Among American Indians ages 45-74, 26.8% of men and 27.5% of women have high blood pressure, defined as definite hypertension: systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher on one occasion or reported to be currently taking antihypertensive medication. Hypertension is strongly linked to heart disease- the number one killer of American Indians, according to IHS "Trends in Indian Health".

When the heart beats, it pumps blood for circulation through the body. Blood pressure is measured as systolic (pressure of the blood in the arteries when the heart beats) and diastolic (pressure between heartbeats). High blood pressure, or hypertension, is generally considered to be greater than 140 systolic and 90 diastolic (measured in millimeters of mercury). High blood pressure is a serious but modifiable risk factor for heart disease and stroke.

• Although you may not know the exact cause of your hypertension, there are several factors that may contribute to it. Some are beyond your control, but some can be controlled by changing your lifestyle.
• The factors you can't control are heredity, race, age and gender (generally men are more likely to have hypertension).
• The factors you can influence are obesity, lack of physical activity and exercise, sodium (salt) consumption, smoking, stress management and alcohol consumption.
• Some women develop hypertension during pregnancy. If there is a history of hypertension in your family (especially pregnancy-induced), notify your obstetrician early in the pregnancy.
• Some women develop hypertension while on oral contraceptives. The likelihood of this increases in women who have other risk factors, such as family history, being overweight or mild kidney disease).

• Heavy sodium intake increases blood pressure in some people. Your doctor may recommend a sodium-restricted diet to help lower your blood pressure.
• That means you will have to avoid salty foods, reduce or eliminate salt in cooking and refrain from adding salt at the table.
• The American Heart Association recommends that healthy adults reduce their sodium intake to no more than 2,400 milligrams per day. This is about 1� teaspoons of salt.
• Substitute herbs and spices for the salt in your cooking. Experiment with different combinations.
• Choose fresh or frozen foods over canned products. If you eat canned products, rinse the salt from the foods. Use fewer "instant" products.
• When dining out, ask the waiter to have your meal prepared without any added salt.
• Get in the habit of reading food labels. You can look for the different sodium compounds that are added to foods. Watch for the words "soda," "sodium" and the symbol "Na" on labels. These indicate that the product contains sodium.
• Make it a practice to carefully read the labels on all over-the-counter drugs as well. Look at the ingredient list and warning statement to see if sodium is in the product.

Source: American Indian Clinic, Inc. 1994-1997