º º § § º * º National High Blood 9 8 5 National Institutes of Health Public Health Service National Heart, Lung, and Blood Institute U.S. Department of Health and Human Pressure Education Program ë;"ViCeS S & ź KIT CONTENTS his kit is divided into two parts. Part one provides Sug- gestions for planning and implementing your National High Blood Pressure Month activities. Included is guid- ance about how to use the media, how to learn from your Suc- cesses and failures, and ways to continue HBP Control after May Part one also includes a sample 3-month calendar and a blank one for your own use. Part two contains the following SectionS. T MEDIA RELEASES Articles ready for local placement in newspapers and public service announcements for use by local radio stations. FACT SHEETS Information and recommendations on ways to control HBP (e.g., adherence to drug therapy, family support, Sodium restric- tion, and smoking cessation). - • • * x REPRODUCIBLE PAMPHLETS - Materials that may be reproduced for use as handouts. SUPPLEMENTARY MATERIALS • . . . ." Short filler articles, a payroll stuffer in both English and Span- ish, a patient wallet card, a Certificate of Recognition for volun- teers, a HBP Month Proclamation, and reproducible handbills. POSTER For display during May and year-round. ADDITIONAL RESOURCES A list of patient education materials that may be ordered directly from distributors. EVALUATION AND ORDER FORM To use in commenting on this kit and for ordering free materials from the NHBPEP ay of every year is desig- nated as National High | A \ | | BIOOd PreSSUre Month. Established in 1974, this annual event, sponsored by the National High Blood Pressure Education Program (NHBPEP), coordinated by the National Heart, Lung, and Blood Institute, is a broad-based effort that promotes the involve- ment of and encourages working relationships among a large number and variety of groups in high blood pressure (HBP) control. The scope of HBP Month expands every year. More than 200 organizations now participate during HBP Month in a wide variety of activities involving professional and public education and community action. These orga- nizations join together to focus attention on HBP among the public, health care professionals, and patients and their families. Although May is HBP Month, many national and state organizations also encourage their local affiliates to remain involved in HBP control activities throughout the year. THIS IS THE 11th NATIONAL HI 3. & & & PARTICIPATING IN NATIONAL HIGH. B.OOD) PRESSURE MONTH We hope that you and your organi- zation will want to take part in the 1985 National High Blood Pressure Month, either on your own or in a joint activity with another group or groups. Your organization may have unique skills or offer services in a specialized field that would be of considerable help to another group engaged in HBP Month activ- ities. Whether on your own or with other organizations, there are four major categories of activities your organization may become involved In: m identifying and referring hyper- tensive patients to sources of Care in educating members of your orga- nization and those of Other groups m tracking persons with elevated blood pressures m increasing general awareness of HBP/cardiovascular risks. This year, HBP Month materials place more emphasis on helping identified hypertensives stay on their treatment and less emphasis on mass Screening programs. Active detection efforts, if done, should be concentrated where the greatest benefits are likely, namely: (a) identifying HBP in persons in groups known to be at high risk (e.g., blacks, persons with a family history of hypertension, and all groups with limited access to health care services); and (b) monitoring blood pressures of identified hyper- tensives to help them get appropri- ate therapy and stay on it. HOW TO USE THIS KHT This 1985 National High Blood Pressure Month kit is a do-it- yourself guide to HBP control activi- ties. Although the kit contains a number of materials, each One requires additional action by users. For example, most HBP Month kit materials are reproducible. By reprinting these materials yourself, you will have a ready, immediate supply of easy-to-use professional, patient, and consumer publications to let you start your activities imme- diately. The theme for this year's High Blood Pressure Month is “Make Control Your Lifetime Goal.” Conse- quently, the kit suggests ideas and techniques for use in improving adherence to therapy. Since the great majority of hypertensives require medication to control their HBP the kit provides a good deal of information on this topic. In addi- tion, this year's HBP Month kit con- tains up-to-date information on several nondrug approaches that, in combination with antihyperten- sive medication Or SOmetimes alone, can help patients control their high blood pressure: control- ling weight, reducing sodium intake, and moderating alcohol consump- tion. Further, the kit offers sugges- tions for modifying other factors that, with HBP increase the risk of cardiovascular disease. The Month kit includes resources for further information, as well as printed materials for your use in planning and promoting activities with hyper- tensive patients. These materials are just the beginning, however. The most important ingredients to make HBP. Month Successful are you, your community, and an increasing commitment to HBP con- trol during May and all year long. INTRODUCTION TO HIGH BLOOD CARDIOVASCULAR RISKS igh blood pressure is one of the Nation's major public || || health problems. An esti- mated 60 million Americans are at increased risk of stroke, heart attack, and kidney disease due to elevated blood pressures. Studies show that these HBP-related risks increase continuously as blood pressure rises. Although HBP is most often treated with pharmaco- logic agents, hypertensives can help the effectiveness of their medi- cation by losing weight, reducing salt intake, and moderating alcohol intake. Hypertensives may further reduce their risk of cardiovascular disease by decreasing tobacco use. Convincing evidence exists that overweight, high sodium intake, and excessive alcohol are associated with pressure elevations and modi- fying them can enhance the benefi- cial effects of antihypertensive medications. The combination of risk factors such as smoking and hypertension increases the probability of cardio- vascular disease. For example, when HBP and smoking are pres- ent in a 40-year-old man his risk of Cardiovascular disease is three and one-half times as great as that of in a man without these risks.” This year's Month kit emphasizes the importance of addressing these factors and their modification in the treatment of hypertension. Identi- fied hypertensives can use this information to make personal changes that will help them lower their blood pressures. Most hyper- tensives will have to continue taking their prescribed medications throughout their lives, and changes in lifestyle are unlikely to become permanent substitutes for taking medication. But these changes may help them reach and maintain goal blood pressure without medica- tions, and, in many other cases, adopting healthier habits will *McGee, D, in W.B. Kanneland T. Gor- don (eds). The Framingham Study: An Epidemiological Investigation of Cardio- vascular Disease, National Heart, Lung, and Blood Institute, U.S. Department of Health and Human Services, Bethesda, Maryland, 1973. º - - - Žº % % % ~ % reduce the amount of medication needed. Those helping hypertensives to make behavior changes must remember that personal patterns, such as food preferences and life- styles, are the product of years of development and repetition. Conse- quently, quick changes may not be possible, and for some hyperten- sives it may be best to undertake one change at a time, mastering one new pattern before attempting the next. Hypertensives and those helping them to control HBP need patience and persistence to achieve long-term behavior change. Today, many health profession- als, community programs, voluntary agencies, social groups, churches, and family members work to pro- mote HBP control. Using the kind of information contained in this HBP Month kit, they assist hypertensives in achieving one or more of the fol- lowing benefits: m achieving blood pressure control sooner by using several approaches simultaneously (e.g., medication plus sodium reduc- tion plus weight reduction). m reducing the amount of medica- tion needed, under the supervi- sion of the prescribing physician, after blood pressure control has been reached and maintained for 6 to 12 months. m controlling HBP without medica- tion in a limited number of Cases, when the initial blood pressure level is in the mildest range (dias- tolic 90-94 mm Hg) and when no organ damage or diseases related to Cardiovascular risks already exist. HBP/CARDIOVASCULAR RISK FACTORS Scientists do not yet know the pre- cise cause(s) of most cases (over 95 percent) of HBP. However, research findings reveal that over- eating and high sodium intake—— two behavioral factors that can be modified——are often contributing factors. Furthermore, the research data indicate that weight reduction in the overweight and sodium restriction are often effective ther- apy for patients with mild blood pressure elevations. OBESITY The large number of overweight Americans has led experts to regard obesity as a major health problem in the United States. Data developed through skinfold mea- surement (one method of measur- ing obesity) indicate that—— between the ages of 40 and 65—— 40 percent of black women, 20 per- cent of white women, 12 percent of black men, and 13 percent of white men are Obese. Research shows that hypertension and obesity are interrelated and, when they occur in the same individual, they increase that person's risk of cardiovascular disease and death substantially. This is true for men and Women of all ages, black or white. Further- more, weight gain in young adults is especially suggestive of subse- quent blood pressure increases.” Weight reduction has been shown to be an effective method of lowering blood pressure levels in both obese and moderately over- weight hypertensive patients. And blood pressure tends to decrease with weight reduction even if nor- mal weight is not achieved. Although weight reduction does not “cure” hypertension in overweight persons, it can have a striking and long-lasting pressure-lowering effect. *Current Research and ReCOmmenda- tions from the Task Force Reports on Therapy, Pregnancy, Obesity, U.S. Department of Health, Education and Welfare publication (NIH) 79-1631. Report of the Hypertension Task Force, 1979. Vol. 9. SODIUM INTAKE Scientific evidence shows that Salt intake and average blood pressure are related in many populations. The evidence is mixed, however, with respect to the specific effects in individuals: Some but not all hypertensive patients show sub- stantial lowering of blood pressure when dietary sodium is reduced. In most cases, a low-Sodium diet, Combined with the use of a diuretic, lowers blood pressure more than drugs alone. This effect empha- sizes the adjunctive role of sodium restriction in treating all levels of hypertension. Although the average daily intake of sodium by Americans ranges from 2.4 to 72 grams per person, the average requirement has been estimated to be only about 0.5 gram per person per day." The NHBPEP NHBPEP recommends that individ- uals with hypertension restrict their sodium intake to 2 grams daily, this is the sodium content of 5 grams of table salt. Patients need informa- tion to assist them in their attempts to lower salt consumption, including the knowledge that, generally, one- third of an individual's Salt intake occurs naturally in the foods con- sumed, one-third is added during food processing, and one-third is added by the individual consumer *Meneely, G. R., M.D., and Battarbee, H.D., Ph.D. "Sodium and Potassium," Nutrition Review, 34(8):225-235, Novem- ber 23, 1976. Data also indicate that men Consume more Salt than do WOmen, and that intake declines in both sexes with age. EXERCISE To date, the major value attributed to exercise for hypertensive patients is as an aid in weight Con- trol. Moreover, there is an increas- ing body of data attesting to the relaxation effects of regular exer- cise programs. Physically active persons have a lower incidence of cardiovascular diseases than those who live sedentary lives, and research is under way to assess whether and how much of a preven- tive role exercise may play. Hyper- tensive persons who have other Cardiovascular disease Should begin exercise programs only after proper guidance from their physi- Cians. ALCOHOL CONSUMPTION Evidence exists that links regular intake of large amounts of alcoholic beverages to hypertension. Although a cause-and-effect rela- tionship between alcohol and hypertension has not been proved and the precise threshold for the link has not yet been defined, inves- tigators are concluding that daily consumption of three or more alco- holic drinks increases blood pres- sure and is related to hypertension. The evidence also suggests that hypertensives who drink excessive amounts of alcohol are likely to achieve long-term benefits by reducing their intake of alcohol. Therefore, the 1984 Report of the Joint National Committee (JNC) on Detection, Evaluation, and Treat- ment of High Blood Pressure rec- ommends moderating alcohol consumption to help control ele- vated blood pressure. Specifically, the JNC recommends that the daily consumption of alcohol should be less than 16 oz of wine, 48 oz of beer, or 4 oz of whiskey. It should also be noted that the high caloric but empty nutritional value of alco- hol is an important concern for hypertensives who are trying to lose weight. SMOKING Cigarette smoking has been shown to raise blood pressure acutely in the short term. However, long-term Scientific studies to establish an association between smoking and the onset of hypertension have not yet been conducted. But the evi- dence linking cigarette smoking and cardiovascular disease is very for- midable. Research also demon- strates that hypertensives who quit smoking reduce their cardiovascu- lar risk and to an impressive degree. Therefore, hypertensives who smoke should be told that they are further——and significantly ——increasing risk of heart disease and death. DIETARY FATS The JNC suggests that there is a role for lowering saturated fat intake in the diet of hypertensives who have elevated cholesterol levels. In light of the known increased cardio- vascular risk from elevated Choles- terol levels, hypertensive patients would benefit from reducing the amount of saturated fats they COnSUIT!e. OD PRESSURE MONTH step 1: Planning your high blood ACTIVITIES ational High Blood Pressure N Month activities will reflect - the level of effort you put into them. Your efforts Will be suc- cessful if you spend enough time and resources to plan thoroughly and match your May activities with your community's needs and pro- gram goals. Four easy planning tips are outlined below to assist you in preparing for May. The theme for 1985 HBP Month, “Make Control Your Lifetime Goal.” offers countless opportunities for community HBP programs. The fol- lowing planning tips may help you make the most effective use of your program's time and resources in designing your HBP Month activi- ties: In Investigate so you won’t dupli- cate: List the groups and organi- zations in your community that are involved in HBP Control activ- ities. In this inventory, include the services provided, kind and num- ber of clients served, Schedules, and any other important informa- tion. Be sure to survey groups in the public, private, and voluntary sectors (e.g., health depart- ments, Red CrOSS and American Heart Association chapters, as well as major corporate employ- ers). m Focus your interests and activi- ties: No single organization or club can do everything. After completing your community assessment, decide which activi- ties your program could under- take to complement your community's existing HBP con- trol efforts and needs. For exam- ple, detection and referral sites may be needed in communities with significant numbers of per- sons at high risk for HBP (such as the elderly or minority popula- tions), or a series of radio talk shows on weight control and food preparation could be arranged. Choose activities that promote your program's goal and add to your community's overall efforts. m Select your Month activities: Will your HBP Month activities be internal or external, i.e., for your members or employees only, or offered to the entire community? Will they be directed to a specific population? For example, research indicates that young males, especially young black males, experience the most diffi- cult time remaining on therapy for HBP COntrol. - Plan Ahead: Create a HBP Month planning calendar. (See page ) Remember, Month activities often require 2 to 3 months of planning time. Several months prior to May you will need to: —Complete and evaluate your Community assessment as early in the year as possible. —Determine the scope of your HBP Month activities. Specify what they will be, how and when they will be carried out, which staff person(s) will conduct them, with which groups they will be COOrdinated, etc. —Schedule, recruit, Orient, and train any volunteers needed to supplement staff for special classes, presentations, or detec- tion activities. —Find out in advance (and meet) deadlines for placing items in newspapers and newsletters and completing special mailings. “Pig- gyback" HBP information in regu- larly scheduled mailings for other purposes (e.g., payroll or insur- ance bills). —Schedule radio Or television interviews or talk shows On HBP Control. —Place television and radio pub- lic Service announcements (PSAs) with local stations; pre- pare local tag lines promoting your program's services. —Reproduce quantities of mate- rials from this HBP Month kit. —Order supplemental materials from the NHBPEP and Other sources. (See Month order form.) This Month kit includes a 3-month sample planning calendar, as well as a 3-month blank Calen- dar, to assist you in your planning efforts. The sample calendar illus- trates types of HBP Month activities requiring advance preparation. A planning calendar can be a very effective tool in organizing and tracking the many detailed tasks that Contribute to the Success Of your program's Month activities. sample event calendar MARCH 1985 SUNDAY MONDAY TUESDAY WEDNESDAY | THURSDAY FRIDAY SATURDAY 1 (i) 2 3 4 5 6 7 (2) 8 9 10 11 12 13 14 15 16 17 18 (3) 19 (3) 20 (5) 21 22 (6) 23 24 25 26 27 28 29 30 31 1. Determine Month PLANNING GROUP membership. 2. Convene Month PLANNING GROUP-begin community assessment planning. 3. Review assessment results—decide Month activities (group decided on two community seminars with guest speakers, one on nutrition awareness and one on stress reduction and HBP control). 4. Order supporting materials—NHBPEP and other sources. 5. Write membership newsletter article(s); arrange for April placement. 6. Reserve meeting rooms at local libraries for May seminars—blanket community with supporting materials, e.g., posters/announcements. APRIL 1985 SUNDAY MONDAY TUESDAY WEDNESDAY | THURSDAY FRIDAY SATURDAY 1 2 (7) 3 4 (9) 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 (O) 27 28 29 30 7. Contact local media for talk show slots to promote seminars and HBP Month. 8. Send letters of invitation to health/social service and community groups. 9. Confirm speaker, audiovisual, and logistical needs. 10. Mail announcements to local papers. |MAY 1985 SUNDAY MONDAY TUESDAY WEDNESDAY | THURSDAY FRIDAY SATURDAY 1 (5) 2 3 4 5 6 7 8 9 (2) 10 11 12 13 14 15 (3) 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 (15) 11. Mail announcements to local radio/TV stations; arrange onsite interview(s) with guest speaker(s). 12. NUTRITION AWARENESS SEMINAR (see 3 above). 13. Same as 11. 14. STRESS REDUCTION SEMINAR (see 3 above). 15. Write articles on (a) success of seminars, and (b) importance of HBP control. AVGHſl_IVS AVCNIH- AVCISHſ)HL AVCISENCIENA AVCISEſ) L AVCINOW AVCINſ)S AVW AVOEſ), LVS AVCIIH- AVCISHſ)HL AVCISENGENA AVCISEſ) L AVCINOW AVCINſ)S TIE CV AVOEſ), LVS AVCIIH- AVCISHſlHL AVCISENCIENA AVCISEſ) L AVCNOW AVCINſ)S HQ: WW tep 1 suggested important action steps for deciding Which activities Or events to offer during May. Step 2 focuses on putting those ideas into action—— carrying out National High Blood Pressure Month activities. Keep in mind that you can make others aware of your HBP Month (and year-long) plans by including HBP information and services in ongoing programs, rather than organizing separate activities just for May. In this way, each group involved will have an opportunity to contribute according to its own interest and resources. Local cooperation can reduce duplication of services pro- vided. By working together, various groups can share resources, which may lead to additional services offered and perhaps even expan- sion to a year-round community effort. SUGGESTED ACTIVITIES: HBP MONTH 1985 There are many kinds of organiza- tions that are interested in partici- pating in HBP Month, and there are a number of ways each organiza- tion can contribute. The following paragraphs contain suggestions for activities that you and your organi- zation might undertake in support of HBP. Month. Remember to use planning results from step 1 as you consider these and any other imple- mentation ideas that you may develop. Health providers and health facili- ties such as physicians' offices, hospitals, health departments, com- munity health centers, health main- tenance organizations, etc. Included here are public, private, and voluntary sector personnel and organizations. Rationale for action: Patient adherence to treatment regimens requires ongoing support and encouragement from health provid- ers. May is an ideal time to focus on patient information to promote HBP control. It is particularly appro- priate this year because the latest guidelines for the detection, evalua- tion, and treatment of HBP include a number of important changes. Highlights include new medications and new nondrug therapies. In addition, special populations such as diabetics, the elderly, and preg- nant women require particular attention in HBP management. Implementation ideas: Some of the following ideas may meet the needs identified in your community assessment (step 1). In Distribute copies of the NHBPEP's 1984 Joint National Committee Report of the Detec- tion, Evaluation, and Treatment of High Blood Pressure to health professionals (see Month Order Form). Sponsor continuing med- ical education sessions in May, on topics covered in the report such as new pharmacologic agents to treat high blood pres- SUre. In Send special messages to hyper- tensive patients encouraging them to continue controlling their HBP by following their doctors' advice and staying on therapy. If they have been prescribed medi- cation, they should continue tak- ing it as directed. Provide these patients with the opportunity to report problems or fears and to ask questions. Consider estab- lishing a HBP call-in time during May. m Focus a May meeting on approaches to controlling HBP Highlight the various HBP and Cardiovascular risk factor reduc- tion efforts Outlined in the 1984 Joint National Committee's report. In Arrange for a nutritionist to speak at a professional society meeting about sodium and weight control, emphasizing practical facts that providers need to know for effec- tive patient counseling (e.g., sodium, potassium, and calorie content of various foods; making a realistic diet plan that involves small, incremental changes; how to work with various health disci- plines such as dietitians, nurses, pharmacists, etc., for the patients' benefit.) m Sponsor a seminar for health care professionals on the rela- tionship of HBP and other known and suggested risk factors for heart disease (e.g., Smoking, stress, sedentary lifestyle). Dis- cuss what is known about reduc- ing these risks and how to counsel patients on preventive health practices. In Develop a list of ongoing and upcoming community activities related to nondrug recommenda- tions for HBP patients (e.g., weight and sodium control, exer- cise, and smoking cessation). Distribute the list as a resource to others in your locale who are involved in the treatment of HBP patients. In Set measurable objectives for the educational activities you sponsor, both during HBP Month and year-round. Keep records on how activities were undertaken, who and how many persons par- ticipated, how the activities were received, and the results. Eval- uative information can help you plan future program efforts and justify resources allocated to these areas. (See page 11.) - Arrange to have a patient educa- tor/nurse clinician speak at pro- fessional meetings on how they help their patients stay on phar- macologic therapy. Develop a list of critical patient behaviors and discuss how professionals can use them to keep patients on therapy. WORKSITES Rationale for action: Occupational settings are a “natural” for HBP education and control activities. A large proportion of the adult popula- tion can be found in WorkSites, which are accessible locations for HBP control efforts. Worksites offer a convenient place for detecting and referring as well as for counsel- ing hypertensives to maintain their HBP therapy. |MPLEMENTATION IDEAS m Hold a “brown bag lunch" at work one day each week to dis- cuss weight and sodium control. Ask participants to bring interest- ing low-sodium, low-calorie lunches and discuss the Choices they have made. In Work with staffs of cafeteria and vending machine companies to increase employee awareness about the benefits of healthy diet. Work with these parties to make appetizing low-calorie, low- Sodium, low-fat foods available. m Make May HBP Month at your worksite. Sponsor a film about HBP and cardiovascular risk reduction and follow up with posters, articles in newsletters, and brochures inserted with employee paychecks. (See the paycheck stuffer in the supple- mentary materials section.) In Integrate your employee program with other community resources. Know what is available, and explore ways your company's or union's program can work with existing health projects. For example, hold a series of classes on coping with HBP in conjunc- tion with the American Heart ASSOciation or American Red Cross. Focus on skill-building aspects to promote staying on therapy. Increase the number of participants by offering free blood pressure services, includ- ing rescreening, referral, fol- lowup, and education Counseling for those with elevated readings. - Offer educational materials and displays in cafeterias, hallways, and other places where employ- ees congregate. Rural community groups such as Ruritan, the Grange, 4-H Clubs, county extension service offices, Homemakers' Councils, churches, Farm Bureau affiliates, and Future Farmers of America. Rationale for action: Socioeco- nomic and demographic factors prevailing in rural communities make health care delivery and pre- ventive programs particularly diffi- cult to operate and sustain. Studies suggest that the control of HBP in rural communities has not improved as rapidly as in urban areas. Try some innovative approaches with this hard-to-reach population. |MPLEMENTATION IDEAS m Make a special effort to hold pro- grams or distribute materials where rural people meet (e.g., churches, post offices, shopping centers, and meetings of special groups). m Provide transportation to encour- age people to participate in HBP control activities, particularly Senior citizens and rural resi- dents in remote areas. m Use National Hospital Week (May 11-18) to educate patients and consumers about high blood pressure. There are thousands of small and rural hospitals in the United States. Offer detection and referral Services at a COm- munity open house. - Target educational programs or messages to the educational level, language, and cultural characteristics of the population. OTHER INTERMEDIARY GROUPS Putting ideas into action for HBP Month requires careful thought and planning. It also requires continu- ous updating and working with new and different community groups whose expertise or clientele result in an ideal partnership and make HBP control successful. The follow- ing are examples of other interme- diary organizations that reach people in groups: m School health education pro- grams can include information on the relationship of diet and exer- cise to HBP and on how good health habits may help keep BP down. Libraries can distribute materi- als about diet, exercise, and HBP May is a time to develop a spe- cial display of low-sodium, low- calorie cookbooks and to post information about low-SOdium cooking demonstrations and related activities. Parent-Teacher Associations can sponsor educational pro- grams for adults and children about diet, good health habits, and HBP. PTAs can also help influence the content of School curricula and help teachers update the information in their presentations. Churches, synagogues, and social or civic clubs can spon- sor good tasting, low-Sodium, low-calorie meals at One Or more regular functions. Give sample menus to those who will prepare the food, or have a dietitian offer Some advice. Train members of the congregation to serve as HBP control aides. Make them the focal point for individual problem-solving about medica- tions, staying on treatment, and available resources, etc. Grocery stores can provide Con- Sumers with information about the sodium and calorie Content of foods. This might include devel- oping shelf markers to spotlight recommended items and “Stuff- ers" for shopping bags (low-fat, low-calorie recipes; flyers on how to read labels; information On weight, salt, and HBP etc.). Also try prominently advertising low- sodium foods; offering store spe- cials on low-calorie, low-SOdium items, or highlighting manufac- turer coupon specials for low- calorie or low-sodium items. Weight loss, fitness, and ama- teur athletic groups can serve as a resource for patients who want to lose weight; distribute educational materials, or display information about Month activi- ties. Fast food eateries can encour- age nutrition labeling of selected items, lower calorie options such as salad bars, or unsalted entrees available on request. WORKING WITH THE MEDIA ational High Blood Pressure Month is a time to focus community interest on HBP concerns. Step 2 listed a variety of activities that community organiza- tions can sponsor during May or year-round. Promoting these activi- ties to others is important and should not be overlooked as you plan and carry out HBP Month activities. Using the media, you can raise awareness about HBP and help to communicate the latest information on the subject. Promo- tional efforts can attract attention and clients to your program, build local support for HBP services, and help your community learn impor- tant new facts. Radio and television Stations, newspapers, and other media wel- come information about community activities. Below are some ideas for working with the local media to inform the community about your HBP Month activities and your ongoing programs. You can feature current topics such as diet and exercise for weight control. Most of these ideas use materials provided in this kit or materials you can order with the enclosed form. Some of them are for May, but others can be used to promote HBP control all year. m Develop a distribution list for press releases. When your activi- ties or other news about HBP needs attention, Send a release to everyone on the list. Keep your list up to date. Include newspaper editors of the family, food, health, and Science Sec- tions and, for worksite efforts, the business section; the editor of your own newsletter and those of related organizations you work with; information officers of pub- lic and private health agencies; & & and local or regional wire service bureaus (Associated Press and United Press International are the major ones). The question- and-answer article in the Media Tools Section of this kit is designed to be sent to newspa- per editors. Make sure you replace Dr. Edward J. Roccella's name (who is listed as the speaker in the article) with the name of your guest speaker. Check with public service announcers, program directors, Or hosts of talk shows at local radio and television Stations about producing a half-hour or hour special on HBP. The NHBPEP has developed an easy-to-use television kit called “The Silent Disease,” to make it easy, with scripts, videotaped inserts, slides, and questions and answers for a guest inter- view. The program is ideal for stations in medium- and Small- sized markets. Do not forget Cable television stations and closed-circuit educational Outlets. (See available materials lists for contact information.) Contact television and radio pub- lic service directors in your area about having their announcers read short HBP messages during May. You may want to use the sample 20-second announce- ment included in the feature sheets and tailor it to your pro- gram needs. The NHBPEP Spring media campaign will also include new live announcer copy as well as public service announcements for print and electronic media. Be Sure to list your organization as the contact for further information. Work with program directors from local radio and television talk shows to schedule guests from your organization (or coop- erating groups) during May. They can discuss HBP issues, such as ways of staying on therapy, and provide your activities and orga- nization free publicity. The question-and-answer article in the Media Tools Section can be used as a sample format. Again, replace Dr. Roccella's name with the name of your guest speaker. Hold a dinner or ceremony to rec- ognize volunteers. Reproduce copies of the Certificate of Appreciation in the “Supplemen- tary Materials," package it attrac- tively, and distribute to volunteers at the presentation. Send press releases about the ceremony and the volunteers' activities to edi- tors and media directors on your distribution list. Try to include a black-and-white photograph in releases, particularly those to newspapers. Organization news- letters or neighborhood newspa- pers will often use a release naming “one of their own.” Take the HBP MOnth Proclama- tion in the Supplementary Materi- als to the mayor, county commissioner, or governor to get an official to declare May as HBP Month. Often the jurisdiction will issue a news release describing HBP Month, this year's theme, and your activities. With advance notice and information about the prevalence of HBP in your area, a local television station may be interested in covering the signing of the proclamation. Media cover- age may be enhanced if the offi- cial issues or reads the proclamation at a program site. Work with other local HBP pro- grams to develop a calendar with times, places, and descriptions of May activities. Send the calendar to everyone on your distribution list. Some editors may publish the whole calendar Once, while others may include relevant por- tions in regular, daily, or weekly community calendar features. 10 Remember, using the media to feature your activities requires effort. Your message must be pre- sented and perceived as having news value or being of particular interest to readers Or viewers. To assist you in determining what would likely be used to help you write attention-getting HBP mes- sages, review the 11 items below to help you in what may appeal to media gatekeepers. 1. Something new that no one has ever said or heard before. 2. Something timely; yesterday's news is old news. 3. Something that involves a pub- lic figure, a celebrity, or a well- known organization. 4. Something unusual or ironic. 5. Something with a human inter- est angle. 6. Something visual (for television and photographs). 7. Something that centers around an event. 8. Something that effects a large number of people. 9. Something accessible to the media (e.g., location, time, etc.). 10. Something that is a variation of a theme already receiving media attention. 11. Something interesting on an otherwise slow news day. Any one of these characteristics alone may not be enough to raise interest in the media, but a few in combination can often make good COpy. & - ź º eviewing the Successes and - failures of your HBP Month El Bºl efforts will help you to plan your next activities. Review these activities using the available facts, compare the results of each activity with its original intent, and then determine the effectiveness of each activity. This review can help you in many new ways. Identifying and diagnosing prob- lems: Be aware of the initial response to HBP Month activities in case modification or adjustments are necessary. For example, low rates of success in finding undi- agnosed hypertensives in a screen- ing and referral activity may indicate that the screening site or the strategy for promoting the pro- gram should be altered. Identifying effective activities: When the decisions are being made to repeat certain HBP activities, those which have been most effec- tive and best received by the spe- cific target audience are usually at the top of the list. By carefully observing the elements of an activ- ity that contributed to its success, program administrators can often improve less effective activities and offer advice to other groups in the community that are planning similar HBP Control activities. Evaluating educational efforts: Although the effects of a patient or Consumer HBP education class may not be as easy to measure as other types of activities, it is still possible to learn from them and improve future educational efforts. Giving the participants a simple question-and-answer quiz before and after a class is one way to obtain concrete information about the participants' understanding of the material presented. Also, pay attention to informal participant feedback to gain information about how your activities are being received. Planning and evaluating new ini- tiatives: Review the results of previ- ous program efforts to provide the basis for objective planning of new program activities. This ongoing process can provide further infor- mation for continuously refining and improving future efforts. Gaining and maintaining sup- port: Information collected on the effectiveness and usefulness of your activities can demonstrate your progress and accomplish- ments to Consumers, business leaders, funding sources, and other constituents. You may gain addi- tional support and funding for your activities by presenting information from your evaluations to such groups. Cooperating with others: Lessons sons learned about local response to activities or local problems in delivering services can and should be shared with other organizations in your community. Areawide HBP control is enhanced by cooperating with other local groups, and dupli- cation of efforts can be avoided. In summary: Gathering and using the information from each activity increases the quality of your deci- sions and reduces the need to rely on intuitive judgments about future HBP control activities. It allows you to improve your procedures, shift resources to use them most effec- tively, cooperate better with local organizations, and improve your credibility in the community. 11 ſº ontinue the momentum e achieved in May during \º National High Blood Pres- sure Month by using the activities below to decide how you and your organization will continue the momentum from 1985 HBP Month. Controlling HBP is a year-round effort. Reducing risks takes sus- tained interest and activity. YEAR-ROUND ACTIVITIES In Organize a self-run support group among your treated patients to enable them to help one another with lifestyle changes, problem solving, and family reactions to their condition and the requirements of their individual regimens. Hold periodic open meetings to give family members of your treated patients an opportunity to ask questions, receive praise for their support, and vent their frus- trations. Find a community newspaper or journalist willing to establish a regular Column of questions and answers about HBP and its con- trol. Ask a grocery or drugstore to sponsor a HBP poster contest with donated prizes. Approach a local service or busi- ness club about dedicating its next community event to HBP control, contributing all or part of the funds raised to establish a needed HBP Service. Visit the public library and arrange to place HBP information in One or more locations. Place an article about low- Sodium cooking, including reci- pes, in a local publication such as the food section of the weekly newspaper or neighborhood “advertiser.” Talk to members of your civic or Church group about having a HBP information table at its next regular gathering, or start a HBP education Committee. Remember that hypertensive patients need to continue their dietary and/or medication regi- mens all year to control their blood pressure. Remind them of it every chance you get. Know your allies in HBP control ——the groups and facilities in your area that regularly offer HBP Services, such as a litera- ture rack, free blood pressure measurement, patient education classes for treated patients, or free public education sessions. 12 TOMORROW TOMORROW TOMORROW TOMORROW TO DRROW TOMORROW TOMORROW TOMORROW TO OMORROW TOMORROW TOMORROW TOMORROW T OW TOMORROW TOMORROW TOMORROW TOMORRC DMORROW TOMORROW º TOMORROW TOM TOMORROW TOMORROW TOMORROW TOMORROW T IORROW TOMORROW TOMORROW TOMORROW TOMO TOMORROW TOMORROW TOMORROW TOMORROW Tomorrow Tomorrow toworrow Tomoh.now DW TOMORROW TOMORROW TOMORROW TOMORRO MORROW TOMORROW TOMORROW TOMORROW TOMO | If you want all these tomorrows, folke core of your high blood pressure foddy. High B000 Pressure. Tredi iſ for life. . . foddy. IA National High B000 Pressure Education Program,National Heart, Lung, and B000 Institute. National InstituteS Of Health, Public Health Service. U.S. Department of Health and Human Services TAKE LOSE USE SALT EXERCISE IF YOU MEDICATIONS EXTRA SENSIBLY REGULARLY SMOKE, AS POUNDS Walk, jog, ride) STOP PRESCRIBED U.S. Department of Public Health National Institutes National Heart, National High Blood Health and Human Service of Health Lung, and Blood Pressure Education Services Institute Program ; ; ź ź ź 2 º & % Evaluation AND ORDER FORM National High Blood Pressure Month 1985 HIGH BLOOD PRESSURE INFORMATION CENTER 120/80 National Institutes of Health Bethesda, Maryland 20205 (301) 496-1809 (All items are free, allow 6 weeks for delivery) Name Organization Street City State Zip Code Telephone No. (Include area code) Please complete this section and return, even if you are not ordering additional materials. 1. What type of organization best describes your program setting? (check the appropriate response) [] Health Department [] Voluntary Health Agency D Business or Industry [] Hospital [] Neighborhood Health Center D Civic or Service Group [ ] Educational Institution [ ] Armed Forces [] Other (specify) [] Nursing Home || Professional Association [] Solo or Group Practice 2. Does your organization target its high blood pressure control activities toward any of the following special populations? (check all that apply) [I] Elderly [ ] Minorities - [ ] Youth | | Rural [] Employees [] Other (specify) 3. How many years has your organization participated in National High Blood Pressure Month? (check the appropriate response) [ ] This Is Our First Time [ ] 4-6 Years [ ] 1-3 Years | || 7-10 Years 4. In which blood pressure activities is your organization involved? (check all that apply) | | Professional Education | | Public Education [] Referral and Followup || Patient Education | | Detection [] Other (specify) 5. Do you conduct these activities year-round or only during May? (check appropriate response) […] All Year | | Part of Year [] May Only 6. How useful are the items in the National High Blood Pressure Month kit to your organization? (circle one response for each type of material) Type of Extremely Very Somewhat Material Useful Useful Useful Useful Not at all a. Planning Calendar 1 2 3 4 5 b. Media Tools 1 2 3 4. 5 C. Handbills 1 2 3 4 5 d. Reproducible Pamphlets 1 2 3 4 5 e. Wallet Cards 1 2 3 4 5 f. POSter 1 2 3 4 5 g. List of Materials Available 1 2 3 4 5 from Other Sources 7. Will your organization place a special emphasis on any of the following issues for your National High Blood Pressure Month activities? (check all that apply) [] Nondrug Therapy [ ] Risk Factor Assessment || Patient Adherence [] Mild High Blood Pressure 8. Do you have any suggestions for ways we could improve the National High Blood Pressure Month kit? MATERIALS FOR PROFESSIONALS These materials are designed for use by health professionals in conjunction with professional education programs or as program planning resources. Quantity Ordered 1984 Report of the Joint National Committee on Detection, Evaluation, and Treatment of High Blood Pressure (36 pages) Presents latest Consensus recommen- dations for diagnostic tests, stepped-care approaches, nonpharmacologic therapy, and long-term maintenance. Community Guide to High Blood Pressure Control (137 pages) Summarizes approaches to program devel- opment, examines education and patient teaching, and dis- cusses funding. High Blood Pressure Con- trol: information and Edu- cation Strategies for Messages to Public and Patient Audiences (20 pages) NHBPEP communica- tions strategy statement for public and patient information and education messages. The Public and High Blood Six-Year Followup Survey of Public Knowledge and Reported Behavior (134 pages) Compares results of 1973 and 1979 surveys on public knowledge and atti- tudes about high blood pres- SUſe. Report of the Working Group on Critical Patient Behaviors in the Dietary Management of High Blood Pressure (44 pages) A 10- step definition of patient and professional behavior and skills for controlling sodium intake and weight. The State Legislature and High Blood Pressure State- ment on Hypertension Pro- gram Funding (6 pages) Explains how to work with state and federal legislators to promote funding and sup- port for high blood pressure programs. The Physician's Guide: How to Help Your Hypertensive Patients Stop Smoking (24 pages) Shows what every physician can do within a busy office practice to per- suade hypertensive patients to stop smoking. Collaboration in High Blood Pressure Control: Among Professionals and with the Patient (4 pages) Position statement by the NHBPEP Coordinating Committee dis- cusses the benefits of Collab- oration between health professionals and patients. Patient Tracking for High Blood Pressure Control (66 pages) manual for planning and operating a patient tracking health system for improved control of high blood pressure in a variety of Care settings. Printed Aids for High Blood Pressure Education: A Guide to Evaluated Materi- als (98 pages) Description of materials from a variety of Sources categorized by over- all quality and reading level. High Blood Pressure Con- trol: A Resource Package for Nurse Educators Con- tains materials to assist nurse educators in increasing their students' knowledge and skills in high blood pressure COntrol. High Blood Pressure and What You Can Do About it (32 pages) Describes nature and measurement of blood pressure, both normal and high, with discussion of treat- ment and Side effects as well as lifestyle changes that might be recommended. Teaching Patients About Hypertension and Diet (10 pages) Summarizes teaching issues related to nutritional management of high blood pressure and emphasizes the need to control the patients' Sodium intake, potassium bal- ance, and weight. Also pre- Sents suggestions for helping individuals develop new eat- ing patterns. Statement on Hypertension in the Elderly of the NHBPEP Coordinating Committee (8 pages) A state- ment on elevated blood pres- sure diastolic and systolic elevation, and treatment of “mild” hypertension in the elderly. Based on findings of the Hypertension Detection and Follow-up Program. Low-Salt Medications: An Updated List to Help Phar- macists (16 pages) Lists 773 prescriptions and over-the- counter products that can be recommended for use by patients on salt-restricted diets. MATERIALS FOR PATIENTS AND CONSUMERS A Note on Selecting Patient and Consumer Materials An asterisk (*) placed next to some listings indicates that the publication was specifically designed for a certain minority audience. Reading level indications for pamphlets were calculated using the SMOG Readability Formula. The levels roughly correspond to these grade levels: Very Easy, grades 6-7, Easy, grade 8; Average, grades 9-10; Fairly Difficult, grades 11-13. Quantity Ordered Pamphlets "Blacks and High Blood Pressure (brown and grey pamphlet, 8 pages) Describes high blood pressure, its importance to blacks, the need for treatment, and the role of the patient's family. Very Easy reading level. High Blood Pressure Facts and Fiction (black, white, and blue leaflet, 4 pages) Ideal handout to anyone get- ting a blood pressure mea- surement. Contains basic facts about high blood pres- Sure, and COrrects SOme COm- monly held misconceptions. Easy reading level. Questions About Weight, Salt, and High Blood Pres- sure (black, white, and pink pamphlet, 8 pages) Describes what is known about the rela- tionship between certain diet changes and high blood pres- sure. Average reading level. OTHER MATERIALS *Verdad y Ficcion Sobre la Presion Arterial Alta (black, white, and green leaflet, 4 pages) Spanish version of High Blood Pressure Facts and Fiction. Easy reading level. Posters High Blood Pressure Mes- sages (16"x20") National High Blood Pressure Month poster with blank space to write in announcements of your activities. Life Savers (16"x20") Full- color poster describes a vari- ety of actions needed to maintain one's high blood pressure treatment regimen. Make Control Your Lifetime Goal (11"x25") Four-color poster reminds patients to take their medication, lose ex- tra weight, use salt sensibly, exercise regularly, and, if they smoke, stop. Some Hints for People Who Take High Blood Pressure Medicine (12"x18") Magenta, blue, and black poster reminds patients to develop medication-taking skills and to talk with their doctor, nurse, or pharmacist when questions arise. *Their Future Is in Your Hands. Treat Your High Blood Pressure Everyday (16" x 20") Five different full-color posters depicting children representing various ethnic and geographic groups. Poster may be - ordered with children repre- senting the following groups: Blacks Hispanics (copy in Spanish) Native Americans Rural Populations U.S. Asian and Pacific Island Populations Quantity Ordered Down with High Blood Pres- sure (lapel stick-on badge, 2" diameter) Red and white badge with message and high blood pressure symbol. . Useful for screenings, patient education, meetings, etc. Ż 2 z: ź gº Ż For More information In addition to distributing materials listed here, the High Blood Pressure Information Center serves as a central national clearinghouse for information on various aspects of hypertension control and can assist in locating speakers and other SOurces of educational materials and audiovisual aids. HIGH BLOOD PRESSURE INFORMATION CENTER 120/80 National Institutes of Health Bethesda, Maryland 20205 (301) 496-1809 MATERIALS AVAILABLE FROM OTHER SOURCES PATIENT AND CONSUMER PAMPHILETS The Sodium Content of Popular Prepared Food Items (pamphlet, 11 pages) This pamphlet provides a handy ref- erence guide to meal planning for individuals Who Want to reduce their Sodium intake. Contains charts that list the Sodium values of Common prepared foods. Availability: Attention: Consumer Affairs Morton Salt Division Morton Norwich Products 110 North Wacker Drive Chicago, IL 60606 (312) 621-5582 Cost: Free, limited quantities AGE PAGE: Be Sensible About Salt (flyer, 1 page) This flyer discusses salt and sodium and their relationship to high blood pressure, and provides practical tips for reducing the amount of sodium in the diet. Availability: NIA/Age Page 9000 Rockville Pike Building 31, Room 5C35 Bethesda, MD 20205 Cost: Free, up to 50 copies NOTE: This is a government publi- cation and may be reprinted without permission. Please send a postcard when ordering. Exercise and Your Heart (pam- phlet, 43 pages) This pamphlet, directed toward a general audience, presents up-to- date information on the effects of physical activity on the heart, and offers practical guidelines for start- ing and staying on your own exer- cise program. Availability: (single copy) Publications Section Public Inquiries and Reports Branch National Heart, Lung, and Blood Institute Bethesda, MD 20205 Cost: Free Availability: (multiple copies) Superintendent of Documents U.S. Government Printing Office Washington, DC 20402 Order no. 017-043-00105-2 Cost: $80 per 50 copy package 10 percent discount on orders of 100 copies or more Sodium: Facts for Older Citizens (pamphlet, 11 pages) This pamphlet discusses what Sodium is, what it does, where it is found, and how to Watch the amount you eat. Availability: Food and Drug Administration 5600 Fishers Lane Rockville, MD 20857 Order NO: HHS Pub. No. 83-21.69 Cost: Single copies available free. This is a government publication and may be reprinted without permission. f ſ SOURCES OF INFORMATION SERVICES The following resources provide information services, such as publi- cations and referrals, to both Con- sumers and health professionals. Please contact the organization directly. CONSUMER INFORMATION Consumer Information Center Pueblo, CO 81009 (202) 566-1794 Distributes consumer publications on topics such as children, food and nutrition, health, exercise, and weight control. The Consumer Information Catalog is available free from the Center and must be used to identify requested publica- tions. NUTRITION Food and Drug Administration (FDA) Office of Consumer Affairs, Public Inquiries 5600 Fishers Lane (HFE-88) Rockville, MD 20857 (301) 443-3170 Answers consumers' inquiries to the FDA and serves as a clearing- house for its consumer publications on a variety of topics including vita- mins, food additives, and minerals. PROFESSIONAL AND CONSUMER INFORMATION American Heart ASSOciation National Center 7320 Greenville Avenue Dallas, TX 75321 Or contact your state affiliate of AHA. m = FILLER ARTICLES Use these articles in your organization's periodicals, or reproduce them as handouts. WHAT IS HIGH BLOOD PRESSURE? High blood pressure is a condition in which a person's blood pressure becomes too high and stays there. Blood pressure normally goes up and down during the day, depend- ing on a person's activities. The problem occurs when blood pres- sure stays too high. About One in four Americans has high blood pressure. It is a danger- Ous disease if untreated because it can lead silently but directly to crip- pling or deadly events—heart attack, stroke, and kidney failure. High blood pressure is especially dangerous because it has no out- ward signs. A person can have it and not even know. It rarely pro- duces symptoms. It does not hurt, and it rarely causes dizziness, nerv- Ousness, or headaches. As a result, many people live with high blood pressure for years without knowing it, but they still suffer the physical effects. It is very important for people to have a regular blood pressure checkup and, if it is high, to follow the prescribed treatment. Along with drugs, salt reduction, weight loss for the overweight, and exer- cise are among the most important ways to treat high blood pressure. GOOD HEALTH HABITS HELP YOU BEAT THE ODDS What do uncontrolled high blood pressure, high blood cholesterol, and smoking have in common? They all increase your chances of getting heart disease. And don't forget: excessive salt consumption and heavy drinking may contribute to your chances of having high blood pressure. But you can reduce your odds by losing excess weight, quitting smoking, reducing salt consumption, and controlling your blood pressure. How much? The answer is differ- ent for each person. Your doctor can tell you how big a chance you may be taking with your health by not controlling risks that can be modified Or eliminated. How many risks are you willing to try to reduce? Talk with your doctor about changing everyday habits to help you beat the odds. Then decide which change you are able to make first, and begin immedi- ately. sALT AND Your Blood PRESSURE Research shows that some people can lower their high blood pressure by cutting down on their salt intake. Table salt is a compound made up of Sodium and chloride. It is the sodium in salt that causes the prob- lem. Most of us consume much more than we need. If you are hav- ing a problem with your blood pres- sure, your doctor may prescribe pills or ask you to cut down on your salt consumption. To reduce your sodium intake, you can eliminate table salt from your diet and avoid prepared and canned foods. Ask your doctor or dietitian for more specific ways to cut down on salt intake. HIGH BLOOD PRESSURE IS A FAMILY AFFAIR Doctors have found that there is a chance of more than One member of a family having hypertension. Family members will benefit if they learn early on how to deal with high blood pressure, watch their own weight, cut back on salt, and get more exercise. As they help you treat your high blood pressure, they will help themselves. Give your family members things to do to help them help you control your high blood pressure. Your doc- tor or nurse can tell you how to measure blood pressure and record readings on a chart. A family mem- ber might be asked to remind you to take daily medication. Family mem- bers also can help with pill refills, doctor visits, and getting help from Other health WOrkers like educators, nutritionists, or dietitians. Friends can help, too. Changes your doctor asks you to make— such as reducing your weight, using less salt, exercising more, or smok- ing less—effect activities often done among friends. Tell a friend you need help following your doc- tor's advice. : # illions of Americans have M high blood pressure and need to control this risky situation. Maybe you do, too. If your doctor prescribes medication, follow this advice, and take your pills everyday. Doctors often suggest losing weight and reducing the sodium in your diet as part of the treatment. This is where you can take control of your diet to help bring down your high blood pressure and reduce the risk of suffering a stroke or heart disease. Losing weight and avoiding salty foods aren't easy. Your doctor, nurse, or nutritionist can make helpful suggestions, but eventually you are the one in con- trol of your life. : # illions of Americans have M high blood pressure and need to control this risky situation. Maybe you do, too. If your doctor prescribes medication, follow this advice, and take your pills everyday. Doctors often suggest losing weight and reducing the sodium in your diet as part of the treatment. This is where you can take control of your diet to help bring down your high blood pressure and reduce the risk of suffering a stroke or heart disease. Losing weight and avoiding salty foods aren't easy. Your doctor, nurse, or nutritionist can make helpful suggestions, but eventually you are the one in con- trol of your life. # # : s |-- m -- (-) © illions of Americans have M high blood pressure and need to control this risky situation. Maybe you do, too. If your doctor prescribes medication, follow this advice, and take your pills everyday. Doctors often suggest losing Weight and reducing the sodium in your diet as part of the treatment. This is where you can take control of your diet to help bring down your high blood pressure and reduce the risk of suffering a stroke or heart disease. Losing weight and avoiding salty foods aren't easy. Your doctor, nurse, or nutritionist can make helpful suggestions, but eventually you are the one in con- trol of your life. ão illiones de personas tienen M presion de sangre elevada y necisitan tomar control de esta situacion. Possiblemente, usted es una de esas personas tambien. Si su medico le receto medicamento, necesita seguir su consejo, y tomar sus pildoras todos los dias. Como parte del tratamiento, medicos tambien sugieren que pierda peso y reduzca el uso de la sal en sus comidas. Aqui es donde usted puede tomar control de su dieta al bajar la presion de la san- gre y reducir el resigo de un ataque del Corazon o enfermedad del Cora- zon. No es facil perder peso y evitar las comidas saldas. Su medico, enfermera, o especilista en nutri- cion le pueden dar sugerencias saludables, pero solo usted puede tomar control de su vida. illiones de personas tienen M presion de sangre elevada y necisitan tomar control de esta situacion. Possiblemente, usted es una de esas personas tambien. Si su medico le recetO medicamento, necesita seguir su consejo, y tomar sus pildoras todos los dias. Como parte del tratamiento, medicos tambien sugieren que pierda peso y reduzca el uso de la sal en sus comidas. Aqui es donde usted puede tomar control de su dieta al bajar la presion de la san- gre y reducir el resigo de un ataque del corazon o enfermedad del Cora- zon. No es facil perder peso y evitar las comidas saldas. Su medico, enfermera, o especilista en nutri- cion le pueden dar sugerencias saludables, pero solo usted puede tomar control de su vida. illiones de personas tienen M presion de sangre elevada y necisitan tomar control de esta situacion. Possiblemente, usted es una de esas personas tambien. Si su medico le receto medicamento, necesita seguir su consejo, y tomar sus pildoras todos los dias. Como parte del tratamiento, medicos tambien sugieren que pierda peso y reduzca el uso de la sal en sus comidas. Aqui es donde usted puede tomar control de su dieta al bajar la presion de la san- gre y reducir el resigo de un ataque del corazon o enfermedad del COra- zon. No es facil perder peso y evitar las comidas saldas. Su medico, enfermera, o especilista en nutri- cion le pueden dar sugerencias saludables, pero solo usted puede tomar control de su vida. WALLET CARD (Back side of card) This is your blood pressure record for you to keep This is your blood pressure record for you to keep Date Date Date Date Date Date Blood Pressure / Blood Pressure / Weight Weight Smoke? HOW much? Smoke? HOW much? Add salt to food? Add salt to food? --> tº- º- - º is -º- -> - - t- - - -º-º: º - - -ºmºs mº tº- - -* = H This is your blood pressure record for you to keep — | This is your blood pressure record for you to keep | | | | | | | | | | | | | | Date Date Date | Date Date Date Blood Pressure / Blood Pressure / Weight | Weight Smoke? How much? | Smoke? How much? Add salt to food? Add Salt to food? |—————————————————————— –––––––––––––––––––––––– | This is your blood pressure record for you to keep This is your blood pressure record for you to keep | | | | Date Date Date | Date Date Date | Blood Pressure / | Blood Pressure / Weight Weight | Smoke? HOW much? | Smoke? How much? | Add Salt to food? | Add salt to food? | This is your blood pressure record for you to keep This is your blood pressure record for you to keep Date Date Date Date Date Date Blood Pressure / Blood Pressure / Weight Weight Smoke? How much? Smoke? How much? Add Salt to food? Add salt to food? H– ºmº- *- --- -: tº-º - - ---, tºmº - - - -º- - - --> sºme e- - --> —f - - - ams - - -g =e *- - -> tº- - - -> gººms - - --> ºms - - – WALLET CARD (Front side of card) Name Telephone Number Dr.'s Name Dr's Telephone Number Medication(s) Goal Weight Goal Blood Pressure Date to Quit Smoking Name Telephone Number Dr.'s Name Dr’s Telephone Number Medication(s) Goal Weight Goal Blood Pressure Date to Quit Smoking Name Telephone Number Dr.'s Name Dr's Telephone Number Medication(s) Goal Weight Goal Blood Pressure Date to Quit Smoking Name Telephone Number Dr.'s Name Dr's Telephone Number Medication(s) Goal Weight Goal Blood Pressure Date to Quit Smoking Name Telephone Number Dr’s Name Dr's Telephone Number Medication(s) Goal Weight Goal Blood Pressure / Date to Quit Smoking Name Telephone Number Dr.'s Name Dr’s Telephone Number Medication(s) Goal Weight Goal Blood Pressure / Date to Quit Smoking Name Telephone Number Dr.'s Name Dr’s Telephone Number Medication(s) Goal Weight Goal Blood Pressure / Date to Quit Smoking Name Telephone Number Dr.'s Name Dr’s Telephone Number Medication(s) Goal Weight Goal Blood Pressure / Date to Quit Smoking CERTIFICATE OF RECOGNITION This is to recognize the volunteer contributions of to high blood pressure control in our community. Volunteer efforts such as these are fundamental to program success in reducing death and disability related to high blood pressure. This certificate is offered with appreciation and pride. signed signed PROCLAMATION National High Blood Pressure Month Whereas high blood pressure is a major cause of Cardiovascular and related diseases, contributing to more than 770,000 deaths annually . . . Wher60S great progress has been made during the past 10-12 years in publicizing the dangers of uncontrolled high blood pressure and fostering improved control of the disease . . . Whereas the thousands of national and local organizations and groups that work for high blood pressure control can be justifiably proud of the gratifying results they have helped to achieve . . . Whereas a national survey has shown that more than 90 percent of adult Americans know that high blood pressure is a serious disease that cannot be cured, only controlled by continued treatment . . . Whereas an estimated 60 million Americans have high blood pressure and, although three of four persons with hypertension are aware of their condition, surveys show that only one in three is satisfactorily controlling the condition . . . Wher60S people with uncontrolled high blood pressure risk premature illness or death from coronary heart disease, stroke, or kidney failure and people who effectively control the conditon can lead normal, healthy lives . . . Tſierefor€ as , I hereby proclaim the month of May 1985 as National High Blood Pressure Month and I strongly urge all civic, Scientific, medical, educational, voluntary, and health care organizations and professionals to join me in using this month — and the months and years to Come — to educate the public, patients, and health care professionals in the detection, treatment, and control of high blood pressure. Furthermor€, I strongly urge you, my fellow citizens, to have your blood pressure checked regularly and, if it is high, seek and follow your physician's advice. Signature Date º - § § ; - - w º - º: º: ; - - -- § º - - ~ § - É § - §§ w § § § º § §§ É º º §§ §§ º ºš sº §º § § º ; ; º º 㺠: º § Fº §§ É. § § ń. ſº }: § #º § º: - º § § §§ § § §§ - #3 ºùº § É § º: ; § § wr § § §§ # §§§ & § i º º º §§ § § § § § ; § § § ºš º §