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Date Created: 08/17/15
ACSM Position Stand Exercise and Hypertension Notes added to Dr Chen39s Outline 0 De ne Hypertension SBP greater or equal than 140 mm Hg andor diastolic BP greater or equal than 90 mm Hg 0 Prehypertension category SBP 120139 mm Hg DBP 8089 mm Hg o Is hypertension an inevitable consequence of old age No it is also based on lifestyle Types of Hypertension Secondary Hypertension an exact cause can be diagnosed a cure exists 0 Primary Hypertension poorly understood no exact cause Pathophysiology of hypertension Accompanied by low level systemic in ammation abnormal because the in ammatory response is constantly present at a low level in hypertensive individuals not known if hypertension or abnormal in ammation comes rst 0 Question for EXSC Science how do we reduce hypertension with exercise Epidemiology of Hypertension 0 Demographics BP increases with age 0 Comparing age and gender hypertension is more prevalent in younger males but more prevalent in older females Antihypertensivedrug therapy effective treatment Exercise Blood Pressure and Prediction of Hypertension and CVD morbidity and mortality using exercise to predict if hypertension may occur 0 For both prediction of hypertension and prediction of CVD complications evidence is weak levels C and D more studies are needed Exercise and Blood Pressure Bene ts 0 Exercise training in the treatment and management of HTN a lot of data from Caucasianbased studied but currently used for all ethnicities Night blood pressure is always lower 0 Acute Endurance effects postexercise hypotension 57 mm Hg drop in blood pressure for up to 22 hours Resistance Exercise 0 Acute Effects of Resistance Exercise after 1 bout of exercise resting SBP and DBP decreases 3 mm Hg 0 This decrease is small but signi cant because of the effects it may have on chronic disease risks further explained in article notes 0 How Resistance exercise can increase cardiac output there is still somewhat of an aerobic component leading to an increase in blood ow and stroke volume Special Populations with Exercise 0 Children and Adolescents no drop in BP hard to identify level of hype engon Sex similar effects on both 0 Ethnicity shouldn t be different Exercise Recommendations 0 Frequency everyday in order to achieve post exercise hypotension o lntensity 4059 V02R 359 METs Heart Rate Reserve 40 59 RPE 1213 higher intensities no differences seen also there is lower injury risk and higher compliance 0 Time 30 minutes or more 6090 min for additional improvements no more than 90 minutes 0 Type aerobic supplemented by resistance resistance should be circuit weight at 4060 1 rep max with a 1545 second break Exercise and Hypotension Article Notes statements taken directly from the article that he emphasizedhighlighted when we went through his outline A person with a normal BP at 55 years of age has a 90 lifetime risk of acquiring HTN o HTN increases with age and is higher among men than women at younger ages but the reverse is true in older individuals HTN is associated with increased incidence of all cause and CVD mortality stroke coronary heart disease heart failure peripheral arterial disease and renal insufficiency 0 Drug therapy signi cantly reduced CVD mortality by 21 in patients with systolicdiastolic HTN and 18 in patients with isolated systolic HTN this amounted to 42 and 30 risk reduction for fatal and nonfatal stroke and 14 and 23 for coronary artery disease 3 points on dynamic aerobic training 1 Dynamic aerobic training reduced resting BP in individuals with normal BP and in those with HTN 2 The decrease in BP appears to be more pronounced in HTN than normotensive subjects 3 Aerobic training also reduces ambulatory BP and BP measured at a xed submaximal workload Average PEH post exercise hypotension is 57 mm Hg drop for up to 22 hours after an exercise bout Resistance Exercise drop in 3 mm Hg for both resting SBP and DBP from progressive resistance training signi cant because this is estimated to reduce coronary heart disease by 59 stroke by 8 14 and all cause mortality by 4 The limited evidence available suggests that static exercise reduces BP in adults with elevated BP There is no evidence to support the idea that trainingcaused BP alterations differ between younger and older adults No convincing evidence exists to support the idea that ethnic differences exist in BP response to chronic and acute exercise
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