Hypertension: a call to action

In the past few weeks I have presented information about hypertension and the effects of exercise and diet. Now it is up to you. Since hypertension is associated with an increased risk of cardiovascular disease, you can add years to your life by taking good care of yourself. It's really simple: exercise and eat a healthy diet most of the time. Although pharmacological treatments can also treat some BP conditions effectively, lifestyle modifications should also be implemented as soon as possible.

Both cardiovascular training and resistance training can lower high blood pressure. Aim for moderate intensity exercise performed for at least 30 minutes on most days of the week. Just yesterday we heard from the "Heart and Stroke" people that 1 in 3 Canadians will be affected by heart disease; the number 1 reason that people cited for not exercising was "not enough time". Let's find the time.

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Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
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Hypertension: what about combining exercise with diet

Overweight and obesity are associated with many cardiovascular risks, including hypertension. Exercise has become a staple in weight management and weight loss programs, but is mostly effective when implemented concurrently with diet modifications. Specific dietary guidelines that have been shown to lower hypertension are explained in the Dietary Approaches to Stop Hypertension (DASH) diet, which recommends a diet rich in fruits, vegetables and low-fat dairy foods, as well as restrictions in alcohol and sodium intake (Bacon et al. 2004). A recent review of lifestyle interventions found that combining these recommendations with the intake of fish oil supplements resulted in significant reductions in BP (Dickinson et al. 2006). Although other studies have suggested that potassium, magnesium and calcium supplementation also play a role in BP reduction, the Dickinson review failed to find strong clinical support for these claims.

Controversy remains over whether combining exercise with weight reduction has an “additive” effect. Both have been shown to help reduce BP independently, yet a comprehensive review by Hagberg and colleagues (2000) concluded that exercise training and dietary weight loss are independent, and that exercise can be effective in lowering BP without dietary changes. Other reviews maintain this idea but also recommend combining diet and exercise to facilitate weight loss (Bacon et al. 2004).

For more information about the DASH diet visit: http://dashdiet.org/

To be continued



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Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
www.gaiaadventures.com
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Hypertension: what exercise mode is best?

Cardiovascular Training. A significant amount of evidence indicates that cardiovascular training helps reduce BP. In a meta-analysis of 54 clinical trials, findings included a reduction in SBP of an average of 3.84 and in DBP of an average of 2.58 in hypertensive men and women (Whelton et al. 2002).

Resistance Training. Although to date there is less research on the effect of resistance exercise on BP, one recent meta-analysis found a decrease of 3.2 and 3.5 for SBP and DBP, respectively (Cornelissen & Fagard 2005a). Yet there is debate—in fact, an association has been shown between vigorous resistance training and reduced arterial compliance (i.e., the arteries stiffen and do not expand as well to increased blood flow) (Miyachi et al. 2003), which can lead to an increase in SBP. However, a study by Kawano and colleagues (2006) demonstrated that aerobic training performed in conjunction with resistance training negated the decrease in arterial compliance. This suggests that resistance training should be accompanied by aerobic training as an intervention strategy, which is in agreement with the ACSM recommendations for the prevention, treatment and control of hypertension (Pescatello et al. 2004a).

Alternative Exercise Modes. A recent Chinese study found that qigong (a series of relaxation, breathing, gentle movement and walking exercises) resulted in the reduction of both SBP and DBP (Cheung et al. 2005). This notable finding may lead to further research into alternative exercise methods that may be beneficial in reducing BP.

To be continued

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
www.gaiaadventures.com
Join LuvURLife fitness series: online training only $20/month

Hypertension: how much exercise and for how long

Most exercise recommendations for hypertensive patients suggest a duration of 20–60 minutes of low- to moderate- intensity cardiovascular exercise (40%– 70% VO2max) performed three to five times a week (Wallace 2003). The results of several studies confirm that low- to moderate-intensity training is just as efficient in lowering BP as high-intensity training (>70% VO2max) (Halbert et al. 1997). An individual’s fitness level may play a central role in determining optimal intensity. A recent study of 49 middle-aged men with normal-high (SBP = 130–139; DBP = 85–89) to stage 1 hypertension (SBP = 140–159; DBP = 90–99) randomly assigned to a light or moderate (40% or 60% VO2max) exercise protocol found that lower-intensity exercise led to more reductions in BP in the older, less fit subjects, whereas moderate-intensity exercise was more effective in the physically fit men (Pescatello et al. 2004b).

Although more research is needed to better specify the optimal intensity, the general guidelines of moderate-intensity exercise for 30 minutes or more on most days of the week are appropriate for successfully lowering elevated BP levels. The good news is that moderate-intensity exercise programs can be readily implemented and are easily maintained for many populations. In addition, they impart less musculoskeletal injury for previously sedentary populations, who are not accustomed to vigorous physical exertion.

To be continued

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
www.gaiaadventures.com
Join LuvURLife fitness series: online training only $20/month

Have you heard about the "silent killer"?

During my regular visits to my doctor, for years now, my blood pressure was regularly and predictably measured at 120/80. After all, I exercised every day and kept my body weight within normal ranges. Then something happened after menopause. My blood pressure started climbing. I do not know if it was the fact that now I was over 50, going through some emotional hard times, eating too much processed food, sugar, coffee - but there it was, my blood pressure was now regularly over 135/80 and sometimes even a little higher. My doctor did not seem too alarmed about my readings. She was confident that everything was going to be fine. I started to do research to find out about this "silent killer".

Hypertension is a widespread health problem that affects nearly 25% of the adult population in the United States (Fang, Wylie-Rosett & Alderman 2005). Hypertension increases the risk of cardiovascular disease—the number-one cause of death in the U.S.—and other maladies, including renal disease, stroke, heart failure and peripheral artery disease. Although hypertension is defined as systolic blood pressure (SBP) > 140 millimeters of mercury (mm Hg) and/or diastolic blood pressure (DBP) > 90 mm Hg, risk factors can be seen when blood pressure is as low as 115/75 (SBP/DBP) and begin to double in risk for every 20/10 increase (Pescatello et al. 2004a). A new classification, “prehypertension” (SBP = 120–139 and DBP = 80–89), has been introduced to identify individuals who are at a higher risk of developing the condition.

As you can see, hypertension can have serious consequences. However, the good news is, exercise is one of the best ways to combat hypertension according to American Heart Association, the American College of Sports Medicine, the National Institutes of Health, and more (Wallace 2003). But how much exercise is required? What about diet and weight loss? In my next few blogs I will answer these questions and more.

To be continued

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
www.gaiaadventures.com
Join LuvURLife fitness series: online training only $20/month

Safe Strength Training - Part 2

When executed properly, group strength training (or solo training) is a safe form of exercise that provides many benefits. Here are a few fundamentals that will assist you in being injury-free.

Warm Up. A good general warm-up increases blood circulation to the muscles, lubricates the joints and prepares the entire body to handle increased loads placed on the muscles and joints. The warm-up should address all major muscle groups and associated joints and increase the heart rate at a gentle pace.

Learn Alignment. Learn proper alignment for each exercise. Train for perfect alignment with little or no resistance before progressing to loads. The success of your training depends on how well you can safely execute the movement consistently.

Slow Down. Perform the exercise slowly at first, in good alignment. Add speed as the last training variable. When good form starts to suffer, take it as a signal that you have exceeded your own safe “speed limit.”

Modify. If you have challenges with your body, you must know how to modify the moves to suit your skills and body characteristics. Decrease the range of motion, lower the resistance (different color band or weight), do fewer reps or change the exercise if you feel joint discomfort or pain.

Regular exercise in a group setting can be hugely rewarding to your health and well-being. See you out there!

Learn more about strength training at my Stability Ball Training workshops accredited for Massage Therapists and Personal Trainers across Canada or try a private personal training session. http://www.gaiaadventures.com/bodyball.html

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Kinesiologist, Workshops
www.gaiaadventures.com

Safe Strength Training: Injury Avoidance

Injuries happen during a workout, particularly in a group class setting. It's helpful to know what kind of injuries might occur, and then learn how to avoid them.

Muscles. A strain occurs when muscle tissue stretches or tears. Many people call muscle strains “pulled muscles.” Deconditioned group strength participants often experience muscle strains and delayed onset muscle soreness (DOMS). It is common, for example, to see pulled hamstrings and/or lower-back injuries when participants overestimate their hamstring flexibility while executing a dead lift. DOMS occurs 24–48 hours after the exercise session and can last several days. It is not considered serious; however, an individual’s voluntary range of motion may be hindered, which can also affect subsequent training sessions. If pain persists past the initial period of soreness and/or increases in intensity, students should be referred to a physician.

Tendons and Bursae. Tendonitis and bursitis are common overuse injuries seen in group strength training. Tendonitis is an inflammation or irritation of a tendon. Tendons are the thick, fibrous cords that attach muscles to bones. Bursitis is inflammation or irritation of a bursa. Bursae (the plural of bursa) are small sacs located between moving structures such as bones, muscles, skin and tendons. Bursae act as cushions to allow smooth gliding between these structures (American College of Rheumatology 2005). If participants perform exercises such as biceps curls, triceps extensions and push-ups with too much weight or too many repetitions, they may irritate tendons and bursae in the shoulders, elbows and wrists. Gripping heavy bars and dumbbells before developing adequate strength in the wrists can exacerbate carpal tunnel syndrome (chronic impingement of the median nerve) or cause wrist strain.

Ligaments. Participants who incorrectly perform exercises such as squats may place undue stress on the ligaments of the back, knees and ankles. Common errors when squatting include lowering the body below 90 degrees of knee flexion; having an exaggerated forward lean of the upper body; and lifting the heels off the floor to extend the range of motion. People who hyperextend their knees or elbows—as when resuming a standing posture from a squat or lunge, or straightening the elbows in the up position of a push-up—place additional stress on stabilizing ligaments and tendons, which can inflame joint structures. Hyperextending the elbows when doing biceps curls or triceps extensions is another common error.


To be continued

Let's connect at info@gaiaadventures.com.

Catherine D'Aoust at GAIA Adventures, Personal Training/Kinesiologist, Workshops
www.gaiaadventures.com
Join LuvURLife fitness series: online training only $20/month