ISSA Hypertension Evaluation
Hypertension is a chronic condition characterized by sustained elevated arterial blood pressure. Current guidelines define hypertension as systolic blood pressure above 130mmHg and diastolic blood pressure of more than 80mmHg (Meisel). Hypertension is a silent, insidious disease. Complications of this disease have been implicated in significant morbidity and mortality. Cerebrovascular infarction and myocardial infarction are macrovascular complications of hypertension that have resulted in several fatalities. Its management is key in preventing complications attributable to the condition.
On self-hypertension evaluation, the resting blood pressure was found to be 124/82mmHg. On moderate exercise, the readings were 140/85mmHg and 122/81mmHg after a moderate bench press. Changes in blood pressure readings were noted on different occasions. Considerable increases in blood pressure readings were established upon moderate exercising. A slight decrease in blood pressure was noted when the readings were taken shortly after a bench press exercise.
Exercise causes an increase in blood pressure. Increases in blood pressure seen during exercise activities often correspond to the intensity of the exercise. More intense exercise results in higher increases in blood pressure. Blood pressure usually returns to normal briefly after exercising. A quick return to normal blood pressure after exercising has been linked to better cardiovascular health. After exercise activities, blood pressure may sometimes fall to values lower than the initial resting blood pressure. This is mostly seen after intense exercise activities and is due to the pooling of blood in the muscles.
Changes in blood pressure readings seen during exercise activities vary across individuals and are dependent on the type and intensity of exercise conducted. Supine and seated bench press differ in the range of their muscular involvements. The supine bench press provides a wider range of muscle involvements and is more likely to produce higher increases in blood pressure compared to the seated bench press. Breath-holding also produces changes in blood pressure. Blood pressure is found to be slightly elevated after brief moments of holding breath. This increase is due to the reactive mechanism to offset respiratory acidosis caused by CO2 buildup upon holding breath.
Non-pharmacological interventions remain the first line in managing all new hypertensive patients. Non-pharmacological interventions are recommended for all patients presenting to the clinic with elevated blood pressure, regardless of their gender, age, cardiovascular risk status, and potential comorbidities. Lifestyle changes, such as exercising, dietary modification, weight reduction, and smoking cessation, among others, remain key modalities employed in the non-pharmacological management of hypertension. Below is a comprehensive exercise program for an adult male aged 50 years presenting with a resting blood pressure of 145/92.
The exercise program for the male adult individual will be composed of aerobic exercises, flexibility exercises, and dynamic resistance exercises. These exercises will be tailored to the individual to meet the physical and physiologic capabilities of the body. This individual will engage in aerobic exercise 5-7 days a week. Aerobic exercises will be supplemented by flexibility exercises 2-3 days a week and dynamic resistance exercises 2-3 days a week.
Aerobic exercises should be done more frequently by this individual. Frequent aerobic exercises have been linked to blood pressure decreases of between 5-8mmHg, persisting for close to 24 hours (Pedersen and Saltin). The client should, therefore, be advised to practice frequent aerobic exercise for better sustained results. The intensity of these exercises should be that which causes noticeable increases in breathing and heart rate. Blood pressure reductions are realized when more intense and vigorous exercises are conducted. The intensity should however not be so much that it causes physical distress to the individual. These exercises should be done under close monitoring by a specialist to prevent any complications that may be detrimental to the individual.
The duration of each exercise should be established based on the individual’s tolerance to the exercise. However, standard exercise time may be necessary for this individual. A minimum of 30 minutes is required for aerobic exercises. Intermittent aerobic exercise is also recommended, especially for individuals with low exercise tolerance. Intermittent exercising, characterized by short bouts of aerobic exercise of about 3-5 minutes spread across the day, has been linked to considerable decreases in blood pressure (Zaleski). Intermittent exercise is preferred in older adults due to its efficacy in lowering blood pressure and its tolerability in these individuals.
The type of exercise also matters. For aerobic exercises, greater emphasis is placed on rhythmic activities that utilize large groups of muscles. Such activities include walking, swimming, and cycling. Resistance training should consist of at least 2 sets of at least 8 repetitions for each of the muscle groups utilized. Holding each muscle for at least 30 seconds and in at least 3 repetitions is recommended for flexibility exercises. Balance training may also be necessary for this individual. Balance training has been linked to good physical strength in older adults (Zaleski). Its inclusion in the exercise program is therefore necessary.
Hypertension remains a health concern in adulthood. Proper management prevents the occurrence of complications attributable to the condition. Non-pharmacological interventions such as exercise are recommended for all patients presenting with elevated blood pressure. Exercise programs for older adults should be tailored to meet the physical capabilities of an individual. Balance training, flexibility exercise, and aerobic exercises have been implicated in considerable decreases in blood pressure.
Meisel, Peter. “Hypertension, Diabetes”. Hypertension, vol 46, no. 5, 2018. Ovid Technologies (Wolters Kluwer Health), https://doi.org/10.1161/01.hyp.0000188406.38247.fd.
Pedersen, B. K., and B. Saltin. “Exercise As Medicine – Evidence For Prescribing Exercise As Therapy In 26 Different Chronic Diseases”. Scandinavian Journal Of Medicine &Amp; Science In Sports, vol 25, 2015, pp. 1-72. Wiley, https://doi.org/10.1111/sms.12581.
Zaleski, Amanda. “ACSM Blog”. ACSM_CMS, 2022, https://www.acsm.org/blog-detail/acsm-certified-blog/2019/02/27/exercise-hypertension-prevention-treatment.
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Perform a hypertension evaluation on yourself. (This evaluation is to be done only if medically approved.) The purpose of this assignment is to understand the body’s basic response to exercise. Take a resting blood pressure. After taking the blood pressure, take your blood pressure while doing moderate to vigorous aerobic exercise. On another occasion, take your blood pressure after doing mild- moderate arm curls also mild- moderate bench presses, then take your blood pressure after doing mild to moderate leg extensions and leg presses. Explain what happened and why the reading might have been different. See what happens when you hold your breath. Consider what influence supine has over seated bench press or seated leg press vs. inverted leg press.
After doing this self-evaluation, design a comprehensive exercise program for a hypertensive 50-year-old male with a resting BP of 145/92. Explain why every exercise is included.
Reading Assignment: Chapters 8-10
Exercise Therapy 3rd edition
National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP) – This site helps to promote health and well-being through the prevention and control of chronic diseases.
http://www.cdc.gov/chronicdisease/index.htm (Links to an external site.)
National Heart Blood and Lung Institute (NHLBI) – Information for professionals and the general public about heart and vascular diseases, lung diseases, blood diseases and resources, and sleep disorders.
http://www.nhlbi.nih.gov/health/public/heart/index.htm (Links to an external site.)
Mayo Clinic – This site offers award-winning medical and health information and tools for healthy living.
COPD: http://www.mayoclinic.com/health/copd/DS00916 (Links to an external site.)
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) – This site contains information about many different health topics, current research and clinical trials, advances and initiatives, and useful links. Use the following link to access information about Diabetes: http://diabetes.niddk.nih.gov/ (Links to an external site.)
Full exercise as therapy for chronic conditions –
http://onlinelibrary.wiley.com/doi/10.1111/sms.12581/ (Links to an external site.)
Methods to build consistency –
http://www.sparkpeople.com/resource/motivation_articles.asp?id=759 (Links to an external site.)
Defining and identifying progress –
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