GIOVANIO VIEIRA DA SILVA
Projetos de Pesquisa
Unidades Organizacionais
Instituto Central, Hospital das Clínicas, Faculdade de Medicina - Médico
14 resultados
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conferenceObject Influence of Time of Day on Post-Exercise Hypotension Might Be Different in Hypertensives Receiving Different Anti-hypertensive Drugs: An Exploratory Study(2016) BRITO, Leandro; PECANHA, Tiago; FECCHIO, Rafael; SOUSA, Patricia; REZENDE, Rafael; NAVARRO, Manilla; SILVA, Giovanio; ABREU, Andrea; MION-JUNIOR, Decio; FORJAZ, Claudia- Effects of long term device-guided slow breathing on sympathetic nervous activity in hypertensive patients: a randomized open-label clinical trial(2017) BARROS, Silvana de; SILVA, Giovanio Vieira da; GUSMAO, Josiane Lima de; ARAUJO, Tatiana Goveia de; SOUZA, Dinoelia Rosa de; CARDOSO JR., Crivaldo Gomes; ONEDA, Bruna; MION, DecioPurpose: Device-guided slow breathing (DGB) is indicated as nonpharmacological treatment for hypertension. The sympathetic nerve activity (SNA) reduction may be one of the mechanisms involved in blood pressure (BP) decrease. The aim of this study is to evaluate the long-term use of DGB in BP and SNA.Subjects and methods: Hypertensive patients were randomized to listen music (Control Group-CG) or DGB (aim to reduce respiratory rate to less than 10 breaths/minute during 15minutes/day for 8 weeks). Before and after intervention ambulatory blood pressure monitoring (ABPM), catecholamines and muscle sympathetic nerve activity (MSNA) by microneurography were performed.Results: 17 volunteers in the DGB and 15 in the CG completed the study. There was no change in office BP before and after intervention in both groups. There was a reduction in systolic and diastolic BP in the awake period by ABPM only in the CG (13110/929 vs 128 +/- 10/88 +/- 8mmHg, p<0.05). In relation to SNA, no difference in catecholamines was observed. In the volunteers who had a microneurography record, there was no change the MSNA (bursts/minute): DGB (17(15-28) vs 19(13-22), p=0.08) and CG (22(17-23) vs 22(18-24), p=0.52).Conclusion: Long-term DGB did not reduce BP, catecholamines levels or MSNA in hypertensive patients.ClinicalTrials.gov identifier: NCT01390727
- Home blood pressure (BP) monitoring in kidney transplant recipients is more adequate to monitor BP than office BP(2011) AGENA, Fabiana; PRADO, Elisangela dos Santos; SOUZA, Patricia Soares; SILVA, Giovanio Vieira da; LEMOS, Francine Brambate Carvalhinho; MION JR., Decio; NAHAS, William Carlos; DAVID-NETO, EliasBackground. Hypertension is highly prevalent among kidney transplantation recipients and considered as an important cardiovascular risk factor influencing patient survival and kidney graft survival. Aim. Compare the blood pressure (BP) control in kidney transplant patients through the use of home blood pressure monitoring (HBPM) is more comparable with the results of ambulatory blood pressure monitoring compared to the measurement of office blood pressure. Methods. From March 2008 to April 2009 prospectively were evaluated 183 kidney transplant recipients with time after transplantation between 1 and 10 years. Patients underwent three methods for measuring BP: office blood pressure measurement (oBP), HBPM and ambulatory blood pressure monitoring (ABPM). Results. In total, 183 patients were evaluated, among them 94 were men (54%) and 89 women (46%). The average age was 50 6 11 years. The average time of transplant was 57 6 32 months. Ninety-nine patients received grafts from deceased donors (54%) and 84 were recipients of living donors (46%). When assessed using oBP, 56.3% presented with uncontrolled and 43.7% with adequate control of BP with an average of 138.9/82.3 +/- 17.8/12.1 mmHg. However, when measured by HBPM, 55.2% of subjects were controlled and 44.8% presented with uncontrolled BP with an average of 131.1/78.5 +/- 17.4/8.9 mmHg. Using the ABPM, we observed that 63.9% of subjects were controlled and 36.1% of patients presented uncontrolled BP with an average 128.8/80.5 +/- 12.5/8.1 mmHg. We found that the two methods (oBP and HBPM) have a significant agreement, but the HBPM has a higher agreement that oBP, confirmed P = 0.026. We found that there is no symmetry in the data for both methods with McNemar test. The correlation index of Pearson linear methods for the ABPM with the other two methods were 0.494 for office measurement and 0.768 for HBPM, best value of HBPM with ABPM. Comparing the errors of the two methods by paired t-test, we obtained the descriptive level of 0.837. Looking at the receiver operating characteristic curve for BP measurements in each method, we observed that oBP is lower than those obtained by HBPM in relation to ABPM. Conclusion. We conclude that the results obtained with HBPM were closer to the ABPM results than those obtained with BP obtained at oBP, being more sensitive to detect poor control of hypertension in renal transplant recipients.
- Activation of Mechanoreflex, but not Central Command, Delays Heart Rate Recovery after Exercise in Healthy Men(2021) PECANHA, Tiago; BRITO, Leandro Campos de; FECCHIO, Rafael Yokoyama; SOUSA, Patricia Nascimento de; SILVA, Natan Daniel; COUTO, Patricia Guimaraes; ABREU, Andrea Pio de; SILVA, Giovanio Vieira da; MION, Decio; LOW, David A.; FORJAZ, Claudia Lucia de MoraesThis study tested the hypotheses that activation of central command and muscle mechanoreflex during post-exercise recovery delays fast-phase heart rate recovery with little influence on the slow phase. Twenty-five healthy men underwent three submaximal cycling bouts, each followed by a different 5-min recovery protocol: active (cycling generated by the own subject), passive (cycling generated by external force) and inactive (no-cycling). Heart rate recovery was assessed by the heart rate decay from peak exercise to 30s and 60s of recovery (HRR (30s) , HRR (60s) fast phase) and from 60s-to-300s of recovery (HRR (60-300s) slow phase). The effect of central command was examined by comparing active and passive recoveries (with and without central command activation) and the effect of mechanoreflex was assessed by comparing passive and inactive recoveries (with and without mechanoreflex activation). Heart rate recovery was similar between active and passive recoveries, regardless of the phase. Heart rate recovery was slower in the passive than inactive recovery in the fast phase (HRR (60s) =20 +/- 8vs.27 +/- 10bpm, p<0.01), but not in the slow phase (HRR (60-300s) =13 +/- 8vs.10 +/- 8bpm, p=0.11). In conclusion, activation of mechanoreflex, but not central command, during recovery delays fast-phase heart rate recovery. These results elucidate important neural mechanisms behind heart rate recovery regulation.
- Brazilian Guidelines of Hypertension-2020(2021) BARROSO, Weimar Kunz Sebba; RODRIGUES, Cibele Isaac Saad; BORTOLOTTO, Luiz Aparecido; MOTA-GOMES, Marco Antonio; BRANDAO, Andrea Araujo; FEITOSA, Audes Diogenes de Magalhaes; MACHADO, Carlos Alberto; POLI-DE-FIGUEIREDO, Carlos Eduardo; AMODEO, Celso; MION JUNIOR, Decio; BARBOSA, Eduardo Costa Duarte; NOBRE, Fernando; GUIMARAES, Isabel Cristina Britto; VILELA-MARTIN, Jose Fernando; YUGAR-TOLEDO, Juan Carlos; MAGALHAES, Maria Eliane Campos; NEVES, Mario Fritsch Toros; JARDIM, Paulo Cesar Brandao Veiga; MIRANDA, Roberto Dischinger; POVOA, Rui Manuel dos Santos; FUCHS, Sandra C.; ALESSI, Alexandre; LUCENA, Alexandre Jorge Gomes de; AVEZUM, Alvaro; SOUSA, Ana Luiza Lima; PIO-ABREU, Andrea; SPOSITO, Andrei Carvalho; PIERIN, Angela Maria Geraldo; PAIVA, Annelise Machado Gomes de; SPINELLI, Antonio Carlos de Souza; NOGUEIRA, Armando da Rocha; DINAMARCO, Nelson; EIBEL, Bruna; FORJAZ, Claudia Lucia de Moraes; ZANINI, Claudia Regina de Oliveira; SOUZA, Cristiane Bueno de; SOUZA, Dilma do Socorro Moraes de; NILSON, Eduardo Augusto Fernandes; COSTA, Elisa Franco de Assis; FREITAS, Elizabete Viana de; DUARTE, Elizabeth da Rosa; MUXFELDT, Elizabeth Silaid; LIMA JUNIOR, Emilton; CAMPANA, Erika Maria Goncalves; CESARINO, Evandro Jose; MARQUES, Fabiana; ARGENTA, Fabio; CONSOLIM-COLOMBO, Fernanda Marciano; BAPTISTA, Fernanda Spadotto; ALMEIDA, Fernando Antonio de; BORELLI, Flavio Antonio de Oliveira; FUCHS, Flavio Danni; PLAVNIK, Frida Liane; SALLES, Gil Fernando; FEITOSA, Gilson Soares; SILVA, Giovanio Vieira da; GUERRA, Grazia Maria; MORENO JUNIOR, Heitor; FINIMUNDI, Helius Carlos; BACK, Isabela de Carlos; OLIVEIRA FILHO, Joao Bosco de; GEMELLI, Joao Roberto; MILL, Jose Geraldo; RIBEIRO, Jose Marcio; LOTAIF, Leda A. Daud; COSTA, Lilian Soares da; MAGALHAES, Lucelia Batista Neves Cunha; DRAGER, Luciano Ferreira; MARTIN, Luis Cuadrado; SCALA, Luiz Cesar Nazario; ALMEIDA, Madson Q.; GOWDAK, Marcia Maria Godoy; KLEIN, Marcia Regina Simas Torres; MALACHIAS, Marcus Vinicius Bolivar; KUSCHNIR, Maria Cristina Caetano; PINHEIRO, Maria Eliete; BORBA, Mario Henrique Elesbao de; MOREIRA FILHO, Osni; PASSARELLI JUNIOR, Oswaldo; COELHO, Otavio Rizzi; VITORINO, Priscila Valverde de Oliveira; RIBEIRO JUNIOR, Renault Mattos; ESPORCATTE, Roberto; FRANCO, Roberto; PEDROSA, Rodrigo; MULINARI, Rogerio Andrade; PAULA, Rogerio Baumgratz de; OKAWA, Rogerio Toshiro Passos; ROSA, Ronaldo Fernandes; AMARAL, Sandra Lia do; FERREIRA-FILHO, Sebastiao R.; KAISER, Sergio Emanuel; JARDIM, Thiago de Souza Veiga; GUIMARAES, Vanildo; KOCH, Vera H.; OIGMAN, Wille; NADRUZ, Wilson
- Poor sleep quality is associated with cardiac autonomic dysfunction in treated hypertensive men(2020) OLIVEIRA-SILVA, Laura; PECANHA, Tiago; FECCHIO, Rafael Y.; REZENDE, Rafael A.; ABREU, Andrea; SILVA, Giovanio; MION-JUNIOR, Decio; CIPOLLA-NETO, Jose; FORJAZ, Claudia L. M.; BRITO, Leandro C.Hypertensives present cardiac autonomic dysfunction. Reduction in sleep quality increases blood pressure (BP) and favors hypertension development. Previous studies suggested a relationship between cardiovascular autonomic dysfunction and sleep quality, but it is unclear whether this association is present in hypertensives. Thus, this study evaluated the relationship between sleep quality and cardiac autonomic modulation in hypertensives. Forty-seven middle-aged hypertensive men under consistent anti-hypertensive treatment were assessed for sleep quality by the Pittsburgh Sleep Quality Index (PSQI-higher score means worse sleep quality). Additionally, their beat-by-beat BP and heart rate (HR) were recorded, and cardiac autonomic modulation was assessed by their variabilities. Mann-Whitney andttests were used to compare different sleep quality groups: poor (PSQI > 5, n = 24) vs good (PSQI <= 5, n = 23), and Spearman's correlations to investigate associations between sleep quality and autonomic markers. Patients with poor sleep quality presented lower cardiac parasympathetic modulation (HR high-frequency band = 26 +/- 13 vs 36 +/- 15 nu,P = .03; HR total variance = 951 +/- 1373 vs 1608 +/- 2272 ms(2),P = .05) and cardiac baroreflex sensitivity (4.5 +/- 2.3 vs 7.1 +/- 3.7 ms/mm Hg,P = .01). Additionally, sleep quality score presented significant positive correlation with HR (r = +0.34,P = .02) and negative correlations with HR high-frequency band (r = -0.34,P = .03), HR total variance (r = -0.35,P = .02), and cardiac baroreflex sensitivity (r = -0.42,P = .01), showing that poor sleep quality is associated with higher HR and lower cardiac parasympathetic modulation and baroreflex sensitivity. In conclusion, in treated hypertensive men, poor sleep quality is associated with cardiac autonomic dysfunction.
- Can blood pressure decrease after maximal exercise test predict the blood pressure lowering effect of aerobic training in treated hypertensive men?(2023) AZEVEDO, Luan Morais; BRITO, Leandro Campos de; PECANHA, Tiago; FECCHIO, Rafael Yokoyama; REZENDE, Rafael Andrade; SILVA, Giovanio Vieira da; PIO-ABREU, Andrea; MION JUNIOR, Decio; HALLIWILL, John Robert; FORJAZ, Claudia Lucia de MoraesThe acute decrease in blood pressure (BP) observed after a session of exercise (called post-exercise hypotension) has been proposed as a tool to predict the chronic reduction in BP induced by aerobic training. Therefore, this study investigated whether post-exercise hypotension observed after a maximal exercise test is associated to the BP-lowering effect of aerobic training in treated hypertensives. Thirty hypertensive men (50 & PLUSMN; 8 years) who were under consistent anti-hypertensive treatment underwent a maximal exercise test (15 watts/min until exhaustion), and post-exercise hypotension was determined by the difference between BP measured before and at 30 min after the test. Subsequently, the patients underwent 10 weeks of aerobic training (3 times/week, 45 min/session at moderate intensity), and the BP-lowering effect of training was assessed by the difference in BP measured before and after the training period. Pearson correlations were employed to evaluate the associations. Post-maximal exercise test hypotension was observed for systolic and mean BPs (-8 & PLUSMN; 6 and -2 & PLUSMN; 4 mmHg, all P < 0.05). Aerobic training reduced clinic systolic/diastolic BPs (-5 & PLUSMN; 6/-2 & PLUSMN; 3 mmHg, both P < 0.05) as well as awake and 24 h mean BPs (-2 & PLUSMN; 6 and -2 & PLUSMN; 5 mmHg, all P < 0.05). No significant correlation was detected between post-exercise hypotension and the BP-lowering effect of training either for clinic or ambulatory BPs (r values ranging from 0.00 to 0.32, all p > 0.05). Post-exercise hypotension assessed 30 min after a maximal exercise test cannot be used to predict the BP-lowering effect of aerobic training in treated hypertensive men.
- Morning versus Evening Aerobic Training Effects on Blood Pressure in Treated Hypertension(2019) BRITO, Leandro C.; PECANHA, Tiago; FECCHIO, Rafael Y.; REZENDE, Rafael A.; SOUSA, Patricia; SILVA-JUNIOR, Natan Da; ABREU, Andrea; SILVA, Giovanio; MION-JUNIOR, Decio; HALLIWILL, John R.; FORJAZ, Claudia L. M.Introduction: The acute blood pressure (BP) decrease is greater after evening than morning exercise, suggesting that evening training (ET) may have a greater hypotensive effect. Objective: This study aimed to compare the hypotensive effect of aerobic training performed in the morning versus evening in treated hypertensives. Methods: Fifty treated hypertensive men were randomly allocated to three groups: morning training (MT), ET, and control (C). Training groups cycled for 45 min at moderate intensity (progressing from the heart rate of the anaerobic threshold to 10% below the heart rate of the respiratory compensation point), while C stretched for 30 min. Interventions were conducted 3 times per week for 10 wk. Clinic and ambulatory BP and hemodynamic and autonomic mechanisms were evaluated before and after the interventions. Clinic assessments were performed in the morning (7: 00-9: 00 AM) and evening (6: 00-8: 00 PM). Between-within ANOVA was used (P <= 0.05). Results: Only ET decreased clinic systolic BP differently from C and MT (morning assessment -5 +/- 6 mm Hg and evening assessment -8 +/- 7 mmHg, P G 0.05). Only ET reduced 24 h and asleep diastolic BP differently from C and MT (-3 +/- 5 and -3 +/- 4 mm Hg, respectively, P G 0.05). Systemic vascular resistance decreased from C only in ET (P = 0.03). Vasomotor sympathetic modulation decreased (P = 0.001) and baroreflex sensitivity (P G 0.02) increased from C in both training groups with greater changes in ET than MT. Conclusions: In treated hypertensive men, aerobic training performed in the evening decreased clinic and ambulatory BP due to reductions in systemic vascular resistance and vasomotor sympathetic modulation. Aerobic training conducted at both times of day increases baroreflex sensitivity, but with greater after ET.
- Reduction of Sympathetic Nervous Activity With Device-Guided Breathing(2014) BARROS, Silvana de; SILVA, Giovanio Vieira da; GUSMAO, Josiane Lima de; ARAUJO, Tatiana Goveia de; MION JR., Decio
- Effects of ACEi and ARB on post-exercise hypotension induced by exercises conducted at different times of day in hypertensive men(2020) BRITO, Leandro C.; AZEVEDO, Luan; PECANHA, Tiago; FECCHIO, Rafael Yokoyama; REZENDE, Rafael Andrade; SILVA, Giovanio Vieira da; PIO-ABREU, Andrea; MION, Decio; HALLIWILL, John R.; FORJAZ, Claudia L. M.Background Post-exercise hypotension (PEH) is greater after evening than morning exercise, but antihypertensive drugs may affect the evening potentiation of PEH. Objective: To compare morning and evening PEH in hypertensives receiving angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II receptor blockers (ARB). Methods Hypertensive men receiving ACEi (n = 14) or ARB (n = 15) underwent, in a random order, two maximal exercise tests (cycle ergometer, 15 watts/min until exhaustion) with one conducted in the morning (7 and 9 a.m.) and the other in the evening (8 and 10 p.m.). Auscultatory blood pressure (BP) was assessed in triplicate before and 30 min after the exercises. Changes in BP (post-exercise - pre-exercise) were compared between the groups and the sessions using a two-way mixed ANOVA and consideringPResults In the ARB group, systolic BP decrease was greater after the evening than the morning exercise, while in the ACEi group, it was not different after the exercises conducted at the different times of the day. Additionally, after the evening exercise, systolic BP decrease was lower in the ACEi than the ARB group (ARB = -11 +/- 8 vs -6 +/- 6 and ACEi = -6 +/- 7 vs. -8 +/- 5 mmHg, evening vs. morning, respectively, P for interaction = 0.014). Conclusions ACEi, but not ARB use, blunts the greater PEH that occurs after exercise conducted in the evening than in the morning.