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