Efeitos do treinamento multicomponente sobre o estado mental, modulação autonômica cardíaca e força de preensão manual em mulheres idosas com hipertensão arterial sistêmica: ensaio clínico randomizado

Abstract

Objective: To analyze the effects of a multicomponent physical training protocol on cardiovascular risk variables, mental health, body composition, and cardiac autonomic modulation in hypertensive older women. Methods: A series of anamnesis procedures were performed, including the International Physical Activity Questionnaire, Beck Anxiety and Depression Inventories, Pittsburgh Sleep Quality Index, handgrip strength test, blood pressure measurements, bioimpedance data collection, and heart rate variability. The investigation was conducted in two phases: 1) A randomized clinical trial that subjected elderly hypertensive women to a multimodal training protocol (strength, aerobic, and flexibility exercises) for 8 weeks (16 sessions), comparing them with a control group. A two-way ANOVA and Fisher's exact test were performed for statistical analysis; 2) A cross-sectional study that compared elderly hypertensive women who regularly practiced physical exercise with non-practitioners. The following were evaluated: blood pressure, body composition (bioimpedance), handgrip strength, heart rate variability (HRV), Baevsky Stress Index, sleep quality (SPQI), anxiety (IAB), and depression (IDB). For statistical analysis, the Student's t-test, Mann-Whitney U test, Fisher's exact test, and Pearson's correlation test were used. Results: In the clinical trial, the group that underwent multicomponent training showed significant improvements compared with the control group, including reduced anxiety levels, better sleep quality, increased fat-free mass, skeletal muscle mass, handgrip strength, and basal energy expenditure; reduced body fat percentage and anxiety scores; and improved cardiac autonomic modulation, as evidenced by increases in SDNN,

RMSSD, SD1, and SD2 of HRV and a decrease in resting heart rate. The cross- sectional study supported these findings, demonstrating that regular exercise

practitioners had better body composition, greater strength, lower anxiety and depression, improved sleep quality, and a lower cardiovascular stress index. Conclusion: Multicomponent physical training proved to be an effective intervention to attenuate multiple cardiovascular risk factors in hypertensive older women. The observed benefits range from direct physiological adaptations, such as improved cardiac autonomic modulation and body composition, to enhancements in mental health and sleep quality. The findings reinforce the importance of prescribing multicomponent exercise as an integral part of hypertension management in this population, with potential implementation in public health programs. Long-term studies

are recommended to assess the persistence of these benefits and their impact on clinical outcomes.