202430 EHR519 Week 3 lecture 2 exercise guidelines for hypertension GB.pdf

Warning This material has been produced and communicated to you by or on behalf of Charles Sturt University in accordance with section 113P of the copyright act (Act). The material in this communication may by subject to copyright under the act. Any furth...

Warning This material has been produced and communicated to you by or on behalf of Charles Sturt University in accordance with section 113P of the copyright act (Act). The material in this communication may by subject to copyright under the act. Any further reproduction or communication of this material by you may be the subject of copyright protection under this act. Do not remove this notice 1 EHR519 week 3b (hypertension) Exercise Testing and prescription Dr Gavin Buzza 2 Clinical Considerations – Signs and Symptoms Many do not experience symptoms Symptoms tend to accompany a hypertensive crisis (SBP >180mmHg or DBP >120mmHg) rather than hypertension per se. Headache Dizziness Palpitations Epistaxis (nose bleed) Hematuria (RBC in urine) Blurred vision 3 Individuals who do not require medical evaluation of exercise testing prior to beginning an exercise program: Controlled hypertension (115 mmHg Treadmill Rate Pressure Arrhythmias and Use of medications (2-3METs/3min stage) Product (RPP) myocardial (vasodilators or β- RPE ischemia blockers) should be Ventilatory taken at usual time expired gas relative to exercise responses session Resistance Free weights Determine 1RM or MVC; 1RM 1-RM; MVC Evaluate physical signs Observe for or resistance may be estimated from a and symptoms, exaggerated pressor machines higher RM (e.g., 5RM) abnormal BP or HR response (i.e., systolic responses; if ECG is BP >250 mmHg or monitored, evaluate for diastolic BP >115 arrhythmias and mmHg); avoid myocardial ischemia Valsalva maneuver 15 Role of Exercise Prescription 16  Progress gradually, avoiding large increases in any of the FITT components; increase exercise duration over first 4-6 wk, and then increase frequency, intensity, and time (or some combination of these) to achieve recommended quantity and quality of exercise over next 184-8 months Considerations Level of BP control Recent changes in antihypertensive medications Medication-related adverse effects Presence of target organ disease and other comorbidities Age 19  Special Considerations An exaggerated BP response to relatively low exercise intensities and at HR levels