PHYSI CAL ACTI VI TY LEVEL I N PEOPLE W I TH HI GH BLOOD PRESSURE
Lar issa Cast elo Guedes Mar t ins1 Nir la Gom es Gu edes2 I an e Xim en es Teix eir a1 Mar cos Venícios de Oliv eir a Lopes3 Thelm a Leit e de Ar auj o4
Mar t ins LCG, Guedes NG, Teixeira I X, Lopes MVO, Arauj o TL. Phy sical act iv it y level in people w it h high blood
pr essur e. Rev Lat ino- am Enfer m agem 2 0 0 9 j ulho- agost o; 1 7 ( 4 ) : 4 6 2 - 7 .
This st udy aim ed t o analy ze t he lev el of phy sical act iv it y for people w it h high blood pr essur e car ed for in a healt h cent er . This cr oss- sect ional st udy w as conduct ed w it h 310 indiv iduals bet w een 18 and 69 y ear s of age t hr ough t he I nt er nat ional Phy sical Act iv it y Quest ionnair e ( I PAQ) . The m aj or it y ( 80% ) of par t icipant s pr esent ed low or m oder at e lev els of ph y sical act iv it y . Th e an aly sis of associat ion bet w een sociodem ogr aph ic v ar iables and physical act ivit y level r evealed t hat older m en fr om t he int er ior of t he st at e w it h higher educat ional levels h av e a gr eat er ch an ce of ex h ibit in g low er lev els of ph y sical act iv it y . Th e logist ic r egr ession m odel r ev ealed t hat or igin, schooling and diabet es ar e pr edict or s of low physical act ivit y level. The conclusion is t hat par t of t he sam ple does not m at ch t he desir able pr ofile t o pr act ice r egular phy sical act iv it y .
DESCRI PTORS: m ot or act iv it y ; h y per t en sion , ex er cise
NI VEL DE ACTI VI DAD FÍ SI CA EN PORTADORES DE HI PERTENSI ÓN ARTERI AL
El obj et iv o de est e est u dio f u e an alizar el n iv el de act iv idad f ísica de per son as por t ador as de h iper t en sión ar t er ial, acom pañadas en un cent r o de at ención am bulat or ial. Se t r at a de un est udio t r ansv er sal desar r ollado con 3 1 0 in d iv id u os d e 1 8 a 6 9 añ os. Se u t ilizó com o b ase el I n t er n at ion al Ph y sical Act iv it y Qu est ion n air e ( I PAQ) . La m ayor par t e del gr upo ( 80% ) fue encuadr ada en los niveles de baj a y m oder ada act ividad física. En el an álisis de asociación en t r e las v ar iables sociodem ogr áf icas y el n iv el de act iv idad f ísica, se v er if icó qu e per sonas del sexo m asculino, pr ocedent es del int er ior del Est ado, con m ás edad y con m ayor nivel de escolar idad son m ás p r op en sas a d esar r ollar u n n iv el d e act iv id ad f ísica b aj o. En el m od elo d e r eg r esión log íst ica, la pr oceden cia, t iem po de escolar idad y de diabet es f u er on in dicador es obt en idos com o f act or es de pr edicción sign ificat iv os par a el n iv el baj o de act iv idad física. Se con clu y e qu e par t e de la m u est r a n o posee u n per fil deseable en r elación a la pr áct ica r egular de act iv idad física.
DESCRI PTORES: act iv idad m ot or a; h iper t en sión , ej er cicio
NÍ VEL DE ATI VI DADE FÍ SI CA EM PORTADORES DE HI PERTENSÃO ARTERI AL
O obj et iv o desse est udo foi analisar o nív el de at iv idade física de pessoas por t ador as de hiper t ensão ar t er ial, acom panhadas em cent r o de at endim ent o am bulat or ial. É um est udo t r ansver sal desenvolvido com 310 indivíduos de 18 a 69 anos. Ut ilizou- se com o base o I nt er nat ional Physical Act ivit y Quest ionnair e ( I PAQ) . A m aior par cela do gr u po ( 8 0 % ) f oi en qu adr ada n os n ív eis de baix a e m oder ada at iv idade f ísica. Na an álise de associação ent r e as v ar iáv eis sociodem ogr áficas e o nív el de at iv idade física, v er ificou- se que pessoas do sex o m asculino, pr ocedent es do int er ior do Est ado, m ais v elhas e com m aior nív el de escolar idade são m ais pr opensas par a d esen v o l v er n ív el d e at i v i d ad e f ísi ca b ai x o . No m o d el o d e r eg r essão l o g íst i ca, a p r o ced ên ci a, t em p o d e escolar id ad e e d e d iab et es f or am in d icad or es ob t id os com o p r ed it or es sig n if ican t es p ar a o n ív el b aix o d e at iv idade física. Concluiu- se que par t e da am ost r a não possui per fil desej áv el em r elação à pr át ica r egular de at iv idade f ísica.
DESCRI TORES: at iv idade m ot or a; h iper t en são, ex er cício
1
RN, e- m ail: lar issacast elo@hot m ail.com , ianexim [email protected] .br ; 2RN, Doct or al St udent in Nur sing, Univer sidade Feder al do Cear á, Br azil, e- m ail: nir lagom es@hot m ail.com ; 3Adj unct Pr ofessor, Univer sidade Federal do Cear á, Br azil, e- m ail: m ar [email protected] ; 4Associat e Pr ofessor, Univer sidade Federal do Cear á, Br azil, e- m ail: t helm aar auj o2003@hot m ail.com .
I NTRODUCTI ON
S
edent ar iness has been ident ified as a r isk f act or f or car diov ascu lar diseases. A pr ev iou s st u dyfound t hat 76.9% of people w ho had suffer ed a hear t
at t ack and 81.2% of people w it h ar t er ial hyper t ension
d i d n o t p er f o r m a n y k i n d o f p h y si ca l a ct i v i t y( 1 - 2 ).
How ever, t he evaluat ion of physical act ivit y is hindered
b y t h e l a c k o f s t a n d a r d i z e d i n s t r u m e n t s a n d a
precision so t hat it can be used in populat ion st udies
and in differ ent social cont ex t s( 3).
I t is cu r r en t ly w ell est ab lish ed t h at a d aily
r o u t i n e o f p h y si cal ex er ci se h el p s t o p r ev en t an d
r ecov er f r om car diov ascu lar diseases becau se of it s
ben ef icial ef f ect s on t h e car diov ascu lar sy st em an d
on t he cont r ol of t he r em aining r isk indicat or s( 4).
Due t o t he global concern w it h t he high levels
of p h y sical in act iv it y an d h ar m t h is lack of act iv it y
c a u s e s , s o m e r e s e a r c h e r s h a v e f o c u s e d o n t h e
ev alu at ion of p sy ch om et r ic ch ar act er ist ics ( valid it y,
r epr oducibilit y and obj ect iv it y ) of quest ionnair es t hat
aim t o m easure levels of physical act ivit y. Am ong t he
sev er al t y p es o f q u est i o n n ai r es, t h e I n t er n at i o n al
Physical Act ivit y Quest ionnaire – I PAQ has reasonable
m easurem ent propriet ies t o m onit or levels of physical
act ivit y of adult populat ions bet w een 15 and 69 year s
of age( 5).
Co n s i d e r i n g t h e a s s o c i a t i o n b e t w e e n a
sed en t ar y lif est y le an d t h e d ev elop m en t of ch r on ic
diseases, t his st udy focused on hy per t ensiv e people
aim ing t o accurat ely charact erize t he levels of physical
act ivit y of t his populat ion. Hence, t his st udy is j ust ified
by t he beneficial and proven effect s of physical act ivit y
o n t h e p r e v e n t i o n a n d t r e a t m e n t o f h i g h b l o o d
pr essur e( 6). I t is a m eans t hr ough w hich pr ofessionals
can int ervene, providing educat ion in healt h and, t hus,
sensit ize t his group regar ding t he need for a physically
act iv e life.
METHOD
Th is cr oss- sect ion al an d ex p lor at or y st u d y
a i m ed t o a n a l y ze t h e l ev el o f p h y si ca l a ct i v i t y o f
h y p e r t e n s i v e p e o p l e . I t w a s c a r r i e d o u t i n a n
ou t pat ien t s’ r ef er en ce cen t er t h at pr ov ides car e f or
individuals wit h high blood pressure and diabet es. The
p o p u l a t i o n w a s co m p o sed o f h y p er t en si v e p eo p l e
t en d ed in t h is car e cen t er. Th e f ollow in g in clu sion
c r i t e r i a w e r e c o n s i d e r e d : d i a g n o s i s o f a r t e r i a l
hypert ension, being cared for by t he program and being
18 t o 69 years old. The exclusion crit erion was m edical
count er indicat ion t o exercise report ed by part icipant s.
Th e st u d y sam p le w as calcu lat ed b ased on
t h e f or m u la r ecom m en ded f or sam ple est im at ion in
cr o ss- se ct i o n a l st u d i e s o f f i n i t e p o p u l a t i o n s. Th e
f o l l o w i n g p a r a m e t e r s w e r e c o n s i d e r e d : 9 5 %
significance level ( Za= 1.96) ; 5% sam pling er r or ; size of popu lat ion : 6 , 0 4 2 h y per t en siv e people r egist er ed
in t h e sy st em ; a p r ev alen ce of an est im at ed 7 0 %
accor ding t o a st udy focusing on epidem iology of r isk
f act or s f or ar t er ial h y p er t en sion( 7 ). Based on t h ese
p ar am et er s, t h e r esear ch er select ed a con v en ien ce
sam ple com posed of 3 1 0 h y per t en siv e people.
Pr i m a r y d a t a w e r e c o l l e c t e d t h r o u g h
int erviews bet ween Novem ber 2007 and January 2008.
The used inst r um ent pr esent ed t he final classificat ion
a c c o r d i n g t o t h e I n t e r n a t i o n a l Ph y s i c a l A c t i v i t y
Quest ionnaire – I PAQ, which is divided in t hree levels,
low , m od er at e an d h ig h . Th e I PAQ sh or t an d lon g
versions cont ain dat a on m oderat e t o vigorous physical
act ivit y in different cont ext s ( work environm ent , house
t ask s, t r an spor t at ion an d leisu r e) r egar din g t h e last
sev en day s or a r egular w eek . The long v er sion w as
ch o sen b ecau se i t al l o w s co l l ect i n g m o r e d et ai l ed
inform at ion in a regular w eek t hrough int erview s( 5).
Th e v ar iab le cit y w as cod ed as cap it al an d
int er ior, w her eas m et r opolit an r egions w er e coded as
capit al as well. Marit al st at us not ed if t he pat ient was
living wit h or wit hout a part ner at t he t im e. Schooling
w as q u an t if ied accor d in g t o y ear s con clu d ed . Dat a
relat ed t o weight , height and durat ion of hypert ension
and diabet es m ellit us were obt ained t hrough pat ient s’
report s. The weight and height variables were used t o
com put e Body Mass I ndex ( BMI ) ( weight / height2) . BMI
w a s c l a s s i f i e d a c c o r d i n g t o t h e Wo r l d H e a l t h
Or g a n i za t i o n st a n d a r d s( 8 ). Th e i n co m e p e r ca p i t a
v ar iable w as der iv ed fr om t he sum of all sour ces of
fam ily in com e.
D a t a a r e p r e s e n t e d i n t a b l e s i n d i c a t i n g
ab sol u t e f r eq u en cy an d p er cen t ag e, t en d en cy an d
dispersion m easures. To evaluat e associat ion bet w een
cat egor ical var iables, t he Chi- squar e t est w as applied.
Th e Kolm ogor ov - Sm ir n ov t est w as u sed in t h e dat a
sy m m e t r y a n a l y si s. Th e Ma n n - W h i t n e y t e st w a s
applied t o check m edian differ ences bet w een gr oups.
Based on v ar iables t hat pr esent ed st at ist ical
significance below 0. 2, a st epw ise logist ic r egr ession
w as dev eloped t o ident ify pr edict or fact or s of lev els
of phy sical act iv it y t hat influence t he dev elopm ent of
h ig h lev els of p h y sical act iv it y. For t h at , lev els of
phy sical act iv it y w er e gr ouped in t w o cat egor ies: t he
act ivit y and t he second only included individuals w it h
low levels of physical act ivit y. The Wald t est w as used
t o verify t he significance of coefficient s t hat int egrat ed
t he logist ic equat ion; t he Om nibus t est w as used t o
v er if y t h e sig n if ican ce of t h e m od el; t h e Hosm er –
Le m e sh o w t e st e v a l u a t e d t h e d i f f e r e n ce b e t w e e n
ob ser v ed an d ex p ect ed f r eq u en cies; Nag elk er k e R2
w as used t o m easur e t he m odel’s goodness of fist . I n
ad d i t i o n t o t h ese st at i st i cs, t h e f i n al d ef i n i t i o n o f
p r e d i c t o r s c o n s i d e r e d t h e r e d u c t i o n o f t h e l o g
lik elihood r at io ( - 2 log) .
Al l r e co m m e n d a t i o n s r e g a r d i n g r e se a r ch
dev eloped w it h hum an beings pr ovided by Resolut ion
196/ 96 of t he Nat ional Healt h Council w er e follow ed.
Per m ission t o car r y ou t t h e r esear ch w as ob t ain ed
f r o m t h e i n st i t u t i o n ’ s Re se a r ch Et h i cs Co m m i t t e e
( Pr ot ocol no 212/ 2007) .
RESULTS
Th e st u d y r e v e a l e d t h a t t h e m a j o r i t y o f
par t icipant s w er e fem ale ( 65.5% ) , or iginally fr om t he
capit al ( 8 6 . 1 % ) and Cat holic ( 7 4 . 5 % ) . The m aj or it y
( 6 4 . 5 % ) r ep or t ed a d om est ic p ar t n er ; t h e t y p e of
e x i st i n g m a r i t a l r e l a t i o n sh i p w a s i r r e l e v a n t . Th e
o ccu p a t i o n v a r i a b l e v a r i ed , t h o u g h r et i r ed p eo p l e
( 2 5 . 5 % ) p r e d o m i n a t e d f o l l o w e d b y h o u s e w i v e s
( 2 2 . 2 % ) . On ly 5 . 6 % of t h e sam p le r ep or t ed b ein g
unem ployed. Half t he sam ple w as up t o 56 year s old,
had nine y ear s of schooling and a per capit a incom e
of R$ 433. 33 ( Br azilian cur r ency ) .
Table 1 – Clinical dat a of specialized cent er pat ient s
w it h ar t er ial hy per t ension
I n d i v i d u a l s w i t h h i g h l e v e l s o f b o d y f a t
pr edom in at e: 8 0 % w er e classif ied as ov er w eigh t or
o b e se . Th i s f a ct w a s e v i d e n ce d b y t h e h i g h BMI
av er ag e ( 2 9 . 1 2 ) . Ad d it ion ally, 7 0 % of t h e st u d ied
individuals had diabet es m ellit us. Anot her not ew or t hy
f a c t i s t h e t i m e o f t h e d i a g n o s i s o f a r t e r i a l
h y p er t en si o n . Hal f o f t h e g r o u p k n ew ab o u t t h ei r
condit ion for m or e t han t en y ear s.
Regarding t he I PAQ classificat ion, w e highlight
t h at t h e m aj or it y ( 4 4 . 2 % ) h ad m od er at e lev els of
p h y sical act iv it y f ollow ed b y low lev els of p h y sical
act ivit y ( 40% ) and only 15.8% of t he sam ple pr esent ed
high lev els of phy sical act iv it y.
When analyzing pot ent ial associat ion bet w een
t he var iables of gender, or igin and dom est ic par t ner
w it h t he variable level of physical act ivit y, a significant
st at ist ical associat ion bet w een t h e v ar iables gen der
and or igin ( p= 0.043 and 0.039, r espect ively) w as found
w hen low and m oderat e levels of physical act ivit y w er e
c o m p a r e d . Me n p r e s e n t e d 6 9 % m o r e c h a n c e o f
pr esent ing low lev el of phy sical act iv it y com par ed t o
w om en ( OR= 1.691; CI 95% = 0.015 – 2.818) . We also
o b ser v ed t h a t t h e p er cen t a g e o f p eo p l e f r o m t h e
int erior w ho present ed a low level of physical act ivit y
in cr eased t w o- f old w h en com p ar ed t o p eop le f r om
t h e ca p i t a l ( OR= 2 . 0 9 ; CI 9 5 % = 0 . 9 8 – 4 . 5 2 ) . Th e
av er age len gt h of sch oolin g w as sign ifican t ly h igh er
am ong individuals w it h a low level of physical act ivit y
com par ed t o t hose w it h a high level of physical act ivit y
( p= 0 . 0 4 1 ) .
Table 3 show s t hat t he var iables ident ified as
pr edict or s of a low lev el of ph y sical act iv it y in clu de
p eop le f r om t h e in t er ior of t h e st at e w it h a h ig h er
e d u c a t i o n a l l e v e l a n d a s h o r t e r t i m e s i n c e t h e
d i a g n o s i s o f d i a b e t e s . D e s p i t e t h e s t a t i s t i c a l
significance of t he est im at ed coefficient s, t he logist ic
m od el p r esen t ed a low coef f icien t of d et er m in at ion
( R2= 0 . 0 6 7 ) .
DI SCUSSI ON
The pr edom inance of fem ales ( 65.5% ) found
i n t h i s st u d y d i f f er s f r o m a st u d y co n d u ct ed w i t h
hypert ensive people in w hich t he prevalence of m ales
w as significant ly higher( 9). How ever, w om en in Br azil
k now m or e about t heir high blood pr essur e condit ion
t h an m en , t h u s t h ey seek m or e h ealt h ser v ices( 1 0 ),
w hich m ay ex plain t heir pr edom inance in t he st udied
car e ser v ice. s
e l b a i r a
V No. %
n o it a c if i s s a l c I M B
t h g i e w r e d n
U 3 1.1
t h g i e w l a m r o
N 52 19
t h g i e w r e v
O 107 39.1
e s e b
O 112 40,9
l a t o
T 274 100
s e t e b a i D
s e
Y 218 70.3
o
N 92 29.7
l a t o
T 310 100
e u l a v
P Average Standard
r o r r
E Median
t h g i e
W 0.069 73.81 13.25 73
t h g i e
H 0.171 1.59 0.08 1.600
I M
B 0.691 29.12 4.61 28.81
l a i r e t r a f o e m i T
n o i s n e t r e p y
Table 2 – Bivar iat e analy sis of levels of phy sical act iv it y accor ding t o sociodem ographic dat a
Table 3 – Logist ic r egr ession for pr edict or fact or s of lev el of phy sical act iv it y ( 0 – m oderat e/ h igh ; 1 – low )
ident ified in people w it h ar t er ial hy per t ension
l a c i s y h p f o l e v e L s r o t c i d e r p / y t i v i t c
a Coef. Wald(Sig) OMN(Sig) HL R2 -2Log
n i g i r
O 1.013 6.235(0.013) 13.546 2.131 0.067 343.330
g n il o o h c
S 0.073 5.238(0.022) (0.004) (0.977)
s e t e b a i d f o e m i
T -0.615 4.349(0.037)
t n a t s n o
C -1.450 4.476(0.034)
OMN – Om nibus t est ; HL - Hosm er and Lem eshow t est ; Wald – Wald t est ; R2 - Nagelker ke coefficient of det er m inat ion; - 2 Log – log likelihood r at io s e l b a i r a
V Levelofphysicalactivity Total Statistics
w o
L Moderate
r e d n e G . 1 e l a
M 52 41 93 p=0.043
e l a m e
F 72 96 168 OR=1.691
l a t o
T 124 137 261 CI95%:1,015-2.818
n i g i r O . 2 r o i r e t n
I 24 14 38 p=0.039
l a t i p a
C 100 122 222 OR=2.090
l a t o
T 124 136 260 CI95%:0.980-4.520
r e n t r a P c it s e m o D . 3 s e
Y 85 82 167 p=0.144
o
N 39 55 94 OR=1.462
l a t o
T 124 137 261 CI95%:0.878-2.435
e g a r e v a s k n a R e g A .
4 128.88 132.92 p=0.666
g n il o o h c S .
5 132.73 125.74 p=0.444
a t i p a c r e p e m o c n I .
6 126.76 131.96 p=0.576
e t a r e d o
M High
r e d n e G . 1 e l a
M 41 14 55 p=0.858
e l a m e
F 96 35 131 OR=1.068
l a t o
T 137 49 186 CI95%:0.520-2.193
n i g i r O . 2 l a t i p a
C 122 44 166 p=0.986
r o i r e t n
I 14 5 19 OR=0.990
l a t o
T 136 49 185 CI95%:0.337-2,.09
r e n t r a p c it s e m o D . 3 s e
Y 82 33 115 p=0.354
o
N 55 16 71 OR=0.723
l a t o
T 137 49 186 CI95%:0.363-1.438
e g a r e v a s k n a R e g A .
4 99.17 77.64 p=0.016
g n il o o h c S .
5 97.19 83.19 p=0.111
a t i p a c r e p e m o c n I .
6 96.75 82.60 p=0.113
w o
L High
r e d n e G . 1 e l a
M 52 14 66 p=0.103
e l a m e
F 72 35 107 OR=1.806
l a t o
T 124 49 173 CI95%:0.883-3.691
n i g i r O . 2 l a t i p a
C 100 44 144 p=0.147
r o i r e t n
I 24 5 29 OR=0.473
l a t o
T 124 49 173 CI95%:0.170-1.322
r e n t r a P c it s e m o D . 3 s e
Y 85 33 118 p=0.878
o
N 39 16 55 OR=1.057
l a t o
T 124 49 173 CI95%:0.521-2.143
e g a r e v a s k n a R e g A .
4 92.79 72.36 p=0.016
g n il o o h c S .
5 89.85 73.11 p=0.041
a t i p a c r e p e m o c n I .
I t i s i m p o r t a n t t o h i g h l i g h t t h a t t h e
char act er ist ics r egar ding t he r em aining dem ogr aphic
f act or s id en t if ied am on g t h e st u d y p ar t icip an t s ar e
s i m i l a r t o t h e p r o f i l e u s u a l l y d e s c r i b e d f o r t h i s
p o p u l a t i o n . Fa c t o r s s u c h a s a d v a n c e d a g e , l o w
soci oecon om i c l ev el an d l ow ed u cat i on al l ev el ar e
n o t ed a s i m p o r t a n t ch a r a ct er i st i cs o f p eo p l e w i t h
h y p er t en sion( 1 1 ). Socioecon om ic d if f er en ces p lay an
im p or t an t r ole in h ealt h con d it ion s d u e t o sev er al
fact ors such as access t o t he healt h care syst em , level
o f i n f o r m at i o n , u n d er st an d i n g o f t h e p r o b l em an d
adh er en ce t o t r eat m en t .
Th e p e r c e n t a g e o f o v e r w e i g h t o r o b e s e
individuals ( 80% ) is highlight ed in t he analyzed clinical
dat a. This fact is confirm ed in t he analysis of 40 art icles
w h er e t h e pr ev alen ce of obesit y v ar ied f r om 7 . 9 t o
2 0 . 8 % an d b ei n g o v er w ei g h t v ar i ed f r o m 2 5 . 7 t o
51. 6% . I n t his sam e st udy, m or e t han t w o t hir ds of
i n d i v i d u a l s i n s t u d i e d p o p u l a t i o n s d i d n o t h a v e
adequ at e r egu lar ph y sical act iv it y( 1 2 ). An ot h er st u dy
focusing on t he incr eased pr ev alence of hy per t ension
show ed t hat t his is direct ly proport ional t o t he increase
of body m ass so t hat over w eight and obese individuals
p r e se n t e d h y p e r t e n si o n co n si d e r a b l y h i g h e r t h a n
indiv iduals w it hin t he nor m al r ange of w eight , w hich
suggest s a cause and effect r elat ionship bet w een t hese
t w o v ar iables( 13).
The st r ong associat ion bet w een excess w eight
and t he occur r ence of ar t er ial hy per t ension indicat es
t he ur gent need for m easur es capable of influencing
r i sk i n d i ca t o r s t h a t ca n d e ci si v e l y d e t e r m i n e t h e
pr ev alence of hy per t ension in populat ions( 9).
Anot her r elev ant piece of infor m at ion, w hich
i s a l s o d i r e c t l y a s s o c i a t e d w i t h h i g h B MI a n d
hypert ension, is t he presence of diabet es m ellit us in a
large share of t he st udied sam ple ( 70% ) . The lit erat ure
d e s c r i b e s a c l e a r i n c r e a s e i n t h e p r e v a l e n c e o f
hypert ension and diabet es m ellit us wit h weight gain( 14).
The verificat ion of t he level of physical act ivit y
t hr ough I PAQ r ev ealed t he pr edom inance of low and
m od er at e lev els of p h y sical act iv it y in t h e st u d ied
populat ion. Sim ilar dat a w er e found in ot her st udies
evaluat ing t he level of physical act ivit y in people w it h
h y p er t en si o n an d an i n v er se r el at i o n sh i p b et w een
p h y s i c a l a c t i v i t y a n d t h e p r e v a l e n c e o f a r t e r i a l
h y p er t en si o n w a s f o u n d( 1 5 ). A st u d y co n d u ct ed i n
Pelot as, RS, Brazil w it h m et hodological crit eria sim ilar
t o t h i s s t u d y r e v e a l e d a p r e v a l e n c e o f p h y s i c a l
in act iv it y bet w een 3 8 an d 4 1 % bet w een 2 0 an d 6 5
y ear s of age( 16).
I t is im p or t an t t o h eed t h e f act t h at m an y
st udies pr esent t he Br azilian populat ion as having, in
general, charact erist ics relat ed t o low levels of physical
act iv it y. How ev er, t h e evalu at ion of a popu lat ion as
phy sically inact iv e should be consider ed w it h caut ion
becau se t h er e is a lim it at ion obser v ed in st u dies in
which physical act ivit y is increasingly relat ed t o leisure
act iv it ies. Fr om t his per spect iv e, t he I PAQ ev aluat ion
cr it er ia ar e m or e r elev an t in p oor cou n t r ies w h er e
act iv it ies r elat ed t o t r an spor t at ion , h om e an d w or k
t asks, and not only leisure act ivit ies, regularly im pose
a c o n s i d e r a b l e e n e r g y e x p e n d i t u r e o n t h e s e
popu lat ion s.
The result s of t his st udy were sim ilar t o t hose
of a pr ev iou s st u dy in w h ich m en pr esen t ed h igh er
rat es of low levels of physical act ivit y and sedent ariness
w a s s i g n i f i c a n t l y m o r e f r e q u e n t i n m e n t h a n i n
w om en( 4 ). An in v er se r elat ion sh ip b et w een p h y sical
act iv it y an d ag e w as f ou n d in t h is st u d y : y ou n g er
individuals present ed higher levels of physical act ivit y
( p < 0 , 0 0 1 ) . Th is r esu lt is in ag r eem en t w it h cr
oss-sect ional and longit udinal st udies t hat point t o a decline
in t he level of physical act ivit y from 1 t o 20% a year,
sh ow in g a t en d en cy f or t h e p r op or t ion of in act iv e
individuals t o increase as t hey becom e older( 17).
Th e lev el of ph y sical act iv it y in t h e st u died
sam p le w as sig n if ican t ly low er f or p eop le f r om t h e
int erior when com pared t o t hose from t he capit al. This
r esult differ s fr om pr ev ious r esear ch in w hich people
f r om t h e m et r opolit an ar ea of São Pau lo pr esen t ed
low er lev els of ph y sical act iv it y com par ed t o people
from t he int erior and coast( 18). I t is im port ant t o keep
in m in d d em og r ap h ic d if f er en ces b et w een t h e t w o
st at es. I n t he case of Fort aleza, Ce, Brazil, for inst ance,
it s m et r op olit an r eg ion in clu d es t h e coast . Hen ce,
com parison bet ween t he t wo st udies is lim it ed because
in t he art icle m ent ioned above( 18), people who lived on
t he coast of São Paulo present ed t he highest levels of
phy sical act iv it y, w hich m at ches t he r esult s fr om t his
st udy.
Low and m oder at e lev els of phy sical act iv it y
id en t if ied in t h is st u d y w er e p ossib ly in f lu en ced b y
socioeconom ic condit ions, considering t hat a large part
of the study population has low per capita incom e, which
can reduce the free tim e people have available for physical
act ivity, t hat is, t hey have t o fill out m ost of t heir t im e
with labor activities. I n addition, there is a higher chance
of these individuals to be relatively m isinform ed regarding
the benefits of physical activity to health.
I n t his cont ext , w e not ed t he need for fur t her
r esear ch f ocu sin g on t h e dev elopm en t of st r at egies
t hat encour age t he adopt ion of r egular physical act ivit y
as a w ay t o cont r ol and pr ev ent healt h pr oblem s.
Com par ison of t his st udy’s r esult s w it h ot her
st udies w as lim it ed because ot her aut hor s r e- codified
I PAQ a cco r d i n g t o t h e o b j e ct i v e o f t h e i r st u d i e s.
A n o t h e r p o i n t t h a t d e s e r v e s a t t e n t i o n w a s t h e
par t icipant s’ difficult y in r ecollect ing infor m at ion. Due
t o quest ionnaire lengt h and det ails in relat ion t o how
m any t im es and how long act iv it ies w er e per for m ed,
t her e w as t he per cept ion t hat , oft ent im es, par t icipant s
only est im at ed t hese values, w hich hindered a reliable
collect ion of essent ial inform at ion t o develop t his st udy.
Thus, t hese result s should be considered w it h caut ion
and confir m ed in ot her populat ions and age r anges.
I t is im por t ant t o highlight t hat nur ses hav e
con sid er ed t h e ev alu at ion of p h y sical act iv it y as a
n u r si n g d i a g n o si s, r e f e r r i n g t o i t a s a se d e n t a r y
lifest y le. How ever, in r esear ching t his diagnosis, one
st ill n eed s in st r u m en t s an d st r at eg ies t h at en ab le
a c c u r a t e m e a s u r e m e n t / v e r i f i c a t i o n o f t h e
ch ar act er ist ics t h at def in e t h is h u m an r esp on se. I n
t h is per spect iv e, a seden t ar y lifest y le is a diagn osis
t h a t p r e se n t s d e f i n i n g ch a r a ct e r i st i cs d i f f i cu l t t o
m easur e and for w hich t he I PAQ has t he pot ent ial t o
provide a m ore accurat e evaluat ion. Finally, given t he
scope and com plex it y of t he sedent ar iness pr oblem ,
w e st r ess t he need t o change t his condit ion t hr ough
t he supplem ent at ion and expansion of act ions able t o
influence t he behav ior of populat ions w it h a v iew t o
p r o m o t e p h y s i c a l a c t i v i t y s o a s t o d i m i n i s h t h e
p r e v a l e n c e o f h y p e r t e n s i o n a n d a l s o h e a l t h
com plicat ions due t o t his disease.
REFERENCES
1. Colom bo RCR, Aguillar OM. Estilo de vida e fatores de risco de pacientes com prim eiro episódio de infarto agudo do m iocárdio. Rev Lat ino- am Enferm agem 1997 abril; 5( 2) : 69- 82.
2. Sim onet t i JP, Bat ist a L, Car valho LR. Hábit os de saúde e f at or es de r isco em pacien t es h iper t en sos. Rev Lat in o- am En f er m ag em 2 0 0 2 m aio- j u n h o; 1 0 ( 3 ) : 4 1 5 - 2 2 .
3 . B e n e d e t t i TB , M a z o GZ , B a r r o s M V G. A p l i c a ç ã o d o Q u e s t i o n á r i o I n t e r n a c i o n a l d e A t i v i d a d e s Fís i c a s p a r a av aliação do nív el de at iv idades físicas de m ulher es idosas: v alidade con cor r en t e e r epr odu t ibilidade t est e- r et est e. Rev Br as Ciên e Mov 2 0 0 4 j an eir o- m ar ço; 1 2 ( 1 ) : 2 5 - 3 4 . 4 . Siqueir a FV, Facchini LA, Piccini RX, Tom asi E, Thum é E, Si l v e i r a D S, e t a l . At i v i d a d e f ísi ca e m a d u l t o s e i d o so s r esident es em ár eas de abr angência de unidades básicas de saú de de m u n icípios das r egiões Su l e Nor dest e do Br asil. Cad Saú d e Pú b lica 2 0 0 8 j an eir o; 2 4 ( 1 ) : 3 9 - 5 4 .
5 . I n t er n at ion al Ph y sical Act iv it y Qu est ion n air e [ h om epage on t he I nt er net ] . Sw eden: Kar olinska I nst it ut et [ updat ed 2008 j u l ] . Gu i d e l i n e s f o r d a t a p r o ce ssi n g a n d a n a l y si s o f t h e I nt er nat ional Phy sical Act iv it y Quest ionnair e: shor t and long f o r m ; [ 1 scr e n ] . Av a i l a b l e f r o m : h t t p : / / w w w . i p a q . k i . se / scor in g . p d f
6. Sim ão M, Hayashida M, Sant os CB, Cesar ino EJ, Nogueir a MS. Hip er t en são ar t er ial en t r e u n iv er sit ár ios d a cid ad e d e Lu b an g o, An g ola. Rev Lat in am En f er m ag em 2 0 0 8 j u lh o-ag o st o ; 1 6 ( 4 ) : 6 7 2 - 8 .
7 . Gu s I , H a r z h e i m E, Z a sl a v sk y C, Me d i n a C, Gu s M. Pr e v a l ê n ci a , Re co n h e ci m e n t o e Co n t r o l e d a Hi p e r t e n sã o Ar t er ial Sist êm ica no Est ado do Rio Gr ande do Sul. Ar q Br as Car d iol 2 0 0 4 n ov em b r o; 8 3 ( 5 ) : 4 2 4 - 8 .
8 . W o r l d H e a l t h Or g a n i za t i o n . Ob e si t y : p r e v e n t i n g a n d m an agin g t h e global epidem ic. Gen ev a: WHO; 2 0 0 0 ( WHO t ech n ical r epor t ser ies, 8 9 4 ) .
9. Jar dim PCB, Gondim MRP, Monego ET, Mor eir a HG, Vit or ino PVO, Souza WKSB, et al. Hiper t ensão ar t er ial e alguns fat or es d e r isco em u m a cap it al b r asileir a. Ar q Br as Car d iol 2 0 0 7 ab r il; 8 8 ( 4 ) : 4 5 2 - 7 .
1 0 . Tav ei r a LF, Pi er i n AMG. O n ív el so ci o eco n ô m i co p o d e in f lu en ciar as car act er íst icas de u m gr u po de h iper t en sos? Re v La t i n o - a m En f e r m a g e m 2 0 0 7 s e t e m b r o - o u t u b r o ; 1 5 ( 5 ) : 9 2 9 - 3 5 .
1 1 . Co st a JSD, Ba r ce l l o s FC, Scl o w i t z ML, Scl o w i t z I KT, Cast anheir a M, Olint o MTA, et al. Pr evalência de hiper t ensão ar t er ial em adult os e fat or es associados: um est udo de base popu lacion al u r ban a em Pelot as, Rio Gr an de do Su l, Br asil. Ar q Br as Car d iol 2 0 0 7 j an eir o; 8 8 ( 1 ) : 5 9 - 6 5
1 2 . Bloch KV, Rodr igu es CS, Fiszm an R. Epidem iologia dos fat or es de r isco par a hiper t ensão ar t er ial – um a r evisão cr ít ica da lit er at ur a br asileir a. Rev Br as Hiper t ens 2006 abr il- j unho; 1 3 ( 2 ) : 1 3 4 - 4 3 .
13. Feij ão AMM, Gadelha FV, Bezer r a AA, Oliveir a AM, Silva M S S , Li m a JW O . Pr e v a l ê n c i a d e Ex c e s s o d e Pe s o e Hiper t en são Ar t er ial em Popu lação Ur ban a de Baix a Ren da. Ar q Br as Car d iol 2 0 0 5 j an eir o; 8 4 ( 1 ) : 2 9 - 3 3 .
1 4 . Car n eir o G, Far ia NA, Rib eir o FF Filh o, Gu im ar ães A, Ler ár io D, Fer r eir a SGF, et al. I n f lu ên cia da dist r ibu ição da gor dur a cor por al sobr e a pr ev alência de hiper t ensão ar t er ial e out r os fat or es de r isco car diovascular em indivíduos obesos. Rev Assoc Med Br as 2 0 0 3 j u lh o- set em b r o; 4 9 ( 3 ) : 3 0 6 - 1 1 . 1 5 . Cast r o RAA, Mon cau JEC, Mar copit o LF. Pr evalên cia de hiper t ensão ar t er ial sist êm ica na cidade de For m iga, MG. Ar q Br as Car d iol 2 0 0 7 m ar ço; 8 8 ( 3 ) : 3 3 4 - 9 .
1 6 . Ha l l a l PC, Vi ct o r a CG, W el l s JCK, Li m a RC. Ph y si ca l I n act iv it y : Pr ev alen ce an d Associat ed Var iables in Br azilian Adult s. Med Sci Spor t s Ex er c 2003 Nov em ber ; 35( 11) : 1894-9 0 0 .
1 7 . Al v e s JGB, Mo n t e n e g r o FMU, Ol i v e i r a FA, Al v e s RV. Pr át ica de espor t es dur ant e a adolescência e at iv idade física de lazer na vida adult a. Rev Br as Méd Espor t e 2005 set em br o-ou t u b r o; 1 1 ( 5 ) : 2 9 1 - 4 .
1 8 . M a t s u d o S M , M a t s u d o V R, A r a ú j o T, A n d r a d e D , An d r ad e E, Oliv eir a LC, et al. Nív el d e at iv id ad e f ísica d a p op u lação d o Est ad o d e São Pau lo: an álise d e acor d o com o g ê n e r o , i d a d e , n í v e l s o c i o e c o n ô m i c o , d i s t r i b u i ç ã o g eog r áf ica e d e con h ecim en t o. Rev Br as Ciên e Mov 2 0 0 2 o u t u b r o ; 1 0 ( 4 ) : 4 1 - 5 0 .
