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Physiology > Hypertension and Physical Activity > Flashcards

Hypertension and Physical Activity Flashcards

1
Q

What is blood pressure?

A

Force/pressure exerted by blood on the vessel walls

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2
Q

What are the 3 factors which determine blood pressure?

A
  • Cardiac Output
  • Resistance to blood flow (diameter of blood vessels)
  • Viscosity of blood (plasma volume and red cell mass)
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3
Q

How do you measure blood pressure?

A

With a sphygmomanometer

Records the number of systoles (contractions) and diastoles (rest)

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4
Q

What are systoles?

A

Heart contractions

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5
Q

What are diastoles?

A

Rest between heart contractions

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6
Q

What are normal values of BP?

A

120/80

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7
Q

Where is BP greatest?

A

In arteries

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8
Q

Where is BP the lowest?

A

Capillaries and veins

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9
Q

How is BP regulated in the short-term?

A

Rapid responses initiated by the brain to maintain BP in response to changes in CO

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10
Q

How does the sympathetic NS affect HR?

A

It increases HR

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11
Q

How does the parasympathetic NS affect HR?

A

It decreases HR

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12
Q

What is hypertension?

A

High blood pressure at rest

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13
Q

What is Mean Arterial Pressure?

A

= DBP + 1/3 (SBP-DBP)

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14
Q

What percentage of time is spent in systole?

A

A third

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15
Q

What percentage of time is spent in diastole?

A

Two thirds

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16
Q

What is Mean Arterial Pressure useful for?

A

Can give better indications since SBP and DBP vary greatly between people

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17
Q

How many adults in the UK live with controlled hypertension? %

A

10%

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18
Q

How many adults in the UK live with untreated hypertension? number

A

> 5.5 million

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19
Q

Why do so many adults in the UK live with untreated hypertension?

A

Because it is asymptomatic

20
Q

How many older adults have high blood pressure?

A

Almost 80%

21
Q

What is secondary hypertension?

A

Hypertension due to something else (e.g. kidney disease?

22
Q

What is primary/idiopathic hypertension?

A

Hypertension from unknown causes

23
Q

What are the risk factors of hypertension? (7)

A
  • excessive sodium intake
  • genetic predisposition
  • sedentary lifestyle
  • stress
  • excessive alcohol consumption
  • age
  • oral contraceptives
24
Q

Ultimately why is hypertension dangerous?

A

Because it increases the risk of Coronary Heart Disease and Myocardial Infraction

25
Q

What is the effect of hypertension on the heart?

A

Increases the work of the heart (double-product)
Puts a greater strain on the heart
Increases chances of ischaemia

26
Q

How does the heart respond to hypertension?

A

Pronounced hypertrophy of the heart (thickening of the chamber walls)
But no change in chamber size
> doesn’t help maintain stroke volume

27
Q

What are the consequences of hypertrophy of the heart?

A
  • greater demand for oxygen
  • diffusion distances from the sites at which the blood is being provided to the site of the working cardiac muscles increase
  • increased chances of ischaemia
28
Q

What is the effect of hypertension on blood vessels? (mostly arteries)

A
  • increased shear stress on the surface of endothelial cells

- increases normal stress within blood vessels

29
Q

What is the consequences of endothelial cells disruption due to hypertension?

A

endothelial cells dysfunction and it increases the likelihood of developing atherosclerosis

30
Q

What are the consequences of hypertension with ageing?

A

Large increase in absolute risk in heart diseases, stroke and intermittent claudication in older adults

31
Q

What is intermittent claudication?

A

Inadequate blood flow to meet the demands of skeletal muscles which leads to pain
Usually in the peripheries (e.g. calf)

32
Q

What is the chronic effect of endurance training on BP with ageing? (+ref)

A

Seals et al. (1999)

endurance training could avoid the increase in BP associated with age

33
Q

Does endurance exercise intensity matter to chronically reduce BP? (+ref)

A

Hagberg et al. (1989)

moderate intensity exercise (50% VO2max) is the ideal intensity to reduce SBP and DBP

34
Q

What is the Cornelissen and Fagard (2005) study? (meta analyses)

A

Meta analyses
On average endurance exercise has a large effect in hypertensive adults and small in normotensive
SBP/DBP decrease of 5/7 mmHg hypertensive
SBP/DBP decrease of 2/2 mmHg normotensive

35
Q

Reduction of 1 mmHg reduces risk of cardiovascular event by how much?

A

5-20%

36
Q

What is the Smart et al. (2019) study? (meta-analyses)

A

Meta-analyses on isometric exercise

Consistent positive effect

37
Q

What is the chronic effect of isometric training on BP? (+ref)

A

Garg et al. (2014)
3x/week isometric exercise 5x 3 min of hand-grip dynamometer exercise
Meaningful reductions in SBP and DBP
anyone could do it!

38
Q

What is the acute effect of exercise on BP in hypertensives? (+ref)

A

Pescatello et al. (1991)

MAP decreased on average by 7 mmHg for over 12 h

39
Q

What are the implications of the acute effect of exercise on BP in hypertensives?

A

Exercise can reduce BP for transient periods of time below values where is would have been otherwise
Need more research!

40
Q

Who said ‘the mechanisms by which PA may reduce BP and prevent the development of hypertension are unclear”?

A

Diaz & Chimbo (2013)

41
Q

What is the optimal prescription of PA to reduce BP?

A

Unclear

42
Q

Within populations at risk of hypertension (parental history, diabetics, pre-hypertension) can exercise help? (+ref)

A

Yes (Diaz & Shimbo 2013)
Within population at risk, those who are physically active are at lower risk of developing hypertension compared to low fit individuals

43
Q

What do we need more research on?

A

Dose-response

Type of exercise

44
Q

What are some mechanisms through which endurance exercise might help regulate BP? (5)

A
  • enhance renin-angiotensin activation
  • improve endothelial function
  • improve baroreflex sensitivity
  • reduce arterial stiffness
  • increase Nitric Oxide Bioavailability
45
Q

What are some mechanisms through which resistance exercise might help regulate BP? (4)

A
  • improve BP auto-regulation
  • reduce arterial stiffness
  • improve baroreflex sensitivity
  • increase Nitric Oxide Bioavailability
46
Q

What is the clinical threshold of hypertension?

A

SBP/DBP over 140/90

Physiology (5 decks)

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