Influência da atividade física aeróbica sobre a pressão arterial e fluxo sangüíneo feto-placentário em gestantes hipertensas

Abstract

The association between chronic hypertension and pregnancy is a major public health problem for high rates of morbidity and maternal and fetal mortality, a fact that makes the drug and not relevant to the medical prognosis of pregnancy. Among nonpharmacological measures are the reduction of sodium intake, controlling weight gain, and physical activity. The latter, despite the well-studied in hypertensive patients in general, needs to be better evaluated among hypertensive women. Thus, this study aimed to evaluate the acute effects of aerobic physical activity on blood pressure, heart rate and fetal-placental blood flow in hypertensive pregnant women. For this study were selected 17 patients with clinical diagnosis of chronic hypertension, in the Clinic of the High-Risk Pregnancy, Hospital Universitário, Universidade Federal de Mato Grosso do Sul, with gestational age between 24 and 32 weeks, and that started prenatal care before the 20th week of gestation. All pregnant women were subjected to the same protocol that is to evaluate blood pressure (BP) and heart rate (HR), in sitting positions (PS) and left lateral decubitus (DLE) and measure the resistance index (RI) and pulsatility (PI) of umbilical and middle cerebral arteries of the fetus by Doppler examination, before and after aerobic physical activity. Physical activity was performed in ergometric treadmill with no inclination, for thirty minutes, and the speed was adjusted so that reach 70% of maximum heart rate. The results were analyzed by non-parametric tests, the signals (TS) and Wilcoxon (TW), both with reliability of 95% and statistical significance of 5% (p <0.05). Among the women selected, 12 completed the research protocol. After the physical activity was significantly increased systolic blood pressure sitting TS (p = 0.03) and TW (p = 0.02) and heart rate measured in two positions, sitting TS (p = 0.006) and TW (p = 0.003) and left lateral decubitus TS (p = 0.003) and TW (p = 0.001). There was no statistically significant difference in systolic blood pressure results in DLE, and blood pressure, diastolic and mean, in both positions evaluated. There were also changes in RI and PI of umbilical and middle cerebral arteries. These results show that acute aerobic physical activity reflected in increased heart rate in both positions and the estimated systolic blood pressure in the sitting position, and did not significantly alter the diastolic and mean blood pressures in positions evaluated. As the fetal-placental blood flow there was no statistically significant immediately after the intervention performed.