Under Pressure

Healthily.com provides an excellent, plain English introduction to the definition of hypertension and its association with type 2 diabetes and cardiac health risks.

As you may expect, prescriptive exercise is an increasingly popular intervention used in primary care to reduce the onset of hypertension in at risk individuals, with a meta analyses by [2] revealing that aerobic training is effective in reducing clinical blood pressure in the general population as well as in hypertensive patients. [1] conducted a thorough review of the evidence to determine the role of aerobic and resistance exercise on hypertensive individuals. They found that aerobic exercise should be used to decrease ambulatory blood pressure in hypertensive individuals and resistance training used as an adjunct to this.

Self-monitoring

Testing at-risk people is a critical means for identifying and assessing the level of risk. As found in an extensive population study by [4]

"an exaggerated blood pressure response to heart rate during exercise is predictive of future hypertension independent of other important risk factors and lend further support to the concept that blood pressure measurement during exercise test is a valuable means of identifying normotensive individuals at high risk for developing hypertension."

In conjunction with regular testing, those who are deemed at some risk are encouraged to monitor their blood pressure at home; [3] identifies a number of valid reasons for pursuing this practice, including:

1.Helps aid early diagnosis particularly if you have presented with prehypertension as seen with persistent, slightly elevated blood pressure.

2.Helps track and manage any treatment effects. Traditionally, this has been focused on medication dosages but with the rise of prescriptive exercise interventions there is an opportunity to track the association between your exercise regime and blood pressure.

3.Potential reduction in health care costs through less clinic visits. This reflects a more effective self management process underpinned by BP monitoring and the individual's greater sense of volition and control.

One of the best units we have encountered is the iHEALTH Wireless Blood Pressure Monitor a reliable, lightweight non intrusive device for accurately and reliably recording your blood pressure data. As well, we are planning to integrate its data into your dialog.fit service so we can provide broader and deeper coverage of your vital signs backed by our social, communication and data analytics environment.

References

[1] Cardoso Jr, C., Gomides, R., Queiroz, A., Pinto, L., Lobo, F., Tinucci, T., Mion Jr, D. and Forjaz, C. (2010). Acute and chronic effects of aerobic and resistance exercise on ambulatory blood pressure. Clinics, 65(3), pp.317-325.

[2] Fagard, R. (2006). EXERCISE IS GOOD FOR YOUR BLOOD PRESSURE: EFFECTS OF ENDURANCE TRAINING AND RESISTANCE TRAINING. Clin Exp Pharmacol Physiol, 33(9), pp.853-856.

[3] Mayoclinic.org, (2015). Get the most out of home blood pressure monitoring - Mayo Clinic. [online] Available at:http://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889[Accessed 18 Dec. 2015].

[4] Miyai, N., Arita, M., Miyashita, K., Morioka, I., Shiraishi, T. and Nishio, I. (2002). Blood Pressure Response to Heart Rate During Exercise Test and Risk of Future Hypertension. Hypertension, 39(3), pp.761-766.

Dr Daryl Foy

Dr Daryl Foy is a Behavioural Scientist who specialises in the design of effective health behaviour change apps based on evidence including his own validated models for optimising persistent use. He consults to industry on how-to integrate persuasive design into LEAN product development as well as conversational UI. He can be contacted at dlfoy@mortonlawson.com