M onoam ine responses to acute and chronic aerobic exercise in
norm otensive and hypertensive subjects
Experimental
Neurology and Biochimistry
Department,
Escola Paulista de Medicina,
Universidade Federal de Silo Paulo - Silo Paulo, Brazil.
O b je ctive s: T h e p u rp o se o f th e p re se n t stu d y w a s to co m p a re th e p la sm a a n d se ru m m o n o a m in e le ve ls in se d e n ta ry, u n tra in e d n o rm o te n sive a n d h yp e rte n sive m e n a t re st w ith le ve ls m e a su re d a fte r a n a cu te b o u t o f e xe rcise a n d to co m p a re sim ila r m e a su re m e n ts fo llo w in g a 1 2 -w e e k a e ro b ic tra in in g p ro g ra m . P la ce o f stu d y: T h e d a ta o b ta in e d fo r th is stu d y w a s co "lIe cte d fro m a clin ic fo r th e p re ve n tio n o f h e a rt d ise a se a n d ca rd ia c re h a b ilita tio n (F IT C O R ) a n d a n a lyze d in th e F e d e ra l U n ive rsity o f S a o P a u lo (E P M ), L a b o ra to ry o f E xp e rim e n ta l N e u ro lo g y. S u b je cts: T w o g ro u p s o f u n tra in e d m a le su b je cts, i.e ., n o rm o te n sive (N = 1 6 ) a n d h yp e rte n sive (N = 1 9 ), w e re su b m itte d to a n a cu te b o u t o f e xe rcise to a n a lyze th e a cu te e ffe ct o f e xe rcise o n th e m o n o a m in e le ve ls. T o stu d y th e ch ro n ic e ffe ct o f e xe rcise (p h ysica l tra in in g p ro g ra m ), so m e in d ivid u a ls o f e a ch g ro u p w e re a rra n g e d in tw o o th e r g ro u p s; n o rm o te n sive (N = 1 1 ) a n d h yp e rte n sive (N = 8 ). M e a su re m e n t: P la sm a ca te ch o la m in e s a n d se ru m se ro to n in le ve ls w e re d e te rm in e d b y h ig h p e rfo rm a n ce liq u id ch ro m a to g ra p h y co u p le d w ith e le ctro ch e m ica l d e te ctio n . R e su lts: A sig n ifica n t re d u ctio n in d ia sto lic b lo o d p re ssu re a t re st w a s o b se rve d in th e h yp e rte n sive g ro u p a fte r th e p h ysica l tra in in g p ro g ra m (p<0 .0 5 ). O n ly th e m e a n p la sm a n o ra d re n a lin e co n ce n tra tio n in cre a se d sig n ifica n tly p o st-e xe rcise in a ll g ro u p s o f in d ivid u a ls (a cu te e ffe ct o f e xe rcise - p < 0 .0 1 fo r u n tra in e d n o rm o te n sive a n d h yp e rte n sive ; ch ro n ic e ffe ct o f e xe rcise - p < 0 .0 0 1 fo r u n tra in e d a n d tra in e d n o rm o te n sive , p < 0 .0 1 fo r u n tra in e d a n d tra in e d h yp e rte n sive ). C o n clu sio n : T h e se d a ta sh o w th e b e n e ficia l e ffe ct o f p h ysica l e xe rcise in re d u cin g th e b lo o d p re ssu re in h yp e rte n sive p a tie n ts, w h ich d o e s n o t se e m to b e re la te d to ch a n g e s in circu la tin g m o n o a m in e s.
U N IT E R M S : M o n o a m in e s. A e ro b ic e xe rcise . P h ysica l tra in in g . H yp e rte n sio n . H u m a n s.
IN T R O D U C T IO N
S
e v e ra lp h y s ic a ls tu d ie se x e rc is e ,h a v em a ys h o w na ffe c tth a t a c u tec a te c h o la m in e rg ica n d c h ro n ic a n d s e ro to n in e rg ic s y s te m s (1 , 2 , 3 , 4 ). T h e in v o lv e m e n t o f m o n o a m in e s in h y p e rte n s io n h a s b e e nre p e a te d l y re p o rte d ( 5 ) .
S y m p a th e tic n e rv o u s s y s te m o v e ra c tiv ity is re p o rte d
to b e a n im p o rta n t m e c h a n is m in th e in itia tio n o f b lo o d
.p re s s u re e le v a tio n in e s s e n tia l h y p e rte n s io n (6 , 7 ). T h e
A d d r e s s fo r c o r r e s p o n d e n c e : E s p e r A b r a o C a v a lh e ir o R u a B o tu c a tu , 8 6 2
S a o P a u lo / S P - B r a s il - C E P 0 4 0 2 3 - 9 0 0
re la tio n s h ip b e tw e e n b lo o d p re s s u re a n d c o n c e n tra tio n
o f c irc u la tin g m o n o a m in e s h a s n o t b e e n c o n c lu s iv e ly
e s ta b lis h e d .a lth o u g h th e re a re re p o rts th a t lin k
h y p e rte n s io n to c a te c h o la m in e le v e ls (6 , In .
L o w e r b lo o d p re s s u re fo llo w in g tra in in g is
fre q u e n tly a s s o c ia te d w ith lo w e r h e a rt ra te a n d c a rd ia c
o u tp u t a t re s t a n d d u rin g s u b m a x im a l e x e rc is e (9 ). A lth o u g h . th e m e c h a n is m s b y w h ic h re p e a te d e x e rc is e m a y lo w e r
b lo o d p re s s u re h a v e n o t b e e n c le a rly d e fin e d , th e s e
p h y s io lo g ic a l a d a p ta tio n s a re s im ila r to th o s e a c h ie v e d
th ro u g h ~ -a d re n o c e p to r b lo c k in g . T h e s e s im ila ritie s
s u g g e s t th a t e x e rc is e lo w e rs b lo o d p re s s u re th ro u g h a
re d u c tio n o f s y m p a th e tic n e u ra l a c tiv ity (9 ).
L ik e c a te c h o la m in e s , s e ro to n in is a ls o p re s e n t in th e
p e rip h e ra l s y s te m a n d p la y s its p h y s io lo g ic a l ro le o n
v a s c u la r s m o o th m u s c le (1 0 ,1 1 ). It is a ls o k n o w n th a t b o th
S a o P a u lo M e d ica l Jo u rn a l/R P M 1 1 6 (1 ): 1 6 1 8 -1 6 2 4 , 1 9 9 8 A R ID A , R .M .; N A F F A H -M A Z Z A C O R A T II, M .G .; S O A R E S , J.; C A V A L H E IR O , E .S . - M o n o a m in e re sp o n se s to a cu te a n d ' ch ro n ic
cen tral an d p erip h eral sero to n in erg ic sy stem s are in v o lv ed
in card io v ascu lar reg u latio n an d th e actio n o f o th er
v aso activ e su b stan ces lik e n o rad ren alin e an d an g io ten sin e
II are am p lified b y sero to n in . T h erefo re, ab n o rm al
sero to n in erg ic activ ity m ay p articip ate in th e p ath o g en esis
o f essen tial h y p erten sio n ( 1 1 ) .
P h y sical train in g m o d u lates th e activ ity o f th ese
n eu ro tran sm itters at rest an d d u rin g ex ercise,
d em o n stratin g an ex p o n en tial relatio n sh ip w ith
in creasin g w o rk lo ad (1 2 , 1 3 , 1 4 ).
S in ce p erip h eral m o n o am in es are in v o lv ed in
m ech an ism s th at co n tro l b lo o d p ressu re, an d p h y sical
ex ercise affects m o n o am in erg ic sy stem s, th is w o rk aim ed
at stu d y in g th e in v o lv em en t o f m o n o am in e lev els in th e
b en eficial effect o f an aero b ic train in g p ro g ram . T o
ach iev e su ch g o als w e d eterm in ed th e lev el o f circu latin g
m o n o am in es at rest, p o st-ex ercise an d after a p erio d o f
aero b ic p h y sical train in g in sed en tary n o rm o ten siv e an d
h y p erten siv e su b jects.
P art o f th e d ata fo r th e ch ro n ic effect o f ex ercise
w as refereed in th e B razilian Jo u rn al o f M ed ical an d
B io lo g ical R esearch (1 9 9 6 ) in a S h o rt C o m m u n icatio n
fo rm .
M A T E R I A L A N D M E T H O D S
T w o g ro u p s o f u n train ed m ale su b jects, i.e.
. n o rm o ten siv e
(UT/N,
N = 1 6 ) an d h y p erten siv e (U T /H ,N = 1 9 ), w ere su b m itted to an acu te b o u t o f ex ercise to
an aly ze th e acu te effect o f ex ercise o n th e m o n o am in e
lev els. S o m e in d iv id u als o f each g ro u p w ere arran g ed in
tw o o th er g ro u p s (resp ectiv ely
TIN,
N = ll an d T /H , N = 8 )to stu d y th e ch ro n ic effects o f ex ercise (p h y sical train in g
p ro g ram ). S in ce so m e in d iv id u als d id n o t fo llo w th e
p ro to co l d eterm in ed fo r th e stu d y , th ese w ere n o t in clu d ed
in stu d y in g th e ch ro n ic effect o f ex ercise. A ll in d iv id u als
w ere recru ited fro m a clin ic fo r th e p rev en tio n o f h eart
d isease an d card iac reh ab ilitatio n (F IT C O R ) an d w ere
in fo rm ed ab o u t th e stu d y d esig n an d o b jectiv e an d freely
d ecid ed to p articip ate in th is stu d y . N o n e w as in v o lv ed in
a reg u lar aero b ic ex ercise p ro g ram b efo re th e stu d y o r
w as tak in g m ed icatio n s d u rin g th e p h y sical train in g
p ro g ram . A cco rd in g to th e W o rld H ealth O rg an izatio n
(W H O ) criteria (I5 ), all su b jects classified as h y p erten siv e
w o u ld h av e a d iasto lic b lo o d p ressu re = 9 5 m m H g
reco rd ed after 1 0 m in u tes in th e sittin g p o sitio n o n at least
th ree d ifferen t o ccasio n s. A ll m easu rem en ts w ere m ad e
w ith a m ercu ry sp h y g m o m an o m eter an d th e d iasto lic
b lo o d p ressu re w as reco rd ed at th e fifth p h ase o f
{
K o ro tk o ff's so u n d s. A n th ro p o m etric d ata (1 6 ) w ere
o b tain ed in th e tw o g ro u p s (N an d H ) b efo re an d after th e
p erio d o f th e p h y sical train in g p ro g ram .
A ll su b jects w ere su b m itted to an erg o m etric test
b efo re an d after th e p h y sical train in g p ro g ram . E ach
su b ject p erfo rm ed a m ax im al tread m ill test (In b ram ed
M o d . K T -2 0 0 0 ) u sin g th e E llestad p ro to co l (1 7 ). O x y g en
u p tak e w as m easu red co n tin u o u sly d u rin g th e test th ro u g h
th e o p en -circu it m eth o d u n til ex h au stio n (O x y g en sen so r
N -2 2 m , O x y g en an aly zer
S-3A11,
C arb o n D io x id e sen so rP -6 1 B , C arb o n D io x id e an aly zer C D -3 A (A m etek ), D T M
-3 2 5 -M A O P -I0 p si, A m erican M eter). H eart rate,
electro card io g ram (H ew lett - P ack ard S y stem 4 7 0 0 A
C ard io g rap h ) an d b lo o d p ressu re w ere m easu red d u rin g
su p in e rest, d u rin g each m in u te o f th e tread m ill test, an d
at th e first, seco n d , fo u rth an d six th m in u tes o f reco v ery .
B lo o d p ressu re reco rd ed at rest an d at th e in ten sity o f
6 0 % o f m ax im al o x y g en u p tak e ( V 0
2m ax ) w as co n sid ered
fo r statistical an aly sis.
Sampling Procedure
T h e su b jects w ere in stru cted n o t to ch an g e an y
d ietary o r sleep in g h ab its, ex cep t fo r a 1 2 h o u r fast b efo re
b lo o d sam p lin g . B lo o d sam p les (1 0 m l fo r catech o lam in es
an d 5 m l fo r sero to n in assay ) w ere d raw n b y v en ip u n ctu re
fro m each su b ject in th e sittin g p o sitio n in to h ep arin ized
tu b es (catech o lam in es) an d in to d ry tu b es (sero to n in ) after
2 0 m in u tes o f rest p re-ex ercise an d im m ed iately p o
st-ex ercise in th e sittin g p o sitio n , b etw een 7 :0 0 an d 9 :0 0
a.m ., b efo re an d after th e p h y sical train in g p ro g ram . T h e
.d ry tu b es w ere th en p laced o n ice fo r 3 h o u rs fo r clo t
retractio n an d th e p lasm a an d seru m w as o b tain ed b y
refrig erated cen trifu g atio n at 3 0 0 0 g fo r 1 5 m in . P lasm a
an d seru m w ere th en sto red in liq u id n itro g en u n til assay
tim e, fo r n o m o re th an tw o m o n th s.
Physical training program
S u b jects p articip ated in a p h y sical train in g p ro g ram
fo r a p erio d o f th ree m o n th s (3 6 sessio n s, 3 d ay s p er w eek )
at an in ten sity o f 6 0 % o f m ax im al o x y g en u p tak e
( V 0
2m ax ). E x ercise b o u ts co n sisted o f 4 0 m in u tes o f
aero b ic ex ercise (2 0 m in u tes o n a cy cle erg o m eter an d 2 0
m in u tes o f w alk in g an d /o r jo g g in g ) an d 3 0 m in u tes o f
n eu ro m u scu lar en d u ran ce ex ercise, flex ib ility an d co
-o rd in ati-o n . H eart rate w as m easu red w h ile th e su b ject w as
o n th e cy cle erg o m eter, w alk in g
andlor
jo g g in g at th eb eg in n in g , d u rin g an d at th e en d o f all sessio n s o f ex ercise
in o rd er to co n tro l th e in ten sity o f effo rt (6 0 % V 0
2m ax )
as reco m m en d ed b y th e A m erican C o lleg e o f S p o rts
M ed icin e (1 8 ). T h e w o rk lo ad w as ad ju sted d u rin g th e
A R I D A , R . M . ; N A F F A H - M A Z Z A C O R A T I I , M . G . ; S O A R E S , J.;
C A V A L H E I R O , E . S . - M o n o a m in e r e s p o n s e s t o a c u t e a n d c h r o n ic
~ A r n h i~ A Y A r ~ i~ A in n n r m n t A n ~ iv A ~ n r l h v n A r t A n ! = \ iv A ! = \ u b iA c t s
p h y sic a l tra in in g p ro g ra m u sin g th e h e a rt ra te to m a in ta in
a p p ro p ria te e x e rc ise in te n sity . T h e b lo o d sa m p lin g w a s
d o n e a t th e sa m e in te n sity o f p h y sic a l e ffo rt (a sse sse d
th ro u g h h e a rt ra te ) b e fo re a n d a fte r th e p h y sic a l tra in in g
p ro g ra m .
Sample Preparation
T h e sa m p le w a s p re p a re d a s p re v io u sly re p o rte d (1 9 )
fo r c a te c h o la m in e s a n d se ro to n in (2 0 ). C irc u la tin g p la sm a
c a te c h o la m in e s a n d se ru m se ro to n in le v e ls w e re
d e te rm in e d b y H ig h P e rfo rm a n c e L iq u id C h ro m a to g ra p h y
c o u p le d w ith e le c tro c h e m ic a l d e te c tio n (H P L C - E D ).
Statistical Analysis
S ta tistic a l a n a ly sis w a s d o n e b y e m p lo y in g th e
A N O V A te st w ith T u k e y p o st te st. S ig n ific a n c e w a s
e sta b lish e d a t th e p < 0 .0 5 le v e l.
R E S U L T S
A n th ro p o m e tric d a ta a re p re se n te d in ta b le 1 . T h e re
w e re n o sta tistic a lly sig n ific a n t d iffe re n c e s in m e a n a g e ,
w e ig h t o r h e ig h t b e fo re a n d a fte r th e p h y sic a l tra in in g
p ro g ra m e ith e r in H o r N g ro u p s. T h e su m o f 7 sk in fo ld
th ic k n e ss w a s c o m p a re d b e tw e e n th e H "a n d N g ro u p s a n d
d iffe re d sig n ific a n tly o n ly w ith th e a c u te e ffe c t o f e x e rc ise .
H o w e v e r, th e re w e re n o sig n ific a n t d iffe re n c e s in th e b o d y
m a ss in d e x o f th e sa m e g ro u p , o r b e tw e e n th e N a n d H
g ro u p s b e fo re a n d a fte r th e p h y sic a l tra in in g p ro g ra m .
Blood pressure -
U T IN a n d U T IH sh o w e d sig n ific a n td iffe re n c e s in d ia sto lic b lo o d p re ssu re (D B P ) a t re st a n d
d u rin g .p h y sic a l e ffo rt (fig u re 1 ). W h e n th e tw o g ro u p s
(TIN
a n dTIH)
w e re c o m p a re d fo r th e c h ro n ic e ffe c t o fe x e rc ise , th e y sh o w e d sig n ific a n t d iffe re n c e s a t re st b e fo re
th e p h y sic a l tra in in g p ro g ra m in D B P . A fte r th e p h y sic a l
tra in in g p ro g ra m , th e re w e re n o sig n ific a n t d iffe re n c e s in
D B P a n d sisto lic b lo o d p re ssu re (S B P ) b e tw e e n
TIN
a n dTIH.
D B P w a s sig n ific a n tly re d u c e d a t re st in th eTIH
g ro u p (fig u re 2 ).
Monoamines
-
P la sm a n o ra d re n a lin e (N A )c o n c e n tra tio n w a s sig n ific a n tly h ig h e r p o st-e x e rc ise in
a ll fo u r g ro u p s (ta b le s 2 a n d 3 ). P la sm a a d re n a lin e (A )
a n d se ru m se r'o to n in (5 -H T ) c o n c e n tra tio n s w e re n o t
sig n ific a n tly c h a n g e d a t re st a n d p o st-e x e rc ise in a n y
o f th e fo u r g ro u p s (ta b le s 2 a n d 3 ). M o n o a m in e
c o n c e n tra tio n s in tra in e d g ro u p s
(TIN
a n dT/H)
o b ta in e d e ith e r a t re st o r a fte r e x e rc ise w e re n o t
sig n ific a n tly d iffe re n t fro m th e ir re sp e c tiv e u n tra in e d
g ro u p s
(UT/N
a n dUT/H).
D IS C U S S IO N
T h e re su lts p re se n te d in th is stu d y sh o w e d a
re d u c tio n o f d ia sto lic b lo o d p re ssu re in h y p e rte n siv e
T a b le 1
A n th ro p o m e tric d a ta fo r th e a c u te a n d c h ro n ic e ffe c t o f e x e rc is e in n o rm o te n s iv e a n d h y p e rte n s iv e s u b je c ts
A c u te E ffe c t o f E x e rc is e C h ro n ic E ffe c t o f E x e rc is e
B e fo re T ra in in g A fte r T ra in in g B e fo re T ra in in g A fte r T ra in in g
N o rm o te n s iv e H y p e rte n s iv e N o rm o te n s iv e H y p e rte n s iv e
N ° o f s u b je c ts 1 6 1 9 1 1 1 1 8 8
A g e (y e a rs ) 4 5 .9 :t 5 .2 4 7 .0 :t 5 .2 4 5 .5 :t 5 .6 4 5 .5 :t 5 .6 4 7 .5 :t 3 .9 4 7 .5 :t 3 .9
W e ig h t (k g ) 8 2 .3 :t 1 0 .8 8 9 .6 :t 1 5 .1 8 2 .0 :t 1 1 .7 8 1 .7 :t1 0 .9 7 7 .7 :t 1 2 .8 7 4 .7 :t 1 5 .6
H e ig h t (c m ) 1 7 3 .5 :t 6 .8 1 7 2 .2 :t 6 .1 1 7 2 .9 :t 7 .1 1 7 2 .9 :t 7 .1 1 6 7 .5 :t 8 .2 1 6 7 .5 :t 8 .2
S 7 S F (m m ) 1 5 5 .8 :t 3 0 .1 1 8 5 .5 :t 4 8 .8 * 1 5 1 .0 :t 2 0 .6 1 4 3 .8 :t 1 8 .8 1 7 8 .7 :t 6 5 .5 1 4 4 .0 :t 4 7 .4
B M I (k g /m2
) 2 7 :3 :t 2 .4 3 0 ~ 5 :t 4 .5 2 7 .4 :t 2 .8 2 7 .3 :t 2 .5 2 7 .7 :t 3 .3 2 6 .6 :t 4 .8
V 0
2m a x (m l.k g .m in ) 3 9 "."1:t 1 2 .4 3 7 .4 :t 6 .2 3 8 .8 :t 1 1 .5 4 4 .0 :t 9 .7 4 0 .2 :t 4 .0
5 1 .0 :t 7 .3
T h e m e a n s -:t S O v a lu e s o f a g e , w e ig h t, h e ig h t, s u m o f 7 S k in fo ld s (S 7 S F ) (b ic e p s , tric e p s , s u b s c a p u la r, s u p ra ilia c ,
m id a x illa ry , a b d .o m in a l, c a lf), B o d y M a s s In d e x (B M I) a n d m a x im a l O x ig e n U p ta k e (V 02 m a x ). * S ta tis tic a lly s ig n ific a n t
d iffe re n c e b e tw e e n n o rm o te n s iv e a n d h y p e rte n s iv e g ro u p s (A N O V A te s t) w ith p < 0 ,0 5 .
s a o P a u lo M e d ic a l J o u rn a l/R P M 1 1 6 (1 ): 1 6 1 8 -1 6 2 4 , 1 9 9 8 A R ID A , R .M .; N A F F A H -M A Z Z A C O R A T II, M .G .; S O A R E S , J .; C A V A L H E IR O , E .S . - M o n o a m in e re s p o n s e s to a c u te a n d c h ro n ic
• n o r m o te n s iv e 1 8 0
2 0 0 1 9 0 1 8 0 1 7 0 1 6 0 1 5 0 1 4 0 1 3 0 1 2 0
C l 1 1 0 ] 1 0 0 E 9 0 S O 7 0 6 0 5 0 4 0 3 0 2 0 1 0 0
D B P R e s t D B P E x e r c is e S B P R e s t S B P E x e r c is e
IJ h y p e r te n s iv e
1 9 0 1 7 0 1 6 0 1 5 0 1 4 0
1 3 0
1 2 0 1 1 0
~100 ~ 90 8 0 7 0 6 0 5 0 4 0 3 0 2 0 1 0
D B P R e s t D B P E x e r c is e S B P R e s t S B P E x e r c is e
O N b e fo r e tr a in in g
D N a fte r tr a in in g
r:aH b e fo r tr a in in g
H a fte r tr a in in g
F ig u r e 1 - B lo o d p r e s s u r e v a lu e s in n o r m o te n s iv e a n d h y p e r te n s iv e
s u b je c ts a t r e s t a n d d u r in g e ffo r t a n a ly z e d fo r th e a c u te e ffe c t o f
oe x e r c is e a t a n in te n s ity o f 6 0 % o f m a x im a l O
2 u p ta k e ( V 02m a x ) .
D a ta a r e e x p r e s s e d a s m e a n : tS O . 0
* S ta tis tic a lly s ig n ific a n t d iffe r e n c e b e tw e e n n o r m o te n s iv e a n d
h y p e r te n s iv e g r o u p s (A N O V A te s t) w ith p< 0 .0 0 1 fo r D B P a t
r e s t;
S ta tis tic a lly s ig n ific a n t d iffe r e n c e b e tw e e n n o r m o te n s iv e a n d h y p e r te n s iv e g r o u p s (A N O V A te s t) w ith p< 0 .0 5 fo r D B P d u r in g
e x e r c is e . D B P - D ia s to lic b lo o d p r e s s u r e . S B P - S y s to lic b lo o d
p r e s s u r e .
s u b j e c t s a t r e s t , a f t e r t h e p h y s i c a l t r a i n i n g p r o g r a m . S u c h
f i n d i n g s a r t ? i n a g r e e m e n t w i t h s e v e r a l o t h e r s t u d i e s t h a t
h a v e e s t a b l i s h e d r e g u l a r e x e r c i s e a s t h e m o s t e f f e c t i v e
n o n - p h a r m a c o l o g i c a l m e t h o d f o r l o w e r i n g b l o o d p r e s s u r e
i n b o t h s e d e n t a r y n o r m o t e n s i v e a n d h y p e r t e n s i v e s u b j e c t s .
D e s p i t e t h e e f f e c t i v e n e s s o O fe x e r c i s e t h e r a p y i n m i l d l y
h y p e r t e n s i v e s u b j e c t s ( 2 1 ,2 2 ,2 3 ,4 ) , o t h e r f a c t o r s h a v e t o b e
c o n s i d e r e d w i t h r e s p e c t t o t h e d i f f e r e n c e s i n r e s u l t s f r o m
s t u d i e s a b o u t h y p e r t e n s i o n , i n c l u d i n g : t h e t y p e o f e s s e n t i a l
h y p e r t e n s i o n , i n d i v i d u a l r e s p o n s e t o e x e r c i s e a n d t h e
q u a l i t y a n d q u a n t i t y o f t h i s e x e r c i s e .
C o n f l i c t i n g d a t a a b o u t p l a s m a c a t e c h o l a m i n e
c o n c e n t r a t i o n a t r e s t a n d a f t e r e x e r c i s e h a v e b e e n
r e p o r t e d
qy
v a r i o u s a u t h o r s . S t u d i e s i n w h i c h p l a s m ac a t e c h o l a m i n e s h a v e b e e n u s e d a s a n i n d e x o f
s y m p a t h e t i c n e r v o u s a c t i v i t y h a v e s h o w n a r e d ~ c t i o n
i n s y m p a t h e t i c d r i v e f o r t h e s a m e a b s o l u t e w o r k l o a d
f o l l o w i n g t r a i n i n g ( 1 2 ,2 4 ,2 5 ) . F o r a r e l a t i v e w o r k l o a d ,
h o w e v e r , t h e s y m p a t h e t i c n e r v o u s r e s p o n s e w a s
r e p o r t e d t o b e u n c h a n g e d ( 2 5 ) , d e c r e a s e d ( 1 2 ) o r e v e n
i n c r e a s e d a f t e r t r a i n i n g ( 2 6 ) .
I n t h e p r e s e n t s t u d y , p l a s m a n o r a d r e n a l i n e a t r e s t
a n d f o r t h e s a m e r e l a t i v e w o r k l o ~ d w a s n o t a f f e c t e d b y
t h e p h y s i c a l t r a i n i n g p r o g r a m i n t h e h y p e r t e n s i v e g r o u p ,
a l t h o u g h t h e r e w a s a t e n d e n c y f o r h i g h e r l e v e l s a f t e r
F ig u r e 2 - B lo o d p r e s s u r e v a lu e s in n o r m o te n s iv e a n d h y p e r te n s iv e
s u b je c ts a t r e s t a n d d u r in g e ffo r t, b e fo r e a n d a fte r p h y s ic a l tr a in in g p r o g r a m . D a ta a r e e x p r e s s e d a s m e a n : tS O .
* S ta tis tic a lly s ig n ific a n t d iffe r e n c e o f D B P a t r e s t fr o m
n o r m o te n s iv e g r o u p b e fo r e p h y s ic a l tr a in in g p r o g r a m (A N O V A
te s t) fo r p< 0 .0 0 1 ;
. * * S ta tis tic a lly s ig n ific a n t d iffe r e n c e o f D B P a t r e s t a fte r p h y s ic a l
tr a in in g p r o g r a m in h y p e r te n s iv e g r o u p (A N O V A te s t) fo r p <
0 .0 5 .
D B P - D ia s to lic b lo o d p r e s s u r e . S B P - S y s to lic b lo o d p r e s s u r e .
t r a i n i n g . T h e s e r e s u l t s , t h e r e f o r e , s u g g e s t t h a t a f t e r a
p h y s i c a l t r a i n i n g p r o g r a m t h e s y m p a t h e t i c n e r v o u s a c t i v i t y
d o e s n o t c h a n g e a t r e s t a n d f o r t h e s a m e r e l a t i v e w o r k
l o a d i n h y p e r t e n s i v e s u b j e c t s b u t , a s r e p o r t e d i n o t h e r
s t u d i e s ( 2 7 , 2 8 \ c a n b e r e d u c e d f o r t h e s a m e a b s o l u t e w o r k
l o a d .
T h e r e s u l t s p r e s e n t e d i n t h i s w o r k , s h o w i n g n o
s i g n i f i c a n t d i f f e r e n c e s i n p l a s m a a d r e n a l i n e l e v e l s p o s t
-e x -e r c i s -e , a r e i n a g r e e m e n t w i t h s t u d i e s o f K j a e r e t a f .( 2 9 )
a n d U r h a u s e n e t a l . ( 3 0 ) , w h o m e a s u r e d c a t e c h o l a m i n e
c o n c e n t r a t i o n s d u r i n g e x e r c i s e o f d i f f e r e n t i n t e n s i t i e s ,
r e l a t i n g c a t e c h o l a m i n e i n c r e a s i n g a t h i g h e r e f f o r t
i n t e n s i t i e s ( a n a e r o b i c ' t h r e s h o l d ) . .
I n a g r e e m e n t w i t h o u r r e s u l t s , s o m e i n v e s t i g a t i o n s
h a v e d e m o n s t r a t e d t h a t t h e s y m p a t h e t i c n e r v o u s s y s t e m
a c t i v i t y i s n o t i n c r e a s e d i n e s s e n t i a l h y p e r t e n s i o n ( 3 1 ) . B y
r e v i e w i n g 6 4 s t u d i e s , G o l d s t e i n ( 6 ) o b s e r v e d t h a t 8 0 % o f
t h e s t u d i e s r e p o r t e d h i g h e r p l a s m a n o r a d r e n a l i n e l e v e l s
i n h y p e r t e n s i v e t h a n i n n o r m o t e n s i v e s u b j e c t s , b u t
s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e s w e r e f o u n d i n o n l y
a b o u t 4 0 % o f t h e m . C o n s i d e r i n g p l a s m a a d r e n a l i n e l e v e l s ,
t h e m a j o r i t y o f s t u d i e s h a v e s h o w n h i g h e r a d r e n a l i n e
l e v e l s i n h y p e r t e n s i v e p a t i e n t s a s c o m p a r e d w i t h
n o r m o t e n s i v e s u b j e c t s , a n d a l s o o n l y a b o u t 4 0 % o f s t u d i e s
h a v e r e p o r t e d s t a t i s t i c a l l y s i g n i f i c a n t d i f f e r e n c e s .
A R ID A , R .M .; N A F F A H - M A Z Z A C O R A T T I, M .G .; S O A R E S , J .; C A V A L H E IR O , E .S . - M o n o a m in e r e s p o n s e s to a c u te a n d c h r o n ic
T a b le 2
P la s m a le v e ls o f N o r a d r e n a lin e ( N A ) a n d A d r e n a lin e ( A D ) a n d s e r u m S e r o to n in ( 5 - H T ) fo r th e a c u te e ffe c t o f e x e r c is e ( 6 0 0 / 0 V 02m a x ) in n o r m o te n s iv e a n d h y p e r te n s iv e s u b je c ts
N o r m o te n s iv e H y p e r te n s iv e
R e s t P o s t- E x e r c is e R e s t P o s t- E x e r c is e
N A 1 2 6 .5 2 :t 3 8 .6 3 1 9 6 .4 9 :t 7 1 .1 1 * 1 4 9 .1 5 ':t 4 8 .5 4 2 1 1 .3 1 :t 5 7 .6 8 *
( N = 1 6 ) ( N = 1 6 ) ( N = 1 9 ) ( N = 1 9 )
A D 4 5 .6 5 :t 1 5 .8 4 4 6 .2 3 :t 1 3 .1 8 4 6 .6 4 :t 2 8 .3 8 4 4 .6 3 :t 2 0 .7 3
( N = 1 3 ) ( N = 1 4 ) .( N = 1 7 ) ( N = 1 7 )
5 - H T 1 6 5 .0 9 :t 5 6 .1 6 1 6 8 .1 3 :t 8 9 .1 5 1 2 7 .5 9 :t 3 8 .2 9 1 4 2 .8 9 :t 4 5 .5 1
( N = 1 5 ) ( N = 1 5 ) ( N = 1 9 ) ( N = 1 9 )
D a ta a r e e x p r e s s e d a s m e a n :t S D in p g .m l-1
fo r c a te c h o la m in e s a n d n g .m l-1
fo r s e r o to n in .
* S ta tis tic a lly s ig n ific a n t d iffe r e n c e .fr o m r e s t to e ffo r t in n o r m o te n s iv e a n d h y p e r te n s iv e g r o u p s ( A N O V A te s t) w ith p < 0 .0 1 . N = n u m b e r o f s u b je c ts .
T a b le 3
P la s m a le v e ls o f N o r a d r e n a lin e ( N A ) a n d A d r e n a lin e ( A D ) a n d s .e r u m S e r o to n in ( 5 7 H T ) . fo r th e c h r o n ic e ffe c t o f e x e r c is e in n o r m o te n s iv e a n d h y p e r te n s iv e s u b je c ts
B e fo r e T r a in in g A fte r T r a in in g
N o r m o te n s iv e H y p e r te n s iv e N o r m o te n s iv e H y p e r te n s iv e
N A R e s t 1 2 0 .5 2 :t3 1 .2 7 1 2 9 .5 2 j:2 4 .3 2 1 3 8 .3 9 :t3 1 .4 7 1 6 7 .1 9 :t4 7 .6 0
( N = 1 1 ) ( N = 8 ) ( N = 1 1 ) ( N = 8 )
N A P o s t- E x e r c is e 2 1 7 .3 8 :t7 5 .8 4 * 2 3 4 .2 8 :t5 0 .9 6 * * 2 3 0 .8 6 :t6 1 .8 6 * 2 6 3 .7 7 :t5 3 .8 7 * *
( N = 1 1 ) ( N = 8 ) ( N = 1 1 ) ( N = 8 )
A D R e s t 4 6 .5 9 :t1 7 .4 4 4 1 .4 6 :t:1 2 .7 6 4 1 .5 1 :t1 4 .1 0 3 9 .9 6 :t2 7 .6 2
( N = 1 0 ) ( N = 8 ) ( N = 9 ) ( N = 8 )
A D P o s t- E x e r c is e 4 6 .8 8 :t1 4 .5 8 4 3 .3 6 :t:1 7 .3 2 5 0 .0 3 :t4 6 .0 9 3 5 .9 1 :t1 3 .0 2
( N = 1 0 ) ( N = 8 ) ( N = 9 ) ( N = 8 )
5 - H T R e s t 1 5 2 .0 3 :t7 2 .8 7 1 2 2 .3 5 :t1 5 .1 5 1 2 7 .4 8 :t5 5 .9 6 1 0 6 .0 8 :t4 0 .7 9
( N = 1 1 ) ( N = 8 ) ( N = 1 1 ) ( N = 8 )
5 - H T P o s t- E x e r c is e 1 5 2 .3 9 :t9 6 .4 8 1 2 6 .8 6 :t6 1 .0 4 1 2 6 .9 5 :t 7 8 .9 1 1 1 4 .0 0 .:t5 3 .4 1
( N = 1 1 ) ( N = 8 ) ( N = 1 1 ) ( N = 8 )
D a ta a r e e x p r e s s e d a s m e a n :t S D in p g .m l-1
fo r c a te c h o la m in e s a n d n g .m l-1
fo r s e r o to n in .
* S ta tis tic a lly s ig n ific a n t d iffe r e n c e fr o m r e s t to p o s t- e x e r c is e b e fo r e a n d a fte r tr a in in g in n o r m o te n s iv e g r o u p ( A N O V A te s t) w ith p < 0 .0 0 1 ;
* * S ta tis tic a lly s ig n ific a n t d iffe r e n c e fr o m r e s t to p o s t- e x e r c is e b e fo r e a n d a fte r tr a in in g in h y p e r te n s iv e g r o u p ( A N O V A te s t) w ith p < 0 .0 1 . N = n u m b e r o f s u b je c ts .
I n c o n t r a s t t o o t h e r s t u d i e s , t h e p o s s i b i l i t y t h a t
s e r o t o n i n c o u l d m e d i a t e t h e i n f l u e n c e o f p h y s i c a l e x e r c i s e
o n c a r d i o v a s c u l a r f u n c t i o n i s n o t f a v o u r e d b y t h e p r e s e n t
f i n d i n g s . N o s i g n i f i c a n t d i f f e r e n c e s i n s e r u m s e r o t o n i n
l e v e l s b e t w e e n r e s t i n g a n d p o s t - e x e r c i s e m e a s u r e m e n t s ,
e i t h e r b e f o r e o r a f t e r t h e p h y s i c a l t r a i n i n g p r o g r a m , w e r e
f o u n d i n h y p e r t e n s i v e o r n o r m o t e n s i v e s u b j e c t s , o r u p o n
c o m p a r i s o n o f t h e t w o g r o u p s .
S t r o n g e v i d e n c e s e e m s t o i m p l i c a t e s e r o t o n i n i n
h y p e r t e n s i o n , a n d p e r h a p s t h e m o s t r e l e v a n t f a c t i s t h e
S a o P a u lo M e d ic a l J o u r n a l/R P M 1 1 6 ( 1 ) : 1 6 1 8 - 1 6 2 4 , 1 9 9 8 A R ID A , R .M .; N A F F A H - M A Z Z A C O R A T II, M .G .; S O A R E S , J .;
efficacy of serotonin antagonists in lowering blood
pressure in hypertensive patients both acutely and
chronically (3Z). In contrast, the correlation between
physical exercise and serotonin has not been conclusively
established. The serotonin response to exercise has been
investigated minimally. Co'nsidering our results, probably
the aerobic exercise (60% VOzmax) does not provoke
significant alterations in peripheral serotonin levels. A
reduction in its level would probably be necessary to
suppress the vasoconstrictor effects of serotonin, and
therefore, lower the blood pressure.
The results of this study suggest that aerobic exercise
programs have an important effect in the reduction of
blood pressure. However, this influence cannot be directly
related to changes in plasma monoamines.
ACKNOWLEDGEMENTS
Research supported by CNPq, FAPESP and FINEP.
R.M.A. and J.S. were fellows from CAPES.
REFERENCES
1. Chaouloff F. Physical exercise and brain monoamines: a
review. Acta Physiol.Scand 1989; 137: 1-13.
2. Bailey SP, Davis JM, Ahlborn EN. Effect of increased brain
serotoninergic (5- HT \) acti vi ty on endurance performance
in the rat. Acta Physiol Scand 1992; 146: 76-77.
3~ Soares J, Naffah-Mazzacoratti MG, Cavalheiro EA.
Increased serotonin levels in physically trained men.
Brazilian J Med BioI Res 1994;27: 1635-1638.
4. Arida RM, Naffah-Mazzacoratti MG, Soares J, Cavalheiro
EA. Effect of an aerobic exercise program on blood pressure
and catecholamines in normotensive and hypertensive
subjects. Brazilian J Med BioI Res 1996;29:633-637.
5. Elghozi J L, Miach PJ, Meyer P. Central monoaminergic
mechanisms in the regulation of arterial blood pressure.
In: Saito H, Parvez H, Parvez S, Nagatsu T, eds. Progress
in hypertension, vol I, Neurotransmitters as modulators of
blood pressure. VSP, UTRECHT; 1988:9-26.
6. Goldstein DS. Plasma catecholamines in essential
hypertension: An analytical review. Hypertension 1983;
5:86-99.
7. Anderson EA, Sinkey CA, Lawton WJ, Mark AL. Elevated
sympathetic nerve activity in borderline hypertensive
humans. Hypertension 1989;14:177-183.
8. Ottosson A-M, Karlberg BE. Nisoldipine-effects on the
renin-angiotensin-aldosterone system and catecholamines.
Studies in normotensive and hypertensive subjects. J
Internal Medicine 1990;228:503-509.
9. Ducan JJ, Farr JE, Upton J, Hagan D, Oglesby ME,
Blair SN. The effects of aerobic exercise on
plasma catecholamines and blood pressure in
patients with mild essential hypertension. JAMA
1985 ;254: 2609-2613.
10. Van Nueten JM. Serotonin and the blood vessel wall. J
Cardiovasc Pharmacol 1985;7(suppl 7):S49-S51.
11. Chandra M, Chandra N. Serotoninergic mechanisms in
hypertension. Int J Cardiol 1993;42: 189-196.
A R I D A , R . M . ; N A F F A H - M A Z Z A C O R A T T I , M . G . ; S O A R E S , J . ; C A V A L H E I R O , E . S . - M o n o a m in e r e s p o n s e s t o a c u t e a n d c h r o n ic
~prnhi~ AVAr~ic:::A in nnrmntAn~h/A ~nrl hvnArtAn~ivA ~llhiAr.t~
1 2 . H a rtle y L H , M a so n lW , H o g a n R P e t a l. M u ltip le h o rm o n a l 2 4 . W o lfso n S , .A c o sta A E , R o se L I, P a risi A F , E n g e lm a n I.
re sp o n se s to g ra d e d e x e rc ise in re la tio n to p h y sic a l tra in in g . E ffe c ts o f c o n d itio n in g o n p la sm a c a te c h o la m in e s le v e ls
1 A p p l P h y sio l 1 9 7 2 ;3 3 :6 0 2 -6 0 6 . d u rin g e x e rc ise in p a tie n ts w ith c o ro n a ry a rte ry d ise a se .
1 3 . E la m M , S v e n sso n T H , T h o re n P . B ra in m o n o a m in e A m 1 C a rd io l 1 9 7 2 ;2 9 :2 9 7 -2 9 8 .
m e ta b o lism is a lte re d in ra ts fo llo w in g sp o n ta n e o u s, lo n g - 2 5 . C o u sin e a u D , F e rg u so n R l, D e C h a m p la in 1 , G a u th ie r P ,
d ista n c e ru n n in g . A c ta P h y sio l S c a n d 1 9 8 7 ; 1 3 0 :3 1 3 -3 1 6 . C o te P , B o u ra ssa M . C a te c h o la m in e s in c o ro n a ry sin u s
1 4 . M a z z e o R S , M a rsh a ll P . In flu e n c e o f p la sm a c a te c h o la m in e s d u rin g e x e rc ise in m a n b e fo re a n d a fte r tra in in g . 1 A p p l
o n th e la c ta te th re sh o ld d u rin g g ra d e d e x e rc ise . 1 A p p l
P h y sio l 1 9 7 7 ;4 3 : 8 0 1 -8 0 6 .
P h y sio l 1 9 8 9 ;6 7 : 1 3 1 9 -1 3 2 2 .
2 6 . W in d e r W W , H a g b e rg 1 M , H ic k so n R C , E h a n i A A , M c L a n e
1 5 . W o rld H e a lth O rg a n iz a tio n - 1 9 9 3 G u id e lin e s fo r th e
lA . T im e c o u rse o f sy m p a th o a d re n a l a d a p ta tio n to
m a n a g e m e n t o f m ild h y p e rte n sio n . M e m o ra n d u m fro m
a w o rd h e a lth o rg a n iz a tio n /in te rn a tio n a l so c ie ty o f e n d u ra n c e e x e rc ise tra in in g in m a n . 1 A p p l P h y sio l 1 9 7 8 ;
h y p e rte n sio n m e e tin g . C h a n tilly , W H O , 1 9 9 3 . 4 5 :3 7 0 -3 7 4 .
1 6 . L o h m a n T G , R o c h e A F , M a rto re ll K . A n th ro p o m e tric 2 7 . P e ro n n e t F , C le ro u x 1 , P e rra u lt H , C o u sin e a u D , d e
sta n d a rd iz a tio n re fe re n c e m a n u a l. C h a m p a ig n , H u m a n C h a m p la in 1 , N a d e a u R . P la sm a n o re p in e p h rin e re sp o n se
K in e tic s B o o k s; 1 9 9 1 :5 5 -6 9 . to e x e rc ise b e fo re a n d a fte r tra in in g in h u m a n s. 1 A p p l
1 7 . E lle sta d M H . S tre ss te stin g . P rin c ip le s a n d p ra c tic e . P h y sio l 1 9 8 1 ;5 1 :8 1 2 -8 1 5 .
P h ila d e lp h ia : F .A . D a v is C o m p a n y . 1 9 8 6 . 2 8 . E h sa n i A A , H e a th G W , M a rtin III W H , H a g b e rg 1 M ,
1 8 . A m e ric a n C o lle g e o f S p o rts M e d ic in e . A C S M 's G u id e lin e s H o llo sz y 1 0 . E ffe c ts o f in te n se e x e rc ise tra in in g o n p la sm a
fo r e x e rc ise te stin g a n d p re sc rip tio n . W illia m s &W ilk in s. c a te c h o la m in e s in c o ro n a ry p a tie n ts. 1 A p p l P h y sio I 1 9 8 4 ;
B a ltim o re 1 9 9 5 . 5 7 (1 ):1 5 4 -1 5 9 .
1 9 . N a ffa h -M a z z a c o ra tti M G , C a sa rin i D E , F e rn a n d e s M IS , 2 9 . K ja e r M , C h riste n se n B , S o n n e B , R ic h te r E A , G a lb o
C a v a lh e iro E A . S e ru m c a te c h o la m in e le v e ls d e te rm in e d b y H . E ffe c t o f e x e rc ise o n e p in e p h rin e tu rn o v e r in tra in e d
h ig h p e rfo rm a n c e liq u id c h ro m a to g ra p h y c o u p le d w ith a n d u n tra in e d m a le su b je c ts. 1 A p p l P h y sio l 1 9 8 5 ;
e le c tro c h e m ic a l d e te c tio n . A rq B ra s E n d o c rin o l M e ta b
5 9 : 1 0 6 1 -1 0 6 7 .
1 9 9 2 ;3 6 : 1 1 9 -1 2 2 .
3 0 . U rh a u se n A , W e ille r B , C ;o e n B , K in d e rm a n n W . P la sm a
2 0 . N a ffa h -M a z z a c o ra tti M G , R o se n b e rg R , F e rn a n d e s M IS
c a te c h o la m in e s d u rin g e n d u ra n c e e x e rc ise o f d iffe re n t
e t a l. S e ru m se ro to n in le v e ls o f n o rm a l a n d a u tistic c h ild re n .
B ra z ilia n 1 M e d B io I R e s 1 9 9 3 ;2 6 :3 0 9 -3 1 7 . in te n sitie s a s re la te d to th e in d iv id u a l a n a e ro b ic th re sh o ld .
2 1 . K iy o n a g a A , A ra k a w a K , T a n a k a H , S h in d o M . B lo o d E u r 1 A p p l P h y sio l 1 9 9 4 ;6 9 :1 6 -2 0 .
p re ssu re a n d h o rm o n a l re sp o n se s to a e ro b ic e x e rc ise . 3 1 . T o sti-C ro c e C , L u c a re lli C , B e tto P e t a l. P la sm a
H y p e rte n sio n 1 9 8 5 ;7 : 1 2 5 -1 3 1 . c a te c h o la m in e s re sp o n se d u rin g a p e rso n a lise d p h y sic a l
2 2 . le n n in g s G , N e lso n L , K o rn e r P , E sle r M . T h e p la c e o f stre ss a s a d y n a m ic c h a ra c te riz a tio n o f e sse n tia l
e x e rc ise in th e lo n g -te rm tre a tm e n t o f h y p e rte n sio n . h y p e rte n sio n . P h y sio l B e h a v .1 9 9 1 ;4 9 :6 8 5 -6 9 0 .
N e p h ro n 1 9 8 7 ;4 7 (su p p l 1):3 0 -3 3 . 3 2 . A m e ry A , F e g a rd R , F io c c h i R . A n ti-h y p e rte n siv e a c tio n
2 3 . A rro l B , B e a g le h o le R . D o e s p h y sic a l a c tiv ity lo w e r b lo o d a n d se ro to n in in d u c e d p la te le t a g g re g a tio n d u rin g lo n g te rm
p re ssu re ? A c ritic a l re v ie w o f th e ~ lin ic a l tria ls. 1 C lin k e ta n se rin tre a tm e n t in h y p e rte n siv e p a tie n ts. 1 C a rd io v a sc
E p id e m io l 1 9 9 2 ;4 5 :4 3 9 -4 4 7 . P h a rm a c o l 1 9 8 4 ;6 : 1 8 2 -1 8 5 .
Sao Paulo Medical JournaI/RPM.116(1): 1618-1624, 1998 ARIDA, R.M.; NAFFAH-MAZZACORATTI, M.G.; SOARES, J.;
CAVALHEIRO: E.S. - Monoamine responses to acute and chronic
