Blood Pressure + Wall Squat - Exsc Testing

Measurement of BP

1. Blood flow restricted to max 200 mmHg and then released

2. Blood released coincides with the left ventricular contraction known as systole or phase 1

3. First faint thud sound is the start of phase 1 aka systolic pressure

4. Blood flow is fully streamlined and sound disappears known as diastole or phase 5

5. Last faint thud sound of hear is the end of phase 5 known as diastolic pressure

Normal Resting BP

120/80

Important Testing Procedures/Protocol

1. Refrain from smoking or drinking caffeine 3 hours prior and exercise 30 mins prior

2. Sit comfortably in chair with back rest for at least 5 mins

3. Arm at supported at heart level and feet uncrossed on floor

4. Appropriate cuff size placed 2.5 cm or 1 inch above antecubital space

5. If BP is known inflate cuff to ~20-30 mmHg above expected systolic

6. If BP is unknown inflate cuff to ~160-200 mmHg

7. Slowly deflate cuff at a rate of ~2-3 mmHg per second

8. Listen for 10-20 mmHg after last sound to confirm disappearance

9. Repeat after 1-2 min and average the readings, only repeat if measurement differs by more then 5 mmHg

Body and Arm Positions for BP: Sitting/Supine

No difference between BP

Body and Arm Positions for BP: Standing

Higher diastolic measurement, no change in systolic

Body and Arm Positions for BP: Hanging Arm

Erroneously high BP reading

Difference between BP for Arm Above and Below Heart

• Above: 1 mmHg below for each cm above heart

  • Below: 1 mmHg above for each cm below heart

Normal BP Evaluation

• Systolic BP: <120 mmHg

  • AND

• Diastolic: <80 mmHg

Elevated BP Evaluation

• Systolic: 120-129 mmHg

  • AND

• Diastolic: < 80 mmHg

Hypertension: Stage 1 Evaluation

• Systolic: 130-139 mmHg

  • OR

• Diastolic: 80-89 mmHg

Hypertension: Stage 2 Evaluation

• Systolic: ≥140 mmHg

  • OR

• Diastolic: ≥ 90 mmHg

Normal BP Recommended Follow-Up

• Promote optimal lifestyle habits

• Reassess in 1 year

Elevated BP Recommended Follow-Up

• Promote habits

• Non-pharmacological therapy

• Reassess in 3-6 months

Hypertension: Stage 1 BP Recommended Follow-Up

• Low CVD Risk:

  • Non-pharmacological therapy

  • Reassess in 3-6 months

• High CVD Risk:

  • BP lowering medications

  • Reassess in 1 month

Hypertension: Stage 2 BP Recommended Follow-Up

• Non-pharmacologic

• BP lowering medications

• Reassess in 1 month

Drives Changes in BP

Vascular Resistance + Reactive Hyperemia

Physiological Effects of Isometric Training on BP

• Effective antihypertensive intervention

• Clinically significant changes (≥ 2 mmHg) seen in short-term interventions of ~3-4 weeks

• Largest change in those with highest resting BP

Wall Squat Test: Body Placement

• Back rested on a fixed wall for a vertical trunk

• Feet parallel and shoulder width a part

• Knee joint angle measured using level

  • Anterior midline of right thigh

  • Midway point between inguinal fold and top of the patella

Wall Squat Test: Testing Procedures

• Total duration of 10 mins (5 consecutive 2 min stages)

  • No standing or resting between stages and must maintain angled position until exhaustion or test completion

• Knee angles start at 45º decreasing by 10º for each stage until reaching 5º

• Physiological measurements done during last 30 secs of each stage: HR, RPE, BP at completion of test