Efficiency and costless of a long-term physical exercise program to nom-medicated hypertensive males
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2013
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Resumo
Hipertension is a highly prevalent disease that often goes indetected and is associated with other comorbities and risk factors that create high costs and overhead. Lowering of blood pressure and prevention of hypertension is in first instance preferable by lifestyle changes with aerobic exercise being an integral component. However it has been neglected frequently by heatlh care programs that has costly medication actions instead. To investigate the aerobictraining/detraining effects on blood pressure (BP) efficiency and costs the study involved 80 adults, overweight men who were not taking antihypertensive medications or dieting, and were accomplished to all intervention tasks. Based on their initial BP the subjects were assigned for either a normal BP (NG, n=31, SBP 123.7 ± 8.3/DBP 79.9 ± 6.5 mmHg, BMI 28.3 ± 3.7 kg/m2 ) or high BP (HG, n=49, SBP 146.5 ± 11.2/DBP 94.3 ± 7.5 mmHg, BMI 29.4 ± 3.7 kg/m2 ) groups. The intervention phase was a two (NG)-three (HG) year period in which all the subjects followed an 8 month/year supervisioned exercise training followed immediately by a 4 mo./yr rest (detraining). The aerobic (80% of maximum heart rate) training occurred 3-5 times a week for 30 minutes walking/jogging, in addition to 30 min warm up and cool down. BP measurements were taken before and after the exercise sessions (LISC program). No dietary changes were recommended during the exercise intervention. Descriptive and mean values comparisons were undertaken among moments of intervention and between groups for p < 0.05. The LISC protocol gradually decreased the BP at rest. In the HG the 2-8 mo. average reductions in SBP and DBP varied from 6.2 to 11.9 mmHg and from 3.1 to 10.2 mmHg respectively. In the following years the BP decreased 8.0 (year 2) and 7.7 mmHg (year 3) for SBP and 7.2 and 4.9 mmHg for DBP. The normal BP was restored yearly after the 8 mo. training. The BP responses also occurred in NG, confirming that physical exercise is an effective approach to preventing hypertension. It is noteworthy that the BP reductions occurred in a stable diet and body weight situations. The 4 mo. detraining period resulted in BP increase nearly back to their baseline levels. With the found efficiency of 31.6% in normalizing high BP (affecting 28.5% of the Brazilian adults at an estimated cost of US$ 1.18 billion a month) this 8 mo LISC (at a professional cost of US$ 6000/8mo) would result in an estimated save of US$ 373.3 million (spent with medication drugs) if the LISC would be replicated nationwide. In conclusion the present LISC as a tool for high BP normalization demonstrated to be feasible, efficient and costless (in comparison with drugs) highly recommendable for replication in other similar communities.
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Advanced studies in medical sciences, v. 1, n. 3, p. 111-123, 2013.