Exercise is an effective intervention for treating hypertension and arterial stiffness, but little is known about which exercise modality is the most effective in reducing arterial stiffness and blood pressure in hypertensive subjects. Our purpose was to evaluate the effect of continuous vs. interval exercise training on arterial stiffness and blood pressure in hypertensive patients. Sixty-five patients with hypertension were randomized to 16 weeks of continuous exercise training (n¼26), interval training (n¼26) or a sedentary routine (n¼13). The training was conducted in two 40-min sessions a week. Assessment of arterial stiffness by carotid-femoral pulse wave velocity (PWV) measurement and 24-h ambulatory blood pressure monitoring (ABPM) were performed before and after the 16 weeks of training. At the end of the study, ABPM blood pressure had declined significantly only in the subjects with higher basal values and was independent of training modality. PWV had declined significantly only after interval training from 9.44 ± 0.91 to 8.90 ± 0.96 m s À1 , P¼0.009 (continuous from 10.15 ± 1.66 to 9.98 ± 1.81 m s À1 , P¼ns; control from 10.23 ± 1.82 to 10.53 ± 1.97 m s À1 , P¼ns). Continuous and interval exercise training were beneficial for blood pressure control, but only interval training reduced arterial stiffness in treated hypertensive subjects.

Exercise training has an important role in the prevention and treatment of hypertension, but its effects on the early metabolic and hemodynamic abnormalities observed in normotensive offspring of hypertensive parents (FH+) have not been studied. We compared high-intensity interval (aerobic interval training, AIT) and moderate-intensity continuous exercise training (CMT) with regard to hemodynamic, metabolic and hormonal variables in FH+ subjects. Forty-four healthy FH+ women (25.0 ± 4.4 years) randomized to control (ConFH+) or to a three times per week equal-volume AIT (80-90% of VO 2MAX ) or CMT (50-60% of VO 2MAX ) regimen, and 15 healthy women with normotensive parents (ConFHÀ; 25.3 ± 3.1 years) had their hemodynamic, metabolic and hormonal variables analyzed at baseline and after 16 weeks of follow-up. Ambulatorial blood pressure (ABP), glucose and cholesterol levels were similar among all groups, but the FH+ groups showed higher insulin, insulin sensitivity, carotid-femoral pulse wave velocity (PWV), norepinephrine and endothelin-1 (ET-1) levels and lower nitrite/nitrate (NOx) levels than ConFHÀ subjects. AIT and CMT were equally effective in improving ABP (Po0.05), insulin and insulin sensitivity (Po0.001); however, AIT was superior in improving cardiorespiratory fitness (15 vs. 8%; Po0.05), PWV (Po0.01), and BP, norepinephrine, ET-1 and NOx response to exercise (Po0.05). Exercise intensity was an important factor in improving cardiorespiratory fitness and reversing hemodynamic, metabolic and hormonal alterations involved in the pathophysiology of hypertension. These findings may have important implications for the exercise training programs used for the prevention of inherited hypertensive disorder. Keywords: arterial stiffness; endothelial function; exercise; nervous system, sympathetic; prevention INTRODUCTION Essential arterial hypertension (HPT) is the most common risk factor for cardiovascular morbidity and mortality and is associated with substantial health-care expenditures. 1,2 Consequently, primary prevention for individuals at high risk for HPT has been emphasized. 3 Among the population at high risk for HPT, those who have hypertensive parents (FH+) are worthy of special attention. It has been well established that a positive family history of HPT is a strong risk factor for future HPT in nonhypertensive offspring, independent of other risk factors. 4 Moreover, hemodynamic, metabolic and hormonal abnormalities, as well as concentrations of biomarkers that may have a key role in the development of HPT, are increased in nonhypertensive offspring of parents with HPT. [5][6][7]

A prática regular de atividade física tem sido recomendada para a prevenção e reabilitação de doenças cardiovasculares e outras doenças crônicas por diferentes associações de saúde no mundo, como o American College of Sports Medicine, os Centers for Disease Control and Prevention, a American Heart Association, o National Institutes of Health, o US Surgeon General, a Sociedade Brasileira de Cardiologia, entre outras. Estudos epidemiológicos têm demonstrado relação direta entre inatividade física e a presença de múltiplos fatores de risco como os encontrados na síndrome metabólica. Entretanto, tem sido demonstrado que a prática regular de exercício físico apresenta efeitos benéficos na prevenção e tratamento da hipertensão arterial, resistência à insulina, diabetes, dislipidemia e obesidade. Com isso, o condicionamento físico deve ser estimulado para todos, pessoas saudáveis e com múltiplos fatores de risco, desde que sejam capazes de participar de um programa de treinamento físico. Assim como a terapêutica clínica cuida de manter a função dos órgãos, a atividade física promove adaptações fisiológicas favoráveis, resultando em melhora da qualidade de vida.

Our purpose was to investigate the effects of low-volume, high-intensity interval training (HIT) on cardiometabolic risk and exercise capacity in women with type 2 diabetes mellitus (T2DM). Sedentary overweight/obese T2DM women (age=44.5±1.8 years; BMI=30.5±0.6 kg/m(2)) were randomly assigned to a tri-weekly running-based HIT program (n=13) or non-exercise control follow-up (CON; n=10). Glycemic control, lipid and blood pressure levels, endurance performance, and anthropometry were measured before and after the follow-up (16 weeks) in both groups. Medication intake was also assessed throughout the follow-up. Improvements (P<0.05) on fasting glucose (14.3±1.4%), HbA1c (12.8±1.1%), systolic blood pressure (3.7±0.5 mmHg), HDL-cholesterol (21.1±2.8%), triglycerides (17.7±2.8%), endurance performance (9.8±1.0%), body weight (2.2±0.3%), BMI (2.1±0.3%), waist circumference (4.0±0.5%) and subcutaneous fat (18.6±1.4%) were found after HIT intervention. Patients of HIT group also showed reductions in daily dosage of antihyperglycemic and antihypertensive medication during follow-up. No changes were found in any variable of CON group. The HIT-induced improvements occurred with a weekly time commitment 56-25% lower than the minimal recommended in current guidelines. These findings suggest that low-volume HIT may be a time-efficient intervention to treat T2DM women.

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. Acute aerobic exercise reduces 24-h ambulatory blood pressure levels in long-term-treated hypertensive patients. Clinics. 2008;63:753-8. BACKGROUND:Even with anti-hypertensive therapy, it is difficult to maintain optimal systemic blood pressure values in hypertensive patients. Exercise may reduce blood pressure in untreated hypertensive, but its effect when combined with long-term anti-hypertensive therapy remains unclear. Our purpose was to evaluate the acute effects of a single session of aerobic exercise on the blood pressure of long-term-treated hypertensive patients. METHODS: Fifty treated hypertensive patients (18/32 male/female; 46.5±8.2 years; Body mass index: 27.8±4.7 kg/m 2 ) were monitored for 24 h with respect to ambulatory (A) blood pressure after an aerobic exercise session (post-exercise) and a control period (control) in random order. Aerobic exercise consisted of 40 minutes on a cycle-ergometer, with the mean exercise intensity at 60% of the patient's reserve heart rate. RESULTS: Post-exercise ambulatory blood pressure was reduced for 24 h systolic (126±8.6 vs. 123.1±8.7 mmHg, p=0.004) and diastolic blood pressure (81.9±8 vs. 79.8±8.5 mmHg, p=0.004), daytime diastolic blood pressure (85.5±8.5 vs. 83.9±8.8 mmHg, p=0.04), and nighttime S (116.8±9.9 vs. 112.5±9.2 mmHg, p<0.001) and diastolic blood pressure (73.5±8.8 vs. 70.1±8.4 mmHg, p<0.001). Post-exercise daytime systolic blood pressure also tended to be reduced (129.8±9.3 vs. 127.8±9.4 mmHg, p=0.06). These post-exercise decreases in ambulatory blood pressure increased the percentage of patients displaying normal 24h systolic blood pressure (58% vs. 76%, p=0.007), daytime systolic blood pressure (68% vs. 82%, p=0.02), and nighttime diastolic blood pressure (56% vs. 72%, p=0.02). Nighttime systolic blood pressure also tended to increase (58% vs. 80%, p=0.058). CONCLUSION: A single bout of aerobic exercise reduced 24h ambulatory blood pressure levels in long-term-treated hypertensive patients and increased the percentage of patients reaching normal ambulatory blood pressure values. These effects suggest that aerobic exercise may have a potential role in blood pressure management of long-term-treated hypertensive.

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Diabetes is the second most prevalent non-communicable chronic diseases (NCDs) in patients with coronavirus disease 2019 (COVID-19) and is highly associated with increased incidence of disease severity and mortality. Individuals with diabetes and poor glycemic control have an even worse prognosis. Despite of the need/effectiveness of social distancing measures (i.e.: home confinement, quarantine and/or lockdown) during COVID-19 outbreak, preliminary findings showed an increase in negative behaviors during COVID-19 home confinement (i.e.:~33.5% reduction in physical activity,~28.6% (~3.10h) increase in sedentary behavior (i.e.: daily sitting, reclining and lying down time), and more unhealthy food consumption and meal pattern), which may have important clinical implications. For example, we estimated that this reduction in physical activity can increase the cases of type 2 diabetes (from~7.2% to~9.6%;~11.1 million cases per year) and all-cause mortality (from~9.4% to~12.5%;~1.7 million deaths per year) worldwide. Few weeks of reduction in physical activity levels result in deleterious effects on several cardiometabolic (i.e.: glycemic control, body composition, inflammatory cytokines, blood pressure, vascular function…) and functional parameters (i.e.: cardiorespiratory/muscle fitness, balance, agility…). In contrast, physical activity and exercise are important tools for preventing and treating diabetes and others NCDs. Home-based exercise programs are useful, safe and effective for the management of diabetes, and could be widely used during COVID-19 outbreak. In this context, there is an urgent need for recommending physical activity/exercise, during and beyond COVID-19 outbreak, for improving the management of diabetes, as well as to prevent the increase in global burden of COVID-19, diabetes and others NCDs.