Manual Therapy, Posturology & Rehabilitation Journal
https://app.periodikos.com.br/journal/mtprehab/article/doi/10.17784/mtprehabJournal.2016.14.290
Manual Therapy, Posturology & Rehabilitation Journal
Review

Effects of exercise on blood pressure and arterial stiffness in patients with type 2 diabetes mellitus: a literature review

Moura, Mirian Rebeca Alves; Bezerra, Paula Taysa da Rocha; Medeiros, Melyssa Lima de; Silva, Rodrigo Marcel Valentim da

Downloads: 1
Views: 803

Abstract

Introduction: Diabetes mellitus type 2 increases the mortality and the risk of premature morbidity related to cardiovascular disease. High blood pressure stands out as the main morbidity in this diabetic patient and arterial stiffness by one of the common complications associated with the disease, both of which can precipitate the occurrence of vascular disorders. In this context, the physical exercise is considered an important component in the treatment of these patients, as it helps in the control of cardiovascular risk factors. Objective: To investigate the effects of the physical exercise on pressure and arterial stiffness in patients with type 2 Diabetes mellitus. Methods: This is a literature review conducted in the period March-April 2015 in MEDLINE, LILACS, SciELO, PubMed and Cochrane databases. The keywords used were “Type 2 Diabetes Mellitus”, “Exercise”, “Arterial Stiffness” and “Arterial Pressure”, combined by the boolean operator “and” being considered for this review only studies published between 2009 and 2015. Results: A total of 146 publications, were select 8 studies that investigated the effects of physical exercise on blood pressure and arterial stiffness in patients with type 2 Diabetes mellitus. Of these, 6 studies investigated the effects of physical exercise on blood pressure, which was completed in 4 of them, that it was effective in promoting protective effects of blood pressure. With respect to arterial stiffness, analyzed in four studies, it was found that aerobic training was able to generate reductions in their values after 3 months of intervention, which however were not maintained after longer periods. Conclusion: The physical exercise can be appointed as a promising strategy for arterial pressure control in patients with diabetes mellitus type 2. With regard to arterial stiffness, it is assumed that structural vascular changes manifested in the disease process present irreversible characteristics and therefore can not be modified even after long periods of intervention.

Keywords

Type 2 Diabetes Mellitus, Exercise, Arterial Stiffness and Arterial Pressure

References

1. Association AD. Diagnosis and classification of Diabetes Mellitus. Diabetes Care. 2008;31.

2. Arsa G, Lima L, Almeida SS, Moreira SR, Campbell CSG, Simões HG. Diabetes Mellitus tipo 2: Aspectos fisiológicos, genéticos e formas de exercício físico para o seu controle. Rev Bras Cineantropom Desempenho Hum. 2009;11(1):103-11.

3. Vasconcelos HCA, Araújo MFM, Damasceno MMC, Almeida PC, Freitas RWJF. Fatores de risco para diabetes mellitus tipo 2 entre adolescentes. Rev Esc Enferm USP. 2009;44(4):881-7.

4. Diretrizes SBD. Diretrizes da sociedade brasileira de diabetes 2013-2014. AC Farmacêutica. 2014.

5. Federation ID. IDF diabetes atlas – sixth edition. 2013;6.

6. Guelho D, Paiva I, Carvalheiro M. Diabetes mellitus – um «continuum» fisiopatológico. Rev Port Endocrinol Diabetes Metab. 2013;8(1):44-49.

7. Colberg SR, Sigal RJ, Fernhall B, Regensteiner JG, Blissmer BJ, Rubin RR, Chasan-Taber L, Albright AL, Braun B. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement executive summary. Diabetes Care. 2010;33(12):2692-6.

8. Parati G, Bilo G, Ochoa JE. Benefits of tight blood pressure control in diabetic patients with hypertension. Diabetes Care. 2011;34(2):297-303.

9. Pinto LC, Ricardo ED, Leitão CB, Kramer CK, Zanatta CM, Gross JL, Canani LH. Controle inadequado da pressão arterial em pacientes com diabetes melito tipo 2. Arq Bras Cardiol. 2010.

10. Bortolotto LA. Alterações das propriedades funcionais e estruturais de grandes artérias no diabetes mellitus. Arq Bras Endocrinol Metab. 2007;51(2):176-84.

11. Organization WH. Global recommendations on physical activity for health. World Health Organization. 2010.

12. Marwick TH, Hordern MD, Miller T, Chyun DA, Bertoni AG, Blumenthal RS, Philippides G, Rocchini A. Exercise training for type 2 diabetes mellitus, impact on cardiovascular risk, a scientific statement from the American Heart Association. Circulation. 2009;119:3244-62.

13. Morais PK, Campbell CSG, Sales MM, Motta DF, Moreira SR, Cunha VNC, Benford RE, Simões HG. Acute resistance exercise is more effective than aerobic exercise for 24h blood pressure control in type 2 diabetics. Diabetes & Metabolism. 2011;(37):112-117.

14. Morais, PK, Sales, MM, Almeida JA, Motta-Santo D, Sousa CV, Simões HG. Effects of aerobic exercise intensity on 24-h ambulatory blood pressure in individuals with type 2 diabetes and prehypertension. J Phys Ther Sci. 2015;27(1):51-56.

15. Simões HG, Asano Ry, Sales MM, Browne RAV, Arsa G, Motta-Santos D, Puga GM, Lima LCJ, Campbell CSG, Franco OL. Type 2 Diabetes Elicits Lower Nitric Oxide, Bradykinin Concentration and Kallikrein Activity Together with Higher DesArg9 -BK and Reduced Post-Exercise Hypotension Compared to Non-Diabetic Condition. PLoS One. 2013;8(11).

16. Monteiro LZ, Fiani CRV, Freitas MCF, Zanetti ML, Foss MC. Redução da pressão arterial, do IMC e da glicose após treinamento aeróbico em idosas com diabete tipo 2. Arq Bras Cardiol. 2010;5(95):563-570.

17. Madden KM, Lockhart C, Cuff D, Potter TF, Maneilly GS. Aerobic traininginduced improvements in arterial stiffness are not sustained in older adults with multiple cardiovascular risk factors. Journal of Human Hypertension. 2013;(27):335-339.

18. Dobrosielski DA, Gibbs BB, Ouyang P, Bonekamp S, Clark JM, Wang N, Silber HA, Shapiro EP, Stewart KJ. Effect of Exercise on Blood Pressure in Type 2 Diabetes: A Randomized Controlled Trial. J Gen Intern Med. 2012;27(11):1453-9.

19. Madden KM, Lockhart C, Cuff D, Potter TF, Meneilly GS. Short-term aerobic exercise reduces arterial stiffness in older adults with type 2 diabetes, hypertension, and hypercholesterolemia. Diabetes Care. 2009;32(8):1531-35.

20. Loimaala A, Groundstroem K, Rinne M, Nenonen A, Huhtala H, Parkkari J, VUORI I. Effect of long-term endurance and strength training on metabolic control and arterial elasticity in patients with type 2 diabetes mellitus. AM J Cardiol. 2009;103:972-7.

21. Beckman JA, Creager MA, Libby P. Diabetes and atherosclerosis: epidemiology, pathophysiology, and management. JAMA. 2002;287(19):2570–81.

22. Macdonald JR. Potential causes, mechanisms, and implications of post exercise hypotension. Journal of Human Hypertension. 2002;16:225-36.

23. Forjaz CLM, Tinucci T. A medida da pressão arterial no exercício. Rev Bras Hipertens. 2000;7(1):79-87.

24. Rezk CC, Marrache RCB, Tinucci T, Junior DM, Forjaz, CLM. Post-resistance exercise hypotension, hemodynamics, and heart rate variability: influence of exercise intensity. Eur J Appl Physiol. 2006;98:105-12.

25. Terra DF, Mota MR, Rabelo HT, Bezerra LMA, Lima RM, Ribeiro AG, Vinhal PH, Dias RMR, Silva FM. Redução da pressão arterial e do duplo produto de repouso após treinamento resistido em idosas hipertensas. Arq Bras Cardiol. 2008;91(5):299-305.

26. Vieira LGU, Queiroz ACC. Análise metodológica do treinamento de força como estratégia de controle da pressão arterial em idosos: uma revisão. Rev Bras Geriatr Gerontol. 2013;16(4):845-54.

27. Monteiro MF, Filho DCS. Exercício físico e o controle da pressão arterial. Rev Bras Med Esporte. 2004; 10(6):513-6.

28. Vaz-de-melo RO, Toledo JCY, Loureiro AAC, Cipullo JP, Júnior HM, Martin JFV. Ausência de Descenso Noturno se Associa a Acidente Vascular Cerebral e Infarto do Miocárdio. Arq Bras Cardiol. 2010;94(1).

29. Bahia L, Aguiar LGK, Villela NR, Bottino D, Bouskela E. O endotélio na síndrome metabólica. Arq Bras Endocrinol Metab. 2006;50(2):291-303.

30. Nogueira IC, Santos ZMSA, Mont’alverne DGB, Martins ABT, Magalhães CBA. Efeitos do exercício físico no controle da hipertensão arterial em idosos: uma revisão sistemática. Rev Bras Geriatr Gerontol. 2012;15(3):587-601.

31. Lopes AA, Andrade J, Noblat ACB, Silveira MA. Redução da pressão arterial diastólica e mortalidade cardiovascular em hipertensos não diabéticos. Uma reanálise do Hot Study. Arq Bras Cardiol. 2001;77(2):132-4.

32. Moreira GC, Cipullo JP, Vilela-martin JF. Existem diferenças entre os diversos diuréticos? Rev Bras Hipertens. 2013;20(2):55-62.

33. Program NHBPE. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC7). 2004;03–5233.

34. Gravina CF, Rosa RF, Franken RA, Freitas EV, Liberman A, et al. Sociedade brasileira de cardiologia. II Diretrizes brasileiras em cardiogeriatria. Arq Bras Cardiol. 2010;95(3 supl.2):1-112.

35. Pitanga FJG, Lessa I, Pitanga CPS, Costa MC. Atividade física na prevenção das comorbidades cardiovasculares em mulheres obesas: quanto é suficiente? Revista Brasileira de Atividade Física & Saúde. 2011;16(4):334-38.

36. Van Dijk RA, Bakker SJ, Scheffer PG, Heine RJ, Stehouwer CD. Associations of metabolic variables with arterial stiffness in type 2 diabetes mellitus: focus on insulin sensitivity and postprandial triglyceridaemia. Eur J Clin Invest 2003;33(4):307-15.

37. Miyachi M. Effects of resistance training on arterial stiffness: a metaanalysis. BR J Sports Med. 2013;47:393-6.

38. Umpierre D, Stein R. Efeitos hemodinâmicos e vasculares do treinamento resistido: implicações na doença cardiovascular. Arq Bras Cardiol. 2007;89(4):256-62.

588167f47f8c9d710a8b45f8 mtprehab Articles
Links & Downloads

Man. Ther., Posturology Rehabil. J.

Share this page
Page Sections