EFFECTS OF A PHYSICAL ACTIVITY COUNSELING PROGRAM ON AMBULATORY BLOOD PRESSURE AND HEALTH-RELATED OUTCOMES IN MIDDLE-AGED INDIVIDUALS WITH HYPERTENSION: A RANDOMIZED CONTROLLED PILOT TRIAL
PALAVRAS-CHAVE: hypertension; ambulatory blood pressure monitoring; physical activity counseling
Objective: To analyze the effects of a physical activity (PA) counseling program on ambulatory blood pressure (BP) and health-related outcomes in middle-aged individuals with hypertension.
Methods: Twenty-two middle-aged individuals with hypertension (♂ = 6, ♀ = 18) were randomly allocated into two groups: i) PA counseling program (n = 11, 49.6 ± 8.1 years, office BP 130.5 ± 14.3 / 78.6 ± 8.8 mmHg, body mass index [BMI] 33.0 ± 5.3 kg/m2) or ii) control group (n = 11, 47.9 ± 6.7 years, office BP 130.8 ± 13.9 / 85.4 ± 10.0 mmHg, BMI 31.3 ± 5.1 kg/m2). The PA counseling group had six 60-minute bi-weekly meetings where they were counseled to increase the PA levels following weekly progressive goals. This intervention was based on the five “As” model (i.e., assess, advise, agree, assist, and arrange). The control group received general information about the PA practice during a single 15-minute meeting. Before and after 12 weeks, PA level (pedometer for seven days), ambulatory BP (24 h ambulatory BP monitoring), office BP, body composition (DEXA), anthropometric measures, cardiometabolic risk factors (fasting glucose, total cholesterol, HDL, LDL, and triglycerides), markers of renal function (creatinine and urea), and markers of hepatic function (TGO, TGP, and GAMA GT). The intention-to-treat analysis was adopted and the mixed ANOVA followed by the Bonferroni post-test was used to compare the outcomes between the groups . The results are expressed as mean and 95% confidence interval. A p-value <0,05 was considered statistically significant.
Results: The PA counseling group increased the PA level (643.8 steps/day [13.3,1274.2] vs. -172.3 steps/day [-802.8,458.1]; p < 0.05), decreased office systolic BP (-7.3 mmHg [-14.2,-0.4] vs. -2.2 mmHg [-9.1,4.7]; p < 0.05), and increased HDL-cholesterol (10.5 mg/dL [3.7,17.3] vs. 5.4 mg/dL [-1.4,12.2]; p < 0.01). The control group increased waist circumference (1.8 cm [0.1,3.4] vs. -1.3 cm [-2.9,3.0]; p < 0.02), and decreased triglycerides levels (-37.2 mg/dL [-62.9,-11.5] vs. 17.1 mg/dL [-8.6,42.8]; p < 0.01). There were no changes in ambulatory BP, body composition, fasting glucose, total cholesterol, LDL-cholesterol, markers of renal and hepatic function in both groups after 12 weeks (p > 0.05).
Conclusion: The PA counseling program increased the PA level of middle-aged individuals with hypertension; however, the intervention was not effective to decrease ambulatory BP and improve body composition and cardiometabolic risk factors in these individuals.