Impacto da apneia obstrutiva do sono sobre a resposta da pressão arterial ao exercício aeróbio em idosos hipertensos

Abstract

Introduction: In recent decades, several studies have shown that Obstructive Sleep Apnea Syndrome (OSAS) is also highly prevalent in patients with Arterial Hypertension (AH), and may even represent an additional risk for cardiovascular diseases. Objective: Thus, the objective of this study was to evaluate the impact of OSAS on BP in hypertensive elderly people submitted to a session of moderate intensity aerobic exercise. Methods: Eighteen elderly people with a mean age of 66 ± 3 years, of both genders, with controlled hypertension with and without OSAS were admitted to the study. They were divided into two experimental groups: AH + SAOS and AH and submitted to two experimental sessions: aerobic exercise and control. Exercise testing and 24-hour blood pressure monitoring were performed using ABPM. The data were tabulated in SPSS version 21 for Windows. Mean, standard deviation, absolute or relative values, difference between means and confidence intervals were presented. Student's t-test was performed for independent samples. The effect size was calculated to assess the magnitude of intra-session and inter-session differences. Pearson's correlation for AHI and HPE was also performed. Results: The HPE behavior of SBP, DBP and MBP during 24 hours, both in the HA + OSAS group (Δ = -11; Δ = -5; Δ = -7) and in the AH group (Δ = -11; Δ = -7; Δ = -7), were similar. In the intra-group evaluation, both the AH + OSAS group (Δ = -16; Δ = -12) and the AH group (Δ = -14; Δ = -12) when submitted to an aerobic exercise session reduced SBP and MAP during sleep in a similar way, resulting in an increase in effect size from d = 0.80 to d = 0.99, respectively. In the inter-group evaluation, it was found that the HPE response to SBP, DBP and MAP to aerobic exercise of moderate intensity was not different between groups with OSAS (Δ = -5; Δ = -0; Δ = -1) and without OSAS (Δ = -6; Δ = -1; Δ = -2) and presented a moderate effect size for SBP; Pearson's correlation found a moderate positive correlation (r = 0.53; p = 0.03). The nocturnal decline was more attenuated in the AH + OSAS group. Conclusion: Based on the results, we can conclude that hypertensive elderly people with OSAS do not have an attenuated effect of PEH when compared to the values of HPE found in hypertensive elderly people without OSAS. These results as a whole refuted the hypothesis of our study.