Effect of Physical Training on Nitric Oxide Levels in Patients with Arterial Hypertension: An Integrative Review

• Published in: International journal of cardiovascular sciences
• Main Authors: Facioli, Tábata de Paula, Buranello, Mariana Colombini, Regueiro, Eloisa Maria Gatti, Basso-Vanelli, Renata Pedrolongo, Durand, Marina de Toledo
• Format: Journal Article
• Language: English
• Published: Sociedade Brasileira de Cardiologia 2022
• Subjects: CARDIAC & CARDIOVASCULAR SYSTEMS; Blood Pressure; Hypertension; Endothelium Dependent Relaxing Factors; Exercise; Physical Conditioning Human; Nitric Oxide; Vasoactive Substances; Cardiovascular System
• ISSN: 2359-4802; 2359-5647; 2359-5647
• DOI: 10.36660/ijcs.20200244

Abstract The regular practice of physical exercise as a non-pharmacological treatment of arterial hypertension (AH) has been encouraged due to causing a series of physiological responses in the cardiovascular system, such as the production of vasoactive substances, including nitric oxide (NO). NO is a relaxation factor released by the endothelium, and the decrease in its bioavailability is related to coronary and arterial diseases, such as AH. This study aimed to perform an integrative literature review to elucidate the effect of physical training on NO levels in patients with AH and to establish a relationship between these levels and blood pressure (BP) control. A literature review was was performed by searching PubMed / MEDLINE, Lilacs, Scielo, Cinahl and Embase databases. The search string used was ("arterial hypertension" OR hypertension) AND (exercise OR "physical exercise" OR "aerobic exercise" OR "exercise training" or "physical activity") AND ("nitric oxide"). We included fully available controlled and uncontrolled clinical trials published in English and Portuguese languages in the last 10 years. The review consisted of 16 articles, of which 13 reported an increase in NO production after the physical training intervention, and three studies found no change. In addition, 15 studies observed a reduction in BP after the intervention. In conclusion, regular practice of physical exercises, advocating moderate intensity, can improve NO bioavailability in pre-hypertensive and hypertensive individuals, which seems to be one of the mechanisms responsible for BP reduction.