Taming the “Silent Killer”- The Place Of Exercise In the Management Of High Blood Pressure

High blood pressure (hypertension) is often referred to as “the silent killer” because though it may be causing a lot of harm to your body, one may be feeling perfectly well. Hypertension can only be diagnosed by taking blood pressure readings and one should not depend on the presence of symptoms before checking.

Hypertension is best managed by combining life-style modifications (exercise and dietary modifications) and medications. For certain blood pressure readings, your healthcare professional will start you on only dietary modifications, exercise and stress management. There are currently many effective medications but without the appropriate life-style changes, your doses and number of medications will be increased over a period to control your blood pressure and reduce the incidence of complications. Increasing the dose and types of drugs also come with an increase of drug side-effects and drug-drug interactions.

Suggestions made here only act as guidelines, only your healthcare professional together with a qualified fitness therapist can recommend the appropriate exercises. It is highly recommended that you get a clearance from your doctor before starting any exercise programme.

Life-style modifications to help manage hypertension:

• Exercise
• No smoking
• Limited (or no) alcohol consumption
• DASH (dietary approaches to stop hypertension) diet : low sodium(salt), increased potassium from fruit and vegetables, low or no saturated fats and increased fibre
• Stress management

Exercise plays a vital role in the management of hypertension. There are three broad categories of exercise and all of these are vital in the wellbeing of an individual and the lowering of blood pressure

• Aerobics – Moderate intensity aerobic exercise improves cardiac function and lowers blood pressure
• Strength training – Increases endurances, reduces heart’s demands during daily activities, helps to reduce blood pressure at rest, makes client stronger and reduces stress
• Stretching – Plays a complementary role by increasing tendon flexibility, improving joint ROM and function and hence incidence of injury that can cause pain and increase blood pressure. It also enhances muscular performance.

Warm Up and Cool Down: Warming up will take 5-10 minutes each session and should be done religiously. Warming up is the process of preparing the body for more vigorous exercise. It should be gradual and one only needs to break into a light sweat. Cool down shoul also be long to ensure heart rate etc returns to close to normal levels. Warm up and cool down are extremely important in every exercise regime and more so in one with hypertension or heart disease. NEVER start or end any exercise session without these two.

Certain high blood pressure readings may require rest for a while before exercising. You may need to avoid certain exercises such as abdominal exercises since they cause an increase in intra-abdominal pressure (valsava ) and probably blood pressure. In certain cases you may need to avoid strength training or weight training briefly and concentrate on aerobic or cardiovascular exercise such as walking, cycling, treadmill etc. and flexibility exercises.

Many people are wary of weight training or strength training, especially adults with high blood pressure but as stated earlier, this form of exercise also plays a vital role in managing high blood pressure. It is important to note the following:

• Avoid exercises that require lifting weights above the head; supine exercises preferred
• Limit the number of sets and repetitions for upper body exercises eg arms, chest, shoulders etc
• Increase or maximize the number of repetitions and sets for lower body exercises such as squats for thighs etc since these tend to help reduce blood pressure through a complex mechanism including peripheral pooling of blood just after exercising

It is important to note that when exercising to control blood pressure (like in all other cases) one needs to start gradually and increase the duration and type of exercises over a period. The rule of thumb is to listen to your body at all times – NO PAIN NO GAIN IS INSANE!!!!

Dr. Kojo Cobba Essel
Medical Doctor & Fitness Therapist
Moms Health Club
www.healthclubsgh.com Back up

THE TRUTH WILL SET YOUR ABDOMINAL FAT FREE

Stand still for a few minutes in a busy area and observe the midsection of those who walk by. It is a sight to behold and an indication that we are sitting on a health bomb. It gets even scarier when you consider the fact that many of those riding in cars are also very well endowed with “pot-bellies”.

Abdominal fat is a health hazard and may cause many problems including:

• Increasing our risk for cardiac disease
• Drawing us closer to diabetes
• Affecting our posture and causing back pain
• Reducing our self confidence

Truth is most of you like me will never achieve a six-pack (you probably had one years ago) but we can tame the bulge around our midsection. It is important that we learn the facts instead of spending a life-time doing sit-ups/crunches and many fancy exercises to “work our abs”

Truth #1
We have this pouch (one-pack) because we do not EAT RIGHT.

• We need to eat well balanced meals but with an eye on the carbohydrates and fat. Three to five small meals a day is great
• Late night dinners such as fufu, kenkey etc can be disastrous and a sweet tooth will keep the six-pack hidden.

Yes, I know supper is often the only family meal of the day, but lets watch what we eat and the time we have our dinner and part of the battle will already be won. The earlier and the “lighter” the meal the better.

Truth #2
Abdominal (stomach) exercises alone will get you NO WHERE!! Yes you can have a six or eight-pack covered by layers of fat. You can feel it (hopefully) but NOBODY ELSE WILL KNOW. Doing all those sit-ups will reward you with a big hard belly.

Truth #3
Cardiovascular/Aerobic exercise is king!
That pouch overhanging your belly is fat and it can’t be a good thing. It is aerobic exercise that will “burn the fat” and we need to keep it off by eating right. So dear reader, lace your boots and start taking 45 minutes brisk walks, cycling, jogging, treadmill, elliptical, swimming, skipping, dancing and many more. The important point is to have a large group of muscles moving repeatedly and having your heart rate elevated for a long period.

So the simple truth is; Eat the right food at the right time, cut down the alcohol, do a lot more aerobic/cardiovascular exercises and only then will it be worth your time to do sit ups/crunches etc to strengthen and define your “stomach” muscles.

Do spread the TRUTH!!

Dr. Kojo Essel
Health & Fitness Consultant
Moms Health Club Back up

Workplace Wellness Programmes - The Answer To Escalating Healthcare Costs!

Escalating health care costs continue to remain an issue of great concern for many health professionals, employers and insurance companies. The latest statistics establish that 80% of illnesses and disease in Canada and the United States (data for Ghana not available yet but will be comparable) are preventable. This accounts for eight of the nine leading causes of death.

Heart disease though preventable in many instances remains one of the biggest killers as well as a major cause of morbidity and days off work. Other illnesses such as the common cold and back pain which are major causes of absenteeism can be prevented to a large extent with regular mild to moderate intensity exercise.

Studies show that employees who exercise as little as once a week will incur health care costs that are one-third to one-half lower than those who don’t.

A structured corporate wellness programme will ensure that people with life-style diseases will gain renewed health and some may end up reducing the number or doses of medications they currently take.  Future costs will also be reduced since the improved life-styles will reduce the incidence of new cases of chronic diseases.

Data from corporate bodies show that for every $1 invested in a corporate wellness programme, the return could be as high as $10.0. This does not include all the intangibles such as increased employee morale, reduced turnover of skilled/trained staff and happier employees.

Background

For many companies, medical costs can consume half of corporate profits – or more. Some employers look to cost sharing, cost shifting, health insurance, risk rating, and cash based rebates or incentives. But these methods merely shift costs. Only worksite health promotion/corporate wellness programme stands out as the long term answer for keeping employees well in the first place.

Worksite wellness is health reform that works. Results from North America’s finest companies and strides made here in Ghana offer ample proof.

The benefits of a corporate wellness programme include, but are not limited to:

• Reduced Absenteeism and Presenteeism
• Higher Productivity
• Reduced use of health care benefits
• Reduced Injuries
• Increased Morale and Loyalty

Over the years, Ghana’s population has seen an alarming increase in life-style diseases such as:

• Obesity with all its associated problems
• Diabetes
• High Cholesterol
• Heart diseases
• Chronic Fatigue Syndrome
• Osteoarthritis
• Stress

A lack of exercises and poor dietary habits are major causes of this alarming trend.

STATISTICS

• Johnson and Johnson, reduced their absenteeism rate by 15% within two years of introducing their wellness programme. They also cut their hospital costs by 34% after just three years. (human resources executive, April 1993)
• To prevent back injuries among employees, a county in California offered classes and fitness training to all its workers. As a result, there was a significant decrease in sick days related to back injuries, producing  a net cost-benefit ratio of 1 to 1.79.
• British Columbia Hydro electric’s wellness programme participants had an annual turnover rate of 3.5%, compared to a company-wide average of 10.3%
• Coca Cola: The Company reported a reduction in health care claims with an exercise programme alone, saving $500 per employee per year for the employees (60%) who joined their fitness programmes.
• Ghana Cocoa Board – Has one of the most comprehensive corporate wellness programmes in Afrca. At least 80% of those who regularly take part in the wellness programmes say this is the happiest time of their lives and they are extremely happy with their employer for having their well being at heart.
• Metso Minerals Gh Ltd:  most employees have adopted a healthy lifestyle and “can run up the stairs without stopping to catch my breath

Overall return on Investment

Dollars Saved for every $1 Invested

Source: IRSA, the association of Quality Clubs, Employee Benefit News

Corporate Wellness Programmes include:

• Health Screening or encouraging staff to visit a healthcare professional at least once a year even if they think they are perfectly healthy. Such visits not only prevent disease complications but may also increase the awareness of staff.
• Making information on health and fitness & disease states easily available to staff either through seminars or leaflets. Also consider lunch & learn sessions where staff is educated on different health topics during their lunch break.
• Starting onsite group exercise sessions, where upper management will participate to encourage all others. Corporate bodies may even set up onsite health clubs to increase utilization rates or in the event where no space is available, one may choose to register staff in off-site clubs.

Corporate Wellness Programmes work and in the future, it will be a requirement for all corporate bodies. Currently some people are choosing their next employer based on the presence or absence of a Wellness Programme.

Dr. Kojo Cobba Essel
Health & Fitness Consultant
Moms Health Club Back up