1. Blood Pressure

2.  Although blood pressure increases during exercise, an exercise program helps to lower blood pressure overall.

3.  A strong healthy heart allows blood to circulate (move) throughout the body at a lower pressure than normal.

4.  Well trained athletes tend to have lower blood pressure than average people.  Following an exercise session, individuals typically have a drop in resting blood pressure for up to 2 hours following the exercise session.

5.  During vigorous exercise, your systolic blood pressure rises because your heart must work harder to pump more blood with each contraction to keep your muscles supplied with oxygen.

6.  The more strenuous the exercise, the greater the rise in systolic pressure.  During a very vigorous workout, systolic blood pressure in a healthy athlete may rise to as high as 200 mm Hg.

7.  Normally, diastolic blood pressure changes very little, if at all.  In a young, healthy person, diastolic blood pressure typically rises by no more than a few mm Hg, even during a strenuous workout. That's because the blood vessels in your working muscles widen, decreasing peripheral resistance.

8.  During vigorous aerobic exercise, systolic blood pressure normally rises, while diastolic pressure changes very little.

9.  Abnormal blood pressure responses to a workout, such as a large increase in diastolic pressure or an exaggerated spike in systolic pressure, may indicate that you are at risk for developing high blood pressure or cardiovascular disease.

10.  Take blood pressure of every client prior to first training session  Most people do not know their blood pressure and do not have it measured on a regular basis  Screening blood pressure on every client allows you to know if the client should see their doctor before beginning an exercise program  Have client get medical clearance if initial blood pressure is considered hypertensive

11.  Remind client to breathe  Have the client listen to their body- how a person feels should dictate the intensity of the workout

12.  Perform an extended warm up and cool down (7-10 minutes)  Perform low intensity cardiovascular exercise for 30-60 minutes 5 days per week OR  Perform Moderate Intensity Exercise for 20 minutes 3-5 times per week

13.  During strength training blood pressure in working muscle increases substantially  Frequency: 2-3 times per week  8-10 exercises focusing on each major muscle group  Complete 1-3 sets of 8-15 repetitions per exercise

14.  Remind client to breathe - exhale during the hardest part of the exercise  Have clients avoid using the Valsalva Maneuver  Avoid exercises that put the head below the heart

15.  Perform unilateral exercises (single leg press, single arm dumbbell bench press, single arm row)  Reduce overhead loaded exercises (shoulder presses, shrugs) – cause large increase in blood pressure in neck and head  Don’t have client perform 1 rep max testing  Don’t have client perform a more than 2 isometric exercises during a training session

16.  An isometric muscle contraction occurs when tension is generated within a muscle but the length of the muscle does not change.  Isometric contractions are sometimes called static contractions.  Exercises that are classified as isometric include the wall sit and abdominal planks.

17.  Isometric exercise can cause a very dramatic elevation in blood pressure, which may be dangerous is you suffer from hypertension.  Yoga primarily consists of isometric training it is important to remind clients to breathe and avoid poses where the client puts their head below their heart

19.  If your client has a cold, a common medication to take is Dayquil. This can exaggerate heart rate and blood pressure response to exercise. Keep intensity of exercise lower than normal.

20.  If a client is on a Beta Blocker heart rate will not elevate with exercise intensity. It’s important to have your client monitor how they feel during their workout to avoid over doing it.

21. Medications That Increase BPMedications That Decrease BP  Acetaminophen (Tylenol, Ibuprofen etc.)  Antidepressants  Hormonal Birth Control  Caffeine  Cold Medicines (decongestants)  Herbal Supplements (Ephedra, Guarana)  Illegal drugs – Steroids, Cocain, Ecstasy, Methamphetamines  Beta-Blockers – cause heart rates to stay relatively low even when exercising  ACE Inhibitors – work by flushing excess water and sodium out of the body – makes you have to urinate a lot  Calcium Channel Blockers – prevents calcium from entering the muscles of the heart, causes a decreased force of contraction