O Effect of cardiac rehabilitation on the nociceptive threshold increased of hypertensive subjects
DOI:
https://doi.org/10.33233/fb.v23i3.4780Keywords:
cardiac rehabilitation; hypertension; analgesiaAbstract
Objectives: Hypertensive subjects have an increased nociceptive threshold, which may contribute to the pain perception reduction. Thus, the aim of this study was to evaluate the effect of a cardiac rehabilitation program (CRP) on the increased nociceptive threshold of hypertensive subjects. Methods: Forty-one participants were divided into two groups: a normotensive group and hypertensive group. In both groups, the body mass index, abdominal circumference, systolic and diastolic blood pressure, heart rate, nociceptive threshold and functional capacity by six-minute walking test (6MWT) were evaluated. The CRP was composed of aerobic exercises on a treadmill for 30 min, 3 times a week for 7 weeks. Results: After the CRP, there was a reduction (p < 0.001) in the mechanical nociceptive threshold and an increase in the distance walked during the 6MWT (p < 0.001) in the hypertensive group. No differences were found in the body mass index between the groups. Conclusion: The results of the present study suggested that aerobic exercise is an important modality to normalize the nociceptive threshold and improved the functional capacity of the hypertensive subjects.
References
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
Published
Issue
Section
License
Copyright (c) 2022 Ana Clara Desiderio Maldonado, João Paulo Prado, Tarcísio Nema de Aquino, Fernanda de Carvalho Vidigal, Juliana Bassalobre Carvalho Borges, Giovane Galdino de Souza
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors are authorized for non-exclusive distribution of the version of the work published in this journal (eg, publishing in an institutional repository or as a book chapter), with acknowledgment of authorship and initial publication in this journal.
