Swimming Lowered Blood Pressure In Sedentary Over 50s

Main Category: Hypertension Also Included In: Seniors / Aging; Sports Medicine / Fitness Article Date: 25 Jan 2012 - 4:00 PST

Older adults who don't do much exercise, and whose blood pressure is getting to the point where they may need treatment, should perhaps consider swimming as a way to help bring it back down, at least that is what a small US study of sedentary over-50year-olds might suggest. The study was published early online in The American Journal of Cardiology earlier this month. Swimming is an ideal form of exercise for older, sedentary people because it puts little weight-bearing stress on the body and is not likely to lead to overheating. However, despite this, we know little about the effect this form of exercise has on the arteries and blood pressure, write the authors, from the University of Texas (UT) at Austin. They found that 12 weeks of swimming significantly lowered blood pressure and improved the function of arteries in a group of sedentary, unmedicated over-50s whose blood pressure was on the verge of "unhealthy" (prehypertension) or in stage 1 of hypertension. For their study, Dr Nantinee Nualnim, of UT's Cardiovascular Aging Research Laboratory, and colleagues, recruited 43 sedentary people aged over 50 (average age of 60) who also had prehypertension or stage 1 hypertension but were not on any medication. They randomly assigned them either to do 12 weeks of swimming or 12 weeks of gentle relaxation exercises (the controls). The researchers also took a number of measurements before, during, and at then end the 12 weeks, including measures of height, body weight, body fat, blood pressure, vascular function, blood glucose and cholesterol. Before the 12 weeks, there were no significant differences between the swimmers and the controls. Body mass, body fat (adiposity) and blood levels of glucose and cholesterol did not change in either group throughout the 12 weeks. However, they found that blood pressure (casual systolic) fell from 131 to 122 mm Hg in the swimming group (note that 120 is the "ideal" for a healthy heart, as in 120/80).

There were also significant changes to vascular function, such as the "stiffness" of arteries, in the swimming group. The authors note: "Swimming exercise produced a 21% increase in carotid artery compliance (p <0.05). Flow-mediated dilation and cardiovagal baroreflex sensitivity improved after the swim training program (p <0.05)." But there were no significant changes in any of the measurements in the control group. The authors conclude: "... swimming exercise elicits hypotensive effects and improvements in vascular function in previously sedentary older adults."

REFERENCE: http://www.medicalnewstoday.com/articles/240743.php

BOARD EXAM QUESTIONS WITH ANSWER/RATIONALE: (MEDICAL WARD) 1. Lisa is newly diagnosed with asthma and is being discharged from the hospital after an episode of status asthmaticus. Discharge teaching should include which of the following: a. Limitations in sports that will be imposed by the illness b. Specific instructions on staying cal during an attack c. The relationship of symptoms and a specific trigger such as physical exercise d. Incidence of status asthmaticus in children and teens ANSWER: c. The relationship of symptoms and a specific trigger such as physical exercise COPD clients have low oxygen and high carbon dioxide levels. Therefore, hypoxia is the main stimulus for ventilation is persons with chronic hypercapnea. Increasing the level of oxygen would decrease the stimulus to breathe.

2. Which of the following symptoms is most characteristic of a client with a cancer of the lung? a. air hunger b. exertional dyspnea c. cough with night sweats d. persistent changing cough ANSWER: d. persistent changing cough The most common sign of lung cancer is a persistent cough that changes. Other signs are dyspnea, bloody sputum and long term pulmonary infection. Option A is common with asthma, option B is common with COPD and option C is common with TB. 3. The client has ST segment depression on his 12-lead ECG. The nurse determines that this would indicate the following: a. necrosis b. injury c. ischemia d. nothing significant ANSWER: c. ischemia Depressed ST segment and inverted T-waves represent myocardial ischemia. Injury has a ST segment elevation.

4. Red has just returned from the postanesthesia care unit (PACU) from a hemorrhidectomy. His postoperative orders include sitz baths every morning. The nurse understands that sitz bath is use for: a. promote healing b. relive tension c. lower body temperature d. cause swelling ANSWER: 4. a. promote healing Sitz bath provides moist heat to the perineal and anal area to clean, promote healing and drainage and reduce soreness to the area. Sitz bath helps healing with cleaning action and promotion of circulation, thereby reducing swelling. Sitz bath usually has no therapeutic value in lowering body temperature. Although relief of tension can occur, this effect is secondary to the promotion of healing.

5. Trousseaus sign is associated with which electrolyte imbalance? a. hyponatremia b. hypocalcemia c. hypernatremia d. hypercalcemia ANSWER: 5. b. hypocalcemia Trousseaus sign is a carpal pedal spasm elicited when a blood pressure cuff is inflated on the arm of a patient with hypocalcemia.

6. A 36 year old female complains of headache and neck pain. The nurses assessments reveal painful flexion of the neck to the chest. The nurse understands that nuchal rigidity is associated with: a. brain tumor b. CVA c. meningitis d. subdural hematoma ANSWER: 6. c. meningitis

A patient with meningitis will exhibit signs that include photophobia and nuchal rigidity, which is pain on the flexion of the chin to chest.

7. The nurse teaching the client about behavioral changes, which can affect development of atherosclerosis, should discuss which of the following as a nonmodifiable risk factor for atherosclerosis? a. cigarette smoking b. hyperlipidemia c. female over 55 years of age d. sedentary lifestyle ANSWER: 7. c. female over 55 years of age Lifestyle, cigarette smoking and hyperlipidemia can be changed by changing behaviors.

8. A 76 year old man enters the ER with complaints of back pain and feeling fatigued. Upon examination, his blood pressure is 190/100, pulse is 118, and hematocrit and hemoglobin are both low. The nurse palpates the abdomen which is soft, non-tender and auscultates an abdominal pulse. The most likely diagnosis is: a. Buergers disease b. CHF c. Secondary hypertension d. Aneurysm ANSWER: 8. d. Aneurysm The symptoms exhibited by the client are typical of an abdominal aortic aneurysm. The most significant sign is the audible pulse in the abdominal area. If hemorrhage were present, the abdomen would be tender and firm. 9. Nurse Fiona is caring a patient with Raynauds disease. Which of the following outcomes concerning medication regimen is of highest priority? a. Controlling the pain once vasospasm occur b. Relaxing smooth muscle to avoid vasospasms c. Preventing major disabilities that may occur d. Avoiding lesions on the feet ANSWER: 9. b. Relaxing smooth muscle to avoid vasospasms

The major task of the health care team is to medicate the client drugs that produce smooth muscle relaxation, which will decrease the vasospasm and increase the arterial flow to the affected part. The drugs used are calcium antagonists.

10. Mr. Roberto Robles complains of a severe headache and is extremely anxious. The nurse checks his vital signs and finds him to have a heart rate of 57 bpm and a blood pressure of 230/110 mmHg. The nurse should also assess for? a. presence of bowel sounds b. presence of babinski reflex c. fecal incontinence d. urinary catheter patency

ANSWER: 10. d. urinary catheter patency The patient is complaining of symptoms of autonomic dysreflexia, which consists of the triad of hypertension, bradycardia and a headache. Major causes of autonomic dysreflexia include urinary bladder distention and fecal impaction. Checking the patency of the urinary catheter will check for bladder distention. REFERENCE: www.nurseslabs/boardexam-questions/1234529.com