If you are an adult with a blood pressure of 140/90 mm HG or above, you have high blood pressure and are at greater risk for heart disease, stroke, and other medical problems.  One in three adults in the US has high blood pressure and about 30% of them don't know they have it.

There are several risk factors that may contribute to high blood pressure and raise your risk for heart attack and stroke.  If you have any of these risk factors and haven't had your blood pressure checked in a while, you should contact your doctor and learn how to manage your blood pressure.

Controllable risk factors:

• Obesity:  Men who have a waist circumference of 40" or higher and women who have a waist circumference of 35" or higher are more likely to develop high blood pressure.  To measure your waist, locate the top of your hipbone and place tape measure evenly around bare abdomen.
• Eating too much salt:  A high sodium intake increases blood pressure in some people.  The average person should consume less than 2300 mg of sodium per day.  This includes not only table salt but also all sodium in cooked and processed foods.
• Lack of physical activity:  An inactive lifestyle makes it easier to become overweight and increases the chance of high blood pressure.  Choose activities that you enjoy and are convenient for you at least 30 minutes on most or all days of the week.
• Stress:  Too much stress over a long period of time, and unhealthy responses to it, may create health problems in some individuals.  Find healthy ways to handle stress - exercise, meditation, massage, etc.

Uncontrollable risk factors:

• Heredity:  If your parents or other family members have high blood pressure, you're more likely to develop it.
• Age:  The older you get, the greater your chance of developing high blood pressure.  Women are more likely to develop it after menopause and men are more likely to develop it between the ages of 35-55.
• Race:  Blacks develop high blood pressure more than whites, and it tends to occur earlier and be more severe.

Saturated fat is likely to raise blood cholesterol more than any other food in your diet (except for, perhaps, trans fat). Saturated fat is found in animal products and some plant foods, while cholesterol is found only in animal products. Many foods contain both saturated fat and cholesterol.

Try these recommendations:

• Eat more of a plant-based diet with fruits, vegetables, and whole grains, and limit red meat, full-fat dairy products, baked goods, and fried foods.
• Limit fatty meats such as corned beef, pastrami, ribs, steak, ground meat, frankfurters, sausage, bacon, and processed meats like bologna.
• Limit high-cholesterol organ meats (liver and kidney) and egg yolks. Replace with skinless chicken or turkey, lean beef, veal, pork, lamb, fish, and meatless main dishes.
• Limit snack crackers, muffins, quick breads, croissants, and cakes made with extra fat, saturated or hydrogenated fat, whole eggs, or whole milk.
• Be sure to read labels and ingredients.
• Avoid fast foods (such as hamburgers, fries, fried chicken, and tacos), which are high in both total fat and saturated fat. When you eat out, choose broiled sandwiches or chicken without skin, salads with low-fat dressing, and foods that aren't fried. Ask the server to leave off the cheese and high-fat dressings like mayonnaise.
• Instead of using butter or margarine on bread and vegetables, try olive oil.

Read labels and try to track your daily saturated fat grams until you get an idea of how much your typical food choices contain. Lowering your saturated fat intake means you'll help lower your cholesterol.

Stacey Whittle, RD, CPT and Dorothy Bernet, MS, RD, CPT are Co-Founders of Healthy By Design Nutrition Specialists in Santa Monica, CA. For more information visit their website at: www.healthybydesignnutrition.com

The most common warning sign of a heart attack in both men and women is chest discomfort.  Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back.  It can feel like uncomfortable pressure, squeezing, fullness or pain.  Women, however, are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain.  Women aren't the only ones who can have these atypical symptoms, as men aren't the only ones to have the classic heart attack symptoms.

In the past, many of the major cardiovascular studies were conducted on men.  There are currently several clinical studies under way that may help clarify gender differences that may affect diagnosis and treatment of women with heart disease.  Since many women tend to have heart attacks later in life than men do, they often have other diseases (such as arthritis or osteoporosis) that can mask heart attack symptoms.  Increased age and the more advanced stage of heart disease in women can affect treatment options and can also explain women's greater mortality rate after heart attacks. 

Recent research by the National Institutes of Health indicates that women often experience new or different physical symptoms as long as a month or more before experiencing a heart attack.  The symptoms most commonly reported were unusual fatigue, sleep disturbance, shortness of breath, indigestion, and anxiety.

Not all symptoms occur during a heart attack, but because every second counts, if you experience any signs or symptoms have them checked out.  Don't wait more than 5 minutes to call 911.  It is vital to get help at the first sign of a heart attack.  Don't wait, even if you aren't sure what's going on - let your doctor figure that out.

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