The Power Is in Your Hands. A Guide To Help African Americans Lower Heart Disease and Stroke Risks

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Arthur Osborne
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1 The Power Is in Your Hands A Guide To Help African Americans Lower Heart Disease and Stroke Risks

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I m Strong. The Power is in Your Hands Heart disease and stroke are major health risks for all people. But African Americans are at particularly high risk.

Cardiovascular (heart and blood vessel) diseases claim the lives of more than 101,000 blacks each year. In fact, they account for 35.

Unfortunately, many blacks aren t doing much to combat heart disease and stroke. We re bystanders in our own health. It s time to act!

3 I m Strong. The Power is in Your Hands Heart disease and stroke are major health risks for all people. But African Americans are at particularly high risk. Consider this: Heart disease and stroke are the No. 1 and No. 3 causes of death for blacks. Cardiovascular (heart and blood vessel) diseases claim the lives of more than 101,000 blacks each year. In fact, they account for 35.5 percent of all deaths among blacks in the United States. Risk factors such as high blood pressure tend to develop much earlier in life and be much more severe in blacks. Unfortunately, many blacks aren t doing much to combat heart disease and stroke. We re bystanders in our own health. It s time to act! Use this guide to learn the risk factors for heart disease and stroke. Then get screened it s the only way to find out if you re at risk. If you are, work with your healthcare provider to develop an action plan to cut your risk. Use the chart on page 20 to track your progress and celebrate your success. Your best defense against heart disease and stroke is you. It s time to take your health into your own hands. 1 Proud.

Risk Factors for Heart Disease and Stroke Traits or behaviors that increase your risk for heart disease and stroke

Some risk factors can be changed or treated. Others can t.

Risk Factors You Can t Change Increasing Age Your risk for heart disease and stroke goes up with age.

Older women who have heart attacks are more likely than men to die from them within a few weeks.

Family Health History and Race Like your eye color, tendencies for many health conditions can be genetically passed

4 Risk Factors for Heart Disease and Stroke Traits or behaviors that increase your risk for heart disease and stroke are called risk factors. The more risk factors you have, the greater your chance of having a heart attack or stroke. Some risk factors can be changed or treated. Others can t. Those you can t change include increasing age and family health history and race. Risk Factors You Can t Change Increasing Age Your risk for heart disease and stroke goes up with age. More men develop heart disease and develop it earlier, but women narrow the gap after age 55. Older women who have heart attacks are more likely than men to die from them within a few weeks. Older African-American women are at highest risk of stroke. Family Health History and Race Like your eye color, tendencies for many health conditions can be genetically passed from one family member to another. As an African American, there s a good chance that you or a relative has high blood pressure (also called hypertension). More than 40 percent of non-hispanic black Americans have it. This is partly why we re at much higher risk for developing heart disease than whites are. Real. I m Real. 2

Diseases like hypertension and diabetes increase the risk for stroke, heart disease and other major health problems. Having a blood relative with these conditions significantly increases your risk.

Record blood relatives who ve had a stroke or heart attack at an early age, or have high blood pressure. Then talk to your healthcare professional about what this means to you and your family.

The six major changeable risk factors are: smoking high cholesterol high blood pressure Smoking Strong.

5 Diseases like hypertension and diabetes increase the risk for stroke, heart disease and other major health problems. Having a blood relative with these conditions significantly increases your risk. That s why knowing your family health history is so important. Use the family tree on page 19 to map your family s health history. Record blood relatives who ve had a stroke or heart attack at an early age, or have high blood pressure. Then talk to your healthcare professional about what this means to you and your family. Risk Factors You Can Change Because African Americans are at higher risk for heart disease and stroke, it s important to change all the risk factors you can. The six major changeable risk factors are: smoking high cholesterol high blood pressure Smoking Strong. diabetes physical inactivity being overweight Smoking is the single greatest cause of preventable death in the United States. Among non-hispanic blacks, 26.7 percent of men and 17.3 percent of women smoke. If you smoke, your risk of heart disease and stroke is more than twice that of nonsmokers. Constant exposure to other people s tobacco smoke in your workplace or at home increases your risk even if you don t smoke. 3

6 The good news is, You have the power to quit. Each year, more than 1.3 million smokers quit. With good smoking cessation programs, 20 to 40 percent of participants can quit and stay off cigarettes for at least a year. Here s the bottom line: If you don t smoke, don t start. If you do smoke, quit now! Ask your healthcare provider to suggest a smoking cessation plan that will work for you. High Cholesterol Among non-hispanic blacks age 20 and older, about 44.8 percent of men and 42.1 percent of women have total blood cholesterol levels over 200 mg/dl. That s the level at which the risk for heart disease and stroke starts to rise. Know your numbers to know your risk. A simple blood test can show if your blood cholesterol level is desirable, borderline-high or high. You ll get a total cholesterol number. The levels of LDL cholesterol and HDL cholesterol also may be measured to determine your risk. LDL is the bad cholesterol. When too much of it is in the blood, it and other substances can build up and narrow arteries that feed the heart and brain. If a blood clot or particle blocks a narrowed artery, a heart attack or stroke can occur. HDL is the good cholesterol. High HDL levels help protect against heart attack by carrying bad cholesterol to the liver to be passed from the body. I am strong. 4

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Power. Your first step is to get screened. Contact your local American Heart Association I am the Power. to find out about free or low-cost screenings in your community.

8 Power. Your first step is to get screened. Contact your local American Heart Association I am the Power. to find out about free or low-cost screenings in your community. Record your results in the chart on page 20. Then use the chart below to see if your results are at the desirable, borderline-high or high-risk level. Cholesterol Level Desirable Borderline-High High Risk (mg/dl) (low risk) Risk Total cholesterol Less than or higher LDL ( bad ) cholesterol Less than 130* or higher HDL ( good ) cholesterol 40 or higher** Less than 40 Less than 40 ** People who have had an ischemic stroke or heart attack (or are at high risk for having one) may be advised by their doctor to keep their LDL level below 100 or, if they re at very high risk, below 70. * * The higher the better an HDL of 60 mg/dl and above is considered protective against heart disease. If your total blood cholesterol level is below 200 mg/dl, your risk for heart disease and stroke is low, unless you have other risk factors. Keep it that way by eating a healthy diet low in saturated fat, trans fat and cholesterol and staying physically active. Have your blood cholesterol level checked every five years or more often if you re a man over age 45 or a woman over 55. 6

If your blood cholesterol level is between 200 and 239 mg/dl, you re borderline-high. That means your heart disease risk is somewhat greater.

You should also eat less of foods high in saturated fat, trans fat and cholesterol. Butter, cheese, cakes, pies, crackers and fatty meat are examples.

In general, people whose total cholesterol is 240 mg/dl have twice the risk for coronary heart disease as people whose cholesterol level is below 200 mg/dl. But everyone s case is different.

9 If your blood cholesterol level is between 200 and 239 mg/dl, you re borderline-high. That means your heart disease risk is somewhat greater. Have your cholesterol and HDL rechecked in one to two years if: Your total cholesterol is in this range. Your HDL is less than 40 mg/dl. You don t have other risk factors for heart disease. You should also eat less of foods high in saturated fat, trans fat and cholesterol. Butter, cheese, cakes, pies, crackers and fatty meat are examples. This will help reduce your blood cholesterol level to below 200 mg/dl. Being physically active is also important. If your blood cholesterol is 240 mg/dl or more, it s high. In general, people whose total cholesterol is 240 mg/dl have twice the risk for coronary heart disease as people whose cholesterol level is below 200 mg/dl. But everyone s case is different. Talk to your doctor about monitoring your blood cholesterol levels and developing a plan that s right for you. Eating healthier and becoming more physically proud. active help. If that s not enough, your doctor may also prescribe medicine to help reduce your risk. Be sure to take it as you re told and never stop taking it without first talking to your doctor. Sticking to the plan is an important part of taking charge of your health. 7

I m Real. High Blood Pressure High blood pressure is often called the silent killer because it has no symptoms.

Compared to whites, we re more likely to have high blood pressure, develop it earlier in life, and have more severe

In between visits, check it at your local drugstore.

The first number (systolic pressure) measures the force of blood in the arteries when your heart beats.

Record your blood pressure readings in the chart on page 20 to track your progress.

10 I m Real. High Blood Pressure High blood pressure is often called the silent killer because it has no symptoms. It affects more than 40 percent of adult non-hispanic blacks. Compared to whites, we re more likely to have high blood pressure, develop it earlier in life, and have more severe cases. Have your blood pressure checked each time you visit your doctor. In between visits, check it at your local drugstore. Your doctor measures two numbers, to get a reading such as 120/76 mm Hg Real. (millimeters of mercury). The first number (systolic pressure) measures the force of blood in the arteries when your heart beats. The second number (diastolic pressure) is the force while your heart rests between beats. Record your blood pressure readings in the chart on page 20 to track your progress. Compare your results to the chart below to see if you re at risk. Blood Pressure Normal Prehypertension High (mm Hg) Systolic Less than or higher Diastolic Less than or higher If your blood pressure reading is 140/90 or higher and stays at this level for an extended time, you have high blood pressure. Consult with your doctor to develop a plan to control it. 8

Prehypertension is a borderline category. It includes people whose systolic blood pressure is 120 139 mm Hg or whose diastolic pressure is 80 89 mmhg.

Lifestyle changes such as eating a healthy diet, being physically active and quitting smoking can help prevent or postpone full-blown hypertension.

11 Prehypertension is a borderline category. It includes people whose systolic blood pressure is mm Hg or whose diastolic pressure is mmhg. If your blood pressure is in this range, you re more likely to develop high blood pressure. Lifestyle changes such as eating a healthy diet, being physically active and quitting smoking can help prevent or postpone full-blown hypertension. If you already have high blood pressure, don t be discouraged. You can lower your blood pressure and reduce your risk of heart disease and stroke. Being physically active, losing excess weight and eating less salt can help lower your blood pressure. If you drink alcohol, limit yourself to one drink a day (for women) or two a day (for men). If your blood pressure is still too high after changing your lifestyle, your doctor may prescribe medication to lower it. Be sure to take your medicine just as you re told. If a problem develops, tell your doctor. Never stop taking your medication without talking to your doctor first. Uncontrolled high blood pressure can lead to heart disease and stroke. Diabetes Diabetes is common among African Americans. In fact, you probably know someone who has it maybe even in your own family. more than 10 percent of non-hispanic black males age 20 or older and 13.2 percent of females have diabetes, often Proud. referred to as sugar. Sadly, a third of people with diabetes don t know they have it. Proud. 9

I am. Heart disease and stroke strike people with diabetes more often than they strike others. Have your glucose (blood sugar) levels checked regularly, especially if diabetes runs in your family.

12 I am. Heart disease and stroke strike people with diabetes more often than they strike others. Have your glucose (blood sugar) levels checked regularly, especially if diabetes runs in your family. A simple blood test done at the doctor s office or at a screening can show if you re at risk. A random glucose test (non-fasting) reading of 185 or more, or a fasting test reading of 126 or more, indicates that you may be diabetic. Prediabetes, also called impaired fasting glucose, is a fasting test reading of If your glucose levels fall in either category, work with your healthcare provider to develop a plan that s right for you. Losing excess weight and increasing physical activity often help. Record your glucose levels in the chart on page 20 along with your other screening results. This will give your doctor a more complete picture of your health. Obesity Obesity is a major health problem for all Americans, and especially for African Americans. Studies show that 79.6 percent of non-hispanic black women and 67 percent of non-hispanic black men age 20 and older are overweight or obese. If you re obese or overweight, you have a much higher risk of developing heart disease. That s because excess weight puts a strain on your heart. It also raises blood pressure and blood cholesterol levels and makes diabetes more likely to develop. 10

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You can often decrease your heart disease risk factors by losing as little as 10 to 20 pounds. But don t buy into fad diets or promises to rapidly lose weight.

You didn t gain the extra weight overnight, so don t expect to lose it that quickly either. Obesity isn t an appearance issue; it s a health issue.

About 45 percent of black men and more than 55 percent of black women aren t physically active. Being active has huge benefits.

Help control high blood pressure. Prevent bone loss. Boost energy levels. Manage stress. Improve self-image. Strong. Pick an activity that you like and stick to it.

14 You can often decrease your heart disease risk factors by losing as little as 10 to 20 pounds. But don t buy into fad diets or promises to rapidly lose weight. Work with a healthcare professional to set up a sensible eating and physical activity plan that will help you reach and maintain a healthy weight. You didn t gain the extra weight overnight, so don t expect to lose it that quickly either. Obesity isn t an appearance issue; it s a health issue. Whether you like how you look or not, you owe it to yourself to develop a healthy lifestyle. Physical Inactivity It s time to get moving! Your health depends on it. About 45 percent of black men and more than 55 percent of black women aren t physically active. Being active has huge benefits. Combined with healthy eating, at least 30 minutes of moderately-vigorous physical activity on five or more days of the week can: Keep weight under control. Improve blood cholesterol levels. Help control high blood pressure. Prevent bone loss. Boost energy levels. Manage stress. Improve self-image. Strong. Pick an activity that you like and stick to it. You don t have to join a gym or become a world-class athlete. Just start doing the things you used to enjoy like dancing, swimming, walking, riding a bike or playing with your kids. Then track your progress on the physical activity log on page 15. Set a goal to increase your physical activity every week until you reach 30 minutes or more on five or more days of the week. Reward yourself at each step toward your goal. I m Strong. 12

15 I am. Other (Stroke) Risk Factors You Can Change P The risk factors we ve just discussed affect the risk for both heart attack and stroke. But there are some additional risk factors that are specific to stroke. They include: Carotid or other artery disease Atrial fibrillation Other heart disease Transient ischemic attacks (TIAs) Let s briefly discuss these now. Sickle cell disease Excessive alcohol Some illegal drugs Carotid or other artery disease. The carotid arteries in your neck bring blood to your brain. A carotid artery that s narrowed by fatty deposits from atherosclerosis (plaque buildups in artery walls) may become blocked if the plaque ruptures and a blood clot forms. People with peripheral artery disease have a higher risk of carotid artery disease and stroke, too. Peripheral artery disease is the buildup of fatty deposits in artery walls of the legs and arms. Atrial fibrillation. This heart rhythm disorder raises the risk of stroke. The heart s upper chambers quiver instead of beating strongly and effectively, which can let the blood pool and clot. If a clot breaks off and lodges in an artery leading to the brain, a stroke can result. 13 Proud.

valve disease and some types of congenital heart defects also raises the risk of stroke.

TIAs are warning strokes that produce stroke-like symptoms, often lasting just a few minutes, but

Recognizing and treating TIA can reduce your risk of a major stroke.

Sickle cell disease (also called sickle cell anemia).

Sickled red blood cells are less able to carry oxygen to the body s tissues and organs.

stroke. This disorder often causes strokes in African-American children. Excessive alcohol.

16 ower. Other heart disease. Having coronary heart disease, heart failure, dilated cardiomyopathy (an enlarged heart), heart valve disease and some types of congenital heart defects also raises the risk of stroke. Transient ischemic attacks (TIAs). TIAs are warning strokes that produce stroke-like symptoms, often lasting just a few minutes, but that most often produce no lasting damage. Recognizing and treating TIA can reduce your risk of a major stroke. Call and get medical help immediately if they occur. Sickle cell disease (also called sickle cell anemia). This is a genetic disorder that mainly affects African Americans. Sickled red blood cells are less able to carry oxygen to the body s tissues and organs. They also tend to stick to blood vessel walls, which can block arteries to the brain and cause a stroke. This disorder often causes strokes in African-American children. Excessive alcohol. Excessive alcohol intake is associated with an increased risk of stroke as well as an increase in blood pressure. If you drink alcohol, do so in moderation. This means an average of one to two drinks per day for men and one drink per day for nonpregnant women. Some illegal drugs. Intravenous drug abuse carries a high risk of stroke. Cocaine use has been linked to strokes and heart attacks. Some have been fatal even in first-time users. Power. I m Real. 14

17 I m Strong. Strong. Physical Activity Log Remember to start out slowly and increase your activity over time. If you have a health condition or haven t been active for a long time, talk with your healthcare provider before starting any new exercise program. Date Home Work Play 8/4/05 climbed stairs 15

18 Take Charge Now! You ve made a great first step by learning more about the risk factors for heart disease and stroke. Now it s time to act. Check off these items as you do them: Complete the family history tree. Share it with other family members. Get screened. Record your results for future reference. Discuss screening results and your family history with your doctor. Develop a plan with your doctor to reduce your risk. Stick to it! Ask questions if you don t understand. If you smoke, quit! Get up and get moving! If your doctor prescribes medication, take it exactly as instructed. Learn the signs of heart attack and stroke in case of emergency. 16

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Power. You can take control of your health. This booklet can help you get started. The resources listed below can give you more information to help you live a healthier life.

org (800) AHA-USA1 American Stroke Association www.strokeassociation.org/power (888) 4-STROKE Black Women s Health Imperative www.blackwomenshealth.

20 Power. You can take control of your health. This booklet can help you get started. The resources listed below can give you more information to help you live a healthier life. American Association of Diabetes Educators (800) American Diabetes Association (800) DIABETES American Heart Association (800) AHA-USA1 American Stroke Association (888) 4-STROKE Black Women s Health Imperative (202) Centers for Disease Control and Prevention Chi Eta Phi Sorority Inc. National Black Nurses Association National Heart, Lung, and Blood Institute National Medical Association Proud. 18

22 Date Blood Pressure Cholesterol Blood Glucose LDL HDL Total 20

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Heart Attack Warning Signs 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.

Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath. May occur with or without chest discomfort. Other signs.

24 Heart Attack Warning Signs 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. Discomfort in other areas of the upper body. Symptoms can include pain or discomfort in one or both arms, the back, neck, jaw or stomach. Shortness of breath. May occur with or without chest discomfort. Other signs. These may include breaking out in a cold sweat, nausea or lightheadedness. Strong. Not all of these warning signs occur in every heart attack. If one does, don t wait. Get help immediately. Heart attack is a medical emergency call I m Strong. I m Proud. I m Real. 22

Stroke Warning Signs You and your family should learn the warning signs of stroke today.

weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or

or coordination Sudden, severe headache with no known cause Not all of these warning signs occur in every

25 Stroke Warning Signs You and your family should learn the warning signs of stroke today. If you or someone you re with has any of these signs, a stroke may be occurring: Sudden numbness or weakness of the face, arm or leg, especially on one side of the body Sudden confusion, trouble speaking or understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or coordination Sudden, severe headache with no known cause Not all of these warning signs occur in every stroke. If one does, don t wait. Get help immediately. Stroke is a medical emergency call I m Real. Strong. 23 I m Proud.

26 National Center 7272 Greenville Avenue Dallas, Texas StrokeAssociation.org About the American Stroke Association The goal of the American Stroke Association, a division of the American Heart Association, is to reduce disability and death from stroke through research, education and advocacy. In its fiscal year, the association spent more than $157 million on stroke. How Can I Get Involved? You can help African Americans take steps to protect themselves, their loved ones and others in their community from the devastation of stroke. Get involved today in Power To End Stroke! Take the Pledge. Call STROKE. Visit StrokeAssociation.org/power. Go to the Shop Power Web site and order Power To End Stroke brochures, materials and merchandise online. For more information, log on to the Web site at shoppower.org. Water symbolizes purification, freedom and good fortune in the African-American culture. These positive concepts reinforce the values of the Power To End Stroke program. 2008, American Heart Association A 4/08

NORTH MISSISSIPPI MEDICAL CENTER MEDICAL CENTER. Stroke: Are you at risk? A guide to stroke risk factors & resources at ACUTE STROKE UNIT

North Mississippi Medical Center Acute Stroke Unit 830 South Gloster Street Tupelo, MS 38801 (662) 377-3000 or 1-800-THE DESK (1-800-843-3375) www.nmhs.net Stroke: Are you at risk? A guide to stroke risk