Combining aerobic physical activity with the use of the drug losartan increases the benefits for patients with hypertension, especially in relation to cardiac autonomic control, which contributes to the proper functioning of the cardiovascular system.
This is the result of a survey of male volunteers FMRP-USP (At the Ribeiro Prieto School of Medicine (University of Sao Paulo).
Scientists have proven that 45 minutes of walking three times a week can improve heart rate, a scientifically validated marker that measures the activity of the autonomic nervous system, which is responsible for regulating bodily processes such as blood pressure and respiration rate.
The drug is considered to be the first line of treatment for high blood pressure (reducing the risk of cardiovascular events) and cardiac arrest, and is also indicated for kidney protection. It has an action mechanism that blocks the AT1 receptor for angiotensin 2 – a peptide that narrows the muscle walls of small arteries (arteries) and raises blood pressure.
According to a study published in the journal Science Clinical and Experimental Hypertension Losartan can lower blood pressure and bring it back to normal, but without physical exercise, cardiac autonomic control remains very poor.
“Heart rate variability is not adequately restored with medication alone. It is important to note that a patient treated with Losartan has a lower rate of heart rate variability than untreated person. This means that the heart system is not at a sufficient level. -Says Hugo Celso Dutra de Souza, a professor at USP and co-author of the article.
The research was supported by FAPESP, whose first author was Tábata de Paula Facioli, a student at the Souza Coordinated Laboratory of Physiotherapy and Cardiovascular Physiology.
Cases
A global analysis of trends in the prevalence, detection, treatment, and control of hypertension, led by Imperial College London and the World Health Organization (WHO), showed an increase in the number of adults with the disease (between 30 and 79). 650 million to 1.28 billion in the last 30 years.
About half of these people are unaware that they have this condition. According to the Brazilian Society of Cardiology (SBC), in Brazil, 30% of adults have hypertension.
Hypertension increases the risk of heart, brain and kidney disease. It is one of the leading causes of death and disease worldwide and can be easily detected by measuring blood pressure. In most cases, it is effectively treated with inexpensive drugs, including losartan, enalapril melate, hydrochlorothiazide, propranolol, and amlodipine.
In 2015, Susa recalls that another study published by her group with FAPESP support investigated heart rate variations in animal models.
“At the time, we were working with spontaneous hypertension mice (SHR) to determine if aerobic exercise was more appropriate for certain pharmacological therapies.
Method
The researchers had a sample of 32 men (aged between 40 and 60) who were divided into two groups: people with normal blood pressure (Normotensives) and people with hypertension treated by Losartan.
They did 16 weeks of aerobic physical training. Measures hemodynamic parameters before and after exercise, heart rate variability, blood pressure variability, and natural baroreflex sensitivity (a short-term blood pressure control system).
Prior to training, both groups recorded similar values of hemodynamic parameters. However, spontaneous baroreflex in patients with hypertension results in decreased sensitivity and heart rate variability, as well as decreased sympathetic and oral modulation.
After exercise, as in hypertensive subjects, normotensive subjects have a relaxed heart rate that decreases. However, this last group also showed a decrease in blood pressure and sympathetic modulation; Increased oral modulation and spontaneous baroreflex sensitivity, but heart rate variability is lower than in normal individuals.
The autonomic nervous system regulates the internal processes of the body through two branches: sympathetic and parasympathetic (also known as vagal).
Sometimes both can have opposite effects on the same organ. For example, sympathetic division increases heart rate and parasympathetic division decreases it. Overall, together, they ensure that the body responds appropriately to different situations such as stress.
Souza explains that there is a distinction in the development of research, as women have a different autonomic nervous system modulation than men, mainly as a result of ovarian hormones.
“Studies with women are in its final stages. We have already observed interesting results, especially comparing the effects of hypertension in women before and after menopause,” says the professor.
Researchers are also working on a paper that compares Losartan to enalapril malate to show differences. The first inhibits the angiotensin receptor and enalapril acts on the angiotensin-converting enzyme.
“Physical exercise is important and is considered a kind of magic pill. However, we need to understand what it does to the body, who knows, and in the future, may try to mimic its effects pharmacologically,” Susa concludes.