DEPARTMENT OF BIOMEDICAL ENGINEERING FACULTY OF ENGINEERING UNIVERSITY MALAYA

Lab 11 : Cardiovascular Assessment

OBJECTIVE
The main objective of this assessment is to measure the blood pressure of a person before and after a defined exercise on the treadmill. The investigation will be separate into two parts which are on a flat surface and on an incline surface. Comparisons between these two surface conditions will be made.

EQUIPMENT
Automatic blood pressure recorder and treadmill with inclined capabilities and also the digital stopwatch.

INTRODUCTION
During exercise, the arterial blood pressure will increase as the heart contracts more rapidly and forcefully. This is because the heart is working hard to deliver enough amount of oxygen for the body. Systolic blood pressure (SBP) is affected by most of the increased of the output of the heart. Besides that, it also will be increase proportionally with the exercise intensity and also the cardiac output. In contrast, the resistance to blood flow decreases during exercise because of dilation of small arteries and arterioles in the muscle. This causes a more rapid movement of blood out of the arteries and a more rapid fall in arterial pressure during diastole. Therefore, this will induced the diastolic blood pressure (DBP) stays almost constant or increase only slightly even during intense rhythmic exercise. There are many variables will influence the blood pressure. Generally, these influences can be grouped into physiological (internal) and environmental (external) factors. The physiological factors that can affect the blood pressure are cardiac output, peripheral resistance, vessel condition or elasticity of the vessel, total blood volume and blood viscosity. These physiological factors can cause a change in blood pressure. While the environmental factors that will affect the blood pressure will be body position, exercise, temperature, altitude, emotions, foods and drugs. There are two situations that can happen to us and we consider these two situations as hypertension and hypotension. Hypertension is the situation where the person having excessively high blood pressure. There are many people suffers from this but the origin of this problem remains unknown. The cause might be the diet-related in which the amount of sodium intake will causes fluid retention where will creating a hyper tense condition. 95% of hypertension patients have blood pressure that is elevated for no readily definable reason. However, hypertension is so dangerous if remains uncontrolled as it may lead to myocardial infarction, stroke or if untreated for many years congestive heart failure. Hypotension is the situation where the person having unusually low blood pressure.

It is usually an indicator of insult or injury to the body. Conditions such as shock, myocardial infarction and drugs can create hypotension. Standing very quickly after lying down or sitting can also create a drop in blood pressure. The standard method for reporting blood pressure is to report the Systolic Blood Pressure (SBP) over the Diastolic Blood Pressure (DBP), (SBP/DBP).

PROCEDURE
A. Preparation/Precaution before doing the lab. 1. Abstain from eating or drinking one hour prior to test. 2. No caffeine, smoking or alcohol few hours before test. 3. Wear comfortable and loose clothing. B. Methods for proper Blood Pressure Measurement. 1. The cuff size needed to be made sure that it is appropriate for the size arm of the person who will do the assessment. Most of the cuffs have a marking line which will designate whether a larger or smaller cuff needed to be used or not. The bladder should wrap about 3/4 of the way around the arm. By the way, most of the cuffs have an arterial reference indicator near the center of the cuff that is placed securely over the brachial artery and the lower edge of the cuff should be about 1 inch above the antecubital space. 2. The antecubital space at the elbow is where the brachial artery nears the surface. With a straight arm, apply moderate pressure and locate the pulse of the subject on his dominant arm. 3. By using the instruction given in the above, blood pressure can be obtained through the automatic blood pressure recorder.

C. Treadmill Test Procedure 1. The supine and the standing blood pressure of the subject needed to be measure. 2. Instruction must be give to the subject on how to walk on the flat surface of the treadmill and have them doing the exercise at the following workloads for at least 3 minutes each after a brief warm-up (off the treadmill) lasting about 2 minutes. 3. The blood pressure must be measure every 3 minutes. After 2 minutes and 45 seconds, the blood pressure should be obtained and recorded at the minute

mark. The subject must under observed to watch any symptoms after each workloads and record them. Treadmill Protocol Warm-up : Speed 2.0 mph 1st load : Speed 3.4 mph 2nd load : Speed 4.0 mph Rest 4. After a rest for 10 to 15 minutes, the procedures should be repeat including the treadmill protocol on an incline surface of the treadmill. 5. The measurement should be recorded into the worksheet given.

RESULTS
Exercis Testing Sheet Treadmill Test Group No : 11 Name of the Subject : Nor Zainah Binti Mohammad Age : 20 Date : 24 April 2012 Height (m) : 147.5cm Weight (kg) : 39kg Medications : no Resting Blood Pressure (Supine) : 99/70 mmHg Resting Blood Pressure (Standing) : 120/100 mmHg

Flat surface

Time (min, sec) Warm Up 2 min

BP (mmHg) 103/62

1st Load 3 min

112/78

2nd Load 3 min

129/99

Resting 10 min

103/69

Incline surface Warm Up 2 min

98/66

1st Load 3 min

102/68

Heartbeat per minute Signs/Symptoms 94 Breathing rate and heart rate slowly increase 127 Breathing rate and heart rate becomes higher 131 Breathing rate and heart rate further increase 98 Breathing rate and heart rate slow down and become normal 109 Breathing rate and heart rate slowly increase 113 Breathing rate

2nd Load 3 min

115/76

137

Resting 10 min

94/68

102

and heart rate becomes higher Breathing rate and heart rate further increase Breathing rate and heart rate slow down and become normal

DISCUSSION
1. During the subject exercise on the flat surface treadmill, her warm up blood pressure which is 103/62 mmHg is actually slightly higher that the supine positions blood pressure which is 99/70 mmHg. This is because the subject is started to do exercise and her heart need to contract and relax faster as to overcome the depth of the oxygen level in the muscle. The blood pressure later keeps on increase for the 1st load and the 2nd load exercise which is 112/78 and 129/99 mmHg. This is because more oxygen is needed for the utility of the energy for her body during the exercise. Thus, her breath rate is increase as well. When the subject rest for 10 min, her heart rate and the blood pressure will slowly drop back to normal which is 103/69 mmHg. This is because her body is slowly adapted and slowly recovers from the exhaust state. 2. For the inclined surface, the heart rate and the blood pressure of the subject is increasing as the load of the exercise increase. But, from the result, the blood pressure during the flat surface is higher during the exercise done on the inclined surface. Theoretically, the blood pressure of the subject during inclined surface should have higher that the blood pressure taken during the flat surface. This is because more energy is required by our body to overcome the inclined surface exercise load. This will happen may be is because of our subject is slowly adapt to the exercise increase rate. Thus, her blood pressure and the heart rate will not increase that much. The blood pressure for the warm up is 98/66 mmHg, 1st load is 102/68 mmHg, 2nd load is 115/76 mmHg and for the rest is 94/68 mmHg. 3. The subject of the experiment can be said is under healthy range. But she might need to monitor her blood pressure more frequently as her blood pressure is actually slightly lower than the normal range which is 120/80 mmHg. 4. There are some precautions need to be taken into consideration ass to eliminate various errors of the experiments. They include of the systematic error. When using the automated blood pressure measuring machine, we need to make sure that the cuff is being placed in the correct position and the subject have to be sitting straight when taking the supine BP and standing straight when taking the standing BP. Besides that, we have to make sure the subject is health and did not having any health problems and no taking any types of the medicines before doing the experiment.

CONCLUSION
The objectives of the experiment are achieved. The blood pressure of the subject before, during and after the exercise are measured and recorded. Comparisons had been made between the flat surface treadmill exercise and the inclined surface treadmill exercise.

REFERENCES
1. Edith Applegate. (2006) The Anatomy and Physiology Learning System 3rd Edition. USA:Saunders Elsevier. 2. Widmaier Raff Strang. (2011)Vander s Human Physiology The Mechanisms of Body Function 12th Edition. New York:McGraw Hill.

APPENDIX

The references table of the automated blood pressure measuring machine.