Efeito agudo da hidroterapia sobre a pressão arterial e o augmentation index em grávidas hipertensas crônicas

Abstract

Acute effect of hydrotherapy on blood pressure and augmentation index in chronic hypertensive pregnant women Introduction and objectives: Chronic hypertension and elevation of augmentation index in pregnancy are associated with the risk of complications such as superimposed preeclampsia and low fetal growth. The impact of hydrotherapy had not yet be enassessed in this context.Objectives: To evaluate the acute effect of a session of aquatic physiotherapy (hydrotherapy), a modality of non-pharmacological treatment, on blood pressure and augmentation index in chronic hypertensive pregnant women.Methods: A cross-sectional controlled study evaluated the effect of a hydrotherapy session on the blood pressure and arterial stiffness of pregnant women. We used Mobil-O-Graph-NG equipment for arterial variables, before and after a hydrotherapy session, involving stretching, warming, strengthening and relaxation.Results: We evaluated 36 pregnant women, 12 hypertensives, 24 controls, 30.4 ± 4.8 years old, 29.2 ± 3,3 weeks of gestation. In both groups, we observed reduction in augmentation index adjusted for 75 bpm (hypertensives: 28.8 ± 7.3%, before, 22.4 ± 6.9%, after, p = 0.024 and controls: 29.1 ± 7 , P= 0.001), and heart rate reduction (hypertensives: 93.4 ± 11.8 bpm, before, 82.4 ± 10.0 bpm, after, p <0.001 and controls: 91.4 ± 13.4 bpm, before, 81.5 ± 12.6 bpm, then; p <0.001). Hydrotherapy promoted a borderline significant redution in systolic blood pressure in hypertensive patients (139.6 ± 12.1 mmHg, before, 130.1 ± 12.6 mmHg, later, p= 0.050). Conclusions: We demonstrated for the first time that a hydrotherapy session acutely reduces the arterial stiffness expressed by the augmentation index, as well as attenuation in the heart rate of hypertensive pregnant women, regardless of the reduction of the blood pressure. The intervention proved to be safe and could represent a potential accessory non-pharmacological strategy for the prevention of maternal-fetal complications associated with chronic hypertension during pregnancy.