Hypertension and the Spinning® Program
By Sabrina Fairchild

According to the American Heart Association, hypertension (high blood pressure) currently affects about 73 million Americans over the age of 20. What makes this so scary? High blood pressure is a major contributing factor to heart attacks and strokes, which kill nearly 800,000 Americans each year. Even scarier—many people don’t even know they have it.

Hypertension isn’t something a person can feel, and it’s not something we as Spinning instructors can see as we scan the faces of our students. Therefore, we must take into consideration that approximately 30% of our participants are afflicted with high blood pressure. It is our responsibility to understand the medical facts regarding this condition and the exercise guidelines that are recommended.

As Spinning instructors, we can play an important role in creating awareness within our participants regarding their blood pressure and cardiovascular health. We regularly cue about training in our heart rate zones. We know that a reduction of blood pressure is a benefit of regular cardio respiratory exercise. It is within our scope to encourage our students to get their blood pressure checked on a regular basis. Most local pharmacies will have a blood pressure station that is free and easy to use. Your own health club probably has a blood pressure unit and people on staff trained in measuring blood pressure. Set an example by doing it for yourself, so you can inform your members of how easy and convenient it can be to get theirs’ checked.

What creates high blood pressure? This seems to be a medical mystery according to the American Heart Association; however, they do provide numerous risk factors that contribute to it. Heredity, race (African American) and increasing age (over 35) are three factors that cannot be altered, whereas there are numerous controllable risk factors. A sedentary lifestyle, heavy alcohol consumption, too much salt, extra weight and stress are all factors that can be regulated. Spinning classes and other modes of cardio respiratory exercise have a positive effect on the controllable risk factors. Going to class 3-5 times a week creates an active lifestyle, burns excess calories, lowers sodium through sweat and reduces stress. Alcohol consumption may also be reduced as a secondary side effect of living a healthier lifestyle if someone’s drinking is stress related.

There are also a number of over-the-counter medications that can increase blood pressure. They include ibuprofen, decongestants and diet pills. Steroids also increase blood pressure and are commonly used in gyms, but obtained on the black market. As a Spinning instructor, you can include health information right into your class cueing. For example, if you have planned a ride that includes anaerobic intervals, you can say at the beginning of the ride, “If you have underlying health conditions such as hypertension or diabetes, or if you have taken over-the-counter medication today, please keep your heart rate aerobic during the intervals. I’ll be walking around a bit during the warm-up, so if anyone has any questions, please let me know.” It is our responsibility to give our participants enough information so they can make informed decisions about their training.

There are exercise prescription guidelines for those with hypertension. They are published by the American College of Sports Medicine in the Guidelines for Exercise Testing and Prescription, 7th edition. For reduction of blood pressure using aerobic activity they are as follows: 3-7 days per week with daily being optimal at 40-70% MHR for 30-60 minutes. Please note that the guidelines do not include anaerobic intensity because it is not appropriate. The good news is that hypertension is a manageable condition and aerobic exercise lowers blood pressure for several hours after exercising as well as chronically over time.

One last aspect to consider is that some people with hypertension will be under treatment with Beta Blockers or diuretics. These are prescription medications and they create some special circumstances. They may make patients more prone to heat illness in hot or humid conditions. Beta Blockers inhibit heart rate response during exercise as well as lower capacity, so wearing a heart rate monitor is futile. Those clients must use perceived exertion. Another set of medications called Alpha Blockers, calcium channel blockers and vasodilators may cause post-exercise hypotension. Review your Spinning Instructor Manual (pages 1.20-1.21) for proper cool-down technique to avoid a rapid drop in blood pressure.

As a Spinning instructor, you may feel overwhelmed by large classes and the amount of information you are responsible for cueing. There are a variety of ways to educate your students:

• Impart information during bike setup
• Post information on a bulletin board
• Give all-inclusive as well as individual cues while you are coaching
• Model responsible training methods.

Education doesn’t happen in one class; it happens over time. Be consistent, encouraging and approachable, and you will help a multitude of people.

For more information on hypertension, please visit http://www.americanheart.org.