Cours 14 : hypertension

Question 1

What is hypertension?

Answer 1

Cardiovascular problem where the blood exters more volume than normal in the inner walss of the blood vessels.
Damage to the heart, brain, kidneys and eyes because of circulatory problems (due to blood vessel damage)
- Major risk fro death by stroke + heart attack

Question 2

What are the 2 mechanical causes?

Answer 2

Increase fo stroke volume and peripheral resistance
- decrease in vasodilation of blood vessels
- arterial walls become thickened , inelastic and resistant to blood flow
** one of these 2 is good enough to increase BP

Question 3

What is the incidence of hypertension?

Answer 3

Linear relation with age
20 to 25% of Canadians suffer from hypertension
1/3 do not know it
Mild + moderate = no symptoms (very often, silent killer)
Severe = blurred vision, severe headaches and confusion

Question 4

Where does hypertension stand in the risk factor table?

Answer 4

1 for death

Question 5

How do we measure Blood pressure?

Answer 5

With a sphygmomanometer provides 2 measures of BP
- Optimal BP = 120/80 mmHg

120 = systolic pressure (contraction of the heart)

80 = diastolic pressure (relaxation phase)

Question 6

How does the B fluctuate during the day?

Answer 6

Bp varies depending on what we do (ADLs)

Question 7

What are the factors that are causing BP to temporarily rise?

Answer 7

Stress, smoking, exercise, caffeine

Question 8

Why does Systolic and diastolic pressure rise in Winter and drops in Summer?

Answer 8

Blood vessels constricts in the cold causing the heart to work. harder to push blood through the veins and arteries (less space for the blood to travel)

More weight and less exercise in Winter

Question 9

What are the causes?

Answer 9

1: primary or essential (no specific medical cause can be found to explain a patient’s condition) = 90% –> believed to be about 50% genetic, 50% environnemal

2. FACTORS
   - pregnancy
   - coarctation of the aorta
   - obesity
   - smoking
   - PI
   - High fat diet + increase salt intake
   - large amounts of alcohol
   - increase stress

Question 10

What is the correlation with Hypertension and Atherosclerosis?

Answer 10

High BP –> Arteries : walls swell & stretch –>endothelial injury –> attraction of LDL cholesterol and WBC (white blood cells) –> formation of plaque –> atherosclerosis –> major risk for death by stroke and heart attack

Question 11

What are the recommendations for exercise programming?

Answer 11

Endurance training
mode: large muscle, aerobic
frequency: 3 to 7 days / week
duration: 20-60 minutes
intensity: 50-85% of peak HR
lower intensity 40-70% is very good too

Question 12

Which of the following is not a risk factor of high BP in children?

Answer 12

a) obesity
b) poor nutrition habit
c) family history of increase BP
d) none of the above (correct answer)

Question 13

Where does the high BP begins?

Answer 13

130 (systolic) and 80 (diastolic)

Question 15

What are the effects of aerobic exercise on BP?

Answer 15

There’s a normal BP response to Aerobic Exercise

Systolic : increases by 30-60 might

diastolic = no changes

Question 16

What is the blood pressure response to exercise?

Answer 16

At rest = from 75 to 125 mmhg
Aerobic Exercise = from 75 to 175 mmhg
2-arm heavy curl = from 150 to 245 mmhg
2-leg press, heavy load = from 176 to 275 mmhg

Question 17

What are the effects of regular exercise on BP response at rest in participants with hypertension in aerobic training?

Answer 17

decrease in Systolic BP of 5-7 mmHg and in Diastolic BP of 3-5 mmHg

Question 18

What are the effects of regular exercise on BP response at rest in participants with hypertension in dynamic resistance training?

Answer 18

decrease BP by 2-3 mmHg in both Systolic and Diastolic BP

Question 19

What are the effects of regular exercise on BP response at rest in participants with hypertension in isometric resistance training?

Answer 19

Potential for the largest decrease in Systolic and Diastolic BPs: However, ↑ risk of medical complications

Question 20

How much should the reduction in SBP and DBP be to lower stroke risk by 14% and 17% respectively, and the risk of coronary artery disease by 9% and 6%, respectively ?

Answer 20

2%

Question 21

What are the effects of moderate weight reduction onrushing and exercise blood pressure in overweight subjects?

Answer 21

At rest = decrease in systolic BP

During exercise : decrease in systolic and diastolic BP (but there’s a stronger effect in systolic)

Question 22

Acoording to the American College Sports Medicine, exercise is contraindicated when what?

Answer 22

The resting BP exceeds : 180/110 mmhg

During exercise : 250/115 mmhg

High intensity isometric exercise and heavy strength training activities involving a Valsalva effect (weight lifting) are contraindicated

Medications (antihypertensive agents) can affect BP during and after exercise
(decrease of the peripheral resistance by vasodilation –> can produce post exercise hypotension (dizziness, feeling faint)

Question 23

What is the main goal to manage hypertension?

Answer 23

to control BP by the least intrusive means possible. BP should be lowered and maintained below __130/80____ mm Hg (stage 1)

Question 24

What are the best ways to control hypertension?

Answer 24

• Medications
• Healthy diet:
  Focusing on fruits, vegetables and low-fat dairy products, and especially, ↓ the salt in your diet
• Exercise
• Management of emotional stress

-Weight control

Question 25

What are diurectics?

Answer 25

Work by flushing excess water and sodium from the body thus lowering BP, which may be enough along with lifestyle changes to control your blood pressure (stage 1)

Question 26

What are beta blockers?

Answer 26

Work by blocking certain nerves and hormonal signals to the heart and blood vessels thus lowering blood pressure

Question 27

What are calcium channel blockers?

Answer 27

Prevent calcium from going into the heart and blood vessels muscle cells, thus causing the cells to relax, which lowers blood pressure