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HEART Insight:
doi: 10.1097/01.HEARTI.0000429709.00193.fd
Departments: Life's Simple 7

Modest Lifestyle and Behavioral Changes That Can Improve Your Health

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Understanding blood pressure readings

Because high blood pressure, or hypertension, can seriously affect your health, it's important to keep track of your blood pressure readings. Hypertension often has no signs or symptoms, so it's important to have your blood pressure checked regularly. Whether you're getting it checked at your doctor's office or doing it yourself at home, you need to know what the readings mean in order to understand if your blood pressure is at a healthy level or if it's too high.

Blood pressure is typically recorded as two numbers, written as a ratio that looks like this:

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This is read as “120 over 72 millimeters of mercury.”

The top number, which is also the higher of the two numbers, is your systolic measurement. It measures the pressure in your arteries when your heart muscle contracts, or squeezes. The bottom number, which is the lower of the two numbers, is your diastolic measurement. It measures the pressure in your arteries between beats, when the heart muscle is resting and refilling with blood. Your blood pressure goes up when your heart beats and goes down when it relaxes between beats.

Since your blood pressure can change from minute to minute depending on if you're standing, sitting or feeling stress, your doctor will want to take several readings over time to get an average reading. Once your doctor has this average reading, he or she will determine if you have normal blood pressure, prehypertension or hypertension.

Hypertension is divided into two categories, Stage 1 and Stage 2. Knowing which category your blood pressure falls into is important for your doctor to know so you can get the proper treatment. The chart below shows where blood pressure readings fall into each category.

What your number mea...
What your number mea...
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Normal blood pressure in adults over age 20 should be less than 120/80 mm Hg (less than 120 systolic and less than 80 diastolic). If your blood pressure is higher than normal, your doctor will take several measurements over time or ask you to monitor your blood pressure at home before diagnosing you with prehypertension or hypertension. If your readings stay at 140/90 mm Hg or above (over 140 systolic and over 90 diastolic) over time, your doctor will begin a treatment program to help you lower your blood pressure, which will include lifestyle changes and perhaps prescription medicine.

Lifestyle changes that you can make to improve your blood pressure include eating a heart-healthy diet that's low in saturated and trans fats, cholesterol and added sugars, maintaining a healthy weight, managing stress, avoiding tobacco smoke, limiting alcohol, lowering your salt intake (the AHA recommends consuming less than 1500 mg of sodium a day) and exercising regularly.

If you're monitoring your blood pressure and your systolic reading is over 180 mm Hg, or if your diastolic reading is over 110 mm Hg, wait a few minutes and take it again. If it's still just as high, call 9-1-1 for emergency medical help. If you can't access the emergency medical services, have someone drive you to the hospital right away. Blood pressure readings that high are called a hypertensive crisis, and you need immediate medical attention.

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Eating healthy when you dine out

Eating healthy is easier when you cook at home—you control the ingredients and how they're cooked, and you can read nutrition labels to help you avoid “bad” fats like saturated and trans fats. But what do you do when you eat out?

It used to be that eating out meant calorie-laden meals smothered in butter and fat, and while you can certainly find these kinds of foods on most menus, many restaurants are becoming more aware of their customers' needs and now offer heart-healthy choices.

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Before you decide where you're going to eat, see if you can check out a restaurant's menu online. Choosing what you're going to have before you get there will help you avoid being tempted by high-fat meals. Try to stay away from buffets because you're more likely to eat more food than you need at these all-you-can-eat feasts.

When choosing an entrée, avoid ones that contain the words fried, au gratin, crispy, scalloped, pan-fried, sautéed, buttered, creamed or stuffed. These are almost always high in fat and calories. Steer clear of foods that are served pickled, smoked, in broth, au jus, or in soy or teriyaki sauce because they're high in sodium. Instead, look for entrees that are steamed, broiled, baked, grilled, poached or roasted. If the menu doesn't provide a lot of information about a meal, ask your server how it's cooked. Choose seafood, chicken or lean meats over fatty meats. Often, menus will have a “healthy” icon marking entrees that are lower in fat and calories.

When it comes time to order, skip “extras” like appetizers, bread and butter or cocktails to avoid the added calories. If the item you're ordering comes with dressing, such as a salad, ask for it on the side so you can control how much you use. If you're indulging at the salad bar, choose wisely—avoid cheeses, marinated salads and pasta salads. Fill your plate with fresh greens, raw veggies and garbanzo beans and have low-fat or fat-free dressings on the side. Ask your server if some foods can be prepared to order or if they can substitute items—for example, can you get that fried fish grilled instead, with very little or no oil? Can you trade French fries for a baked potato with low-fat or fat-free sour cream? How about getting a green salad instead of mayonnaise-laden coleslaw?

Also ask if smaller portions are available or if you can share a meal with a dining companion. If they don't offer smaller portions or don't allow sharing, ask for a to-go box when you order and place half your meal in the box to bring home and eat later.

Eating out doesn't have to mean eating unhealthy foods. With a little preparation beforehand and some careful selections, you can enjoy an evening out and stay heart healthy!

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Life's Simple 7 in a Nutshell

Cardiovascular health encompasses two basic components: ideal health behaviors and ideal health factors.

The behaviors include not smoking, maintaining a healthy weight, meeting or exceeding AHA recommendations for physical activity and eating a healthy diet.

The health factors include blood pressure, fasting blood glucose and total cholesterol levels that are within the AHA's recommended range—preferably without needing medication to keep them there.

Modest lifestyle or behavioral changes can move you in the right direction. And those who make behavioral changes before developing any serious health risks can look forward to a better quality of life and moving toward excellent heart health.

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Helping kids get physical activity at home

Did you know that kids and adolescents should get at least 60 minutes (1 hour) or more of physical activity a day? When they're at school that's difficult to do, especially with physical education classes disappearing from the school day. If your kids aren't part of a sports team that practices after school, how can you help them get the exercise they need? It's easier than you think.

One of the most important things you can do to get your kids moving is to limit TV, video game and computer time. Put a limit of 2 hours on these sedentary activities. If they're not sitting in front of a screen, they can get moving.

To get ‘em moving, suggest activities that they find fun. After your kids come home from school, suggest jumping rope, dancing, playing catch or briskly walking the dog. On weekends, get everyone involved in making household chores fun (it can be done!). Try placing a sticky note on all of the items in your home that need cleaning or tidying up, like the kitchen counter or sofa. Tell each child to collect the sticky notes after they clean the item. Make it a fun competition—offer a prize (like a jump rope or a Frisbee from the dollar store) for the winner. Give each child a pedometer to wear during the day, and whoever has the most steps at the end of the week wins a prize.

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Another idea to get kids moving around the house is to increase the intensity of their cleaning chores by putting a time limit on them. Plug in the iPod and allow a certain number of songs to get each chore done. For example, allow two songs to vacuum the living room, three songs to wash the dishes or one song to make the bed. Your kids will move faster to try and beat the clock, all while increasing their heart rate and getting stronger.

Make sure that the adults at home get involved, too—you're not allowed to sit in front of the computer checking Facebook while your kids do all the work. Join them in housecleaning tasks and compete with them to get chores done. After dinner, give everyone a task—clearing the table, washing the dishes, loading the dishwasher. If the weather's nice, have the whole family take an after-dinner walk or bike ride—not only will you all be getting exercise, but it's a great way to bond with your kids as you spend time together and talk about what's going on in their lives.

The key to getting kids moving at home is to make it fun and get the entire family involved. They may be a little reluctant at first, but once your kids see you having fun they'll definitely want to join in!

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Should you add strength training to your workout?

In addition to daily aerobic exercise, strength training is an important part of a workout. We're not talking about bodybuilding but challenging your muscles to help increase strength and muscle mass. And you don't have to go to a gym to do it—strength training (also called weight training or resistance training) can be done anywhere.

Talk to your doctor before you begin to make sure you're healthy enough for strength training and ask for recommendations on the best exercises for you. Strength training should be done twice a week, not on consecutive days, to give your muscles time to recuperate.

Strength training can be done with dumbbells, weight machines, rubber band devices or just your own body weight (think pushups, squats and lunges). A good strength training program will work all of your muscle groups: arms, shoulders, chest, trunk, back, hips, legs and ankles.

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Besides improving the look of your muscles, strength training can improve your balance and coordination, helping you avoid dangerous falls. It can decrease arthritis pain, improve blood sugar control for people with diabetes, increase bone density in women, boost your energy levels and improve your mood. If your current physical activity plan doesn't include strength training, talk to your doctor about how to get started—your body will thank you!

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Diabetes and heart disease

If you've been diagnosed with type 2 diabetes, did you know that your chances of having high blood pressure or high cholesterol go up? And having two or three of these conditions greatly increases your chances of having a heart attack or stroke. Diabetes tends to lower “good” cholesterol levels and raise triglyceride and “bad” cholesterol levels, which increase the risk for heart disease and stroke. That's why it's so important for people with diabetes to keep a close eye on their blood pressure and cholesterol levels, even if they don't have a history of heart disease.

Because high blood pressure is so closely linked to diabetes, controlling your blood pressure is just as important as controlling your blood sugar. If your blood pressure is consistently above 130/80 mm Hg, your doctor may prescribe a blood pressure medicine to prevent it from going too high. If your doctor finds that your cholesterol is too high, he or she may prescribe a medication called a statin to help lower the amount of cholesterol in your blood.

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So while your doctor may prescribe a medicine to manage your diabetes—whether it's a pill or an insulin shot—you may also need to take drugs for high cholesterol or high blood pressure, or both.

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Life's Simple 7® Assessments

To understand the steps you may need to take to improve heart health and quality of life, visit

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Eat healthy when eating out

For a list of restaurants that serve heart-healthy meals, visit

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Track your heart health

To track your blood pressure, blood glucose, weight, cholesterol and more online, visit

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Get physically active

For ideas on how to incorporate physical activity into your life, visit

© 2013 by the American Heart Association