Hypertension or high blood pressure has often been referred to as The Silent Killer.  It is possible to have high blood pressure and not realize it until symptoms of other disease have shown up.  Hypertension is persistently high blood pressure.  A diagnosis of hypertension is not made after just one reading, but several.  It is a good idea for all of us to be aware of our normal blood pressure. There are blood pressure cuffs in all pharmacies now and we should take advantage of using these at regular intervals.  The other alternative is to have an automatic blood pressure cuff at home.  "Blood pressure is the force exerted by the blood against a vessel wall.  During a normal cardiac cycle, blood pressure reaches a peak that is followed by a trough.  The peak or maximum pressure occurs during systole as the left ventricle pumps blood into the aorta. 

Normal systolic pressure is 120 mm Hg.  The trough occurs during diastole as the ventricles relax.  This is the time when minimal pressure is exerted against the arterial walls at all times.  Normal diastolic pressure is 80 mm Hg."  (Source:  Fundamentals of Nursing, Potter and Perry)

"Hypertension is not a single disease entity in the usual sense, but rather a major indicator of the prognosis for future development of cardiovascular, cerebrovascular and renal disease."  (Source: Encyclopedia and Dictionary of Medicine Nursing and Allied Health, Miller and Keane)

Hypertension causes thickening and loss of elasticity in the arterial walls.  Blood flow to vital organs such as the heart, brain and kidneys decreases.  High blood pressure is often asymptomatic which is the problem because with no symptoms there is no reason to seek medical attention.  Even if symptoms are present they are often felt to be insignificant and ignored.  Factors that have been linked to essential hypertension include
heredity, smoking, high cholesterol, obesity, stress and excess alcohol consumption.  Hypertension can be controlled and it's resulting disease processes can also be controlled.  Exercise can help to control blood pressure, promote relaxation and control body weight.  An excellent resource for more information is www.heartandstroke.com   If you go to the "National Site" you will find a button for blood pressure.

The chart below is from the Canadian Heart and Stroke web site.  Please refer to it for more in depth information.  "Lifestyle changes to manage your high blood pressure. There are two ways to control and manage your blood pressure: medication and lifestyle habits. Medication can help you control your blood pressure, but it cannot cure it. That's why it's important to make sure your lifestyle habits are healthy, too. Smoking, eating salty,
fatty foods, drinking alcohol and being inactive are harmful to your heart and may also raise your blood pressure. Thankfully, making changes to your lifestyle habits are within your control, unlike your family medical history. Studies show that each lifestyle change you make has the potential to lower your blood pressure readings. Look at the chart below to see where you can make a difference." For more information on the DASH diet, please
check out the heart and stroke web site.

Physical Activity – Engaging in moderate or vigorous physical activity 30-60 minutes per week = lowers blood pressure by 4.9/3.7 points (systolic/diastolic)

Weight control – For losing weight, per kilogram lost = lowers blood pressure by 1.1/0.9 points

Diet – By following a DASH diet = lowers blood pressure by 11.4/5/5 points

Sodium (salt) intake – By reducing sodium intake by 1,800 mg = lower blood pressure by 5.12/7 points.

Alcohol consumption – By reducing intake by 3.6 drinks per day = lowers blood pressure by 3.9/2.4 points.

There you have it, the ups and downs on blood pressure.  It is the one disease within our control, so if you have a family history of hypertension or have any of the risk factors associated with high blood pressure, please see what you can do to make the changes necessary to maintain a healthy blood pressure.

Till next time,

Narina Prokosch, RN, CPT

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Exercise intensity is often a misunderstood concept. How hard should I be working out, or how hard do I need to work out to see
benefits. If you are unaccustomed to exercise, even a moderate amount of intensity will be of benefit. But if you looking to make
noticeable changes to your body, lose weight and increase muscle tone, then exercise intensity is important. In fact, not only is
it important, but along with necessary nutritional changes, it could be the deciding factor in the equation. What I am talking
about is referred to as the “afterburn” or EPOC. EPOC stands for excess postexercise oxygen consumption.

EPOC, or this sustained oxygen consumption was originally referred to as an oxygen debt and was first hypothesized by A. V. Hill and H. Lupton in 1922.

A brief overview of EPOC is provided by Dr. Len Kravitz, PhD., Associate Professor of Exercise Science, The University of New
Mexico.

www.drlenkravitz.com

“During EPOC the body is restoring iteself to its pre-exercise state, and thus is consuming oxygen at an elevated rate. This
means that energy is also being expended at an elevated rate. The following occurs during EPOC:

1. Replenishment of Energy Resources: Replenishment occurs for the immediate source of energy, known as the phosphagen system, which is comprised of creatine phosphate and ATP (adenosine triphosphate).

2. Re-oxygenation of Blood and Restoration of Circulatory Hormones: During exercise metabolism, large amounts of oxygen are used to break down food substrates for energy. Therefore, the body continues to expend energy after exercise to re-oxygenate the blood.

3. Decrease in Body Temperature: As energy is liberated from the exercising muscle tissues of the body, heat is produced. Thus,
during EPOC, the body must expend energy to return to the normal core body temperature.

4. Return to Normal Ventilation and Heart Rate: Energy expenditure is greatly elevated as the body rapidly returns to a normal
breathing rate. Heart rate is also returning to a pre-exercise rate.

Because the body continues to expend energy after exercise, EPOC plays a supplemental role in an exercise program for weight
management.”

Studies have shown that resistance training elevates EPOC for upwards of 24-48 hours after training. Steady state cardio does
not elevate EPOC much, so once your cardio session is done, you are done buring calories. In order to elevate EPOC, you must be
working at an intensity high enough to create this oxygen debt.

So we know now, that creating EPOC will have positive benefits in our weight loss program. The key is what do we have to do in our workout sessions to create EPOC and appreciate the afterburn effect. There are several ways this can be done:

1. Increase the Demand of Each Exercise – Choose exercises that use many muscles or multi joint exercises. For example you get more bang for your buck doing squats that arm curls. Choosing “big” exercises such as squats, deadlifts, kettlebell swings, step ups
will incorporate the whole body. No isolating muscle groups. In fact the more you can group exercises together, the higher the
intensity. Again, instead of doing just a squat, perform a squat with a dumbbell curl to an overhead press. Or perform a romanian
deadlift to a row, or a romanian deadlift with a calf raise to a shoulder shrug. There are endless varieties of exercises that can
be grouped together to take the intensity to the next level. Several exercises can be grouped together into a “complex” and
performed with minimal rest.

2. Increase the Demand of Each Workout – It is not only each exercise that you need to think about, but the whole workout. How
the exercises are grouped together. How the rest periods are incorporated into the workout. Decreasing the rest periods and
increasing the metabolic demand of each exercise will take your workout to the next level and you won't be just feeling the effects
of the afterburn, but you'll be sizzling!

3. Perform High Intense Interval Training – Cardio workouts also need to be looked at. As mentioned above, there is little place
for steady state cardio except in the very early stages of a conditioning program. Once an aerobic base is built, cardio
workouts should consist of high intense intervals. This can be achieved by using hill sprints on a treadmill, kettlebell swings or
sled training. All these workouts will put a huge metabolic demand on the body and create EPOC.

So, take a look at your workouts. Are you working out intensely enough to burn those calories for hours afterward? A good
productive workout should have you breathing hard and sweating! Making changes to your physique takes hard work; there are no short cuts or easy roads to follow. But, making sure your time in the gym is metabolically demanding, will go a long way to giving you the body you want.

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What Do We Mean – Single Leg?

A question that often comes up both with clients and with trainers themselves, is the need for single leg work. Years ago, it was thought that squats and deadlifts were all there were needed to keep the body strong and for the athletic community, all that were
needed to build strength and power. Strength training has primarily been on two limbs and in the sagittal plane (moving front
to back). With the increased knowledge in the area of functional anatomy over the last 10 years, training methods have also changed.

It is now known that single leg training involves working more muscles resulting is greater strength and stability.

Very little in life or sport happens with two feet on the ground. With all movements, there is always one foot on the ground and one
in motion. Simple walking is a case of single leg movement.

What Muscles are we Training with Single Leg Exercises?

When performing double leg exercises, we are using the prime movers mainly (quads, gluteus maxiumus, hamstrings). With single leg
squats, the stabilizing muscles (glutes medius, adductors or inner thigh) and spinal stabilizers must all come into play to maintain a
stable pelvis. Some examples of single leg exercises are: step ups, lunges, split squats, bulgarians (ugh!) and one leg squats.
With all of these single leg exercises, all but one have the non working foot supported. With lunges, the non working foot is still
on the ground. With bulgarians, the non working or rear leg is supported on a block. The only unsupported single leg exercise is
the single leg squat. With this squat, the non working foot is not allowed to touch the ground.

With the supported single leg exercises, some of the stabilizing muscles aren't working as hard as they could be. With an unsupported single leg squat, the stabilizing muscles of the hip and pelvis must actively work. More muscles will work in an
unsupported single leg squat, resulting in greater strength and stability. And, from a pure caloric point, more muscles working
means more calories being burned = greater fat burning.

Not All Single Leg Work Requires Squats or Lunges?

Another group of exercises done as a single leg is the deadlift. The single leg deadlift is done in the sagittal plane and is
primarily a hip hinge movement. But, the spinal erector muscles as well as the lower trapezius and rhomboid muscles of the back must
work to stabilize the spine and shoulder. The glute (or hip rotators) and pevlic muscles must work to stabilize the pelvis and
keep it in the sagittal plane. This is one exercise that gives you a big bang for your buck. Not only is it working a huge amount of
muscles, but there is less stress on the lower back than with a two foot traditional deadlift.

So, even though single leg work can be demanding and even a little frustrating at times, it is vital to our overall health and well
being. Single leg squats and deadlifts are excellent examples of strength training exercises that will be as much or more benefit to
you outside the gym as in.

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