CH. 10 (2) Chronic Conditions... Flashcards
Stats about hypertension
77.9 million US adults > or equal to 20 y/o and more than 1 billion people worldwide have it
Stage 1 Hypertension
SBP 130-139 or DBP 80-89
Stage 2 Hypertension
SBP > or equal to 140 or DBP > or equal to 90
Causes of Primary Hypertension
- can’t identify
- genetic
- alcohol
- stress
- high fat diet
- high salt diet
- physical inactivity
- obesity
Cause of Secondary Hypertension
(Develops through the manifestation of other medical problems)
- genetic
- renal
- vascular
- Endocrine
- Over the counter medications
Pathophysiology of Hypertension
High Sympathetic nervous system activity
Structural narrowing of small arteries and arterioles
Reduction of capillaries
Arterial Stiffness
Increase resistance to blood flow (TPR)
BP equation
=HR x SV x TPR
Capillaries
Gas exchange occurs here therefore there is only one layer of endothelial cells
Vascular Smooth Muscle Cells
wrap around the endothelial cells
vasoconstriction/vasodilation brings about contract and makes the vessel restrict (producing resistance in TPR)
Sympathetic Nervous System
controls the motor neurons release and communication through the muscles
-releases norepeniphrin for muscle to contract
Motor neurons
tell skeletal muscle to contract
Acetlycholine
Excite the PGSN
baroreceptors
Detect high blood pressure and the body will work to keep it at normal range
Sends signal to PNA to increase and SNA to decrease
Negative Feedback
Slow HR
Digoxin
Slow the HR at atria and ventricles
Patients with uncontrolled BP (SBP ≥ 140 or DBP ≥ 90)
consult with physician prior to starting exercise program (Check for exercise testing)
Patients with uncontrolled BP (SBP ≥ 160 or DBP ≥ 100)
- shouldn’t partake in any exercise
- no exercise testing prior to medical eval and adequate BP management
- Medically supervised symptom limitied exercise test is recommended prior to engage in an exercise testing program
Beta-Blockers (β-Blockers)
- Adversely affect thermoregulatory function
- Increase the hypoglycemia in certain individuals (especially with DM patients)
- Reduce submax and max exercise capacity primarily in patients w/o myocardial ischemia
Antihypertensive medications (a-blockers, calcium channel blockers, vasodilators)
- Sudden excessive reductions in post exercise BP (post exercise hypotension)
- Stop exercise gradually with a cool down period. Therefore your HR and BP will slow to resting levels under controlled conditions
Alpha Blockers
Relax vascular smooth muscle cells, vasodilate—-> reduces resistance and increases blood flow
Calcium Channel Blockers
Slow HR, Reduce strength of cardiac muscle contraction —–> prevent or reduce the opening of channels, not allowing CA2+ on adrenergic beta receptors of SNS
Exercise Effect on Hypertension
AVG reduction of 5-10 mm Hg in resting Bp
Potential alteration in renal function, decrease in plasma norepinephrine, increase in circulating vasodilator substances
FITT for hypertension (Aerobic)
5-7 days/wk
Moderate intensity
≥30 min of continuous or accumulation(intermittent bouts start with 10 min bouts)
Prolonged rhythmic activities of large muscles
FITT for hypertension (Resistance)
2-3 days/wk 60-70% of 1RM beginners start with 40-50% 2-4 sets of 8-12 reps machines or free body weights/body weight
FITT for hypertension (Flexibility)
≥2-3 days/wk
stretch to tightness or discomfort
static stretch for 10-30 seconds for 2-4 reps
Static, Dynamic, or PNF
Stats of Dyslipidemia
Nearly 30% of people in the US have it… major risk factor to atherosclerotic CVD
Dyslipidemia
Abnormal amount of lipids (triglycerides, CHO, phospholipids) in the blood
Hyperlipidemias/cholesterolemia
Cause of Dyslipidemia
High Fat diet
Excess Alcohol Intake
Physical Inactivity
Effects of Exercise on Dyslipidemia
- lowers tryglycerides (better skeletal muscle uptake)
- Higher HDL
- Reduction LDL
- Reduction in post prandial lipemia
Treatment of Dyslipidemia (Drugs)
hydrooxymethylglutaryl-CoA reductase inhibitors (Statin Drugs)
consistently improves survival by preventing MI and Stroke
Can cause muscle weakness and soreness, injury, unusual soreness during exercise
Myalgia
soreness/muscle weakness from STATINS
Obesity Statistics
68% if US adults are classified as either overweight or obese
32% of children and adolescents are overweight or obese
Obese BMI
≥30 kg/m^2
Cause of Obesity
Diet, sedentary lifestyle, genetics, gut bacteria
Pathophysiology of Obesity
Adipose tissue, Leptin, Central nervous system/hypothalamus
FITT for individuals with Overweight and Obesity (Aerobic)
≥5 days/wk
Moderate initial intensity (40-59% VO2R or HRRR)
30 min or increase 60 min a day (accumulate 250-300min/ wk)
Prolonged, rhythmic activities
FITT for individuals with Overweight and Obesity (Resistance)
2-3 days per week
60-70% of 1 RM
2-4 sets of 8-12 reps
Machines and free weights
FITT for individuals with Overweight and Obesity (Flexibility)
≥2-3 days/week
stretch to tightness or slight discomfort
hold for 10-30 seconds 2-4 reps of each exercise
Static/Dynamic/PNF
Metabolic Syndrome
- The name for the group/cluster of risk factors that raise your risk for cardiovascular disease, diabetes and stroke
- About 35% of US Adult population (2011-2012)
- Increases with age
- Differences in sex, race, ethnicity
Defining Metabolic Syndrome
Need at lease 3 risk factors
-Abdominal/central obesity
High Fasting blood glucose (Hyperglycemia)
-Dislipidemia
(High serum triglyceride level, low serum HDL cholesterol level)
-Hypertension
-Microalbuminuria
Causes of Metabolic Syndrome
Aging Genetics Diet Sedentary Lifestyle (Physical Inactivity) Disrupted Sleep Stress Mood disorders/psychotropic medication use Excessive alcohol use
Overall effect of exercise of metabolic syndrome
Weight loss/abdominal fat loss
Decrease in serum triglyceride, LDL, and VLDL cholesterol levels
Increase in serum HDL level
Reduction in blood pressure
Lower Fasting glucose (Improvement of insulin resistance)
FITT to reduce risk with CVD & DM
3 days/week
Start at moderate intensity, move to more vigorous
Minimum of 150 min/wk or 30 min a day
Moderate intensity (% if VO2)
40-60% VO2 or HRR
Vigorous Intensity
≥60 VO2 or HRR
FITT to reduce body weight/fat
5 days/week
moderate intensiry
Minimum of 300 min/wk or 50-60 min/day, progression of 60-90 min/day
To reduce overall metabolic syndrome severity…
- Hypocaloric Diet
- Low fat and high fiber diet
- Mediterranean Diet
- Aerobic Interval Training
- High/Vigorous intensity interval training
- High intensity endurance exercise mixed with resistance training
