By Sandra Millon Underwood, RN, PhD
FAAN Professor, UW-Milwaukee School of Nursing
Most of us know that the heart is one of the most important organs of the body, but did you know that the average heart is the size of an adult’s fist? Your heart beats about 115,000 times each day and pumps about 2,000 gallons of blood every day. And, the Scripture that paraphrased reads, “a merry heart does good like medicine” is true. Laughter really is good for your heart. It reduces stress and gives a boost to your immune system. While these facts are meant to be light and interesting, maintaining a healthy heart is serious business. One of the best ways to do this is by practicing healthy eating habits and exercising.
The Center for Disease Control and Prevention (CDC) recommends that adults get at least 150 minutes of moderate-intensity aerobic physical activity or 75 minutes of vigorous-intensity physical activity each week. The guidelines also recommend that children and adolescents be active for at least 60 minutes every day. A single round of moderate- to-vigorous physical activity can improve sleep, memory, and the ability to think and learn. It also reduces anxiety symptoms. Following these guidelines can contribute to overall health and decrease the risk of chronic diseases such as heart disease, cancer, and diabetes.
When some people think of exercise, they think of gyms. These options often come with prohibitive barriers such cost and transportation. There is another, FREE way to exercise—walking. Walking is a great way to get the physical activity needed to obtain health benefits and it does not require any special skills, gym membership or expensive equipment.

DNP, RN, AGPCNP-BC,
Dr. Nygil Matthews, DNP, RN, AGPCNP-BC, a nurse practitioner at the Medical College of Wisconsin agrees.
“Too many people undervalue the impact of a 10-15 minute walk. It can make a big difference. And, if walking outside isn’t your best option, try walking in place while watching television, during commercials. It also helps to find a walking buddy to keep you on track and be accountable to each other,” said Matthews.
Matthews is also a big proponent of health education and learning to advocate for yourself.
“Health education is big in maintaining a healthy heart. So much of clinical time is spent rushing patients in and out, so sometimes we miss that teaching component. Blood pressure is a silent killer and, over time, can contribute to heart disease. As health providers, we must do a better job of meeting people where they are; where they are more comfortable talking about some of the things that affect their health. Then, once they are comfortable, we can share the education piece,” said Matthews. According to the CDC high blood pressure is a major risk factor for heart disease and stroke because it damages the lining of the arteries, making them more susceptible to the buildup of plaque, which narrows the arteries leading to the heart and brain. About 108 million US adults (1 in 3) have high blood pressure. Only about half (48 percent) of these people have their high blood pressure under control. Eating too much sodium can lead to high blood pressure. Americans aged two years or older consume an average of about 3,400 mg of sodium each day, well over the 2,300 mg recommended by the Dietary Guidelines for Americans. More than 70 percent of the sodium Americans consume is added outside the home (before purchase), not added as salt at the table or during home cooking.

Dr. Deborah M. Boateng, a nurse practitioner with Outreach Community Health Centers, regularly sees patients living with hypertension and is somewhat surprised by patient dietary choices—especially since the African American community is plagued with many health disparities.
“Diet and exercise are critical to having a healthy heart. I’m surprised at the number of people in the community that consume sunflower seeds in the shells. This product has a lot of salt. Other foods that are heavily consumed are potato chips and soda; they both contain lots of salt. I try to educate people about the importance of decreasing their salt intake and exercising. And, in terms of exercise, I tell my patients to start small and set achievable goals for walking— gradually moving from five minutes a day to ten minutes. The goal is to get to at least 30 minutes of daily exercise,” said Dr. Boateng.
Along with diet and exercise, Dr. Boateng also advocates engaging proactively with your health care provider and asking questions or expressing your concerns. She said that sometimes faith or lack of funds also cause patients to neglect their plan of care.
“Sometimes patients with strong religious beliefs look to their faith—not medication— for help and deliverance. They believe their higher power will help them stay healthy and alive, but there is human responsibility to consider as well. Other times, money is a barrier—but it shouldn’t be. At Outreach Community Health Centers and other local federally qualified health centers, we have programs that can connect patients to resources to get the medications they need. Our pharmacy also has a subsidized medication program. Follow up and transportation are also barriers that prevent people from staying on track with their plan of care. Our clinics works hard to address those barriers as well.
“Pay attention to your body. If you’ve been diagnosed with high blood pressure, it’s important to understand the gravity of the situation. Hypertension (high blood pressure) can be controlled, but left unchecked it can lead to stroke or heart attack,” said Dr. Boateng.
The Healthy Eating and Active Living Milwaukee (HEAL) is a culturally-tailored program that aims to provide education, resources to secure healthy foods, and active living supports for adults at-risk for developing lifestyle-related diseases; and, to empower adults to make changes in their physical and social environment to improve nutrition and physical activity. ‘Like’ their Facebook page that’s full of videos of healthy recipes and low-cost, no-cost exercise.