Respostas pressóricas ao treinamento combinado em mulheres hipertensas após a menopausa sob efeito de medicamentos beta-bloqueadores ou bloqueadores de receptores de angiotensina

Abstract

Introduction: Postmenopausal women are a hypertension risk group, and one of the ways of treating this condition is the practice of regular physical exercises. However, it has not been well described whether antihypertensive drugs influence this ability of exercises to assist in blood pressure control. Objective: The different blood pressure responses were investigated after combined exercise training in hypertensive postmenopausal women under influence of β-blockers or angiotensin receptor blockers. Methods: 21 postmenopausal hypertensive patients were divided into 2 groups: ARB+Ex - angiotensin AT1 receptor blockers users (n=11); and BB+Ex - β-adrenergic blockers users (n=10). Before and after 12 weeks of combined (aerobic and resistance) moderate intensity exercise training, volunteers underwent a battery of evaluations that included: anthropometry, resting and outpatient measures of BP, heart rate (HR) and double product (DP), as well as BP variability analysis (BPV). Results: The generalized two-factor estimation equation test (GEE; time * group) showed time effects with reductions in systolic BP (SPB) at rest (p=0.009; ΔARB+Ex = -5.2±6.4; ΔBB+Ex= -1.6±6.0 mmHg), awake and 24h (p=0.006; 24h ΔARB+Ex = -5.7±8.3; 24h ΔBB+Ex = -3.1±6.7 mmHg), as well as falls in Double Product, SBP standard deviations (i.e. BPV), SPB pressure loads and 24h SBP area under curve in both groups (p=0.005). Group effects were observed with lower values in BB+Ex in HR at rest (p=0.009), awake (p=0.005), sleep (p=0.003) and 24h (p=0.004), as well as DP at rest (p=0.002), awake (p=0.002), sleep (p=0.001) and 24h (p=0.001). Furthermore, were found interaction effects with greater BB+Ex improvements in BPV in awake SBP standard variation (p=0.047; ΔARB+Ex = -0.1±2.2; ΔBB+Ex = -2.3±2.8 mmHg) and awake Diastolic BP (DBP) standard variation (p=0.018; ΔARB+Ex = -0.7±1.6; ΔBB+Ex = -1.3±1.6 mmHg). Conclusions: Resting and ambulatorial BP responses after moderate intensity combined exercise training are similar between BB+Ex and ARB+Ex. This training can reduce SBP and DP during awake and 24h values and reduce SBP variability in both groups, but it seems that these variability responses are greater in BB+Ex.