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Efeito da terapia estrogênica sobre o controle autonômico da freqüência cardíaca e a capacidade aeróbia de mulheres saudáveis
(Universidade Federal de São Carlos, 2007-02-12) Neves, Valéria Ferreira Camargo; Silva, Ester da; https://lattes.cnpq.br/3171959033305034
The effects of female sex hormones on the cardiovascular system have been the topic of much discussion and controversy in the literature. Nevertheless, many scientists believe that estrogens play an important cardioprotective role in premenopausal women, with their effects being observed directly on blood vessels or indirectly by the promotion of an antiatherogenic lipid profile. In recent years, studies have reported that estrogen hormone levels may also influence autonomic control of heart rate (HR) and exercise tolerance. However, other researches have found no modification of these parameters in function of hormone therapy. Within this context, three studies were conducted to verify whether estrogen therapy (ET) could attenuate the age-related decline in autonomic control of HR under resting and exercise conditions and aerobic capacity of healthy women. Thirteen young women (mean age: 24 years), 10 postmenopausal women undergoing ET (PMET, mean age: 53 years) and 15 postmenopausal women not undergoing ET (PMnET, mean age: 56 years) were studied. Hormonal treatment consisted of 0.625 mg/day of conjugated equine estrogens. In the first study, the effect of age and ET on HR variability (HRV) under resting conditions in the supine and sitting positions was evaluated. HRV was analyzed by time (TD) and frequency domain (FD) methods. In this study, higher values of the temporal indices of HRV were observed for the young group. In the analysis of FD, the PMnET group presented lower values in the indices reflecting vagal activity and higher values in the indices reflecting sympathetic activity compared to the young group (supine position) and to the PMET group (sitting position). These results suggest that HRV decreases during aging and that ET may attenuate this process by promoting a reduction of sympathetic activity on the heart and contributing to the cardioprotective effect of estrogen hormones. In the second study, the effect of age and ET on the autonomic control of HR during dynamic exercise and anaerobic threshold (AT) was evaluated. Dynamic exercise was performed on a cycle ergometer starting at 15 W and followed by 5 W increments, until the loss of HR response stabilization was identified by a semiparametric model, characterizing AT. The autonomic control of HR during exercise was analyzed by vagal withdrawal at the beginning of exercise and by calculating the rMSSD index of the stable interval of each workload level. The vagal withdrawal and the rMSSD index were higher for the young group at the workloads studied. The young group also presented higher workload and HR values at AT compared to the postmenopausal groups. These results suggest that autonomic modulation of HR during exercise and aerobic capacity are strongly influenced by age. Hypoestrogenism and ET had no effect on the variables studied. In the third study, the effect of age and ET on cardiorespiratory responses during a cardiopulmonary exercise test was evaluated. This test was performed on a cycle ergometer with 10 to 20 W/min increments until physical exhaustion. The AT was determined by graphic visual analysis of the curves for carbon dioxide output and oxygen uptake ( O2). Higher workload and HR values both at AT and at the peak of exercise were observed for the young group. HR was similar between groups at AT and significantly higher at peak exercise for the young group. The percentages of AT in relation to peak exercise for O2 and HR values were higher for the postmenopausal groups. These results suggest that ET had no effect on cardiorespiratory responses during the incremental exercise test. In conclusion, the results obtained in the three studies suggest that the vagal-protective effect of estrogen hormones detected at rest is not maintained during exercise. In addition, exercise tolerance does not seem to depend on the physiological levels of estrogens. On this basis, the present findings support the importance of the prescription of physical exercise in the clinical orientation for climacteric women
Avaliação da influência dos programas Universidade Aberta da Terceira Idade e Revitalização Geriátrica sobre a qualidade de vida de idosos
(Universidade Federal de São Carlos, 2007-02-12) Castro, Paula Costa; Oishi, Jorge; https://lattes.cnpq.br/1417328590472858; https://lattes.cnpq.br/3790263464498111
There was evaluated the influence on quality of life and its physical parameters correlation of the elderly during the first term of São Carlos Open University of the Third Age (named UATI) and Geriatric Revitalization Program (REVT). Participants - 135 individuals of first year at UATI and Geriatric Revitalization Program with mean age of 63,83 (±7,22) years. The volunteers were evaluated on physical measures (balance, body flexibility, muscle strength, aerobic capacity, blood pressure, weight, height and heart rate), besides aswering the the SF36 and WHOQOL-bref quality of life questionaries and happyness enterview on the beginning and after four months intervention. The UATI intervention concerns physical activities, including physical therapy group, art, culture and leisure. The REVT had 48 physical activity sessions, 16-week period, three times a week, lasting 50-55 minutes each. The data were analyzed using ANOVA with repeated measurements. There were no differences between the two groups. Both groups showed significant increase on quality of life level according the overall result WHOQOL bref; on Psychological domain, Environment domain, Question 1 and Question 2 of WHOQOL bref; and General Health of SF36. The Physical and Social domains of WHOQOL bref and other domains of SF36 do not showed significant improvement. Between physical measures, both groups showed improvement on body flexibility, balance, maximal oxygen uptake and blood pressure. There was no differences on muscle strength, weight, height and heart rate. There was weak and most times no significant correlation among physical measures and quality of life questionary domains. There was also weak correlation (or no correlation) between similar domains of WHOQOL-bref and SF36, indicating difference between the measures. The WHOQOL-bref showed better sensivity for this study sample. These programs contributed to increase quality of life according to WHOQOL - bref.