The following are some isolated but important health facts which will be beneficial for you to know.

• If you are 55 years of age, and if you do NOT have hypertension, your life-time risk of developing hypertension is 90%.

Because of the aging process and dietary salt in western diets, your life-time risk of developing hypertension is virtually 100%. You can take steps to avoid this. Not only will avoiding hypertension decrease your risk of having a stroke, but it will save you the time, trouble and money of having to treat a disease you could have avoided. How do you avoid developing high blood pressure? Stop smoking! Loss weight! Start exercising! Don't add salt to your food and don't eat large amounts of canned foods. Ask you SETMA healthcare provider for a low sodium diet.

• If you are a woman and you smoke, you will decrease your life expectancy by 14.5 years; if you are a man and you smoke, you will decrease your life expectancy by 13.2 years.

There is nothing you can do for your health which will have greater benefit than stopping smoking and avoiding the fumes of others' smoking. This is not the position of a non-smoker; this is the evidence of every study on every disease known to man. Smoking is the most significant modifiable health risk which we face. You can stop. You must stop. And, you must avoid inhaling the smoke created by others. In restaurants, when I am asked, "Smoking or non-smoking," I respond, "No smoke!" I not only will not sit in a smoking section; I will not sit in a non-smoking section which has any smoke in it because of how close it is to the smoking section.

• If you are overweight or obese, you are at a greater risk for cardiovascular disease than someone who is not overweight or obese. However, if you have cardiopulmonary (heart and lung) fitness, you virtually eliminate the health risk of excess weight.

The February issue of the American Diabetes Association's journal, Diabetes Care , stated, "Obesity and Metabolic Syndrome are associated with an increased risk of all-cause and CVD mortality (death), however, these risks were largely explained by cardiorespiratory fitness (CRF)." Cardiopulmonary fitness greatly decreases the effect of Metabolic Syndrome on all-cause and CVD mortality in all weight categories. The amount of physical activity required to achieve the levels of CRF that were protective in this study is 30 minutes of moderate intensity activity on most days of the week, which are the currently recommend physical activity levels for health.

• If you are pre-hypertensive - you do not yet have high blood pressure but your systolic blood pressure (the top number) is between 121 and 139, or the diastolic pressure (the bottom number) is between 81 and 90 - you can prevent the development of hypertension by losing weight, changing your diet, stopping smoking and by beginning to exercise.

The DASH Diet - DASH stands for Dietary Approach to Stop Hypertension - was designed to help avoid or control hypertension. Following the DASH Diet will reduce your systolic blood pressure by 8-14 mm Hg, which is the same effect as taking one blood pressure medication. Ask your SETMA healthcare provider for information on the DASH Diet.

The following are risk factors for developing hypertension: smoking, diabetes, family history of high blood pressure, heavy alcohol consumption (more than ½ ounce of 90 proof alcohol a day), high fat diet, high salt diet, being overweight, being male, being African-American, sedentary lifestyle (being a couch potato), being on birth control pills, being over 50 years of age, or being post-menopausal. Some of these you can change; some you can't. The more unchangeable risks you have, the more aggressively you must address those which can be changed.

• If you have high blood pressure, it will usually take 2 or more medications, along with life-style changes to control your blood pressure.

Often, we unconsciously think that having to take more than one medication for the control of blood pressure means that we have failed to select the right medication. Actually, seven landmark studies of blood pressure treatment programs demonstrated that 2.5 to 4.0 drugs were needed to get the majority of patients to their target treatment goal.

The following lifestyle changes will affect the blood pressure:

• eliminating or severely restricting alcohol consumption will decrease the systolic blood pressure 2-4 mm Hg;
• losing weight will decrease the pressure by 5-20 mm Hg with a 20 pound weight loss;
• exercise will decrease your blood pressure by 4-9 mm Hg;
• reducing salt intake will reduce the blood pressure by 2-8 mm Hg.

Add these up - and they are not necessarily cumulative in their effect - and add in the DASH Diet, shows that you can potentially reduce your blood pressure by 21-55 mm Hg without medication.

• If you are a couch potato, you need to know that a sedentary life style is a greater risk factor for the development of congestive heart failure (CHF) than having diabetes mellitus. And, one of the best treatments for CHF is physical activity.

A recent review of the medical literature showed that the following conditions cause congestive heart failure:

• physical inactivity 9.2%
• hypertension 10.2%
• diabetes 3.2%
• obesity 8.0%

Furthermore, patients diagnosed with CHF benefit greatly from participating in exercise-training programs. For example, exercise training of patients with moderate to severe CHF lowered all-cause mortality by 63% and reduced hospital readmission for heart failure by 71%. Therefore, physical inactivity can directly or indirectly account for the development of a significant percentage of cases of CHF and also worsen conditions associated with previously diagnosed CHF patients.

In heart failure, two of the main symptoms are fatigue and limitation in exercise capacity. Bed rest and exercise restriction lead to deconditioning and increased morbidity in patients with symptomatic heart failure. Conversely, the evidence is quite clear that exercise improves the overall function and exercise capacity of people with CHF.

Congestive heart failure (CHF) patients who exercise regularly can increase exercise tolerance, decrease dyspnea (shortness of breath) and fatigue, reduce the risk of arrhythmias, and improve quality of life. Patients need to begin aerobic exercise with interval training and progress slowly. Strength exercise is also useful. Exercise used along with the customarily prescribed CHF medications improves symptoms more than either modality alone. SETMA's Congestive Heart Failure clinic and/or any SETMA healthcare provider can give you an exercise prescription specifically designed for those with CHF. Ask for it, it will change your health.

• If you have tried to lose weight with a fad diet, you need to know that the 2005 United States Department of Agriculture (USDA) Dietary Guidelines declare that the only effective way to lose weight is to decrease the calorie intake and the only long-term success in maintaining weight loss is associated with the maintenance of a consistent, moderately intense exercise program.

The Adkins Diet, the South Beach Diet, the Zone Diet, you can go on and on. The reality is that unless you use more calories than you take in each day, you will NOT lose weight. And, don't be fooled by the low carbohydrate diet fads. Carbohydrates are important to your health. The type of carbohydrate you need is what is critical. Ask your SETMA healthcare provider about a low glycemic diet plan which will help you learn about "good" carbs and "not-so-good" carbs.

• If your children are overweight or obese, you need to know that the USDA states that the more parents know about nutrition the less likely it is that their children will be obese.

A recent government report on childhood obesity showed a direct and inverse link between parental nutrition knowledge and whether their children were fat or not. The more the parent knows about food, the less likely it is that their children are fat. This makes sense because the more a parent knows about nutrition, the less likely they are to feed their children doughnuts and fast foods and the more likely they are to keep fresh fruits and fresh vegetables as principle parts of their diet. Also, the more a parent knows about nutrition, usually the less television they will allow their children to watch, thus increasing their activity and exercise.

• Do you know your short-term risk of developing heart disease? It is possible for your healthcare provider to give you your ten-year risk for the development of heart disease and/or a stroke.

The Framingham Risk Score (FRS) for heart disease and stroke risk is easy for your healthcare provider to calculate. The FRS is expressed in percentages. The level of risk is as follows:

• Low <10%
• Intermediate 10-20%
• High >20%

If you are at intermediate or high risk, you need to aggressively deal with your weight, your blood pressure, your blood sugar and your cholesterol and triglycerides. As your SETMA healthcare provider to calculate your Framingham Risk Score every time you are seen. It will help you keep your focus on how to improve your health.

• Do you know your long term risk of developing heart disease? While the Framingham Risk Score tells you your short term risk for developing heart disease, the presence or absence of the Metabolic Syndrome tells you your long-term risk.

Your SETMA healthcare provider can quickly and easily tell you whether you have the Metabolic Syndrome. If you do, you can take actions to eliminate the Metabolic Syndrome. SETMA's LESS Initiative is the best way: lose weight, exercise, and stop smoking.

• Did you know the six risk factors for your developing diabetes (seven for women)?

Ask your healthcare provider to evaluate you for your risk of developing diabetes. SETMA does this each time you are seen in the clinic. If you do not have diabetes, but are at risk you should be screened every three years

• Did you know that taking 10,000 steps a day is as effective for having a healthy heart as an organized exercise program?

Don't like to exercise? Then you can get a pedometer - an instrument which tells you how many steps you take each day - and increase your routine walking in your daily activities to 10,000 steps a day. While this will not make you an athlete, it will make you healthy.

What you don't know can hurt you and what you do know can save your life. Remember, it is your life and it is your health.