Efeito Agudo do Exercício Intervalado versus Contínuo sobre a Pressão Arterial: Revisão Sistemática e Metanálise

Abstract

Background: Continuous aerobic exercise (CE) is one of the main non-pharmacological recommendations for hypertension prevention and treatment. CE is safe and effective to reduce blood pressure chronically, as well as in the first few hours after its performance, a phenomenon known as post-exercise hypotension (PEH). Interval exercise (IE) also results in PEH. Objective: This systematic review and meta-analysis sought to compare the magnitude of PEH between CE and IE in adults. Methods: A systematic review of studies published in journals indexed in the PubMed, Web of Knowledge, Scopus and CENTRAL databases was performed until March 2020, which compared the magnitude of PEH between CE and IE. PEH was defined as between 45-60 minutes post-exercise. The differences between groups on blood pressure were analyzed using the random effects model. Data were reported as weighted mean difference (WMD) and 95% confidence interval (CI). A p-value <0.05 was considered statistically significant. The TESTEX scale (0-15) was used to verify the methodological quality of the studies. Results: The IE showed a higher magnitude of PEH on systolic blood pressure (WMD:-2.93 mmHg [95% CI:-4.96,-0.90], p = 0.005, I2 = 50%) and diastolic blood pressure (WMD:-1,73 mmHg [IC95%: 2,94,-0,51], p= 0.005, I 2 = 0%) when compared to CE (12 studies, 196 participants). The scores of the studies on the TEXTEX scale varied from 10 to 11 points. Conclusions: The IE resulted in a higher magnitude of PEH when compared to CE between 45 and 60 minutes postexercise. The absence of adverse event data during IE and CE in the studies prevents comparisons of the safety of these strategies.

Exercício Intervalado de Alta Intensidade versus Exercício Contínuo: Há Diferença na Magnitude de Redução da Pressão Arterial?

“…In this study, the assessed individuals were physically active and normotensive. Thus, the results found by Perrier-Melo et al 11 should be viewed with caution regarding the pressure values of individuals with SAH, especially regarding diastolic BP. Despite the interesting study, some limitations should be recalled, such as the low number of studied patients and the heterogeneity of BP measurement methods.…”

“…Therefore, exercise intensity seems to influence BP reduction magnitude, with the HIIT being superior to the MICT. 10 In this issue of the Brazilian Archives of Cardiology (Arquivos Brasileiros de Cardiologia), Perrier-Melo et al 11 compared the magnitude of post-exercise hypotension (PEH) -considering between 45 and 60 minutes post-exercise -in HIIT (~ 80 to 100% of HR peak ) versus CT in adult individuals. In this study, protocols with both moderate (64 to 76% of HR peak ) and vigorous intensity (77 to 95% of HRpeak) were considered eligible for the CT group.…”

“…compared to CT on PEH in the 45-60 minutes after the end of the exercise. 11 An important point to be mentioned in relation to the meta-analysis by Perrier-Melo et al 11 is that, although HIIT significantly reduced diastolic BP, when the study by Maya et al 12 was omitted from the analysis, the benefit disappeared. In this study, the assessed individuals were physically active and normotensive.…”

“…Moreover, the inclusion of normotensive, pre-hypertensive and hypertensive individuals in the same forest plots also does not allow a more assertive conclusion, since the magnitude of PEH may be different between these groups; although the authors carried out a sensitivity analysis, they found no differences after removing each of the included studies. 11 Another recent meta-analysis compared the effects of HIIT and MICT in hypertensive individuals. Significant differences were found in systolic BP with both interventions, when compared to the control group: HIIT, 5.64 mmHg and MICT, 3.7 mmHg, as well as in diastolic BP: HIIT, 4.8 mmHg, and MICT, 2.41 mmHg, when compared to the control group.…”

Muito Além Das Endorfinas – Efeitos Do Exercício Físico Na Hipertensão Arterial

“…O exercício físico aeróbico (AERO) possui efeitos diretos e indiretos na redução na PA (PERRIER-MELO et al, 2020). O efeito direto está relacionado à hipotensão pós-exercício (HPE) causado pela vasodilatação periférica, reduzindo a pós-carga por até 24 horas após o término do exercício (KASIAKOGIAS; SHARMA, 2020).…”