CH. 10 (2) Chronic Conditions... Flashcards
(46 cards)
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
