Fight high blood pressure.

Taming the "silent killer"

As you have read, high blood pressure has earned its name, the "silent killer." It is subtle, yet it is devastating, often damaging the body without noticeable symptoms. But the very good news is that high blood pressure can be controlled with appropriate medication and lifestyle changes, such as diet and exercise.

The problem is that many people, including African Americans, don't take their medications faithfully. The American Heart Association notes that one billion, prescriptions are taken incorrectly every year. The result is worsened health, including about nine million adverse drug reactions a year. What's more, up to 21 percent of people who receive prescriptions for various medications never fill their prescriptions.

People with high blood pressure may mistakenly think that taking their medication once in a while or just when they "feel sick" will help them to stay healthy. If your doctor prescribes high blood pressure medication for you, there is a good chance you will have to take it all your life. This may seem like an inconvenience, lint consider the alternative--without your medication, you risk disability or even death. Taking your medication regularly whether you feel sick or well can often be the difference between living a long healthy life and living with increased risk of heart disease, stroke and kidney disease.

There are many different types of medications used to lower blood pressure, including diuretics, calcium channel blockers, angiotensin converting enzyme (ACE) inhibitors and beta blockers.

Your doctor may prescribe more than one type of medication. Diuretics work very well to lower high blood pressure in African Americans, especially if your high blood pressure has been caught early and is mild or moderate. Calcium channel blockers also work well in African Americans who need more than a diuretic. But beta blockers and ACE inhibitors do not tend to work well for African Americans unless they are also taking diuretics. In addition, some medications are more effective at controlling systolic blood pressure than others. It's important to ask your doctor which type of blood pressure medication would be best for you.

If you are like many Americans, you take some sort of medication or remedy that your doctor has not prescribed. These may take the form of over-the-counter, or OTC, medications. About one in three American adults uses unconventional therapies, such as special diets, chiropractic and megavitamins. Or perhaps you take herbal medicines. A landmark medical study found that 28 percent of people who see a doctor for a medical condition, such as high blood pressure, also use unconventional treatment for the problem. But most of these people--more than seven in ten--don't tell their doctors about their use of alternative medicines. Keeping your doctor in the dark is a bad idea because unsupervised use of unconventional therapy can be harmful.

Whatever your medication schedule, it will probably take your doctor a few office visits to adjust the dosage to your circulatory system's needs. There are medications that have a long-term record of safe clinical use and that require that you take only one daily dose. It is important that you follow your medication schedule and not skip a dose. You should take your medication every day until your doctor tells you to stop taking it. Also, don't forget to get your prescription refilled when it runs out. If you have another cardiovascular problem such as angina, be aware that your doctor may be able to give you a single high blood pressure medication that may help you with both conditions.

If you experience a problem with your blood pressure medication, call your doctor right away and then follow his or her instructions. Never suddenly stop taking your medication until your doctor tells you to because abruptly stopping medications can be and often is dangerous.

Optimizing your nutrition plays an important role in fighting high blood pressure. You should strive for a low-fat, high-fiber diet rich in fruits and vegetables and low in salt and sugar. Choosing foods with your blood pressure ill mind will be a challenge at first, but most people who stick with such a diet find that they gradually lose their taste for fatty, sugary foods.

Be sure to talk to your doctor about your diet, and then follow his or her advice. If your doctor doesn't mention nutrition, you should bring it up.

Here are the basics:

Throw your salt shaker away Salt is a combination of the elements sodium and chlorine and is our chief source of sodium, which tends to raise the blood pressure of African Americans more than that of whites. So you should reduce your salt intake to about a teaspoonful a day. You should also go easy on processed foods, that can supply 75 percent of dietary sodium.

Fat City African Americans tend to have a high dietary fat consumption, and this dietary preference greases the wheels of out-of-control health risks. It also makes us one of the heaviest people in the nation, setting us up for a wide spectrum of illnesses. In fact, 57 percent of African American men and 67 percent of African American women are overweight. So reduce the fat in your diet by choosing fish and turkey over red meat and by removing the skin from poultry. Also choose monounsaturated fats such as canola oil, which can be friendlier to your blood vessels. Other types of fats, especially saturated fat, promote atherosclerosis, or hardening of the arteries, which narrows arteries and drives up your blood pressure.

Green Scene Develop a passion for fruits and vegetables--the less processed, the better.

Grain of sense Eating whole and minimally processed gains promotes regularity, discourages colon cancer and may help keep your arteries and heart healthy as well by helping to regulate cholesterol levels. Grains are not for breakfast only. Beans and rice provide balanced protein, and whole-grain breads provide important vitamins. Learn to prepare delicious North African specialties such as couscous, hummus, tabouleh and bulghur as a delightful change from meat. Speaking of meat, you needn't become a vegetarian to fight high blood pressure. But take a cue from our African ancestors and make meat a side dish, not the main attraction.

Dining out In a restaurant, everything sometimes seems to work against the careful eater. Hefty portions are the norm and fatty meats top the menu. But you can eat well, even away from home, if you take a few minutes beforehand to decide what will make a smart dinner. Order salads with dressing on the side. Choose fish or turkey instead of beef and ask that your food be prepared without fat by boiling or baking it. Try fresh fruit or sorbet for dessert.

Try to avoid fast-food restaurants because many of their offerings are high in calories, fats, sugar and/or salt. But if you find yourself at the fast-food counter, ask for a nutrition card. Then choose foods relatively low in calories, fat, sugar and salt.

The soul-food pyramid symbolizes a healthy diet. A healthy diet includes 6-11 servings daily of grains and cereals at the base of the pyramid, 2-4 servings of fruits, 3-5 servings of vegetables, 2-3 servings of dairy and 2-3 servings offish, poultry or meat. Eat very little of the fats, oils and sweets at the narrow tip of the pyramid.

Soul-food pyramid [C] Hebni Nutrition Consultants, Inc.

SOUL-FOOD SUBSTITUTES

Prepare your favorite soul-food delicacy in a manner that kicks the
fat and sugar to the curb while embracing the taste.

Instead of ...               Try

Pork or ham hocks            Smoked turkey
in greens

Fried chicken or fish        Poached or baked chicken or fish

Sugar                        Spiced fruit juice, pineapple or
                             cinnamon

Mayonnaise                   Mustard, low-fat mayonnaise
                             substitute

Cream used in baking pies,   Evaporated milk whipped with
custards and crab cakes      egg whites

Butter                       Olive, canola or safflower oil

Salt                         Packaged no-salt seasoning or
                             potassium chloride

Candied yams                 Baked yams with cinnamon