But I don't have the energy to exercise

Exercise is supposed to help lower your blood pressure. But what if you don't have the energy to exercise? Where does the energy come from?

Energy, in the form of calories, comes from the food we eat.
In addition to "burning" some of these food calories immediately, just to keep warm, and sending some off to the muscles and other organs to keep us breathing, thinking, and moving around, the body also stores some of the food calories as fat.  If you've got body fat, you've got PLENTY of energy.

So why don't you FEEL LIKE you've got the energy to get outside and move around?

If your life were in danger, wouldn't you get up and take action? Wouldn't you run as hard and fast as you could, for as long as you could, to get away from the danger? Of course you would.

Suppose you have just had a mini-stroke.  You know this means your well-being, and even your life, are in danger from a big stroke. You know you have a 40% chance of a major stroke in the next few months. Stroke is chasing you -- why don't you run?

Unless you can actually SEE the monster chasing you, you don't feel like you have the energy to get out and move around.

What can you do about it?

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Less salt, more potassium, calcium, and magnesium

The 2010 USDA guidelines recommend 1500 mg or less of sodium each day for at least half the population -- including anyone over 51, with diabetes, high blood pressure, or kidney disease.

But have you ever looked at a can of soup? One half-cup serving of Campbell's condensed tomato soup has 710 mg of sodium -- that's half your daily allowance in a teacup. Or  make a pot of Wegmans beef chili, and get 1600 mg in a single serving. Luckily, you can find a recipe for Wegmans turkey chili with only 440 mg in a serving.

One thing diet researchers have learned is that potassium, calcium, and magnesium pills don't do much for blood pressure. But eating foods high in potassium, calcium, and magnesium leads to dramatic changes in blood pressure.  In the DASH study, researchers saw significant changes in blood pressure only days after study subjects started the DASH diet.

So eat fresh fruits and vegetables for potassium. Half of what you eat every day should be fruits annd vegetables.  For calcium, eat kale and drink low-fat dairy products, eat low-fat cheeses and yogurts. For magnesium, eat beans and peas, nuts (walnuts or almonds), seeds, leafy green vegetables, and fish like halibut. You'll also get some magnesium in your dairy products. Potatoes, watermelon, and bananas also contain magnesium.

Kale is the super food of the day -- rich in calcium, magnesium, and potassium, low in calories, and high in other important nutrients like iron, vitamins A, B,and C. And low in carbs, fat, and total calories. It is also high in vitamin K, which could be an issue if you taking coumadin (warfarin).

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Read more here:

• Ways to eat more fruits and vegetables
• Greens -- an Introduction
• Recipe: A big pot of greens
• Recipe: Blackened beef with greens, potatoes, and rutabaga

Read more elsewhere:

• USDA dietary guidelines 2010
• Good sources of potassium, calcium, and magnesium
• How the DASH diet lowers blood pressure
• The best leafy greens

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Healthy hot cocoa

Natural (not dutched, or processed with alkali) cocoa is chock full of antioxidants. Plenty of recent studies show that even moderate increases in cocoa consumption can reduce the risk of heart attacks and stroke.

But most of the ways of eating chocolate are full of sugar and fat. And the forms of chocolate and cocoa we like the best have been processed with alkali (dutched), to make them less bitter -- and that destroys some of the antioxidants.

But if you enjoy a cup of black coffee, you can enjoy a cup of black cocoa.

Just stir a tablespoon of natural unsweetened cocoa powder (Hershey's or Ghirardellis are easy to find) into eight ounces of warm water or warm milk. Add a little cinnamon if you like, up to 1/8 of a teaspoon, for an extra burst of sweet flavor, and even more antioxidants.

Too bitter? Add some of your favorite low-calorie sweetener, like stevia (truvia and other brands), or your favorite sweetener packet.

This warming drink won't throw off your calorie count or your blood sugar. In fact, it can help your body regulate its blood sugar, reduce inflammation, and help fight arterial disease.

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Get Outside and Move Around in the Sun to keep your blood pressure low

Today is going to be a beautiful sunny day in Pennsylvania. Put on a sweater and get out in the fresh air....

Exercise and vitamin D both help keep your blood pressure low. They also make your heart, lungs, and brain stronger, lose a couple of pounds, preserve bone density and help you sleep well at night. Just get outside in the sun and move around. Or move around inside and soak up the sun separately. You can take your activity level up a notch, 10 minutes at a time, 3 times a day.

Anyone who can go around and around the mall for Christmas shopping can manage a little physical activity every day.

Anything that gets you out of the house is good. If you decide to join a club, volunteer to read with second-graders, or take an art class, you can choose to park a little way from the best entrance, then take an indirect route through the building to give you 10 minutes of walking. Or you can walk around in the mall. Or even join an aerobics or aquasize class, to make exercise less boring.

And remember the sunlight. As little as 10 minutes a day in the sun can give you more vitamin D than you could ever get from a pill.

Keep the stroke away. Move around every day.

• Vitamin D, the Sun, and your Heart
• Safe exercise when you have high blood pressure
• Exercise to sleep better
• Exercise benefits and tips

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Preventing Strokes -- lowering your blood pressure

High blood pressure is the leading risk factor for stroke. It increases your risk for hemorrhagic (bleeding) stroke and for ischemic (blockage) stroke. It damages arteries throughout the body....

Over time, it can create weak places that rupture easily, or thin spots that balloon out from the artery wall. It can make the arteries stiffer, and less able to move blood well. It can accelerate the build-up of fatty plaques, causing narrowing of the arteries. This is why it is important to maintain a healthy blood pressure, day after day after day.

In the short term, sudden spikes in blood pressure can cause problems, too, especially when stroke risk factors are high.

• When blood vessels are already weakened, high blood pressure can cause them to bleed
• If you have unstable plaques on your artery walls, high blood pressure can dislodge them, and the particles can block a narrow place in a blood vessel

This is why it is a good idea to maintain healthy habits every day.

The good news is that high blood pressure can be controlled through diet and exercise, and with the help of blood pressure medications.

A plan for lowering blood pressure would include:

• Becoming more Active
• Getting enough Vitamin D from diet and, especially, from sunlight. Just 10 minutes of direct sun a day could be enough.
• Maintaining a Healthy Weight through diet and exercise
• Reducing salt in your diet, by reducing processed and canned foods, and choosing lower-salt versions of foods like tomatoes and beans
• Getting more Potassium, Calcium, and Magnesium in your diet, by eating fresh fruits and vegetables, lowfat and nonfat dairy products, and beans, seeds, nuts, halibut, tomatoes, potatoes, bananas, watermelon, and leafy green vegetables
• Manage stress.

More reading

• Stroke and High Blood Pressure, the State of Victoria, Australia, Better Health Channel
  
• Stroke and High Blood Pressure, The American Heart Association.

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Preventing a Stroke

If you've just had a mini-stroke, you have a 40% risk of having a big stroke eventually, and about a 10% chance of having that "big one" in the next three months.
You can't bring that risk down to 0 immediately, but you can dial it back considerably. Your doctor will probably recommend a lot of tests. It's hard to see excactly what's going on in every blood vessel in your body, so the doctor will order up blood tests. Blood pressure, blood sugar, cholesterol, triglycerides, C-reactive protein (and A1C, if you are diabetic). The doctor might have something to say about your weight and your physical fitness level, too. Your doctor will set some goals about where all of these values should be, and when they should get there. And maybe even give you some tips on diet and exercise.
But every body is different. Your doctor may or may not have recommended a particular diet or excercise. You can find out about exercise and diet to meet your health goals and reduce the risk of stroke....

If you've read about strokes, you'll know that they can be caused by

• blood vessels getting narrow from growing plaque deposits, and blocking blood flow
• broken bits of blood clots or unstable plaques travelling to a narrow place in a blood vessel (maybe one narrowed by plaque) and blocking blood flow
• damaged blood vessels breaking, causing reduced blood flow downstream, and pooling of blood in the brain at the break

The National Institute of Neurological Disorders and Stroke says the most important treatable risk factors for stroke are

• Lower your High Blood Pressure
  • Increase potassium in your diet, and reduce salt
  • Get enough vitamin D (10 minutes in the sun)
  • Take medication to lower your blood pressure; avoid medications (like decongestants) that raise it
  • Get more exercise
  • Maintain proper weight
• Quit Cigarette Smoking. It raises blood pressure, contributes to heart disease, thickens blood.
• Treat Heart Disease
  • lower your blood pressure (see above)
  • if your doctor says so, take a blood thinner (like aspirin) to prevent clots
  • improve your diet to slow plaque development
  • get checked for coronary artery disease, valve defects, irregular heart beat, or enlargement of the heart, which can all lead to blood clots
• Warning signs or history of TIA or stroke
  • Learn the warning signs of a stroke and be prepared to call 911 early
  • A second stroke could be twice as bad, if it affects a part of the brain doing double duty for the section damaged in an earlier stroke.
• Blood sugar, insulin, and diabetes
  • Reduce blood sugar and insulin to control blood pressure
  • Reduce blood sugar and insulin to protect your blood vessels
  • Reduce blood sugar and insulin to control heart disease
  • reduce blood sugar to reduce the amount of brain damage during a stroke
• Balance your Cholesterol
  • Reduce your LDL to reduce plaque buildup, atherosclerosis, blood vessel narrowing
• Increase your Physical Activity
  • Inactivity is associated with hypertension, heart disease, and diabetes
  • Aim for a good waist circumference to hip circumference ratio -- a high waist-to-hips ratio raises the ischemic stroke risk by 300%

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References

• Preventing Stroke: Treatable Risk Factors, National Institute of Neurological Disorders and Stroke.
• Vitamin D Levels Linked with Health of Blood Vessels, and Vitamin D status is associated with arterial stiffness and vascular dysfunction in healthy humans.

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More about strokes

Within three months of having a TIA [mini-stroke], about 10% to 15% of people will have an actual stroke." That means that, if you have had a mini-stroke in the fall, you have better than a 1 in 10 chance of having a big stroke before winter is over. Maybe just in time for Christmas....

The good news is that "chances of preventing a major stroke with the appropriate treatments following a TIA are excellent". But only if you seek medical attention right away, and follow through "with the treatments and recommendations" of your health care providers.

It means making extra trips to the doctor's office. As many as you need. It means making sure the doctor understands you. It means making sure you understand everything the doctor wants you to do.

It means getting exercise, getting out in the sunlight, and improving your diet.

It means doing your own reasearch, so you can understand what is going on in your body. You are in charge of your own health.

There is plenty of information available about strokes. For example, there is the WebMD Stroke Health Center. You can even find Stroke Risk Calculators online, like this one from the UCLA Stroke Center.

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What is a mini-stroke?

The biggest thing I've learned recently is that a mini-stroke is a warning that a big stroke is on the way...

A stroke is kind of like a heart attack, only in the brain instead of the heart. Here are some scary pictures

When you have a mini-stroke, an artery is blocked or partially blocked, or else it starts to bleed a little bit. You get symptoms that are like stroke symptoms, but usually milder. Then, when the blockage clears, or when the bleeding stops, the symptoms go away on their own.  The symptoms depend on which part of the brain is affected.  So you could experience anything from trouble talking to unexplained dizzyness to a sudden severe headache.

It's scary.

If you've had a mini-stroke in one part of your brain -- the next time, it could be in another part of your brain. It could be a real stroke next time.

Even scarier -- if you've noticed one mini-stroke, you may already have had several. And never noticed them. You could keep on having them. And never notice. Except that slowly, silently, they can kill a few brain cells at a time. And silently steal away your memories and your ability to think.  This is called vascular dementia. Your doctor might talk about multi-infarct dementia, which is the most common form of vascular dementia.

If you are at immediate risk for another stroke, you probably want to take some immediate steps to decrease your risk.

Their are two main causes of stroke.

• Ischemic stroke is cause by blockages, often blood clots, in small blood vessels, or in arteries already narrowed by plaque build-up
• Hemorrhagic (bleeding) stroke is caused by blood vessels bursting and bleeding, often because they have been weakened by high blood pressure over a long time

To prevent ischemic strokes, you want to decrease inflammation immediately and continue to make choices that will slow down or even reverse narrowing of your arteries.  To prevent bleeding strokes, you want to get your blood pressure under control.

Sunshine, exercise, and a healthy diet will help with artery disease, blood pressure, and inflammation.

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