Marla Richmond

Stay Tuned In and Turned On to Better Health There Ought to Be Cell-Safety Laws In order to operate a motor vehicle in the United States, individuals are required to take driver’s education courses, acquire a permit, pass written examinations, and then take and pass practical competency tests prior to licensure. Penalties, license suspensions and revocations are imposed on individuals who commit moving violations. Tickets are issued for exceeding time limits in parking spaces. Current seat belt laws in most states mandate their use.

To my knowledge, there is virtually no official regulation of a human being’s conduct in managing his or her physical condition/ wellness. While health education is required coursework throughout the school years, passing grades do not guarantee understanding, application and the daily practice of appropriate health behaviors. There are neither “living” permits nor rules that mandate regular physical examinations. There are no “sitting” violations or time limits for doing so.

There are no penalties for the failure to comply with the proper monitoring of or following the appropriate protocols for the prevention and treatment of such (hazardous) health conditions as high blood pressure, high cholesterol, or diabetes. While seatbelt laws have forced those who might otherwise not buckle up to “CLICK IT” or get a ticket, there no equivalent laws with regard to body cell safety.

The Leading Cause of Death

Recklessness combined with Hazardous Conditions

ON THE ROAD
According to the World Health Organization (WHO), traffic accidents are the leading cause of death among individuals between 10 and 24 years of age; 400,000 young people under the age of 25 are killed in crashes every year. Millions more are injured or disabled. Some of the factors associated with a high risk for motor vehicle accidents and related deaths are poor road design and roadway environment and unsafe vehicle design. Controllable factors include speeding, driving too fast for weather and road conditions, or under the influence of alcohol. Recently prohibited in some municipalities, the use of such (distracting) items as cellular phones while driving has been added to this list. The WHO notes that since seat belt laws have been passed, there has been a steady decline in passenger vehicle occupant fatalities.

IN LIFE
According to a current report issued by the WHO, cardiovascular disease is the No. 1 cause of death worldwide. Without resolution, by 2015, an estimated 20 million people will die yearly from the disease, primarily from heart attacks and strokes. Primary risk factors are high blood pressure, high cholesterol, and diabetes. Controllable factors include physical inactivity, poor diet and the resulting obesity, smoking, and excessive alcohol use.

Blood Pressures approaching record highs

Current research suggests that 60 to 70 million American adults, and at least a billion worldwide, have high blood pressure. Millions more have it, and are yet to be diagnosed. Fewer than half of the individuals with diagnosed high blood pressure follow through with appropriate treatment protocols. People who have high blood pressure may have 3-4 times the risk of a heart attack, and 7 times the risk of a stroke than those with normal blood pressure.

Laws impose clear and consistent consequences for violations and infractions

The above statistics are both compelling and frightening and reveal the necessity for change. Yet, risky living behaviors seem to persist while irreverent driving behaviors are deterred by as little as the threat of a traffic ticket. Why?

Is it that:

• the conditions associated with CVD that may lead to a possible heart attack or a stroke are typically silent?
• the "penalties" associated with negligent living do not seem as imminent?
• the information presented to the public by various means and media is not well understood?
• people don't know how to apply health information to their own lives?
• people simply don't know, or know how to practice, healthy living behaviors?

Perhaps it is a little of each, and all of the above, and that there is too great a distance between daily "violations" and consequences; that coupled with the illusion that medications are an adequate substitution for behavior change. There ought to be laws that regulate how we care for our bodies; a threat of public reprimand associated with and tickets, fines and/or drastic penalties issued for non-compliance.

The Importance of Staying Tuned in and Turned on To Better Health
One late afternoon, as I backed out of a parking space and proceeded a few hundred feet out of the lot, I was startled by the repetitive beeping and simultaneous flashing of a bright red icon on my dashboard. In automatic obedience, I fastened my seatbelt, while a radio newscaster reported the day's financial events. "Stocks catch a bid, with the S&P 500 climbing to modesty below the unchanged mark. Financials are playing a large role in the up-tick, as the sector makes it into positive territory…" CLICK!

I turned off the radio and chuckled to and at myself, as I did not understand a word of the report. While I assumed that "S & P 500" did not refer to a new supermarket chain, I made a mental note to contact one of my business-savvy friends to translate it without ridiculing me for my ignorance about money matters.

My thoughts diverted to this month's page. I wondered how many people, who might well understand that stock report, do not comprehend health information presented to them daily by multiple means and media. While people hear and/or view such reports, few listen and grasp their significance; and worse, when the facts become too confusing or frightening, they often tune them out or turn them off. "Current research has shown that normotensive* individuals at age 55 have a 90% lifetime risk for developing high blood pressure. The good news - a healthy diet and regular exercise can prevent and treat it …" CLICK!

Coincidently, a few weeks later, while out for dinner on a Saturday evening, a friend chuckled as he confessed to being on blood pressure medications for years, yet hadn't a clue if they were still working. He admitted that the various concepts had been explained to him several times, yet he still doesn't "get" the difference between, or the significance of, the "top number or the bottom number" of the blood pressure measurement. He asked why he gets dizzy while changing positions from lying down to sitting and from sitting to standing. He knew that he should exercise, but did not know what kind of exercise was best for him and said, "I just keep taking my meds and do what my doctor tells me to do."

*normotensive means having normal blood pressure.

I attempted to explain blood pressure to him in common terms. He was appropriately disgusted when I told him that persistent high blood pressure damage on the inner walls of his arteries might look something like the roads in the Chicago area after an icy, salty winter - gouged and cracked with potholes. I confessed that I would not know any more than he did had I not studied and researched the topic for years. He was amazed to hear that as little as a daily 30-minute brisk walk could lower blood pressure 5-7 millimeters of mercury for 22 or more hours. Then he asked, "What are millimeters of mercury?"

• Do you know the answer to that question?
• Do your kids/students know the significance of a blood pressure measurement?
• Do you/your students/ family members have annual physical examinations to check their blood pressure and other important measurements that may reveal a risk for cardiovascular and other diseases?

Blood Pressure is measured in millimeters of mercury (mmHg)

The technical definition of a millimeter of mercury (mmHg) is the pressure exerted at the base of a column of fluid exactly 1 mm high, when the density of the fluid is exactly 13.5951 g/cm³ (grams per cubic centimeter), at a place where the acceleration of gravity is exactly 9.80665 m/s² (meters per second squared.).

For the rest of us --- imagine a hammer and bell game at a carnival in which an individual strikes/bangs a target with a hammer as hard as he or she can, and then a piece of metal rises to reflect the strength of the bang of the hammer.

With regard to blood pressure measurement, millimeters of mercury serves as a reference as to the pressure (the bang) exerted against arterial walls under two different circumstances during heartbeats. The first (top number) is the pressure exerted during the heart's contraction (systole); the second, during the heart's relaxation (diastole).

Don't Be Clueless About Your Blood Pressure

Word Scramble
Here are a dozen blood pressure terms to unscramble. The clues are given below. Understanding them may help to save yours or a loved one's life!

1. pymmtsso
2. laedi
3. itlsocys
4. liocstida
5. syereneviptrhpe
6. iyadl
7. necraelca
8. ntod
9. cantiseser ngtrinai
10. htareb
11. srests
12. eiszdnisz

Clues

1. High blood pressure has few, if any, obvious of these.
2. Resting blood pressure measurement of 115/75 is regarded as this.
3. Top number; blood pressure measurement of the bang on arterial walls when the heart is contracting and pushing blood into a full piping system.
4. Bottom number; blood pressure measurement of the bang when the heart is relaxed and filling with blood.
5. Blood pressure measurement of >120-139/80-89 and considered to fell into this new category.
6. American College of Sports Medicine recommended frequency for moderate cardiovascular exercise for the treatment of high blood pressure.
7. A must from the doctor before starting any exercise program.
8. A blood pressure of >200/110 means this with regard to exercise.
9. American College of Sports Medicine recommends high repetition and low to moderate intensity of this type of exercise twice a week.
10. Avoid holding this when performing the above (9) type of exercise.
11. Reducing this is an important lifestyle strategy for lowering blood pressure.
12. Blood pressure medications may cause this when you stand up too quickly, so change positions slowly when exercising.

answers at bottom of this page

Lesson: Blood Pressure - what it is and if it's high

What is blood pressure? What is hypertension?

The cardiovascular system consists of the heart muscle and the blood vessels, the arteries, and veins. The heart is a strong muscular pump that pumps blood to the lungs for gas exchange (oxygen comes in and carbon dioxide leaves). It also pumps oxygen-rich blood throughout the body. Blood is pumped out to tissues through a closed piping system of arteries of varying size. It is then returned from tissues by way of a piping system of veins of varying size.

This system of blood vessels is not rigid, but pliable. It varies throughout in its pliability. The system must be able to accommodate the rhythmic pulsations of the heart as well as fluctuations in pressure. Blood is delivered selectively. Arterioles leading to capillaries rhythmically open and close depending on the second-to-second nutrient and oxygen demands of tissues. Speed and force of delivery must be appropriate.

Sometimes blood flows more slowly and less forcefully. Sometimes blood and its constituents surge through blood vessels like a rushing river. It flows turbulently and at high speeds to active tissues. Arterioles leading to active tissues open, and those leading to inactive tissues contract or narrow. Blood pressure is the force exerted by this rushing river of blood and its constituents on the inner walls of arteries. Blood pressure pushes blood and its nutrients and oxygen from larger blood vessels to the tiniest of capillaries that serve tissue cells.

Blood pressure is measured by an instrument called a sphygmomanometer. Two measurements of blood pressure are taken: systolic and diastolic. Systolic blood pressure is the force of blood exerted on the inner wall of arteries when the heart is contracted or in systole. Diastolic blood pressure is the force exerted when the heart is relaxed or in diastole. Systolic pressure occurs when the heart is pumping a load of blood into an already-filled piping system of blood vessels. This creates higher pressure than when the heart is at rest or filling with blood during diastole. Normal blood pressures range from 90/60 to about 120/80. Blood pressure fluctuates according to body position and activity level.

The inner walls of arteries consist of a layer of cells that smoothly connect together, protecting the tissue beneath them. This protective layer is called the endothelial lining. It is designed to withstand the second-to-second fluctuations in pressure exerted against it.

Blood pressure is created by a combination of factors. The first factor is the push of the heart muscle as it pumps blood into the closed piping system. The second factor is the tightness of the piping system. The volume of fluid that fills the piping system influences its tightness. The tightness is also a matter of how many arterioles are open and how many are closed. If more are closed, the system is tighter and pressures are greater. If more are open, such as when the large muscles of the body are performing cardiovascular activity, pressures are lower. The pressure resulting from constricted arterioles is called peripheral resistance; the greater the number of constricted arterioles, the greater the peripheral resistance. The heart has to exert more pressure to overcome this resistance.

Blood must arrive at active tissues quickly enough to deliver sufficient oxygen and nutrients. However, speed and pressure must be appropriate. When blood is not immediately required, turbulence and high pressure are not only unnecessary, but may in fact, damage the smooth cell-to-cell connections of the endothelial lining. Chronically elevated blood pressure is a disorder called hypertension. A resting blood pressure of more than 120/80 is considered pre-hypertensive. A blood pressure of 140/90, once considered mildly hypertensive, is now considered high blood pressure and demands medical attention.

Hypertension damages the endothelial lining and exposes vulnerable tissues not only to more damage by elevated blood pressure, but also to invasion of this tissue by other blood constituents. The result of this damage and invasion contributes to the development of atherosclerosis. Atherosclerosis and hypertension are two of the most common diseases of the cardiovascular system.

How do diet and exercise help treat and prevent hypertension?

Regular cardiovascular exercise and a moderate-calorie, nutrient-dense, low-fat, low-sodium diet are beneficial to a hypertensive person for several reasons. First of all, excess body fat is lost so that the heart does not struggle to pump blood through a disproportionately over-fat body. A heart that is exercised on a regular basis is a stronger and more efficient pump. The push of the heart muscle into the closed piping system requires less effort. More blood is pumped with greater ease and fewer beats. A diet low in sodium prevents excess fluid retention in the piping system. Regular cardiovascular exercise helps to relax the arteries and stimulate the growth of additional networks of blood vessels. This loosening or spreading out of the piping system creates less peripheral resistance. These factors interact to result in lowered blood pressure at rest and during activity.

If hypertension cannot be controlled through diet and exercise alone, several antihypertensive medications may be prescribed. Once blood pressure is controlled, progressive resistance training is encouraged. With a physician's approval, a low to moderate resistance program may be added to cardiovascular exercise.

Blood Pressure Monitoring Family Project

Create Your Own 7-day Blood Pressure Monitoring Family Project

TOOLS & MATERIALS:

• A sphygmomanometer (electronic blood pressure monitor); purchase the best one that the family can afford.

  Make sure the cuff is an appropriate size. Individuals who are significantly above or below "average" height or weight should probably not use a standard-sized cuff, which is meant to be used for average sized people, and may produce an inaccurate reading. Below are the some helpful guidelines:

  • Arm circumference 22 to 26 cm, 'small adult' cuff, 12 x 22 cm
  • Arm circumference 27 to 34 cm, 'adult' cuff: 16 x 30 cm
  • Arm circumference 35 to 44 cm, 'large adult' cuff: 16 x 36 cm
  • Arm circumference 45 to 52 cm, 'adult thigh' cuff; 16 x 42

• Poster Materials - Poster board, construction paper, graph paper, pencils, markers, and a ruler

INSTRUCTIONS

Each family member will:

• design and creatively decorate a personalized poster onto which his/her 7-day blood pressure monitoring graph is to be mounted.
• take his/her blood pressure in the morning upon awakening before activity and eating to get a baseline blood pressure measurement. If that is not possible, then blood pressure must be taken no less that one hour after exercising or consuming food, caffeine or alcohol.
• keep a daily record of both the systolic and diastolic blood pressure measurements and enter them on the graph. Different colored markers must be used to distinguish the two measurements.
• leave a space for comments on the graph paper next to each blood pressure measurement entry

Why Comments?

Several factors may influence any given blood pressure reading. Such factors include, but are not limited to, diet, the consumption of caffeine or alcohol, exercise, stress and resulting emotional reactions, sleep patterns, digestion, medications, and hormonal environment. For example, if a student is sleep-deprived and nervous about an exam at school, his or her blood pressure readings may be higher than normal. That should be noted.

*Blood pressure is measured:

• with the individual seated comfortably with both feet on the floor, and after allowing at least 10 minutes to relax and adjust to the room temperature and environment
• on a relaxed, uncovered arm that is supported at the level of the heart; only the part of the arm where the blood pressure cuff is fastened need to be at heart level
• using a cuff that is wrapped comfortably all the way around the upper part of the arm with the arrow at the front of the elbow crease.
• by pressing a button at which time the cuff will inflate to a particular level and then automatically deflate. A read-out of the blood pressure measurement will appear on the screen.

*During that week, if any family member's blood pressure readings are repeatedly higher than normal (as indicated on the chart above), the family physician must be contacted.

There are no laws that regulate yours or your family members' conduct with regard to managing your wellness. Therefore, it is up to you to choose to practice body cell safety. Some suggestions - - buckle your seatbelt and drive carefully, monitor your blood pressure, and live actively. After all, eventually all of your choices do in fact become you!

Marla Richmond, M.S., Exercise Physiologist/Author of The Physiology Storybook: An Owner's Manual for the Human Body, 2nd ed.
Order directly from AAHPERD or from the author - Marla Richmond (order form)

answers to Word Scramble

resources:

• Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure
• World Health Organization
• National Institutes of Health
• National Heart, Lung and Blood Institute
• National High Blood Pressure Education Program
• American College of Sports Medicine
• American Council on Exercise
• American Heart Association
• American Academy of Pediatrics

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