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Effects of physical training in warm water pool in patients with resistant hypertension


Resistant hypertension is defined as blood pressure (BP) that remains above target, despite the use of three classes of antihypertensive drugs at optimal doses including a diuretic. The prevalence of this disease is still unknown, but it is estimated that about 20-50% of the hypertensive population may actually have resistant hypertension. The resistant hypertension is considered a common disease, but difficult to treat, due to the multiple systemic changes that it causes, such as sympathetic over activity, endothelial dysfunction, target organ damage, kidney dysfunction and alterations in the renin angiotensin aldosterone system (RAAS). Because of all these systemic changes, physical activity is an important resource in the treatment of resistant hypertension but still, few studies have been done for this particular type of hypertension. We Hypothesized that physical activity performed in a heated pool may be a new approach in the treatment of resistant hypertension, because warm water immersion may cause benefic hemodynamic changes to patients with hypertension. Objectives: To assess endothelial function, plasma catecholamines, endothelin-1, nitric oxide (NO), vasopressin (ADH), plasma aldosterone concentration and plasma renin activity (PRA), besides the behavior of the PA within 24 hours of patients diagnosed with resistant hypertension, before and after undergoing a program of physical activity in a temperature controlled swimming pool. Methodology: We will study 28 patients between 40 and 70 years with the diagnosis of resistant hypertension, which will be submitted to a maximum effort test, assessment of endothelial function, blood pressure monitoring, blood analysis of the concentration of endothelin-1, catecholamines, NO, ADH, aldosterone and PRA. These patients will be randomized and divided into two groups, one shall be subjected to a supervised program of physical training in a temperature controlled swimming pool by three months, and another group will serve as a control. At the end of three months of treatment, both groups will be reassessed. (AU)

Articles published in Agência FAPESP Newsletter about the research grant:
Treinamento em piscina aquecida ajuda a controlar hipertensão resistente 
Training in heated pool helps to control resistant hypertension  

Scientific publications
(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
GUIMARAES, GUILHERME VEIGA; FERNANDES-SILVA, MIGUEL MORITA; DRAGER, LUCIANO FERREIRA; DE BARROS CRUZ, LAIS GALVANI; CASTRO, RAFAEL ERTNER; CIOLAC, EMMANUEL GOMES; BOCCHI, EDIMAR ALCIDES. Hypotensive Effect of Heated Water-Based Exercise Persists After 12-Week Cessation of Training in Patients With Resistant Hypertension. CANADIAN JOURNAL OF CARDIOLOGY, v. 34, n. 12, p. 1641-1647, DEC 2018. Web of Science Citations: 1.

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