Kin 4100 exam 2

What is considered prehypertension?

(120-139)/(80-90)

___% of of US adults are obese

34

2 types of hypertension

Primary & Secondary

Blood FLOW formula

change in pressure/resistance

Cardiac output is inversely proportional to

resistance

Define Obesity

•A chronic disease characterized by excessive body fat •Leads to serious health problems •BMI >30

Waist to hip ratio

•Circumference of waist / hips •Distribution of fat

Waist Circumference

•Corresponds to abdominal fat (visceral)

Diuretics

•Decrease blood volume •Excretion of potassium

Will exercise help a person avoid the loss of muscle weight or water weight when he or she diets?

•During a low-calorie diet about 75% of the weight loss is fat and 25% is FFM •Exercise, whether aerobic or weight training does not appear to affect the loss of FFM

What does it mean to be overweight?

•Excess weight according to a standard, such as height •Less than obese •BMI = 25 -29.9

Does exercise cause the body to burn calories for a long time after an exercise session?

•Exercise will increase RMR post exercise •20 to 45 minutes, resulting in an extra 10 to 30 extra calories •Very small to have a significant effect

Theories of Obesity

•Genetic and parental influences: •May explain up to 25% of difference •Identical twins separated show similar weights •Lifestyle factors may be important •High-calorie, high fat diets •Insufficient energy expenditure

Being obese puts you at risk for what other diseases

•Hypertension •Hypercholesterolemia •Type 2 diabetes •Coronary heart disease •Stroke •Certain cancers

Set Point Theory

•Hypothesizes that the body has an internal control mechanism

Resistance depends on

•Length & Radius of vessel •Viscosity of blood

Why is it that if a person diets while loosing weight, they don't always loose weight

•More rest throughout day counters exercise •Increased caloric intake •Net energy cost of exercise is not that great

Factors influencing primary hypertension

-Blood plasma volume. -Hormone activity in people who manage blood volume and pressure using medication. -Environmental factors (stress and lack of exercise (NORMAL HTN) PHTN= BV -H-EF

Physical activity influence on weight

-contributes to weight loss -helps minimize weight gain as one ages - appears to be the best single predictor in maintaining weight loss

Optimal weight loss is

1% body weight per week

What are the top 4 countries suffering from obesity

1) American Somoa 2) Kiribati 3)Saudi Arabia 4)US

ANS 3 functions:

1. system of motor neurons that innervate the smooth muscle, cardiac muscle, and glands of the body 2. Maintains homeostasis 3. Unconscious control

Stage 1 hypertension

140-159/90-99

When was BP first measured?

1733

First sphygmomanometer invented in what year

1880's

________ % are unaware they have HYPT

25

A BMI of >/= _____ is considered obese

30

Caloric expenditure of ______ to ____kcal/day (1000 to 2000 kcal/week)

300 to 500

•Caloric expenditure of ___________ kcal/day (1000 to 2000 kcal/week)

300 to 500

ACSM weight loss recommendation: negative caloric balance of

500 to 1000 kcal/day

Estimated that in U.S., ____% of adults are overweight

68%

prevalence of hypertension

75 mill in US ~30%

What is considered a normal BP

<120 systolic/<80 diastolic

1 lb. of fat

= 3500 calories

Stage 2 hypertension

>160/>100

What are actions of the Sympathetic system

Accelerates heart rate •Causes a release of epinephrine (adrenaline) •Dilates peripheral BV's, pupils, bronchi •Slows down digestion

Prospective Cohort Studies (2)

Aerobic Center Longitudinal Study by Stephen Blair Harvard Alumni Health Study by Paffenbarger

Obesity is most prevalent in what races

American Indian Black non hispanic hispanic

what is the standard method of measuring overweight and obesity

BMI

Effects of untreated HTN

Enlargement of heart •Cause aneurisms •Damage to the kidneys •Accelerate CAD

biological plausibility of HTN

Exercise training can lower RBP by reducing basal Q or TPR Insulin -HTN patients often insulin resistant

Stephen Blair's study looked at

Fit vs Unfit & relationship to HTN

NIH identifies obesity as a chronic diseases that develops from an interaction of what 4 factors

Genotype •Environment Dietary habits Physical activity habits NIH obesity=GEDP

50 million have "______ ________" BP

High normal

When looking at hemodynamics, there is a proportional difference btwn ________ and ___________.

MAP & Right Arterial Pressure (change in pressure)

At age 75 and older what is the % if having high BP in US?

Males-75% Females-80%

In what region in the US is HTN most prevalent?

Mid-eastern south (OK, AR, LA, MS, AL)

What neurotransmitters are present in Parasympathetic, Sympathetic, and Somatic

Para-ACH Sympa-ACH, EPI, NE Somatic- ACH

Explain pressure changes of BP across the systematic circulation.

Pressure difference in greatest in LEFT Ventricle, then Large Art's

• 1905 - ________used a stethoscope to detect arterial pulse

Russian Nikolai Sergeyevich Korotkoff

What are actions of the Parasympathetic system

Slows heart rate •Constricts peripheral BV's, Bronchi, & pupils •Aids or speeds up digestion and absorption of nutrients

Components of PNS

Somatic & ANS

somatic vs autonomic nervous system

Somatic or INVOL: single axon w/ cell bodies IN CNS Autonomic or VOL: Pre & post ganglionic neurons Cell bodies IN & OUTside of CNS

Classification of Overweight & Obesity by BMI (kg/m^2)

Underweight <18.6 Normal 18.5-24.9 Overweight 25-29.9 Obesity: I 30-34.9 II 35-39.9 III Extreme Obesity >/= 40

BP depends on ______, _______, _______.

Volume of blood Rate of Flow Diameter/Radius of Vessels BP= V, R, D

What are two ways of measuring patterns of body fat and disease risk

Waist Circumference & Waist to hip ratio

HTN -Cross-sectional Studies demonstrate

an association w/ inactivity & HTN

What race is obesity the lowest

asain

ACSM weight loss recommendation: should include ______ modifications & an _________ program

behavior exercise

What are the types of meds to treat HTN

beta blockers Calcium channel blockers Diuretics

What race has the highest risk for HTN in US ages 20 years and older?

black Americans

Motor Division of PNS

breaks into ANS & Somatic Nervous System (ANS & SNS)

sensory division of PNS

brings info to CNS from receptors in peripheral tissues and organs

Causes of secondary hypertension

caused from something else that is known, for example kidney disease, pregnancy

yoyo dieting What is yoyo dieting associated with?

continuing pattern of gaining and losing weight; especially dangerous to health •"Weight variability" is associated with a higher risk for CVD and all-cause mortality

•A comprehensive weight loss program should include

diet, exercise, and behavior modification

MAP or mean arterial pressure should be ____mm Hg.

equiv to 100

Obesity affects people in what two ways?

ethnicity & years of education

Sympathic nervous system is also as the "______ _______" system

fight or flight

Aerobic Center Longitudinal Study on compared ______ to ______ and found that those who were ___ had an increased risk for ______.

fit vs unfit unfit CVD mortality

Blair and Paffenbarger conclusively found a relationship btwn

increased activity and its positive effect on health including HTN

resistance formula

length x viscosity/radius^4

Long term success rate of treating obesity is ____

low

ACSM weight loss recommendation: weight loss per week

max 0.5 to 1 kg/week

ACSM weight loss recommendation: caloric intake /day

no lower than 1200 kcal/day

Parasympathetic NS is most active in ________ situations while Sympathetic nervous system is stimulated during __________________ _____________.

non stressful situations vigorous activity

What kind of activities are recommended for obese individuals

non-weight bearing

HTN can develops on a _____ or ____ factor.

one or all

Obese individuals are at an increase risk of __________

orthopedic injury

what is the best single predictor in maintaining weight loss

physical activity

Cardiac output is directly proportional to _______________________________________________.

pressure difference btwn 2 ends of the system

Beta Blockers

reduce resting & exercise BP

A small change in vessel diameter can have a dramatic impact on _______.

resistance!

parasympathetic nervous system is also know for "______ & _____"

rest & digest

Harvard Alumni Health Study by Paffenbarger looked at

risk factors that could be modified with control of amount of exercise

HTN is also know as the "____ ____"

silent killer

somatic nervous system controls _______ muscle while ANS controls ________, ______, and _______.

skeletal Smooth muscle, glands, cardiac muscle

2 divisions of the autonomic nervous system

sympathetic and parasympathetic

ANS separated into

sympathetic and parasympathetic

Hemodynamics

the science of the blood flow through the circulation from hight to low pressure

True/False: Obesity has increased in ages 20-74 as well as ages 6-19

true

Treating Hypertension -Lifestyle Modifications

•Lose weight if overweight •Reduce sodium intake •Regular aerobic physical activity •Limit alcohol intake •Maintain proper dietary potassium and calcium •Consume a diet rich in fruits & vegs

Will exercise help RMR stay higher?

•RMR may drop 10 to 30% •Studies indicate that exercise will not help increase RMR during dieting •In fact, exercise may cause RMR to slow down further

•Behavior Modification of treating obesity

•Self-monitoring: Food diary •Control of events the precede eating: Effects of moods •Development of helpful techniques •Reinforcement through rewards

•Cooper Clinic in Dallas

•Stephen Blair •Risk of CVD and mortality were compared based on fitness level •Low fit men show twice the risk regardless of BMI

Can regular exercise help prevent weight gain during adulthood?

•Studies indicate that as physical activity decreases, degree of obesity increases •Long-term physical activity is r/t to a lower risk of weight gain •People who are active may be more disciplined in other areas of their lifestyle. •Regular exercise can help maintain body composition as one ages

Dr. Glenn Gaesser research questioned if fatness automatically increase ones risk of death found what?

•Sufficient evidence is lacking showing that overweight and obesity are directly responsible for early death •Coronary heart disease, hyperlipidemia, hypertension, & type 2 diabetes

What are the main benefits of exercise for weight loss?

•To improve: health aerobic fitness lipid profile psychological state •Lower risk of obesity-related diseases •Enhance long-term maintenance of weight loss*

Calcium Channel Blockers

•Vasodilation (reduce total peripheral resistance) •Potential for post-exercise hypotension

Settling Point Theory

•Weight loss and gain is related to patterns of diet and physical activity •Persons "settle" into habit