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Hypertension is the clinical term used to describe a high blood pressure (BP) of 140/90 or higher. It is such a health risk that the world health organisation (WHO) claims that it is “one of the biggest challenges facing public health authorities and medical practitioners”. Worldwide, high blood pressure affects 1 billion people (NIH 2003) and is estimated to cause 7.1 million deaths: 13% of all deaths globally. For those suffering with hypertension there is increased risk of coronary artery disease, strokes, renal disease and all cause mortality (so that means everything else!!).
Hypertension as almost always asymptomatic or without symptoms (WHO 2002), thus it is described as the “silent killer” and is normally only detected with the use of a sphygmomanometer (the thing that the doctor puts on your arm and inflates). Only people with severe hypertension or an abrupt rise in blood pressure will experience the symptoms of headaches, blurred or impaired vision, fits or blackouts. Elevated levels of BP can produce a variety of structural changes to the arteries that supply the brain, heart, kidneys and elsewhere. Yet 7 out of 10 people globally are not being properly treated for hypertension.
Fortunately, in most cases exercise and correct nutrition will cause a reasonably quick lowering of high BP. At Diets Don’t Work all our personal trainers are qualified to train special populations including those with high blood pressure. In most cases some structured exercise at the correct level with your personal trainer wil lead to a big improvement in your blood pressure.
Blood pressure is commonly measured by wrapping an inflatable cuff around the upper arm. Air is pumped into the cuff until the blood vessels in the arm get so squeezed that the circulation is cut off; when a stethoscope is then placed just under the cuff there should be relative silence. As the air is slowly let out of the cuff the squeezing eases, blood begins to flow again and can be heard through the stethoscope. This is the point of greatest pressure (called Systolic), and is usually expressed as how high it forces a column of mercury to rise in a tube. At its highest normal pressure, the heart would send a column of mercury to a height of about 120 millimeters. At some point, as more and more air is let out of the cuff, the pressure exerted by the cuff is so little that the sound of the blood pulsing against the artery walls subsides and there is silence again. The last audible beat heard through the stethoscope is the point of lowest pressure (called Diastolic), which normally raises the mercury to about 80 millimeters. Systolic and Diastolic readings are both important but it must always be remembered that lots of things will cause fluctuations in BP. Exercise will make the systolic leap up, while the lower reading (the diastolic) will usually stay fairly constant. Simply having your BP taken can cause an elevation in BP (white coat syndrome – the nerves you feel make your BP go up!). Diastolic pressure has traditionally been emphasized because it is less subject to fluctuations. However, recent studies have revealed that systolic pressure may be as significant a heart attack predictor as diastolic pressure.
Normal blood pressure is thus usually said to be 120/80 (systolic/diastolic), measured in millimeters of mercury (abbreviated as mm Hg). What do blood pressure numbers indicate? The first is the big push from the larger left ventricle (the heart is lopsided, one side being stronger than the other.) The second reading is the relaxation of the heart between beats as the right atrium pulls blood into the heart. The higher (systolic) number represents the pressure while the heart is beating, or on the push. The lower (diastolic) number represents the pressure when the heart is resting between beats, creating lower pressure and sucking blood in. A good way of imagining this is to look at the heart as your central heating pump – the pipes and radiators are your blood vessels. The clearer the pipes (blood vessels) the less pressure will be exerted on the system by the pump. But if the pipes are clogged (with fatty deposits!!) then the pressure in the system will be higher and the pump will have to work harder to force circulation through the narrower pipes (or blood vessels), eventually to breaking point. The systolic pressure is always stated first and the diastolic pressure second. For example: 122/76 (122 over 76); systolic = 122, diastolic = 76. Blood pressure of less than 140 over 90 is considered a normal reading for adults. A systolic pressure of 130 to 139 or a diastolic pressure of 85 to 89 needs to be watched carefully. A blood pressure reading equal to or greater than 140 (systolic) over 90 (diastolic) is considered elevated (high).
A good test of your personal trainer is to see is he/she understands this. A personal trainer worth his salt and at REPS level 3 will have an in depth knowledge of BP and the ways to help it.
With blood pressure it’s important to “know your numbers”. Life-threatening complications can develop over a course of years when hypertension exists. Increased pressure on the inner walls of blood vessels make the vessels less flexible over time and more vulnerable to the buildup of fatty deposits in a process known as atherosclerosis. High blood pressure or hypertension also forces the heart to work harder to pump adequate blood throughout the body (see the previous blog). This extra work causes the muscles of the heart to enlarge, and eventually the enlarged heart becomes inefficient in pumping blood. An enlarged heart may lead to heart failure, in which the heart cannot pump enough blood to meet the body’s needs.
In some people, the system that regulates blood pressure goes awry: arteries throughout the body stay constricted, driving up the pressure in the larger blood vessels. Sustained high blood pressure – above 140/90 mm Hg, according to most experts – is called hypertension. About 90 percent of all people with high blood pressure have “essential” or “primary” hypertension – meaning that it has no identifiable cause. It is, however, common that a combination of the usual suspects, stress, anxiety, lack of exercise, nutrition high in saturated fats, high salt intake and excessive alcohol all play a part. In the remaining 10 percent of cases, the elevated blood pressure is due to kidney disease, diabetes, or another disorder. This is known as “secondary” hypertension.
Remember that at Diets Don’t Work our personal trainers are qualified to deal with this high blood pressure, and can prescribe a suitable exercise programme to start tackling the problem. Here are the numbers, so you know whether you are OK or whether you need to eat better (included in our block booking personal training sessions) and get moving!!
|Blood Pressure Category||Systolic
|Normal||less than 120||and||less than 80|
|Stage 2||160 or higher||or||100 or higher|
We have had a look at the benefits of exercise, today I’ll go through the total benefits of all the lifestyle changes you can make when added together. At Diets Don’t Work we approach fitness not just from a personal training angle but also try to adapt your lifestyle in an achievable way so that you get the all-round benefits of exercise AND a healthy lifestyle.
The NIH (2003) developed the following lifestyle measures for reducing high blood pressure, and also gives the actual amount that you can expect your blood pressure to come down by:
Weight reduction, maintaining a BMI of 18-24, gets you a reduction of 5-20mmHg per 10kg loss.
Nutritional changes and following the wholefood diet gets you 8-14mmHg
A reduction of salt intake, sodium of less than 2.4g/day gets you 2-8mmHg
Engaging in some exercise as outlined in the previous blog gets you 2-10mmHg
Moderation of alcohol gets you 2-4mmHg
Smoking cessation gets you 10-15mHg
So if you do ALL of these changes that’s a possible grand total change of a whopping 71mmHg less that your blood pressure will be. So go for it, make some changes, it will not only make your BP better and lessen the chances of a horrid death, but you will feel and look much better both mentally and physically too.
To lower your blood pressure, go out and have fun. Researchers in the U.S. have found that laughter not only lifts the mood but it also has a powerful effect on hypertension. The study, reported by Sciencedaily.com, split people into two groups. One group was shown clips from the comedy “There’s Something About Mary” while the other was shown parts of the war movie “Saving Private Ryan”. During the funny scenes (in the first film of course!) the volunteers’ blood vessels dilated and expanded, improving circulation and lowering blood pressure. “The magnitude of change we saw after the laughter was similar and consistent with the benefits that we might see with the use of statins and aerobic exercise” said Dr Miller of the Maryland School of Medicine.
If you are not generally amused however why not try a bit (and I mean a bit) of chocolate? A Cambridge University review of studies using data from 114,900 patients found that consumption of chocolate was associated with a 37% reduction of cardiovascular disease over not having chocolate. The experts did warn though that these results should be interpreted with caution, as chocolate does of course have a high sugar content, so too much will lead to weight problems, diabetes and heart disease.
Other recent studies have also shown that you don’t need to sweat it out in the gym for hours at a time; short reasonably high intensity bouts of exercise can be just as effective in making you fitter and healthier. So spend your time constructively when exercising, don’t wander aimlessly, and success will be yours. Many of our personal training clients have really busy lives, so we use short effective homework routines outside of their one-on-one sessions to keep them fit and trim.