In this largest clinical trial of β-blockers for prevention of cardiotoxicity under contemporary ANT dosage, the authors noted a 13.5% to 14.5% incidence of cardiotoxicity. In this scenario, carvedilol had no impact on the incidence of early onset of LVEF reduction. However, the use of carvedilol resulted in a significant reduction in troponin levels and diastolic dysfunction. (Carvedilol Effect in Preventing Chemotherapy-Induced Cardiotoxicity [CECCY]; NCT01724450).

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.

SummaryBackground: The Minnesota Living with Heart Failure Questionnaire (MLHFQ) is an important measurement instrument for assessing the quality of life of heart failure patients. Despite being largely used within our context, the questionnaire had not yet been translated and validated into the Portuguese language.

In elderly patients with optimally treated CHF, meditation reduced NE, improved quality of life, and reduced the VE/VCO(2) slope. Our results support the possible role of meditation as a new hope in the treatment of CHF.

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HEx reduced office BPs and 24-hour ABPM levels in resistant hypertensive patients. These effects suggest that HEx may be a potential new therapeutic approach in these patients.