Luiz Fernando Farias-Junior

Purpose: Arterial stiffness is a subclinical marker of cardiovascular disease (CVD). The pre-frailty phenotype is associated with a higher risk for CVD. This study investigated the association between the pre-frailty phenotype and arterial stiffness in community-dwelling older adults without diagnosed CVD. Methods: In total, 249 community-dwelling older adults aged 60–80 years were included in this cross-sectional study. The pre-frailty phenotype was defined by the standardized Fried criteria (muscle weakness; slow walking speed; low physical activity; unintentional weight loss; self-reported exhaustion). Participants with one or two standardized Fried criteria were classified as pre-frail and those with zero criteria as robust. Arterial stiffness was measured by aortic pulse wave velocity (aPWV). The data were analyzed using the generalized linear model. Results: From 249 participants (66.1 ± 5.3 years; 79.5% females), 61.8% (n = 154) were pre-frail and 38.2% (n = 95) robust. Pre-frail older adults had a higher aPWV (β = 0.19 m/s; p = 0.007) compared to their robust peers. Conclusions: The pre-frailty phenotype was associated with higher arterial stiffness in community-dwelling older adults aged 60–80 years. Pre-frail older adults may have a higher risk for CVD.

Purpose: This study compared the effect of low-volume high-intensity training (LV-HIIT) sessions with different work-recovery durations on muscle damage markers.Methods: Twenty-four trained adult males (22.3 ± 2.9 years; 24.6 ± 2.7 kg∙m-2) performed two LV-HIIT sessions (10 x 60 s and 20 x 30 s at 100% of maximal aerobic speed on treadmill (Vmax) interspersed with equal time passive recovery, respectively) in a randomized, counter-balanced order, separated by a 1-week interval. Delayed onset muscle soreness (DOMS) and countermovement vertical jump height (CVJH) performance were assessed before, and 24-h and 48-h post sessions.Results: Pressure-pain threshold (PPT), pressure-pain tolerance (PPTol) and perceived pain intensity (PPI) using pressure algometry assessed DOMS in the rectus rectus femoris, biceps femoris and gastroctemius. A non-significant session by time interaction for PPT, PPTol and PPI in all muscles analyzed was observed (all P > 0.260). Additionally, a non-significant session by time interaction was observed for CVJH performance (P = 0.836).Conclusion: LV-HIIT sessions with different work-recovery durations elicited non-significant changes on muscle damage markers following 24- and 48-h in trained males.

We investigated the acute effects of isometric biceps exercise on resting and ambulatory blood pressure in hypertensive adults. A total of 12 medicated hypertensive adults (aged 47±7 years; body mass index 27.2±2.7 kg/m²; resting blood pressure 123±12/74±6 mmHg) performed an isometric biceps exercise session (bilateral biceps exercise; 4×1 min at 30% of 1-RM, 2 min recovery) and a control session (without exercise) in a randomized order separated by a 7 to 10-day period. Resting blood pressure, heart rate, and heart rate variability indexes (SDNN, RMSSD, LF, HF, and LF/HF) were measured pre- and up to 30 min post-sessions. Next, ambulatory blood pressure was monitored during 22-hour post-sessions (awake and asleep periods). No significant changes were observed for resting blood pressure, heart rate, or heart rate variability indexes up to 30 min post-sessions (p>0.05). Furthermore, no significant differences were observed in average ambulatory blood pressure values in 22-hour (126±11/71±6 mmHg vs. 126±15/71±9 mmHg), awake (127±10/74±6 mmHg vs. 130±14/75±10 mmHg), and asleep (123±15/68±6 mmHg vs. 120±17/66±9 mmHg) periods between the control and isometric sessions, respectively (p>0.05). In conclusion, an isometric biceps exercise session does not elicit an acute antihypertensive effect in adults with hypertension, which suggests that its prescription to improve the acute BP control is limited. Received: 07 October 2020 Accepted: 07 December 2020 Publication Date: 22 February 2021 (online) © 2021. Thieme. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

The effect of physical activity counseling (PAC) in hypertensive adults is unclear. This study investigated the effect of PAC on blood pressure (BP), physical activity level, sitting time, metabolic profile, and body composition in hypertensive adults. Twenty-two hypertensive adults (48.8 ± 7.3 years) participated in this pilot trial. The 12-week PAC was based on the 5 A’s model considering the FITT principle (Frequency, Intensity, Time, and Type) of physical activity. The control group received instructions about FITT in one face-to-face meeting at baseline. Pedometer-measured physical activity, sitting time, resting and ambulatory BP, metabolic profile (cholesterol, triglycerides, fasting glucose), and body composition (fat mass, abdominal fat, fat free mass) were assessed. The PAC group showed higher steps per day (5839 ± 992 vs. 5028 ± 902; p = 0.044) and a trend for lower sitting time (5.6 ± 1.3 vs. 8.0 ± 4.0 h/day; p = 0.059) than the control group. No changes were observed in BP, metabolic profile, and body composition (p > 0.05). In conclusion, 12 weeks of a PAC program based on the 5 A’s model resulted in a modest increase of ~800 steps per day and a trend to decrease ~2 h/day in sitting time, but there were no associated reduction in BP and improvements in metabolic and body composition.

This study investigated the acute post-exercise effect of high-velocity resistance exercise on ambulatory blood pressure in hypertensive older women. Fourteen volunteers (67.9±5.1 years) performed a high-velocity resistance exercise session (8 exercises using Thera-Band, 3 sets of 6 repetitions as fast as possible in the concentric phase with moderate intensity) and a control session, separated by a 7–10-day period. Ambulatory blood pressure was monitored following 12-h post-sessions and compared between conditions at 1 to 4-h, 5 to 8-h, and 9 to 12-h. Average 24-h ambulatory blood pressure, awake, asleep periods, and blood pressure load were also analyzed. There was a condition by time interaction for systolic ambulatory blood pressure over 12-h post-sessions (P=0.043). It was observed a lower systolic ambulatory blood pressure in the first 4-h period following the high-velocity resistance exercise session compared to the control session (−6.7 mmHg, 95% CI − 11.6 to −1.8 mmHg; P=0.011). No changes were observed for diastolic ambulatory blood pressure over 12-h post-sessions as well as for the other variables analyzed (P>0.05). In summary, a single high-velocity resistance exercise session elicits a post-exercise antihypertensive effect and may be considered as a strategy to acutely improve blood pressure control in hypertensive older women.

Purpose: To investigate the short-term effect of self-selected training intensity (SSTI) on ambulatory blood pressure (BP) in hypertensive older women. Participants and Methods: This is a randomized, single-blind, two-arm, parallel-group controlled trial that included 40 medicated hypertensive older women (64.4± 3.6 years; resting systolic 118± 19 and diastolic BP 68± 9 mmHg). SSTI intervention was performed three times per week, 30– 50 minutes per session (n=20). The control group participated in health education meetings once per week (n=20). Ambulatory BP (primary outcome) and six-minute walking test performance (secondary outcome) were assessed at baseline and following 8 weeks of intervention. Heart rate (HR), rating of perceived exertion (RPE, 6– 20), and affective valence (ie, feeling scale, − 5/+5) were recorded during all SSTI sessions. Intention-to-treat and per-protocol analyses were used for data analyses. Results: Fifteen participants from the SSTI group and 17 from the control group completed the study. No differences in ambulatory BP (24-h, awake, and asleep) were observed between SSTI and control groups (intention-to-treat and per-protocol analyses; p> 0.05). The SSTI group showed a greater six-minute walking test performance than the control group in the intention-to-treat and per-protocol analyses (p< 0.05). The participants exercised at 52± 10% of HR reserve reported an RPE of 11± 1 and an affective valence of 3.4± 1.1 over the 8-week period. Conclusion: SSTI is a feasible approach to induce a more active lifestyle and increase health-related fitness in hypertensive older women, although it does not improve BP control over a short-term period.

Self-selected exercise intensity (SSE) is a simple approach to encourage an active lifestyle. This study aimed to investigate whether a SSE intensity session meet the recommended intensity for hypertension management (i.e. moderate-vigorous), and whether heart rate (HR), rating of perceived exertion (RPE) and affective responses are reproducible. Thirteen inactive hypertensive older women (age: 64.54 ± 4.16 years; blood pressure: 122.51/62.15 mmHg) performed two 30-minute SSE intensity sessions outdoors. HR reserve (HRR), RPE and affective responses were assessed. Paired t-test, intraclass correlation coefficient (ICC) and typical error (TE) were used for the analyzes. Participants exercised at moderate-vigorous intensity (≥ 40% of HRR). No differences were found for HRR (56.46 ± 8.01% vs. 59.08 ± 10.57%), RPE (11.26 ± 1.14 vs. 10.98 ± 1.52) and affective response (3.47 ± 1.13 vs. 3.38 ± 1.23) (p > 0.05). RPE showed excellent reliability (ICC = 0.82; 95%CI: 0.42; 0.94; p = 0.003). There was a poor reliability for HRR (ICC = 0.40; 95%CI: -0.97; 0.82; p = 0.193) and affective responses (ICC = 0.19; 95%CI: -2.10; 0.76; p = 0.369). TE between sessions for HRR, RPE, and affective response were 8.11 bpm, 0.75 and 1.11, respectively. In conclusion, inactive hypertensive older women seem to meet the recommended intensity for hypertension management when they exercise at a self-selected pace and report it as light-moderate and pleasant. Despite only RPE, but not HR and affective response, has shown good reproducibility, the results seem to support the use of SSE intensity as a simple approach to encourage an active lifestyle in this population.

A total of 17 participants (30.2 +/- 4.8 years; 35.4 +/- 4 kg/m(2); 38.2 +/- 3.6 % body fat) were enrolled in this randomized crossover trial to analyze the effects of a single session of high-intensity interval (HIIE) and moderate-intensity continuous exercise (MICE) on the physical activity and sedentary behavior levels in inactive obese males. The participants performed two exercise sessions and one control session (no exercise): i) low-volume HIIE (10 x 60 s at 90% of maximal aerobic velocity [MAV] interspaced by 60 s at 30% of MAV); ii) MICE (20 min at 70% of maximum heart rate); and iii) control (25 min in a seated position). After all sessions, the physical activity and sedentary behavior levels were monitored by accelerometer over seven consecutive days. No differences in the physical activity (activity counts, and time spent at light, moderate, and vigorous intensities) and sedentary behavior (time spent at sedentary behavior, breaks, and bouts) levels were found among the sessions (HIIE, MICE and control) (p > 0.05). In summary, a single session of HUE and MICE does not change the physical activity and sedentary behavior levels in inactive obese males. Therefore, low-volume of both high- and moderate-intensity exercise should be considered for inactive obese males given that it does not reduce the physical activity level or increase the time spent at sedentary behavior.

Background: This study analyzed the effect of walking breaks or low-volume high-intensity interval exercise (LV-HIIE) on markers of metabolic syndrome relative to a day of prolonged sitting. Methods: Twenty-five adults with excess body fat participated in this crossover trial: (1) 10-hour sitting day (SIT), (2) LV-HIIE followed by a sitting day (EX+SIT), and (3) sitting day with 5-minute walking breaks for every 20 minutes (SIT+WB). Glucose and blood pressure (BP) were measured before and 1 hour after 4 meals and 2 hours after lunch. Triglycerides were measured at baseline, 2, and 3.5 hours after lunch. Generalized mixed models were used to identify differences in the area under the curve (AUC) of BP and incremental AUC (iAUC) of glucose and triglycerides among the sessions. Results: iAUC-glucose was lower in SIT+WB than SIT (β = −35.3 mg/dL·10 h; 95% confidence interval, −52.5 to −8.2). AUC-diastolic BP was lower in SIT+WB than SIT (β = −14.1 mm Hg·10 h; 95% confidence interval, −26.5 to −1.6) and EX+SIT (β = −14.5 mm Hg·10 h; 95% confidence interval, −26.9 to −2.1). There were no differences in triglycerides and systolic BP levels among the sessions. Conclusion: Adults with excess body fat present lower glucose and diastolic BP during a day with breaks in sitting time compared with a prolonged sitting day with or without an LV-HIIE session.