By Sharon Paul-Sylvestre, RN Visiting Nurse Service of New York
HEALTH- February is American Heart Month—and an excellent time to review heart health risks and guidelines, especially among members of the African American and Latino communities.
Untreated and longstanding high blood pressure can lead to hypertensive heart disease (HHD), which includes heart failure, coronary artery disease, and other conditions.
HHD is the leading cause of death associated with high blood pressure for all Americans. High blood pressure also puts people at risk for experiencing a stroke.
The American Heart Association says African American population is particularly vulnerable to HHD and stroke since roughly 40 percent of African American men and women have high blood pressure, a higher rate than any other racial group in the U.S.
Each year, approximately 100,000 home care patients in the U.S. report a prior stroke, and a recent study at the Visiting Nurse Service of New York Center for Home Care Policy & Research further shows that, at start of care, recurrent stroke risk is high for many patients and in particular, African Americans, due to uncontrolled blood pressure.
As a registered nurse providing care at home for high-risk patients with chronic heart failure, hypertensive heart disease and post-stroke, I know how important it is to work with these vulnerable patients and their families to help them make lifestyle changes and link them to continuous, responsive hypertension care.
My colleagues and I at the Visiting Nurse Service of New York are part of a workforce of skilled nurses, rehabilitation therapists and home health aides who work together to provide care coordination and support for more effective chronic care self-management of these health issues. Everyday, we visit at-risk New Yorkers in their homes to help patients and their families understand the persistent hypertension-related disparities that increase the risk for heart disease, stroke, re-hospitalization and even death. Here are a few guidelines for closing hypertensive heart health disparities in the African American community.
The most powerful weapon we have against hypertensive heart disease and stroke is knowledge. Take every opportunity to learn about your risk for high blood pressure. You can find excellent resources online at the American Heart Association’s www.Heart.org and www.VNSNY.org.
Manage Your Diet: this one can be the most challenging especially when your cultural eating habits conflict with healthy eating recommendations.
It’s important to manage your cholesterol levels by reducing your daily fat intake gradually over time. Talk to your doctor or home health provider about establishing dietary goals that support healthy blood pressure. Even small changes to your diet can make a big difference in your health. Learn how to read food labels and become especially mindful of salt and sodium intake, which can have adverse effects on hypertension and diabetes, respectively.
Limit or Stop Smoking and Drinking: smoking enhances blood pressure and can cause strokes – try to cut back or stop smoking. Limiting your alcohol consumption is important as alcohol can adversely affect some medications. Each person is different, but moderation is crucial.
Be on the Lookout for Depression
Patients with heart disease and stroke survivors are at high risk for experiencing depression.
Adapting to a new lifestyle and temporary or permanent limitations to mobility, speech or cognitive function can present significant challenges.
Frustration and depression are especially common in the winter months. Talk with your health care provider about the signs and symptoms of depression and online or community resources that may be available easily accessible for you.
Move a Little: just 15 to 30 minutes of light physical activity three to five days a week can help reduce your risk for stroke and heart disease.
Small steps can lead to big progress if you just add a little activity to your life: walk to the mailbox or the corner bodega every day, get off one stop early and walk a few extra blocks if you ride the bus or subway, do stretches and “hall laps” at home if you need to in order to get started.
Manage Your Stress: sometimes stress is unavoidable, but most of the time we can take a few minutes to separate from the typical tensions that we all face in a busy day. This is especially important when recovering from any heart-related health issue.
Give yourself 10-minute de-stressing breaks to listen to music, visit with a friend, meditate, practice gentle yoga or take care of a pet to help reduce your risk for hypertension.
Keep a Health Journal: take the time to write down all of your medications and any changes your doctor makes to each prescription. Don’t forget to write down over-the-counter medications you take too, from baby aspirin to vitamins.
Note how you feel each day, especially on days when you feel a little groggy, tired, sad or confused. This way you have a record of your health so every health professional on your care team can understand your full medical history at any time.
American Heart Month is a great time to begin implementing heart healthy habits for everyone, but it is especially important for those with high risk for hypertension to stay in communication with their physicians and be mindful of high blood pressure and related health risks. As always, it is important to consult your health provider before making significant changes in your diet or fitness routine.