Lifestyles, Fitness and Rehabilitation

Hypertension
Lifestyles, fitness and rehabilitation
•
– Pressure created by the heart as it pumps blood through the arteries and the circulatory system
•
– Top number (Systolic)= Pressure while heart is beating
– Bottom number (Diastolic)= Pressure while heart is resting between beats

Hypertension
Lifestyles, Fitness and Rehabilitation
•
– Blood Pressure of < 140/ 90
– Blood Pressure of 130 to 139/ 85 to 89 should be closely watched
•
– Blood Pressure > 140/ 90

Hypertension
Lifestyles, Fitness and Rehabilitation
• How can I tell if I have High
Blood Pressure?
– Usually NO SYMPTOMS!
– “The Silent Killer”
– May have:
• Headache
• Blurry vision
• Chest Pain
• Frequent urination at night

Hypertension
Lifestyles, Fitness and Rehabilitation
•
– Sphygmomanometer
– Systolic pressure= pressure when 1 st sound is heard
– “Diastolic pressure= pressure when last sound is heard
•
– Small – children and small adults
– Average
– Large – overweight and large adults

Lifestyles, fitness
And Rehabilitation
BP
Category
Systolic
(mmHg)
Optimal < 120
Normal < 130
Diastolic
(mmHg) and < 80
Follow-up and < 85
Recheck
2 years
Recheck 2 years
High
Normal
130-139 or 85-89 Recheck 1 year

Lifestyles, fitness
And Rehabilitation
BP
Category
Stage 1
(mild HTN)
Systolic
(mmHg)
Diastolic
(mmHg)
Follow-up
140-159 or 90-99
Confirm within months
Stage 2
(moderate
HTN)
Stage 3
(severe HTN)
160-179 or 100-109
Evaluate within
1 month
180 or > or 110 or >
Evaluate immediately

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Causes High Blood
Pressure?
– Cause unknown in 90 to 95% of cases =
Primary Hypertension
– Secondary Hypertension = 5 to 10%
• Kidney Abnormalities
• Narrowing of certain arteries
• Rare tumors
• Adrenal gland abnormalities
• Pregnancy

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Causes High Blood
Pressure?
– Controllable Risk Factors
• Increased salt intake
• Obesity
• Alcohol
• Stress
• Lack of exercise

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Causes High Blood
Pressure?
– Uncontrollable Risk Factors
• Heredity
• Age
– Men between age 35 and 50
– Women after menopause
• Race
– 1 out of every 3 African Americans
– Higher incidence in non-Hispanic blacks and
Mexican Americans

Hypertension
Lifestyles, Fitness and Rehabilitation
• Women and High Blood Pressure
– Birth Control Pill
– Pregnancy
– Overweight
– After Menopause
– African Americans

Hypertension
Lifestyles, Fitness and Rehabilitation
•
– Certain nerve impulses cause arteries to become larger (dilate) or smaller (contract)
– If vessels wide open blood flows easily
– If vessel narrows pressure inside increases causing hypertension

Hypertension
Lifestyles, Fitness and Rehabilitation
•
– Stroke
– Congestive heart failure
– Kidney failure
– Heart attack
– Heart rhythm problems
– Aneurysm

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Can I Do?
– High blood pressure is a lifelong disease
– Blood pressure can be controlled not cured
– Controlling blood pressure will reduce the risk of stroke, heart attack, heart failure and kidney disease

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Can I Do?
– Loose weight if your overweight
– Get regular physical activity
– Avoid excessive alcohol
– Stop smoking
– Manage your stress

Hypertension
Lifestyles, Fitness and Rehabilitation
• What Can I Do?
– Decrease salt intake
– Eat for heart health
– Discuss the use of oral contraceptives with your doctor
– Discuss the use of some medications with your doctor

Hypertension
Lifestyles, Fitness and Rehabilitation
• Ten Commandments for Blood
Pressure Control
1 – Know your blood pressure
• Have it checked regularly
2 – Know what your weight should be
• Keep it at that level or below
3 – Don’t use excessive salt in cooking or at meals
• Avoid salty foods

Hypertension
Lifestyles, Fitness and Rehabilitation
• Ten Commandments for Blood
Pressure Control
4 – Eat a low-fat diet
• According to AHA regulations
5 – Don’t smoke cigarettes
• Or use tobacco products
6 – Take your medicine exactly as prescribed
• Don’t run out of pills even for a single day

Hypertension
Lifestyles, Fitness and Rehabilitation
• Ten Commandments for Blood
Pressure Control
7 – Keep your appointments with the doctor
8
– Follow your doctors advice about exercise
9 – Make certain family members have their blood pressure checked regularly
– Live a normal life in every other way!

Hypertension
Lifestyles, Fitness and Rehabilitation
• Medication for High Blood
Pressure
– Diuretics
• Rid the body of excess fluids and salt
– Beta-blockers
• Reduce the heart rate and the work of the heart
– Calcium antagonists
• Reduce heart rate and relax blood vessels

Hypertension
Lifestyles, Fitness and Rehabilitation
• Medication for High Blood
Pressure
– Angiotensin II receptor blockers(ACE)
• Interfere with the bodies production of angiotensin, a chemical that causes the arteries to constrict (narrow)
– Vasodialators
• Cause the muscle in the wall of the blood vessels to relax, allowing the vessel to dialate (widen)

Hypertension
Lifestyles, Fitness and Rehabilitation
• Medication for High Blood
Pressure
– Sympathetic nerve inhibitors
• Sympathetic nerves go from the brain to all parts of the body, including the arteries
• Cause arteries to constrict raising blood pressure
• These drugs reduce blood pressure by inhibiting these nerves from constricting blood vessels

Hypertension
Lifestyles, Fitness and Rehabilitation
• Home Blood Pressure
Monitoring
– Mercury sphygmomanometer
• Standard for BP monitoring
• No calibration
• May be bulky
• Need a second person to use machine
• May be difficult for hearing impaired or patients with arthritis

Hypertension
Lifestyles, Fitness and Rehabilitation
• Home Blood Pressure
Monitoring
– Aneroid equipment
• Inexpensive, lightweight and portable
• Two person operation/need stethoscope
• Delicate mechanism, easily damaged
• Needs calibration with mercury sphygmomanometer

Hypertension
Lifestyles, Fitness and Rehabilitation
• Home Blood Pressure
Monitoring
– Automatic equipment
• Contained in one unit
• Portable with easy-to-read digital display
• Expensive, fragile
• Must be calibrated
• Requires careful cuff placement