Efeito da ordem de execução do exercício concorrente nas respostas agudas da pressão arterial em idosos hipertensos controlados: ensaio clínico randomizado e cruzado

Abstract

Introduction: Concurrent exercise (CE) provides benefits in strength, cardiorespiratory capacity and reductions in blood pressure (BP). However, it is unknown about the influence of the order of performance of these exercises on acute responses in BP. Objective: To analyze the acute responses of BP after CE in different orders (aerobic-strength and strength-aerobic) in controlled hypertensive elderly. Material and Methods: Fifteen elderly (64±5 years) participated in three randomized crossover sessions with a 48h washout period: control session (C), the CE in the aerobic-strength (AS) order and the CE in the strength-aerobic (SA) order. The CE was performed for 1h, 30min for the strength exercise with 5 exercises at 70% of 1RM and 30min for the aerobic exercise on a treadmill with an intensity corresponding to the first ventilatory threshold. Clinical BP was assessed at rest, in post-exercise over 2h and 24h after the session. For the statistical analysis, the Generalized Estimating Equations test was applied, using Bonferroni’s as a complementary test. In comparisons of the area under the curve (AUC), Shapiro-Wilk test for normality and ANOVA for repeated measures (α = 0.05). Results: Systolic BP decreased 30min after the AS session (-8mmHg), while in the SA session we obtained reductions during 1h after the session (-7mmHg) in relation to rest. Between sessions, we obtained lower values in both CE sessions compared to session C at 30min (-11mmHg), 45min (-11mmHg) and 90min (-10mmHg). In the SA session, there was a blood pressure drop compared to session C at 60min after the session (-11mmHg). No differences in AUC were found between exercise sessions, however, we observed differences in exercise sessions in relation to session C. Diastolic BP decreased 30min after AS (-5mmHg) and in the SA session, there were no reductions compared to rest. Between sessions, no statistical difference was found for diastolic BP and there were also no differences in AUC between sessions. Finally, in the mean BP, there was a pressure drop in relation to rest 30min (-6mmHg) after AS and in the SA session there was no reductions compared to rest. Between sessions, a decrease in BP compared to session C was observed in session 30 minutes (-9mmHg) and 45 minutes (-9mmHg). We did not find differences in AUC between the AS and SA sessions in mean BP, however, we observed differences in the exercise sessions in comparison to session C. Conclusion: We can conclude that CE was effective in generating post-exercise hypotension regardless of the order in controlled hypertensive elderly.