RMD ANO 13 | Nº4 Julho 2022
Susana Lopes, José Mesquita-Bastos, MD, PhD, Catarina Garcia, MSc, et al. Effect of Exercise Training on Ambulatory Blood Pressure Among Patients with Resistant Hypertension. A Randomized Clinical Trial. JAMA Cardiol. 2021; 6(11):13171323.doi:10.1001/jamacardio.2021.2735
Question: Is aerobic exercise training an effective antihypertensive treatment in patients with resistant hypertension?
Findings: In this randomized clinical trial including 53 patients, a 12-week exercise training intervention promoted a clinically meaningful reduction in 24-hour and daytime ambulatory systolic and diastolic blood pressure.
Meaning: The findings show that aerobic exercise added to optimized medical therapy reduces blood pressure in patients with low responsiveness to drug treatment and has the potential to be incorporated in the standard care of these patients.
Lindsay M. Bearne, Brittannia Volkmer, Janet Peacock et al. Behavior Change Intervention vs Usual Care on Walking in Adults with Peripheral Artery Disease. The MOSAIC Randomized Clinical Trial. JAMA. 2022; 327(14):1344-1355.doi:10.1001/jama.2022.3391
Question: Does a home-based, walking exercise behavior change intervention delivered by physical therapists improve walking capacity compared with usual care in adults with peripheral artery disease (PAD) and intermittent claudication?
Findings: In this randomized clinical trial that included 190 participantswith intermittent claudication due to PAD, receipt of the intervention, compared with usual care, resulted in a statistically significant adjusted difference in mean 6-minute walk distance of 16.7 m at 3 months.
Meaning: Among adults with PAD, a home-based, walking exercise behavior change intervention, compared with usual care, increased 6-minute walking distance at 3 months.
Matthew Pearce, Leandro Garcia, Ali Abbas et al. Association Between Physical Activity and Risk of Depression. A Systematic Review and Meta-analysis. JAMA Psychiatry. Published online April 13, 2022. doi:10.1001/jamapsychiatry.2022.0609
Question: What is the dose-response association between physical activity and incident depression in adults?
Findings: This systematic review and meta-analysis of 15 prospective studies including more than 2 million person-years showed an inverse curvilinear association between physical activity and incident depression, with greater differences in risk at lower exposure levels. Adults meeting physical activity recommendations (equivalent to 2.5 h/wk of brisk walking) had lower risk of depression, compared with adults reporting no physical activity.
Meaning: In this study, relatively small doses of physical activity were associated with substantially lower risks of depression.
Michael G. Shlipak, Anoop Sheshadri, Fang-Chi Hsu et al. Effect of Structured, Moderate Exercise on Kidney Function Decline in Sedentary Older Adults. An Ancillary Analysis of the LIFE Study Randomized Clinical Trial. JAMA Intern Med. Published online May 2, 2022. doi:10.1001/jamainternmed.2022.1449
Question: Can a moderate-intensity physical activity and exercise intervention slow the rate of decline of estimated glomerular filtration rate per cystatin C in sedentary older adults?
Findings: In this ancillary analysis of a randomized clinical trial of 1199 adults aged 70 to 89 years, those randomized to the physical activity and exercise intervention had statistically significantly lower decline in estimated glomerular filtration rate per cystatin C over 2 years compared with those in the health education arm.
Meaning: Clinicians should consider prescribing physical activity and moderate-intensity exercise for older adults to slow the rate of decline of kidney function.
Anoop T. Balachandran, James Steele, Daniel Angielczyk et al. Comparison of Power Training vs Traditional Strength Training on Physical Function in Older Adults: A Systematic Review and Meta-analysis. JAMA Netw Open. 2022; 5(5):e2211623.doi:10.1001/jamanetworkopen.2022.11623
Question: Is power training associated with an improvement in physical function compared with traditional strength training in community-living older adults?
Findings: In this systematic review and meta-analysis of 20 randomized clinical trials enrolling 566 older adults, low-certainty evidence showed improvement in physical function and self-reported function with power training. Power training was associated with an improvement in physical function in 13 RCTs and self-reported physical function in 3 RCTs.
Meaning: The findings of this study suggest that power training may be associated with a modest improvement in physical function compared with traditional strength training in healthy, community-living older adults.
Young-Rock Hong, Sandhya Yadav, Ryan Suk et al. Assessment of Physical Activity and Healthy Eating Behaviors among US Adults Receiving Bariatric Surgery. JAMA Netw Open. 2022; 5(6):e2217380. doi:10.1001/jamanetworkopen.2022.17380
Question: What are the differences in lifestyle patterns among individuals who received bariatric surgery compared with those eligible for surgery who did not receive it and those with normal weight?
Findings: In this cross-sectional study of 4659 participants, postbariatric surgery patients reported more time spent on physical activity (50.6 min/wk) and lower total energy intake (−295 kcal/d) than those eligible for surgery, with levels of physical activity comparable with those with normal weight.
Meaning: These results suggest that postoperative support for sustained behavioral changes is needed for post bariatric patients to help achieve long-term health benefits.