To compare clinical and functional parameters in hypertensive patients who underwent two cardiac rehabilitation protocols: supervised and partially supervised.Design and method:
This randomized clinical trial included patients with stage I or II hypertension, > 18 years, with no contraindication to physical exercise, who did not use beta blockers and used at least three antihypertensive drugs and also did not have limited voluntary ambulation. Group 1 participated in partially supervised cardiac rehabilitation and group 2, supervised rehabilitation. All participants did warm-up exercises, physical conditioning, resistance training, and cool-downs three days a week with sessions lasting 45 minutes over a period of three months. Before and after the intervention, the patients underwent physical evaluation, a six-minute walking test, treadmill exercise test, metabolic exams, and central and peripheral measures of blood pressure.Results:
We evaluated 61 patients (30 in group 1/31 in group 2) with a mean age of 60.3 ± 11.3 years; 78.7% were women. In the initial evaluation, the groups were homogenous with regard to all parameters except for mean body mass index values, which were 30.1 ± 5.5 Kg/m2 in group 1 and 26.6 ± 7.0 Kg/m2 in group 2 (p = 0.040). After the intervention, both groups were able to walk farther in the six-minute walking test: group 1 increased mean distance by 30.6 meters (p = 0.004) and group 2 increased by 55.0 meters (p < 0.001). In addition, group 2 had higher values for weight bearing achieved in muscular strength tests, advancing from 2.3 ± 0.7 Kg to 3.0 ± 0.7 for upper limbs (p < 0.001) and from 3.4 ± 0.9 Kg to 3.8 ± 0.8 Kg for the lower limbs (p < 0.001). Gains were also seen in the maximal consumption of oxygen, from 24.7 ± 8.6 mlO2/Kg/min to 28.4 ± 7.5 mlO2/Kg/min (p = 0.003). Adherence to the intervention was similar for both groups: 77.5 ± 11% (G1) and 82 ± 10% (G2) (p = 0.124).Conclusions:
The partially supervised cardiac rehabilitation program resulted in significant improvements in the distance covered in the six-minute walking test. The supervised cardiac rehabilitation program yielded, in addition to this gain, significant improvements in muscular strength and maximal consumption of oxygen. Adherence was satisfactory in both groups.