RESUMO A população mundial está envelhecendo rapidamente, e nem todas as cidades estão preparadas para lidar com as necessidades dessa população. As cidades devem desenvolver estratégias para os idosos, incluindo aspectos de saúde, nutrição, defesa do consumidor, habitação, transporte, meio ambiente, assistência social, renda, emprego, segurança e educação. A Organização Mundial da Saúde (OMS) possui um programa denominado “cidade amiga dos idosos”, cujos objetivos são preparar as cidades para o envelhecimento da população e minimizar os custos desse processo proporcionando a inserção ativa dos idosos na vida socioeconômica das cidades. A certificação (selo) de cidade amiga dos idosos pela OMS. A maioria da população idosa vive nos espaços urbanos, o que isso representa um desafio e um ambiente de oportunidades para as cidades. Um desafio, pois ao envelhecer ocorre uma maior demanda pelos cuidados em saúde e instituições de longa permanência. Por outro lado, a população idosa apresenta um potencial de ambiente de negócios específicos para essa faixa etária, como os setores de alimentação, educação, e setores de entretenimento. No Brasil, a população idosa responde por cerca de 20% do consumo nacional. Apenas 16 cidades brasileiras receberam esse selo de certificação internacional para atender aos requisitos estipulados pela OMS. No estado de São Paulo, apenas duas cidades foram qualificadas para a obtenção do selo. Portanto, os objetivos do presente artigo são a) fornecer um breve histórico desse importante programa da OMS; b) despertar nos gestores das cidades a vontade de desenvolver iniciativas efetivas para que as cidades estejam preparadas para um rápido envelhecimento populacional, que tenha potencial para contribuir com a sociedade em suas diferentes capacidades.

ABSTRACT The world population is aging fast and not all cities are prepared to cope with the needs of the elderly people. Cities need to develop strategies for senior citizens including the aspects of health, nutrition, consumer protection, housing, transportation, environment, social welfare, income, employment, safety, and education. The World Health Organization (WHO) created a program dedicated to older adults called the age-friendly city. This program is about creating the environment and opportunities that enable older people to be and do what they value throughout their lives. Most of the elderly population lives in urban spaces, and aging represents a challenge as well as opportunities to the cities all over the world. Recently, only 16 Brazilian cities have received the seal of international certification by meeting the requirements stipulated by the WHO. In the State of Sao Paulo, only two cities have been qualified for this seal. Therefore, the aims of this article are (a) to provide a brief history of this important initiative taken by the WHO and (b) to urge the decision-makers of Brazilian municipalities to develop effective initiatives for their cities to be prepared for this demographic modification.

Abstract Background: Cardiovascular disease is the leading cause of mortality in the world and physical inactivity represents an important risk factor. Objective: This study aimed to evaluate the prevalence of physical inactivity in the adult population and its effects on blood pressure, blood glucose and lipid profile. Methods: A population-based cross-sectional study with stratified simple random sampling was conducted in 1,717 adults divided by age groups: 18-39, 40-49, 50-59, 60-69 and ≥ 70 years. The participants answered the physical activity questionnaire and were classified as physically active or inactive. The bootstrap statistical method was used to assess physical activity, associated with lipid profile and blood glucose levels. The level of significance was 5%. Results: The prevalence of physical inactivity in the general population was 65.8%. There was a significant difference in the group older than 70 years. There was a significant decrease in physical activity in the group with lower educational level, with a significant difference between social classes AB and C. The prevalence of hypertension was 27.5% among physically inactive and 21.4% among active individuals (p = 0.04). The prevalence of metabolic syndrome was 26.1% in inactive and 16.7% in the active individuals (p = 0.007). Total cholesterol, low-density lipoprotein and triglycerides levels were more elevated in the physically inactive group, which was not observed with high-density lipoprotein levels. Blood glucose was also higher in the inactive group. Conclusion: This study shows a high prevalence of physical inactivity and a positive correlation between risk factors for cardiovascular disease, mainly blood pressure, glucose and lipids profiles. (Int J Cardiovasc Sci. 2018; [online].ahead print, PP.0-0)

Abstract AIM The aim of this study was to investigate the lactate response in physically inactive hypertensive women submitted to the treadmill maximal lactate steady state (MLSS) protocol. METHODS Twenty-two hypertensive women (40 - 64 years) performed a familiarization period of walking on the treadmill following by one incremental test for estimating the initial workload for exercise testing. MLSS protocol was composed by walking in a treadmill during thirty minutes with fixed velocity in 5.5 km/h. Incline was used for determination of the intensity of each volunteer. Blood samples were collected from the ear lobe in the rest period, minute 10th and at the end of the test (minute 30th or at exhaustion time point) for lactate analysis. RESULTS Hypertensive women showed a lower lactate concentration at MLSS (3.25 ± 0.81 mmol/L) as compared with data obtained in the literature (4 mmol/L), approximately 18.8%. Neither inclines nor age affected MLSS parameters in the population. A positive and strong correlation was found between incline and MLSS, as well as incline and lactate level at minute 30th, even when adjusted by age factor. CONCLUSION Physically inactive hypertensive women show a lower MLSS than the average established in the literature but within the range of variations previously reported. Furthermore, a higher MLSS incline correlates positive and directly with higher lactate concentrations for the same aerobic capacity regardless of age.

Abstract The second messenger cGMP has been largely studied as a therapeutic target in a variety of disorders such as erectile dysfunction, arterial hypertension and heart failure. Evidence has shown thatcGMP activators are less efficient in estrogen-deficiency animals, but no studies exist involving non-pharmacological approacheson NO/cGMP signaling pathway in hypertensive postmenopausal women. The aim of this study is to examine NO/cGMP pathway, redox state and blood pressure in trained treatedhypertensive (HT) postmenopausal women comparing with normotensive (NT) group. The rationale for that is most of HT patients is encouraged by physician to perform exercise associated with pharmacological treatments.Aerobic exercise training (AET) consisted of 24 sessions, 3 times/week.Parameters were evaluated at baseline and after AET for both groups (HT=28; NT=33).In treatedHT group, AET was significantly effective in increasing cGMP concentrations (28%) accompanied by an up-regulation of SOD (97%) and catalase activity (37%). In NT group, we found an increasein SOD activity (58%). TreatedHT postmenopausal women were still responsive to AET increasing cGMP levels and up-regulating antioxidant system. It should also be emphasized that these findings provide information on the circulating biomarkers that might delay the developing of cardiovascular events in this particular population.

Abstract The validity and relevance of research with animals for the development of knowledge in Exercise Science have for long been discussed. Given the complexity of the biological systems, the use of animal models offers a significant contribution to uncover new findings about acute and chronic effects of exercise, particularly when these studies in humans have limitations and ethical implications. There have been notable findings using experimental animals either in basic sciences or in clinical studies involving physiology, pharmacology, genetic, biochemistry, urology, endocrinology and cancer. This article presents a brief review of scientific research using animal models with a focus on exercise training as an effective tool for the prophylaxis and treatment of different pathological processes, which are the basis of many concepts taught and used in undergraduate courses and graduate programs, as well as in new researches showed in scientific conference meetings in numerous areas of science.

Abstract This study examined gender differences after resistance exercise (RE) by measuring fasting plasma levels of creatine kinase, lipid profile, blood glucose, adiponectin, tumor necrosis factor alpha (TNF-α), and leptin. Thirteen women (23.6 ± 7.3 years) and 11 men (29.5 ± 9 years) were enrolled in the study. Two bouts of RE were performed on two different occasions separated by 48 h each. Blood samples were collected and analyzed at baseline and 15 h after the last RE session. Increased creatine kinase levels and improvements in lipid profile and blood glucose were found for both genders. No changes in adiponectin and TNF-α levels were observed for both genders, but leptin levels were reduced (p < 0.05) only for women after RE. Collectively, our findings clearly show that RE was effective in lowering blood glucose and that this effect was not accompanied by changes in adiponectin levels in healthy subjects, indicating that RE is still an important tool for the prevention of metabolic diseases. Furthermore, two sessions of RE promoted a reduction in leptin levels in women, even though no changes in body weight were found, showing that RE is an interesting approach to study obese patients and metabolic regulation.

Abstract Alterations in the heart rate recovery and heart rate variability have been associated with greater risk of mortality and early prognosis of cardiac diseases. Thus, strategies for assessing autonomic nervous system and its modulation to the heart are crucial for preventing cardiovascular events in healthy subjects as well as in cardiac patients. In this review, an update of studies examining heart rate variability (HRV) and its use as indicator of cardiac autonomic modulation will be discussed. It will be described the indexes and methods of analysis and its applicability and the effects of exercise training on HRV and heart rate recovery in different population.

Abstract The endothelium is now recognized as an endocrine organ that acts to maintain vascular homeostasis regulating the vascular tone and structure. The endothelial cells synthetize a variety of mediators among them, the main agent is the nitric oxide (NO), a potent vasodilator. NO exerts its protective role preventing leukocyte adhesion and migration, expression of adhesion molecules, platelet aggregation, cell proliferation, and promoting the relaxation of smooth muscle cells. On the other hand, endothelial dysfunction present in many chronic diseases such as atherosclerosis, coronary artery disease, peripheral artery disease, hypertension and diabetes mellitus, is characterized by reduced NO bioavailability. Thus, a few decades ago, measurement of endothelial function has emerged as valuable tool that provides insights in the pathophysiological mechanisms, opportunity to identify early disease and cardiovascular risk, preventing future events or avoiding the progression of the disease. Diabetic patients, particularly, have been a target to apply this technique, mainly because this condition has been related with an impairment of endothelium-dependent dilation and it is believed that the endothelium dysfunction is the basis of diabetes complications such as coronary artery disease and accelerated atherosclerosis. In addition, cardiovascular complications represent the leading cause of morbidity and death in diabetes mellitus. Besides pharmacological therapy, lifestyle modifications have been recommended by specific organizations as a strategy to improve the endothelial function or even prevent the development of diabetes. The aim of this mini eview is to give an update about the importance of endothelium, most common non-invasive technique to evaluate its function, and to summarize some mechanisms involved in endothelial dysfunction and the beneficial effects of exercise in diabetes mellitus.

OBJETIVO: Analisar a influência da associação dos polimorfismos do gene da sintase do óxido nítrico endotelial (NOS3) para as posições -786T>C, Glu298Asp e íntron 4b/a e a aptidão cardiorrespiratória sobre as concentrações de nitrito/nitrato, pressão arterial, perfil lipídico e prevalência de doenças cardiometabólicas em adultos. SUJEITOS E MÉTODOS: Noventa e duas pessoas foram divididas de acordo com o genótipo: não polimórficas (NP) e polimórficas (P). Posteriormente, foram subdivididas pela aptidão cardiorrespiratória associada ao genótipo: alta (ANP e AP) ou baixa (BNP e BP). RESULTADOS: Os indivíduos que apresentavam polimorfismo para as posições Glu298Asp+Íntron 4b/a e Glu298Asp+-786T>C e baixa aptidão cardiorrespiratória apresentaram maiores valores de colesterol total e maior prevalência de dislipidemia. CONCLUSÃO: Nossos dados demonstram que os polimorfismos do gene da NOS3 para essas duas associações influenciam os níveis de colesterol plasmático, e essa associação foi mais claramente observada quando os indivíduos apresentavam menor nível de aptidão cardiorrespiratória.

OBJECTIVE: To evaluate the influence of the interaction between endothelial nitric oxide synthase gene (NOS3) polymorphisms at positions -786T>C, Glu298Asp and intron 4b/a, and cardiorespiratory fitness on plasma nitrite/nitrate levels, blood pressure, lipid profile, and prevalence of cardiometabolic disorders. SUBJECTS AND METHODS: Ninety-two volunteers were genotyped for NOS3 polymorphisms at positions (-786T>C and Glu298Asp) and (intron 4b/a) and divided according to the genotype: non-polymorphic (NP) and polymorphic (P). After that, they were subdivided according to the cardiorespiratory fitness associated with genotype: high (HNP and HP) and low (LNP and LP). RESULTS: The subjects with polymorphism for the interactions at positions Glu298Asp + intron 4b/a, and Glu298Asp+-786T>C showed the highest values in total cholesterol, as well as dyslipidemia. CONCLUSION: Our findings show that NOS3 gene polymorphisms at positions -786T>C, Glu298Asp, and intron 4b/a exert negative effects on the lipid profile compared with those who do not carry polymorphisms.

FUNDAMENTO: A doença coronária tem sido amplamente estudada em pesquisas cardiovasculares. No entanto, pacientes com doença arterial periférica (DAP) têm piores resultados em comparação àqueles com doença arterial coronariana. Portanto, os estudos farmacológicos com artéria femoral são altamente relevantes para a melhor compreensão das respostas clínicas e fisiopatológicas da DAP. OBJETIVO: Avaliar as propriedades farmacológicas dos agentes contráteis e relaxantes na artéria femoral de ratos. MÉTODOS: As curvas de resposta de concentração à fenilefrina contrátil (FC) e à serotonina (5-HT) e os agentes relaxantes isoproterenol (ISO) e forskolina foram obtidos na artéria femoral de ratos isolada. Para as respostas ao relaxamento, os tecidos foram contraídos com FC ou 5-HT. RESULTADOS: A potência de classificação na artéria femoral foi de 5-HT > FC para as respostas contráteis. Em tecidos contraídos com 5-HT, as respostas de relaxamento ao isoproterenol foram praticamente abolidas em comparação aos tecidos contraídos com FC. A forskolina, um estimulante da adenilil ciclase, restaurou parcialmente a resposta de relaxamento ao ISO em tecidos contraídos com 5-HT. CONCLUSÃO: Ocorre uma interação entre as vias de sinalização dos receptores β-adrenérgicos e serotoninérgicos na artéria femoral. Além disso, esta pesquisa fornece um novo modelo para estudar as vias de sinalização serotoninérgicas em condições normais e patológicas que podem ajudar a compreender os resultados clínicos na DAP.

BACKGROUND: Coronary heart disease has been widely studied in cardiovascular research. However, patients with peripheral artery disease (PAD) have worst outcomes compared to those with coronary artery disease. Therefore, pharmacological studies using femoral artery are highly relevant for a better understanding of the pathophysiologic responses of the PAD. OBJECTIVE: The aim of this study was to evaluate the pharmacologic properties of the contractile and relaxing agents in rat femoral artery. METHODS: Concentration response curves to the contractile phenylephrine (PE) and serotonin (5-HT) and the relaxing agents isoproterenol (ISO) and forskolin were obtained in isolated rat femoral artery. For relaxing responses, tissues were precontracted with PE or 5-HT. RESULTS: The order rank potency in femoral artery was 5-HT > PE for contractile responses. In tissues precontracted with 5-HT, relaxing responses to isoproterenol was virtually abolished as compared to PE-contracted tissues. Forskolin, a stimulant of adenylyl cyclase, partially restored the relaxing response to ISO in 5-HT-precontracted tissues. CONCLUSION: An interaction between β-adrenergic- and serotoninergic- receptors signaling pathway occurs in femoral artery. Moreover, this study provides a new model to study serotoninergic signaling pathway under normal and pathological conditions which can help understanding clinical outcomes in the PAD.

FUNDAMENTO: La enfermedad coronaria ha sido ampliamente estudiada en las investigaciones cardiovasculares. Sin embargo, los pacientes con enfermedad arterial periférica (EAP), tienen los peores resultados en comparación con aquellos con la enfermedad arterial coronaria. Por tanto, los estudios farmacológicos con la arteria femoral son extremadamente importantes para obtener una mejor comprensión de las respuestas clínicas y fisiopatológicas de la EAP. OBJETIVO: Evaluar las propiedades farmacológicas de los agentes contráctiles y relajantes en la arteria femoral de los ratones. MÉTODOS: Las curvas de concentración-respuesta a los agentes conctráctiles fenilefrina (FE) y a la serotonina (5-HT) y los agentes relajantes isoproterenol (ISO) y forskolina, se obtuvieron en la arteria femoral de ratones ya aislada. Para las respuestas a la relajación, los tejidos fueron contraídos con FE o 5-HT. RESULTADOS: La potencia de clasificación en la arteria femoral fue de 5-HT > FE para las respuestas contráctiles. En los tejidos contraídos con 5-HT, las respuestas de relajación al isoproterenol fueron prácticamente eliminadas en comparación con los tejidos contraídos con FE. La forskolina, un estimulante de la adenilil ciclasa, restauró parcialmente la respuesta de relajación al ISO en los tejidos contraídos con 5-HT. CONCLUSIÓN: Ocurre una interacción entre las vías de señalización de los receptores β-adrenérgicos y serotoninérgicos en la arteria femoral. Además, esa investigación suministra un nuevo modelo para estudiar las vías de señalización serotoninérgicas en condiciones normales y patológicas que puedan ayudar a comprender los resultados clínicos en la EAP.

FUNDAMENTO: A prevalência de dislipidemias vem aumentando em diversas partes do Brasil, porém não é claro ainda quanto de exercício físico é necessário para se obter efeitos benéficos sobre os níveis de lipoproteínas plasmáticas. OBJETIVO: O estudo analisou, em oito cidades do Estado de São Paulo, a associação entre a prática continuada de exercícios físicos ao longo da vida e a ocorrência de dislipidemia na idade adulta. MÉTODOS: Estudo transversal envolvendo 2.720 adultos, de ambos os sexos, residentes em oito cidades do Estado de São Paulo. Por meio de entrevista domiciliar, a presença de dislipidemias foi autorreferida e a prática de exercícios físicos foi analisada na infância (7-10 anos), na adolescência (11-17 anos) e na idade adulta (atividades de lazer). No tratamento estatístico, modelos multivariados foram criados com a regressão logística binária. RESULTADOS: A prevalência de dislipidemia foi de 12,2% (IC95%= 11,1%-13,5%) e não houve diferença entre as cidades (p = 0,443). Mulheres (p = 0,001) e obesos (p = 0,001) apresentaram maior taxa de dislipidemia. Exercício físico atual não se associou com a presença de dislipidemia ([> 180 minutos por semana] p = 0,165), porém, a prática de exercício físico, tanto na infância (p = 0,001) como na adolescência (p = 0,001), foi associada com menor ocorrência da doença. Adultos fisicamente ativos em todos os três momentos da vida apresentaram 65% menos chances de reportar dislipidemia (RC = 0,35 [0,15-0,78]). CONCLUSÃO: A prática continuada de exercícios físicos ao longo da vida foi associada com menor ocorrência de dislipidemia entre adultos do Estado de São Paulo.

BACKGROUND: The prevalence of dyslipidemia is increasing in many parts of Brazil, but it is yet unclear how much exercise is needed to attain beneficial effects on plasma lipoprotein levels. OBJECTIVE: The study analyzed eight cities of the state of São Paulo, the association between the continued practice of physical exercise throughout life and the occurrence of dyslipidemia in adulthood. METHODS: Cross-sectional study involving 2,720 adults, of both sexes, living in eight cities of the state of São Paulo. Through household interviews, the presence of dyslipidemia was self-reported and physical exercise practice was assessed in childhood (7-10 years), adolescence (11-17 years) and adulthood (leisure activities). In the statistical analysis, multivariate models were created using binary logistic regression. RESULTS: The prevalence of dyslipidemia was 12.2% (95%CI: 11.1% -13.5%) and there was no difference between cities (p = 0.443). Women (p = 0.001) and obese individuals (p = 0.001) had a higher rate of dyslipidemia. Current practice of physical exercise was not associated with the presence of dyslipidemia ([> 180 minutes per week] p = 0.165); however, physical exercise, both in childhood (p = 0.001) and adolescence (p = 0.001) was associated with a lower incidence of the disease. Physically active adults in all three stages of life were 65% less likely to report dyslipidemia (OR = 0.35 [0.15 to 0.78]). CONCLUSION: The continued practice of physical exercise throughout life was associated with a lower incidence of dyslipidemia in adults in the State of São Paulo.

O óxido nítrico é formado a partir da L-arginina exercendo um papel fundamental na regulação da pressão arterial, na inibição da agregação plaquetária e na gênese da aterosclerose. A maioria dos estudos mostra que os efeitos benéficos da suplementação de L-arginina está diretamente associado a maior biodisponibilidade do óxido nítrico para as células, melhorando a disfunção endotelial, reduzindo o estresse oxidativo, a dislipidemia e a resistência à insulina. No entanto, alguns estudos mostram resultados contraditórios. Considerando a importância do endotélio na etiopatogenia das DCV e das doenças endócrino-metabólicas, essa revisão terá como enfoque descrever os mecanismos moleculares de produção de NO e suas vias de sinalização no controle da função vascular. Abordar-se-á também os principais resultados obtidos em ensaios clínicos que utilizaram a suplementação oral de L-arginina, aliada ou não ao exercício físico, na tentativa de promover efeitos benéficos sobre os sistemas cardiovascular e endócrino-metabólico, em pacientes e em indivíduos saudáveis.

Nitric oxide is synthesized from L-arginine and plays an important role in blood pressure regulation, platelets aggregation and atherosclerosis development. most of the studies have shown that the beneficial effects of the L-arginine supplementation are related to an increasing of nitric oxide bioavailability to the cells, improving the endothelial dysfunction, decreasing oxidative stress, ameliorating lipid profile and insulin resistance. However some studies show conflicting results. Considering the role of the endothelium on the pathogenesis of the cardiovascular diseases as well as on the endocrine-metabolic diseases, this review will update studies involving the role of nitric oxide and its signaling pathways in the regulation of vascular function. Furthermore, this review will focus on the main results of the clinical trials using oral L-arginine supplementation, with or without physical exercise, in an attempt to obtain beneficial effects on the cardiovascular and endocrine-metabolic systems in patients and healthy subjects.

Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

Las enfermedades crónicas degenerativas constituyen una de las principales causas de muerte a nivel mundial, por lo que su crecimiento significativo ha puesto en alerta a varios países, los cuales están adoptando medidas para combatir los factores de riesgos, algunos de los cuales son modificables; siendo el ejercicio regular, un medio de prevención y rehabilitación de estas enfermedades. Esta revisión tiene por objetivo, analizar los parámetros necesarios a tomar en cuenta en la prescripción de un programa de ejercicios en pacientes con obesidad, hipertensión arterial, dislipidemia y diabetes mellitus tipo 2.

Chronic degenerative diseases constitute one of the main causes of death at a global level, and their significant increase has alerted many countries, which are taking measures to reduce risk factors, some of which are modifiable; being the regular exercise a means of prevention and rehabilitation of these diseases. The objective of this revision is to analyze the necessary parameters to take into account for the prescription of an exercise program in patients with obesity, high blood pressure dyslipidemia and diabetes mellitus type 2.

Las enfermedades crónicas degenerativas constituyen una de las principales causas de muerte a nivel mundial, por lo que su crecimiento significativo ha puesto en alerta a varios países, los cuales están adoptando medidas para combatir los factores de riesgos, algunos de los cuales son modificables; siendo el ejercicio regular, un medio de prevención y rehabilitación de estas enfermedades. Esta revisión tiene por objetivo, analizar los parámetros necesarios a tomar en cuenta en la prescripción de un programa de ejercicios en pacientes con obesidad, hipertensión arterial, dislipidemia y diabetes mellitus tipo 2.