cardiovascular disease risk factors Flashcards
peripheral artery disease is caused by ______, resulting in _____
same process as coronary artery disease, reduction of blood flow to regions distal to the area of occlusion
PAD blood flow reduction creates a mismatch between
oxygen supply and demand
PAD blood flow reduction creates a mismatch between oxygen supply and demand causing
ischemia to develop in the affected areas
PAD severity can be ranked based on
presence of signs and symptoms or by the ankle/brachial pressure (ABI)
PAD treatments
CV risk reduction, exercise training, pharmacological therapy, and peripheral revascularization
PAD stage 1
asymptomatic
PAD stage 2
intermittent claudication
PAD stage 2a
distance to pain onset >200m
PAD stage 2b
distance to pain onset <200m
PAD stage 3
pain at rest
PAD stage 4
gangrene, tissue loss
PAD exercise testing can be performed to determine
functional capacity, to assess exercise limitations
time of onset of claudication pain
total walking time before and following therapeutic intervention
diagnose the presence of CVD and assess for other exercise safety factors
PAD frequency aerobic
min 3d/wk, up to 5
PAD frequency resistance
at least 2d/wk, non consecutive days
PAD frequency flexibility
> 2-3d/wk, pref. daily
PAD intensity aerobic
moderate, 40-59% VO2R, to moderate pain or 50-80% max speed walking
PAD intensity resistance
60-80% 1-RM
PAD intensity flexibility
stretch to tightness/slight discomfort
PAD time aerobic
30-45min/day, 12 week, can progress to 60min
PAD time resistance
2-3 sets 8-12 rep, 6-8 exercises targeting major groups
PAD time flexibility
10-30s hold for static
20-4 rep
PAD type aerobic
weight-bearing intermittent, seated rest when moderate pain is reached, resume when pain is completely gone
PAD type resistance
whole body, focus large muscles, emphasis on lower limbs
PAD type flexibility
static, dynamic, PNF
PAD exercise considerations
some may need to begin 15min/day, gradually increase 5min biweekly
weight bearing may be supplemented by non weight bearing
cycling or other non weight bearing modalities may be used as warm up
claudication
aching or burning in leg muscles
reliably reproduced at a set distance of walking
relieved within mins of rest
never present at rest
not exacerbated by position
initial claudication time
the time at which the patient first begins to feel claudication symptoms
intermittent claudication pre-exercise assessment
careful evaluation of the lower extremity skin and feet, along with instruction regarding proper shoes to avoid skin irritation and breakdown
patients with PAD are at an increased risk for non-healing _____, and careful _____ reassessment is extremely important, especially for those with ______
skin ulcers, foot and skin, diabetes, neuropathy
exercise prescription for claudication
walk/bike to moderate pain level (3-4 of 5 on scale)
stop and sit and rest until pain completely gone, then resume
eventual goal is to progress to cumulative 50 mins
progression should occur during the next session
hypertension SPB and DBP
> 140/130
90/80
the known contributors of primary hypertension include
genetic and lifestyle
high-fat, high-salt, physical inactivity
estimated ____ US adults >20 years old and more than ____ people worldwide have hypertension
78 million
1 billion
guidelines for the management of hypertension also emphasize
lifestyle modifications
individuals with HTN may have an ___ BP response to exercise
exaggerated
individuals with HTN who’s BP is not controlled should
consult with their physician prior to initiating exercise program
stage 2 HTN
> 160/>100
individuals with stage 2 HTN or with target organ disease _______ prior to medical evaluation and BP management
must not engage in exercise
HTN aerobic
frequency, intensity, time, type
> 5-7d/wk
moderate 40-59% O2R, RPE 12-13
30 min/day continuous or accumulated
prolonged, rhythmic activities (walking, cycling, swimming)
HTN resistance
frequency, intensity, time, type
> 2-3d/wk
moderate 60-70% 1RM
2-4 sets 8-12 reps, >20 mins per session
resistance machines, free weights, bands, functional body weight
HTN flexibility
frequency, intensity, time, type
> 2-3d/wk
to point of tightness
hold 10-30s 2-4 rep, total 60 sec, <10min
satin, dynamic, PNF
hypertension: it is prudent to maintain SPB ___ mmHg and/or ___ DPB mmHg when exercising
<220
<105
although vigorous intensity aerobic exercise is not necessarily contradicted in individuals with HTN, _______is greatly recommended to optimize benefit-to-risk ratio
moderate intensity aerobic
vallsalva maneuver can result in
extremely high BP responses, dizziness, fainting
BP with exercise
systolic:
diastolic:
increase
remain the same, or change within 10mmHg
antihypertensive medications such as a-blockers, calcium blockers, and vasodilators may lead to _______, therefore termination of exercise should be
sudden excessive reductions in post exercise PB
gradual, cool down extended
postexercise hypotension
BP lowering effects of aerobic exercise are immediate
how to modulate postexercise hypotension effects
continued very light intensity exercise
if an individual with HTN has ischemia during exercise
the program for those with CVD with ischemia should be utilized
vital signs
HR, RR, Sp O2, temp
