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Programa de rehabilitación cardía= ca en adultos mayores con hipertensión arterial=

 

Cardiac rehabilitation program for older adults with hypertension=

 <= /p>

1

Gabriela Alejandra Delgado Masache

 

https://orcid.org/0000-0002-1776-7924

 

Licenciada en Tera= pia Física y Deportiva - Magister en Fisioterapia mención Cardiorespiratoria, Universidad Nacional de Chimborazo

gabriela.delgado@unach.edu.ec

2

María Fernanda Lóp= ez Merino

 

https://orcid.org/0009-0001-2585-8754  

 

 Licenciada en Terapia Física Master Universitario en Fisioterapia Respiratoria y = Cardíaca, Universidad Nacional de Chimborazo

maria.lopezm@unach.edu.ec

3

Johannes Alejandro Hernández Amaguaya

 

https://orcid.org/0000-0001-7016-8499  =

 

Licenciado en Tera= pia Física y Deportiva - Master Universitario en T= erapia Manual Universidad Nacional de Chimborazo

johannes.hernandez@unach.edu.ec

4

Ana Jeley Chucuri Mero

 

https://orcid.org/[RCD1] 0009-0001-7580-519= 1

 

Egresada de la Carrera[EC2]  de Fisioterapia, Universidad Nacional de Chimborazo

ana.chucuri@unach.edu.ec =

 

 

 

 

 

Artícu= lo de Investigación Científica y Tecnológica

Enviado: 29/10/20= 23

Revisado: 26/11/20= 23

Aceptado: 15/12/2023

Publicado:28/12/2023    <= /p>

DOI: https://do= i.org/10.33262/anatomiadigital.v6i4.3.2824

 

 

 

Cítese:

 

 

Delgado Masache, G. A., López Merino, M. F., Hernández Amaguaya, J. A= ., & Chucuri Mero, A. J. (2023). Programa de rehabilitación cardíaca en adultos mayores con hipertensión arterial. Anatomía Digital, 6(4.3), 593-= 604. https:= //doi.org/10.33262/anatomiadigital.v6i4.3.2824<= /o:p>

 

 

&= nbsp;

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La revista es editada por la Editorial Ciencia Digital (Editorial de prestigio registrada en la Cámara Ecuatoriana de Libro con No de Afiliación 663) www.celibro.org.= ec

 

 

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Esta revista está protegida bajo una licencia Creative Commons Atribución-NoComercial-CompartirIgual 4.0 International. Copia de la licencia: https://creative= commons.org/licenses/by-nc-sa/4.0/deed.es

 

Palabras claves:

hipertensión arterial, rehabilitación cardíaca, enfermedades cardiovasculares, adulto mayor.

 

Resumen

La sangre bombea bajo una presión la cual se denomina tensión arterial, se c= onsiderada normal cuando su valor es de 120/80 mmHg, sin embargo, cuando estos valor= es son más altos se considera que una persona tiene hipertensión arterial, el cual es un trastorno médico grave que incrementa potencialmente el riesgo= de desarrollar enfermedades cardiovasculares, cerebrales y renales. El objet= ivo es determinar los efectos de un programa de rehabilitación cardiaca en los adultos mayores con Hipertensión Arterial, mediante la recopilación de información bibliográfica científica publicadas en diferentes bases de da= tos, para proporcionar una información actualizada. Se demuestra que la rehabilitación cardíaca mejora los niveles de lipoproteínas de alta densi= dad, reduce los valores de los factores de riesgo como: colesterol, triglicéri= dos, presión arterial sistólica, presión arterial diastólica, índice de masa corporal perímetro abdominal. Área de estudio general: Fisioterapia. Área de estudio específica: Rehabilitación Cardiaca. Tipo de estudio:  Articulo Original .

 

 

Keywords:

high blood pressure, cardiac rehabilitatio= n, cardiovascular diseases, older adults.

 =

Abstract

Blood is pumped under pressure, which is referred to as blood pressure. It is considered normal when its value is 120/80 mmHg; however, when these values are higher, it is considered that a person has high blo= od pressure, which is a serious medical disorder that potentially increases = the risk of developing cardiovascular, cerebral, and renal diseases. The aim = is to determine the effects of a cardiac rehabilitation program in older adu= lts with hypertension by gathering scientific literature information publishe= d in different databases to provide updated information. It is demonstrated th= at cardiac rehabilitation improves high-density lipoprotein levels, reduces risk fac= tors such as cholesterol, triglycerides, systolic blood pressure, diastolic bl= ood pressure, body mass index, and waist circumference

 

 

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Introducción<= /b>

La OMS afirma que las enfermedades cardiovasculares son la principal causa de defunción a nivel mundial se est= ima que cobra 17,9 millones de vidas anualmente, estas enfermedades forman parte del grupo de afecciones cardiacas, que incluyen cardiopatías coronarias, enfermedades cerebrovasculares y cardiopatías reumáticas.

De igual manera, defi= ne a la hipertensión como un trastorno médico grave que incrementa potencialmente el riesgo de desarrollar enfermedades cardiovasculares, cerebrales, renales entre otras. Las estadísticas rev= elan que 1 de cada 4 hombres y 1 de cada 5 mujeres, se encuentran afectados, es decir más de 1000 millones de personas en el mundo = (1).

La organización Panamericana de la Salud (OPS) menciona que la hipertensión arterial (HTA) = es uno de los principales factores de riesgo para desarrollar una enfermedad cardiovascular. En todo el mundo 1,6 millones de personas menores de 70 años mueren anualmente, siendo afectada del 20 a 40 = % de la población adulta mayor = (2).

En el 2012 en Ecuador según el INEC la prevalencia de HTA en la población mayor de 50 años es de 38.7%, considerándose así la segunda causa= de muerte, mientras que el año 2015 la hipertensión arterial en conjunto con d= iferentes enfermedades incrementó los ingresos hospitalarios a 7,500 y en   2017 se reportaron 5,776 casos de hipertensión arterial primaria. Además, Ecuador es uno de los países de América Latina con las tasas más altas de H= TA con un 46%, solo el 15% de la población tiene un control adecuado, además presentan baja actividad física con un 27% (3).<= /span>=                         

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Figura1: Clasificación OMS de la presión Arterial

El objetivo determinar los efectos de un programa de rehabilitación cardiaca en los adultos mayores con Hipertensión Arterial.

La presión arterial es la fuerza que ejerce la sangre sobre las paredes de los vasos sanguíneos, la hipertensión en una condición de elevación persistente= de la presión arterial sistémica es el producto del gasto cardíaco y la resistencia vascular periférica total. Múltiples factores están involucrado= s en la regulación a corto y largo plazo de la presión arterial para una perfusi= ón tisular adecuada = (4) = (5)[RCD3] .

La organización Panamericana de la Salud (OPS) menciona que la hipertensión arterial (HTA) es uno de los principales factores de riesgo para desarrollar una enfermedad cardiovascular. En todo el mundo 1,6 millones de personas menores de 70 años mueren anualmente, siendo afectada del 20 a 40 % de la población adulta mayor. (2)

Tipos de hipertensión arterial:

Primaria o esencial: la padecen el 90 % de los pacientes siendo la más prevalente durante el envejecimiento. Además, puede originarse por la reducción de la excreción renal que eliminan la orina lo = cual retiene de forma involuntaria elevando la presión arterial.

Secundaria: corresponden a un 10% y se dan a consecuencia de medicamentos, enfermedad renal, apnea obstructiva del sueño y otras causas como hipertiroidismo, corticoides, antinflamatorios no esteroideos. (6)

Diagnostico:

El diagnostico se fundamenta en la medici= ón de la presión arterial (PA) en la consulta médica, el paciente debe estar al menos 5 minutos en reposo y al menos 30 minutos antes no hacer ejercicio físico, fumar y no ingerir alcohol. Cuando el paciente tiene cifras mayores= a 140/90 mmHg de forma continua, se recomiendan estudios complementarios como análisis de laboratorio, electrocardiograma, ecocardiograma y monitoreo ambulatorio de presión arterial (7).

Definición de rehabilitación cardiaca

De acuerdo con la Asociación Americana del corazón (American Heart Asociation) es un programa supervisado que está conformado por un equipo multidisciplinario diseñado para ayudar a los pacientes con enfermedades cardiacas, el cual puede ser ejecutado en una clínica o en un centro de rehabilitación. Asimismo, tiene como objetivo establecer una planificación para que el paciente retorne a sus actividades diarias, identificando los hábitos que deben ser modificados para tener una vida más saludable (8).

El ejercicio aeróbico y el de resistencia= son importantes en los programas de rehabilitación cardiaca debido a que aument= an la capacidad física del paciente. Deberá realizar ejercicios de intensidad moderada (9).

 

Factores de Riesgo

Modificables: son aquellos que pueden ser corregidos como, por ejemplo, el tabaquismo, diabetes, obesidad, sobrepeso, colesterol alto, sedentarismo, alto consumo = de sal y alcohol.

No modificables: se refiere a una situación donde la intervención no es posible, como en el caso de antecedentes familiares, raz= a, envejecimiento, enfermedades renales crónicas, apnea obstructiva de sueño.<= b> (4)

Rehabilitación cardiaca

De acuerdo con la Asociación Americana de= l corazón es un programa supervisado que está conformado por un equipo multidisciplin= ario diseñado para ayudar a los pacientes con enfermedades cardiacas, el cual pu= ede ser ejecutado en una clínica o en un centro de rehabilitación.

El ejercicio aeróbico y el de resistencia= son importantes en los programas de rehabilitación cardiaca debido a que aument= an la capacidad física del paciente. Deberá realizar ejercicios de intensidad moderada (9).

En la cual se trata al paciente en tres F= ases desde la parte hospitalaria, convalecencia y domiciliaria.

Fases de la rehabilitación cardiaca:

= 1.      Fase I u hospitalaria:

Se realiza cuando el paciente se encuentra hemodinámicamente estable, el objet= ivo de la rehabilitación cardiaca en esta fase será la de que el paciente pueda realizar las actividades básicas de la vida diaria, incluyendo el cuidado personal y la deambulación. La función del fisioterapeuta es realizar movilizaciones activas y pasivas en las extremidades superiores e inferiore= s.

= 2.      Fase II o de convalecencia:

Consta principalmente de un equipo multidisciplinario conformado por cardiólogo, psicólogo, enfermero, fisioterapeuta y nutricionista los cuales tendrán diferentes funciones que cumplir. Esta fase se realizará en los tres primeros meses para modificar los factores de riesgo cardiacos. El fisioterapeuta debe implementar un programa de ejercicio físico individuali= zado y diseñado a las necesidades del paciente.

 

 

= 3.      Fase III o de mantenimiento:

El ejercicio físico se realizará en el domicilio o en el centro de rehabilitac= ión, los cuales deben estar acompañados sobre hábitos de vida saludables encamin= ados a mantener y mejorar los hábitos adquiridos en la fase anterior (10).

Metodología

El tipo de investigación es práctica docum= ental bibliográfico, y descriptiva en la cual se efectuó la lectura y análisis de varios artículos científicos con la temática “Programa de rehabilitación cardíaca en adultos mayores con hipertensión”, El método utilizado fue inductivo, ya que fue necesario realizar un análisis de las conclusiones generales posteriores al proceso de observación indirecta y del análisis e interpretación de la información específica sobre el programa de rehabilita= ción cardiaca la cual incluye al ejercicio físico en adultos mayores con Hipertensión Arterial.

De un total de 100 artículos recolectados = de las diferentes bases de datos, se incluyeron 35 artículos científicos de pacientes que cumplieron con las variables hipertensión arterial y rehabilitación cardíaca. Después de identificar los artículos científicos q= ue corresponden al programa de rehabilitación cardíaca en adultos mayores con hipertensión arterial, se realizó el reconocimiento de la calidad metodológ= ica de los artículos, para lo cual se utilizó la escala de PEDro. Al ser un est= udio documental bibliográfico no se necesitó autorización de instituciones, consejos científicos, comité de ética, consentimiento informado[RCD4] .

Discus= ión

La hipertensión arterial se incrementa principalmente en países en vía de desarrollo, considerándose así una causa principal de mortalidad y morbilidad. A nivel mundial 1,6 millones de perso= nas mueren anualmente, siendo afectada del 20 a 40 % de la población adulta may= or (Brandão et al.,2020). De acuerdo con los resultados de los artículos menci= onan que la mayoría de la población de estudio fue de sexo masculino, que tienen= un rango de 54 a 77 años. En cuanto a los factores qué se encuentran asociados= a la hipertensión son: tabaco, obesidad, dislipidemia, sedentarismo y raza ne= gra (11), (12). (13)

El programa de rehabilitación cardiaca en adultos mayores hipertensos es un tratamiento multidisciplinario que se basa en el ejercicio físico, educación nutricional, y tratamiento farmacológico, cuyo objetivo es ayudar a preveni= r y disminuir los factores de riesgo que presentan las enfermedades cardiovasculares. (12), (14).

A través de los estudios realizados por (11), (15), (13). Donde se apl= icó la prueba de caminata de 6 minutos para valorar diferentes parámetros como: presión arterial, índice de masa corporal, y frecuencia cardíaca obteniendo como resultados la disminución de la presión arterial tras realizar la actividad física mejorando la calidad de vida de los pacientes hipertensos. Además, en el estudio de (13) se pudo demos= trar un aumentó de distancia recorrida en la prueba de caminata de 6 minutos de = 30,6 m y 55 metros, mientras que en el estudio de (16) se observó un aumento de la frecuencia cardiaca después de la prueba de caminata de 6 min= utos en hombres de 97 a 112 Lpm y en mujeres de 100 a 110 Lpm.=

En la revisión de artículos que implementaron el ejercicio aeróbico 3 veces a = la semana con un periodo de tiempo de 60 minutos en el que se realizaba 5 minu= tos de calentamiento, ejercicio de fuerza por 20 minutos con un peso de 2 a 4 l= b, con una frecuencia cardiaca máxima de 50% y 75% para aquellos pacientes que tomaban medicamentos betabloqueantes. Es decir, la PAS disminuyó 13 mmHg en= el grupo con insuficiencia cardíaca y 10 mmHg en el grupo de disfunción ventricular, de igual forma mejoró la capacidad aeróbica = (17).

La rehabilitación cardíaca domiciliaria y convencional que incluyeron un progr= ama de nutrición como lo mencionan (18), (19), (20) y (21) el medico nutricionista asesoró personalmente al paciente en una dieta semanal que se basó en vegetales, frutas, verduras, legumbres y mariscos demostraron resultados positivos en la presión arterial y una mejora de hábitos higiéni= cos alimenticios.

Asimismo, en los estudios de autores como (14), (19), (20) (21) evidenciaron = que los pacientes que recibieron terapia psicológica que se basó en llamadas telefónicas personalizadas mostraron una disminución de la ansiedad mejoran= do la conducta y abandonando el hábito tabáquico.

En planes con programas educativos que incluyó vídeos, sesiones grabadas quincenalmente y videoconferencia a través de las plataformas zoom en el qu= e se proporcionó información de la etiología, tratamiento farmacológico y cómo controlar los factores de riesgos cardiovasculares obteniendo la disminució= n de la disnea y la presión arterial de 7mmHg (21). Mientras que= (22). entregó semanalmente material educativo que incluyó educación sobre la hipertensión, diabetes, salud cardiovascular, nutrición saludable, medicamentos, bienestar psicológico y abandono del tabaco teniendo como resultado la disminución de= la presión arterial sistólica de 130 a 122 mmHg de igual manera presentó menor LDL-C. Por otra parte, se encuentra los diferentes tipos de ejercicio, duración, intensidad. Sin embargo, los materiales educativos fueron creados= a través de las recomendaciones basadas y aprobadas por médicos.

Mediante el estudio realizado por <= !--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemDa= ta":{"ISSN":"15651088","PMID":"3255= 8441","abstract":"Background: Cardiac rehabilitation (CR) is underutilized globally despite evidence of clinical benefit. Major obstacles for wider adoption include distance from = the rehabilitation center, travel time, and interference with daily routine. Tele-cardiac rehabilitation (tele-CR) can potentially address some of these limitations, enabling patients to exercise in their home environment or community. Objectives: To evaluate the clinical and physiological outcomes = as well as adherence to tele-CR in patients with low cardiovascular risk and to assess exercise capacity, determined by an exercise stress test, using a treadmill before and following the 6-month intervention. Methods: A total o= f 22 patients with established coronary artery disease participated in a 6-month tele-CR program. Datos Health (Ramat Gan, Israel), a digital health applica= tion and care-team dashboard, was used for remote monitoring, communication, and management of the patients. Results: Following the 6-month tele-CR intervention, there was significant improvement in exercise capacity, asses= sed by estimated metabolic equivalents with an increase from 10.6 ± 0.5 to 12.3= ± 0.5 (P =3D 0.002). High-density lipoproteins levels significantly improved, whereas low-density lipoproteins, triglyceride, glycosylated hemoglobin, and systolic and diastolic blood pressure levels were not significantly changed. Exercise adherence was consistent among patients, with more than 63% of patients participating in a moderate intensity exercise program for 150 min= utes per week. Conclusions: Patients who participated in tele-CR adhered to the exercise program and attained clinically significant functional improvement. Tele-CR is a viable option for populations that cannot, or elect not to, participate in center-based CR programs.","author":[{"dropping-particle":"&q= uot;,"family":"Nabutovsky","given":"Iren= e","non-dropping-particle":"","parse-names&qu= ot;:false,"suffix":""},{"dropping-particle":&= quot;","family":"Ashri","given":"Sa= ar","non-dropping-particle":"","parse-names&q= uot;:false,"suffix":""},{"dropping-particle":= "","family":"Nachshon","given":&quo= t;Amira","non-dropping-particle":"","parse-na= mes":false,"suffix":""},{"dropping-particle&q= uot;:"","family":"Tesler","given":&= quot;Riki","non-dropping-particle":"","parse-= names":false,"suffix":""},{"dropping-particle= ":"","family":"Shapiro","given"= ;:"Yair","non-dropping-particle":"","par= se-names":false,"suffix":""},{"dropping-parti= cle":"","family":"Wright","given&qu= ot;:"Evan","non-dropping-particle":"","p= arse-names":false,"suffix":""},{"dropping-par= ticle":"","family":"Vadasz","given&= quot;:"Brian","non-dropping-particle":"",&quo= t;parse-names":false,"suffix":""},{"dropping-= particle":"","family":"Offer","give= n":"Amir","non-dropping-particle":"",&qu= ot;parse-names":false,"suffix":""},{"dropping= -particle":"","family":"Grosman-Rimon",&= quot;given":"Liza","non-dropping-particle":"&= quot;,"parse-names":false,"suffix":""},{"= ;dropping-particle":"","family":"Klempfner&qu= ot;,"given":"Robert","non-dropping-particle":= "","parse-names":false,"suffix":""}= ],"container-title":"Israel Medical Association Journal","id":"ITEM-1","issue":"6&q= uot;,"issued":{"date-parts":[["2020"]]},"= ;page":"357-363","title":"Feasibility, safety, and effectiveness of a mobile application in cardiac rehabilitation","type":"article-journal","vol= ume":"22"},"uris":["http://www.mendeley.com/d= ocuments/?uuid=3D161b5edd-85fc-4365-b9a0-b777e4e520e8"]}],"mendel= ey":{"formattedCitation":"(23)","plainTextFor= mattedCitation":"(23)","previouslyFormattedCitation&quo= t;:"(23)"},"properties":{"noteIndex":0},"= ;schema":"https://github.com/citation-style-language/schema/raw/m= aster/csl-citation.json"}(23) donde se aplicó a un grupo de pacientes rehabilitación cardíaca se observó la mejora solamente de los niveles de lipoproteínas de alta densidad, mientras que (14) y (24) demostraron una reducción significativa en los valores de los factores de riesgo como: colesterol en un 16,85%,), triglicéridos 12,19%, presión arterial sistólica (5,29 mmHg), presión arter= ial diastólica (3,46 mmHg, índice de masa corporal (IMC) y perímetro abdominal.=

Por otra parte en los estudios de <= !--[if supportFields]>ADDIN CSL_CITATION {"citationItems":[{"id":"ITEM-1","itemDa= ta":{"DOI":"10.1016/j.rh.2021.04.002","ISSN&q= uot;:"15783278","PMID":"33958199","abstr= act":"Introduction and objective: Cardiac rehabilitation has the highest level of recognition = in medical guideline references. The rise of COVID-19 pandemic, particularly during the first months of strict containment, cause to temporally stop mos= t of the ongoing programs. We studied the effects of an interdisciplinary phase = II secondary prevention in patients diagnosed with a recent acute coronary syndrome with the use of new technologies, home-exercise and telemedicine. Methods: Between the 2nd and 11th of March 2020, we included 37 patients wi= th recent acute coronary syndrome (76.4%), low-risk and preserved systolic fun= ction and underwent a 12-week treatment. A dynamic muscle toning with overload domiciliary training program was applied, in addition to nutritional counselling, as well as psychological and educational therapy. Results: Of = the initial cohort, 30 patients finished. At the end of the program, we observed and increased functional capacity over the 6-min walking test (+47.13 m; 95% CI: 32.82-61.45, P <.001), and improvement to the subjective feeling of dyspnoea on the modified Borg scale (−0.5 units; 95% CI: −0.76 = to −0.24, P =3D.001), and an improvement over both initial and final tra= ining systolic blood pressure (−6.67 mmHg; 95% CI: −10.98 to −2= .35, P =3D.004) (−7 mmHg; 95% CI: −12.86 to −1.14, P =3D.021).= We also observed an increase in the level of physical activity during leisure time = in the IPAQ questionnaire (+1162.93 min/week; 95% CI: 237.36–2088.5, P =3D.016= ), and in the Mediterranean eating habits on the PREDIMED test (+2.1 units; 95% CI: 1.32–2.28, P <.001). Conclusions: After three months of a domiciliary cardiac rehabilitation program, patients increased their functional capacit= y, feeling of dyspnoea, blood pressure and eating habits. Domiciliary telemedi= cine cardiac rehabilitation program produces an improvement in the patient after acute coronary syndrome.","author":[{"dropping-particle= ":"","family":"Arias Labrador","given":"E.","non-dropping-particle= ":"","parse-names":false,"suffix":"= "},{"dropping-particle":"","family":&quo= t;Vilaró Casamitjana","given":"J.","non-dropping-parti= cle":"","parse-names":false,"suffix":&qu= ot;"},{"dropping-particle":"","family":&= quot;Blanco Díaz","given":"S.","non-dropping-particle&quo= t;:"","parse-names":false,"suffix":"&quo= t;},{"dropping-particle":"","family":"Ar= iza Turiel","given":"G.","non-dropping-particle&q= uot;:"","parse-names":false,"suffix":"&q= uot;},{"dropping-particle":"","family":"= Paz Bermejo","given":"M. A.","non-dropping-particle":"","parse-names&q= uot;:false,"suffix":""},{"dropping-particle":= "","family":"Brugada Terradellas","given":"R.","non-dropping-parti= cle":"","parse-names":false,"suffix":&qu= ot;"}],"container-title":"Rehabilitacion","id= ":"ITEM-1","issue":"1","issued"= ;:{"date-parts":[["2022"]]},"page":"11-1= 9","publisher":"Sociedad Espa&ntilde;ola de Rehabilitaci&oacute;n y Medicina F&iacute;sica","title":"Effects of home-based stren= gth training during COVID-19 lockdown in acute coronary syndrome","type":"article-journal","volume&qu= ot;:"56"},"uris":["http://www.mendeley.com/documen= ts/?uuid=3Dad35dd06-299f-4cf1-8787-42732d8d5591"]}],"mendeley&quo= t;:{"formattedCitation":"(21)","plainTextFormatted= Citation":"(21)","previouslyFormattedCitation":&qu= ot;(21)"},"properties":{"noteIndex":0},"schem= a":"https://github.com/citation-style-language/schema/raw/master/= csl-citation.json"}(21) y (25) coinciden que la rehabilitación cardíaca disminuye la disnea, incluso en el estudio realizado por (16) se demostró que la rehabilitación cardíaca redujo los niveles de estrés y mejoró el estado de ánimo de los pacientes.<= o:p>

Conclu= siones

·         Los programas de rehabilitación cardiaca deben estar conformados por un equipo médico multidisciplinario quienes serán los encargados de enseñar, brindar seguridad, controlar y supervisar a los pacientes con la finalidad de evitar complicaciones durante el desarrollo del tratamiento.

·         Es importante que los pacientes que presentan hipertensión arterial realicen rehabilitación cardiaca de forma rutinaria ya que  esta patología es una de las causas más frecuentes de mortalidad y morbilidad a nivel mundial, dentro de la recopilación bibliográfica se han encontrado efectos positivos de la rehabilitación cardiaca convencional o domiciliaria en la disminución de la tensión arterial, así como también de diferentes factores de riesgo como triglicéridos, colesterol, índice de masa corporal. También, reduce los niv= eles de estrés y ansiedad mejorando la calidad de vida de los pacientes.

·         Estudios recientes demuestran que la rehabilitación cardíaca ha sido combinada con el ejercicio interválico de alta intensidad mostrando efectos positivos en la reducción de la presión arterial y aumento de la capacidad aeróbica de los pacientes y asimismo el entrenamiento con agarre isométrico mostró reduccio= nes, pero no es recomendado para aquellos pacientes que han tenido con anteriori= dad problemas cardiacos.

Conflicto de intereses

No existe conflicto de intereses = por parte de los autores

Declaración de contribución de los autores[RCD5] 

Gabriela Alejandra Delgado Masache: revisión sistemática, redacción, estructura y contenido.

María Fernanda López Merino: síntesis de resultados, conclusión, redacción. =

Johannes Hernández Amaguaya:  metodología, análisis de resultados y revisión.

Ana Jeley Chucuri Mero: proceso de revisión sistemática y redacción final

Referencias bibliográficas

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2.=        Organzación Panamerica De la Salu= d. Hipertensión. 2022; Available from: https://www.paho.org/es/temas/hipertension

3.=        J C. ‘En América Latina, el país = con la mayor prevalencia de hipertensión es el Ecuador.’ INFOMED [Internet]. 2012; Avail= able from: https://temas.sld.cu/hipertension/tag/ecuador/

4.=        PERADEJORDI. Vigilancia médica pa= ra la prevención del riesgo cardiovascular [Internet]. Available from: https://peradejordi.com/es/vigilancia-medica-para-la-prevencion-del-riesg= o-cardiovascular/

5.=        Pérez RFT, León MSQ, Rodríguez MR= P, Toca EPM, Orellana FMÁ, Toca SCM, et al. Risk factors for essential blood hypertension and cardiovascular risk. Rev Latinoam Hipertens. 2021;16(4):321–8.

6.=        Santamaría Olomo R, Gorostidi M. Hipertensión arterial secundaria. Soc Española Nefrol . 2021;1–18. <= /o:p>

7.=        Sosa-Rosado JM. Tratamiento no farmacológico de la hipertensión arterial. An la Fac Med. 2011;71(4):241.=

8.=        American Heart Association. ¿ Qué= es la rehabilitación cardíaca ? [Internet]. Respuestas del Corazón. 2020. Available from: https://www.heart.org/-/media/Files/Health-Topics/Answers-by-Heart/Answer= s-by-Heart-SPANISH/What-is-Cardiac-Rehab-Spanish.pdf

9.        European Asociation of Preventive Cardiology. Re= habilitación cardíaca – ¿qué, por qué y cuándo? [Internet]. Healthy Heart.org. 2022. Available fr= om: https://www.healthy-heart.org/es/vivir-con-una-cardiopatia/mejore-el-esta= do-de-su-corazon/?gclid=3DCj0KCQjwjIKYBhC6ARIsAGEds-L9GE22QKrBbXH8MNOukBCO6= t2dS7Jj0xhI2DSyDCCA2m6A4lbejqcaAigUEALw_wcB

10= .      D DL, Muñoz M OC. La antropometría = en el reconocimiento del riesgo cardiovascular. Rev Cuba Aliment Nutr. 2017;23(1):1561–2929.

11= .      Maldonado ACD, Prado JP, Aquino TN = de, Vidigal F de C, Borges JBC, Souza GG de. Effect of cardiac rehabilitatio= n on the nociceptive threshold increased of hypertensive subjects. Fisioter Bras. 2022;23(3):357–71.

12= .      Brandão Rondon MUP, Alves MJNN, Bra= ga AMFW, Teixeira OTUN, Barretto ACP, Krieger EM, et al. Postexercise blood pressure reduction in elderly hypertensive patients. J Am Coll Cardiol. 2002;39(4):676–82.

13= .      Parreira LB, de Oliveira Vitorino P= V, Jardim PCBV, Sousa ALL, Jardim TV, de Moura Sousa W, et al. Comparison Between Supervised a= nd Partly Supervised Cardiac Rehabilitation Protocols in Hypertensive Patien= ts: A Randomized Controlled Trial. Cu= rr Hypertens Rev. 2018;14(2):161–9.

14= .      Fernandez Ortega L, García Abad M d= el M, Ferreira Diaz MJ, María del Carmen Coria  Abel, Marta Cerecedo Fernández, María Isabel Imedio Granullaque, et al. Eficacia de un programa de rehabilitación cardiaca en el control de l= os factores de riesgo cardiovascular: experiencia durante el primer año en nuestro centro. Enfermería en Cardiol. 2022;(85):5–12. =

15= .      Rocio E, Fl T. ´ Arterial en prueba= de marcha de 6 comportamiento de la presi on. 2020;15(1):42–7.

16= .      Araya Felipe. Evidencia Científica = de la Rehabilitación Cardiaca en Costa Rica. Rev Costarric Cardiol. 2021;23.=

17.      Ávila-Valencia JC, Hurtado-Gutiérrez H, Benavides-Córdoba = V, Betancourt-Peña J. Aerobic exercise in patients with heart failure with a= nd without ventricular dysfunction in a cardiac rehabilitation programme. Rev Colomb Cardiol. 2019;26(3):162–8.

18.      Blumenthal JA, Hinderliter AL, Smith PJ, Watkins LL, Craig= head L, Ingle K, et al. Hypertension : Results of the TRIUMPH Randomized Clinical Trial. Pmc. 2022;144(15):1212–26.

19.      Anghel R, Adam CA, Marcu DTM, Mitu O, Roca M, Tinica G, et= al. Cardiac Rehabilitation in Peripheral Artery Disease in a Tertiary Center—Impact on Arterial Stiffness and Functional Status after 6 Months.= Life. 2022;12(4).

20= .      Heredia Ñahui MA, Férnandez C. R, Fernández C. J, Heredia Ñ. M, Gordillo M. X, Palomino R, et al. Rehabilitación Cardiaca En Pacientes Con Cardiopatía Coronaria En El Instituto Nacional Cardiovascular De Essalud Setiembre 2017-Febrero 2018.= Rev Médica Basadrina. 2019;13(1):16–21.

21= .      Arias Labrador E, Vilaró Casamitjan= a J, Blanco Díaz S, Ariza Turiel G, Paz Bermejo MA, Brugada Terradellas R. Eff= ects of home-based strength training during COVID-19 lockdown in acute coronary syndrome. Rehabilitacion [Internet]. 2022;56(1):11–9. Available from: https://doi.org/10.1016/j.rh.2021.04.002

22= .      Ma J, Ge C, Shi Y, Xu Y, Zhao C, Ga= o L, et al. Chinese Home-Based Cardiac Rehabilitation Model Delivered by Smartph= one Interaction Improves Clinical Outcomes in Patients With Coronary Heart Disease. Front Cardiovasc Med. 2021;8(October):1–11.

23.      Nabutovsky I, Ashri S, Nachshon A, Tesler R, Shapiro Y, Wr= ight E, et al. Feasibility, safety, and effectiveness of a mobile application = in cardiac rehabilitation. Isr Med Assoc = J. 2020;22(6):357–63.

24= .      Mamataz T, Alamc SI, Pakosh M, Grac= ia SL. Efectos de la rehabilitación cardíaca en países de ingresos bajos y medianos : una revisión sistemática y metanálisis de ensayos controlados aleatorios. 2022;70(May 2020).

25= .      Tino Martinez MJ, Lerma Espinosa R, Llaguno López R, Trejo Bahena NI, Ocaña Sánchez MA, Cortés Benítez A. Efe= cto de la rehabilitación cardiaca fase II en pacientes con insuficiencia card= iaca diagnosticados con miocardio no compacto. Rev Sanid Milit. 2018;72(2):84–= 9. <= /p>

 

 

 

 

 

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El artículo que se publica es de exclusiva responsabilidad de los autores y no necesariamente reflejan el pensamiento = de la Revista Anatomía Digital.

 

 

 

 

El artículo queda en propiedad de la revista y, por tanto, su publicación parcial y/o total en otro medio tiene = que ser autorizado por el director de la Revista Anatomía Digital.<= /o:p>

 

 

 

 

 


 

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Vol. 6 No. 4.3, pp. 593 – 604, diciembre 20= 23

 

 

 

 

 

                                      Ciencias Médicas         =          Página 591 | 604

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