Blood pressure is measured using a sphygmomanometer. Learning the technique of taking blood pressure using a sphygmomanometer should be standard practice for all health and wellness coaches. Being able to explain why other devices are not as useful to your client is a recommended skill to have going forward, as your client may be using other equipment to obtain a blood pressure value.
Blood pressure is considered too low when it causes symptoms of fainting, dizziness or lightheadedness. Even newer research indicates an increase in systolic blood pressure paired with a decrease in the diastolic blood pressure doubles the risk of dying from cardiovascular disease.
In physiology, we refer to the difference between systolic blood pressure and diastolic blood pressure as pulse pressure. With age, systolic blood pressure increases – and can also increase due to poor lifestyle habits, causing arteries to lose resilience and elasticity. If at the same time, the diastolic blood pressure (DBP) decreases because of plaque-ridden or constricted blood vessels, stiff or brittle arteries can become problematic. Of the 58 million Americans known to have hypertension, over 45,000 people die of complications from hypertension each year.
Hypertension is also the most important risk factor known to cause strokes, as well as being a major risk factor for heart disease overall. Over 700,000 brain attacks or strokes occur every year in America, with certain segments of our population being at higher risk – such as African- Americans, This group is more likely to suffer a stroke or experience kidney damage than are white, Latino, or Asian-Americans.
In general the higher the blood pressure, the greater the risk. The lower the blood pressure, the better.
Current Blood Pressure Guidelines
In 2017, new guidelines from the American Heart Association, the American College of Cardiology, and nine other health organizations lowered the numbers for the diagnosis of hypertension (high blood pressure) to 130/80 millimeters of mercury (mm Hg) and higher for all adults. The previous guidelines set the threshold at 140/90 mm Hg for people younger than age 65 and 150/80 mm Hg for those ages 65 and older.
This means 70% to 79% of men ages 55 and older are now classified as having hypertension. That includes many men whose blood pressure had previously been considered healthy.
The new guidelines have other changes, too. First, they don’t offer different recommendations for people younger or older than age 65. The 2017 SPRINT study looked at all patients regardless of age and didn’t break down groups above or below a certain age.
The guidelines also redefined the various categories of hypertension. It eliminated the category of prehypertension, which had been defined as systolic blood pressure of 120 to 139 mm Hg or diastolic pressure (the lower number in a reading) of 80 to 89 mm Hg. Instead, people with those readings are now categorized as having either elevated pressure (120 to 129 systolic and less than 80 diastolic) or Stage 1 hypertension (130 to 139 systolic or 80 to 89 diastolic).
A reading of 140/90 mm Hg or higher is considered Stage 2 hypertension, and anything higher than 180/120 mm Hg is a hypertensive crisis.
Training Clients with High Blood Pressure
It’s pretty likely that you will have clients who present with hypertension. It then seems logical for you to be able to provide some coaching suggestions for your client which may include all or some of the following: weight loss, salt and alcohol restriction, adequate intake of calcium, potassium, and magnesium, voluntary relaxation techniques, regular physical activity, and any prescribed medications.
Since excess body weight increases the work for the heart muscle, knowing appropriate body weight and body composition metrics is required for you to make personal recommendations to your client in order to either manage blood pressure or prevent the onset of hypertension.
The wellness coach is instrumental in exercise programming. After initial goals and behavior changes have been mapped out, exercise program design may be one of the strategies that you employ. Again, among the diverse skills required in the coaching and training fields, you may not have a background in exercise program design. But learning exercise programming skills are complementary to the coaching process.
When possible, refer to guidelines and standards, presented as policy or position statements, from reputable sources. One reference that may be useful to wellness coaches is the American College of Sports Medicine, but this is just one of many resources available to the wellness coach. Some of the more compelling conclusions supported by new and emerging research include:
Exercise Recommendations for Clients with Hypertension
Endurance exercises lower blood pressure by 5- 7 mmHg. This is a significant reduction because small decrements and systolic blood pressure, as little as 2 mmHg, reduce the risk for stroke by 14% and coronary heart disease by 9%; a 2 mmHg decrease in diastolic blood pressure reduces the risk for stroke by 17% and coronary heart disease by 6%.
The recommended exercise prescription for lowering blood pressure is as follows:
- Frequency: on most, preferably all days of the week
- Intensity: Moderate
- Time: 30 minutes or more
- Type: endurance exercise supplemented with resistance training
Communicating with your client might mean that you have to explain concepts that are unknown to them. Blood pressure tends to be one of these. Being able to describe the mechanism and pathology for how endurance exercise can help lower blood pressure, is, therefore, useful to know. In this scenario, explain to the client that endurance exercise:
- Lowers blood levels of catecholamines (epinephrine, norepinephrine, and dopamine), which are vasoconstrictor that increases resistance to blood flow and increased blood pressure
- Endurance exercise helps to prevent peripheral resistance to blood flowing in the blood vessels by dilating blood vessels
- Endurance exercise lowers body weight; a growing body of evidence suggests and supports that systolic blood pressure is lowered by 5 to 22 points for every 20 pounds of excess body fat lost
- Endurance exercise also improves cellular sensitivity to insulin which encourages the kidneys to excrete sodium, therefore, having a lowering effect on blood pressure
Checking Blood Pressure at Home
The new guidelines note that blood pressure should be measured on a regular basis and encourage people to use home blood pressure monitors. Monitors can range from $40 to $100 on average, but your insurance may cover part or all of the cost. Measure your blood pressure a few times a week and see your doctor if you notice any significant changes. Here are some tips on how to choose and use a monitor.
- Select a monitor that goes around your upper arm. Wrist and finger monitors are not as precise.
- Select an automated monitor, which has a cuff that inflates itself.
- Look for a digital readout that is large and bright enough to see clearly.
- Consider a monitor that also plugs into your smartphone to transfer the readings to an app, which then creates a graph of your progress. Some devices can send readings wirelessly to your phone.
- Avoid caffeinated or alcoholic beverages 30 minutes beforehand.
- Sit quietly for five minutes with your back supported and your legs uncrossed.
- Support your arm so your elbow is at or near heart level.
- Wrap the cuff over bare skin.
- Don’t talk during the measurement.
- Leave the deflated cuff in place, wait a minute, then take a second reading. If the readings are close, average them. If not, repeat again and average the three readings.
- Keep a record of your blood pressure readings, including the time of day.
Getting Started
Become a Heart Rate Performance Specialist. Effectively design fitness training programs targeting ideal heart rate zones. Whether your clients want to train to improve sports and fitness performance or simply enjoy a healthier lifestyle, the most effective way to do both is to listen to your body.
health and wellness coaches is the perfect addition for the fitness professional who wants to offer more all-inclusive wellness services to clients.
The time is now for you to enjoy this exciting and rewarding career, which offers you personal fulfillment while improving the lives of others.
If you haven’t yet, be sure to check out what it takes to start a career in personal fitness training. This is your most affordable and fastest way to become a highly qualified personal trainer.
NESTA coaching programs are open to anyone with a desire to learn and help others. There are no prerequisites.
That’s it for now.
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