Abstract
Aims: To perform a systematic review of randomized controlled trials that assess the benefits of physical exercise (regular or competitive) for the health of the elderly and prevention of cardiovascular diseases.Methods: Publications in PubMed, Web of Science, Library of Congress, Cochrane, and in databases with records of clinical trials between 2005 and 2016, and also in the proceedings of major congresses on cardiovascular diseases in the elderly were investigated using the terms defined in accordance with the "patient, intervention, comparison, and outcome" methodology. The following key words were used: physical effort, exercise, exercise therapy, physical activity, physical fitness, resistance training, cardiovascular disease, C-reactive protein, dyslipidemia, heart failure, cardiac insufficiency, revascularization, cardiac stent and heart transplant. Only randomized clinical trials with individuals aged over 60 years were included. The articles were assessed independently by two reviewers.Results: A total of 3,672 studies were assessed and 24 that met the inclusion criteria were selected. Most of these studies had small sample sizes and showed physical exercise as health-promoting. Only 16 studies reported the relationship of adherence to physical exercise as a preventive factor against cardiovascular diseases. The outcome measures included quality of life, physical ability or fitness status, muscle strength, heart rate, psychological aspects, inflammatory and nutritional markers, and progression of cardiovascular diseases. There is strong evidence that aerobic exercise improves physical fitness, muscle strength, and the quality of life of elderly patients with cardiovascular disease.Conclusions: The benefits of exercise training for elderly patients with cardiovascular disease are well established, supporting the prescription of exercise training for their regular treatments. Interventions that use exercise need to be progressively included in cardiovascular treatment regimens, although the best exercise protocol for patients with cardiovascular disease is not yet fully established.
Highlights
O viés material foi definido como o viés de suficiente magnitude a ter efeito notável nos resultados ou conclusões, reconhecendo a subjetividade de cada julgamento
Entretanto, apesar da falta de evidências baseadas em ensaios clínicos randomizados (ECR) sobre o efeito do exercício na mortalidade, os efeitos documentados do exercício no condicionamento físico, na força, na qualidade de vida e na condição cardiovascular são suficientes para apoiar a recomendação de atividade física de intensidade moderada (entre 60 e 75% da FCM) para pacientes com doença cardiovascular (DCV) em qualquer estágio de desenvolvimento da doença
Summary
Envelhecimento saudável e atividade física: uma revisão sistemática sobre os efeitos do exercício nas doenças cardiovasculares. Objetivos: Realizar uma revisão sistemática dos ensaios clínicos randomizados que avaliaram os benefícios do exercício físico (regular ou competitivo) para a saúde de idosos e a prevenção de doenças cardiovasculares. Métodos: Foram investigados os registros no Pubmed, Web of Science, Library of Congress, Central de Registros Cochrane e as bases de dados com os registros dos ensaios clínicos de 2005 a 2016, juntamente com os anais das maiores conferências sobre doenças cardiovasculares no envelhecimento usando os termos definidos de acordo com a metodologia "paciente, intervenção, comparação e resultado". As evidências mais fortes apontam para os efeitos do exercício aeróbico na melhoria da capacidade física, força muscular e qualidade de vida de pacientes idosos com doença cardiovascular. Conclusões: Os benefícios do treinamento físico para pacientes idosos com doença cardiovascular estão bem estabelecidos, apoiando a prescrição de exercícios físicos nos seus tratamentos regulares. DESCRITORES: envelhecimento; doenças cardiovasculares; exercício aeróbico; educação física e treinamento
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