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THE EFFECT OF COMBAT EXERCISES ON CARDIOVASCULAR RESPONSE: AN EXPLORATORY STUDY
Title
THE EFFECT OF COMBAT EXERCISES ON CARDIOVASCULAR RESPONSE: AN EXPLORATORY STUDY.
Creator
Gantt, MeLisa, Sole, Mary Lou, University of Central Florida
Abstract / Description
PURPOSE: Hypertension (HTN) affects one in every three adults in the United States. Often associated with the older population, this silent killer has emerged in an unsuspecting group, young military soldiers. With the rapid succession of multiple deployments, long intervals between blood pressure (BP) assessments, and the absence of cardiovascular (CV) measures during the pre and post deployment health screenings; soldiers may be at higher risk for HTN than their civilian counterparts of the...
Show morePURPOSE: Hypertension (HTN) affects one in every three adults in the United States. Often associated with the older population, this silent killer has emerged in an unsuspecting group, young military soldiers. With the rapid succession of multiple deployments, long intervals between blood pressure (BP) assessments, and the absence of cardiovascular (CV) measures during the pre and post deployment health screenings; soldiers may be at higher risk for HTN than their civilian counterparts of the same age. The purpose of this study was to explore real-time continuous CV measures of soldiers before, during, and after exposure to a simulated combat stressor as well as to assess which personal characteristics played a significant role. METHODS: Applying the Allostasis/Allostatic Load theoretical framework, a repeated measure quasi-experimental design was used to compare the CV measures of two groups: one exposed to a physical combat stressor (experimental) and the other exposed to a psychological combat stressor (control). A convenience sample of 60 college Army Reserve Officer Training Corps cadets were fitted with Tiba Medical Ambulo 2400 ambulatory BP monitors for 48 continuous hours. Several CV indices were analyzed using one-way Analysis of Variance (ANOVA), paired t-test, and independent sample t-test. Four instruments (Participant Information Sheet, State-Trait Anxiety Inventory, Paintball Perceived Stress Questionnaire, and Army Physical Fitness Test) were used to assess which characteristics played the most significant role in the CV response. RESULTS: Demographic characteristics between the two 30-cadet groups were not statistically different, with the exception of deployment history (experimental = 4, control= 0). Hours after the stress exposure, subjects in the experimental group had a higher mean awake systolic blood pressure (SBP) when compared to the control group (113.76 mm Hg vs 102.98 mm Hg, p= 009). When assessing pre and post stressor morning BP surge and evening BP decline, the control group showed the biggest change. Significant bivariate correlations (p < .05) found that: Females consistently had higher pulse rates (PR) throughout each of the phases. Age positively correlated with elevated BP during the stressor, and increased morning BP surge post stressor. African Americans had higher sleep BPs pre stressor, and decreased SBP recovery post stressor; Hispanics had higher PRs during and after the stressor. Waist circumference positively correlated with elevated BP morning surge pre stressor but, body mass index (BMI) positively correlated with elevated BP morning surge post stressor as well as elevated BP during the stressor. Family history of HTN played no significant role; however, deployment history correlated with mean awake SBP post stressor. Trait anxiety scores negatively correlated with SBP recovery while state anxiety scores positively correlated with post stressor awake mean arterial pressure and evening SPB decline. Perceived stress during the stressor negatively correlated with post stressor SBP morning surge with females reporting higher anxiety and stress. Finally, Army Physical Fitness (APFT) total scores as well as APFT run scores negatively correlated with pre and post stressor sleep PRs. DISCUSSION/IMPLICATIONS: Age, female gender, African American descent, Hispanic ethnicity, waist circumference, BMI, previous deployment history, level of fitness and the psychological stress state during and after a stressor played significant roles in soldiersÂÂÂÂ' CV response. SBP was the most dynamic and informative of the CV indices and a psychological stressor was comparable to a physical stressor when observing the residual effect of stress. If a combat exercise was enough of a stressor to produce residual CV effects that lasted well into following morning, the residual effect of a lengthy strenuous deployment may be alarming. This study not only provided a snapshot of the CV health of incoming young soldiers, but also provided evidence to support policy change regarding the implementation of regular CV health assessments before and after deployment.
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Date Issued
2010
Identifier
CFE0003390, ucf:48458
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003390
COMPARATIVE RETROSPECTIVE ANALYSIS: ASSESSMENT OF EXTRACELLULAR VOLUME EXCESS IN HYPERTENSIVE HEMODIALYSIS PATIENTS
Title
COMPARATIVE RETROSPECTIVE ANALYSIS: ASSESSMENT OF EXTRACELLULAR VOLUME EXCESS IN HYPERTENSIVE HEMODIALYSIS PATIENTS.
Creator
Serwaah-Bonsu, Amma, Wink, Diane, University of Central Florida
Abstract / Description
Cardiovascular disease, including hypertension, accounts for almost 50% of the deaths in patients with end stage renal disease (ESRD) on hemodialysis (HD) yet hypertension remains very poorly controlled in this population. The purpose of this study was to retrospectively compare control of hypertension in hemodialysis (HD) patients when extracellular volume (ECV) was assessed and managed by clinical parameters and physical assessment data alone with control of hypertension when data from...
Show moreCardiovascular disease, including hypertension, accounts for almost 50% of the deaths in patients with end stage renal disease (ESRD) on hemodialysis (HD) yet hypertension remains very poorly controlled in this population. The purpose of this study was to retrospectively compare control of hypertension in hemodialysis (HD) patients when extracellular volume (ECV) was assessed and managed by clinical parameters and physical assessment data alone with control of hypertension when data from blood volume monitoring (BVM) technology was also used to assess and manage ECV in a freestanding outpatient hemodialysis unit. The main cause of hypertension in the ESRD population has been identified as increased ECV most likely secondary to increased interdialytic weight gain and failure to attain and maintain patient's dry weight. HD nurses often employ clinical parameters along with physical examination to determine a patient's pre, intra, and post dialytic fluid status and this approach can have a high index of error. BVM technology is being used in many hemodialysis units to assist with assessment of ECV. A comparative retrospective chart review was used to collect data for this project. A descriptive, cross-sectional design was employed to answer the question:"Are hypertensive hemodialysis patients who dialyze in a freestanding dialysis unit, where BVM technology is utilized, more likely to be normotensive as defined by a pre dialysis blood pressure of less than 140/90 and post dialysis blood pressure less than 130/80"? A pilot study was conducted to determine if the patient population and data were available in existing patient records for extrapolation. Approval for the study was obtained from the University IRB. A convenience sample was obtained from the records of patients meeting the inclusion criteria. Variables were measured and analyzed using descriptive statistics such as sampled paired T-test to compare pre and post BVM systolic, diastolic blood pressures, intradialytic weight gain, serum Albumin and sodium levels, and hemoglobin. A p-value of 0.05 was assigned for statistical significance. Data analysis showed there were statisticaly significant differences in the pre dialysis systolic blood pressure, post BVM, and the serum sodium pre and post BVM when the two groups were compared These statistically significant findings support a correlation between reduction in the HD patient's ECV and improved blood pressure control. The reduction of pre-dialysis SBP was significant because many patients on hemodialysis have systolic hypertension that may or may not coexist with diastolic hypertension. The findings of this study may be used to formulate a protocol to be used in the HD units where the BVM is available. The protocol would rely on accurate nursing assessment of clinical parameters, patient verbalizations of symptoms, and the routine use of the BVM in order to continuously assess the patient's fluid status. Future research recommendations include conducting the study in a population closer to the national sample, a study where glucose readings and /or hemoglobin A1C levels are measured to assess the impact of glucose on ECV, and which antihypertensive class of medication works best with BVM technology to effectively manage hypertension in this population.
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Date Issued
2011
Identifier
CFE0003569, ucf:48927
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0003569
SODIUM (NA) LEVELS IN DRINKING WATER (H20) AND DEVELOPMENT OF HYPERTENSION IN CHILDREN
Title
SODIUM (NA) LEVELS IN DRINKING WATER (H20) AND DEVELOPMENT OF HYPERTENSION IN CHILDREN.
Creator
Schiffman, Sara, Bushy, Angeline, University of Central Florida
Abstract / Description
This integrative review of the literature focused on sodium (Na) content in drinking water (H2O) supplies and the subsequent effect on blood pressure levels in children. Studies for this review were drawn from the Cumulative Index of Nursing and Allied Health, PubMED, Science and Technology Databases, PsychInfo, United States (US) Environmental Protection Agency (EPA) and EPA in Florida websites. Criterion for inclusion in the data base searches were hypertension, high blood pressure, sodium...
Show moreThis integrative review of the literature focused on sodium (Na) content in drinking water (H2O) supplies and the subsequent effect on blood pressure levels in children. Studies for this review were drawn from the Cumulative Index of Nursing and Allied Health, PubMED, Science and Technology Databases, PsychInfo, United States (US) Environmental Protection Agency (EPA) and EPA in Florida websites. Criterion for inclusion in the data base searches were hypertension, high blood pressure, sodium in drinking water, drinking water salinity, children or preg*. Subsequently, further article selection criteria included children (under 18 years of age)and published in the English language (N=59). Findings of the review as summarized in this thesis could guide nursing research, education, policy and practice related to primary, secondary and tertiary interventions associated with sodium levels in drinking as a contributing factor to blood pressure levels in children.
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Date Issued
2013
Identifier
CFH0004469, ucf:45123
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFH0004469
Adherence Practices of Caucasian Women With Hypertension Residing in Rural Florida: An Exploratory Study
Title
Adherence Practices of Caucasian Women With Hypertension Residing in Rural Florida: An Exploratory Study.
Creator
Hopple, Jeanne, Bushy, Angeline, Sole, Mary, Covelli, Maureen, Oetjen, Dawn, University of Central Florida
Abstract / Description
Hypertension, or high blood pressure, is a major risk factor for heart disease and stroke. Elevated blood pressure is often a silent process affecting multiple organ systems. Risk for heart disease is associated with poorly treated or unrecognized hypertension that is more common among women than men. Non-adherence to prescribed treatment regimens has been identified as a major reason for inadequate hypertension management. This exploratory descriptive qualitative study using narrative...
Show moreHypertension, or high blood pressure, is a major risk factor for heart disease and stroke. Elevated blood pressure is often a silent process affecting multiple organ systems. Risk for heart disease is associated with poorly treated or unrecognized hypertension that is more common among women than men. Non-adherence to prescribed treatment regimens has been identified as a major reason for inadequate hypertension management. This exploratory descriptive qualitative study using narrative inquiry investigated adherence practices among Caucasian women with diagnoses of hypertension from a rural area of Florida. The purpose of this study was to gain an understanding from women who had been diagnosed with hypertension about the challenges of living with and managing this chronic condition in their daily lives. Participants included Caucasian women (n = 11) recruited from a Federally Qualified Rural Health Center in Florida. Semi-structured interviews were used to collect data. Content analysis procedures were used to analyze the interviews. Emergent themes included: work stress affecting health and leading to high blood pressure; silent (")sneaky, gradual(") onset of mild to moderate symptoms leading to high blood pressure; and strong influence of family members with high blood pressure and related complications that instilled fear in participants to adhere to their prescribed treatment plan in some, or in others to non-adherence. Social support from friends and coworkers was a repeated theme supporting adherence. Minor themes associated with non-adherence included fear of potential side effects of medications, challenges of daily living caring for family, fatigue from high blood pressure and medications affecting daily work, poor food choices due to finances and availability of high sodium and fatty foods at work and home, stress and time demands affecting ability to exercise to control high blood pressure, and focus on family forgetting self-needs. Limitations of the study included a small convenience sample with findings that may not be applicable to a population of hypertensive women from different rural settings. Future nursing studies in similar populations may contribute to improved adherence practices, leading to reduced complications from poorly controlled hypertension.
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Date Issued
2011
Identifier
CFE0004120, ucf:49100
Format
Document (PDF)
PURL
http://purl.flvc.org/ucf/fd/CFE0004120