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Virgin Islands Health Topics
HIGH BLOOD PRESSURE

VIRGIN ISLANDERS AND HIGH BLOOD PRESSURE
Anyone can develop high blood pressure, also called hypertension. People of African/Caribbean descent are at higher risk for this serious disease than any other racial or ethnic group. High blood pressure tends to be more common, happens at an earlier age, and is more severe for many African/Caribbeans.

The good news is that high blood pressure can be controlled and better yet, it can be prevented.

Many Virgin Islanders with high blood pressure refer to it as "the pressure". This may imply that it is caused by stress. Although stress can increase your blood pressure, it is usually a temporary condition, and blood pressure returns to normal, once you are relaxed.

But high blood pressure that is diagnosed by a physician is a very serious condition which, if not treated, can lead to stroke, heart attack, kidney failure, eye problems, and death.
Source: National Institutes of Health

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WHAT IS BLOOD PRESSURE?
Blood pressure is the force of blood pushing against your blood vessels. Your blood pressure is at its greatest when your heart contracts and is pumping blood. This is systolic blood pressure. When your heart rests between beats, your blood pressure falls. This is called diastolic blood pressure. Blood pressure is always given as these two numbers: the systolic and diastolic pressures, and are usually written one above or before the other, with systolic first, for example, 120/80.

When your blood pressure is high, your heart has to work harder than it should to pump blood to all parts of the body.

Your blood pressure should be checked by your health care provider at least once each year. If you have high blood pressure, it should be checked much more often. You can have your blood pressure checked at your doctor's office, your nearest clinic, or community health fairs. Make sure you measure the blood pressure in both of your arms each time, as the reading may be slightly different in each.

You can also check it yourself at home using a digital monitor. If you have a digital monitor, take it to your doctor's office to be checked for accuracy. You should have your monitor checked once a year. Be sure to follow the operating and storage instructions that come with the monitor. Ask your doctor or nurse to teach you how to use your blood pressure monitor correctly. Proper use of it will help you and your doctor achieve good results in controlling your blood pressure.
Reference: National Institutes of Health, 2004

Blood Pressure Categories for Ages 18 and Older
Normal:
High normal:
High blood pressure:
Systolic: 130 or less
Systolic: 130 -139
Systolic: 140 or more
Diastolic: 85 or less
Diastolic: 85 - 89
Diastolic: 90 or more
It is best to strive for an optimal blood pressure of 120/80 or less. However, a systolic pressure below 90 is considered too low.
Reference: American Heart Association, 2004

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SYMPTOMS
High blood pressure is called the "silent killer" because most people feel healthy and don't even know that they have it.

One out of four adult Americans are treated for high blood pressure, and only half of them have their blood pressure under control. But most disturbing is that a quarter of all people with hypertension may not realize they have it. People may not have symptoms until organ damage occurs, but early red flags are headaches, nosebleeds, chest discomfort, occasional weakness or numbness in arms or legs, and visual disturbances.
Reference: Woods, 2001

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PREVENTION
Making healthy changes in your lifestyle is generally the best and safest way to control your blood pressure. By doing so, you may be able to avoid taking medications, which can be costly and may have significant side effects. Even if you need medications to treat your blood pressure, lifestyle modification is still very important in your treatment.

If you make even a single healthy lifestyle modification, you may be up to 11 times more likely to achieve blood pressure control than someone who doesn't make any changes, according to the Mayo Clinic (2004). Still, only about half of those with high blood pressure even try to modify their lifestyle as a way to treat it.

For most people, these are not drastic changes in daily life. And you can enjoy many rewards from adopting a healthier lifestyle. When your blood pressure is under control, your risk of life-threatening complications (such as stroke, heart attack, kidney failure, eye problems and death), decreases and you may live a longer and happier life.
Source: National Institutes of Health

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LIFESTYLE RECOMMENDATIONS
Aim for healthy weight and fitness -
Blood pressure often increases as weight increases. Losing just 10 pounds can help reduce your blood pressure. If you're overweight and lose 22 pounds, your systolic blood pressure may drop as much as 20 points. Weight loss also helps increase the effectiveness of blood pressure medications.

Choose foods lower in fat and calories -
Eat smaller portions. Try not to gain extra weight. Lose weight if you are overweight. Lose weight slowly, about 1/2 to 1 pound each week until you reach a healthy weight. Click here to review popular diet plans.

Be physically active every day -
Walk a little further each day. Dance, skip, jump, run. Take every opportunity to move your body. Strength training can slow and even reverse declines in strength, bone density and muscle mass that occur as you age. Strength training is also helpful in controlling blood pressure.

Eat less salt -
Limiting salt consumption to less than 2 teaspoons a day, for instance, can reduce your systolic blood pressure by up to 8 points.

  • Read food labels. Canned foods are usually very high in salt. Choose foods with less salt and sodium.
  • Prepare lower sodium meals from scratch instead of using convenience foods that are high in sodium.
  • Use spices, herbs, and salt free seasoning blends instead of salt.
  • Use only small amounts of cured or smoked meats for flavor.
  • Use less salt when cooking. Try using Mrs. Dash (contains potassium chloride instead of sodium chloride); or Light Sazon which contains less salt.
  • Avoid foods like salt fish, salt pork and souse.
  • Eat 2 to 4 servings of fruits and vegetables, and 3 to 5 servings of WHOLE grains each day.
  • Eat fewer red meats, sweets and beverages with sugar or high fructose corn syrup.

When you cook, try adding herbs and spices instead of salt. For example:
  • Chicken or Turkey - Ginger, rosemary, thyme, curry powder, dill, sage, tarragon, oregano, cloves, orange rind.
  • Fish - Curry powder, pepper, lemon juice, ginger, marjoram, onion, paprika.
  • Mutton or Pork - Garlic, onion, sage, ginger, curry, cloves, bay leaf, oregano.
  • Okra - Garlic, pepper, thyme, onion.
  • Greens - Thyme, ginger, onion, dill, garlic.
  • Potatoes - Garlic, pepper, paprika, thyme, onion,sage.
  • Beans - Thyme, onion, dill, cumin, oregano, garlic, tarragon, rosemary.

Cut back on the alcohol -
Alcohol raises blood pressure. Alcohol also adds calories and may make it harder to lose weight. Men who drink should have no more than two drinks a day. Women who drink should have no more than one drink a day. Pregnant women should not drink any alcohol.

Reduce stress -
As with caffeine, the influence of stress on blood pressure isn't completely known. Stress or anxiety might temporarily increase blood pressure. That's why some people develop "white-coat hypertension", a brief rise in blood pressure when they visit the doctor's office or are in stressful situations, for instance. Some evidence suggests that stress, especially job stress, can lead to long-term increases in blood pressure. Here's what can you do:

  • Take time to think about what causes you to feel stressed, such as work, family, finances or illness. Being aware of what causes your stress is important, but making behavior or lifestyle changes will help you cope.
  • Relaxation techniques, such as yoga and meditation, also might help. Learning how to do deep breathing from your diaphragm can be relaxing and help reduce blood pressure.
  • Talk to your doctor or nurse if you aren't sure what kinds of lifestyle changes you need or how to make them.

Source: National Institutes of Health

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MEDICATION
Follow these important tips if you take medicine for high blood pressure, a category of drugs known as anti-hypertensives:

  • Take your medicine the way your doctor tells you. To help you remember, plan to take your medicine at the same time every day. If you're taking more than one medication, make a chart for yourself.
  • Tell the doctor right away if the medicine makes you feel sick or dizzy. The doctor may make changes in your medicine, or lower the dosage.
  • Make sure you don't miss any days. If you do, do not double up on the dose, as your blood pressure may drop too low.
  • Drugs for high blood pressure often deplete potassium levels in your body. Eat potassium rich foods each day, like bananas or orange juice.
  • Refill your prescription before you run out of your medicine.
  • Have your blood pressure checked often to be sure your medicine is working the way you and your doctor have planned.
  • Don't stop taking your medicine if your blood pressure is okay--that means the medicine is working!

Source for this section: National Institutes of Health

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HERBAL THERAPIES
NOTE: Ask your doctor about using herbal remedies, especially if you are taking prescription medication! Drug and herbs can interact and create serious side effects!

Many Virgin Islanders use plants and herbs to treat their health. In "Traditional Plants of St. Croix, St. Thomas and St. John" (1997), Toni Thomas lists the following local plants as being used for high blood pressure:
Love Bush, Love Weed, Love Vine.

For kidney problems:
Beggar's Tick, Spanish Needle.

In Mosby's 2006 Nursing Drug Reference, these herbs are listed for treating high blood pressure:

Astragulus, Borage, Garlic, Goldenseal, Hawthorn, Maitake, Passionflower, Yarrow.

RESOURCES IN THE VIRGIN ISLANDS

Virgin Islands Chronic Disease Prevention Program
St. Croix - Charles Harwood Hospital, 340-773-1311
St. Thomas - Community Health at Schneider Hospital, 340-774-7477
St. John - Myra Keating Smith Clinic, 340-693-8900

SOURCES

National Library of Medicine and the National Institutes of Health

American Heart Association

The Mayo Clinic

REFERENCES

American Heart Association (2004). http://www.americanheart.org.

Mayo Clinic (2004)

National Institutes of Health (2004)

Skidmore-Rush, L. (2006). Mosby’s 2006 Nursing Drug Reference. St. Louis: Mosby.

Thomas, T. (1997). Traditional Medicinal Plants of St. Croix, St. Thomas and St. John. St. Thomas: University of the Virgin Islands Cooperative Extension Service.

Woods, A. D. (2001). Improving the odds against hypertension. Nursing 2001, (8), 36 - 41.

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