Lab 9Lab 9Weight Loss and Weight Loss and

HypertensionHypertension

KerryAnn Suteu, Josh McDonald, KerryAnn Suteu, Josh McDonald, Mike LombardoMike Lombardo

What is HypertensionWhat is Hypertension Hypertension is persistently high blood pressure. It is the most

common disorder affecting the heart and blood vessels and is the major cause of heart failure, kidney disease, and stroke.

Two types: Primary and Secondary, primary includes 95% of cases and has no cause. Secondary hypertension may be reversible and includes renal parenchymal disease, renal vascular hypertension, adrenal hyperfunction, and coarctation of the aorta. Normal blood pressure is Systolic <130 mmHg and Diastolic <85 mmHg. Systolic blood pressure is the force exerted by blood on arterial walls during ventricular contraction, the highest pressure measured in the large arteries. Diastolic blood pressure is the force exerted by blood on arterial walls during ventricular relaxation, the lowest blood pressure measured in the large arteries.

Stages of HypertensionStages of Hypertension

Hypertension Systolic (mmHg) Diastolic (mmHg)

Stage 1 (mild) 140-159 90-99

Stage 2 (moderate) 160-179 100-109

Stage 3 (severe) 180-209 110-119

Stage 4 (very severe) 210 120

Untreated HypertensionUntreated Hypertension

Hypertension is known as the “silent killer” because it can cause considerable damage to blood vessels, heart, brain, and kidneys before it causes pain or other noticeable symptoms. It is a major risk factor for heart disease and stroke. In blood vessels hypertension causes: thickening of the tunica media, accelerates development of atherosclerosis and coronary artery disease, and increases systemic vascular resistance. In the heart: myocardial hypertrophy that is accompanied by muscle damage and fibrosis. Hypertension also damages kidney arterioles which leads to kidneys secreting more renin, which elevates blood pressure even more.

Lifestyle changes to lower Lifestyle changes to lower HypertensionHypertension

-Lose weight if overweight -Limit alcohol intake to <1 ounce per day of

ethanol -Exercise aerobically regularly -Reduce intake of sodium to less than 2.3 grams

per day -Maintain adequate dietary potassium, calcium,

and magnesium intake -Stop smoking and reduce dietary fat, saturated

fat, and cholesterol intake

MedicationsMedications Initiation of drug therapy requires consideration of several factors: -Severity of Blood pressure elevation -Presence or absence or target-organ disease -Presence or absence of other medical conditions and cardiovascular

disease risk factors

Drug therapies include: Diuretics - decrease BP by decreasing blood volume through increased

elimination of water and salt in the urine Angiotensin converting enzyme inhibitors (ACE) - promote vasodilation and

decrease the liberation of aldosterone. Betablockers - reduce blood pressure by decreasing heart rate and

contractility Vasodilators - relax the smooth muscle in arterial walls Calcium channel blockers - decrease heart rate and the force of myocardial

contraction

Exercise and HypertensionExercise and Hypertension Exercise for Hypertension focuses on aerobic activities

utilizing large muscle groups Frequency - 3-7 days per week Duration - 20-60 minutes Intensity - 50-85% of Max V02

Effects on the Exercise Response After 30 to 45 minutes of moderate intensity exercise reduction in

systolic BP of 10 to 20 mmHg for up to 9 hours Antihypertensive agents that reduce total peripheral resistance by

vasodilation may predispose to postexercise hypotension; prevented by longer cool down period.

Weight LossWeight Loss

BMI is calculated as weight divided by BMI is calculated as weight divided by height squared. Normal weight is defined height squared. Normal weight is defined as a BMI of 18.5 to 24.9. Where as as a BMI of 18.5 to 24.9. Where as overweight is defined as BMI of 25 to 29.9 overweight is defined as BMI of 25 to 29.9 kg/m2. Obesity is defined as a BMI that’s kg/m2. Obesity is defined as a BMI that’s greater than or equal to 30. Limitations to greater than or equal to 30. Limitations to using BMI include very muscular people using BMI include very muscular people (overestimates body fat), older people who (overestimates body fat), older people who have lost muscle mass(underestimates have lost muscle mass(underestimates body fat).body fat).

Considerations and LimitationsConsiderations and Limitations

Heat intolerance, movement restriction, Heat intolerance, movement restriction, limited mobility, weight-bearing stress, limited mobility, weight-bearing stress, posture problems and low back pain and posture problems and low back pain and balance concerns. Mechanical threat to balance concerns. Mechanical threat to movement quality due to: Gravity loading movement quality due to: Gravity loading on joints and musculature, impact loading on joints and musculature, impact loading during locomotion, and control on inertial during locomotion, and control on inertial movements of limbs.movements of limbs.

Problems with HealthProblems with Health

Overweight and obese people are linked with such Overweight and obese people are linked with such health risks as: health risks as:

- Coronary Heart Disease – accumulation of plaque - Coronary Heart Disease – accumulation of plaque within the arteries of the myocardiumwithin the arteries of the myocardium

- Hypertension – High blood pressure. - Hypertension – High blood pressure. - Gallbladder disease – Blockage in the supply of bile- Gallbladder disease – Blockage in the supply of bile - Osteoarthritis – inflammation in joints due to the - Osteoarthritis – inflammation in joints due to the

wearing of the cartilage wearing of the cartilage - Sleep apnoea – pauses in breathing during sleep- Sleep apnoea – pauses in breathing during sleep - Diabetes – High blood sugar- Diabetes – High blood sugar - Respiratory problems - Respiratory problems

Benefits and AdviceBenefits and Advice Aerobic, resistance and flexibility training are Aerobic, resistance and flexibility training are

recommended for people overweight or obese. recommended for people overweight or obese. Moderate levels (150 calories/day) of physical activity for Moderate levels (150 calories/day) of physical activity for 30-45 mins, 3-5 days per week and working at 60% of 30-45 mins, 3-5 days per week and working at 60% of max heart rate, are recommended for people who are max heart rate, are recommended for people who are beginning an exercise program. Progression is beginning an exercise program. Progression is important when designing a program for obese clients important when designing a program for obese clients because they might not be used to doing physical because they might not be used to doing physical activity, so starting off slow is important. Benefits of activity, so starting off slow is important. Benefits of exercise are: increased energy expenditure, reduced risk exercise are: increased energy expenditure, reduced risk of heart disease, help reduce body fat, decrease insulin of heart disease, help reduce body fat, decrease insulin resistance, better dietary compliance (reduced caloric resistance, better dietary compliance (reduced caloric intake), improves your mood, improves body image and intake), improves your mood, improves body image and increases self esteem.increases self esteem.

Exercise Prescription – Cardio Exercise Prescription – Cardio KickboxingKickboxing

For optimal benefits, the following guidelines are followed:For optimal benefits, the following guidelines are followed: Frequency: 3-5 days/week Frequency: 3-5 days/week Intensity: 65-95% Max Heart Rate or 6-10 on RPE scale Intensity: 65-95% Max Heart Rate or 6-10 on RPE scale Duration: 20-60 minutes Duration: 20-60 minutes Strength training: 1 set of 8-10 exercises that conditions major Strength training: 1 set of 8-10 exercises that conditions major

muscle groups 2-3 days/week muscle groups 2-3 days/week Flexibility training: includes static and dynamic stretches 2-3 Flexibility training: includes static and dynamic stretches 2-3

days/weekdays/week Exercise alone without caloric restriction has only a modest effect Exercise alone without caloric restriction has only a modest effect

on weight loss on weight loss Programs conducted at least 3 days per week, using about 250-300 Programs conducted at least 3 days per week, using about 250-300

kcal per exercise session are suggested or 4 days per week using kcal per exercise session are suggested or 4 days per week using 200 kcal per session 200 kcal per session

Warm Up – 10 minutesWarm Up – 10 minutes

Light aerobic activity to increase heart rate Light aerobic activity to increase heart rate Bob and weave, boxer’s shuffle, various punching Bob and weave, boxer’s shuffle, various punching

techniquestechniques Dynamic movements to warm up joints to the range of Dynamic movements to warm up joints to the range of

motion used motion used Teaching AidsTeaching Aids: Step-by-step teaching, starting from : Step-by-step teaching, starting from

beginners leading into more advanced combinations beginners leading into more advanced combinations Lead by example Lead by example CommentsComments:: Participants can work at their own intensity levelsParticipants can work at their own intensity levels Focus on engaging core muscles throughout warm up Focus on engaging core muscles throughout warm up

Exercises and Activities – 30 Exercises and Activities – 30 minutesminutes

Cardiovascular: 20 minutesCardiovascular: 20 minutes Moving towards more intense punching and kickingMoving towards more intense punching and kicking Several combinations of punches and kicks Several combinations of punches and kicks

Teaching Aids:Teaching Aids: Step-by-step teaching Step-by-step teaching Start with basic techniquesStart with basic techniques Add techniques together Add techniques together Move to more advanced combinationsMove to more advanced combinations Lead by example Lead by example

Comments:Comments: 65% APMHR minimum 65% APMHR minimum 220-age(65%)220-age(65%) For the age group of our 3711 class, about 22 beats/10 seconds or 129 For the age group of our 3711 class, about 22 beats/10 seconds or 129

beats per minutebeats per minute Minimum level 6 on a 1-10 scale rating of perceived exertion Minimum level 6 on a 1-10 scale rating of perceived exertion Focus on engaging core muscles Focus on engaging core muscles

Strength componentStrength component Strength training:Strength training: 10 minutes10 minutes Deadlift Deadlift Standing abdominal and oblique crunchesStanding abdominal and oblique crunches Superman Superman Push upsPush ups Isometric partner upper body resistanceIsometric partner upper body resistance Isometric partner lower body resistance Isometric partner lower body resistance Teaching Aids:Teaching Aids: Verbal description, visual demonstration Verbal description, visual demonstration Comments:Comments: Focus on core strength as well as total body strength Focus on core strength as well as total body strength 1 set of 8-10 exercises (depending on time) 1 set of 8-10 exercises (depending on time)

Cool Down – 10 minutesCool Down – 10 minutes Static stretching Static stretching Partner lower body stretches (front kick and side kick)Partner lower body stretches (front kick and side kick) Chest/upper back stretchesChest/upper back stretches Abdominal/oblique stretchesAbdominal/oblique stretches Low back stretchesLow back stretches Quadriceps/hamstring stretchesQuadriceps/hamstring stretches Adductor/abductor stretches Adductor/abductor stretches Breathing exercises Breathing exercises Teaching Aids:Teaching Aids: Lead by exampleLead by example Verbal description and visual demonstration Verbal description and visual demonstration Comments: Comments: Focus on cooling down and relaxing the muscles Focus on cooling down and relaxing the muscles Heart rate should drop Heart rate should drop

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Visual RepresentationsVisual Representations

Challenge ActivityChallenge Activity

The class will be split into 2 teamsThe class will be split into 2 teams Each team forms a line up in front of the kicking padEach team forms a line up in front of the kicking pad Each member has 30 seconds to complete as many front kicks as Each member has 30 seconds to complete as many front kicks as

possiblepossible One person will count the kicks landed for each participantOne person will count the kicks landed for each participant At the end, the number of kicks will be tabulated and a winning team At the end, the number of kicks will be tabulated and a winning team

will be selected will be selected

Comments:Comments: The kicks must be front kicksThe kicks must be front kicks They must hit the target every time They must hit the target every time The foot must touch the floor between every kick for the kick to be The foot must touch the floor between every kick for the kick to be

considered legal considered legal

ReferencesReferences American College of Sports Medicine (1998). The Recommended Quantity

and Quality of Exercise for Developing and MaintainingCardiorespiratory and Muscular Fitness, and Flexibility in Healthy Adults. 30(6) 1-34.

Albright (1997). ACSM’s Exercise Management for persons with Chronic diseases and disabilities. Diabetes

Earle, Roger. Baechle, Thomas. (2004). NSCA’s Essentials of Personal Training. Human Kinetics

Tortora, Gerard J. (2005). Principles of Human Anatomy. John Wiley & Sons, Inc.