Autonomic and Hemodynamic Responses to Inspiratory Muscle Exercise in Pre Hypertensive and Hypertensive Individuals
Condition: Prehypertension; Hypertension
MeSH terms: Prehypertension
Study type: Interventional

Summary: 
      This study aims to evaluate the autonomic and hemodynamic responses triggered by inspiratory
      muscle exercise in prehypertensive and hypertensive individuals. The reason that leads us to
      this study refers to clinical relevance for individuals with high blood pressure levels,
      since this type of exercise can act as a important nonpharmacological agent for arterial
      pressure control. In addition, this study aims to elucidate the mechanisms involved in
      cardiovascular responses to inspiratory muscle exercise and, consequently, provide safety in
      the prescription of these for this population.
    

Detailed description: 
      This is a randomized clinical trial, consisting of a convenience sample of patients from the
      Cardiology Department of the University Hospital (UH) of the Federal University of Juiz de
      Fora (FUJF). The patients will be invited to participate in the study and will receive
      information regarding the objectives and procedures of the study. In case of agreement with
      their inclusion in the study, they will sign a free and informed consent form.

      The entire experiment will be carried out in the Physical Evaluation Laboratory of the
      UH-FUJF, by the researchers previously trained in the application of the protocol. The stages
      of the experimental protocol will be divided into three days as described below.

        1. 1st day of the experimental protocol (initial evaluation): medical historical,
           anthropometric evaluation, electrocardiographic monitoring at rest, evaluation of
           respiratory muscle strength and familiarization with the muscle training device. All
           volunteers will be instructed to refrain from taking caffeinated and alcoholic beverages
           for 24 h before the evaluation and to have a good night's sleep.

        2. 2nd and 3rd days of the experimental protocol: all volunteers will be randomly assigned
           to two exercise sessions (ES): Sham IME (no load) and moderate intensity IME (40% of
           MIP). Initially, the volunteers will perform a 10-minute supine rest for heartbeat
           collection and subsequent calculation of heart rate variability (HRV), blood pressure
           and forearm blood flow measurements and evaluation of the baroreflex system. In sequence
           the ES will be conducted with continuous monitoring of blood pressure, heart rate and
           subjective perception of effort through the Borg Scale. Immediately and until one hour
           after the ES, it will be measured forearm blood flow, blood pressure, heart rate and
           evaluated the baroreflex system and HRV in order to investigate the acute effect of ES.
           The volunteers will be monitored using an equipment capable of evaluating the outpatient
           measurement of blood pressure and electrocardiogram for 24 hours in order to investigate
           the chronic effect of ES.
    

Intervention name(s): IME; Sham IME
Intervention type(s): Other; Other
Intervention description(s): The IME session protocol will consist of 8 sets of 2 minutes with 1 minute rest between sets. Inspiratory load will be set at 40% of maximum static inspiratory pressure. In addition, the volunteer will be instructed to perform diaphragmatic breathing, maintaining a respiratory rate in the range of 12 to 15 ipm (feedback from the evaluator) and the entire exercise protocol will be performed with the patient sitting with their feet flat on the floor and using a clip nasal.; The Sham IME session protocol will consist of 8 sets of 2 minutes with 1 minute rest between sets, but without a load generating resistance. In addition, the volunteer will be instructed to perform diaphragmatic breathing, maintaining a respiratory rate in the range of 12 to 15 ipm (feedback from the evaluator) and the entire exercise protocol will be performed with the patient sitting with their feet flat on the floor and using a nasal clip.
Other intervention name(s): Inspiratory muscle exercise; Sham inspiratory muscle exercise
Allocation: Randomized
Intervention model: Crossover Assignment
Masking: None (Open Label)
Primary purpose: Treatment
Keywords: Breathing Exercises; Autonomic Nervous System; Hemodynamics