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Session 4 - Help Your Heart: Control Your High Blood Pressure

Objectives

By the end of this session, group members will learn:

  • What blood pressure is
  • That it is best to have a blood pressure below 120/80 mmHg (millimeters of mercury)
  • That blood pressure between 120/80 and 139/89 mmHg is prehypertension
  • That a blood pressure of 140/90 mmHg or greater is high
  • What a stroke is and what the warning signs are
  • That eating less salt and sodium can lower the risk of developing high blood pressure
  • That they can take steps to lower the amount of salt and sodium in their diet

Materials and Supplies

To conduct this session, you will need:

  • "With Every Heartbeat Is Life" manual and picture cards
  • Blackboard and chalk or several large pieces of paper, a marker, and tape
  • Measuring spoons (1 teaspoon, ¼ teaspoon)
  • Small amount of salt
  • Ms. Diane's seasoning mixture. Prepare enough to give a small sample to each group member in a plastic bag or cup.
  • (Optional) Note: Arrange for a health professional to come to the session to take blood pressure readings.

Handouts

Give these handouts to each group member during this session:

* Prepare this list before the session. You may find information at your local health department, hospital, or clinic.

Session Outline

Introducing the Session

  1. Welcome
  2. Review of Last Week's Session
  3. About This Session

Conducting the Session

  1. The Facts Don't Lie
  2. Facts About Blood Pressure and Stroke
  3. Lowering High Blood Pressure
  4. Salt and Sodium—How Much Do We Need?
  5. Food Label Activity—Sodium
  6. Shake the Salt and Sodium Habit
  7. Easy on the Alcohol
  8. Manage Your High Blood Pressure With Medicine
  9. Soul Food Makeover—Vegetable Stew Recipe

Review of Today's Key Points

Weekly Pledge

(Optional) Blood Pressure Check

Closing


Introducing the Session

  1. Welcome
    • Welcome group members to the session.
  2. Review of Last Week's Session
    • Say:
      Last week, we talked about why you should be physically active. What do you remember about the benefits of being physically active?
    • Note: Allow about 3 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add the following benefits if they are not mentioned.
      Physical activity:
      • Strengthens your heart and lungs.
      • Builds and maintains healthy bones, muscles, and joints.
      • Helps you feel better about yourself.
      • Helps you control your weight.
      • Helps you lower your high blood pressure.
      • Helps you control your blood cholesterol.
      • Helps you sleep better.
      • Helps you reduce stress and feelings of depression and anxiety.
      • Helps you have more energy.
      • Helps lower your chances of developing diabetes, heart disease, and cancer.
    • Say:
      At the end of our last session, everyone made a pledge to be more active.
    • Note: Share with the group what you did and what barriers you faced.
    • Ask:
      Would any of you like to share with the group what you did? What problems did you face (such as not having time or not getting family support)? How did you solve them?
    • Note: Allow about 5 minutes for responses.
    • Ask:
      Has anyone completed the family health history?
    • Note: Give a prize to group members who have completed the family health history.
    • Ask:
      Does anyone want to share what you have learned about your family health history?
    • Note: Allow about 5 minutes for group members to respond.
  3. About This Session
    • Say:
      Rev. Dr. Martin Luther King, Jr., said, "The time is always right to do
      what is right."
    • Ask:
      What does this quote mean to you?
      Note: Allow 5 minutes for group members to respond.
    • Say:
      Today's session is about blood pressure and the steps you can take to lower your blood pressure or keep it from rising.

Conducting the Session

  1. The Facts Don't Lie
    • Say:
      • More than 65 million people (one in three) in the United States have high blood pressure, which is also called hypertension. Nearly a third of these people don't know they have high blood pressure.
      • Another 59 million Americans have prehypertension, which means they are at risk of developing high blood pressure.
      • Four in 10 African Americans have high blood pressure.
      • African Americans are more likely to have high blood pressure than any other racial or ethnic group in this country. In fact, African Americans have one of the highest rates of high blood pressure in the world.
      • High blood pressure tends to develop at an earlier age and to be more severe in African Americans than in whites.
      • African American women are especially at risk. Compared to white women, African American women are three times more likely to die from heart disease or stroke before age 60.
      • Each year, more than 19,000 African Americans die of stroke
  2. Facts About Blood Pressure and Stroke
    • Show picture card 4.1.
    • Say:
      Blood pressure is the force of blood against the walls of your arteries. Blood pressure is needed to move the blood through your body.
      Note: Blood pressure is measured in millimeters of mercury, which is written as mmHg in this manual. When you see mmHg, you should say millimeters of mercury.
    • Show picture card 4.2.
    • Say:
      Blood pressure is recorded as two numbers——the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats).
    • Say:
      The measurement is written one above the other, with the systolic number on top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mmHg is expressed verbally as "120 over 80."
    • Say:
      It is important to keep track of your blood pressure numbers. Write down your numbers every time you have your blood pressure checked.
    • Ask:
      Do you know your blood pressure numbers?
    • Note: Allow about 2 minutes for group members to respond.
    • Note: Copy this chart on the blackboard or on a large piece of paper taped to the wall.
      Your Blood Pressure Numbers
      Level First number (mmHg) Second number (mmHg) Results
      Normal Below 120 Below 80 Good for you!
      Prehypertension 120—139 80—89 Keep an eye on your blood pressure.It is time to make changes in your eating and physical activity habits. Visit the doctor if you have diabetes.
      High blood pressure 140 or greater 90 or greater Ask your doctor or nurse how to control it.
    • Say:
      A normal blood pressure is less than 120/80 mmHg. Blood pressure between 120/80 to 139/89 mmHg is prehypertension. This means that you don't have high blood pressure yet, but are likely to develop it in the future, unless you make changes in your health habits. Blood pressure is high when it is 140/90 mmHg or greater.
    • Show picture card 4.3.
    • Say:
      If you have high blood pressure—or hypertension—it means your heart has to pump harder than it should to get blood to all parts of your body. High blood pressure raises your chances for having a heart attack, a stroke, kidney problems, or becoming blind.
    • Say:
      High blood pressure is known as the "silent killer" because it often has no symptoms. Most people who have it don't feel sick until they have a stroke, heart attack, or some other problem caused by high blood pressure.
    • Say:
      High blood pressure is a major reason why African Americans are more likely than other racial or ethnic groups to die from stroke.
    • Say:
      High blood pressure is a major risk factor for stroke. Other risk factors that increase your chances of having a stroke include heart disease, smoking, diabetes, obesity, and high blood cholesterol.
    • Ask:
      Do you know anyone who has had a stroke?
    • Note: Allow a few minutes for group members to respond.
    • Give group members the "Know the Stroke Signs. Act Quickly." handout.
    • Show picture card 4.4.
    • Say:
      A stroke is also called a brain attack. A stroke happens when blood suddenly stops going to the brain and brain cells die. A stroke is very serious and can lead to disability and death.
      The warning signs of a stroke happen suddenly. A person may have one or more warning signs. The warning signs of a stroke include:
      • Numbness of the face, arm, or leg (especially on one side of the body)
      • Confusion, trouble talking, and difficulty understanding others
      • Trouble seeing in one or both eyes
      • Trouble walking, dizziness, and loss of balance or coordination
      • Severe headache
    • Say:
      Ministrokes, or transient ischemic attacks (TIAs), have the same symptoms as a stroke, but they do not last as long and usually do not cause brain damage. A ministroke is a warning that a stroke may happen in the future.
    • Say:
      Ministrokes may last a few seconds or an entire day and then go away. These signs should not be ignored. As with a heart attack, act immediately if you or someone you know has stroke symptoms. Calling 9—1—1 right away will help prevent serious problems.
    • Show picture card 4.5.
    • Say:
      Measuring blood pressure is easy and does not hurt. The best way to find out if you have high blood pressure is to have it checked at least once a year. Check it more often if you already have high blood pressure.
    • Give group members:
    • Say:
      Ask for your numbers each time you have your blood pressure checked. Keep a record of each reading on the wallet card.
  3. Lowering High Blood Pressure
    • Ask group members to raise their hands if someone in their families has high blood pressure.
    • Say:
      If a member of your family has high blood pressure, you are at greater risk for getting it, too. Even if you do not have high blood pressure now, you are still at greater risk if a family member has it.
    • Say:
      The good news is that you can take steps now to lower your blood pressure or keep it from rising. Let's find out how.
    • Give each group member the "Take Steps—Healthy Habits To Lower High Blood Pressure!" handout.
    • Read aloud the steps to lower high blood pressure or keep it from rising.
    • Ask:
      Which steps could you and your family take to prevent or lower high blood pressure?
    • Note: Allow 3 minutes for group members to respond.
  4. Salt and Sodium—How Much Do We Need?
    • Note: For this activity, you will need a 1/4 teaspoon measuring spoon, a 1 teaspoon measuring spoon, and some salt. Use a colored plate or a plastic test tube to show the sodium levels.
    • Say:
      Eating less salt and sodium can help you prevent or lower high blood pressure.
      You know what salt is, but you may wonder what sodium is. Sodium is a part
      of salt. It is also part of mixtures used to flavor and preserve foods.
    • Say:
      Some people, including many African Americans, are more sensitive to salt and
      sodium and may need to be especially careful about how much salt they eat.
    • Note: Use the measuring spoon to show ¼ teaspoon of salt.
    • Say:
      Now let's look at how much sodium we really need. The body needs only about
      500 milligrams of sodium each day. That's about ¼ teaspoon of salt.
    • Say:
      Most people are eating much more than 500 milligrams of sodium every day.
    • Say:
      You should cut back the amount of sodium you get from all foods and beverages to less than 2,300 milligrams of sodium, or about 1 teaspoon of salt per day.
    • Note: Now show 1 teaspoon of salt.
    • Say:
      If you have high blood pressure, it would be helpful to decrease your sodium intake to 1,500 milligrams of sodium per day.
      Note: Now show 2/3 teaspoon of salt.
    • Say:
      Most people in the United States eat about 4,000 to 6,000 milligrams of sodium each day.
    • Note: Now show 2 ½ teaspoons of salt.
    • Say:
      This is about 8 to 12 times more sodium than the body needs. Eating this much salt and sodium may lead to high blood pressure.
    • Show picture card 4.6.
    • Say:
      Let's talk about what foods are high in sodium. Most of the sodium that we eat comes from packaged foods, and from restaurants and fast foods. Examples of packaged foods are:
      • Regular canned soups and vegetables
      • Frozen dinners
      • Macaroni and cheese
      • Canned fish and meats, such as salmon, tuna, sardines, and vienna sausages
      • Salty chips
      • Regular lunch meats, such as bologna
      • Meats high in sodium, such as hotdogs or bacon

        When you eat out, most of the food will be high in sodium. If you have high blood pressure, you should eat out less often.

        Sodium also comes from salt added during cooking or at the table.
  5. Food Label Activity—Sodium
    • Show picture card 4.7.
    • Say:
      The food label found on packaged foods is one of the best tools we have for choosing foods for a healthy diet. In this session, we will learn how to use the food label to choose foods that are lower in sodium.
    • Give group members the "Read the Food Label for Sodium!" handout.
    • Say:
      The food label lists the serving size and number of servings in the container. It also gives the amount of calories, sodium, saturated fat, trans fat, and cholesterol in one serving of the food. We will talk about calories, saturated fat, trans fat, and cholesterol in the next two sessions.
    • Point to where the Percent Daily Value is located on the food label.
    • Say:
      The Percent Daily Value helps you compare products. It tells you if a food is high or low in various nutrients. Remember—it is easy to take in more than 2,300 milligrams of sodium. Choose foods with a lower Percent Daily Value for sodium. A Percent Daily Value of 5 or less is low, and a Percent Daily Value of 20 or more is high. Once you get into the habit of looking at food labels, it will be easy.
    • Say:
      Let's take a close look at the Nutrition Facts on an actual label to find the amount of sodium. Let's go back to the "Read the Food Label for Sodium!" handout.
    • Point again to picture card 4.7.
    • Say:
      The food label found on packaged foods is one of the best tools we have for choosing foods for a healthy diet. The Percent Daily Value for sodium in packaged noodle soup is circled on the food label.
    • Say:
      The sodium content of the same food can vary, depending on how it is packaged or what brand it is. Compare food labels to choose foods that are lower in sodium.
    • Say:
      Look at the bottom of the handout. Look at the Percent Daily Value for low-sodium soup and for packaged noodle soup. Which soup is lower in sodium?
    • Say:
      Low-sodium soup is lower in sodium. One serving of low-sodium soup has only 9 percent of the Daily Value for sodium. One serving of packaged noodle soup has 34 percent of the Daily Value for sodium, which is almost four times more sodium than low-sodium soup.
    • Say:
      You can also think of the Percent Daily Value like a budget. For example, if you have a daily budget of $100 for all of your sodium needs for 1 day, and from that daily budget you spend $34 (Percent Daily Value) on one serving, that serving has cost you more than a third of your daily budget. That's not too bad for a whole meal, but it is for one food item. You now have only $66 left. You could easily go over your sodium budget for that day if the sodium content of the rest of your foods is also "expensive."

    More Information: Potassium, Calcium, and Magnesium

    The latest research shows that foods rich in potassium are important in protecting against high blood pressure. Foods rich in calcium and magnesium may help, too. Eat foods that are a good source of these nutrients:

    Potassium: bananas, tomatoes, potatoes, oranges, prunes, spinach, and dry beans

    Calcium: low-fat milk; low-fat, reduced-sodium cheese; low-fat yogurt; calcium-fortified orange juice; leafy greens; and fresh or rinsed canned fish

    Magnesium: whole-grain breads and cereals, beans, nuts, seeds, okra, and spinach

    More Information: The DASH Eating Plan To Lower Your Blood Pressure

    One eating plan that can lower blood pressure is Dietary Approaches To Stop Hypertension (DASH). By using the DASH plan, you can lower blood pressure by eating:

    • Lots of fruits and vegetables
    • Fat-free or low-fat milk products
    • Whole-grain products
    • Fish, poultry, and lean meats
    • Nuts, seeds, and dry beans

    The DASH eating plan also includes:

    • Less salt and sodium
    • Small amounts of fats and oils
    • Small amounts of sweets and beverages that are high in sugar

    People with high blood pressure will get extra benefits from following the DASH eating plan and eating foods low in salt and sodium. This combination also is heart healthy for people who don't have high blood pressure.

  6. Say:
    Choosing and preparing foods that are lower in salt and sodium may help prevent or lower high blood pressure. Eating more fruits and vegetables, whole-grain breads and cereals, and fat-free or low-fat milk products also may help lower blood pressure.
  7. Say:
    If you have trouble eating milk products or have a problem digesting lactose, try using lactose-free products that are low in fat, such as low-fat soy milk.
  8. Say:
    Let's try an activity that will help us choose foods that are low in salt and sodium. First, I am going to describe a situation that may apply to
    you or to family members. Then, using food labels, we are going to learn how to choose lower sodium foods.
  9. Give each group member the "Darnell's Food Choices" handout. Read or ask a volunteer to read the story below.

Darnell's Food Choices

During a recent visit to the doctor, Darnell learned that he has high blood pressure. The doctor told him to cut back on the amount of sodium he eats. Use the food labels to help Darnell choose foods that will help him follow his doctor's advice.

  • Say:
    Let's go over some questions. Use the food labels to choose food that is lower in sodium.
  • Ask these questions. Give the correct answer after group members guess.
Questions Correct Answers
When buying juice, should Darnell choose tomato juice or orange juice? Orange juice
At a neighbor's picnic, should Darnell choose barbecued chicken or herb-seasoned roasted chicken (skinless and with no added salt)? Herb-seasoned roasted chicken (skinless and with no added salt)

Should Darnell buy frozen peas or canned peas? Frozen peas
Should Darnell eat a buttermilk biscuit or an english muffin? English muffin
Should Darnell snack on a handful of salted mixed nuts or a handful of unsalted, dry roasted mixed nuts? Unsalted, dry roasted
mixed nuts

  • Shake the Salt and Sodium Habit
    • Give group members the "Sodium in Foods" handout.
    • Ask:
      Does anyone see a food on the right side of the page that you eat often?
    • Ask the person to name a lower-sodium food on the left side that he or she could eat instead.
    • Say:
      Let's now review some practical tips that will help you cut back on salt and sodium.
    • Give each group member the "Keep Your Heart in Mind: Eat Less Salt and Sodium" handout. Review the tips on how to cut back on salt and sodium when shopping, cooking, and eating.
    • Say:
      Here is a sample of Ms. Diane's secret recipe from the bottom of the "Keep Your Heart in Mind" handout. Fill an empty salt shaker with this seasoning mixture, and put it on your table. Tell your family to try it instead of salt.
    • Give each group member a sample of Ms. Diane's seasoning mixture.
    • Ask:
      Why is it hard for you to cut back on salt and sodium?
    • Note: Allow 3 minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall. Then write down some possible solutions. See the "Salt Solutions Examples" box for some problems and solutions.

    Salt Solutions Examples

    Problems You May Encounter Solutions
    The food has no flavor. Use herbs or spices to add flavor to foods. See the "Use Herbs and Spices Instead of Salt" handout.
    Family members will get upset. Cut back on salt slowly. Use less salt each time you cook, so family members can get used to the taste.
    Adding salt is a habit that is hard to break. Give yourself time to get used to using less salt. Choose brands that are lower in salt. Take the saltshaker off the table.
  • Easy on the Alcohol
    • Say:
      Drinking too much alcohol can raise your blood pressure. It can also harm the liver, brain, and heart. Alcoholic drinks also contain calories. The extra calories can make it hard to control your weight.
    • If you don't drink alcohol, don't start. If you drink alcohol, drink only a moderate amount. That means:
      • Men should have no more than two drinks a day.
      • Women should have no more than one drink a day.
      • Pregnant women should not drink any alcohol.
    • Ask:
      What do you think counts as one drink?
    • Note:Allow 2 minutes for group members to respond.
    • Say:
      One drink is:
      • 12 ounces of beer (regular—150 calories; light—100 calories)
      • 5 ounces of wine (100 calories)
      • 1 ½ ounces of liquor (100 calories)
  • Manage Your Blood Pressure With Medicine
    • Say:
      If you have high blood pressure, making the lifestyle changes we just discussed may not be enough to lower your blood pressure. Medications are available to lower blood pressure. They work in different ways.
    • Give group members the "Tips for Taking Medicine for High Blood Pressure" handout.
    • Ask:
      Do any of you take medicine for high blood pressure?
    • Read aloud the "Tips for Taking Medicine for High Blood Pressure" handout.
    • Ask:
      If you are taking medication for high blood pressure, what are some things you can do to help your medicines work better?
    • Note: Allow a few minutes for group members to respond. Write their answers on the blackboard or on a large piece of paper taped to the wall.
    • Add the following things if they are not mentioned:
      • Ask your doctor the name of your medicine and how to take it.
      • Take your medicine the way the doctor tells you.
      • Tell your doctor the names of all other medicines, home remedies, herbs, or supplements you take.
      • Tell your doctor if the medicine makes you feel strange or sick.
      • Refill your prescription before you run out of medicine.
      • Have your blood pressure checked to see if the medicine is working for you.
      • Keep taking the medicine as your doctor tells you, even if your blood pressure is okay.

    More Information

    • Many people with high blood pressure may take more than one medicine to control their blood pressure.
    • Some medicines can cause side effects or reactions. If this happens, talk to your doctor.
    • Eating more fruits and vegetables, cutting back on salt and sodium, losing weight, and being physically active can help your medicines work better.
  • Soul Food Makeover—Vegetable Stew Recipe

Review of Today's Key Points

  • Say:
    Let's review what we learned today.
  • What is blood pressure?
    • Blood pressure is the force of blood against the walls of your arteries. Blood pressure is needed to move blood through your body.
  • What is a normal blood pressure?
    • A normal blood pressure is below 120/80 mmHg.
  • What is prehypertension?
    • Blood pressure of 120/80 to 139/89 mmHg is prehypertension. This means that you don't have high blood pressure yet, but you're likely to develop it in the future unless you make changes in your health habits.
  • What is high blood pressure?
    • High blood pressure is 140/90 mmHg or greater. Have your blood pressure checked. If it is 140/90 mmHg or greater, see your doctor.
  • Why is high blood pressure dangerous?
    • High blood pressure can lead to heart attack, stroke, kidney problems, eye problems, and death.
  • What can you do to help make your blood pressure medicine work better?
    • Eat more fruits and vegetables, cut back on salt and sodium, lose weight, and be more physically active. Take your medicine as your doctor tells you. Talk to your doctor about side effects.
  • Why should you cut back on salt and sodium in your food?
    • You should cut back on salt and sodium to help prevent or lower high blood pressure.
  • What are some ways to cut back on salt and sodium?
    • Use herbs and spices to season foods. Be careful! Some seasonings such as garlic salt and onion salt are high in sodium. Check the food label to choose foods lower in sodium. Eat more fruits and vegetables for snacks instead of salty snacks such as nuts, pretzels, or chips.
  • How can drinking alcohol affect your blood pressure?
    • Drinking too much alcohol can raise blood pressure.
  • What is a stroke?
    • A stroke is a brain attack. A stroke happens when blood suddenly stops going to the brain. This can happen for different reasons. One example is when a blood vessel bursts. Another way is when a clot blocks the arteries. Either way, the result is the same: blood stops going to the brain, and brain cells die. Both types of stroke are very serious and can lead to disability and death.

Weekly Pledge

  • Say:
    You have learned a lot today about how to prevent and control high blood pressure. You also learned how to cut back on salt and sodium. Now let's think about how you can practice what you have learned. Please think of one change you can make in your everyday life. This will be your pledge for the week.
  • Say:
    Be specific about what you plan to do, how you plan to do it, and when you will start. Here are some examples:
    • I will get my blood pressure checked within the next month.
    • I will read food labels the next time I go to the store to help me choose canned soups that are lower in sodium, or I will prepare homemade soup without adding salt.
    • I will rinse canned foods with water before I cook or eat them, starting tomorrow.
    • I will take the salt shaker off the table, starting tomorrow.
  • Say:
    Write your pledges on the back of the "Keep Your Heart in Mind: Eat Less Salt and Sodium" handout. Keep this handout in a special place so you can review your pledges and keep your goals in mind.
  • Note: Allow 5 minutes for group members to think of a pledge and write it down.
  • Say:
    Would anyone like to share his or her pledge with the group?
  • Note: Write down pledge ideas on the blackboard or on a large piece of paper taped to the wall.
  • (Optional) Say:
    Keeping a personal value in mind can help you make changes in your everyday life to prevent and control high blood pressure. Remember that a personal value is a quality that you consider important.
  • Today's value is openness. Being open means you are willing to consider making changes to improve your health, such as cutting back on foods high in salt and sodium.
  • Say:
    As today's quote states, "The time is always right to do what is right." I hope all of you will encourage your family and friends to grow wiser in heart health by learning how to prevent and control high blood pressure.
  • Ask:
    How can you use openness, or another value, to help you keep your pledge?
  • Note: Allow 3 minutes for group members to share their thoughts.
  • Say:
    We will talk about how you did with your pledge at the next session. Remember to keep working on your pledge to be more physically active.

(Optional) Blood Pressure Check

(Optional—Try to get a health professional to come to your session.)

  • Tell group members that a health professional will now check everyone's
    blood pressure.
  • Ask group members to write their blood pressure numbers on the wallet card.

Closing

  • Say:
    Thank you for coming today. What did you think of today's session?
  • Note: Wait to see if group members have a response.
  • Say:
    I am looking forward to seeing you at the next session. The next session will be about how to prevent and control high blood cholesterol. Please continue to fill out your family health histories.
  • Note: Think about today's session. What worked and what didn't work? Have you decided to make any changes in your own life based on what was covered in today's session?

Handouts

Know the Stroke Signs. Act Quickly.

A stroke happens when blood suddenly stops going to the brain and brain cells die. A stroke is very serious and can lead to disability and death.

Signs of a stroke:

  • Numbness of the face, arm, or leg (especially on one side of the body)
  • Confusion, trouble talking, and difficulty understanding others
  • Trouble seeing in one or both eyes
  • Trouble walking, dizziness, and loss of balance or coordination
  • Severe headache

A Stroke Is Serious. Every Second Counts.

  • Learn the stroke signs and teach them to your family and friends.
  • Call 9—1—1 immediately if you have any of these stroke warning signs.
  • Treatment can reduce the risk of damage from a stroke. You must get help within 3 hours of your first symptoms.

Adapted from the American Stroke Association, "Let's Talk About Risk Factors for Stroke." 1999—2003. A division of the American Heart Association.

My Healthy Heart Wallet Card

Panel 1

Take Care of Your Heart

Check your:

blood pressure, blood cholesterol, weight, waist measure, and blood glucose

Panel 2

Weight
Date
Value
Waist measure
Men—40 inches or less
Women—35 inches or less
Date
Value

Blood tests to check sugar in the blood for diabetes

Blood glucose (fasting) — Less than 100
Date
Value
A1C — 7% or less
Date
Value

Talk to your doctor about what these numbers mean!

Panel 3

Blood Pressure — Less than 120/80 mmHg
Date
Value

Blood tests to measure fats in the blood

Total Cholesterol — Less than 200 mg/dL
Date
Value
LDL
Less than 100 mg/dL—ideal
Less than 130 mg/dL—near ideal
Date
Value
>HDL — 40 mg/dL or more
Date
Value
Triglycerides — Less than 150 mg/dL
Date
Value

Panel 4

Try these tips for a healthy heart!

More
+ fruits, vegetables, whole grains, and fat-free or low-fat milk products
+ physical activity

Less
— calories, saturated and trans fat, cholesterol, and sodium
— weight and waist measure

None
0 cigarettes

= a healthy heart

U.S. Department of Health and Human Services
National Institutes of Health
National Heart Lung and Blood Institute

Take Steps—Healthy Habits To Lower High Blood Pressure!

To prevent high blood pressure:

  1. Aim For a healthy weight.
    Try not to gain extra weight. Lose weight if you are overweight. Try losing weight slowly, about 1 to 2 pounds each week until you reach a healthy weight.
  2. Be active every day for at least 30 minutes.
    You can walk, dance, play sports, or do any activity you enjoy.
  3. Eat less salt and sodium.
    Buy foods marked "sodium free," "low sodium," or "reduced sodium." Take the salt shaker off the table.
  4. Eat more fruits and vegetables, whole-grain breads and cereals, and fat-free or low-fat milk products.
  5. Cut back on alcohol.
    Men who drink should have no more than one or two drinks each day. Women who drink should have no more than one drink a day. Pregnant women should not drink any alcohol.

To lower high blood pressure:

  1. Practice these steps:
    • Maintain a healthy weight.
    • Be active every day for at least 30 minutes.
    • Eat fewer foods high in salt and sodium.
    • Eat more fruits and vegetables, whole-grain breads and cereals, and fat-free or low-fat milk products.
    • Cut back on alcoholic beverages.
  2. Take your medicine the way your doctor tells you.
  3. Have your blood pressure checked often.

Read the Food Label for Sodium!

Food labels tell you what you need to know about choosing foods that are lower in sodium. Here's a food label for packaged noodle soup.

Packaged Noodle Soup

Nutrition Facts
  Packed Noodle Soup
Serving Size 1/2 block
Servings Per Container 2
Amount Per Serving Calories 190
Calories from Fat 70
Nutrient % Daily Value*
Total Fat 8g = 12%
Saturated Fat 4g = 20%
Trans Fat 0g
Cholesterol 0mg = 0%
Sodium 820mg = 34%
Total Carbohydrate 26g = 9%
Dietary Fiber 1g = 4%
Sugars 1g
Protein 5g
Vitamin A 2%
Vitamin C 2%
Calcium 2%
Iron 6%

Amount Per Serving
The nutrient amounts are for one serving. So, if you eat the whole block of noodles, you are eating two servings, and you need to double the nutrient amounts.

Nutrients
Listed are the amounts of sodium in one serving. These amounts are listed in milligrams (mg).

Serving Size and Number of Servings
The serving size is ½ of the block of noodles. The package contains two servings. Remember, the numbers on the label are for one serving, not the whole package.

Percent Daily Value
The Percent Daily Value helps you compare products and quickly tells you if the food is high or low in sodium. Choose products with the lowest Percent Daily Value for sodium: 5 percent or less is low, and 20 percent or more is high.

The Choice Is Yours—Compare!

Which one would you choose?

Low-sodium soup is lower in sodium than packaged soup.
Read the food labels, and choose foods that are lower in sodium to help keep your heart strong.

Low-Sodium Soup
One serving (1 cup) of low-sodium soup, has 210 mg of sodium and 9 percent of the Daily Value for sodium.

Nutrients % Daily Value*
Amount Per Serving Calories 90
Calories from Fat 0
Total Fat 0g = 0%
Saturated Fat 0g = 0%
Trans Fat 0g
Cholesterol 0mg = 0%
Sodium 210mg = 9%

Packaged Noodle Soup
One serving, ½ block of the packaged noodle soup, has 820 mg of sodium and 34 percent of the Daily Value for sodium. This is nearly four times the amount of sodium in a serving of low-sodium soup.

Nutrients % Daily Value*
Amount Per Serving Calories 180
Calories from Fat 0
Total Fat 1.5g = 12%
Saturated Fat 4g = 20%
Trans Fat 0g
Cholesterol 0mg = 0%
Sodium 820mg = 34%

* Percent Daily Values are based on a 2,000-calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

Darnell's Food Choices

During a recent visit to the doctor, Darnell learned that he has high blood pressure.

The doctor told him to cut back on the amount of sodium he eats.

Use the food labels to help Darnell choose foods that will help him follow his doctor's advice.

Mark the number of your choice for each pair in the space between the labels.

  Food 1 Food 2
Nutrient Tomato Juice Orange Juice
Serving Size 8 fl oz (240mL) 8 fl oz (240mL)
Servings Per Container 8 8
Amount Per Serving Calories = 40
Calories from Fat 0
Calories = 110
Calories from Fat 0
Total Fat 0g = 0% 0g = 0%
Saturated Fat 0g = 0% 0g = 0%
Trans Fat 0g 0g
Cholesterol 0mg = 0% 0mg = 0%
Sodium 750mg = 31% 5mg = 0%
Total Carbohydrate 10g = 3% 25g = 8%
Dietary Fiber 1g = 4% 1g = 4%
Sugars 8g 20g
Protein 2g 1g
Vitamin A 22% 0%
Vitamin C 24% 143%
Calcium 2% 2%
Iron 5% 6%



  Food 3 Food 4
Nutrient Barbecue Chicken Herb-Roasted
Chicken
Serving Size 3oz (85g) 3oz (85g)
Servings Per Container 1 4
Amount Per Serving Calories = 90
Calories from Fat 15
Calories = 110
Calories from Fat 10
Total Fat 1.5g = 2% 1g = 2%
Saturated Fat 0g = 0% 0g = 0%
Trans Fat 0g 0g
Cholesterol 30mg = 10% 75mg = 25%
Sodium 345mg = 14% 30mg = 1%
Total Carbohydrate 0g = 0% 0g = 0%
Dietary Fiber 0g = 0% 0g = 0%
Sugars 0g 0g
Protein 20g 25g
Vitamin A 0% 0%
Vitamin C 0% 0%
Calcium 0% 0%
Iron 4% 4%



  Food 5 Food 6
Nutrient Frozen Peas Canned Peas
Serving Size 1/2 cup (63 g) 1/2 cup (85 g)
Servings Per Container 3 3
Amount Per Serving Calories = 50
Calories from Fat 0
Calories = 60
Calories from Fat 0
Total Fat 0g = 0% 0g = 0%
Saturated Fat 0g = 0% 0g = 0%
Trans Fat 0g 0g
Cholesterol 0mg = 0% 0mg = 0%
Sodium 45mg = 2% 215mg = 9%
Total Carbohydrate 9g = 3% 12g = 4%
Dietary Fiber 2g = 8% 3g = 12%
Sugars 3g 4g
Protein 3g 4g
Vitamin A 27% 6%
Vitamin C 10% 10%
Calcium 2% 2%
Iron 5% 8%



  Food 7 Food 8
Nutrient Buttermilk Biscuit English Muffin
Serving Size 1 biscuit (2.2 oz) 1 muffin (57g)
Servings Per Container 5 6
Amount Per Serving Calories = 200
Calories from Fat 90
Calories = 120
Calories from Fat 10
Total Fat 8g = 12% 1g = 2%
Saturated Fat 3g = 15% 0g = 0%
Trans Fat 3g 0g
Cholesterol 0mg = 0% 0mg = 0%
Sodium 570mg = 24% 290mg = 12%
Total Carbohydrate 23g = 8% 25g = 8%
Dietary Fiber 1g = 0% 1g = 4%
Sugars 3g 4g
Protein 4g 4g
Vitamin A 0% 0%
Vitamin C 0% 0%
Calcium 4% 15%
Iron 8% 8%

  Food 9 Food 10
Nutrient Mixed Nuts Unsalted, Dry-Roasted
Mixed Nuts
Serving Size 30 pieces (28g) 30 pieces (28g)
Servings Per Container 12 12
Amount Per Serving Calories = 170
Calories from Fat 140
Calories = 170
Calories from Fat 140
Total Fat 16g = 25% 16g = 25%
Saturated Fat 3g = 15% 3g = 15%
Trans Fat 0g 0g
Cholesterol 0mg = 0% 0mg = 0%
Sodium 120mg = 5% 0mg = 0%
Total Carbohydrate 6g = 2% 6g = 2%
Dietary Fiber 3g = 12% 3g = 12%
Sugars 1g 1g
Protein 4g 4g
Vitamin A 0% 0%
Vitamin C 0% 0%
Calcium 4% 4%
Iron 4% 4%

 

Percent Daily Values are based on a 2,000-calorie diet. Your Daily Values may be higher or lower depending on your calorie needs.

Sodium in Foods

Choose MORE Often

Foods LOWER in Sodium

  • Chicken and turkey (with skin removed)
  • Fresh fish or rinsed canned fish such as tuna* or sardines
  • Canned foods packed in water
  • Low-sodium or reduced-sodium cheeses
  • Low-salt or salt-free chips, nuts, and pretzels
  • Plain rice, noodles, or pasta
  • Homemade, low-sodium, or reduced-sodium soups
  • Fresh, frozen, "no-salt added," or rinsed canned vegetables
  • Spices, herbs, and flavorings such as cilantro, parsley, garlic powder, onion powder,vinegar, and chili powder

Choose LESS Often

Foods HIGHER in Sodium

  • Smoked and cured meats such as bacon, ham, sausage, hotdogs, bologna, fatback, ham hocks, scrapple, and liver pudding
  • Canned fish* such as tuna and sardines (that are not rinsed) and salted/dried codfish
  • Frozen TV dinners
  • Canned foods packed in broth or salt
  • Most cheeses
  • Salty chips, crackers, nuts, and pretzels
  • Quick-cooking rice and boxes of mixed rice, potatoes, noodles, or macaroni and cheese
  • Regular canned and instant soups
  • Regular canned vegetables, pickles, olives, and pickled vegetables
  • Condiments and seasonings such as soy sauce, ketchup, garlic salt, seasoning salt, bouillon cubes, meat tenderizer, monosodium glutamate (MSG), and commercial Cajun or seafood seasonings

* Pregnant and nursing moms: Talk to your health care provider to find out the types of fish you can eat that are lower in mercury.

Rinse canned foods to reduce the sodium.

Keep Your Heart in Mind: Eat Less Salt and Sodium

Do you know your blood pressure numbers?

  • A normal blood pressure is below 120/80 mmHg.
  • If your blood pressure is 120/80 to 139/89 mmHg, you have prehypertension. This means that you don't have high blood pressure yet, but you're likely to develop it if you don't change your health habits.
  • If your blood pressure is 140/90 mmHg or higher, you have high blood pressure. High blood pressure does not go away by itself. Ask your doctor for help in lowering it.
  • Ask your doctor what your blood pressure number is. Keep track of each reading on your wallet card.

Spice it up!

Discover how much flavor you can add by using spices and herbs.

Ms. Diane has learned that it's not hard to get your family to eat less salt and sodium.

To break your family's habit of using the salt shaker at the table, try Ms. Diane's secret recipe!

Look for other salt-free seasonings in the grocery store.

To make food taste good without salt, I use cilantro, cumin, fresh garlic, parsley, onion, green pepper, oregano, and even a dash of hot pepper when I cook. Everyone in my family got used
to the taste of foods with less salt.

Fill the salt shaker with these herbs and spices, and use it instead of salt to flavor foods.

2 tablespoons black pepper
1 tablespoon cayenne pepper
1 tablespoon paprika
1 tablespoon onion powder
1 tablespoon garlic powder
1 bay leaf, ground

Take the lead and try these simple changes:

When Shopping

  1. Buy fresh, frozen, or no-salt-added canned vegetables. Choose food packed in water instead of in broth or salt.
  2. Buy fresh garlic or garlic powder instead of garlic salt.
  3. Choose foods labeled "low sodium," "sodium free," or "no salt added."

When Cooking

  1. Slowly cut back on the amount of salt added when cooking until you don't use any.
  2. Add no salt to the water when cooking beans, rice, pasta, and vegetables.
  3. Cut back on meats high in sodium, such as bologna, ham, hotdogs, and sausage.
  4. Rinse all canned products to reduce the amount of sodium.

When Eating

  1. Fill the salt shaker with a mixture of herbs and spices.
  2. Slowly cut back on the amount of salt added at the table until you don't use any.
  3. Choose fruits and vegetables instead of salty snacks like chips, fries, and pork rinds.

Darnell has learned to control his high blood pressure. He takes his blood pressure pills with breakfast every morning to make sure that he doesn't forget to take them. He walks daily, has stopped smoking, and has found that food can still taste good with less salt and sodium.

Make your personal pledge to do what Darnell has done! Look at these examples:

Breakfast

Cook oatmeal with fat-free or low-fat (1%) milk, raisins, cinnamon, and no salt.

Lunch

Use leftover roasted chicken to make a sandwich instead of using luncheon meats.

Dinner

Make your own soup with vegetables and half the usual amount of salt.

Snack

Eat an orange instead of salty chips.


Your health and your family's health are priceless. Make an investment!

Tips for Taking Medicine for High Blood Pressure

  1. Make sure you take medicine as your doctor tells you, not only on the days when you do not feel well.
  2. Tell the doctor the names of all other medicines, home remedies, herbs, or supplements you take. Bring everything with you when you have a doctor's appointment.
  3. Tell the doctor right away if the medicine makes you feel strange or sick. Ask the doctor about changing the dosage or switching to another type of medicine.
  4. Refill your prescription before you run out of medicine.
  5. Have your blood pressure checked often to see if the medicine is working for you.
  6. Don't stop taking your medicine if your blood pressure is okay. That means the medicine is working.

Questions to ask the doctor:

When the doctor gives you medicine for high blood pressure, ask:

Use Herbs and Spices Instead of Salt

  • Allspice: Use in meats, fish, poultry, soups, stews, and desserts.
  • Basil: Use in soups, salads, vegetables, fish, and meats.
  • Cayenne Pepper: Use in meats, poultry, stews, and sauces.
  • Celery Seed: Use in fish, salads, dressings, and vegetables.
  • Chili Powder: Use in meats, poultry, and stews.
  • Cilantro: Use in meats, sauces, stews, and rice.
  • Cinnamon: Use in salads, vegetables, breads, and snacks.
  • Clove: Use in soups, salads, and vegetables.
  • Cumin: Use in meats and poultry.
  • Curry Powder: Use in meats, shellfish, and vegetables.
  • Dill Weed and Dill Seed: Use in fish, soups, salads, and vegetables.
  • Garlic Powder: Use in meats, poultry, fish, vegetables, salads, soups, and stews.
  • Ginger: Use in soups, salads, vegetables, and meats.
  • Marjoram: Use in soups, salads, vegetables, beef, fish, and chicken.
  • Nutmeg: Use in vegetables and meats.
  • Onion Powder: Use in meats, poultry, soups, and salads.
  • Oregano: Use in soups, salads, vegetables, meats, and chicken.
  • Paprika: Use in meats, fish, poultry, and vegetables.
  • Parsley: Use in salads, vegetables, fish, and meats.
  • Rosemary: Use in salads, vegetables, fish, and meats.
  • Sage: Use in soups, salads, vegetables, meats, and chicken.
  • Thyme: Use in salads, vegetables, fish, and chicken.
Note: To start, use small amounts of these herbs and spices to see if you like them.

Soul Food Makeover—Vegetable Stew Recipe

3 cups water
1 cube vegetable bouillon, low sodium
2 cups white potatoes cut in 2-inch strips
2 cups carrots, sliced
4 cups summer squash, cut in 1-inch squares
1 cup summer squash, cut in four chunks
2 ears fresh corn (1½ cups)
1 teaspoon thyme, ground
2 cloves garlic, minced
1 stalk scallion, chopped
½ small hot red pepper, chopped
1 cup onion, coarsely chopped
1 cup tomatoes, diced

(You can add your other favorite vegetables such as broccoli, cauliflower, or string beans.)

  1. Heat water and bouillon in a large pot, and bring to a boil.
  2. Add potatoes and carrots to the broth, and simmer for 5 minutes.
  3. Cut the corn off the cob.
  4. Add the remaining ingredients, except for the tomatoes, and continue cooking for 15 minutes over medium heat.
  5. Remove the four chunks of squash, and puree in a blender.
  6. Return pureed mixture to pot, and let cook for 10 minutes more.
  7. Add tomatoes, and cook for another 5 minutes.
  8. Remove from heat, and let sit for 10 minutes to allow stew to thicken.

Makes: 8 servings
Serving size: 1¼ cups
Calories: 100
Fat: 1 g
Saturated fat: 0 g
Cholesterol: 0 mg
Sodium: 37 mg
Total fiber: 5 g
Protein: 3 g
Carbohydrates: 23 g
Potassium: 607 mg

Make It a Meal.

To make this dish a meal, serve it with a green salad that includes lettuce (romaine or spinach), cucumber, and other fresh vegetables. Use a light dressing, such as a vinaigrette, or a low-fat or fat-free dressing. Also serve with whole-grain bread or rolls.

The Makeover

In the past, the Harris family added cured and smoked meatsówhich have high amounts of sodiumóto this recipe. This heart healthy vegetable stew doesn't use cured or smoked meats. Instead, this recipe is low in sodium and uses plenty of herbs and spices to give this dish plenty of flavor! This recipe includes several vegetables, which will help you to meet the daily recommendation for vegetables. Try this stew for a great-tasting, low-sodium meal.


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Last Updated December 2010

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