Pandemia de covid-19, aptidão física e desfechos de saúde em pessoas idosas com hipertensão: um estudo longitudinal
DOI:
https://doi.org/10.12820/rbafs.31e0442Palavras-chave:
Covid-19, Ecocardiograma, Teste de exerc´´ício cardiopulmonar, Comportamento sedentário, Atividade físicaResumo
Objetivo: Este estudo examinou as mudanças em desfechos relacionados à saúde cardiovascular, comportamentos de movimento e composição corporal em pessoas idosas com hipertensão após 15 meses do início da pandemia de covid-19. Métodos: Quinze pessoas idosas foram incluídas neste estudo longitudinal com acompanhamento de 15 meses. As avaliações incluíram estrutura e função cardíaca, marcadores de saúde vascular (rigidez arterial, função endotelial e espessura médio-íntimal da carótida), pressão arterial de 24 horas e variabilidade da frequência cardíaca, aptidão cardiorrespiratória, atividade física (AF) e comportamento sedentário (CS) avaliados por acelerometria e composição corporal. Modelos lineares generalizados de efeitos mistos foram utilizados para a análise dos dados. Resultados: Após 15 meses, os participantes apresentaram aumento significativo do CS (β = 41 min/dia; p = 0,007), redução da AF de intensidade leve (β = ‒39 min/dia; p = 0,008), diminuição da contagem de passos (β = ‒1.343 passos/dia; p = 0,002) e redução do consumo máximo de oxigênio (β = ‒1,7 mL/kg/min; p = 0,034). Observou-se também uma pequena, porém significativa, redução na espessura da parede posterior do ventrículo esquerdo (β = ‒0,5 mm; p = 0,046). Não foram encontradas alterações significativas nos demais desfechos (p > 0,05). Conclusão: Alterações deletérias nos comportamentos de movimento e na aptidão cardiorrespiratória foram observadas 15 meses após o início da pandemia de Covid-19 em pessoas idosas com hipertensão, apesar da ausência de mudanças significativas em uma gama mais ampla de desfechos relacionados à saúde cardiovascular.
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1. Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1736–88.
2. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16(4):223–37.
3. Yamada Y, Uchida T, Ogino M, Ikenoue T, Shiose T, Fukuma S. Changes in older people’s activities during the coronavirus disease 2019 pandemic in Japan. J Am Med Dir Assoc. 2020;21(10):1387–8.e1.
4. Browne RAV, Macêdo GAD, Cabral LLP, Oliveira GTA, Vivas A, Fontes EB, et al. Initial impact of the COVID-19 pandemic on physical activity and sedentary behavior in hypertensive older adults: an accelerometer-based analysis. Exp Gerontol. 2020;142:111121.
5. Browne RAV, Cabral LLP, Freire YA, Macêdo GAD, Oliveira GTA, Vivas A, et al. Housing type is associated with objectively measured changes in movement behavior during the COVID-19 pandemic in older adults with hypertension: an exploratory study. Arch Gerontol Geriatr. 2021;94:104354.
6. Park SK, Park S, Jee YS. Effects of physical inactivity behavior during COVID-19 pandemic on physical fitness, body composition, inflammatory cytokine, and immunocytes in older adults: a retrospective and prospective study. Physiol Behav. 2024;284:114640.
7. Ross R, Blair SN, Arena R, Church TS, Després J-P, Franklin BA, et al. Importance of assessing cardiorespiratory fitness in clinical practice: a case for fitness as a clinical vital sign. Circulation. 2016;134(24):e653–e699.
8. Beydoun HA, Beydoun MA, Gautam RS, Alemu BT, Weiss J, Hossain S, et al. COVID-19 pandemic impact on trajectories in cardiometabolic health, physical activity, and functioning among adults from the 2006–2020 Health and Retirement Study. J Gerontol A Biol Sci Med Sci. 2022;77(7):1371–9.
9. Freiberg A, Schubert M, Romero Starke K, Hegewald J, Seidler A. A rapid review on the influence of COVID-19 lockdown and quarantine measures on modifiable cardiovascular risk factors in the general population. Int J Environ Res Public Health. 2021;18(16):8567.
10. Dalton-Alves F, Araújo MBF, Lucena BE, Souto GC, Lopes DSD, Lucena MIS, et al. Effects of high-intensity interval and moderate-intensity continuous training on ambulatory blood pressure and cardiovascular outcomes in older adults with hypertension (HEXA Study): study protocol for a randomised trial. BMJ Open. 2024;14(12):e084736.
11. Lang RM, Badano LP, Mor-Avi V, Afilalo J, Armstrong A, Ernande L, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging. J Am Soc Echocardiogr. 2015;28(1):1–39.e14.
12. Malachias MVB, Souza WKSB, Plavnik FL, Rodrigues CIS, Brandão AA, Neves MFT, et al. 7th Brazilian guideline of arterial hypertension: presentation. Arq Bras Cardiol. 2016;107(3):1–83.
13. Nobre F, Mion D Jr, Gomes MAN, Malachias MVB, Amodeo C. V guidelines for ambulatory blood pressure monitoring (ABPM) and III guidelines for home blood pressure monitoring (HBPM). J Bras Nefrol. 2011;33(3):365–88.
14. Marek Malik, J. Thomas Bigger, A. John Camm, Robert E. Kleiger, Alberto Malliani, Arthur J. Moss. Heart rate variability: standards of measurement, physiological interpretation and clinical use. Eur Heart J. 1996;17(3):354–81.
15. Reference Values for Arterial Stiffness Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: establishing normal and reference values. Eur Heart J. 2010;31(19):2338–50.
16. Papaioannou TG, Karageorgopoulou TD, Sergentanis TN, Protogerou AD, Psaltopoulou T, Sharman JE, et al. Accuracy of commercial devices and methods for noninvasive estimation of aortic systolic blood pressure: a systematic review and meta-analysis of invasive validation studies. J Hypertens. 2016;34(7):1237–48.
17. Weber T, Wassertheurer S, Rammer M, Maurer E, Hametner B, Mayer CC, et al. Validation of a brachial cuff-based method for estimating central systolic blood pressure. Hypertension. 2011;58(5):825–32.
18. Harris RA, Nishiyama SK, Wray DW, Richardson RS. Ultrasound assessment of flow-mediated dilation. Hypertension. 2010;55(5):1075–85.
19. Fletcher GF, Ades PA, Kligfield P, Arena R, Balady GJ, Bittner VA, et al. Exercise standards for testing and training: a scientific statement from the American Heart Association. Circulation. 2013;128(8):873–934.
20. Trost SG, McIver KL, Pate RR. Conducting accelerometer-based activity assessments in field-based research. Med Sci Sports Exerc. 2005;37(Suppl):S531–S543.
21. Choi L, Liu Z, Matthews CE, Buchowski MS. Validation of accelerometer wear and nonwear time classification algorithm. Med Sci Sports Exerc. 2011;43(2):357–64.
22. Freedson PS, Melanson E, Sirard J. Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc. 1998;30(5):777–81.
23. Alves CPL, Câmara M, Macêdo GAD, Freire YA, de Melo Silva R, Paulo-Pereira R, et al. Agreement between upper and lower limb measures to identify older adults with low skeletal muscle strength, muscle mass and muscle quality. PLoS One. 2022;17(1):e0262732.
24. Massarotto RJ, Campbell AJ, Kreiter E, Claydon VE, Cote AT. Effects of detraining on left ventricular mass in endurance-trained individuals: a systematic review and meta-analysis. Eur J Prev Cardiol. 2024;31(4):415–24.
25. Howden EJ, Sarma S, Lawley JS, Opondo M, Cornwell WK, Stoller D, et al. Reversing the cardiac effects of sedentary aging in middle age: a randomized controlled trial. Circulation. 2018;137(15):1549–1560.
26. Toba A, Ishikawa J, Harada K. Ambulatory blood pressure is associated with left ventricular geometry after 10 years in hypertensive patients with continuous antihypertensive treatment. Hypertens Res. 2025;48(1):212–22.
27. Laurent S, Boutouyrie P. Arterial stiffness and hypertension in the elderly. Front Cardiovasc Med. 2020;7.
28. Seals DR, Jablonski KL, Donato AJ. Aging and vascular endothelial function in humans. Clin Sci (Lond). 2011;120(9):357–375.
29. Tanaka H, Palta P, Folsom AR, Meyer ML, Matsushita K, Evenson KR, et al. Habitual physical activity and central artery stiffening in older adults. J Hypertens. 2018;36(9):1889–94.
30. Cabral LLP, Freire YA, Browne RAV, Macêdo GAD, Câmara M, Schwade D, et al. Associations of steps per day and peak cadence with arterial stiffness in older adults. Exp Gerontol. 2022;157:111628. 8
31. Liang C, Song Z, Yao XZ, Xiao Q, Fu H, Tang L, et al. Exercise interventions for the effect of endothelial function in hypertensive patients: a systematic review and meta-analysis. J Clin Hypertens (Greenwich). 2024;26(6):599–614.
32. Cameron AC, Lang NN, Touyz RM. Drug treatment of hypertension: focus on vascular health. Drugs. 2016;76(16):1529–50.
33. Silva IVG, de Figueiredo RC, Rios DRA. Effect of different classes of antihypertensive drugs on endothelial function and inflammation. Int J Mol Sci. 2019;20(14):3458.
34. Whelton PK, Carey RM, Aronow WS, Casey DE 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. Hypertension. 2018;71(6):1269–1324.
35. Feitosa FGAM, Feitosa ADM, Paiva AMG, Mota-Gomes MA, Barroso WS, Miranda RD, et al. Impact of the COVID-19 pandemic on blood pressure control: a nationwide home blood pressure monitoring study. Hypertens Res. 2022;45(2):364–368.
36. Eckberg DL, Kuusela TA. Human vagal baroreflex sensitivity fluctuates widely and rhythmically at very low frequencies. J Physiol. 2005;567(3):1011–19.
37. Thayer JF, Yamamoto SS, Brosschot JF. The relationship of autonomic imbalance, heart rate variability and cardiovascular disease risk factors. Int J Cardiol. 2010;141(2):122–31.
38. Shah B, Kunal S, Bansal A, Jain J, Poundrik S, Shetty MK, et al. Heart rate variability as a marker of cardiovascular dysautonomia in post-COVID-19 syndrome using artificial intelligence. Indian Pacing Electrophysiol J. 2022;22(2):70–6.
39. Lu D, Zhang W, Tan S. Assessing the impact of 24-hour activity behaviors on cardiorespiratory fitness in older adults: a component analysis approach. Front Public Health. 2024;12.
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Copyright (c) 2026 Bruno Erick Barros Lucena, Ludmila Lucena Pereira Cabral, Gabriel Costa Souto, Maria Beatriz da Fonseca-Araújo, Rodrigo Alberto Vieira Browne, Eduardo Caldas Costa
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