Capítulo 6 - Tratamento não medicamentoso

BackgroundHypertension is the main risk factor for most cardiovascular diseases. A coordinated and organized system from the Brazilian Ministry of Healthy involving Family Health Strategy (FHS), a program for the prevention of chronic disease, and the Popular Pharmacy Program (PPP), which subsidizes medications for the population, could allow an earlier identification and better blood pressure (BP) control. Matão Controlling Hypertension (MatCH) is a community-based population project that aims to apply an organized, integrated and coordinated program in the city of Matão, Brazil, involving FHS and PPP in order to actively search, treat and follow-up hypertensive subjects.MethodThis is a population community-based, interventional, follow-up study where all subjects aged ≥ 40 years assisted by the FHS program in Matão will have BP assessed monthly by trained Community Health Agents (CHA) during a domiciliary visit. Identified hypertensive subjects will be referred to FHS physicians for nonpharmacological and pharmacological treatment. Most of the hypertensive drugs used will be available through the PPP. Prevalence of hypertension, awareness, demographics and risk factors will be correlated with BP control. The population study is expected to involve approximately 18.600 subjects. The study period will be four years.DiscussionConsidering that hypertension is asymptomatic in most cases, to reduce the population burden of BP-related deaths and diseases it is essential to detect and treat early all hypertensive patients. If we achieve our large-scale BP control, this program can be applied to other populations from developing countries.

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“…The treatment of hypertension will be based on the recent VII Brazilian Guidelines of Arterial Hypertension [17] , [18] .…”

Section: Methodsmentioning

confidence: 99%

Matão Controlling Hypertension (MatCH) project: Rationale and design

Minelli¹,

Cabral

Leite³

et al. 2017

Contemporary Clinical Trials Communications

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“…Hence, experts in the field [ 7 ] have suggested that complementary therapies may be important supporting actors in the management of RH patients, although no specific guidelines have been proposed. Physical exercise is a well-established strategy to control BP in NON-RH patients [ 8 – 15 ] and recognized as part of the hypertension therapy according to different medical associations [ 16 , 17 ]. Indeed, findings from randomized clinical trials reported reduced BP levels in middle-aged and older adults after different exercise training protocols [ 8 – 15 ].…”

Section: Introductionmentioning

confidence: 99%

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Pires

Coelho-Júnior

Gambassi

et al. 2020

Cardiovascular Therapeutics

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Aim. The present study compared the acute effects of aerobic (AER), resistance (RES), and combined (COM) exercises on blood pressure (BP) levels in people with resistant hypertension (RH) and nonresistant hypertension (NON-RH). Methods. Twenty patients (10 RH and 10 NON-RH) were recruited and randomly performed three exercise sessions and a control session. Ambulatory BP was monitored over 24 hours after each experimental session. Results. Significant reductions on ambulatory BP were found in people with RH after AER, RES, and COM sessions. Notably, ambulatory BP was reduced during awake-time and night-time periods after COM. On the other hand, the effects of AER were more prominent during awake periods, while RES caused greater reductions during the night-time period. In NON-RH, only RES acutely reduced systolic BP, while diastolic BP was reduced after all exercise sessions. However, the longest postexercise ambulatory hypotension was observed after AER (~11 h) in comparison to RES (~8 h) and COM (~4 h) exercises. Conclusion. Findings of the present study indicate that AER, RES, and COM exercises elicit systolic and diastolic postexercise ambulatory hypotension in RH patients. Notably, longer hypotension periods were observed after COM exercise. In addition, NON-RH and RH people showed different changes on BP after exercise sessions, suggesting that postexercise hypotension is influenced by the pathophysiological bases of hypertension.

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“…All groups were submitted to the same experimental exercise protocol. The velocity of movement was maintained by voice commands, approximately two seconds per repetition (1s in the concentric phase and 1s in the eccentric phase) 5 . The laboratory was kept at the same temperature (25°C) for both 1RM and exercise testing.…”

Section: Exercise Protocolmentioning

confidence: 99%

“…Meta-analyses studies have shown that resistance exercise (RE) alone may elicit BP reductions 3,4 . Thus, the Brazilian Society of Cardiology and Hypertension 5 , the American Heart Association (AHA)/American College of Cardiology (ACC) and the task force workgroup 6 , the most recent AHA/ ACC Scientific Statement 7 , the American College of Sports Medicine (ACSM) 8 , and the European Society of Hypertension and European Society of Cardiology 9 recommend resistance exercise (RE) as a complement to aerobic exercise programs treating hypertension.…”

Section: Introductionmentioning

confidence: 99%

Influence of antihypertensive pharmacological treatment on the acute cardiovascular responses to the resistance exercise in hypertensive middle-aged women

Pereira

Miguel-dos-Santos

Filho

et al. 2020

Motriz: rev. educ. fis.

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To investigate the hypothesis that the resistance exercise (RE) may be safer if the blood pressure (BP) is properly controlled through antihypertensive pharmacological treatment in hypertensive middle-aged women. Methods: The final sample was comprised of 19 hypertensive women, with an average age of 58±5 years and a body mass index of 29±5 Kg/m 2. They were divided into three groups: controlled (n=6), uncompensated (n=8), and untreated (n=5). The subjects from all groups were submitted to a test of maximal strength on extensor chair and held a session of RE (knee extension, 3x12 to 60% 1RM) and the cardiovascular response (BP and heart rate) was monitored continuously by photoplethysmography during exercise and until five minutes after exercise (recovery). Results: Systolic BP (SBP) and diastolic BP (DBP) responses were lower in the controlled group compared to the other groups (p<0.05). The heart rate was not different between groups, while the double product was lower in the controlled group compared to the untreated group (p<0.05). The SBP and DBP peaks were lower in the controlled group compared to the other groups (p<0.05). Conclusion: The BP increases significantly during RE when the hypertension is not controlled. Pharmacological control was shown to be effective in preventing the increase of BP during the performance of the RE.

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Capítulo 6 - Tratamento não medicamentoso

Cited by 9 publications

References 59 publications

Matão Controlling Hypertension (MatCH) project: Rationale and design

Matão Controlling Hypertension (MatCH) project: Rationale and design

Combined Aerobic and Resistance Exercises Evokes Longer Reductions on Ambulatory Blood Pressure in Resistant Hypertension: A Randomized Crossover Trial

Influence of antihypertensive pharmacological treatment on the acute cardiovascular responses to the resistance exercise in hypertensive middle-aged women

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