Rui Costa

Body position influences the maximum inspiratory and expiratory mouth pressures of young healthy subjects

OBJECTIVE The purpose of this study was to determine the effects of body position on respiratory muscle strength of young healthy subjects. PARTICIPANTS Sixty-three (50 female, mean age 19.7±1.5 years) healthy subjects participated in the study. DESIGN Participants were measured in the sitting position, semi-upright sitting position, and in the supine position. The order of the three conditions was randomly determined. OUTCOME MEASURES Maximal inspiratory and expiratory mouth pressures (PImax, PEmax) and lung function. RESULTS A significant effect of body position was observed on PEmax values, controlling for gender. PImax in the sitting position (92.8±20.05 cm H2O) was significantly higher than in the supine (84.1±15.1 cm H2O; mean difference: 8.70, 95% CI [5.95, 12.45], p<0.001) and semi-upright sitting positions (84.4±17.5 cm H2O; mean difference: 8.43, 95% CI [5.78, 11.07], p<0.001). PEmax was also significantly higher in the sitting position (125.4±34.2 cm H2O) than in the supine (115.8±29.0 cm H2O; mean difference: 9.59, 95% CI [4.86, 14.32], p<0.001) and semi-upright sitting positions (120.2±33.9 cm H2O; mean difference: 5.21, 95% CI [0.87, 9.54], p=0.013). CONCLUSIONS Body position influences respiratory muscle strength of young healthy subjects. PImax and PEmax are higher in the sitting position than in the supine or semi-upright sitting positions.

Exercise training in the management of patients with resistant hypertension.

Hypertension is a very prevalent risk factor for cardiovascular disease. The prevalence of resistant hypertension, i.e., uncontrolled hypertension with 3 or more antihypertensive agents including 1 diuretic, is between 5% and 30% in the hypertensive population. The causes of resistant hypertension are multifactorial and include behavioral and biological factors, such as non-adherence to pharmacological treatment. All current treatment guidelines highlight the positive role of physical exercise as a non-pharmacological tool in the treatment of hypertension. This paper draws attention to the possible role of physical exercise as an adjunct non-pharmacological tool in the management of resistant hypertension. A few studies have investigated it, employing different methodologies, and taken together they have shown promising results. In summary, the available evidence suggests that aerobic physical exercise could be a valuable addition to the optimal pharmacological treatment of patients with resistant hypertension.

Effects of resistance exercise on endothelial progenitor cell mobilization in women

This study aimed to determine the effect of a single bout of resistance exercise at different intensities on the mobilization of circulating EPCs over 24 hours in women. In addition, the angiogenic factors stromal cell-derived factor 1 (SDF-1α), vascular endothelial growth factor (VEGF), hypoxia-inducible factor 1-alpha (HIF-1α) and erythropoietin (EPO) were measured as potential mechanisms for exercise-induced EPCs mobilization. Thirty-eight women performed a resistance exercise session at an intensity of 60% (n = 13), 70% (n = 12) or 80% (n = 13) of one repetition maximum. Each session was comprised of three sets of 12 repetitions of four exercises: bench press, dumbbell curl, dumbbell squat, and standing dumbbell upright row. Blood was sampled at baseline and immediately, 6 hours, and 24 hours post-exercise. Circulating EPC and levels of VEGF, HIF-1α and EPO were significantly higher after exercise (P < 0.05). The change in EPCs from baseline was greatest in the 80% group (P < 0.05), reaching the highest at 6 hours post-exercise. The change in EPCs from baseline to 6 hours post-exercise was correlated with the change in VEGF (r = 0.492, P = 0.002) and HIF-1α (r = 0.388, P = 0.016). In general, a dose-response relationship was observed, with the highest exercise intensities promoting the highest increases in EPCs and angiogenic factors.