Health and Fitness Metrics

Pulse and Heart Rate

• Heart Rate Fluctuation

  • Heart rate can fluctuate extensively throughout various activities.

• Normal Heart Rate Ranges

  • For the average adult and elderly, the pulse range is typically 60-100 beats per minute (bpm).

  • For extreme athletes, the heart rate can be 50 bpm or below.

• Heart Rate Classifications

  • Bradycardia: less than 60 bpm.

  • Tachycardia: greater than 100 bpm.

  • Normal Resting Rate: 60-100 bpm.

Body Mass Index (BMI)

• Definition and Purpose

  • BMI measures the overall body mass of an individual.

  • It does not differentiate between fat, muscle, or bone mass.

• Considerations

  • Individuals with large muscle mass, such as bodybuilders, may have an inappropriately high BMI.

  • Elderly people may present a lower BMI due to muscle loss and increased fat deposition.

• BMI Calculation Formulas

  • Metric:
    BMI = \frac{weight \text{ (kg)}}{(height \text{ (m)})^2}

  • Imperial:
    BMI = 703 \times \frac{weight \text{ (lbs)}}{(height \text{ (in)})^2}

• BMI Chart Categories

  • Extreme Obesity: BMI 35 - 39.9

  • Obesity: BMI 30 or above

  • Overweight: BMI 25 - 30

  • Normal: BMI 18.5 - 25

  • Underweight: less than 18.5

Blood Pressure

• Systolic/Diastolic Blood Pressure

  • Systolic Blood Pressure: Represents blood pressure when the left ventricle contracts.

  • Diastolic Blood Pressure: Represents blood pressure when the ventricle relaxes and fills with blood.

• Significance of Blood Pressure

  • Blood pressure is critical as it is associated with long-term cardiovascular mortality.

• Causes of Hypertension

  • 90-95% of hypertension cases are essential causes associated with factors such as:

  • High sodium intake

  • Chronic stress

  • Anxiety

  • Depression

  • Metabolic abnormalities

  • Excessive alcohol consumption

  • Smoking

  • Physical inactivity

  • Obesity

  • Pain

  • When talking to patients, it is essential to ask related lifestyle questions.

• Blood Pressure Category Ranges

  • Normal: 120/80 mmHg and less

  • Elevated: 120-129/less than 80 mmHg

  • High Blood Pressure Stage 1: 130-139/80-89 mmHg

  • High Blood Pressure Stage 2: 140 or higher / 90 or higher mmHg

  • Hypertensive Crisis: Higher than 180 and/or higher than 120 mmHg

• Controlled Blood Pressure for Patients on Medication

  • Considered “controlled” if readings are less than 130/80 mmHg.

• Importance of Multiple Readings

  • One reading is not sufficient due to the potential for the 'white coat effect'.

  • Guidelines recommend three readings for accuracy.

• Questions to Ask Patients

  • Medication: Do you take medications for high blood pressure? Did you take them today?

  • Monitoring: When was your last blood pressure checked? How was it? Do you have a machine at home?

  • Diet: What does your diet look like?

  • Metabolism: Do you exercise? What type of activities? Are you trying to lose weight?

  • Motivation: Assess SMART goals and provide specific advice.

  • Medical History: Relevant background regarding the patient's health.

Preventive Strategies for Hypertension

• Weight Loss

  • Losing 5-10% of body weight can significantly reduce blood pressure.

• DASH Diet (Dietary Approaches to Stop Hypertension)

  • Low Sodium: Consume less than 1500 mg/day.

  • Low Saturated Fat: Should be minimized.

  • High Potassium: 3000-3500 mg/day recommended.

• Physical Activity Recommendations

  • Aim for 150 minutes of aerobic exercise per week.

  • Include muscle-strengthening activities at least 3 days a week.

• Lifestyle Factors to Manage

  • Avoid smoking, excessive alcohol consumption, stress, and ensure proper sleep hygiene.

Diabetes

• Diagnostic Criteria for Diabetes

  • Fasting Blood Sugar:

  • Normal: 70-100 mg/dl

  • Pre-diabetic: 101-125 mg/dl

  • Diabetic: 126 mg/dl and above

  • Random Blood Sugar:

  • Normal: 70-140 mg/dl

  • Pre-diabetic: 141-199 mg/dl

  • Diabetic: 200 mg/dl and above

  • Hemoglobin A1c Levels:

  • Normal: less than 5.7%

  • Pre-diabetic: 5.7-6.49%

  • Diabetic: greater than or equal to 6.5%

• Management Goals for Patients on Medication

  • A1c Target: less than 7.0%

  • Before a meal: Maintain blood sugar levels between 80-130 mg/dl.

  • 1-2 hours after a meal: Ideally less than 180 mg/dl.

• Treatment Recommendations for Diabetes

  • Follow the DASH diet.

  • Engage in regular physical activity.

  • Maintain a healthy weight.

  • Stop smoking and reduce alcohol intake.

  • Employ stress reduction techniques.