Efeito do exercício aquático na resposta aguda da pressão arterial

Abstract

Introduction: The aging process is marked by several changes responsible for increasing the risk of chronic diseases, such as arterial hypertension (AH). Additionally, postmenopausal women experience these changes early due to the reduction of female sex hormones. It is known that physical exercise can promote a reduction in blood pressure (BP) after a session, among them, aquatic exercise is widely sought after by this population, and its effects are studied for the prevention and treatment of AH. Objective: To investigate the effects of a session of aquatic exercise, in a vertical position, on blood pressure. Methods: A systematic review and meta-analysis were conducted with a search for clinical trials conducted with the elderly (≥ 60 years) and published until August 2023 in digital databases (EMBASE, PUBMED, Lilacs, SPORTDiscus, and Web of Science). Subsequently, a randomized crossover clinical trial was conducted with 22 hypertensive postmenopausal women (58±4.5 years). Two sessions took place: aquatic high-intensity interval exercise (HIIE) and control (CON) with a total duration of 24 minutes. Assessments were divided into pre-intervention, post-laboratory intervention, and post-ambulatory intervention periods; the variables evaluated were: resting and ambulatory BP, BP and heart rate variability, BP reactivity, and salivary nitrite. Results: Seven studies were included in the meta-analysis, and the results showed that aquatic exercise promoted a reduction in systolic blood pressure (SBP) of -6.86 mmHg up to 1 hour and - 4.14 mmHg during 24 hours after the session. However, it showed a null effect on diastolic blood pressure (DBP) responses. Additionally, subgroup analysis showed that HIIE reduced SBP by -15.50 mmHg and DBP by - 5.97 mmHg after sessions. On the other hand, continuous moderate-intensity exercise reduced SBP by -4.91 mmHg, with no effect on DBP up to 1 hour after sessions. Subgroup analysis for 24 hours was not possible. The clinical trial found that the HIIE session promoted a reduction in SBP and DBP up to 1 hour and SBP during 24 hours after exercise, compared to the CON session (p=0.04). There was no difference in BP and heart rate variability, BP reactivity, and nitrite concentration (p>0.05). Conclusion: Acute aquatic exercise is capable of reducing BP in the elderly and hypertensive postmenopausal women up to 24 hours after sessions. Thus, aquatic exercise performed in a vertical position may be considered beneficial for reducing BP, contributing to the prevention and treatment of AH.