Why is Periodization Important for Weight Training: Workout Cycles for Better Gains

The Benefits of Periodization for Weight Training Gains

Have you ever been in a workout rut? You feel less motivated to work out or you’ve reached a plateau in your training. You simply aren’t seeing the results you expected! Chances are your results dropped off because you kept doing the same training over and over at the same intensity each time you trained. Your muscles need to be stimulated in different ways to keep making gains! Also, if you work your muscles in the same way repeatedly, you run the risk of over-training. One way to avoid this is to periodize your training. This cycle of working out is beneficial to if you who want to loose weight, gain muscle, gain strength or get in better shape. Its good that you started working out but once your body gets comfortable its time to change it up.

The Benefits of Periodization

Periodized training is where you vary the stimulus you place on muscles at varying time points in time. Doing this helps avoid training plateaus as your muscles and reduces the risk of over-training. For example, you can divide your training into phases where each phase focuses on a different goal. In addition, each phase builds on the last phase. One of the simplest ways to organize your training into phases is in this order:

Hypertrophy Phase

Hypertrophy training is a phase designed to enlarge the size of your muscles. During this phase, you will use a moderately heavy resistance. For the hypertrophy phase, choose a resistance equal to about 60 percent to 70 percent of your one-rep max. This should be a weight you can lift 10 to 12 times for three sets. Rest 60 seconds between sets. This type of training not only helps you build muscle, but it prepares you for the next phase, the strength and power phase where the going gets tougher.

Strength Phase

During the strength phase, you’ll increase the resistance modestly, so you’re working with a weight that’s somewhat heavier than what you used in the hypertrophy phase and you’re able to complete fewer reps. Choose a weight that you can complete between 2 and 5 repetitions before the muscles you’re working are spent. That will correspond to a weight of around 80 to 90 percent of your one-rep max. Allow your muscles to rest 2 minutes between each set and aim for 3 to 4 sets. You conditioned your muscles during the hypertrophy phase, so you should be better prepared for this phase, the phase where you focus on strength building.

Power Phase

During the power phase, you’ll focus on increasing the tempo of your lifts to build greater power. Choose a weight of 70 to 80 percent of your one-rep max and lift the weight at a faster tempo. Remember, power is the amount of work you can do in a given time period. So, moving the weight quickly through space will help you become more powerful. Shoot for 3 sets with 3 minutes of rest between sets.

Recovery Phase

The recovery phase is your reward for working hard during the previous three phases. During this phase, you’ll shift the focus of your training away from building strength and muscle size. Instead, do aerobics or other less strenuous exercises to give your muscles and nervous system a chance to recover. This phase is usually shorter than the other phases, no more than a week or so. Long recovery phases could lead to detraining and loss of gains.

Types of Periodization Schemes

Now that you know how the phases are set up, you can organize your phase in two main ways. Some people use linear periodization while others use undulating periodization.

Linear Periodization

This is the classic way to structure a periodized workout. First, choose the overall time period for a complete cycle. This is called a macrocycle. For example, you might want to complete a macrocycle in two months. This is the bigger time picture. In turn, a macrocycle is made up of a series of training phases called mesocycles. These correspond to the four phases just discussed come in. Each phase makes up a mesocycle. Over the two month macrocycle, you’ll cycle through the various phases or mesocycles. For example, you might spend two weeks in the hypertrophy phase, two weeks in the strength phase, two weeks in the power phase, and recover in the final week. But remember, the length of the macrocycle and mesocycles is up to you.

Undulating Periodization

Undulating periodization is another way to structure a periodized workout. With linear periodization, you work in a “straight line.” You go through each phase of training in order and the training intensity gradually increases. With undulating periodization, you change the focus and intensity of your training in a non-linear or undulating manner. For example, you might do hypertrophy training one week followed by peak strength training the next week and then power the next. You’re not moving in a linear sequence through the phases or mesocycles.

Some people even vary the intensity and volume every time they work out. For Monday’s workout, you might lift for hypertrophy and switch to strength on Wednesday. The fact that you’re constantly changing the intensity of your training means your muscles are less likely to adapt to what you’re doing and stop changing. In this way, you keep your muscles “guessing.” You can also adjust any training variable, such as the weight, repetitions, and tempo, in an undulating manner to change the stimulus you place on your muscles.

You might wonder whether undulating periodization is better than linear. A study published in the Journal of Strength and Conditioning Research showed that undulating periodization was more effective for building strength than was a linear periodization scheme. Research also suggests that periodizing weight training, in general, is superior to non-periodized workouts for gains in strength and muscle hypertrophy. So, keep this in mind when designing your routine. Periodization rules and that’s why you should be doing it!

Plan to change your workout at about 6-8 weeks after starting your program. If you have been going at a really high  intensity , then you can go to moderate intensity.  Conversely, increase your intensity if you were on the low to moderate intensity. Last but not least, try different exercises or different variation of the same exercises. Once you mastered the exercise then try something new.

References:

J Strength Cond Res. 2002 May;16(2):250-5.

University of New Mexico “Periodization: Latest Studies and Practical Applications”

How High Blood Pressure Affects Sexual Function

High blood pressure can damage almost every organ in the human body. Over time, it also injures the inner lining of arteries, the blood vessels that carry blood and oxygen to tissues. That’s why it’s so important to monitor your blood pressure frequently and control it. It can do a significant amount of damage if you ignore it!

Hypertension is a silent disease. Many people have it and are unaware of it until they develop a complication. High blood pressure usually causes no symptoms until other health problems appear. Although some people claim to get a headache when their blood pressure is high, this usually only happens when blood pressures are sharply elevated.

What few people talk about is the impact blood pressure elevations have on sexual function. Uncontrolled high blood pressure can have a negative effect on sexual function in both men and women. Let’s look at how elevated pressures cause sexual problems and how these problems manifest.

The Impact of Uncontrolled High Blood Pressure on Sexual Function in Men

Men are the most profoundly affected sexually by high blood pressure. One of the most common disturbances men with poorly controlled blood pressure experience is difficulty achieving an erection. This is a distressing sign to most guys, but many are unwilling to discuss the problem even with their physician. High blood pressure makes it harder, or sometimes impossible, to achieve or maintain an erection because it reduces blood flow to the penis.

Why does blood flow to the penis drop with hypertension? People who have high blood pressure have arteries that don’t expand as much as they should. The lack of expansion is why their blood pressure is high in the first place. Overly tight arteries also impact blood flow to the penis. You need sufficient blood flow to get an erection. When blood flow is sluggish due to tight arteries, initiating or keeping an erection becomes a problem.

How common are erection problems in men with high blood pressure? A study published in the Journal of the American Geriatrics Society found that almost half of men over the age of 40 with hypertension have erectile dysfunction. Some research suggests that the incidence of erectile dysfunction with elevated blood pressure is even more common than this study suggests. For example, a study published in the Journal of Urology found that 68 percent of guys with high blood pressure experienced episodes of erectile dysfunction.

The Effects of Hypertension on Sexual Function in Women

Women don’t have to achieve an erection as men do, but they, too, can experience sexual issues with blood pressure that’s too high. For example, uncontrolled high blood pressure can reduce blood flow to the vagina and clitoris. The decrease in blood flow makes it harder for a woman to stay aroused. In addition, a decline in blood flow can cause vaginal dryness that makes sexual intercourse less comfortable. Women with hypertension can also experience decreased libido and have less desire to have sex. Also, intercourse may be less satisfying due to these issues.

What about Blood Pressure Medications?

Some medications used to treat hypertension also cause sexual problems, particularly for men. Several classes of blood pressure medications make it harder for men to gain an erection. For example, some diuretics reduce blood flow to the penis, and another class called beta-blockers also commonly make it harder to achieve and hold an erection.

Does that mean blood pressure medications have to limit your sex life? Nope! There are still other classes of medications, such as calcium channel blockers and angiotensin-converting enzyme inhibitors (ACE) that lower blood pressure and are less likely to cause sexual problems. These are worth exploring if you have frequent sexual problems.

High blood pressure and the medications used to bring high blood pressure down can negatively affect sexual function, particularly in men. However, there are other causes of decreased sexual desire and erectile dysfunction too. Sometimes, erectile dysfunction is due to several factors beyond just elevated blood pressure.

For example, men with diabetes can have problems gaining and maintaining an erection, especially if their blood sugar levels are poorly controlled. So, discuss all the possible causes with your physician. Also, if blood pressure medications are contributing to sexual problems, they may be able to prescribe a different one that will work without as many sexual side effects.

Sometimes it’s possible, in the case of mild hypertension, to lower blood pressure readings through lifestyle, so that blood pressure medications can be reduced or even eliminated. But don’t change or reduce your medications without consulting your health care provider. Simple lifestyle changes like losing weight and exercising can improve sexual function and fire up the old libido too! A study conducted by researchers at Harvard found a 41 percent reduction in erectile dysfunction in men who walked at least 30 minutes daily. Walking helps lower blood pressure too. So, it’s a win-win activity.

Make sure you’re treating other conditions that can worsen sexual dysfunction. If you have diabetes, work on getting your blood sugar levels down. Also, kick the smoking habit! Smoking constricts the arteries that deliver blood to all tissues, including the sexual organs. It can also worsen high blood pressure. Don’t overdo the alcohol either! Alcohol worsens erectile dysfunction in several ways. It can cause short-term difficulty in getting an erection. Plus, drinking too much alcohol can lower testosterone, a male hormone involved in sexual arousal and sexual desire.

Conclusion

Regardless of its impact on sexual function, it is important to keep high blood pressure under control. If you ignore it, blood vessel damage can worsen and lead to other health problems that interfere with healthy sexual function. So, discuss the options with your health care provider now rather than later. Do it for your health!

References:

WebMD.com. “How High Blood Pressure Leads to Erectile Dysfunction”

Mayo Clinic. “High blood pressure and sex: Overcome the challenges”

Journal of Psychoactive Drugs. Volume 33, 2001 – Issue 3

Harvard Health Publishing. “5 natural ways to overcome erectile dysfunction”

Progressive Overload 101 – Why It’s Crucial for Effective Training

The human body is a well-oiled machine, and it can adapt to almost anything you throw at it. That is important when it comes to your training, whether you’re trying to improve strength, build muscle or increase cardiovascular fitness, and it’s also where the concept of progressive overload comes into play. If you want to keep making progress and continually improving, you’ll need to make some changes to your exercise routine. This article explains what progressive overload is, why it’s important, and how you can use this information to improve your training methods and see serious results.

What Is Progressive Overload?

Progressive overload is of particular importance to strength training athletes, but it’s relevant to anyone who lives an active lifestyle and wants to make progress. Simply put, it refers to the gradual increase in stress placed on the body during exercise. Your body naturally adapts to stress. When you train for mass or strength, this stimulates your body into action, and muscles are broken down and built back up again bigger and stronger than before. Other effects include stronger and denser bones and soft tissue, as well as increased blood flow.

Why Do You Need to Do This

Since your body quickly adapts, you’re going to have to keep challenging it if you want these reactions to occur. The concept of gradually increasing stress is a tried and tested way of doing so. If you keep doing the same thing over and over again, your body will get used to it, and you won’t be stressing it enough for any changes to occur. That can lead to results tailing off because you have reached a plateau. If you stop training for any reason, it will also have significant effects.

Living a sedentary lifestyle can cause muscular atrophy (loss of mass and strength). That is why, if you’ve come back from a lengthy absence, you’ll no doubt have found that your performance has dropped off and your physique is not what it used to be. If there is no demand for the body to adapt, then this atrophy will continue, which is why it’s so important to stay active and train in the right way.

How to Implement Progressive Overload in Your Training

There are many ways you can keep challenging your body and ensuring that it responds to your training. Here are some of the most common methods:

•​Increased volume (more sets, more reps per set)

•​Decreased rest times

•​Increased resistance (heavier weights)

•​Increased time under tension (perform reps more slowly)

•​Increased frequency (training more often)

•​Adapted exercises (one arm push-up, jump squat, deficit deadlift, etc.)

These are just a few of the main ways you can modify your training in line with this principle. How you implement this overload will depending on your goals and type of training, but it’s essential you find some way of stressing the body so you can continue to make progress.

Dangers of Progressive Overload

While the body needs stress to improve, the emphasis is on gradual increases. If you try and change your training too quickly or too drastically, you risk overtraining and causing serious injury to yourself. Here are a few things to keep in mind when coming up with a training plan:

•​Small increases — whether you’re increasing weight, volume or whatever else, it’s important to take your time and build up in small increments. If you usually train for an hour three times a week, suddenly training for two hours every day is a recipe for disaster and could well lead to injury.

•​Adequate rest — if you’re lifting heavier and longer, you’ve got to give the body time to recover from your training properly. Rushing back from a hard training session puts your body at risk.

•​Periodization — periodization is the practice of training in cycles to reach your peak without overloading your body. That means you should avoid going all out every session, and vary the RPE (rate of perceived exertion) or percentage of the 1RM (one rep max) at which you train. Research training plans based on your goals.

Keep Making Gains

If you take your training seriously and want to keep making progress, then it’s essential you understand the principle of progressive overload, and know how to apply it to your workouts. Whether you’re increasing resistance, volume, or intensity, there are plenty of ways of effectively taking your exercise routine to the next level. As long as you’re aware of the potential risks, and ensure that you increase the stress on your body gradually, you should see some great results using this method.

​The Best Fat-Burning Cardio Exercises for Women

 

Your life is busy, whether you work at a paid job or stay at home with kids. You have chores to do and errands to run, while somehow finding time to nurture relationships with partner, family, and friends. It’s hard to find the time to exercise! When you can squeeze in a workout, you want activities that burn fat, can be done pretty quickly, and don’t require tons of equipment or preparation. The best choice for all these needs? Aerobic activities that get your heart pumping and your metabolism jumping. Some you can do at home. No gym membership or equipment required.

Here are some great exercises to try:

Running

Running isn’t for everyone, but it’s a fantastic way to burn calories quickly if you can do it safely (check with your doctor first). You can do it just about anywhere or even inside on a treadmill, and you only need a sports bra and a good pair of running shoes to get started. Try mixing up jogging with bursts of faster running for maximum results.

Walking

Walking at any speed, even just a stroll, is healthier than sitting around. However, to get an effective workout in a short time, you need to keep a good pace. If you feel a bit breathless but can still speak comfortably, you are in a good zone. It doesn’t burn as many calories as running, but it is easier on your feet and joints. You can wear a weighted vested to make this more challenging.

Aerobics

Do you remember your mom doing Jane Fonda or Denise Austin workouts? Aerobics has been popular for decades, and for good reason — it works! It’s fun and energizing to do, and you can burn a lot of calories in a short time, especially if you make large, exaggerated movements. Jane and Denise are still creating new workout videos, and there are tons of other options, including low-impact workouts and even “chair aerobics” designed for seniors.

Dancing

Dance crosses over to aerobics with workouts like Zumba or Jazzercize, but there are lots of other ways to get your groove on and burn off some fat while you do it. You can take a dance class to learn to waltz or tango, or hit a club for a girl’s night out. But the easiest way to do it is to just crank up some favorite tunes and go to town in your living room. You can combine it with housecleaning chores, or squeeze in 5-minute bursts during tv commercials.

Bicycling

If you have a safe outdoor area for bike riding, it’s a perfect way to get in an aerobic workout and enjoy some fresh air. But you can also use a stationary bike at home or in the gym, or to maximize your calorie burn, try a spinning class.

Jumping Jacks

You remember these from gym class back in the day. Jumping jacks burn calories, get your whole body revved up, and best of all, don’t take long and can happen anywhere. Do a set of 50-100 when you wake up in the morning, or during commercials while watching television. Move quickly with big arm and leg movements for the best effect.

Rebounding

Rebounding is one of the exercises that astronauts do to stay fit on the space station, but it works great down here on earth, too. All you need is a small trampoline that you can bounce on. You can keep it as simple as just bouncing up and down while watching tv or listening to music or a podcast, or you can try a class at a gym where you combine your trampoline with aerobic routines.

Swimming

Unlike most of the other exercises, you can’t swim just anywhere. But if you have a pool in your backyard or a nearby neighborhood or gym pool, it’s one of the best ways to burn a lot of fat in a short time, and it’s very easy on your joints. Standard freestyle swimming works well, but if you can do breast or butterfly stroke, you will burn the most calories in each movement because these strokes require full body participation. Twenty or thirty minutes in a lap lane or lap pool and you will be fired up for the rest of the day.

Whatever exercise you choose, make sure you drink enough water, choose healthy foods, and watch your overall caloric intake. Just make sure you are eating enough to avoid pushing your body into starvation mode because it will hang onto that fat instead of burning it off. If you are really crunched for time, break up your session. All you need is 30 mins a day 5 days a week.  You can break you time up in two 15mins session.

Last but not least, any of the above can be use to perform a HIIT workout.

Five Intense Indoor Exercises to Lose Weight

There’s nothing like jogging or biking in the great outdoors. Unfortunately, Mother Nature has a way of foiling workout plans with an ill-timed lightning storm or blizzard. Or perhaps you have to keep an eye on the kids at home and cannot leave the house. Whatever the case, there are plenty of great ways to burn calories indoors. Use these workouts whenever outdoor exercise is not an option.

Weight Circuit Training

Weights aren’t just for strength training; they can be used for some vigorous indoor cardio! The key is to do back-to-back sets of different lifts – with no rest period in between – using low to medium weight. For example, you might do one set of squats, one set of power cleans, and one set of overhead presses, then repeat the entire circuit as many times as you can. You can use barbells, dumbbells, kettlebells, or any heavy object you have around your house.

Plyometrics

Plyometrics is a form of exercise that focuses on short, explosive movements, usually jumping. It is a mainstay of training regimens for gymnasts, martial artists, and basketball players. It’s easy to do plyometrics at home; just do a variety of jumps either for a certain number of reps or on a timer. Some common plyometric exercises include ankle jumps, squat jumps, jump-and-tucks, star jumps, and clapping push-ups. For an extra challenge, try jumping from the floor onto an elevated surface. These exercises will not only get your heart pumping but also build endurance and speed.

Tabata Exercises

Tabata circuits are a form of high-intensity interval training. Each circuit is 20 seconds of exercise of the highest possible intensity followed by 10 seconds of rest. The entire workout consists of eight circuits, making it four minutes in total. Don’t be fooled by the seemingly short duration; a Tabata set will bring you to total exhaustion. You are essentially cramming a half-hour workout into four minutes. You can do almost any exercise as a Tabata workout: squats, push-ups, lunges, flutter kicks, jump rope, sit-ups, and many more. All you need to start a Tabata workout is an interval timer, and many smart phone apps exist for this purpose.

Dance Aerobics

Have you ever wondered why you feel so exhausted after going to a concert or spending the evening at a dance club? It’s because fast-paced dancing is hard work! Dancing provides cardio and endurance training for the entire body. Best of all, you can do this exercise with any kind of music you choose. If you can dance to it, you can work out to it! All you need is a stereo and your favorite tunes.

Shadow Boxing

Even if you’re not a martial artist, you can still knock out some calories by shadow boxing at home. You don’t even need gloves or a punching bag; just stand in a fighting stance and throw punches as fast as you can. You can also add some kicks if you like. These exercises are most effective when done in intervals of about 30 seconds. You’ll feel the burn mostly in your arms, but your abs and legs will get some action as well from the work of keeping your body in an upright position as you throw punches.

Being homebound doesn’t mean you have to skip your workout. All you have to do is switch to a form of exercise that can be done indoors, and as you can see, there are plenty of options. Keep this list in mind next time you need to burn some calories without leaving the house.

What does Muscular Strength Mean?

Exploring the Seven Different Types of Muscular Strength

Being strong is important in any sport. Strength allows you to move heavier weights and makes movements in general feel easier. Strength protects you from injury, and one of the components of speed is being strong enough to do movements explosively and rapidly.

Simply ‘lifting weights in the gym’ without a goal will not prepare you for a competitive career in your chosen sport, however. You have to perform the right kinds of exercises to create the right kind of strength. There are seven different ‘types’ of muscular strength, and each one involves training the muscle fibers in a specific way. Let’s take a quick look at each type of strength, and how you would build it.

Agile Strength

Agile strength involves the ability to use your muscles across multiple planes of motion and to move a mass through gravity across those planes. Traditional lifts involve pushing or pulling in single directions. Agile strength is more complex and is the kind of strength that you would use when carrying heavy objects in day to day life.

To train agile strength, you would use dumbells, sandbags or medicine balls, and work with moderate intensity. It would be dangerous to put a lot of emphasis on your 1RM, but doing multiple repetitions at 75% of your max for two to five sets would generate results.

Starting Strength

The ‘starting strength’ is the measure of strength a person can generate from a stationary position. For example, a lineman shows starting strength when they move from their initial stance before the ball is snapped. Starting strength is important for explosive movements from a stationary position.

Training starting strength requires that the athlete focus on the initial range of motion, with weights of up to 90% of 1RM. The motions are fast and explosive, and are trained for 1-6repetitions, with a large number of sets, to reflect what the athlete may do in their sport.

Endurance and Strength

This is the ability to maintain contractions of your muscles and to generate force over longer periods. Triathletes and marathon runners need the ability to maintain the prolonged performance of their muscles so that they can maintain a rate of exertion that allows them to achieve good times in their races. Training for strength endurance improves the aerobic capacity of the muscles, and this type of strength is one of the more ‘functional’ types.

To train for endurance and strength, practitioners should perform slow reps at moderate intensity, using low to moderate weights, with short rest periods.

Speed

Speed strength is important for sprinters, pitchers, and other people who need to perform high-speed motions. Tennis serves are an example of this, as are shots in wrestling. Speed strength is trained using unloaded bodyweight movements and plyometrics. Where weights are used they are no more than 50% of the athlete’s one rep max. The emphasis is on doing the exercises as quickly as possible, with low rep numbers and a greater number of sets.

Relative Strength

Relative strength is the amount of force that a person can generate as compared to their body weight. If a 150lb person can deadlift 200lbs, and a 175lb person can deadlift 250lbs, the smaller person is stronger in terms of pounds lifted compared to their body weight, so would be considered stronger.

Relative strength is important for weight-class sports. A wrestler who is lean and strong for their body weight would likely overpower someone in the same weight class who carries more body fat and who is less capable in the weight room. Building relative strength requires building general strength and motor recruitment, and also maximizing lean mass at your body weight. This is achieved through diet changes.

Explosive Power

Explosive power allows people to produce large amounts of force in short burst, moving quickly through the appropriate range of motion. Explosive strength is the ability to generate power quickly and with as little transition time in the contraction cycle as possible. Olympic lifters have good explosive strength, as do wrestlers.

Explosive strength involves exercising at 40 to 75% of your one rep max for a small number of reps, performed as quickly as possible, with moderate rest periods in between.

Maximal Strength

Powerlifters and strongmen focus on developing absolute or maximum strength. This is the ability to recruit a muscle or group of muscles to create as much force or tension as possible against external resistance. Sports that rely on maximum strength require people to develop neuromuscular efficiency as well as good coordination between muscle groups.

Building maximum strength requires lifting weights that are close to the 1RM of the lifter, for a low number of repetitions, with longer (up to 4 minutes) rest intervals between sets.

Building Strength

Most people need flexibility, balance, coordination and agility as well as strength. When it comes to strength training, they need to have more than one kind of strength. Being able to bench press a lot of weight will not help a boxer throw heavy punches if they lack strength in their core and if they have imbalances in the other muscles around the chest and pecs.

Being able to squat a lot of weight is useful but could lead to injury if the only leg and core workout being done is simple squats.

Slow, grinding compound lifts are useful but they do not generate explosive power in the same way as plyometrics or kettlebell workouts. Calisthenic training is great for rounded strength training that gives you the chance to develop supporting muscles, but it will not generate maximum strength in the way that compound lifts do. On the other hand, Olympic lifting is good for explosive power in a specific range of motion but again has its own limits.

For this reason, if you want to develop sport-specific strength it is important that you talk to a trainer that understands your sport, and work with them to build up a good programme of exercises that will improve your performance and reduce your risk of injury.

In conclusion, as illustrated , there are 7 different types of muscular strength that targets a specific goal. Since training for each one requires a different training program, being strong in one does equate to being strong in another.

Why You Should Check Your Blood Pressure in Both Arms

When you visit your physician’s office, do they check your blood pressure in both arms? If not, they should be doing it, especially if you’re over the age of fifty, have diabetes, or smoke. Research shows that blood pressure values that differ significantly between the two arms may be a sign of underlying peripheral vascular disease.

What is peripheral vascular disease? It’s a condition where blood vessels called arteries become too narrow. Arteries are the vessels that carry blood from your heart to all the tissues in your body. These sturdy pipelines serve as a “lifeline” to all the organs and tissues in your body. They also supply your extremities, including your arms and legs with oxygenated blood. They are quite efficient at doing this job as long as your heart and arteries are healthy.

One of the first places you typically see peripheral vascular disease is in the arms and legs, most commonly the legs. How do you know if you have it? People with significant peripheral artery disease often experience pain, numbness, tingling, or cramping in a leg, or both legs if both are affected, if they walk a certain distance. As the narrowing of the arteries worsens, the leg discomfort comes on with shorter and shorter walking distances. If you have peripheral artery disease, you may also experience leg cramps when you walk. Typically, the leg discomfort goes away upon resting. However, leg cramps can have other causes as well.

The Role that Blood Pressure Readings Play in Peripheral Vascular Disease

Sometimes, peripheral artery disease can be silent, at least in the early stages. If you don’t routinely walk significant distances, you might not know you have it since exercise is what brings it on in the early stages. This happens because exercise increases the demand for oxygenated blood and narrowed arteries cannot meet the demands as easily. However, taking blood pressure readings in both arms could alert you and your doctor to possible early peripheral vascular disease even when you don’t have obvious symptoms.

A 2012 study highlights how important knowing the blood pressure in each arm is. What the study showed was that systolic blood pressure readings that differ more than 10 points between the two arms should raise the suspicion of possible peripheral vascular disease. Systolic blood pressure is the top number of blood pressure readings. It represents the force in the wall of arteries when the heart is pumping. The lower number is the pressure within the arterial wall when the heart is relaxing between heartbeats.

If systolic blood pressure differs by more than 10 points between the two arms, your physician could recommend a further work-up to look for peripheral vascular disease. Whether they recommend a workup will depend on whether you’re at high risk and whether you have other signs suggestive of arterial disease on physical exam.

The difference in blood pressure between the two arms is a possible sign of peripheral vascular disease of the arteries that supply the arms with blood and oxygen. But people who have arterial disease in the arms often have it in their legs too. If you’re over the age of 50, smoke, have a strong family history of heart or blood vessel disease, or have diabetes, your risk of developing peripheral vascular disease is higher. According to Harvard Health, peripheral vascular disease affects more Americans than cardiovascular disease and stroke combined.

Take Your Blood Pressure Properly and Check It at Home Too

These days, it’s easy to check your blood pressure using home equipment. If you check your blood pressure at home, make sure you’re using the proper size cuff, your bladder is empty, and you’ve rested in a chair for at least 5 minutes beforehand. Activity, a full bladder, and the wrong cuff size can all impact the blood pressure reading you get. Don’t consume caffeine or nicotine before checking your blood pressure. Make sure you’re sitting with your back supported and feet on the floor. Your elbow should be resting on the arm of a chair or table at the level of your heart. Also, take a few readings in each arm. It’s not uncommon for the first reading or two to be higher than subsequent measurements. Record the values so you can show your physician.

Other Risks of Having a Wide Variation in Blood Pressure Between Arms

Are there other possible risks of having a wide variation in blood pressure readings between arms? According to a study published in the Lancet, having a 10 point or more difference in systolic blood pressure between the two arms is also associated with a higher risk of dying of stroke and cardiovascular disease. So, simple tests like measuring blood pressure in both arms can tell us a lot about future health risk! If your medical providers don’t normally check blood pressure in both arms, ask them to do it! Then, check your own readings at home too. Take a proactive role in your own health care by investing in the equipment you need to get an accurate blood pressure reading. Then, learn how to use it properly.

Keeping tabs on your blood pressure is one of the most important things you can do for your health. Hypertension, in general, is a leading risk factor for cardiovascular disease and stroke, and it’s something that can be easily treated through lifestyle or medications. Know your pressures and keep track of them in both arms!

Conclusion

It’s something health care doesn’t do often enough, but now that you’re aware, you can make sure you know what your own pressures are on each side. Take advantage of this way to monitor your health.

References:

Family Practice News. February 1, 2012. “BP Differences between Arms May Signal Vascular Disease”

Harvard Health Publishing. “Different blood pressure in right and left arms could signal trouble”

The Lancet. Volume 379, Issue 9819, P905-914, March 10, 2012.

Merck Manual. Eighteen edition. 2012.

 

Does Anesthesia Cause High Blood Pressure?

 

Going under anesthesia is frightening to many people. It’s scary when you’re not in control! Prior to surgery, anesthesiologists carefully question people about any health problems that you have that might impact your response to anesthesia. If you have hypertension or a history of elevated blood pressure readings, you might wonder whether anesthesia is safe. You might also wonder whether anesthesia can cause your blood pressure readings to be higher than normal. These are all good questions!

Fortunately, the anesthesiologists will monitor your blood pressure and heart rate closely before, during, and after your surgical procedure. Plus, they have medications they can administer if blood pressure becomes too high or too low during surgery. Let’s look at how anesthetic agents affect blood pressure.

How Anesthetic Agents Work

Anesthetic agents act on the central nervous system to reduce the perception of pain. These medications also induce a state where you’re unaware of what’s going on around you. Most anesthetic agents are delivered through an intravenous line or are inhaled as a gas. While under anesthesia, the anesthesiologist monitors you and is aware of how fast your heart is beating, your blood pressure, and breathing rate. He or she can adjust the anesthesia as necessary if they notice unwanted changes.

Sometimes, after surgery, people wake up and find their blood pressure is higher than normal. In fact, research shows that one out of four people experiences elevated blood pressures after surgery.  Although a transient rise in blood pressure after surgery is not likely to be dangerous, you might wonder why this happens, particularly since anesthetic agents typically cause a drop in blood pressure rather than a rise. Why might this happen?

Blood Pressure Increases During Surgery

When you’re under general anesthesia, you have a breathing tube in to protect your airway. Some people have airways that are sensitive to the placement of the breathing tube. When the breathing tube is placed, after you’re asleep, your sympathetic nervous system is activated and this increases blood pressure and heart rate. Once the tube is tube is removed, the sympathetic nervous system slowly quiets down and heart rate and blood pressure gradually come down too. Not everyone experiences a rise in blood pressure during surgery. In fact, some people experience a drop. It varies with the individual, the type of anesthesia, how individuals metabolize the anesthesia, and other factors as well.

Once you awaken from surgery and you’re in pain from the surgery, the discomfort can activate your sympathetic nervous system and cause a rise in blood pressure. Once you receive appropriate pain medications, blood pressure may come down. However, some pain medications can cause an increase in blood pressure. If you’re taking a medication for pain relief that triggers a rise in pressure, blood pressure readings may remain higher until the medication wears off. One common class of medications called non-steroidal anti-inflammatory medications (NSAID) can cause a modest rise in blood pressure.

Sometimes, other factors brought on by the surgery can cause blood pressure readings to be too high. When you wake up, you might be cold or anxious, and this can cause blood vessels to constrict and blood pressure to rise. Also, if you’re not yet breathing normally, lack of adequate oxygen delivery can cause a rise in blood pressure readings. Blood pressure is also impacted by how much fluid is in your body. If you’re receiving intravenous fluids and you aren’t able to urinate after surgery, this can cause a rise in blood pressure. If you have hypertension and routinely take blood pressure medications, the anesthesiologist may have recommended discontinuing them until the surgery is over. Your blood pressure may go up because you’re not taking your medications.

Usually, blood pressure will come down a few hours after surgery, although in some cases, readings can remain high for a day or two, especially if you have a history of hypertension and have been off your medications. If blood pressure reading stays elevated for more than a day or so after surgery, let your physician know.

What if You’re on Blood Pressure Medications?

Depending upon the type of blood pressure medication you’re taking, your medical team may recommend continuing your current blood pressure medication until the day of surgery. But, if you’re taking a class of antihypertensive medications called angiotensin-converting enzymes inhibitors (ACE inhibitors) or angiotensin receptor blocking agents (ARBs), they will probably ask you to discontinue the medications at least 24 hours before surgery. That’s because taking these medications can cause a drop in blood pressure during surgery and studies show outcomes are better when these medications are held prior to surgery.

If you’re taking certain types of blood pressure medications, like beta-blockers, your medical team may recommend that you keep taking them as discontinuing them could cause a sudden spike in blood pressure. Some physicians recommend stopping diuretics, a type of fluid pill used to treat hypertension, prior to surgery to lower the risk of dehydration. However, this is variable, so talk to your physician.

Talk to Your Medical Team

During your pre-surgery evaluation, make sure your medical team knows what medications you’re taking. Bring your prescriptions along and let the team know what supplements you’re on as well. They’ll advise you of which ones you’ll need to stop prior to surgery. Also, let them know if you’re allergic to any medications. If your medical team recommends that you continue taking your medications before surgery. If so, let them know the day of your surgery what medications you took and when. Again, bring your medication bottles along. Ask lots of questions and read any informational material they give you carefully.

Conclusion

Despite the fact that anesthetic agents usually cause a drop in blood pressure, you can still experience a rise in pressures after surgery for a variety of reasons. During and immediately after surgery, your medical team will keep a close eye on your blood pressure and it’s a good idea to monitor your pressures at home after surgery, especially if you have a history of hypertension.

References:

Anesth Prog. 2010 Spring; 57(1): 13-17.

Integr Blood Press Control. 2014; 7: 49-59.

Vasc Health Risk Manag. 2008;4(3):615-627.

Anesthesiology 1 2017, Vol.126, 16-27. doi:10.1097/ALN.0000000000001404.

​Can Birth Control Pills Raise Blood Pressure?

Hypertension is one of the most common medical conditions in both men and women, and the incidence increases with age. Many women develop high blood pressure after menopause, but even young women can have elevated blood pressure readings. Since younger women at high risk for hypertension may also take birth control pills, you might wonder how these pills affect blood pressure readings and whether it’s safe to take them if you’ve had high blood pressure readings in the past. You might also wonder whether birth control pills elevate blood pressure in women without a history of hypertension. Let’s look at what science shows about oral contraceptives and their impact on blood pressure.

How Birth Control Pills Affect Blood Pressure

In the past, oral contraceptives contained higher levels of estrogen than those commonly prescribed today. Studies show a link between birth control pills that contain high-dose estrogen and blood pressure increases. On average, blood pressure elevations while taking these pills was 3 to 6 mmHg for the systolic reading (the upper number) and 2 to 5 mmHg for the diastolic (the lower number). Around 1 in 20 women who used oral contraceptive pills with higher doses of estrogen developed hypertension after taking them.

Since estrogen levels in oral contraceptives have dropped, the risk of hypertension while using them has too. In one study of 68,000 women, the relative risk of developing hypertension was 1.5 times greater in those using low dose estrogen contraceptives relative to those not using them. Even a history of using oral contraceptives in the past is linked with a slightly elevated risk. In most cases, the rise in blood pressure with the newer formulations is mild, although there are cases of women developing a significant rise in blood pressure, to the point of requiring emergency care.

Are certain women at higher risk of developing high blood pressure on oral contraceptives? It does appear that women with certain risk factors are more likely to experience a rise in blood pressure while taking oral contraceptives. One risk factor is a family history of high blood pressure. Also, women who had elevated blood pressure during pregnancy are at increased risk. Blood pressure typically returns to normal after stopping birth control pills, although it can take weeks to months for blood pressures to return to normal in some women.

It is not clear exactly how oral contraceptives increase the risk of hypertension in some women. One theory is that these medications activate a system in the kidneys called the renin-angiotensin system. This system controls fluid balance and how tightly blood vessels called arteries are constricted. When the renin-angiotensin system is overactivated, arteries tighten up and blood pressure rises.

Oral contraceptives also increase the risk of developing a blood clot, usually in the leg. These clots can, on occasion, move to the lungs and be fatal. Also, the risk of developing a stroke or heart attack while taking oral contraceptives is slightly higher, although the risk is small for women under the age of 35.

Are There Birth Control Pills That Don’t Elevate Blood Pressure?

It’s the estrogen component of an oral contraceptive that’s mainly responsible for the elevation in blood pressure. Oral contraceptives that only contain progestin are also available and may be a safer option for women with high blood pressure or a strong family history of hypertension.

Also, hormonal methods of birth control are available that you don’t take by mouth. One example is depot injections of progesterone. With this method, your physician prescribes an injection of a synthetic progestin every three months. This form of contraception seems to have a lower risk of elevating blood pressure, but studies thus far are limited. This form of contraception can also cause bone loss.

Another method that may have a lower risk of elevating blood pressure is an estrogen-containing implant. For this method, you place an estrogen-containing implant under the skin. As with depot progesterone, there aren’t enough studies to say whether it’s safe for women with hypertension.

Should You Take Oral Contraceptives if You Have High Blood Pressure?

Whether it’s safe to take oral contraceptives if you have high blood pressure depends on a variety of factors. Some physicians don’t recommend them at all for women with hypertension, especially those over the age of 35 and women who smoke. Factors that might influence whether a physician is willing to prescribe oral contraceptives include age, whether a person is a smoker, and how well their blood pressure is controlled. At the very least, it requires close blood pressure monitoring.

However, having mildly elevated blood pressure doesn’t completely rule out taking oral contraceptives. Guidelines suggest that younger women under the age of 35 who are otherwise healthy and don’t smoke may still be candidates for oral contraceptives with close blood pressure monitoring. That’s why it’s important to discuss the available options with a trained health care professional. Since estrogen seems to be the component of oral contraceptives that cause a rise in blood pressure, a method that uses only a progestin may be more appropriate. These are all issues to discuss with a health care professional.

Other Birth Control Options

Two other birth control methods to avoid if you have elevated blood pressure are the vaginal ring and the birth control patch. But you still have options that won’t raise your blood pressure. For example, an implant that releases progestin without estrogen is 99.9% effective. Progestins, especially at the dose released by the implant, don’t tend to raise blood pressure the same way estrogens do. Other options include an intrauterine device or condoms. So, explore the options and talk to a knowledgeable health care provider before deciding which is best for you.

References:

Hypertension. 1988 Mar;11(3 Pt 2):II11-5.

Circulation. 1996;94(3):483.

American Family Physician. “Contraception Choices in Women with Underlying Medical Conditions”

Fertil Steril 2006; 86(5):1466-74.

How Does Exercise Affect Blood Pressure and Heart Rate?

Exercise is a heart-healthy activity! How do we know this? Studies show that people who work out, especially aerobic exercise, are at a lower risk of developing cardiovascular disease and stroke. One way exercise benefits heart and blood vessel health is by lowering blood pressure, the force within the wall of arteries, the vessels that carry blood to tissues in the body.

Over the long term, aerobic exercise has a significant impact on blood pressure. To support this, a meta-analysis, an analysis of multiple studies, published in the Annals of Internal Medicine showed that regular exercise lowers systolic blood pressure by 3.84 points and diastolic blood pressure by 2.58 points on average. It lowers blood pressure in men and women with and without hypertension. Therefore, exercise is good “medicine” for a healthy heart! How does blood pressure and heart activity change when you train?

The Short-Term Effects of Exercise on Blood Pressure and Heart Rate

During aerobic exercise, blood pressure, particularly systolic blood pressure, goes up. This is a normal response to any kind of stress on the body, including exercise. Systolic blood pressure, the upper number, is the force in the walls of arteries when the heart is pumping. It makes sense that blood pressure would climb temporarily during exercise since energy demands are higher and the heart must pump harder and faster to deliver oxygen to tissues. Plus, the sympathetic or “fight or flight” component of the nervous system is activated, and this causes a rise in blood pressure.

It’s normal for systolic blood pressure to rise as high as 220 mmHg during an additional exercise session due to the additional demands exercise places on the heart. If blood pressure climbs higher than this during exercise, it could indicate a possible heart problem and should be checked by a physician.

After a workout, systolic blood pressure gradually comes down to its baseline value. People with hypertension sometimes develop larger spikes in systolic blood pressure. If you’re out of shape and unaccustomed to exercising, systolic blood pressure may rise quickly even with minimal activity. As you become more aerobically conditioned, the rise is not as fast or sharp. Certain blood pressure medications, particularly beta-blockers, can interfere with the normal rise in heart rate and blood pressure.

Heart rate also changes during exercise. As mentioned above, heart rate increases proportionally to the demands of exercise. For example, your heart rate will rise more during a bout of high-intensity exercise than it does for a leisurely stroll in the park. In fact, your heart rate is a measure of how hard you’re working. To do this, determine your maximal heart rate using one of the available formulas. One formula is:

220 – age = maximal heart rate

Now, compare your heart rate during exercise to your maximal heart rate. You can do this by taking your pulse for 10 seconds and multiplying by 6.  Moderate-intensity exercise would correspond to a heart rate of 50 to 70% of maximal heart rate. Above that would be high intensity.

The Long-Term Effects of Exercise on Blood Pressure

Over time, aerobic exercise can lower systolic and diastolic blood pressure. One way it does this is through adaptations that make the heart a more efficient pump. You may have noticed that as you become more physically fit, your resting heart rate slows. That’s because your heart becomes more efficient and it doesn’t have to beat as many times per minute to deliver blood and oxygen to tissues at rest. A more efficient cardiovascular system reduces the force on the walls of arteries, the blood vessels that carry blood and oxygen to tissues. This leads to a drop in blood pressure.

Aerobic exercise also improves endothelial function. The endothelium is a thin layer of cells that produce factors that cause arteries to open up or tighten. With regular aerobic activity, endothelial cells produce more factors that cause the arteries to relax or expand. In turn, this leads to a reduction in blood pressure. The endothelium also produces factors that impact blood clotting. Improvements in endothelial function are another way exercise reduces the risk of cardiovascular disease and stroke.

What about long-term effects on heart rate? As mentioned, when you exercise aerobically over several weeks or months, your heart becomes more efficient at pumping blood and oxygen. Therefore, your resting heart rate will slow. If your heart is otherwise healthy, a slow resting heart rate is often a sign of greater aerobic fitness. Endurance athletes frequently have slow resting heart rates, especially athletes that run or cycle long distances.

What about Resistance Training?

Working your body against resistance by lifting weights or doing bodyweight exercises can lead to a temporary rise in blood pressure. In some people, the increase in blood pressure can be substantial. Holding your breath while lifting or using very heavy weights can boost blood pressure even more. That’s why it’s important to check with a health care professional before weight training with hypertension.

However, longer-term research suggests that resistance training may lower blood pressure too. In fact, a meta-analysis published in the journal Hypertension showed resistance training modestly reduced systolic and diastolic blood pressure readings in healthy adults. The degree of blood pressure lowering in response to resistance training was 2%, on average, for systolic blood pressure and 4% for diastolic blood pressure. We think of aerobic exercise as being heart healthy and weight training as a way to develop strength. However, weight training may have heart health benefits as well.

Conclusion

Exercise temporarily raises systolic blood pressure, but over time, the adaptations associated with aerobic training can modestly reduce systolic and diastolic blood pressure. Although exercise is a heart-healthy activity, talk to your physician if you have high blood pressure, heart problems, or any other medical problem before starting an exercise program.

References:

Hypertension. 2000 Mar;35(3):838-43.

Arq Bras Cardiol. 2016 May; 106(5): 422-433.

NewScientist.com. “Exercise may lower high blood pressure as much as medication”