aimed to compare PEH in trained and sedentary hypertensive individuals. Methods Fifty-one well-controlled hypertensive patients of both sexes were assigned to a trained group [60.4±9.4 years; resting blood pressure (BP)=126.3±5.4/75.0±6.3 mmHg; VO2peak=27.3±4.6 ml kg/min] and 58 sedentary hypertensive patients of both sexes were assigned to a sedentary group (63.1±8.9 years; resting BP=134.1±4.2/82.9±5.8 mmHg; VO2peak=20.6±5.5 ml/kg/min). In a cross-sectional design, the individuals were randomized to perform an aerobic exercise session (treadmill; 40 min; 55% VO2peak) and a control session on two different days in the morning. After each session, participants wore an ambulatory BP device for 12 h. Results Although no significant differences were identified in BP after the control session, after the experimental session, the trained participants presented lower values than the sedentary participants for systolic (124.1±6.3 vs. 133.4±5.2 mmHg, P<0.01) and diastolic BP (73.1±4.4 vs. 85.5±6.4 mmHg, P<0.01) over the course of 12 h monitoring. For the trained participants, significant correlations were also identified (P<0.05) between the VO2peak and systolic (R=−0.68) and diastolic BP (R=−0.61) 12 h monitoring. Conclusion In conclusion, the training level of hypertensive patients influences PEH.

Correlação entre o teste de caminhada de seis minutos e o teste do degrau em idosos

O teste do degrau pode ser uma alternativa para substituir o teste de caminhada de seis minutos quando nao ha um espaco fisico amplo para sua realizacao. Existem, no entanto, poucos dados na literatura comparando e correlacionando ambos os testes. Dessa forma, o objetivo deste estudo foi correlacionar o teste de caminhada de seis minutos com o teste do degrau. Uma amostra de 38 idosos (68,5 ± 2,1 anos) realizou aleatoriamente o teste de caminhada de seis minutos e o teste do degrau, duas vezes cada teste, sendo considerado para fins de analise o maior valor obtido em cada teste. Frequencia cardiaca, percepcao subjetiva de esforco, de fadiga muscular e o VO2max estimados ao final do teste do degrau foram significativamente maiores que ao final do teste de caminhada de seis minutos (p=0,001; 0,010; 0,017; 0,001, respectivamente). No presente estudo, nao houve correlacao entre a distância percorrida no teste de caminhada de seis minutos e o numero de subidas e descidas no teste do degrau. Sendo assim, nao se pode afirmar que um teste possa substituir o outro, mas levando-se em consideracao os valores estatisticamente maiores para o teste do degrau nas variaveis analisadas e, por necessitar de espaco fisico minimo, sugere-se que o teste do degrau pode ser uma alternativa para a avaliacao de idosos.

Efeito do treinamento físico no pulmão de ratos submetidos à ingestão alcoólica

Chronic alcohol consumption causes alterations in the lung tissues characterized by edema and formation of large inflammatory infiltrate. The purpose of this work was to evaluate the effect of physical exercise on lung injuries caused by chronic alcohol intake in Wistar rats. MATERIAL AND METHODS: Thirty-two male Wistar rats (261.1 ± 1.3 g) received sugarcane distilled alcoholic beverage diluted (30%, v/v, alcohol group) or tap water (control group) for 120 days. After this period, five animals of each group were sacrificed. The remaining animals received water and were sorted in four groups: alcoholic and sedentary (AS), control and sedentary (CS), alcoholic and trained (AT) and control and trained (CT). The AT and CT groups were submitted to a swimming exercise protocol with progressive daily increase in the training time until 20 minutes per day, five times per week, for five weeks. For the same period, AS and CS groups were maintained at sedentary state. RESULTS: after the alcoholic intake period, the alcohol group presented decreased (P<0.05) body weight and increased relative lung weight (P<0.05). Lungs of alcoholic group showed characteristics of edema and inflammatory infiltrate. The CS and CT groups did not present morphological changes. AT animals showed increased inflammation and number of hyper pigmented macrophages in relation to CT group. CONCLUSION: exercise can increase lung inflammation when applied in animals with inflammatory injury induced by chronic alcohol consumption.

Efeito citotóxico provocado por ciclofosfamida na massa corporal e no tecido muscular estriado esquelético de ratos treinados.

The study examined the changes in body mass and skeletal muscle after a high dose of CF in trained rats. Twenty four Wistar male rats were divided into four groups. Half of the animals were subjected to swimming training lasting up to 40 minutes in moderate intensity for 21 days, the others were kept sedentary. After this period, half the animals in each group (exercise and sedentary) received a single dose of CF, while the other received saline. After seven days, the animals were sacrificed. There was less body mass for animals in the trained groups (227.7 ± 16.6 / 232.3 ± 19.7) compared with sedentary groups (254.6 ± 29.3 / 253.8 ± 29.8). There was no difference in absolute and relative weight of muscle, but a decrease in those areas and in the severity of injuries caused by CF in trained animals was observed.