FREQUENTLY ASKED QUESTONS

Frequently Asked Questions
<Back to FAQs index page>

Presented in part with the support of Novartis Pharmaceuticals and Boston Scientific / Guidant

Hypertension

What Is blood pressure and what happens when it is high?

Since blood is carried from the heart to all of your body's tissue and organs in vessels called arteries, blood pressure is the force of the blood pushing against the walls of those arteries. In fact, each time the heart beats (about 60-70 times a minute at rest), it pumps out blood into the arteries. Your blood pressure is at its greatest when the heart contracts and is pumping the blood. This is called systolic pressure. When the heart is at rest, in between beats, your blood pressure falls. This is the diastolic pressure.

Blood pressure is always given as these two numbers, systolic and diastolic pressures. Both are important. Usually they are written one above or before the other, such as 120/80 mm Hg, with the top number the systolic, and the bottom the diastolic.

Different actions make your blood pressure go up or down. For example, if you run for a bus, your blood pressure goes up. When you sleep at night, your blood pressure goes down. These changes in blood pressure are normal.

Some people have blood pressure that stays up all or most of the time. Their blood pushes against the walls of their arteries with higher-than-normal force. If untreated this can lead to serious medical problems like these:

• Arteriosclerosis ("hardening of the arteries"). High blood pressure harms the arteries by making them thick and stiff. This speeds the build up of cholesterol and fats in the blood vessels like rust in a pipe, which prevents the blood from flowing through the body, and in time can lead to a heart attack or stroke.

• Heart Attack. Blood carries oxygen to the body. When the arteries that bring blood to the heart muscle become blocked, the heart cannot get enough oxygen. Reduced blood flow can cause chest pain (angina). Eventually, the flow may be stopped completely, causing a heart attack.

• Enlarged heart. High blood pressure causes the heart to work harder. Over time, this causes the heart to thicken and stretch. Eventually the heart fails to function normally causing fluids to back up into the lungs. Controlling high blood pressure can prevent this from happening.

• Kidney Damage. The kidney acts as a filter to rid the body of wastes. Over a number of years, high blood pressure can narrow and thicken the blood vessels of the kidney. The kidney filters less fluid, and waste builds up in the blood. The kidneys may fail altogether. When this happens, medical treatment (dialysis) or a kidney transplant may be needed.

• Stroke. High blood pressure can harm the arteries, causing them to narrow faster. So, less blood can get to the brain. If a blood clot blocks one of the narrowed arteries, a stroke (thrombotic stroke) may occur. A stroke can also occur when very high pressure causes a break in a weakened blood vessel in the brain (hemorrhagic stroke).

How Is Blood Pressure Checked?

Having your blood pressure checked is quick, easy, and painless. Your blood pressure is measured with an instrument called a sphygmomanometer (sfig-mo-ma-nom-e-ter).

It works like this: A blood pressure cuff is wrapped around your upper arm and inflated to stop the blood flow in your artery for a few seconds. A valve is opened and air is then released from the cuff and the sounds of your blood rushing through an artery are heard through a stethoscope. The first sound heard and registered on the gauge or mercury column is called the systolic blood pressure. It represents the maximum pressure in the artery produced as the heart contracts and the blood begins to flow. The last sound heard as more air is released from the cuff is the diastolic blood pressure. It represents the lowest pressure that remains within the artery when the heart is at rest.

What Do the Numbers Mean?
Blood pressure is always expressed in two numbers that represent the systolic and diastolic pressures. These numbers are measurements of millimeters (mm) of mercury (Hg). The measurement is written one above or before the other, with the systolic number on the top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mm Hg is expressed verbally as "120 over 80." See the table below which shows categories for blood pressure levels in adults.

If your blood pressure is less than 140/90 mm Hg, it is considered normal. However, a blood pressure below 120/80 mm Hg is even better for your heart and blood vessels. People use to think that low blood pressure (for example, 105/65 mm Hg in an adult) was unhealthy. Except for rare cases, this is not true. High blood pressure or "hypertension" is classified by stages and is more serious as the numbers get higher.

CATEGORIES FOR BLOOD PRESSURE LEVELS IN ADULTS*
(Age 18 Years and Older)

Blood Pressure Level (mm Hg)

Category (Systolic, Diastolic)
Normal (<130, <85)
High Normal (130-139, 85-89)
High Blood Pressure
Stage 1 (140-159, 90-99)
Stage 2 (160-179, 100-109)
Stage 3 (>180, >110)

*For those not taking medicine for high blood pressure and not having a short term serious illness. These categories are from the National High Blood Pressure Education Program.

(< means less than, > means greater than or equal to)

Ambulatory Blood Pressure Monitoring

Blood pressure measurements taken in a doctor's office may or may not be a true representation of a patient's blood pressure. Often patients are nervous in a medical office leading to an elevation of blood pressure. This is commonly referred to as "white coat hypertension". In addition, our blood pressure normally varies over the course of a day and a blood pressure measurement in the office or even at home may not adequately describe that variation.

Ambulatory blood pressure monitoring (ABPM) provides multiple readings over time. The patient wears a blood pressure cuff over a 24 hour period. Blood pressure is taken automatically at intervals over the course of the day and the values are stored for later review by the physician. This methodology may help guide therapy of your blood pressure. To enable automatic blood pressure monitoring, a blood pressure cuff is placed around your upper arm and connected to a device that periodically causes the cuff to inflate then deflate. The blood pressure readings are recorded automatically and are stored in the device along with the time they were taken. When you return the device the readings and times are printed out.

While ABPM is not a cost-effective tool for all hypertensive patients, it can assist in evaluation of such problems as difficult to control hypertension, labile hypertension (episodic hypertension), syncopal episodes (fainting spells) and autonomic dysfunction (a disorder of that part of the nervous system that controls automatic functions). It can also help assess the effectiveness of various medications in controlling your blood pressure.

Who's Likely To Develop High Blood Pressure?

Anyone can develop high blood pressure, but some people are more likely to develop it than others. For example, high blood pressure is more common--it develops earlier and is more severe--in African-Americans than in whites.

In the early and middle adult years, men have high blood pressure more often than women. But as men and women age, the reverse is true. More women after menopause have high blood pressure than men of the same age. And the number of both men and women with high blood pressure increases rapidly in older age groups. More than half of all Americans over age 65 have high blood pressure. And older African-American women who live in the Southeast are more likely to have high blood pressure than those in other regions of the United States.

In fact, the southeastern states have some of the highest rates of death from stroke. High blood pressure is the key risk factor for stroke. Other risk factors include cigarette smoking and overweight. These 11 states--Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia--have such high rates of stroke among persons of all races and in both sexes that they are called the "Stroke Belt States."

Finally, heredity can make some families more likely than others to get high blood pressure. If your parents or grandparents had high blood pressure, your risk may be increased. While it is mainly a disease of adults, high blood pressure can occur in children as well. Even if everyone is healthy, be sure you and your family get your blood pressure checked. Remember, high blood pressure has no signs or symptoms.

Hypertension and Women

Heart Disease Risk Factors

Risk factors are habits or traits that make a person more likely to develop a disease. Many of those for heart disease can be controlled. These include:

• Cigarette smoking
• High blood pressure
• High blood cholesterol
• Overweight
• Physical inactivity
• Diabetes

The more risk factors you have, the greater your risk. So take action--take control!

CORONARY HEART DISEASE is a woman's concern.
Every woman's concern. One in ten American women 45 to 64 years of age has some form of heart disease, and this increases to one in five women over 65. Another 1.6 million women have had a stroke. Both heart disease and stroke are known as cardiovascular diseases, which are serious disorders of the heart and blood vessel system.

High blood pressure, also known as hypertension, greatly increases your chances of developing cardiovascular diseases, and it is the most important risk factor for stroke. Even slightly high levels double your risk. More than half of American women will develop high blood pressure at some point in their lives.

High blood pressure is sometimes called the "silent killer" because most people who have it do not feel sick. That makes it particularly important to have your blood pressure checked each time you see your doctor or other health professional. If your blood pressure is found to be at 140/90 or above, then you have high blood pressure. You will likely need to have your pressure measured on at least two more occasions to be sure the result is accurate.

WHAT YOU CAN DO: CONTROL AND PREVENTION
If you have high blood pressure, you can control it with proper treatment. If you don't have high blood pressure now, you can take steps to prevent it from developing. You can help to control and prevent high blood pressure by taking the following steps:

Limit Your Alcohol Use. If you drink alcohol, have no more than one drink per day. That means no more than 12 ounces of beer, 5 ounces of wine, or 1 1/2 ounces of hard liquor.

Use Less Salt. Try seasoning foods instead with herbs, spices, and lemon juice. Keep in mind that sodium, an ingredient in salt, is "hidden" in many packaged and processed foods. Check product labels for the amount of sodium in each serving. Many experts
advise a total daily salt intake of no more than 6 grams, which equals about 2,400 milligrams of sodium--this includes whatever is added during cooking and at the table. If you would like to try a salt substitute, talk with your doctor first, because they are not safe for everyone.

Be Physically Active. Even low- to modeate-intensity activity, if done regularly, can help control and prevent high blood pressure. Examples of such exercise are walking for pleasure, gardening, yardwork, moderate-to-heavy housework, dancing, and home
exercise. Try to do one or more of these activities every day.

Lose Weight If You Are Overweight. Taking off excess pounds will help to control and prevent high blood pressure, and will lower your chances of developing cardiovascular disease in several other ways. Weight loss will help to prevent and control diabetes, and it can also lower blood cholesterol levels. Finally, since being overweight raises the chances of developing heart disease, losing weight can lower your risk.

Suggestions for making weight loss an easier, safer, and more successful process:
Eat For Health. Choose a wide variety of low-calorie, nutritious foods in moderate amounts. Make sure that these foods are low in fat, especially saturated fat. Remember, fat is the greatest source of calories. If you have a lot of weight to lose, ask your doctor or a nutritionist to help you develop a sensible, well-balanced plan for gradual weight loss.

Keep Milk On the Menu. Don't cut out dairy products in trying to reduce calories and fat. Dairy products are rich in calcium, a nutrient that is particularly important for women. Instead, choose skim or low fat, lower calorie dairy products.

Get Beyond Dieting. To keep the pounds off, change your basic eating habits rather than simply "go on a diet." Learn to recognize social and emotional situations that trigger overeating and find ways to cope with them that work for you.

Avoid Fads and Diet Pills. Most fad diets provide poor nutrition and cause a number of side effects. Although fad diets can give quick and dramatic results, the weight returns quickly once you stop dieting. Also avoid diet pills. Most have troublesome side
effects and none of them work for long-term weight loss.

Get a Move On. While physical activity alone won't take off many pounds, exercise can help burn calories, tone muscles, and control appetite. It will also help you keep off the weight you lose.

Ask For Support. Tell your family and friends about your weight loss plans and let them know how they can help you. You might also want to join a self-help group devoted to weight control. These groups provide support and practical suggestions on nutrition and long-term weight control.

Another Consideration
It is also important to know that if you take birth control pills, your blood pressure is apt to increase slightly. The risk appears to increase with age and with length of use. If you are taking oral contraceptives, you should get your blood pressure checked regularly. If hypertension develops, you should stop using the pill.

Taking Medication
If you have high blood pressure and it stays high even after you make the changes described above, your doctor will probably also prescribe medicine. The amount you take may be gradually reduced, especially if you are successful with the changes you make in your lifestyle. If you feel any uncomfortable side effects from the drug, ask your doctor about lowering the amount you take, or possibly switching to another type of medicine.

Blood Pressure Categories in Adults (18 Years and Older)

Blood pressure is shown as two numbers--the systolic pressure as the heart is beating and the diastolic pressure between heartbeats.

Blood Pressure Level in mmHg
Category (Systolic, Diastolic)

Normal (<130, <85)
High Normal (130-139, 85-89)
Hypertension
Stage 1 (140-159, 90-99)
Stage 2 (160-179, 100-109)
Stage 3 (180-209, 110-119)
Stage 4 (>210, >120)

From: The Fifth Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure, NIH, NHLBI, 1993.

Move It and Lose It

Activities Calories Burned per Hour*

Sitting Quietly 80

Standing Quietly 95

Light Activity 240
Office work
Cleaning house
Playing golf

Moderate Activity 370
Walking briskly (3.5 mph)
Gardening
Bicycling (5.5 mph)
Dancing

Strenuous Activity 580
Jogging (9 min. per mile)
Swimming

Very Strenuous Activity 740
Running (7 min. per mile)
Racquetball


*For a healthy 140-pound woman. If you weigh more than 140 pounds, you will probably burn more calories per hour. If you weigh less, you will probably burn fewer calories per hour.

Source: Dietary Guidelines for Americans, U.S. Department of Agriculture/U.S.Department of Health and Human Services, 1990.

Prevention

What Causes High Blood Pressure?

For most people, there is no single known cause of high blood pressure. This type of high blood pressure is called "primary" or "essential" hypertension. This type of blood pressure can't be cured, although in most cases it can be controlled. That's why it's so important for everyone to take steps to reduce their chances of developing high blood pressure.

In a few people, high blood pressure can be traced to a known cause like tumors of the adrenal gland, chronic kidney disease, hormone abnormalities, use of birth control pills, or pregnancy. This is called "secondary hypertension." Secondary hypertension is usually cured if its cause passes or is corrected.

How Can You Prevent High Blood Pressure?

Everyone--regardless of race, age, sex, or heredity--can help lower their chance of developing high blood pressure. Here's how:

1) Maintain a healthy weight, lose weight if you are overweight,
2) Be more physically active,
3) Choose foods lower in salt and sodium, and
4) If you drink alcoholic beverages, do so in moderation.

These rules are also recommended for treating high blood pressure, although medicine is often added as part of the treatment. It is far better to keep your blood pressure from getting high in the first place.

Another important measure for your health is to not smoke: while cigarette smoking is not directly related to high blood pressure, it increases your risk of heart attack and stroke.

Let's look more closely at the four rules to prevent high blood pressure and for keeping a healthy heart:

1) Maintain a healthy weight, lose weight if you are overweight.
As your body weight increases, your blood pressure rises. In fact, being overweight can make you two to six times more likely to develop high blood pressure than if you are at your desirable weight. Keeping your weight in the desirable range is not only important to prevent high blood pressure but also for your overall health and well being.

It's not just how much you weigh that's important: it also matters where your body stores extra fat. Your shape is inherited from your parents just like the color of your eyes or hair. Some people tend to gain weight around their belly; others, around the hips and thighs. "Apple-shaped" people who have a pot belly (that is, extra fat at the waist) appear to have higher health risks than "pear-shaped" people with heavy hips and thighs.

No matter where the extra weight is, you can reduce your risk of high blood pressure by losing weight. Even small amounts of weight loss can make a big difference in helping to prevent high blood pressure. Losing weight, if you are overweight and already have high blood pressure, can also help lower your pressure.

To lose weight, you need to eat fewer calories than you burn. But don't go on a crash diet to see how quickly you can lose those pounds. The healthiest and longest-lasting weight loss happens when you do it slowly, losing 1/2 to 1 pound a week. By cutting back by 500 calories a day by eating less and being more physically active, you can lose about 1 pound (which equals 3,500 calories) in a week.

Losing weight and keeping it off involves a new way of eating and increasing physical activity for life. Here's how to eat and get on your way to a lower weight:

Choose foods low in calories and fat. Naturally, choosing low-calorie foods cuts calories. But did you know that choosing foods low in fat also cuts calories? Fat is a concentrated source of calories, so eating fewer fatty foods will reduce calorie intake. Some examples of fatty foods to cut down on are: butter, margarine, regular salad dressings, fatty meats, skin of poultry, whole milk dairy foods like cheese, fried foods, and many cookies, cakes, pastries and snacks. See the table below for low fat foods that you can enjoy instead.

TRY THESE LOW FAT FOODS

• Baked, broiled or poached: chicken and turkey (without the skin); fish; lean cuts of meat (like round or sirloin).
• Skim, 1%, or evaporated skim milk and lower-fat, low-sodium cheeses.
• Fresh, frozen, or canned fruit.
• Fresh, frozen, or canned (no salt added) vegetables (without cream or cheese sauces).
• Plain rice and pasta, English muffins, bagels, sandwich breads and rolls, and soft tortillas.
• Cold (ready-to-eat) cereals, lower in sodium and cooked hot cereals (not instant since they are higher in sodium).

Note: When choosing cheeses, breads, and cereals, use the food label to choose those lower in fat and sodium.

Choose foods high in starch and fiber. Foods high in starch and fiber, like those shown in the table, are excellent substitutes for foods high in fat. They are lower in calories than foods high in fat. These foods are also good sources of vitamins and minerals.

FOODS HIGH IN STARCH AND/OR FIBER

• Fruits, vegetables, whole-grain cereals, pasta and rice, whole-grain breads, dry peas and beans.

Note: Use the food label to choose breads and cereals lower in sodium.

Limit serving sizes. To lose weight, it's not just the type of foods you eat that's important, but also the amount . To take in fewer calories, you need to limit your portion sizes. Try especially to take smaller helpings of high calorie foods like high fat meats and cheeses. And try not to go back for seconds.

Here's a good tip to help you control or change your eating habits: keep track of what you eat, when you eat, and why, by writing it down. Note whether you snack on high fat foods in front of the television, or if you skip breakfast and then eat a large lunch. Once you see your habits, you can set goals for yourself: cut back on TV snacks and, when you do snack, have fresh fruit, unsalted air-popped popcorn, or unsalted pretzels. If there's no time for breakfast at home, take a low fat muffin, bagel (skip the cream cheese), or cereal with you to eat at work. Changing your behavior will help you change your weight for the better.

Increase physical activity. There's more to weight loss than just eating less. Another important ingredient is increasing physical activity, which burns calories. Cutting down on fat and calories combined with regular physical activity can help you lose more weight and keep it off longer than either way by itself. Check the table below to see how many calories you can burn during different activities.

CALORIES BURNED DURING PHYSICAL ACTIVITIES
Activity Calories Burned Up Per Hour * (Man**, Woman**)
Light Activity: (300, 240)
Cleaning house
Playing
Playing golf
Moderate activity: (460, 370)
Walking briskly (3.5 mph)
Gardening
Cycling (5.5 mph)
Dancing
Playing basketball
Strenuous activity: (730, 580)
Jogging (9 min./mile)
Playing
Swimming
Very strenuous activity: (920, 740)
Running (7 min./mile)
Racquetball


*May vary depending on a variety of factors including environmental conditions.
** Healthy man, 175 pounds; healthy woman 140 pounds.

Source: Dietary Guidelines for Americans, U.S. Department of Agriculture, U.S. Department of Health and Human Services, Third edition, 1990 (adapted from McArdle, et al., "Exercise Physiology, " 1986).

2) Be More Physically Active.
Besides losing weight, there are other reasons to be more active: being physically active can reduce your risk for heart disease, help lower your total cholesterol level and raise HDL-cholesterol (the "good" cholesterol that does not build up in the arteries), and help lower high blood pressure. And people who are physically active have a lower risk of getting high blood pressure--20 to 50 percent lower--than people who are not active. You don't have to be a marathon runner to benefit from physical activity. Even light activities, if done daily, can help lower your risk of heart disease. So you can fit physical activity into your daily routine in small but important ways. See table below.

BE MORE ACTIVE EVERYDAY

• Use the stairs instead of the elevator.
• Get off the bus one or two stops early and walk the rest of the way.
• Park farther away from the store or office.
• Ride a bike.
• Work in the yard or garden.
• Go dancing.

More vigorous exercise has added benefits. It helps improve the fitness of the heart and lungs. And that in turn protects you more against heart disease. Activities like swimming, brisk walking, running, and jumping rope are called "aerobic." This means that the body uses oxygen to make the energy it needs for the activity. Aerobic activities can condition your heart and lungs if done at the right intensity for at least 30 minutes, three to four times a week. But if you don't have 30 minutes for a break, try to find two 15-minute periods or even three 10-minute periods. Try to do some type of aerobic activity in the course of a week.

Most people don't need to see a doctor before they start exercising, since a gradual, sensible exercise program has few health risks. But if you have a health problem like high blood pressure; if you have pains or pressure in the chest or shoulder area; if you tend to feel dizzy or faint; if you get very breathless after a mild workout; or are middle-age or older and have not been active, and you are planning a vigorous exercise program, you should check with your doctor first. Otherwise, get out, get active, and get fit--and help prevent high blood pressure. The sample walking program at the end of this fact sheet can help you get started.

3) Choose Foods Lower in Salt and Sodium.
Americans eat more salt (sodium chloride) and other forms of sodium than they need. And guess what? They also have higher rates of high blood pressure than people in other countries who eat less salt.

Often, if people with high blood pressure cut back on salt and sodium, their blood pressure falls. Cutting back on salt and sodium also prevents blood pressure from rising. Some people like African-Americans and the elderly are more affected by sodium than others. Since there's really no practical way to predict exactly who will be affected by sodium, it makes sense to limit intake of salt and sodium to help prevent high blood pressure.

All Americans, especially people with high blood pressure, should eat no more than about 6 grams of salt a day, which equals about 2,400 milligrams of sodium. That's about 1 teaspoon of table salt. But remember to keep track of ALL salt eaten--including that in processed foods and added during cooking or at the table. Americans eat 4,000 to 6,000 milligrams of sodium a day, so most people need to cut back on salt and sodium. See the table below for the range of sodium in some types of foods.

If you do not want to read it now, you can skip to the end of the table.

SODIUM IN FOODS
(In Milligrams)
• MEAT, POULTRY, FISH, AND SHELLFISH
• EGGS
• DAIRY PRODUCTS
• VEGETABLES
• BREADS, CEREALS, RICE, PASTA, DRY PEAS AND BEANS
• FRUITS
• FATS AND OILS
• CONDIMENTS

MEAT, POULTRY, FISH, AND SHELLFISH
Fresh meat (including lean cuts of beef, pork, lamb and veal), poultry, finfish, cooked, 3 oz. (less than 90)
Shellfish, 3 oz. (100-325)
Tuna, canned, 3 oz (300)
* Sausage, 2 oz. (515)
* Bologna, 2 oz. (535)
* Frankfurter, 1-1/2 oz. (560)
Boiled ham, 2 oz. (750)
Lean ham, 3 oz. (1,025)

EGGS
Egg white, 1 (55)
* Whole egg, 1 (65)
Egg substitute, 1/4 cup = 1 egg (80-120)

DAIRY PRODUCTS
Milk
* Whole milk, 1 cup (120)
Skim or 1% milk, 1 cup (125)
Buttermilk (salt added), 1 cup (260)

Cheese
* Natural Cheese:
* Swiss Cheese, 1 oz. (75)
* Cheddar cheese, 1 oz. (175)
* Blue Cheese, 1 oz. (395)
Low fat cheese, 1 oz. (150)
* Process cheese and cheese spreads, 1 oz. (340-450)
Lower sodium and fat versions (read the label)
* Cottage cheese (regular), 1/2 cup (455)
Cottage cheese (low fat), 1/2 cup (460)

Yogurt
* Yogurt, whole milk, plain, 8 oz. (105)
Yogurt, fruited or flavored, low fat or nonfat, 8 oz. (120-150)
Yogurt, nonfat or low fat, plain, 8 oz. (160-175)

VEGETABLES
Fresh or frozen vegetables, or no salt added canned (cooked without salt), 1/2 cup (less than 70)
Vegetables, canned, no sauce, 1/2 cup (55-470)
* Vegetables, canned or frozen with sauce, 1/2 cup (read the label)
Tomato juice, canned, 3/4 cup (660)

BREADS, CEREALS, RICE, PASTA, DRY PEAS AND BEANS
Breads and Crackers
Bread, 1 slice (110-175)
English muffin, 1/2 (130)
Bagel, 1/2 (190)
Cracker, saltine type, 5 squares (195)
* Baking powder biscuit, 1 (305)

Cereals (Ready-to-eat)
Shredded wheat, 3/4 cup (less than 5)
Puffed wheat and rice cereals, 1-1/2 to 1-2/3 cup (less than 5)
Granola-type cereals, 1/2 cup (5-25)
Ring and nugget cereals, 1 cup (170-310)
Flaked cereals, 2/3 to 1 cup (170-360)

Cereals (Cooked)
Cooked cereal (unsalted) 1/2 cup (less than 5)
Instant cooked cereal, 1 packet=3/4 cup (180)

Pasta and rice
Cooked rice and pasta (unsalted) 1/2 cup (less than 10)
* Flavored rice mix, cooked, 1/2 cup (250-390)

Peas and beans
Peanut butter (unsalted) 2 tbsp. (less than 5)
Peanut butter, 2 tbsp. (150)
Dry beans, home cooked (unsalted), or no salt added canned, 1/2 cup (less than 5)
Dry beans, plain, canned, 1/2 cup (350-590)
* Dry beans, canned with added fat or meat, 1/2 cup (425-630)

FRUITS
Fruits (fresh, frozen, canned), 1/2 cup (less than 10)

FATS AND OILS
Oil, 1 tbsp. (0)
* Butter (unsalted), 1 tsp. (1)
* Butter (salted),1 tsp (25)
Margarine (unsalted), 1 tsp. (less than 5)
Margarine (salted), 1 tsp. (50)
Imitation mayonnaise, 1 tbsp. (75)
* Mayonnaise, 1 tbsp. (80)
Prepared salad dressings, low calorie, 2 tbsp. (50-310)
* Prepared salad dressings, 2 tbsp. (210-440)

SNACKS
Popcorn, chips, and nuts
Unsalted nuts, 1/4 cup (less than 5)
Salted nuts, 1/4 cup (185)
* Unsalted potato chips and corn chips, 1 cup (less than 5)
* Salted potato chips and corn chips, 1 cup (170-285)
Unsalted popcorn, 2 1/2 cups (less than 10)
Salted popcorn, 2 1/2 cups (330)

Candy
Jelly beans, 10 large (5)
* Milk chocolate bar, 1 oz. Bar (25)

Frozen desserts
* Ice cream, 1/2 cup (35-50)
Frozen yogurt, low fat or nonfat, 1/2 cup (40-55)
Ice milk, 1/2 cup (55-60)

CONDIMENTS
Mustard, chili sauce, hot sauce, 1 tsp. (35-65)
Catsup, steak sauce, 1 tbsp. (100-230)
Salsa, tartar sauce, 2 tbsp. (85-205)
Salt, 1/6 tsp. (390)
Pickles, 5 slices (280-460)
Soy sauce, lower sodium, 1 tbsp. (600)
Soy sauce, 1 tbsp. (1030)

CONVENIENCE FOODS
** Canned and dehydrated soups, 1 cup (600-1,300)
** Lower sodium versions (read the label)
*** Canned and frozen main dishes, 8 oz. (500-1,570)
*** Lower sodium versions (read the label)


* Choices are higher in saturated fat, cholesterol, or both.

** Creamy soups are higher in saturated fat and cholesterol.

*** Limit main dishes that have ingredients higher in saturated fat, cholesterol, or both.


Source: Adapted from Home and Garden Bulletin 253-7, United States Department of Agriculture, July 1993.

You can teach your taste buds to enjoy less salty foods. Here are a few tips:
Check food labels for the amount of sodium in foods. Choose those lower in sodium most of the time. Look for products that say "sodium free," "very low sodium," "low sodium," "light in sodium," "reduced or less sodium," or "unsalted," especially on cans, boxes, bottles, and bags.

Buy fresh, plain frozen, or canned with "no salt added " vegetables. Use fresh poultry, fish and lean meat, rather than canned or processed types.

Use herbs, spices, and salt-free seasoning blends in cooking and at the table instead of salt. This information is also available in a non-table format.

Cook rice, pasta, and hot cereals without salt. Cut back on instant or flavored rice, pasta, and cereal mixes because they usually have added salt.

Choose "convenience" foods that are lower in sodium. Cut back on frozen dinners, mixed dishes like pizza, packaged mixes, canned soups or broths, and salad dressings which often have a lot of sodium.

When available, buy low-or reduced-sodium, or "no-salt-added" versions of foods like these:

• Canned soup, dried soup mixes, bouillon
• Canned vegetables and vegetable juices
• Cheeses, lower in fat
• Margarine
• Condiments like catsup, soy sauce
• Crackers and baked goods
• Processed lean meats
• Snack foods like chips, pretzels, nuts
• Rinse canned foods like tuna to remove some sodium.

4) If You Drink Alcoholic Beverages, Do So In Moderation.
Drinking too much alcohol can raise your blood pressure. It may also lead to the development of high blood pressure. So to help prevent high blood pressure, if you drink alcohol, limit how much you drink to no more than 2 drinks a day. The "Dietary Guidelines for Americans" recommend that for overall health women should limit their alcohol to no more than 1 drink a day.

This is what counts as a drink:

• 1-1/2 ounces of 80-proof or 1 ounce of 100-proof whiskey,
• 5 ounces of wine, or
• 12 ounces of beer (regular or light).

You may have heard that some alcohol is good for your heart health. Some news reports suggest that people who consume a drink or two a day have lower blood pressure and live longer than those who consume excessive amounts of alcohol. Others note that wine raises the "good" blood cholesterol that prevents the build up of fats in the arteries. While these news stories may be correct they don't tell the whole story: too much alcohol contributes to a host of other health problems, such as motor vehicle accidents, diseases of the liver and pancreas, damage to the brain and heart, an increased risk of many cancers, and fetal alcohol syndrome. Alcohol is also high in calories. So you should limit how much you drink.

What Else Might Prevent High Blood Pressure?
Other things also may help prevent blood pressure. Here's a roundup of what's being said about them-and whether it's true or false.

Dietary Supplements--Potassium, Calcium, Magnesium, Fish Oils.
Potassium. Eating foods rich in potassium will help protect some people from developing high blood pressure. You probably can get enough potassium from your diet, so a supplement isn't necessary. Many fruits, vegetables, dairy foods, and fish are good sources of potassium (see table below for examples).

GOOD SOURCES OF POTASSIUM

Catfish Lean Pork Lean Veal
Cod Flounder Trout
Milk Yogurt
Dry Peas and Beans Green Beans

Apricots Peaches Bananas
Prunes and Prune Juice Orange Juice
Lima Beans Stewed Tomatoes Spinach
Plantain Sweet Potatoes Pumpkin
Potatoes Winter Squash

SOURCE: Adapted from "Good Sources of Nutrients, Potassium"
U.S. Department of Agriculture, 1990

Calcium. Populations with low calcium intakes have high rates of high blood pressure. However, it has not been proven that taking calcium tablets will prevent high blood pressure. But it is important to be sure to get at least the recommended amount of calcium--800 milligrams per day for adults (pregnant and breastfeeding women need more)--from the foods you eat. Dairy foods like low fat selections of milk, yogurt, and cheese are good sources of calcium. Low fat and nonfat dairy products have even more calcium than the high fat types.

Magnesium. A diet low in magnesium may make your blood pressure rise. But doctors don't recommend taking extra magnesium to help prevent high blood pressure--the amount you get in a healthy diet is enough. Magnesium is found in whole grains, green leafy vegetables, nuts, seeds, and dry peas and beans.

Fish oils. A type of fat called "omega-3 fatty acids" is found in fatty fish like mackerel and salmon. Large amounts of fish oils may help reduce high blood pressure, but their role in prevention is unclear. But taking fish oil pills is not recommended because high doses can cause unpleasant side effects. The pills are also high in fat and calories. Of course, most fish if not fried or made with added fat are low in saturated fat and calories and can be eaten often.

Other Factors
Fats, Carbohydrates, and Protein. Varying the amount and type of fats, carbohydrates, and protein in the diet has little, if any, effect on blood pressure. But for overall heart health, it is crucial to limit the amount of fat in your diet, especially the saturated fat found in foods like fatty meats and whole milk dairy foods. Saturated fats raise your blood cholesterol level, and a high blood cholesterol level is another risk factor for heart disease. Foods high in fat are also high in calories.

Remember, foods high in complex carbohydrate (starch and fiber) are low in fat and calories--so eating these foods in moderate amounts instead of high fat foods can help you to lose weight if you are overweight or to prevent you from gaining weight.

Caffeine. The caffeine in drinks like coffee, tea, and sodas may cause blood pressure to go up, but only temporarily. In a short time your blood pressure will go back down. Unless you are sensitive to caffeine and your blood pressure does not go down, you do not have to limit caffeine to prevent developing high blood pressure.

Garlic or Onions. Increased amount of garlic and onions have not been found to affect blood pressure. Of course, they are tasty substitutes for salty seasonings and can be used often.

Stress Management. Stress can make blood pressure go up for a while and over time may contribute to the cause of high blood pressure. So it's natural to think that stress management techniques like biofeedback, meditation, and relaxation would help prevent high blood pressure. But this doesn't seem to be the case: the few studies that have looked at this have not shown that stress management helps to prevent high blood pressure. Of course, stress management techniques are helpful if they help you feel better or stick to a weight-loss and/or exercise program.

Here's a Recap
After going through all the things that may affect blood pressure, it's worth noting again the things that are sure to help you prevent high blood pressure:

1) Maintaining a healthy weight--losing weight if you are overweight,

2) Being more physically active,

3) Choosing foods low in salt and sodium, and

4) If you drink alcoholic beverages, doing so in moderation.

By following these guidelines, you can help reduce or prevent high blood pressure for life--and, in turn, lower your risk for heart disease and stroke.

A SAMPLE WALKING PROGRAM

Warm Up Target Zone Exercising * Cool Down Time Total
Week 1
Session A Walk normally 5 min. Then walk briskly 5 min Then walk normally 5 min. 15 min.
Session B --Repeat above pattern--
Session C --Repeat above pattern--

Continue with at least three exercise sessions during each week of the program. If you find a particular week's pattern tiring, repeat it before going on to the next pattern. You do not have to complete the walking program in 12 weeks.

Week 2 Walk 5 min. Walk briskly 7 min. Walk 5 min. 17 min.
Week 3 Walk 5 min. Walk briskly 9 min. Walk 5 min. 19 min.
Week 4 Walk 5 min. Walk briskly 11 min. Walk 5 min. 21 min.
Week 5 Walk 5 min. Walk briskly 13 min. Walk 5 min. 23 min.
Week 6 Walk 5 min. Walk briskly 15 min. Walk 5 min. 25 min.
Week 7 Walk 5 min. Walk briskly 18 min. Walk 5 min. 28 min.
Week 8 Walk 5 min. Walk briskly 20 min. Walk 5 min. 30 min.
Week 9 Walk 5 min. Walk briskly 23 min. Walk 5 min. 33 min.
Week 10 Walk 5 min. Walk briskly 26 min. Walk 5 min. 36 min.
Week 11 Walk 5 min. Walk briskly 28 min. Walk 5 min. 38 min.
Week 12 Walk 5 min. Walk briskly 30 min. Walk 5 min. 40 min.

Week 13 and thereafter:
Check your pulse periodically to see if you are exercising within your target zone. As you get more in shape, try exercising within the upper range of your target zone. Gradually increase your brisk walking time to 30 to 60 minutes, three or four times a week. Remember that your goal is to get the benefits you are seeking and enjoy your activity.

* Here's how to check if you are within your target heart rate zone:
1) Right after you stop exercising, take your pulse: Place the tips of your first two fingers lightly over one of the blood vessels on your neck, just to the left or right of your Adam's apple. Or try the pulse spot inside your wrist just below the base of your thumb.
2) Count your pulse for 10 seconds and multiply the number by 6.
3) Compare the number to the right grouping below: look for the age grouping that is closest to your age and read the line across. For example, if you are 43, the closest age on the chart is 45; the target zone is 88-131 beats per minute.
Return to top of "Sample Walking Program"

AGE TARGET HEART RATE ZONE
20 Years 100-150 beats per minute
25 Years 98-146 beats per minute
30 Years 95-142 beats per minute
35 Years 93-138 beats per minute
40 Years 90-135 beats per minute
45 Years 88-131 beats per minute
50 Years 85-127 beats per minute
55 Years 83-123 beats per minute
60 Years 80-120 beats per minute
65 Years 78-116 beats per minute
70 Years 75-113 beats per minute

SOURCE: Exercise and Your Heart, National Heart, Lung, and Blood Institute and the American Heart Association, NIH Publication No. 93-1677.

| Home | About Us | Prestigious Accreditations | Physicians | Services | FAQs | Links | Directions | Disclaimer | Contact Us |

Cardiology Associates of Fort Lauderdale, P.A.
4725 N. Federal Hwy, Suite #401
The Jim Moran Heart and Vascular Center
Fort Lauderdale, FL 33308
Phone: (954) 772-2136
Fax: (954) 772-7156

©2010, Cardiology Associates of Fort Lauderdale, P.A. All rights reserved.
Web site by Ticsay Internet.