Efeitos de diferentes modalidades de exercícios em pacientes com hipertensão arterial sistêmica: uma revisão guarda-chuva

Abstract

Systemic arterial hypertension (SAH) is a multifactorial condition characterized by sustained high levels of blood pressure (BP), and is the main risk factor for the development of cardiovascular, cerebrovascular, and renal diseases. Physical exercise is, through different modalities, a non-pharmacological tool for prevention and treatment of patients with SAH. Exercise modalities for the treatment of SAH include aerobic exercise (AE), high-intensity interval training (HIIT), resistance exercise (RE), and inspiratory muscle training (IMT). The aim of this umbrella review was to gather evidence of different exercise modalities on BP, functional capacity, and quality of life in patients with SAH. A search strategy, conducted by two independent reviewers, was performed in PubMed, EMBASE, Cochrane CENTRAL, Web of Science, EBSCO, CINAHL and SPORTDiscus databases. The same pair of reviewers performed the selection of the studies in two stages (title and abstract; full text), followed by a methodological quality assessment using the AMSTAR 2 instrument. Systematic reviews and meta-analysis of randomized clinical trials that used AE, HIIT, RE, and IMT as treatment in adults (>18 years) of both genders diagnosed with SAH with no other associated metabolic or cardiovascular diseases were included. A total of 7.535 studies were identified, of which, based on the adopted selection criteria, 7 meta-analyses (3.965 participants) were selected to be included in the review. The results showed that AE, HIIT, RE and IMT reduced both systolic and diastolic BP levels. AE significantly reduced HR, while in RE no difference was observed. AE and HIIT increased VO2max. Furthermore, AE improved the quality of life of patients with SAH. Considering the quality of the meta-analyses, four were defined as very low quality, and three as low quality. It is concluded that the four modalities were effective in reducing SBP and DBP, on the other hand, AE was the only modality that had a positive effect in all the outcomes studied, reduced SBP, DBP, HR, and improved VO2max and quality of life, being the most indicated modality and the most proposed intervention. However, the methodological quality ranged from low to very low.