Blood Pressure

BLOOD PRESSURE

Normal resting blood pressure (BP) is approximately 120/80. The first number (systolic BP) is an indication of how much resistance your heart has to overcome to send blood to the body and lungs when it contracts. The second number (diastolic BP) reflects the tension in your blood vessels when the heart fills during its relaxation phase. It is normal for BP to rise in response to the demands of working muscle during exercise, however elevated BP at rest is a condition that can have serious long term consequences. High blood pressure at rest (hypertension) is defined as a systolic BP equal to or greater than 140 or diastolic BP equal to or greater than 90. Chronic hypertension can damage the lining of blood vessels and promote the process of atherosclerosis which narrows blood vessels and leads to even higher BP. It is also possible to have low BP (hypotension) which can result in insuficient blood flow to the brain and cause fainting.

Classification of blood pressure for adults aged 18 years and older (according to the American College of Sports Medicine).

Cateogory	Systolic BP (mmHg)	Diastolic BP (mmHg)
Hypotension	<90	<60
Optimal	<120	<80
Normal	120-129	80-84
Pre-hypertension	130-139	85-89
Hypertension
Stage 1	140-159	90-99
Stage 2	>160	>100

Measuring resting blood pressure is very important prior to beginning an exercise program. Decisions should be based on two or more readings measured by qualified personnel.

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Lifestyle modifications to reduce hypertension:

• Weight control.
• Increased physical activity.
• Alcohol moderation.
• Restriction of dietary sodium
• Stress management
• Smoking cessation.
• Adequate intake of sodium, calcium, and magnesium
• Possible discontinuation of medications known to elevate BP
  • Birth control pills
  • Antihistamines
  • Coritcosteriods

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Components of Cardiovascular Risk Stratification in Patients with Hypertension.

Major Risk Factors:

• Smoking
• Diabetes mellitus
• 60+ years of age
• Sex (men and postmenopausal women)
• Family history of cardiovascular disease: women under age 65 or men under age 55).

Target Organ Damage caused by hypertension:

• Heart diseases:
  • Left ventricular hypertrophy (enlargement of the left chamber of the heart)
  • Angina/prior myocardial infarction (heart attack)
  • Prior coronary revascularization
  • Heart failure