Managing High Blood Pressure in Personal Training Clients: A Case Study

Question
Hi wonder if you can help.  I am a personal trainer and have a new client who on presenting completed a health questionnaire etc, all seemed well, on testing her blood pressure it was on the high side so I got permission from her GP to continue with exercise prescription.  She has been working well for 2 weeks now.  I introduced the heart rate monitor last week to assess the intensity of her cardiovascular exercise, I wanted to check that her rate of perceived exertion was true to her actual heart rate % ( this I had worked out to her using the HRR method).  She is 63.  She peaked at 178bpm and went down to 133 bpm all in the space of 15 mins, her heart rate jumped around, I turned off all other electrical things in gym, as thought maybe interference, the same result, I then took manually to check and the monitor seems to be working ok.  I popped in to see her today to reiterate the need for a moderate, steady state progression giving her the relevant heart rates to adhere to for now, but she then informed me of this: she thinks although not sure if left or right B Branch block.  I have looked this up and maybe this would explain the irregularity of the beats, but does anyone have any advice as to actual cardio progression, and what to avoid etc.  She is inclined to put her head down (work very hard) and before I became involved got very out of breath, sweaty and experienced occasional checst pains and headaches, which I explained not a good idea and safety top priority.  I dont really want to walk away from this client, but safety is uppermost, anyone with any advice would be greatly appreciated.  Do you think any heart rate taken would be relevant against the general population? My client has made leaps in the last year with her fitness and lost quite considerable weight. She has also said her confidence and happiness has increased massively (this is excellent).  I am not medically trained, but I am a fully qualified personal trainer on the register of exercise professionals.



Thanks


Answer
jo;

i have a concern here,due to the heart problems. i suggest this lady have a work-up from a cardio doctor,for the safety of the patient.

there an underlying cause for her BP's and the chest pain.
i suggest no work-out with out a doctor okays.

catherine;