PMID- 34008811 OWN - NLM STAT- MEDLINE DCOM- 20210524 LR - 20210524 IS - 1678-4170 (Electronic) IS - 0066-782X (Print) IS - 0066-782X (Linking) VI - 116 IP - 5 DP - 2021 May TI - Walking Training Improves Ambulatory Blood Pressure Variability in Claudication. PG - 898-905 LID - S0066-782X2021000600898 [pii] LID - 10.36660/abc.20190822 [doi] AB - BACKGROUND: Walking training (WT) improves walking capacity and reduces clinic blood pressure (BP) in patients with peripheral artery disease (PAD), but its effects on ambulatory BP remains unknown. OBJECTIVE: To investigate the effect of 12 weeks of WT on ambulatory BP and its variability in patients with PAD. METHODS: Thirty-five male patients with PAD and claudication symptoms were randomly allocated into two groups: control (n = 16, 30 min of stretching) and WT (n = 19, 15 bouts of 2 min of walking at the heart rate of leg pain threshold interspersed by 2 min of upright rest). Before and after 12 weeks, 24-hour ambulatory BP was assessed. Ambulatory BP variability indices assessed at both time points included the 24-hour standard deviation (SD24), the awake and asleep weighted standard deviation (SDdn), and the 24-hour average real variability (ARV24). Data were analyzed by mixed two-way ANOVAs, considering P<0.05 as significant. RESULTS: After 12 weeks, neither group had significant changes in 24-hour, awake and sleep BPs. The WT decreased systolic and mean BP variabilities (Systolic BP - 13.3+/-2.8 vs 11.8+/-2.3, 12.1+/-2.84 vs 10.7+/-2.5 and 9.4+/-2.3 vs 8.8+/-2.2 mmHg); Mean BP - 11.0+/-1.7 vs 10.4+/-1.9, 10.1+/-1.6 vs 9.1+/-1.7 and 8.0.+/-1.7 vs 7.2+/-1.5 mmHg) for SD24, SDdn and ARV24, respectively). Neither group had significant changes in diastolic BP variabilities after 12 weeks. CONCLUSIONS: The WT does not change ambulatory BP levels but decreases ambulatory BP variability in patients with PAD. This improvement may have a favorable impact on the cardiovascular risk of patients with symptomatic PAD. (Arq Bras Cardiol. 2021; 116(5):898-905). FAU - Chehuen, Marcel da Rocha AU - Chehuen MDR AUID- ORCID: 0000-0002-9857-8761 AD - Universidade de Sao Paulo - Escola de Educacao Fisica e Esporte, Sao Paulo, SP - Brasil. FAU - Cucato, Gabriel Grizzo AU - Cucato GG AD - Northumbria University, Newcastle Upon Tyne, Reino Unido. FAU - Carvalho, Celso Ricardo Fernandes de AU - Carvalho CRF AD - Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Zerati, Antonio Eduardo AU - Zerati AE AD - Hospital das Clinicas (HCFMUSP), Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP - Brasil. FAU - Leicht, Anthony AU - Leicht A AD - James Cook University, Queensland - Australia. FAU - Wolosker, Nelson AU - Wolosker N AUID- ORCID: 0000-0003-1991-3507 AD - Hospital Israelita Albert Einstein, Sao Paulo, SP - Brasil. FAU - Ritti-Dias, Raphael Mendes AU - Ritti-Dias RM AUID- ORCID: 0000-0001-7883-6746 AD - Universidade Nove de Julho - Programa de Pos-Graduacao em Ciencias da Reabilitacao, Sao Paulo, SP - Brasil. FAU - Forjaz, Claudia Lucia de Moraes AU - Forjaz CLM AUID- ORCID: 0000-0001-7584-4265 AD - Universidade de Sao Paulo - Escola de Educacao Fisica e Esporte, Sao Paulo, SP - Brasil. LA - eng LA - por PT - Journal Article PT - Randomized Controlled Trial PT - Research Support, Non-U.S. Gov't TT - Treinamento de Caminhada Melhora a Variabilidade da Pressao Arterial Ambulatorial em Claudicantes. PL - Brazil TA - Arq Bras Cardiol JT - Arquivos brasileiros de cardiologia JID - 0421031 SB - IM CIN - Arq Bras Cardiol. 2021 May;116(5):906-907. PMID: 34008812 MH - Blood Pressure MH - Blood Pressure Monitoring, Ambulatory MH - Heart Rate MH - Humans MH - *Hypertension MH - Intermittent Claudication/therapy MH - Male MH - *Walking PMC - PMC8121473 OAB - BACKGROUND: Walking training (WT) improves walking capacity and reduces clinic blood pressure (BP) in patients with peripheral artery disease (PAD), but its effects on ambulatory BP remains unknown. OBJECTIVE: To investigate the effect of 12 weeks of WT on ambulatory BP and its variability in patients with PAD. METHODS: Thirty-five male patients with PAD and claudication symptoms were randomly allocated into two groups: control (n = 16, 30 min of stretching) and WT (n = 19, 15 bouts of 2 min of walking at the heart rate of leg pain threshold interspersed by 2 min of upright rest). Before and after 12 weeks, 24-hour ambulatory BP was assessed. Ambulatory BP variability indices assessed at both time points included the 24-hour standard deviation (SD(24)), the awake and asleep weighted standard deviation (SD(dn)), and the 24-hour average real variability (ARV(24)). Data were analyzed by mixed two-way ANOVAs, considering P<0.05 as significant. RESULTS: After 12 weeks, neither group had significant changes in 24-hour, awake and sleep BPs. The WT decreased systolic and mean BP variabilities (Systolic BP - 13.3+/-2.8 vs 11.8+/-2.3, 12.1+/-2.84 vs 10.7+/-2.5 and 9.4+/-2.3 vs 8.8+/-2.2 mmHg); Mean BP - 11.0+/-1.7 vs 10.4+/-1.9, 10.1+/-1.6 vs 9.1+/-1.7 and 8.0.+/-1.7 vs 7.2+/-1.5 mmHg) for SD(24,) SD(dn) and ARV(24), respectively). Neither group had significant changes in diastolic BP variabilities after 12 weeks. CONCLUSIONS: The WT does not change ambulatory BP levels but decreases ambulatory BP variability in patients with PAD. This improvement may have a favorable impact on the cardiovascular risk of patients with symptomatic PAD. (Arq Bras Cardiol. 2021; 116(5):898-905) OABL- eng COIS- Potencial conflito de interesses Nao ha conflito com o presente artigo EDAT- 2021/05/20 06:00 MHDA- 2021/05/25 06:00 PMCR- 2021/05/06 CRDT- 2021/05/19 09:03 PHST- 2019/11/21 00:00 [received] PHST- 2020/03/16 00:00 [accepted] PHST- 2021/05/19 09:03 [entrez] PHST- 2021/05/20 06:00 [pubmed] PHST- 2021/05/25 06:00 [medline] PHST- 2021/05/06 00:00 [pmc-release] AID - S0066-782X2021000600898 [pii] AID - abc.20190822 [pii] AID - 10.36660/abc.20190822 [doi] PST - ppublish SO - Arq Bras Cardiol. 2021 May;116(5):898-905. doi: 10.36660/abc.20190822.