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Kin 187 > Chronic conditions strongly associated with physical inactivity > Flashcards

Chronic conditions strongly associated with physical inactivity Flashcards

1
Q

What is the estimate for US adults with hypertension

A

77.9 million US adults >= 20 years of age and more than 1 billion world wide

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2
Q

Primary Hypertension…

What are the causes

A

Essential, Idiopathic

No definitive cause
Genetic
Alcohol
Stress
High fat diet
High salt diet
Physical inactivity
Obesity
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3
Q

What does idiopathic mean

A

We dont know what caused the hypertension

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4
Q

Secondary Hypertension…

What are the causes

A

Develops through the manifestation of other medical problems

Genetic
Renal
Vascular
Endocrine
Over the counter medications
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5
Q

Pathophysiology of hypertension involves

A

High sympathetic nervous system activity

Structural narrowing of small arteries and arterioles

Reduction of capillaries

Arterial stiffness

Increased resistance to blood flow (TPR)

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6
Q

What detects a change in BP

A

Baroreceptors

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7
Q

Baroreceptors send a

A

Afferent signal to CNS

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8
Q

BP =

A

HR x SV x TPR

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9
Q

Cardiac output

A

HR x SV

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10
Q

What constricts to slow down and build resistance

A

Arteries and arterioles

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11
Q

What controls vasoconstriction

A

VSMC

Vascular smooth muscle cells

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12
Q

What are VSMC

A

Vascular smooth muscle cells

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13
Q

What are VSMC’s controlled by

A

Pre/post ganglion sympathetic neurones

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14
Q

What does pre ganglion sympathetic neurons release

What do post ganglion release

A

Acytle co enz

norephedrine

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15
Q

What has the overall control of BP

A

Kidneys

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16
Q

What is the special considerations for exercise and hypertension with those whose BP not controlled

A

Those whose BP not controlled (SBP >= 140 and/or DBP >= 90) should consult their physician prior to initiating an exercise program to determine if an exercise testing is needed

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17
Q

What is the special consideration for exercise and hypertension for individuals with SBP >=160 or DBP >=100 or with target organ disease

A

Must not engage in any exercise

No exercise testing prior to a medical evaluation and adequate BP management

Medically supervised symptom limited exercise test is recommended prior to engaging in an exercise program test

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18
Q

What do Beta Blockers do

A

Adverse effect on thermoregulatory function

Increase the hypoglycemia in certain individuals

Reduce submaximal and maximal exercise capacity primarily in patients without myocardial ischemia

Decreased submax and max HR

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19
Q

What do Antihypertensive medication such as alpha blockers, calcium channel blockers and vasodilators do

A

Sudden excessive reduction in post exercise BP = postexercise hypotension

Termination of the exercise should be gradual and the cool down period should be extended and carefully monitored until BP and HR return to near resting levels

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20
Q

What are beta blockers

What does it cause the heart to do

A

Target beta receptors in heart which stops NE and Ephedrine from binding and exciting the heart

Therefore slows down heart rate

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21
Q

Mechanism of Digoxin

A

Slows HR at atria to ventricle

Inhibition of sodium potassium adenosine triphosphatase

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22
Q

Mechanism of betablockers

A

Slow HR

Antagonists that block the receptor sites for Epi and NE on adrenergic beta receptors of SNS

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23
Q

Mechanism of calcium channel blockers

A

Slow HR

Reduce strength of cardiac muscle contraction

Prevent or reduce the opening of channels, not allowing Ca++ to get into cells

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24
Q

Mechanism of alpha blockers

A

Relax vascular smooth muscle cells, vasodilate

Reduce vascular resistance

Increase blood flow

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25
Q

A lack of calcium causes

A

Actin to not be exposed

Causes weaker contraction

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26
Q

What are the effects of exercise on hypertension

A

Average reduction of 5 to 10 mmHg in resting BP

Potential alterations:

Alteration in renal function

Decrease in plasma norepinephrine

Increase in circulating vasodilator substances

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27
Q

FITT recommendation for individuals with hypertension and AEROBIC

A

5-7 days

Moderate intensity

> = 30 min of continuous
Intermittent for 10 min bouts

Prolonged activities using large muscles

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28
Q

Estimated number of people in US with dyslipidemia

What is it

A

30% of people

Major risk factor for atherosclerotic CVD

Abnormal amount of lipids in the blood

Hyperlipidemias/hypercholesterolemia

29
Q

What is the cause of dyslipidemia

A

High fat diet

Excess alcohol intake

Physical inactivity

30
Q

What are the effects of exercise on dyslipidemia

A

Lower triglycerides - better skeletal muscle uptake

Higher HDL-c concentrations - with sustained aerobic exercise

Reduction in LDL and total cholesterol levels - weight/fat loss is required

Reduced postprandial lipemia

31
Q

What are the special considerations due to drugs for dyslipidemia

A

Statin drugs (hydroxymethylglutaryl-CoA) reductase inhibitors are very effective for the treatment of dyslipidemia

32
Q

What does statin drugs do

A

Statin therapy consistently improves survival by preventing myocardial infarction and stroke

33
Q

What side effects of lipid lowering drugs may occur

A

May experience muscle weakness and soreness - Myalgia

May cause direct and severe muscle injury

Unusual or persistent muscle soreness when exercising while taking these medications

34
Q

What is myalgia

A

Muscle weakness and soreness from taking lipid lowering drugs

35
Q

FITT recommendation for individuals with dyslipidemia and AEROBIC

A

> = 5 days to max caloric expend

40 - 75%

30-60min to promote weight loss
50-60 min daily

Prolonged activities using large muscles

36
Q

What is the estimated % of US adults with obesity

A

68% overweight/ obese

34% obese

6% extremely obese

37
Q

What is the estimated % of US children with obesity

A

32%

38
Q

What are the causes of obesity

A

Diet

Sedentary lifestyle

Genetics

Gut bacteria

39
Q

What is the pathophysiology of obesity

A

Adipose tissue
Leptin
CNS/hypothalamus

40
Q

FITT recommendation for individuals with obesity and AEROBIC

A

> = 5 days

Moderate 40 - 60%
Progress to vigorous >=60%

30 a day
150 a week
Increase to 60min a day
250-300 min a week

Prolonged activities using large muscles

41
Q

Metabolic syndrome is the name for…

It is seen in _____ of the population

It increases….

There are differences in…

A

A group of risk factors that raise your risk for cardiovascular disease, diabetes and stroke

35% (US adult)

Increase with age

Difference in sex race and ethnicity

42
Q

How many risk factors do you have to be diagnosed with to have metabolic syndrome

What risk factors are they

A

At least 3

Abdominal/central obesity

High fasting blood glucose - insulin resistance, prediabetes

Dyslipidemia - high serum triglyceride level, low serum HDL cholesterol level

High blood pressure

Miscroalbuminuria

43
Q

Metabolic syndrome table??

A

?

44
Q

What are the causes of metabolic syndrome

A

Aging

Genetics

Diet*

Sedentary lifestyle*

Insulin resistance*

Disrupted sleep

Stress

Mood disorders/psychotropic medication use

Excessive alcohol use

45
Q

What are the effects of exercising on signs of metabolic syndrome

A

Weight loss/abdominal fat loss

Decrease in serum triglyceride, LDL and VLDL cholesterol levels

Increase in serum of HDL level

Reduction in blood pressure

Lower fasting glucose - improvement of insulin resistance

46
Q

What is the exercise prescription/recommendation to reduce risk factors associated with CVD and DM (FITT-VP)

A

Frequency:
Minimum 3 days/week and most days of the week

Intensity:
Initial exercise training at moderate intensity (40-60% of VO2R)

Progress to more vigorous intensity (>= 60% VO2R)

Time:
Minimum of 150 min/week, or 30min/day

Type:
?

47
Q

What is the exercise prescription/recommendation to reduce body weight/fat (FITT)

A

Frequency:
5 days/week and most days of the week

Intensity:
Moderate intensity

Time:
Minimum of 300min/week or 50-60 min/day
Progression of 60-90min/day

Type:
?

48
Q

Recent findings show that to reduce overall metabolic syndrome severity…

A

Both diet control and exercise is required

Diet:
Hypocaloric diet

Low fat and high fiber diet

Mediterranean diet

Exercise:
Aerobic interval training

High/vigorous intensity interval training

High intensity endurance exercise mixed with resistance training

49
Q

What is the bottom line

Prevalence:
Prevention:
Treatment:

A

The prevalence of the metabolic syndrome in the US increasing significantly

Prevention:
Healthy lifestyle - healthy diet and physical activity

Treatment:
Change lifestyle - lose weight and reduce risk factors from proper diet and exercise

50
Q

Make flashcards on big flow chart?

A

?

51
Q

If your SBP/DBP is 130/70mmHg, you are classified as _____ according to the new report from American Heart Association

A

Stage 1 Hypertension

52
Q

Vasodilators have antihypertensive effects by lowering heart rate

A

False

53
Q

Chronic exercise (through exercise training) decreases plasma norepinephrine levels in individuals with hypertension because it reduces sympathetic nervous system activity

A

True

54
Q

Higher resistance on blood vessels could be due to constant contractions of vascular smooth muscle cells caused by higher sympathetic outflow

A

True

55
Q

Exercise has positive effects on dyslipidemia by _____

A

Decreasing concentrations of LDL particles in bloodstream

Increasing HDL concentrations

56
Q

High sympathetic nervous system activity increases vasodilation and total peripheral resistance

A

False

57
Q

Following CDD4 recommendations for evaluation of physical functioning, at a minimum patients should be able to do these except

A

20 sit to stand repetitions in 30s

58
Q

If you relate the intensity of physical activity and breathing, moderate activity at 3-6 METs is similar to the breathing which cannot pass the talk test

A

False

59
Q

Gait speed can be placed into the perspective of requirements for various activities and outcomes

A

True

60
Q

If your client’s HDL level is 45 mg/dL, his negative risk factor is absent neutral

A

True

61
Q

If your patient has bilateral edema, it indicates that he/she may have lymphatic blockage

A

False

62
Q

FITT recommendation for individuals with hypertension and RESISTANCE

A

2-3 days

60-70% 1 RM
Progress to 80% 1 RM
Older/novice individuals = 40-50% 1RM

2-4 sets, 8-12 reps

Resistance machine/free weights/body weight

63
Q

FITT recommendation for individuals with hypertension and FLEXIBILITY

A

> = 2-3 days a week

Stretch to point of feeling discomfort

Hold static stretch for 10-30secs
2-4 reps

Static, dynamic and or PNF

64
Q

FITT recommendation for individuals with dyslipidemia and RESISTANCE

A

2-3 days

Moderate 50-70% 1 RM
Progress to vigorous 70-85% 1 RM to improve STRENGTH
<50% 1 RM to improve MUSCLE ENDURANCE

2-4 sets, 8-12 reps for STRENGTH
<= 2 sets, 12-20 reps for MUSCLE ENDURANCE

Resistance machine/free weights/body weight

65
Q

FITT recommendation for individuals with dyslipidemia and FLEXIBILITY

A

> = 2-3 days a week

Stretch to point of feeling discomfort

Hold static stretch for 10-30secs
2-4 reps

Static, dynamic and or PNF

66
Q

FITT recommendation for individuals with obesity and RESISTANCE

A

2-3 days a week

60-70% 1 RM
Increase to enhance strength and muscle mass

2-4 sets of 8-12 reps

Resistance machines/free weights

67
Q

FITT recommendation for individuals with obesity and FLEXIBILITY

A

> = 2-3 days a week

Stretch to point of feeling discomfort

Hold static stretch for 10-30secs
2-4 reps

Static, dynamic and or PNF

68
Q

What is leptin

A

Hormone released from adipose tissue which controls the amount of food you can eat

69
Q

What ethnicities are seen in men for metabolic syndrome

What about females

A

Hispanic and white

Hispanic and African American

Kin 187 (21 decks)

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