Jornal Vascular Brasileiro
https://www.jvascbras.org/article/doi/10.1590/1677-5449.20130092
Jornal Vascular Brasileiro
Original Article

Cardiovascular responses of peripheral artery disease patients during resistance exercise

Respostas cardiovasculares durante o exercício de força em pacientes com doença arterial periférica

Ana Patrícia Ferreira Gomes; Thaliane Mayara Pessôa dos Prazeres; Marilia de Almeida Correia; Fábio da Silva Santana; Breno Quintella Farah; Raphael Mendes Ritti-Dias

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Abstract

BACKGROUND: Resistance training has been used for the treatment of patients with peripheral artery disease (PAD). However, cardiovascular responses during this type of exercise have not been fully elucidated in these patients. OBJECTIVES: To analyze the cardiovascular responses during resistance exercise and to verify whether there are any correlations between these responses and disease severity or blood pressure levels in patients with PAD. METHODS: Seventeen PAD patients performed one set of 10 repetitions of knee extension exercise with an intensity of 50% of one repetition maximum. The responses of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate (HR) were continuously monitored using the finger photoplethysmography technique. The rate-pressure product (RPP) was obtained by multiplication of SBP and HR. RESULTS: During the resistance exercises there were significant increases in SBP (126 ± 14 vs. 184 ± 20 mmHg, p<0.001), DBP (68 ± 8 vs. 104 ± 14 mmHg, p<0.001), HR (76 ± 18 vs. 104 ± 30 bpm, p<0.001) and RPP (9523 ± 2115 vs. 19103 ± 6098 mmHg x bpm, p<0.001). A negative correlation was observed between relative change (Δ) in SBP and SBP at rest (r =-0.549, p=0.022). On the other hand, there was no relationship between Δ SBP and the ankle-brachial index (r=0.076, p=0.771). CONCLUSION: Increases in cardiovascular variables were observed during resistance exercise in PAD patients. The highest increases occurred in patients with lower SBP levels at resting.

Keywords

peripheral artery disease, intermittent claudication, exercise, blood pressure, heart rate

Resumo

CONTEXTO: O treinamento de força vem sendo utilizado para o tratamento de pacientes com doença arterial periférica (DAP). No entanto, as respostas cardiovasculares durante a realização desse tipo de exercício ainda não são claras nesses pacientes. OBJETIVOS: Analisar as respostas cardiovasculares durante a realização do exercício de força e verificar se existe alguma correlação entre essas respostas e a severidade da doença e o nível de pressão arterial em pacientes com DAP. MÉTODOS: Dezessete pacientes com DAP realizaram uma série de dez repetições com intensidade de 50% de uma repetição máxima do exercício extensão do joelho. As respostas da pressão arterial sistólica (PAS) e diastólica (PAD), e da frequência cardíaca (FC) foram continuamente registradas pela técnica de fotopletismografia de dedo. O duplo produto (DP) foi obtido pela multiplicação da PAS pela FC. RESULTADOS: Durante a realização do exercício de força, houve aumento significante dos seguintes parâmetros: PAS (126 ± 14 vs. 184 ± 20 mmHg; p < 0,001); PAD (68 ± 8 vs. 104 ± 14 mmHg; p < 0,001); FC (76 ± 18 vs. 104 ± 30 bpm; p < 0,001), e DP (9523 ± 2115 vs. 19103 ± 6098 bpm x mmHg; p < 0,001). Foi observada correlação negativa entre o delta (Δ) relativo da PAS com a PAS de repouso (r = -0,549; p = 0,022). Por outro lado, não foi observada relação entre o Δ relativo da PAS e o índice tornozelo braço (r = 0,076; p = 0,771). CONCLUSÃO: Foram observados aumentos das variáveis cardiovasculares durante o exercício de força em pacientes com DAP. Os maiores aumentos ocorreram nos pacientes com menor nível de PAS em repouso.

Palavras-chave

doença arterial periférica, claudicação intermitente, exercício, pressão arterial, frequência cardíaca

References

Norgren L, Hiatt WR, Dormandy JA, Nehler MR, Harris KA, Fowkes FG. Inter-society consensus for the management of peripheral arterial disease. Int Angiol.. ;26(2):81-157.

Makdisse M, Pereira AC, Brasil DP, Borges JL, Machado-Coelho GL, Krieger JE. Prevalence and risk factors associated with peripheral arterial disease in the Hearts of Brazil Project. Arq Bras Cardiol.. ;91(6):370-82.

Meves SH, Diehm C, Berger K, Pittrow D, Trampisch HJ, Burghaus I, et al. Peripheral arterial disease as an independent predictor for excess stroke morbidity and mortality in primary-care patients: 5-year results of the getABI study. Cerebrovasc Dis.. ;29(6):546-54.

Caro J, Migliaccio-Walle K, Ishak KJ, Proskorovsky I. The morbidity and mortality following a diagnosis of peripheral arterial disease: long-term follow-up of a large database. BMC Cardiovasc Disord.. ;5(1):14-21.

Diehm C, Schuster A, Allenberg JR, Darius H, Haberl R, Lange S. High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study. Atherosclerosis.. ;172(1):95-105.

Wolosker N, Rosoky RA, Nakano L, Basyches M, Puech-Leão P. Predictive value of the ankle-brachial index in the evaluation of intermittent claudication. Rev Hosp Clin Fac Med Sao Paulo.. ;55(2):61-4.

Topakian R, Nanz S, Rohrbacher B, Koppensteiner R, Aichner FT, and the OECROSS Study Group. High prevalence of peripheral arterial disease in patients with acute ischaemic stroke. Cerebrovasc Dis.. ;29(3):248-54.

Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL. Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Sur. Circulation.. ;113(11):463-654.

Ritti-Dias RM, Wolosker N, Moraes Forjaz CL, Carvalho CR, Cucato GG, Leão PP. Strength training increases walking tolerance in intermittent claudication patients: randomized trial. J Vasc Surg.. ;51(1):89-95.

McDermott MM, Ades P, Guralnik JM, Dyer A, Ferrucci L, Liu K, et al. Treadmill exercise and resistance training in patients with peripheral arterial disease with and without intermittent claudication: a randomized controlled trial. JAMA.. ;301(2):165-74.

Cucato GG, Ritti-Dias RM, Wolosker N, Santarém JM, Jacob Filho W, Forjaz CLMF. Post-resistance exercise hypotension in patients with intermittent claudication. Clinics (Sao Paulo).. ;66(2):221-26.

MacDougall JD, Tuxen D, Sale DG, Moroz JR, Sutton JR. Arterial blood pressure response to heavy resistance exercise. J Appl Physiol (1985).. ;58(3):785-90.

Souza Nery SS, Gomides RS, Silva GV, Moraes Forjaz CL, Mion D Jr, Tinucci T. Intra-arterial blood pressure response in hypertensive subjects during low- and high-intensity resistance exercise. Clinics (Sao Paulo).. ;65(3):271-77.

Bennett T, Wilcox RG, Macdonald IA. Post-exercise reduction of blood pressure in hypertensive men is not due to acute impairment of baroreflex function. Clin Sci.. ;67(1):97-103.

Fleck SJ, Dean LS. Resistance-training experience and the pressor response during resistance exercise. J Appl Physiol (1985).. ;63(1):116-20.

Câmara LC, Ritti-Dias RM, Forjaz CL, Greve JM, Santarém JM, Jacob-Filho W. Cardiovascular responses during isokinetic muscle assessment in claudicant patients. Arq Bras Cardiol.. ;95(5):571-76.

Gomides RS, Dias RM, Souza DR, Costa LA, Ortega KC, Mion D. Finger blood pressure during leg resistance exercise. Int J Sports Med.. ;31(8):590-95.

Clarke DH. Adaptations in strength and muscular endurance resulting from exercise. Exerc Sport Sci Rev.. ;1(1):73-102.

Chagas, MH, Barbosa, JRM, Lima, FV. Comparação do número máximo de repetições realizadas a 40% e 80% de uma repetição máxima em dois diferentes exercícios na musculação entre os gêneros masculino e feminino. Rev Bras Educ Fís Esp.. ;19:5-12.

Câmara LC, Santarém JM, Wolosker N, Dias RMR. Exercícios resistidos terapêuticos para indivíduos com doença arterial obstrutiva periférica: evidências para a prescrição. J Vasc Bras.. ;6(3):246-56.

Bos WJ, Imholz BP, van Goudoever J, Wesseling KH, van Montfrans GA. The reliability of noninvasive continuous finger blood pressure measurement in patients with both hypertension and vascular disease. Am J Hypertens.. ;5(8):529-35.

Olin JW, Sealove BA. Peripheral artery disease: current insight into the disease and its diagnosis and management. Mayo Clin Proc.. ;85(7):678-92.

Gomides RS, Costa LA, Souza DR, Queiroz AC, Fernandes JR, Ortega KC, et al. Atenolol blunts blood pressure increase during dynamic resistance exercise in hypertensives. Br J Clin Pharmacol.. ;70(5):664-73.

Moraes MF, Alexandre GL, Borges PG, Diego Leite R, Vieira A, Frade de Sousa NM. Different cardiovascular responses to a resistance training session in hypertensive women receiving propanolol compared with normotensive controls. ScientificWorldJournal.. ;2012:913271-13271.

Bakke EF, Hisdal J, Jørgensen JJ, Kroese A, Stranden E. Blood pressure in patients with intermittent claudication increases continuously during walking. Eur J Vasc Endovasc Surg.. ;33(1):20-5.

Baccelli G, Reggiani P, Mattioli A, Corbellini E, Garducci S, Catalano M. The exercise pressor reflex and changes in radial arterial pressure and heart rate during walking in patients with arteriosclerosis obliterans. Angiology.. ;50(5):361-74.

Cucato GG, Rodrigues LBCC, Farah BQ, Lins OL, Rodrigues SLC, Forjaz CLM. Cardiovascular responses to an exercise test in subjects with intermittent claudication. Rev Bras Cineantropom Desempenho Hum.. ;13:208-15.

Ritti-Dias RM, Meneses AL, Parker DE, Montgomery PS, Khurana A, Gardner AW. Cardiovascular responses to walking in patients with peripheral artery disease. Med Sci Sports Exerc.. ;43(11):2017-023.

Sheikh MA, Bhatt DL, Li J, Lin S, Bartholomew JR. Usefulness of postexercise ankle-brachial index to predict all-cause mortality. Am J Cardiol.. ;107(5):778-82.

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