Abstract
Introduction: Lifestyle changes (LC) influence peripheral blood pressure (BP) in pre-hypertensive (PH) individuals; the behavior of central systolic BP (CBP) in respect to LC is not fully known. However, pre-hypertension cardiovascular risk is similar to mild hypertension and can be associated with changes in the endothelial function thereby altering the CBP. Objective: Thus, to demonstrate the influence of LC on the peripheral and the central blood pressure in PH individuals.Methods: Fifty-six PH patients were studied before and after three months of LC (Dash diet and aerobic exercises). The CBP was measured by tonometry of the radial artery before and after LC.Results: The mean age of the study population was 48 ± 10.8 years. There were significant reductions in peripheral systolic pressure (127±8.1 vs. 122 ± 9.2, P=0.003), in the body mass index (29.0±4.6 vs. 28.5±4.6, P=0.001) and the waist-hip ratio(0.91 ± 0.07 vs. 0.89 ± 0.06, P=0.0007) and also in the central systolic pressure (113±10.7 vs. 107±10.9, P=0.0001) after three months of LC.Conclusion: Lifestyle changes promote improvement in peripheral and central BP in PH individuals.Aconselhamento sobre mudanças no estilo de vida reduz a pressão arterial central em indivíduos pré-hipertensos: um estudo de intervençãoIntrodução: Aconcselhamento para Modificação no estilo de vida (MEV) influencia diretamente a pressão arterial periférica em indivíduos pré-hipertensos. O comportamento da pressão sistólica central (PSC) em relação à MEV não está plenamente conhecido. Além disso, a pré-hipertensão (PH) oferece risco cardiovascular semelhante ao de um hipertenso leve e pode estar associado com alterações da função endotelial alterando a PSC.Objetivo: Demonstrar a influência da MEV com exercício físico e dieta alimentar em parâmetros antropométricos e hemodinâmicos, incluindo a PSC, em indivíduos pré-hipertensos.Métodos: Foram estudados 56 pacientes com PH antes e após 3 meses de MEV. A PSC foi avaliada utilizando-se um sistema de tonometria da artéria radial antes e após a MEV.Resultados: A média de idade da população estudada foi 48±10,8 anos. Houve redução significativa na PAS (127±8,1 para 122±9,2; p=0,003), PAD (75±7,4 para 72±7,7; p=0,003), PAM (92±7,0 para 89±7,6; p=0,002), IMC (29,0±4,6 para 28,5±4,6; p=0,001) e na relação C/Q (0,91±0,07 para 0,89±0,06; p=0,0007) após 03 meses de MEV. Também se observou redução da PSC (113±10,7 para 107±10,9; p=0,0001) após três meses de MEV.Conclusão: A MEV promoveu melhora pressão arterial periférica e central de indivíduos pré-hipertensos.
Highlights
Lifestyle changes (LC) influence peripheral blood pressure (BP) in pre-hypertensive (PH) individuals; the behavior of central systolic BP (CBP) in respect to LC is not fully known
Recent evidence shows that the central blood pressure (CBP) has greater significance as a predictor of cardiovascular complications than the peripheral blood pressure (BP) measured in the brachial artery[9,6]
The CBP is normally lower than the peripheral BP and many studies have demonstrated a consistent relationship between the CBP and cardiovascular mortality[10, 9]
Summary
Lifestyle changes (LC) influence peripheral blood pressure (BP) in pre-hypertensive (PH) individuals; the behavior of central systolic BP (CBP) in respect to LC is not fully known. The current standard measure to assess the central hemodynamic involves the non-invasive evaluation of the Abbreviations LC – Lifestyle changes BP – Blood pressure PH – Pre-hypertensive CBP – central blood pressure SAH – Systemic arterial hypertension CVD – Cardiovascular disease CAFE – Conduit artery function evaluation study AI – Augmentation index DASH – Dietary approaches to stop hypertension BMI – Body mass index TC – Total cholesterol HDLc – High-density lipoprotein cholesterol TG – Triglycerides GFR – Glomerular filtration ratio MDRD – Modification of diet in renal disease CKD-EPI – Chronic kidney disease epidemiology collaboration LDLc – Low-density lipoprotein cholesterol SBP – Systolic blood pressure DBP – Diastolic blood pressure CSP – Central systolic pressure MS – Metabolic syndrome MAP – mean arterial pressure GLUT-4 – Glucotransporters NO – Nitric oxid
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