Stress Less Blood Pressure Challenge

Challenge Instructions

Binder (For those who do not have access to the binder at a health kiosk)

Participant Results Form

Evaluation Form

Measure your blood pressure at about the same time every day.

• For best results, sit comfortably with both feet on the floor for at least two minutes before taking a measurement. When you measure your blood pressure, rest your arm on a table so the blood pressure cuff is at about the same height as your heart.
• Record your blood pressure results on Participant Results Form.
• Complete one of the stress-reduction activities in the binder, then re-take your blood pressure and record results on the Participants Results Form. 
• After you have tracked your blood pressure before and after completing a stress-reduction activity on at least ten separate days, you can submit the Evaluation Form to earn 15 Healthy Lifestyle Activity Points and be entered into a seasonal drawing for a $100 Corporate Reward gift card*.

*All gift cards are subject to taxation.

About Blood Pressure

How to Read Blood Pressure Results

Blood pressure is typically recorded as two numbers, written as a ratio like this:

117/76 mm Hg

Read as "117 over 76 millimeters of mercury"

• Systolic:The top number, which is also the higher of the two numbers, measures the pressure in the arteries when the heart beats (when the heart muscle contracts).
• Diastolic: The bottom number, which is also the lower of the two numbers, measures the pressure in the arteries between heartbeats (when the heart muscle is resting between beats and refilling with blood).

What is the American Heart Association (AHA) Recommendation for Healthy Blood Pressure?

This chart reflects blood pressure categories defined by the American Heart Association.

Blood Pressure Category	Systolic mm Hg (upper #)		Diastolic mm Hg (lower #)
Low	less than 90	or	less than 60
Normal	less than 120	and	less than 80
Pre-hypertension	120 - 129	or	less than 80
High Blood Pressure (Hypertension) Stage 1	130 - 139	or	80 - 89
High Blood Pressure (Hypertension) Stage 2	140 or higher	or	90 or higher
Hypertensive Crisis (Emergency care needed)	Higher than 180	or	Higher than 120

* Your doctor should evaluate unusually low blood pressure readings.

What is High Blood Pressure (Hypertension)?

High blood pressure is a chronic condition, and the damage it causes to blood vessels and organs generally occurs over years.

However, it is possible for blood pressure to rise quickly and severely enough to be considered a hypertensive crisis. To reduce morbidity and mortality in this situation, early evaluation of organ function and blood pressure elevations at these levels is critical to determine the appropriate management.

Hypertensive crises can present as hypertensive urgency or as a hypertensive emergency.

If, while monitoring your blood pressure, you get a systolic reading of 180 mm Hg or higher OR a diastolic reading of 120 mm HG or higher, wait a couple of minutes and take it again. If the reading is still at or above that level, you should seek immediate emergency medical treatment for a hypertensive crisis. If you can't access the emergency medical services (EMS), have someone drive you to the hospital right away.
 

Hypertensive Urgency

Hypertensive urgency is  situation where the blood pressure is severely elevated [180 or higher for your systolic pressure (top number) or 120 or higher for your diastolic pressure (bottom number)], but there is no associated organ damage. Those experiencing hypertensive urgency may or may not experience one or more of these symptoms:

• Severe headache
• Shortness of breath
• Nosebleeds
• Severe anxiety

Treatment of hypertensive urgency generally requires readjustment and/or additional dosing of oral medications, but most often does not necessitate hospitalization for rapid blood pressure reduction. A blood pressure reading of 180/120 or greater requires immediate evaluation, because early evaluation of organ function and blood pressure elevations at these levels is critical to determine the appropriate management.

Hypertensive Emergency

A hypertensive emergency exists when blood pressure reaches levels that are damaging organs. Hypertensive emergencies generally occur at blood pressure levels exceeding 180 systolic OR 120 diastolic, but can occur at even lower levels in patients whose blood pressure had not been previously high.

The consequences of uncontrolled blood pressure in this range can be severe and include:

• Stroke
• Loss of consciousness
• Memory loss
• Heart attack
• Damage to the eyes and kidneys
• Loss of kidney function
• Aortic dissection
• Angina (unstable chest pain)
• Pulmonary edema (fluid backup in the lungs)
• Eclampsia

If you get a blood pressure reading of 180 or higher on top or 120 or higher on the bottom, and are having any symptoms of possible organ damage (chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking) do not wait to see if your pressure comes down on its own. Seek emergency medical assistance immediately. Call 9-1-1. If you can't access the emergency medical services (EMS), have someone drive you to the hospital immediately.

How is High Blood Pressure Diagnosed?

Your healthcare providers will want to get an accurate picture of your blood pressure and chart what happens over time. Starting at age 20, the American Heart Association recommends a blood pressure screening at your regular healthcare visit or once every 2 years, if your blood pressure is less than 120/80 mm Hg.

Your blood pressure rises with each heartbeat and falls when your heart relaxes between beats. While BP can change from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three U.S. adults has high blood pressure.

If your blood pressure reading is higher than normal, your doctor may take several readings over time and/or have you monitor your blood pressure at home before diagnosing you with high blood pressure.

A single high reading does not necessarily mean that you have high blood pressure. However, if readings stay at 130/80 mm Hg or above (systolic 130 or above OR diastolic 80 or above) over time, your doctor will likely want you to begin a treatment program. Such a program almost always includes lifestyle changes and often prescription medication for those with readings of 130/80 or higher.

Stress Reduction Activity 1

Visual Relaxation - Activity #1

Complete stesp 1 - 3 before beginning

Instructions:

1. Take Blood Pressure and write result on your Participant Results Form. 
2. Stay in a comfortable relaxed seated position. Take a deep breath, and view each photo in the Visualization Relaxation Activty #1 (a suggested amount of time is 5 seconds.) Turn each page slowly, taking time to observe the elements of the photo that feel peaceful and relaxing. Relax your eyes and imagine yourself in the places pictured. Take as much time as feels comfortable – not too quickly, not too slowly.

If you do not have access to the Visualization Relaxation Activity #1, you can follow these steps to use visual imagery for stress relief. Read through first, then complete the activity.

• Find a private calm space and make yourself comfortable.
• Take a few slow and deep breaths to center your attention and calm yourself.
• Close your eyes.
• Imagine yourself in a beautiful location, where everything is as you would ideally have it. Some people visualize a beach, a mountain, a forest, or a being in a favorite room sitting on a favorite chair.
• Imagine yourself becoming calm and relaxed. Alternatively, imagine yourself smiling, feeling happy and having a good time.
• Focus on the different sensory attributes present in your scene so as to make it more vivid in your mind. For instance, if you are imagining the beach, spend some time vividly imagining the warmth of the sun on your skin, the smell of the ocean, seaweed and salt spray, and the sound of the waves, wind and seagulls. The more you can invoke your senses, the more vivid the entire image will become.
• Remain within your scene, touring its various sensory aspects for five to ten minutes or until you feel relaxed.
• While relaxed, assure yourself that you can return to this place whenever you want or need to relax.
• Open your eyes again and then rejoin your world.

3. Take Blood Pressure again and write result on your Participants Results Form.

Why this Works

Guided imagery techniques work to help people relax for several reasons. As is the case with many techniques, they involve an element of distraction which serves to redirect people's attention away from what is stressing them and towards an alternative focus.

Stress Reduction Activity 2

"Happy Place" Sensory Recall - Activity #2

Complete stesp 1 - 5 before beginning

Instructions:

1. Take Blood Pressure and write result on your Participant Results Form.
2. Stay in a comfortable relaxed seated position. Close your eyes and take a few deep breaths, very slowly. Think of a place you have been, or would like to go, that you feel is relaxing and peaceful. If you are having trouble thinking of place you might try one of these:
   1. a relaxing day near the ocean with a beautiful blue sky
   2. a trip to the mountains with pine trees and a gentle breeze
   3. a walking path in a meadow surrounded by wildflowers
   4. curled up in your favorite chair at home with your hands wrapped around a cup of soothing tea
   5. or lying down outside on a lounge chair next to a pool in perfect temperatures
3. Once you have a place in mind, focus your thoughts on what you might experience with each of the 5 senses if you were in that location. What do you:
   1. See?
   2. Smell?
   3. Taste?
   4. Hear?
   5. Feel?

An example of a day at the ocean might go like this…

• seeing a beautiful blue sky with a few wisps of white clouds; the ocean reflecting the blue sky, gentle waves, and a sailboat in the distance.
• hearing the gentle splash of the waves as they roll onto the sand; seagulls calling softly 
• smelling the earthy scent of wet sand and a hint of coconut
• feeling the warmth of dry sand as you sift it between your fingers, and the coolness of the water as you let it wash up onto your toes 
• tasting the saltiness of the sea mist as you lick your lips
• Let your imagination go on a vacation and add to these senses in your own “Happy Place.

4. Open your eyes, take a deep breath...welcome back!
5. Take blood pressure again and write results on your Participant Results Form.

Why This Works

Meditation is good for business. Meditation can make you a better leader. In a Forbes article, one business leader says “It helped me to put stress and demands in a container, dealing with them slowly and focusing on the important decisions, both at work and at home.”

There is scientific research that demonstrates the benefits of meditation for your body and brain. From the Huffington Post: “We already know that psychosocial interventions like mindfulness meditation will help you feel better mentally, but now for the first time we have evidence that they can also influence key aspects of your biology,” lead researcher Dr. Linda Carlson of the Tom Baker Cancer Center at Albert Health Services, said in a statement.

Meditation slows aging. Studies show that meditation changes brain physiology to slow aging. “Cognition seems to be preserved in meditators,” says Sara Lazar, a researcher at Harvard University. – Quote from 8 Ways Meditation Can Improve Your Life.

Source: Be More With Less: http://bemorewithless.com/break/  

Stress Reduction Activity 3

Take a Breath Break - Activity #3

Complete stesp 1 - 5 before beginning

Instructions:

1. Take blood pressure and write result on your Participant Results Form.
2. Stay seated in a comfortable upright, but relaxed position. You should be sitting tall with your ears, shoulders and hips lined up; head and neck in a neutral position or chin tipped slightly downward, and your shoulders relaxed. Do not slouch forward; this impedes breath flow.
3. Close your eyes and take 10 deep breaths, very slowly. With each breath, relax your shoulders and abdomen and allow the air to fill your lungs. 
4. Inhale slowly through your nose and exhale through your mouth. It should take at least 2-3 times longer to exhale than to inhale. You do not need to force the air out on the exhale; just let your lungs empty naturally. With each breath, let go of your body’s tension more and more. After your 10th breath open your eyes. 
5. Smile! Take blood pressure again and write result on your Participants Results Form.

Why this works

Enjoy this exercise any time of day. It is quick, easy to do, and requires no equipment. A five minute breath break can have the same effect on your body as a 20 minute nap, relaxing your muscles, calming your blood pressure and heart rate, slowing respiration, and re-energizing your mind and body.

As it turns out, deep breathing is not only relaxing, it's been scientifically proven to affect the heart, the brain, digestion, the immune system — and maybe even the expression of genes.
 
Mladen Golubic, a physician in the Cleveland Clinic's Center for Integrative Medicine, says that breathing can have a profound impact on our physiology and our health.
 
"You can influence asthma; you can influence chronic obstructive pulmonary disease; you can influence heart failure," Golubic says. "There are studies that show that people who practice breathing exercises and have those conditions — they benefit."

Source: NPR, Just Breathe: Body Has A Built-In Stress Reliever

Stress Reduction Activity 4

Tense & Relax Exercise - Activity #4

Complete stesp 1 - 5 before beginning

Instructions:

1. Take blood pressure and write result on your Participant Results Form.
2. Make yourself as comfortable as possible in a seated position; try to sit up straight with good posture with your hands resting in your lap. You will need to read through this relaxation practice the first time or two. After that, it will become second nature. To save time, please pick 2 or 3 areas of the body to try the technique on. The simplified version of this entire exercise is to tense each muscle group in your body, one at a time; hold the tension for 2 seconds; exhale and release all the tension. Move on to the next muscle group.  In this exercise we start at your feet and work your way up to your head.

• Relaxation of the feet and calves:
  • Flex your feet (pull toes toward the knees)
  • Contract calf muscles and muscles of lower leg 
  •  Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the knees and upper thighs:
  • Straighten your knees and squeeze your legs together 
  • Contract your thigh muscles and all the muscles of your legs
  • Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the hips and buttocks
  • Tense the buttock muscles by squeezing them inward and upward
  • Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the abdomen 
  • Observe your abdomen rising and falling with each breath
  • Exhale and press your navel toward the spine then tense the abdomen
  • Feel the tension build and hold the tension
  • Take a deep breath
  •  As you exhale say the word “RELAX” and let the tension go
• Relaxation of the upper back
  • a. Draw the shoulder blades together to the midline of the body
  • Contract the muscles across the upper back
  • Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the Arms and Palms of the Hands
  • Turn palms face down and make a tight fist in each hand
  • Raise and stretch both arms with fists
  • Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the Chin, Neck, and Shoulders
  • Drop your chin to your chest
  • Draw your shoulders up toward your ears
  • Feel the tension build and hold the tension
  • Take a deep breath
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the Jaw and Facial muscles
  • Clench your teeth together
  • Tense the muscles in the back of your jaw 
  • Turn the corners of your mouth into a tight smile 
  • Wrinkle the bridge of your nose and squeeze your eyes shut
  • Tense all facial muscles in toward the center of your face 
  • Feel the tension build and hold the tension 
  • Take a deep breath 
  • As you exhale say the word “RELAX” and let the tension go
• Relaxation of the Forehead
  • Raise eyebrows up and tense the muscles across the forehead and scalp
  • Feel the tension build and hold the tension
  • Take a deep breath 
  • As you exhale say the word “RELAX” and let the tension go
• Intensification of Relaxation throughout the Body
  • Focus on relaxation flowing from the crown of your head 
  • Over your face 
  • Down the back of your neck and shoulders
  • Down your body through your arms and hands
  • Over your chest and abdomen
  • Flowing through your hips and buttocks 
  • Into your thighs, your knees and calves 
  • And finally into your ankles and feet 
  • Continue to deep breath for several minutes in silence
• Finishing the Tense & Relax Exercise
  • Count backwards in your head from 3 to 1
  • become aware of your surroundings (location, people, noises) 
  • Move your feet, legs, hands, arms, rotate your head
  • open your eyes feeling re-energized, refreshed, and relaxed

3. Take blood pressure again and write results on your Participant Results Form.

Why this works

The relaxation response is perhaps one of the most important skills you will use to gain control over your body. The National Institutes of Health (NIH) recognizes the relaxation response as having broad health benefits including the reduction of pain and restoration of sleep. In addition, research on the relaxation response has shown that this simple technique can: increase energy, decrease fatigue as well as increase arousal from a drowsy state. It can increase motivation, productivity, and improve decision-making ability. The relaxation response lowers stress hormone levels and lowers blood pressure.

Source: http://www.med.umich.edu/painresearch/patients/Relaxation.pdf

Stress Reduction Activity 5

Humor is the Best Medicine - Activity #5

Complete stesp 1 - 3 before beginning

Instructions:

1. Take Blood Pressure and write result on your Participant Results Form. 
2. Read Human is the Best Medicine - Activity #5.
3. Take blood pressure again and write results on your Participant Results Form.

Why this Works

A good sense of humor can't cure all ailments, but data are mounting about the positive things laughter can do.

Short-term benefits

A good laugh has great short-term effects. When you start to laugh, it doesn't just lighten your load mentally, it actually induces physical changes in your body. Laughter can:

• Stimulate many organs. Laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs and muscles, and increases the endorphins that are released by your brain.
• Activate and relieve your stress response. A rollicking laugh fires up and then cools down your stress response and increases your heart rate and blood pressure. The result? A good, relaxed feeling.
• Soothe tension. Laughter can also stimulate circulation and aid muscle relaxation, both of which help reduce some of the physical symptoms of stress.

Long-term effects

Laughter isn't just a quick pick-me-up, though. It's also good for you over the long haul. Laughter may:

• Improve your immune system. Negative thoughts manifest into chemical reactions that can affect your body by bringing more stress into your system and decreasing your immunity. In contrast, positive thoughts actually release neuropeptides that help fight stress and potentially more-serious illnesses.
• Relieve pain. Laughter may ease pain by causing the body to produce its own natural painkillers. Laughter may also break the pain-spasm cycle common to some muscle disorders.
• Increase personal satisfaction. Laughter can also make it easier to cope with difficult situations. It also helps you connect with other people.
• Improve your mood. Many people experience depression, sometimes due to chronic illnesses. Laughter can help lessen your depression and anxiety and make you feel happier

Source: http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

American Heart Association Helpful Resources

• About High Blood Pressure (HBP)
• Why HBP Matters
• Your Risk for HBP
• Symptoms, Diagnosis & Monitoring of HBP
• Prevention & Treatment of HBP
• Tools & Resources