Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors

Carreira, Maria Angela Magalhães de Queiroz; Tavares, Leandro Reis; Leite, Rafaela Ferreira; Ribeiro, Jamila C.; Santos, Antonio Cardoso dos; Pereira, Karla G.; Velarde, Guilhermo C.; Nóbrega, Antônio Cláudio Lucas da

doi:10.1590/s0066-782x2003000200002

Cited by 3 publications

(2 citation statements)

References 17 publications

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“…Carreira et al 94 compared the effect of two angiotensinconverting enzyme inhibitors in arterial hypertensive patients, and found that there was no difference in functional capacity between these two drug regimens, although trandolapril was slightly more effective than captopril in blood pressure control during exercise in arterial hypertensive patients. Other authors compared treatment with nebivolol to placebo during a 6-month period and failed to demonstrate the improvement of exercise capacity in patients with diastolic dysfunction.…”

Section: Antihypertensive Treatment and Functional Capacitymentioning

confidence: 99%

Why is functional capacity decreased in hypertensive patients? From mechanisms to clinical studies

Tadić

Ivanović²

2014

Journal of Cardiovascular Medicine

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The influence of arterial hypertension on functional capacity is poorly understood. Studies have shown that peak oxygen consumption has been reduced in hypertensive patients, but the mechanisms are unclear. Left ventricular systolic and diastolic dysfunction, as well as left ventricular hypertrophy, are associated with lower functional capacity in patients with arterial hypertension. Furthermore, some investigations found a significant relationship between right ventricular systolic function and functional capacity in the general population. The aim of this review was to summarize current knowledge about the mechanisms of reduced functional capacity in hypertensive patients, including the impact of systemic and pulmonary circulations, as well as the influence of the left and right ventricle on oxygen consumption. Additionally, we reviewed all clinical studies regarding functional capacity in the population with arterial hypertension.

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Section: Antihypertensive Treatment and Functional Capacitymentioning

confidence: 99%

Why is functional capacity decreased in hypertensive patients? From mechanisms to clinical studies

Tadić

Ivanović²

2014

Journal of Cardiovascular Medicine

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“…Como verificado por outros estudos 17,18 , os dados indicam que o comprometimento motor foi o fator limitante do teste de esforço físico aeróbico, sendo responsável pelas respostas das variáveis cardiovasculares ficarem bem abaixo dos valores esperados, já que não foram identificadas alterações na avaliação clínica do aparelho cardiorrespiratório Figura 2. Dispersão do índice de variabilidade da frequência cardíaca no domínio do tempo (pNN50) e do consumo pico de oxigênio (n=11) r= -0,61 e p= 0,04. bloqueadores de canais de cálcio e os inibidores da enzima conversora de angiotensina, apesar de aumentar a tolerância ao esforço 21 , deprimem as respostas da frequência cardíaca e da pressão arterial sistólica 22 . Em relação à modulação autonômica da frequência cardíaca, no presente estudo os valores de VFC no domínio da frequência, em unidades normalizadas, se apresentaram dentro da faixa de normalidade referida pela literatura, que considera valores entre 50 a 58 para o índice de baixa frequência, que representa a atividade de ambos os eferentes com predomínio simpático, e entre 26 a 39 para alta frequência, que representa a atividade parassimpática 23,24 .…”

Section: Discussionunclassified

Modulação Autonômica Da Frequência Cardíaca E Capacidade Funcional Aeróbica Em Hemiparéticos

Campos

Vieira

Ambrozin

et al. 2016

Rev Bras Med Esporte

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Artigo originAl Original article artículO Original RESUMOIntrodução: Tem sido observado que indivíduos acometidos por acidente vascular encefálico (AVE) apresentam, além dos danos físicos, diminuição da capacidade aeróbica e alteração da modulação autonômica da frequência cardíaca, sendo estes importantes fatores para o aparecimento de doenças cardíacas e arritmias. Objetivo: Investigar os efeitos crônicos do AVE sobre a capacidade aeróbica (VO 2pico ) e os índices de variabilidade da frequência cardíaca (VFC), e se existe correlação entre essas duas variáveis. Métodos: Foram avaliados 11 indivíduos do sexo masculino, com idade entre 55 e 65 anos, acometidos por lesão cerebrovascular há pelo menos seis meses, e todos com hemiparesia. Foram realizadas as seguintes avaliações: teste de capacidade aeróbica máxima; registro dos intervalos R-R e cálculo dos índices da VFC (RMSSD, pNN50, AF, BF e a razão BF/AF). Para comparação entre VO 2pico previsto e obtido utilizou-se o teste t de Student não pareado. Para testar a hipótese de correlação entre os índices de VFC e o VO 2pico utilizou-se o teste de correlação de Pearson. Resultados: VO 2pico (mL.kg -1 .min -1 ) previsto e obtido, respectivamente = 32,15 ± 1,87 e 16,12 ± 5,51; índices da VFC: RMSSD (ms) = 28,69 ± 26,78; pNN50 (%) = 8,76 ± 12,62; AF (u.n.) = 51,96 ± 22,4; BF (u.n.) = 48,04 ± 22,49. O VO 2pico correlacionou-se negativamente com os índices RMSSD, pNN50 e AF e positivamente com o índice BF (p < 0,05). Conclusão: Na fase crônica do AVE, variabilidade da frequência cardíaca encontra-se normal e os indivíduos com menor capacidade aeróbica apresentam maior modulação parassimpática e menor simpática, provavelmente em consequência da maior exigência física nas atividades de vida diária.Descritores: acidente vascular cerebral; frequência cardíaca; consumo de oxigênio; sistema nervoso autônomo. (mL.kg ABSTRACT

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Hypertension Update and Cardiovascular Risk Reduction in Physically Active Individuals and Athletes

Oliveira

Lawless

2010

The Physician and Sportsmedicine

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Hypertension is a prevalent disease worldwide. Its inadequate treatment leads to major cardiovascular complications, such as myocardial infarction, stroke, and heart failure. These conditions decrease life expectancy and are a substantial cost burden to health care systems. Physically active individuals and professional athletes are not risk free for developing this condition. Although the percentage of persons affected is substantially lower than the general population, these individuals still need to be thoroughly evaluated and blood pressure targets monitored to allow safe competitive sports participation. Regarding treatment, lifestyle modification measures should be routinely emphasized to athletes and active individuals with the same importance as for the general population. Medication treatment can be complicated because of restrictions by athletic organizations and possible limitations on maximal exercise performance. In addition, the choice of an antihypertensive drug should be made with consideration for salt and water losses that routinely occur in athletes, as well as preservation of exercise performance and endothelial function. First-line therapies for athletes and physically active individuals may be different from the general population. Some authorities believe that blocking the renin-angiotensin system with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) is more beneficial compared with diuretics because of ACE inhibitors and ARBs being able to avoid salt and water losses. Dihydropyridine calcium channel blockers (CCBs) are another reasonable choice. Despite effects on heart rate, nondihydropyridine CCBs do not appear to impair exercise performance. beta-Blockers are not used as a first-line therapy in athletes because of effects on exercise and prohibition by the National Collegiate Athletic Association and World Anti-Doping Agency in certain sports. In this article, we address the evidence on hypertension and its related treatments in active individuals to provide recommendations that allow the best competitive sports results and reduce cardiovascular risk.

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Exercise testing in hypertensive patients taking different angiotensin-converting enzyme inhibitors

Abstract: Monotherapy with trandolapril is more effective than that with captopril to control blood pressure during exercise in hypertensive patients.

Cited by 3 publications

References 17 publications

Why is functional capacity decreased in hypertensive patients? From mechanisms to clinical studies

Why is functional capacity decreased in hypertensive patients? From mechanisms to clinical studies

Modulação Autonômica Da Frequência Cardíaca E Capacidade Funcional Aeróbica Em Hemiparéticos

Hypertension Update and Cardiovascular Risk Reduction in Physically Active Individuals and Athletes

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