Modulation of the autonomic system, pulmonary function and sleep disorders in hypertensive patients submitted to aerobic training. A study protocol

Abstract

Background: Systemic arterial hypertension (SAH) is a common cardiovascular disease that reflects an important incidence and prevalence for public health, with obstructive sleep apnea (OSA) being considered the second cause of SAH. Aerobic exercise is one of the actions to control blood pressure changes. Objectives: To verify the anthropometric profile, the physical fitness, the pulmonary function, the presence of respiratory sleep disorders and the behavior of the autonomic activity in hypertensive patients submitted to aerobic training. Methods/Design: This is a randomized, controlled, blinded trial. The design, conduct and report of this study followed the guidelines of the CONSORT (CONsolidated Standards of Reporting Trials statement). The study will be conducted between July 2015 and December 2017, and will include controlled hypertensive patients of both gender, aged between 30 and 70 years, with clinical diagnosis of primary hypertension (stage 1, systolic and diastolic blood pressures with variations from 140/79 to 90/109 mmHg), controlled by specific drugs, which do not contain beta-blockers. The patients who do not present clinical release to participate in the training program, with presence of another cardiovascular disease or disease in target organs and who present the risk factors of smoke and alcohol will be in the exclusion criteria. The sample will be of convenience, forwarded from the Health Office of the Bairro Aeroporto Velho and the Reference Unit Specialized - URE of Santarem (PA). Initially, it will be a clinical evaluation performed by a cardiologist and the subjects will undergo several routine tests such as echocardiogram, chest X-ray and laboratory tests (complete blood count, glucose, fasting glucose, total cholesterol and fractions, triglycerides, C-reactive protein, potassium, etc). After the initial medical evaluation, some questionnaires will be applied and other specific tests such as Quality of Life Questionnaire (SF-36), Physical Activity Readiness Questionnaire, Berlin Questionnaire, Epworth Sleepiness Scale, Stanford Sleepiness Scale, Cardiorespiratory Sleep Monitoring, Physical Fitness Questionnaire, heart rate variability monitoring, pulmonary function tests, and Six-minute Walk Test. All patients will perform the tests before and after the 12-week rehabilitation exercise protocol. The aerobic exercise training protocol will last 30 to 60 minutes, with intensity varying between 70% and 85% of the maximum HR reached in the functional assessment effort test and will be performed for three months, three times a week. TRIAL REGISTRATION: This protocol study has been approved by the Research Ethics Committee of the Nove de Julho University (UNINOVE), Brazil, process nº370474/2010, and will be registered on ensaiosclinicos.gov.br