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Effects of physical activity on heart rate variability in adults with overweight or obesity: A systematic review and meta-analysis
Efecto del ejercicio físico sobre la variabilidad de la frecuencia cardiaca en adultos con sobrepeso u obesidad. Revisión sistemática y metaanálisis
DOI:
https://doi.org/10.15446/revfacmed.v71n4.107632Palabras clave:
Autonomic Nervous System, Exercise, Obesity, High-Intensity Interval Training (en)Sistema nervioso autónomo, Ejercicio, Obesidad, Entrenamiento intervalado de alta intensidad (es)
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Introduction: Cardiovascular autonomic dysfunction is a cardiovascular risk factor associated with various health conditions, mainly in individuals with overweight and obesity. In this regard, heart rate variability (HRV) is one of the tools that allow evaluating the activity of the autonomic nervous system (ANS), facilitating the physiological characterization and diagnosis of any individual.
Objective: To determine the effect of physical activity on HRV in adults with overweight or obesity (>18 years old).
Materials and methods: Systematic review. Cochrane, Medline, Embase, Lilacs, and PEDro databases were systematically searched using the following search strategy: study types: randomized controlled trials (RCTs) assessing the effect of exercise-based interventions on HRV parameters in individuals with overweight and obesity; publication period: January 2015 to June 2021; language: English; search terms: MeSH terms combined with Boolean operators “AND” and “OR”. The review protocol was registered in PROSPERO (code: CRD42021224027). Risk of bias was assessed using the Cochrane risk of bias assessment tool. A random-effects meta-analysis was performed to estimate the pooled effect for each outcome variable (HRV parameter) when the pooling of data was possible. Subgroup analyses were also performed to make comparisons between the different interventions. A significance level of p<0.05 was considered.
Results: The initial searches yielded 2 650 studies; of these, only 10 RCTs met the inclusion criteria. There were no statistically significant differences between the intervention and control groups in terms of changes in the HRV parameters: standard deviation of normal-to-normal R-R (NNN) intervals (SDNN): (weighted mean difference [WMD]=1.30, 95%CI: -5.93 to 8.53; p=0.72); root mean square of successive R-R interval differences (RMSSD): (WMD=0.79, 95%CI: -0.29 to 1.87; p=0.15); high frequency (HF): (WMD=6.67, 95%CI: 1.71 to 11.63; p=0.008), and low frequency (LF): (WMD=-0.32, 95%CI: -0.73 to 0.10; p=0.13).
Conclusions: Physical activity did not affect any of the HRV parameters studied in adults with overweight or obesity.
Introducción. La disfunción autonómica cardiaca es un factor de riesgo cardiovascular asociado a diversas condiciones de salud, principalmente en personas con sobrepeso y obesidad. Al respecto, la variabilidad de la frecuencia cardiaca (VFC) es una de las herramientas que permite evaluar la actividad del sistema nervioso autónomo (SNA), facilitando así la caracterización fisiológica y el diagnóstico de cualquier individuo.
Objetivo. Determinar el efecto del ejercicio físico sobre la VFC en adultos (>18 años) con sobrepeso u obesidad.
Materiales y métodos. Revisión sistemática. Se realizaron búsquedas sistemáticas en Cochrane, Medline, Embase, Lilacs y PEDro mediante la siguiente estrategia de búsqueda: tipos de estudio: ensayos aleatorios controlados (ECA) que evaluaron el efecto de las intervenciones basadas en ejercicio físico sobre los parámetros de VFC en adultos con sobrepeso u obesidad; período de publicación: de enero 2015 a junio 2021; idioma: inglés; términos de búsqueda: términos MeSH combinados con los operadores booleanos “AND” y “OR”. El protocolo fue registrado en PROSPERO (código: CRD42021224027). El riesgo de sesgo se evaluó mediante la herramienta Cochrane de evaluación del riesgo de sesgo. Se realizó un metaanálisis de efectos aleatorios para estimar el efecto agrupado de cada variable de resultado (parámetro VFC) cuando fue posible agrupar los datos. También se realizaron análisis de subgrupos para hacer comparaciones entre las diferentes intervenciones. Se consideró un nivel de significancia de p<0.05.
Resultados. Las búsquedas iniciales arrojaron 2 650 estudios; de estos, 10 ECA cumplieron los criterios de inclusión. No hubo diferencias estadísticamente significativas entre los grupos de intervención y control en los parámetros de la VFC: desviación estándar de los intervalos R-R normales (SDNN): (diferencia de medias ponderadas: [DMP]=1.30, IC95%: -5.93 a 8.53; p=0.72); raíz de la media cuadrática de las diferencias de los intervalos R-R sucesivos (RMSSD): (DMP=0.79, IC95%: -0.29 a -1.87; p=0.15); alta frecuencia (AF): (DMP=6.67, IC95%: 1.71 a 11.63; p=0.008), y baja frecuencia (BF): (DMP=-0.32, IC95%: -0.73 a 0.10; p=0.13).
Conclusiones. El ejercicio físico no afectó ninguno de los parámetros de la VFC estudiados en adultos con sobrepeso u obesidad.
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