Hypertension has been reported that it affects around 29% of the Australian population . The risk of receiving this disease increases after age 40 years old . Men and women at this age should check their blood pressure regularly as persistent hypertension is a risk factor for the development of heart disease, stroke, kidney and metabolic conditions . In Australia, it is a contributing factor in 10.6% of all men and 15% of all female deaths . Fortunately, this condition is treatable, diet, medication and exercise all have been shown to be effective at reducing blood pressure. This summary will define hypertension and discuss its causes in older adults and treatment. In the treatment section, only aerobic exercise will be focused on since it has a great positive effect in reducing blood pressure. Also, exercise recommendations and considerations will be included for older people.
Hypertension is defined as "force exerted by the blood on the walls of the arteries. Hypertension is long and short term high blood pressure" [17, pp2]. It is written as systolic over diastolic (eg. 120/80 mmHg).
Causes of hypertension in older adults
There are some lifestyle factors that are related to high blood pressure. For example, obesity, alcohol consumption, physical inactivity and high intake of salt, sugar and saturated fat can increase the risk of hypertension . Other factors such as stress and smoking also contribute in increasing the risk .
There are some specific causes in older adults that increase the risk of high blood pressure. With ageing, blood vessels become less elastic which increase stiffness in those vessels and aorta . Consequently, resistance against blood flow will be increased, and blood vessels ability to dilate and expand will be reduced . As a result, blood pressure will be raised up. In addition, as people age, fatty tissues cover the blood vessels from inside which narrows the vessels diameter . Moreover, it was hypothesised that Nitric Oxide synthase decreases with ageing which may causes blood vessel stiffness .
There are three ways of treatment diet, drugs and exercise. Diet such as DASH (Dietary Approaches to Stop Hypertension) is a diet that is high in fruits and vegetables, low in salt, sugar and moderate in red meat . Beta blocker is just an example of medication treatment for hypertension . Exercise takes a big part of treatment. What is recommended in this paper is aerobic exercise. Aerobic exercise has been shown to be safe and effective in reducing blood pressure . Many studies showed that moderate intensity exercise is more approachable for older population [10, 11, 13, 14, 19]. There are two methods continuous and interval exercise. Continuous is an activity which is performed at a steady level of intensity throughout the exercise, while interval is alternating between high and low levels of intensity during activity . These methods showed significant benefits such as decreased systolic and diastolic blood pressure, reduced weight, increased VO2max, increased kidney, lung and heart function, improved control of glucose and insulin and increased quality of life [10, 11, 12, 15, 16]. Interval training may be more beneficial than continuous at reducing systolic and diastolic blood pressure, increasing VO2max, decreasing arterial stiffness and increasing muscle strength in older people [10, 13, 14]. Molmen-hansen et al (2011) concluded that interval training helps in reducing systolic and diastolic blood pressure , while Lamina noted that there is no difference between interval and continuous training for blood pressure . However, Guimerase et al (2010) and Nemoto et al (2007) concluded that interval training is more effective at reducing systolic and diastolic blood pressure [10-14]. In Nemoto et al study, the interval group showed improvements in knee extension, flexion forces and legs muscles in elderly .
Mode Frequency Intensity Instruction Progression
Continuous 3 days/week,
15 min/session add 5 min/week until reaching 30-60 min/session 50-70% HR max The activity is performed at continuous %HR( eg, 60%) for the entire exercise, 5-7 days/week 30-60 min/session
Interval 40-70% HR max The activity is performed at lower HR% (eg, 40% HR) for 3 min, and then gradually increase the intensity to achieve higher HR (eg,70% HR) for 3 min. alternating between high and low HR.
Physical assessment and monitoring should be considered prior exercise to make sure that there are no underlying issues . If systolic drops more than 10 mmHg or raises more than 30mmHg, or if the blood pressure is above 250 mmHg systolic and 115 diastolic, then the exercise must be stopped . Also, patients must stop exercising if they experience any abnormal chest pain or breathe shortness .