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INTRODUCTION
Hypertension is the most commonly known non-communicable disease that is of great public health concern worldwide (Muhammad et al., 2020; Carey et al., 2018). Hypertension is a condition that occurs when there is a persistent rise in blood pressure and it is known to be a modifiable major risk factor, for the progression and development of cardiovascular diseases and increased mortality rate (Zaleski, 2019). Abnormal increase in blood pressure has been attributed to be the most common risk factor for cardiovascular and cerebrovascular diseases, including hemorrhagic, ischemic, stroke, ischemic heart disease, heart failure, and peripheral arterial disease (Carey et al., 2018).
Hypertension is classified into primary or secondary hypertension based on the cause (etiology) (Princewel et al., 2019). Primary hypertension is defined as an increase in blood pressure of unknown origin (idiopathic). Secondary hypertension is the rise in blood pressure due to underlying health conditions (Princewel et al., 2019). The main goal in the prevention, treatment and management of hypertension is to reduce the risks of cardiovascular events for individual patients and in the population as a whole (Princewel et al., 2019). If left untreated, complications such as atherosclerosis, heart attack, stroke, enlarged heart, or kidney damage may occur due to high blood pressure (Princewel et al., 2019). Hypertensive conditions can be managed by both pharmacological and nonpharmacological means.
Exercise is therapeutic in several chronic health conditions and is the first?line intervention for such health conditions (Muhammad et al., 2020). Involvement in regular exercise reduces the risk factor for developing hypertension and is recognized as the best therapy for the primary prevention, treatment, and control of hypertensive patients (Zaleski, 2019). It has been recorded that aerobic exercise reduces systolic blood pressure up to 5-7 mmHg at rest, this reduction shows that the risk of cardiovascular diseases has been reduced to 20-30% (Zaleski, 2019). On the other hand, dynamic resistance exercise lowers resting systolic blood pressure up to 2-3 mmHg among hypertensive patients, this type of exercise is still very helpful in blood pressure reduction (Zaleski, 2019). According to Zaleski, blood pressure reduction follows some set of laws called the “law of initial values”, in which Patients with higher baseline blood pressure show increased reduction in blood pressure after engaging in exercise (Zaleski, 2019). Reduction in blood pressure seems to be influenced by a dose-response association such that increases in the levels of exercise elicit greater reductions in blood pressure (Zaleski, 2019). However, preparticipation assessment is important to determine the type of exercise that would benefit an individual based on the individual level of hypertension and other disease condition, by health professionals. This is to ensure that individuals are not exposed to adverse or life-threatening responses due to exercise (Zaleski, 2019). Patients desiring to begin an exercise program should complete the Physical Activity Readiness Questionnaire or as required, the Electronic Physical Activity Readiness Medical Examination or Physician Clearance Form in consultation with their clinician and (or) trained exercise professional (Millar & Goodman, 2014).
Studies have shown that level of exercise prescription to hypertensive patients is very low, among healthcare professionals (Muhammad et al., 2020). According to Muhammad et al.’s study, they observed that exercise should be recommended in line with antihypertensive medications to hypertensive patients (Muhammad et al., 2020). Also, one of the effective guidelines for the prevention and management of hypertension is through increased physical activities (exercise) (Millar & Goodman, 2014). Acute and chronic aerobic exercise has consistently been shown to reduce resting and ambulatory blood pressure, with the largest effects in hypertensive patients (Millar & Goodman, 2014). It has been recommended that involvement in exercise activities from 30–60 min of moderate- to vigorous-intensity aerobic exercise 4–7 days per week, in addition to activities of daily living. Lots of emphasis on utilizing exercise as medicine will produce positive nonpharmacologic benefits for hypertensive patients and improve overall cardiovascular risk profiles (Millar & Goodman, 2014).
Both aerobic and resistance training promote improvements in a variety of general health and hypertension risk factors, but it is dependent on the type of exercise modalities. To illustrate, aerobic training significantly increases the maximum volume of oxygen consumption (VO2max), together with greater reductions in body fat compared more than resistant training. However, a more effective increase in basal metabolism and strength can be gotten with resistance training than aerobic training (Sharman et al., 2015).
The mechanism by which exercise prevent and manage hypertension include; reduction in sympathetically?induced vasoconstriction and reduced catecholamine segregation, increased insulin sensitivity, anti-inflammatory effects, and vascular structural adaptations (Chulvi-Medrano et al., 2016).
However, there are contraindications to exercise activities to protect the patients. Apart from completing a screening test before participating in an exercise program mentioned above, there are other contraindications. If the resting systolic blood pressure (SBP) is greater than 200 mm Hg or diastolic blood pressure (DBP) is greater than 110 mm Hg, it means that the patient should not engage in some form of exercise as such would lead to an excessive blood pressure response to exercise. In patients with SBP > 250 mm Hg or DBP > 115 mm Hg (at rest), it is an indication to terminate exercise. In the absence of other major diseases, patients with hypertension (stage 2 or below) should be encouraged to engage in exercise programs (Sharman et al., 2015).
Studies have shown that aerobic and resistance exercises are effective antihypertensive therapies and also well-known for favorably regulating the sympathetic nervous system activity, inflammatory response, cardiac, and vascular function, which are mainly observed during aerobic exercises (Lopes et al., 2018; Chulvi-Medrano et al., 2016; Gkaliagkousi et al., 2015). However, some older reports have reported that there exists an inverse dose-response relationship between physical activity on hypertension (Ma et al., 2013). Therefore, this present study will investigate the effect of regular exercise in the prevention and management of hypertension.
AIM
SPECIFIC OBJECTIVES
RESEARCH PROBLEM
Hypertension is the most commonly known non-communicable disease that is of great public health concern worldwide (Muhammad et al., 2020; Carey et al., 2018). Hypertension is known as the major risk factor for cardiovascular and cerebrovascular disease, including hemorrhage, ischemic, stroke, ischemic heart disease, heart failure, and peripheral arterial disease (Carey et al., 2018). Exercise is therapeutic in several chronic health conditions and is the first?line intervention for such health conditions (Muhammad et al., 2020). Involvement in regular exercise reduces the risk factor for developing hypertension and is recognized as the best therapy for the primary prevention, treatment, and control of hypertensive patients (Zaleski, 2019). Therefore, it is important to investigate the effect of exercise on the prevention and management of hypertension.
RESEARCH QUESTIONS
SIGNIFICANCE OF THE STUDY
Several studies have shown the beneficial effects of exercise on overall body function. It has been reported that exercise is an effective antihypertensive therapy, since it induces the following roles in the human body as regulating the sympathetic nervous system activity (SNS), inflammatory response, cardiac, and vascular function (Lopes et al., 2018; Chulvi-Medrano et al., 2016; Gkaliagkousi et al., 2015). A meta-analysis study reported that there exists an inverse dose-response relationship between physical activity on hypertension (Ma et al., 2013). Also, the prescription level of exercise by healthcare professionals is very low. Therefore, this present study will determine the effect of regular exercise in the prevention and management of hypertension (Muhammad et al., 2020). This will help address the controversy, and also enable healthcare personnel to see reasons to prescribe exercise for hypertensive patients.
METHODOLOGY
ANALYSIS
The following will be used for analysis in this review, they are; cluster analysis (CA) and/or factor analysis (FA), and/or principal component analysis (PCA). The results will be presented as odds ratios (OR).
RISK ASSESSMENT
The risk assessment conducted for this project is provided in the table below:
Table 1: Risk assessment
Risk
Impact
Mitigation Plan
Inability to meet the deadline
Low
Get an extension from the supervisor in due time
Inability to get required process inputs, skill, and manpower
Moderate
Refer to municipalities and research institutes for help
Inability to properly develop the process set up
High
Refer to your supervisor for help
Insufficient data
Refer to journals and textbooks for help
SCHEDULE
Table 2: Project Plan
Task Name
Start Date
End Date
Duration (Days)
Initial Research
15/01/2022
29/01/2022
14
Proposal
06/02/2022
21
Introduction Chapter
18/03/2022
23/03/2022
5
Literature Review Chapter
20/04/2022
24
Methodology Chapter
02/05/2022
12
Presentation 1
02/07/2022
10/07/2022
8
Analysis
24/07/2022
Evaluation of Gotten Results
01/08/2022
7
Discussion Chapter
11/08/2022
10
Evaluation Chapter
16/08/2022
Conclusion Chapter
18/08/2022
2
Project Management Chapter
20/08/2022
Abstract and Report compilation
22/08/2022
Report Proofreading
01/09/2022
Presentation 2
11/09/2022
REFERENCES
Carey, R. M., Muntner, P., Bosworth, H. B., & Whelton, P. K. (2018). Prevention and Control of Hypertension: JACC Health Promotion Series. In Journal of the American College of Cardiology (Vol. 72, Issue 11, pp. 1278–1293). Elsevier USA. https://doi.org/10.1016/j.jacc.2018.07.008
Chulvi-Medrano, I., Sanchis-Cervera, J., Tortosa-Martínez, J., & Cortell-Tormo, J. M. (2016). Exercise for Hypertension. In Fitness Medicine. InTech. https://doi.org/10.5772/65035
Gkaliagkousi, E., Gavriilaki, E., & Douma, S. (2015). Effects of acute and chronic exercise in patients with essential hypertension: Benefits and risks. American Journal of Hypertension, 28(4), 429–439. https://doi.org/10.1093/ajh/hpu203
Lopes, S., Mesquita-Bastos, J., Alves, A. J., & Ribeiro, F. (2018). Exercise as a tool for hypertension and resistant hypertension management: Current insights. In Integrated Blood Pressure Control (Vol. 11, pp. 65–71). Dove Medical Press Ltd. https://doi.org/10.2147/IBPC.S136028
Ma, W., Xi, B., Huai, P., Xun, H., Reilly, K. H., & Wang, Y. (2013). Physical Activity and Risk of Hypertension A Meta-Analysis of Prospective Cohort Studies Epidemiology/Population. https://doi.org/10.1161/HYPERTENSIONAHA
Millar, P. J., & Goodman, J. M. (2014). Exercise as medicine: Role in the management of primary hypertension. Applied Physiology, Nutrition and Metabolism, 39(7), 856–858. https://doi.org/10.1139/apnm-2014-0006
Muhammad, M., Nuhu, J., Hassan, T., Baba, S., Radda, M., Mutawakkil, M., & Musa, M. (2020). Therapeutic exercise for hypertension: An update for exercise prescribers. Nigerian Journal of Cardiology, 17(1), 11. https://doi.org/10.4103/njc.njc_24_19
Princewel, F., Cumber, S. N., Kimbi, J. A., Nkfusai, C. N., Keka, E. I., Viyoff, V. Z., Beteck, T. E., Bede, F., Tsoka-Gwegweni, J. M., & Akum, E. A. (2019). Prevalence and risk factors associated with hypertension among adults in a rural setting: The case of Ombe, Cameroon. Pan African Medical Journal, 34. https://doi.org/10.11604/pamj.2019.34.147.17518
Sharman, J. E., la Gerche, A., & Coombes, J. S. (2015). Exercise and cardiovascular risk in patients with hypertension. In American Journal of Hypertension (Vol. 28, Issue 2, pp. 147–158). Oxford University Press. https://doi.org/10.1093/ajh/hpu191
Zaleski, A. (2019) Exercise for the Prevention and Treatment of Hypertension - Implications and Application. American college of sports medicine.
Last updated: Jan 28, 2022 06:17 PM
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