As blood flows it has to overcome various variables including that of total peripheral resistance (TPR) which may include fatty deposits. Internal forces may stop the rate of flow and cause pressure to rise and over time without lifestyle changes and PA can ultimately lead to clotting and heart attack (MI) HTN or high blood pressure (HBP) can be defined as “having a sustained blood pressure of 140/90mmHg or above”. The implications for having such a condition can be very serious. HBP if not controlled or ignored can lead to other issues such as the development of CHD.

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Individuals who have a BP > 160/95mmHg have up to a 300% higher incidence rate for developing such heart conditions when compared to someone with normal values (normotensives), Taylor et al, (1996). As the blood flows through the system under high pressure, blood forced can damage the artery walls, in particular the point at which blood flows around bends (the outer walls). Often referred to as the silent killer hypertension has no signs and symptoms but in cases of high readings individuals may experience visual problems, nose bleeds and dyspnoea.

Many risk factors include age; body mass index (BMI), body fat % (BF) salt intake, alcohol, smoking, genetics, stress and lack of physical activity (PA). The most effective exercise prescription usually consists of rhythmical continuous exercise that is low to moderate intensity (aerobic), thus having significant improvement upon the cardiovascular (CV) system (muscle pump/vascular and pulmonary function); in fact research suggests that this type of exercise can reduce SBP by up to 7mmHg. Wilkins (2006), moreover resistance exercise that is low into moderate intensity can also be adopted providing it is safe and effective for the individual.

It is important for individual to make the correct choice when deciding which drug to take in regards to symptoms. My client decided to change to nebivolol as she experienced less symptoms such as dry cough. Nebivolol in my client’s case are BB which have a arteriolar vasodilating action allowing vessels to become more elastic thus reducing total peripheral resistance (TPR). As a result BP is lowered allowing my client to partake in PA to control the condition. An important consideration when participating in an exercise programme is the effect that the medication has upon HR response.

As the drug slows the heart rate down, using heart rate monitors or sensors could prove controversial as the value of HR may not actually be the true value, as a result it may be possible for client to train too hard but not show on their heart rate. Research suggests to allow for 10bpm on top of the value show on the console or heart rate monitor or use the Gellish method and HRR method together. However as this is a guestimation I would use other means as seen in the 6 week program including METS, RPE, observation, talk test, and VO2% to gain a more accurate picture of what is happening and how the person is really feeling.

There are many side effects that happen as a result of administration of such medication as highlighted in Table 4. Common effects include dyspnoea (breathlessness), and fatigue. Through my observation if my client appears to be struggling with normal breathing or shows poor form on all equipment as an instructor I would look back at the programme and identify issues within the programme through discussions with the client that may have further progressed these effects otherwise hydrate, rest (seated), and adapt in terms of the FITTA principle.

Responding safely and effectively is important in all cases, other side effects are highlighted below. Furthermore dizziness and headache can become present, in this case prior to exercise, machines will be used that are safe, supporting and not mainly reliant on balance and coordination. Considerations for the programme include supportive machinery, hydration, use of RPE and slow movements.

Oestrogens are necessary for the development of female secondary sexual characteristics. Premique belongs to the HRT group (hormone replacement therapy) using the chemical name Oestrogens e. g. brands such as Premique is given during HRT in my client’s case as a result of OST to strengthen bones and to maintain hormonal balance by replacing the hormones partly responsible for bone renewal. Oestrogens play an important role in calcium absorption, if we don’t produce it bone become weaker.

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