Effect of Exercise on Untreated and Treated Hypertensive Patients in Babylon Province

Rusul Mazin Mohammad,Ghafil Saihood Hassan,Haider Jabbar
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Keywords : Hypertension, Exercise, Blood pressure, Walking, Systolic, Diastolic.
Medical Journal of Babylon  13:2 , 2016 doi:1812-156X-13-2
Published :10 September 2016

Abstract

Normal blood pressure at rest is diastolic a range of 60-90 mmHg and systolic 100-140 mmHg. Hypertension is chronic elevated arterial systolic blood pressure > 140 mmHg, and diastolic blood pressure > 90 mmHg. Epidemiological indicate studies that elevated blood pressure leads to strike, heart coronary disease, congestive failure heart and end stage of renal disease. There are two types of hypertension; primary (essential) of cause unknown which includes more than 95% of all cases of hypertension, and secondary hypertension which is due to underlying disorder it accounts less than 5% of hypertensive cases. Response to moderate exercise protocol in hypertensive patients. To study the effect of exercise on systolic, diastolic, and lipid profile elements in treated and untreated hypertensive patients. The study was conducted in Marjan medical city in Hilla from April to September 2015. The random sample of 30 patients of hypertension including 16 males and 14 females, their ages from 40 -60 years. Regular treated patients were 23, none treated 7. Patients were recruited from outpatient clinic. History and physical examination were obtained from all patients. Lipid profile tests, BMI, measurement of blood pressure were performed before and after exercise.

Introduction

Normal blood pressure at rest is range of 60-90 mmHg diastolic and 100-140mmHg systolic. Hypertension was presenting if blood pressure is persistently above 140/90 mmHg[1]. Hypertensionischronic elevation of blood pressure (BP) > 140/90 mm Hgatrest, remains one of the most factors risk for cardiovascular disease (e.g.artery coronary disease, failure heart,stroke)[2]. Hypertension is rarely accompanied by any symptoms. Some high thepressureblood report headaches (particular the back of the head in the morning), also vision or fainting episodes[3]. The various types of hypertension are primary(idiopathic or essential) hypertension ofcauseunknown. More than 95% of hypertensions are in those category. Secondary hypertension is systemic hypertension due to underlying disorder. It accounts for <5% cases of the hypertension[4]. Several factors influence primary hypertension. These factors include: Genetics, high intake salt, insulin resistance, sympathetic nervous system, low physical activity, and obesity[5]. In the United States, more than 50 million peoples have blood pressure (BP) more than optimal level (120/80 mm Hg), only approximately half of them receive treatment (antihypertensive drugs) tocontroland decrease their BP to less than 140/90 mm Hg[6]. It is now well accepted that increased degree of physical activity and duration was associated with a reducing incidence of the hypertension[7]. The British Hypertension Society2011has defined range of blood pressure which falls within the normal range and those that indicate hypertension (Table1).

Materials and methods

The present study was conducted at Marjan Teaching city in Hilla, during period from April to September 2015. The random sample of 30 patients of hypertensive patients included (16 male,14 female) and their age from 40 -60 years. Regular treated patients were 23, non-treatedpatients were 7. Patients were recruited from outpatient clinic.  A history and physical examination were obtained and laboratory tests were performed in all patients before and after 8 weeks of aerobic exercise.
Exercise program
Low to moderate intensity exercise such as walking 30 minutes per day (equivalent to ?1.5 mile) for 5 days per week for 8 weeks[12].
Measuring blood pressure, auscultatory method
An inflatable cuff attached to a manometer mercury (sphygmomanometer) ware aroundwrapped the arm and a stethoscope are places on the arterybrachial at elbow.  The cuff ware rapidly inflated until the pressure in it is above the expected systolic pressure in the brachialartery. The pressure in the cuff was then lowered slowly. The cuff pressure at which the sounds were first heard (Korotk off sound phase 1), was the systolic pressure (SBP). Diastolic blood pressure (DBP) was taken when the sound disappears (Korotk off sound phase 5)[19].




Results

Distribution of hypertensive patients according to demographic characteristics Table(1) shows the distribution of hypertensive patients according to demographic characteristics including ( mean age and gender). Mean differences of diastolic and systolic blood pressure before and after two months of regular exercise Table (2) shows mean differences of diastolic and systolic blood pressure (mmHg) before and after two months of regular exercise among hypertensive patients. There were significant differences between means of diastolic and systolic blood pressure before and aftertwo months of regular exercise among hypertensive patients. Mean lipid Profile elements before and after two months of regular exercise among hypertensive patients Table (3) shows mean differences of lipid profile elements including (total serum cholesterol, triglyceride, HDL, LDL and VLDL) before and after two months of regular exercise among hypertensive patients. There were significant differences.

Discussions

There were significant (P-value < 0.001) differences between means of lipid profile elements before and after exercise among hypertensive patients, as shown in table 3-5. This result not agreement with [24] who mentioned that exercise rehabilitation lowered total cholesterol and LDL level by 5.2% P-value < 0.05 and 8% P value <0.01respectively because age of sample and nature of race different. There were significant (P-value <0.001) differences between means of vital capacity before and after exercise among hypertensive patients on regular treatment as shown in table 3-7. Also there were significant (P-value <0.001) differences between means of systolic and diastolic blood pressure before and after exercise among hypertensive patients on regular treatment as shown in table 3-8. Because the ventilatory functions were increased in middle aged patients with hypertension [25]. There were significant (P-value <0.001) differences between systolic and diastolic blood pressure before and after exercise among hypertensive patients on regular treatment as shown in table 3-8. Because several recent clinical trials have demonstrated that physical activity reduces blood pressure in hypertensive patients[26]. There were significant (P- value <0.001) differences between means of lipid profile elements before and after exercise among hypertensive patients on regular treatment as shown in table 3-9. Because the result showed that there was statically significant difference among patients receive medicine in lipid levels. Therefore, it can be concluded that exercise were more effective In reducing lipids in over weight hypertensive postmenopausal women[27]. There were significant (P-value 0.026, 0.017) respectively differences between means of systolic and diastolic blood pressure before and after exercise among untreated hypertensive patients as shown in table 3-12. Because aerobic training induced significant decreased in systolic and diastolic blood pressure in hypertensive patients through reduction of vascular resistance [16]. There were significant (P-value <0.001, <0.001, 0.003, 0.002, < 0.001) decrease in serum TG, serum Cholesterol, serum LDL, increase in serum HDL, decrease in serum VLDL respectively in lipid profile elements before and after exercise among untreated patients as shown in table 3-13. Because physical activity increased fitness and decrease weight and body fat [16].

Conclusions

Systolic and diastolic BP in hypertensive patients showed significant decreases after mild-moderate exercise. Lipid profile of hypertensive patients showed significant decreases except HDL that showed significant increases after mild-moderate exercise.

References

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