Efeito da reabilitação cardíaca sobre o limiar nociceptivo aumentado de indivíduos hipertensos

Autores

DOI:

https://doi.org/10.33233/fb.v23i3.4780

Palavras-chave:

reabilitação cardíaca; hipertensão; analgesia

Resumo

Objetivos: Indivíduos hipertensos apresentam um limiar nociceptivo aumentado, o que pode contribuir para uma redução da percepção da dor. Assim, o objetivo deste estudo foi avaliar o efeito de um programa de reabilitação cardíaca (PRC) sobre limiar nociceptivo aumentados de indivíduos hipertensos. Métodos: Quarenta e um participantes foram divididos em dois grupos: grupo normotenso e grupo hipertenso. Nos dois grupos, foram avaliados a massa corporal, índice de massa corporal (IMC), circunferência abdominal, pressão arterial sistólica e diastólica, frequência cardíaca, limiar nociceptivo e a capacidade funcional pelo teste de caminhada de seis minutos (TC6). O PRC foi composto de exercícios aeróbicos em esteira com duração de 30 minutos, 3 vezes por semana, durante 7 semanas. Resultados: Após o PRC, houve uma significativa redução (p < 0,001) no limiar mecânico nociceptivo e um aumento na distância percorrida durante o TC6 (p < 0,001) no grupo composto por indivíduos hipertensos. Conclusão: Os resultados do presente estudo sugeriram que o exercício aeróbico é uma modalidade importante para normalizar o limiar nociceptivo e melhorar a capacidade funcional de indivíduos hipertensos.

 

Biografia do Autor

Ana Clara Desiderio Maldonado, UNIFAL

Instituto das Ciências da Motricidade, Universidade Federal de Alfenas, Alfenas, MG, Brasil

João Paulo Prado, UNIFAL

Instituto das Ciências da Motricidade, Universidade Federal de Alfenas, Alfenas, MG, Brasil

Tarcísio Nema de Aquino, UNIFAL

Instituto das Ciências da Motricidade, Universidade Federal de Alfenas, Alfenas, MG, Brasil

Fernanda de Carvalho Vidigal, UNIFAL

Curso de Nutrição, Universidade Federal de Alfenas, Alfenas, MG, Brasil

Juliana Bassalobre Carvalho Borges, UNIFAL

Professor do Curso de Fisioterapia, Universidade Federal de Alfenas, Alfenas, MG, Brasil

Giovane Galdino de Souza, UNIFAL

Professor do Curso de Fisioterapia, Universidade Federal de Alfenas, Alfenas, MG, Brasil

Referências

Whitworth JA. World Health Organization, International Society of Hypertension Writing Group. 2003 World Health Organization (WHO)/International Society of Hypertension (ISH) statement on management of hypertension. J Hypertens 2003;21:1983-92. doi: 10.1097/00004872-200311000-00002

Jensen JS, Feldt-Rasmussen B, Strandgaard S, Schroll M, Borch-Johnsen K. Arterial hypertension, microalbuminuria, and risk of ischemic heart disease. Hypertension 2000;35:898-903. doi: 10.1161/01.hyp.35.4.898

Chen CC, Chong CF, Kuo CD, Wang TL. Silent myocardial ischemia in coronary artery disease patients under aspirin therapy presenting with upper gastrointestinal hemorrhage. J Gastroenterol Hepatol 2007;22:13-17. doi: 10.1111/j.1440-1746.2006.04277.x

Ghione S, Rosa C, Mezzasalma L, Panattoni E. Arterial hypertension is associated with hypalgesia in humans. Hypertension 1988;12:491-7. doi: 10.1161/01.hyp.12.5.491

Modolo R, Faria AP, Paganelli MO, Sabbatini AR, Barbaro NR, Nascimento BB. Predictors of silent myocardial ischemia in resistant hypertensive patients. Am J Hypertens 2015;28:200-7. doi: 10.1093/ajh/hpu140

Glazier JJ, Chierchia S, Brown MJ, Maseri A. Importance of generalized defective perception of painful stimuli as a cause of silent myocardial ischemia in chronic stable angina pectoris. Am J Cardiol 1986;58:667-672. doi: 10.1016/0002-9149(86)90335-8

Bonica JJ, Loeser JD. History of pain concepts and therapies. In: Loeser JD, Butler SH, Chapman CR, et al. Bonica's Management of Pain. Philadelphia, PA: Lippincott; 2001:3-16.

Randich A, Maixner W. Interactions between cardiovascular and pain regulatory systems. Neurosci Biobehav Rev 1984;8:343-367. doi: 10.1016/0149-7634(84)90057-5

Randich A, Maixner W. The role of sinoaortic and cardiopulmonary baroreceptor reflex arcs in nociception and stress-induced analgesia. Ann N Y Acad Sci 1986;467:385-401. doi: 10.1111/j.1749-6632.1986.tb14642.x

Zamir N, Simanto R, Segal M. Pain sensitivity and opioid activity in genetically and experimentally hypertensive rats. Brain Res 1980;184:299-310. doi: 10.1016/0006-8993(80)90800-8

Irvine RJ, White JM, Head RJ. The renin angiotensin system and nociception in spontaneously hypertensive rats. Life Sci 1995;56:1073-78. doi: 10.1016/0024-3205(95)00043-6

Pescatello LS, Franklin BA, Fagard R, Farquhar WB, Kelley GA, Ray CA. American College of Sports Medicine. American College of Sports Medicine position stand. Exercise and hypertension. Med Sci Sports Exerc 2004;36:533-553. doi: 10.1249/01.mss.0000115224.88514.3a

Galdino GS, Lopes AM, Franca VM, Duarte IDG, Andrea C Perez AC. Evaluation of exercise and potassium chloride supplementation on blood pressure and nociceptive threshold in hypertensive rats. Appl Physiol Nutr Metab 2010;35:184-7. doi: 10.1139/h09-138

Des Jarlais DC, Lyles C, Crepaz N. The TREND Group. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND Statement. Am J Public Health 2004;94:361-6. doi: 10.2105/ajph.94.3.361

Mancia G, Fagard R, Narkiewicz K, Redón J, Zanchetti A, Böhm M. Task Force Members. 2013 ESH/ESC Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013;31:1281-1357. doi: 10.1097/01.hjh.0000431740.32696.cc

ATS Committee on Proficiency Standards for Clinical Pulmonary Function Laboratories. ATS statement: guidelines for the six-minute walk test. Am J Respir Crit Care Med 2002;166:111-117. doi: 10.1164/ajrccm.166.1.at1102

JCS Joint Working Group. Guidelines for rehabilitation in patients with cardiovascular disease (JCS 2012). Circ J 2014;78:2022-93. doi: 10.1253/circj.cj-66-0094

Lauer MS, Levy D, Anderson KM, Plehn JF. Is there a relationship between exercise systolic blood pressure response and left ventricular mass? The Framingham Heart Study. Ann Intern Med 1992;116:203-10. doi: 10.7326/0003-4819-116-3-203

Borg G. Borg's perceived exertion and pain scales. 1st Ed. Champaign, IL: Human Kinetics; 1998.

Jurio-Iriarte B, Maldonado-Martín S. Effects of different exercise training programs on cardiorespiratory fitness in overweight/obese adults with hypertension: a pilot study. Health Promot Pract 2018;1:1524839918774310. doi: 10.1177/1524839918774310

World Health Organization. Defining the problem of overweight and obesity. In: World Health Organization, ed. Obesity: preventing and managing the global epidemic: report of a Who Consultation. Geneva, GE: WHO Technical Report Series; 2000:241-3.

Harris MM, Stevens J, Thomas N, Schreiner P, Folsom AR. Associations of fat distribution and obesity with hypertension in a bi-ethnic population: The ARIC Study l. Obes Res 2000;8:516-24. doi: 10.1038/oby.2000.64

Janssen I, Katzmarzyk PT, Ross R. Waist circumference and not body mass index explains obesity-related health risk. Am J Clin Nutr 2004;79:379-84. doi: 10.1093/ajcn/79.3.379

Whelton PK, Carey RM, Aronow WS, Casey Jr, Collins KJ, Dennison Himmelfarb C, et al. 2017. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: executive summary: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension 2018;71:1269-1324. doi: 10.1161/hyp.0000000000000066

Stamler J, Stamler R, Neaton JD. Blood pressure, systolic and diastolic, and cardiovascular risks. US population data. Arch Intern Med 1993;153:598-615. doi: 10.1001/archinte.153.5.598

Rapsomaniki E, Timmis A, George J, Pujades-Rodriguez M, Shah AD, Spiros Denaxas S. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million people. Lancet 2014;383:1899-1911. doi: 10.1016/s0140-6736(14)60685-1

Wen H, Wang L. Reducing effect of aerobic exercise on blood pressure of essential hypertensive patients: A meta-analysis. Medicine 2017;96:6150. doi: 10.1097/md.0000000000006150

Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL, et al. Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003;289:2560-72.

Turnbull F. Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of different blood-pressure-lowering regimens on major cardiovascular events: results of prospectively designed overviews of randomized trials. Lancet 2003;362:1527-35. doi: 10.1016/s0140-6736(03)14739-3

Lewington S, Clarke R, Qizilbash N, Peto R, Collins R. Prospective Studies Collaboration. Prospective Studies Collaboration. Age-specific relevance of usual blood pressure to vascular mortality: a meta-analysis of individual data for one million adults in 61 prospective studies. Lancet 2002;360:1903-13. doi: 10.1016/s0140-6736(02)11911-8

Demers C, McKelvie RS, Negassa A, Yusuf S. RESOLVD Pilot Study Investigators. Reliability, validity, and responsiveness of the six-minute walk test in patients with heart failure. Am Heart J 2001;142:698-703. doi: 10.1067/mhj.2001.118468

Chen H, Liang BM, Tang YJ, Xu ZB, Wang K, Yi Q, et al. Relationship between 6-minute walk test and pulmonary function test in stable chronic obstructive pulmonary disease with different severities. Chin Med J [Internet]. 2012 [cited 2022 May 16];125:3053-8. Available from: https://pubmed.ncbi.nlm.nih.gov/22932179/

Mehta S, Pereira S, Janzen S, Mays R, Viana R, Lobo L, et al. Cardiovascular conditioning for comfortable gait speed and total distance walked during the chronic stage of stroke: a meta-analysis. Top Stroke Rehabil 2012;19:463-70. doi: 10.1310/tsr1906-463

Zamir N, Shuber E. Altered pain perception in hypertensive humans. Brain Res 1980;201:471-4. doi: 10.1016/0006-8993(80)91055-0

Dworkin BR, Elbert T, Rau H, Birbaumer N, Pauli P, Droste C, et al. Central effects of baroreceptor activation in humans: attenuation of skeletal reflexes and pain perception. Proc Nati Acad Sci U S A 1994;91:6329-33. doi: 10.1073/pnas.91.14.6329

Randich A, Robertson JD. Spinal nociceptive transmission in the spontaneously hypertensive and Wistar-Kyoto normotensive rat. Pain 1994;58:169-83. doi: 10.1016/0304-3959(94)90197-x

Vignocchi G, Murri L, Rossi B, Rosa C, Ghione S. Correlation between pain thresholds and polysinaptic components of the blink reflex in essential arterial hypertension. Funct Neurol [Internet] 1989 [cited 2022 May 20];4:59-61. Available from: https://pubmed.ncbi.nlm.nih.gov/2737495/

Nalbantgil I, Onder R, Nalbantgil S, Yilmaz H, Boydak B. The prevalence of silent myocardial ischaemia in patients with white-coat hypertension. J Hum Hypertens 1998;12:337-341. doi: 10.1038/sj.jhh.1000607

Publicado

2022-06-27

Edição

Seção

Artigos originais