Resposta pressórica exacerbada durante o exercício físico em pessoas ansiosas

Abstract

INTRODUCTION: Individuals with higher anxiety symptoms can show higher blood pressure levels. The presence of anxiety is associated with cardiovascular diseases. Although physical exercise is increasingly used as non-pharmacological way for the treatment of cardiovascular diseases, the possible mechanisms, related to hemodynamic responses during exercise of people with high anxiety symptoms, are not yet clear. Therefore, we tested the hypothesis that people with higher levels of anxiety have superior blood pressure levels and pressure response during physical activity. METHODS: We included 43 volunteers, 12 volunteers with symptoms of anxiety above the minimum and 31 volunteers with minimal anxiety (Beck Anxiety Inventory). Handgrip exercise was performed at 30% of maximal voluntary contraction, followed by post-exercise ischemia to evaluate the metaborreflex. Blood pressure (Dixtal®), cardiac frequency (ECG-Dixtal®) and forearm blood flow (plethysmograph Hokanson®) were simultaneously measured throughout the experimental protocol. The peripheral resistance was calculated by the division of mean blood pressure by the muscular forearm blood flow and reported in units. RESULTS: Systolic, diastolic and mean blood pressure, at rest, were significantly higher in the group with anxiety superior than the minimum, compared to the group with minimal anxiety (130±11 vs. 122±12 mmHg, p≤0,05; 70±6 vs. 64±8 mmHg, p≤0,05; 90±7 vs. 84±8 mmHg, p≤0,05, respectively). In addition, the group with anxiety superior than the minimum had higher systolic, diastolic and mean blood pressure response and peripheral vascular resistance during physical exercise compared to the group with minimal anxiety (20 ± 9 vs. 13 ± 7 mmHg, p ≤0,05; 17 ± 8 vs. 11 ± 6 mm Hg, p = 0.05; 18 ± 8 vs. 11 ± 6 mm Hg, p = 0.05; 0 ± 13 vs. -7 ± 9 units, respectively). During the post exercise sympathetic excitatory ischemia maneuver, for metoborreflexa evaluation, the group with anxiety superior than the minimum presented diastolic and mean blood pressure response, as well as peripheral vascular resistance significantly higher than the group with minimal anxiety (11 ± 12 vs. 3 ± 4 mmHg, p = 0.05; 10 ± 8 vs. 3 ± 5 mmHg, p = 0.05; 11 ± 9 vs. -2 ± 8 units, respectively). CONCLUSION: People with high anxiety symptoms have superior blood pressure levels and major response during exercise when compared to those with minimal symptoms of anxiety. In part, this augmented response can be explained by increased peripheral vascular resistance during these individual’s physical exercises. Also, people with symptoms of anxiety superior that the minimum show an exacerbated metaborreflex response.