SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
Blood Pressure & Heart Rate
Lab Introduction
Control of blood flow is critical during rest and exercise. At rest, a large amount of blood is directed to vital
organs such as the liver, spleen, kidneys, brain, and heart. During exercise about 85% of blood pumped out of
the heart every minute must be redirected to working skeletal muscle without compromising blood supply to
vital organs. Circulatory control mechanisms, namely vasodilation and vasoconstriction, carefully maintain
blood pressure by reducing peripheral resistance to blood flow during exercise. Meanwhile heart rate
increases to pump more blood every minute to supply adequate amounts of blood to vital organs and working
skeletal muscle.
Blood Pressure (BP)
The rate at which blood flows through the circulation is
determined by blood pressure. Blood pressure is the product of
cardiac output (the amount of blood pumped out of the heart
every minute) and total peripheral resistance (TPR – the resistance
to blood flow). Increased TPR compromises blood supply to vital
organs and working skeletal muscle. Therefore, close monitoring of
blood pressure during rest and exercise is of vital importance.
Systolic Blood Pressure (SBP) is the maximum pressure in the
arteries during contraction of the ventricles. Diastolic Blood
Pressure (DBP) is the minimum pressure in the arteries during the
relaxation of the ventricles. Using a sphygmomanometer (blood
pressure cuff) and a stethoscope both blood pressure values are
determined by listening for the Korotkoff sounds, which are the
audible noises while taking blood pressure. Korotkoff sounds are
broken down into five distinct phases, each with a distinct sound
Figure 1 - Korotkoff Sounds
associated with the phase. Phase I has a clear tapping tone. Phase
II is associated with a softening of the tapping and a swishing element. The sounds are often longer than phase
I. Phase III sounds like phase I but with distinct sharpening, they are high in pitch and intensity. Phase IV is
noted to have abrupt muffling of the sounds. The sounds become less distinct and less audible. Phase V which
is the cessation of all sounds. When taking blood pressure during rest the first Korotkoff sound, or Phase I,
indicates SBP while the complete cessation of sound indicates DBP. When taking blood pressure during
exercise Phase I indicates SBP and Phase IV indicates DBP. Given the significance of good blood flow for
physiological functioning accurate blood pressure readings must be collected and recorded during rest and
exercise.
Heart Rate (HR)
Your heart rate is a good indication of how much effort you are putting into an activity. If you are in a good
state of health, it will be between 60 and 100 bpm. If you are extremely fit, it might even be lower. Arteries
carry oxygenated blood away from the heart to the tissues of the body. Veins carry oxygen depleted blood
from the same tissues back to the heart. The arteries are the vessels with the "pulse," a rhythmic pushing of
the blood in the heart followed by a refilling of the heart chamber.
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
Methods
Proficient measurement of blood pressure (BP) and heart rate (HR) is an integral component of exercise testing
and prescription. Development of these skills requires much practice; this lab is designed to maximize the
number of repetitions in the different scenarios in which they can be executed. Take full advantage of it.
I. Students will familiarize themselves with the assessment procedures for HR and BP.
II. Students will answer four knowledge verification questions.
III. Data Collection and Results Interpretation
a. Students will collect and document their resting HR and BP (get this from your lab partner).
b. Students will assess and document resting heart rate and blood pressure for three individuals.
c. Students will assess and document exercise heart rate and blood pressure for two individuals.
d. Students will use the resting documented data to determine the blood pressure classification of
the individuals assessed.
I. Assessment Procedures
Heart rate assessment and monitoring procedures.
There are some simple manual methods for checking your pulse. And nowadays there are also activity trackers
with integrated sensors that can automatically record your performance data. These modern devices supply
more accurate values, which can help you to optimize data collection and training. You can also wear them as
watches and track variations in your heart rate over the course of an entire day.
The most popular heart rate assessing and monitoring techniques are listed below:
1. Checking your pulse at your wrist (radial pulse)
This method involves checking your pulse on the inside of your wrist below the
thumb. Press down slightly below the wrist joint using your forefinger and middle
finger. During rest, count how many times your heart beats within a 30-second
period, and then multiply this value by two to find the number of beats per
minute. During exercise, count how many times your heart beats within a 15-
second period, and then multiply this value by four to find the number of beats per
minute. The disadvantage of this method is the risk that you will quite literally be all fingers and thumbs:
without the help of technology, it is easy to make mistakes.
2. Checking your pulse at your neck (carotid pulse)
You can check your pulse at your neck by placing your forefinger and middle
finger in the hollow between the windpipe and the large muscle in the neck.
Press gently. Count how many times your heart beats within a 15-second
period, and then multiply this value by four. People can often detect their
pulse more easily at the neck, but as measuring methods go it is still hardly
what you would call innovative.
3. Checking your pulse with a stethoscope
Stethoscopes, like those used during physical examinations, can also be used
to check the pulse by listening to the sound of the heart beating. The head of
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
the stethoscope is placed directly on the skin in the chest area for a period of 15 seconds. The value obtained
is multiplied by four. Medical practitioners are well versed at using these devices and getting an accurate
reading from them.
4. Heart rate monitoring with a chest strap
Chest straps used to be the tool of choice for fitness enthusiasts who wanted to
monitor their heart rate during workouts. The electrodes in the chest strap
measure the electrical impulses given off by the beating heart and the resulting
voltage differential between the left and right sides of the body. The data
gathered by the strap is then transmitted wirelessly to a compatible device, for
example, a heart rate monitor. Since the electrodes need to be as close to the
body as possible, high-quality chest straps are made from soft fabric. If the heart
rate sensor does not seem to be working properly, it can help to moisten the
chest strap with a little water.
5. Heart rate monitoring with a fitness tracker
Optical measurements are the most up-to-date way of checking your pulse.
Dedicated sports watches have integrated optical sensors on their reverse which
monitor heart rate. These sensors use LEDs and photodiodes. The LEDs shine light
into the skin to a depth of a few millimeters, where it is reflected by the blood.
Using information about this reflected light, the watch calculates the blood volume flow rate and therefore
your heart rate. Many fitness enthusiasts find a chest strap too constricting and therefore prefer to wear a
sports watch.
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
Blood Pressure Assessment Procedures
Figure 2 Procedures for Assessment of Resting Blood Pressure
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
Figure 3 - Potential Sources of Error in Blood Pressure Assessment
II. Knowledge verification questions
In your own words, answer the following questions (no cut and paste).
Paraphrase the procedures for the assessment of resting blood pressure. (See box 3.1 above)
The one you are taking the blood pressure from needs to be seated back supported, feet on the floor, and arms
supported. Then you wrap the cuff around the upper arm. Then place your stethoscope below the antecubital space
above the brachial artery. Inflate the cuff to 2mm H. Slowly release it the first sound is that persons SBP and the last
sound is their DBP. Do it on each arm and 1 minute in between. Provide BP and goal BP.
Paraphrase the potential sources of error while assessing blood pressure. (See box 3.2 above)
Some potential sources of error when taking someone blood pressure would be improper cuff size, inaccurate
sphygmomanometer, the auditory acuity, experience, and reaction time of technician, faulty equipment, improper
stethoscope placement and pressure, not having the cuff at heart level, certain physiologic abnormalities, background
noise, and allowing the individuals to hold treadmill handrails or flex elbow.
Which of the Korotkoff sounds is used to determine Systolic Blood Pressure (SBP)? What does this measurement
indicate?
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
The first or two or more Korotkoff sounds. This measurement indicates maximum pressure in the arteries during
contraction of the ventricles. The bottom of your heart is contracting while the top of your heart is rest.
While at rest, what phase of the Korotkoff sounds is used to determine Diastolic Blood Pressure (DBP)? What does this
measurement indicate?
It is Phase 5 and that is when you the Korotkoff disappears. This measurement indicates the minimum pressure around
your arteries. The top of the heart is contracting, and the bottom of the heart is rest.
III. Data collection and Results Interpretation
Please use this log to collect BP and HR in the indicated activities.
Make sure to get your own rest information. In addition, collect data to complete the table. Please collect data
from both male and female subjects.
Subject Activity HR BP Initial BP Classification
SBP/DBP See table below
Self Rest 84 118/70 Normal
John Rest 64 110/60 Normal
Aidan Rest 96 130/70 Hypertension Stage 1
Amy Rest 64 116/70 Normal
Self Exercise 128 150/75
Aidan Exercise 120 140/70
SHS 312 Exercise Testing and Prescription Blood Pressure and Heart Rate Report
Upload the completed lab report to Blackboard no later than the
indicated deadline to be graded.
