Lab 9 Weight Loss and Hypertension

1. Lab 9Weight Loss and Hypertension KerryAnn Suteu, Josh McDonald, Mike Lombardo

2. What 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.

3. Stages of Hypertension

4. Untreated 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.

5. Lifestyle changes to lower Hypertension • -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

6. Medications • 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

7. Exercise 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.

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

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

10. Problems with Health • Overweight and obese people are linked with such health risks as: • - Coronary Heart Disease – accumulation of plaque within the arteries of the myocardium • - Hypertension – High blood pressure. • - Gallbladder disease – Blockage in the supply of bile • - Osteoarthritis – inflammation in joints due to the wearing of the cartilage • - Sleep apnoea – pauses in breathing during sleep • - Diabetes – High blood sugar • - Respiratory problems

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

12. Exercise Prescription – Cardio Kickboxing • For optimal benefits, the following guidelines are followed: • Frequency: 3-5 days/week • Intensity: 65-95% Max Heart Rate or 6-10 on RPE scale • Duration: 20-60 minutes • Strength training: 1 set of 8-10 exercises that conditions major muscle groups 2-3 days/week • Flexibility training: includes static and dynamic stretches 2-3 days/week • Exercise alone without caloric restriction has only a modest effect on weight loss • Programs conducted at least 3 days per week, using about 250-300 kcal per exercise session are suggested or 4 days per week using 200 kcal per session

13. Warm Up – 10 minutes • Light aerobic activity to increase heart rate • Bob and weave, boxer’s shuffle, various punching techniques • Dynamic movements to warm up joints to the range of motion used • Teaching Aids: Step-by-step teaching, starting from beginners leading into more advanced combinations • Lead by example • Comments: • Participants can work at their own intensity levels • Focus on engaging core muscles throughout warm up

14. Exercises and Activities – 30 minutes • Cardiovascular: 20 minutes • Moving towards more intense punching and kicking • Several combinations of punches and kicks • Teaching Aids: Step-by-step teaching • Start with basic techniques • Add techniques together • Move to more advanced combinations • Lead by example • Comments: 65% APMHR minimum • 220-age(65%) • For the age group of our 3711 class, about 22 beats/10 seconds or 129 beats per minute • Minimum level 6 on a 1-10 scale rating of perceived exertion • Focus on engaging core muscles

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

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

17. Visual Representations

18. Visual Representations

19. Visual Representations

20. Visual Representations

21. Visual Representations

22. Visual Representations

23. Visual Representations

24. Visual Representations

25. Visual Representations

26. Visual Representations

27. Challenge Activity • The class will be split into 2 teams • Each team forms a line up in front of the kicking pad • Each member has 30 seconds to complete as many front kicks as possible • One person will count the kicks landed for each participant • At the end, the number of kicks will be tabulated and a winning team will be selected • Comments: • The kicks must be front kicks • They must hit the target every time • The foot must touch the floor between every kick for the kick to be considered legal

28. References • American College of Sports Medicine (1998). The Recommended Quantity and Quality of Exercise for Developing and Maintaining Cardiorespiratory 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.