Physiologic and Training considerations for clients Hypertension

Consistently elevated arterial blood pressure, which, if sustained at a high enough level, is like to induce cardiovascular or end organ damage(resting systolic greater than or equal to 140, diastolic greater than or equal to 90mmHg).

Individuals with resting blood pressure between 120/80 and 135/80mmHg are considered to be pre-hypertensive, normal blood pressure less than 120/80.

  • Blood pressure response to exercise may be variable and exaggerated. Lower intensity(50–45 of work capacity)aerobic exercise is initially recommended.
  • Despite medication, clients may arrive with pre-exercise hypertension.
  • Resistance should consist of peripheral heart action or circuit training, avoid valsalva maneuvers(holding breath) emphasize rhythmic breathing.
  • Hypertension frequently is associated with other conditions such as obesity, diabetes, cardiovascular disease etc.
  • Exercise should target a weekly goal of calorie output of 1500–2000 Kcal progressing as tolerable.
  • Some medications, such as Beta blockers, will attenuate the hear rate at rest and its response to exercise. If taking meds that influence heart rate, don not use predicted maximum heart rage or estimates. Instead us actual heart rate response or the “talk test”.
Basic Exercise Guidelines for Hypertension

hypertension

Mode:stationary cycling, treadmill, walking, rowers
Frequency:3–7 days per week
Intensity:50–85% of maximum heart rate
Stage 1 cardio progression to Stage 2
Duration:30–60 mins
Assessment:push, pull, OH squat, single leg balance(or single leg squat if tolerated).
Flexibility:static and active in a standing or seated position
Resistance 1–3 sets of 10–20 reps 2–3 days a week.
Phase 1 and 2 of OPT model
Tempo should not exceed 1 sec. for isometric and concentric(examples: 4/1/1 instead of 4/2/1 use circuit).
Special considerations
  • Avoid heavy lifting and valsalva maneuvers.
  • Perform exercises in standing or seated position(Head over heart rule).
  • Allow client to stand up slowly and progress slowly.

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