Medical History: Mr. AB, a 60 yr old Caucasian male, comes to your fitness cente
ID: 94885 • Letter: M
Question
Medical History:
Mr. AB, a 60 yr old Caucasian male, comes to your fitness center for an exercise program. He is apparently healthy but has a 15 yr history of hypertension. His goal is to improve his health and fitness and reduce his risk for heart disease. In the past he did heavy resistance training and powerlifting. At present he has a body mass index of 31 kg · m–2. His medications include aspirin (325 mg daily) and atenolol (50 mg daily). He has a familyhistory of premature CHD; his low-density lipoprotein (LDL) cholesterol is elevated (165 mg · dl–1); his resting BP is 148/88 mmHg; and his resting heart rate is 60 beats · min–1. He drinks three or four cans of beer with dinner each evening.
Diagnosis:
Mr. AB has a lengthy history of hypertension. Additional risk factors include obesity, age, family history, dyslipidemia, sedentary lifestyle, and elevated alcohol consumption.
Exercise Test Results:
During a recent maximal exercise test, Mr. AB exercised for 6 min using the Bruce treadmill protocol and achieved a maximum heart rate of 130 beats · min–1 and BP of 240/90 mmHg. He did not develop any significant arrhythmias or ST-segment changes.
Exercise Prescription:
Mr. AB achieved 81% of his age-predicted maximal heart rate (HRmax). The test was negative for underlying cardiovascular ischemia. The initial prescription should be set at a modest intensity (40% V.O2R), and emphasis should be placed on building exercise duration to increase energy expenditure. Non-weight-bearing activities should be emphasized initially to minimize risk of musculoskeletal injury.
Questions:
1. Is it necessary for Mr. AB to exercise at high intensity to help manage his hypertension?
2. How will atenolol (a b-blocker) affect the prescription of a target heart rate range for Mr. AB?
3. What is an appropriate aerobic exercise prescription for Mr. AB?
4. What advice would you give Mr. AB about going back to heavy resistance training and powerlifting?
5. What additional lifestyle modifications should be discussed with Mr. AB to optimize his BP control?
Explanation / Answer
Exercise has multiple health benefits. Even if the main reason to exercise is to improve the composition of our body, we can still enjoy lots of benefits like a healthier heart, improvements in bone density, better brain health and a lower risk for a number of health problems. Even if you have a family history of hypertension and want to avoid getting it? If you’re at risk for high blood pressure, cardiovascular exercise helps to lower blood pressure and may potentially keep hypertension at bay.
1.Ans) Yes . It is necessary for Mr. AB to exercise at a high intensity because many researches found that...,
Based on these factors, we can conclude that high-intensity exercise may be more beneficial for heart health and for preventing hypertension than moderate-intensity exercise.
2.Ans) Atenolol belongs to the group of medicines referred to as beta-blockers.
3.Ans) Cardiovascular or aerobic exercise can help lower the blood pressure and make your heart stronger. Examples: include walking, jogging, jumping rope, bicycling (stationary or outdoor), cross-country skiing, skating, rowing, high- or low-impact aerobics, swimming, and water aerobics.
As the medical diagnosis of Mr. AB has hypertension, obesity, age factor, family history, dyslipidemia, sedentary lifestyle, and elevated alcohol consumption., an appropriate aerobic exercise prescription would be walking, jogging, swimming, bicycling (stationary or outdoor), and yoga for stress relief.
Lastly, cool down. When you're done exercising, don't stop suddenly. Just slow down for a few minutes. This is especially important for someone with high blood pressure.
4.Ans) My advice to Mr. AB is not to go back to heavy resistance training and powerlifting. because,
So, it is better not to go back to heavy resistance training and power lifting.
5.Ans) Lifestyle plays an important role in treating high blood pressure. If you successfully control your blood pressure with a healthy lifestyle, you might avoid, delay or reduce the need for medication.
Here are 10 lifestyle modifications Mr. AB can make to lower his blood pressure and keep it down.
1. Lose extra pounds and watch your waistline;
2. Exercise regularly;
3. Eat a healthy diet;
Eating a diet that is rich in whole grains, fruits, vegetables and low-fat dairy products and skimps on saturated fat and cholesterol can lower your blood pressure by up to 14 mm Hg. This eating plan is known as the Dietary Approaches to Stop Hypertension (DASH) diet.
It isn't easy to change your eating habits, but with these tips, you can adopt a healthy diet:
4. Reduce sodium in your diet;
Even a small reduction in the sodium in your diet can reduce blood pressure by 2 to 8 mm Hg.
5. Limit the amount of alcohol you drink;
Alcohol can be both good and bad for your health. In small amounts, it can potentially lower your blood pressure by 2 to 4 mm Hg.
6. Quit smoking;
Each cigarette you smoke increases your blood pressure for many minutes after you finish. Quitting smoking helps your blood pressure return to normal. People who quit smoking, regardless of age, have substantial increases in life expectancy.
7. Cut back on caffeine;
The role caffeine plays in blood pressure is still debated. Caffeine can raise blood pressure by as much as 10 mm Hg in people who rarely consume it, but there is little to no strong effect on blood pressure in habitual coffee drinkers.
Although the effects of chronic caffeine ingestion on blood pressure aren't clear, the possibility of a slight increase in blood pressure exists.
To see if caffeine raises your blood pressure, check your pressure within 30 minutes of drinking a caffeinated beverage. If your blood pressure increases by 5 to 10 mm Hg, you may be sensitive to the blood pressure raising effects of caffeine. Talk to your doctor about the effects of caffeine on your blood pressure.
8. Reduce your stress;
Chronic stress is an important contributor to high blood pressure. Occasional stress also can contribute to high blood pressure if you react to stress by eating unhealthy food, drinking alcohol or smoking.
Take some time to think about what causes you to feel stressed, such as work, family, finances or illness. Once you know what's causing your stress, consider how you can eliminate or reduce stress.
If you can't eliminate all of your stressors, you can at least cope with them in a healthier way. Try to:
9. Monitor your blood pressure at home and see your doctor regularly;
Home monitoring can help you keep tabs on your blood pressure, make certain your lifestyle changes are working, and alert you and your doctor to potential health complications. Blood pressure monitors are available widely and without a prescription. Talk to your doctor about home monitoring before you get started.
Regular visits with your doctor are also key to controlling your blood pressure. If your blood pressure is under control, you might need to visit your doctor only every six to 12 months, depending on other conditions you might have. If your blood pressure isn't well-controlled, your doctor will likely want to see you more frequently.
10. Get support;
Supportive family and friends can help improve your health. They may encourage you to take care of yourself, drive you to the doctor's office or embark on an exercise program with you to keep your blood pressure low.
If you find you need support beyond your family and friends, consider joining a support group. This may put you in touch with people who can give you an emotional or morale boost and who can offer practical tips to cope with your condition.