Unfortunately, despite being in a practice-what-you-preach profession, I haven't had a practice-what-you-preach week. It seems as if I have eaten my entire body weight in chocolate - my only saving grace being that if you follow "you are what you eat" logic, I am now a Lindt 70 percent "superior quality" chocolate bar, rather than a Snickers (too sweet and a bit nutty.)

Do I have an excuse? Of course! Loads of them! It's amazing how many excuses there are to eat chocolate. But I am now back on a super-healthy tack. The good news is, that if any of us mess up for a few days, it's unlikely to have a lasting impact on our health. Having said that, a healthy heart is something we do need to invest in, so the trick is to make sure that we eat and live well at least 80 percent of the time.

Personally, my investment is paying off. My total cholesterol is low, my good cholesterol is high and my blood pressure is 112/68. This means that my blood pressure is on the lower side of the normal range, the only disadvantage being that I sometimes get a little dizzy if I stand up too quickly, no real problem apart from a few inevitable blonde jokes.

But did you know that very low blood pressure can also cause cardiac problems? Most people don't, so let's just go over the symptoms. They include: dizziness, fainting, poor concentration, blurred vision, nausea, cold/clammy skin, rapid and shallow breathing, fatigue, depression and unusual thirst. If these symptoms apply to you, it's important you check in with your doctor. Now how about the symptoms of high blood pressure (hypertension), what are they?

The problem here is that there often aren't any. Please don't fall into the trap of thinking that if there was something wrong with your heart, you would know! You wouldn't necessarily. If you don't know what your blood pressure is, it's absolutely critical that you find out. Whether you are male or female, heart disease is the number one cause of death in Bermuda, and it's time that we started to take charge. Your doctor will take your blood pressure as part of your annual physical and community health events often provide free screenings. For example, the annual health fair at number one shed, on World Health Day (April 7), provides a great opportunity to have this done. Check out the table to see if your blood pressure is within the healthy range.

So why is blood pressure such a big deal? Well although we are familiar with the term "heart disease", our biggest area of concern is really "artery disease". Three main problems occur in the arteries and all of them contribute to high blood pressure. Firstly, we can develop arterial plaque on the artery walls called atherosclerosis. This plaque reduces the blood flow to the heart. Secondly we can develop blood that is thicker and stickier than normal, containing clots, and thirdly, our arteries can actually harden (a process known as arteriosclerosis.) Individually these are a cause for concern, but together they are especially dangerous ? as they can lead to a blockage of the artery that ultimately stops the flow of blood into the heart. Angina (chest pain upon exertion or stress) usually occurs where there is a partial blockage, and a heart attack occurs where there is a total blockage.

Although low blood pressure can be a concern, high blood pressure is a much more common cause of heart disease. With this in mind, read the steps below to help you to identify and manage your risk. Also, make sure you check in again next Friday to learn about homocysteine - the final piece of the healthy heart jigsaw!

Whilst high blood pressure doesn't necessarily have any symptoms, there are several risk factors you can watch out for. These include: family history, ethnicity (African Americans are more likely to have high blood pressure than Caucasians), increasing age, being overweight, diabetes, kidney disease, alcoholism, stress, poor nutrition, smoking, sedentary lifestyle and pregnancy. Please also note that several medications can contribute to high blood pressure, including oral contraceptives.

A healthy heart is something best invested in early on! This doesn't mean that it's too late to do anything now if you are older, but it does mean that you should be proactive as early as possible. Make sure you go for your annual physical.

Caffeine is a stimulant that promotes the "fight or flight" response, releasing the stress hormones that elevate blood pressure. Avoid caffeinated drinks (including Red Bull and cola) and replace with decaf, or preferably herbal/fruit teas. For those of you haven't yet tried a herbal/fruit/decaf tea you liked, try the Traditional Medicinal brand at Down to Earth or the decaf Revolution teas available at Miles ? quality makes all the difference!

Easier said than done I know, but nicotine is also a stimulant that promotes the fight or flight response. This will of course include the nicotine patch and gum, but both are better alternatives to smoking ? especially if you manage to give up. You can do it!

Be careful here. The American Heart Foundation recommends no more than 2 drinks daily for men and one for women. This doesn't mean that you can save them all up and drink 7-14 in one sitting! Also bear in mind that alcohol raises blood sugar and increases the production of free radicals ? both of which damage arteries.

A layer of muscle surrounds your heart and arteries. Too much sodium and too little potassium can increase the pressure from these muscles, which in turn increases blood pressure. Whilst we all do need some sodium, nobody needs to add salt to their food, there is enough sodium present naturally in our foods. Check food labels for sodium content and aim for less than 1,500 mg daily (that's approximately half a teaspoon.) Ready meals, sauces, deli meats (especially smoked meat or fish) and snack foods often contain lots of sodium. However, it's not enough to simply reduce sodium - you need to increase potassium rich foods too (see next step.)

These foods are rich in calcium, magnesium and potassium ? all important for controlling blood pressure, but magnesium is most important. A severe magnesium deficiency can actually cause a heart attack in the absence of any arterial blockage, as it can result in cramping of a coronary artery. These foods are also rich in fibre, which actively removes bad LDL cholesterol from the body.

Vitamin C has been shown to maintain elasticity of blood vessels. Yellow peppers, blueberries, strawberries, broccoli, oranges and papaya are all rich in vitamin C. You may also choose to supplement vitamin C - try starting with 500mg daily and building up to 1000mg, but if you have any health conditions or are on any medications, do check with your doctor first.

Celery contains something called 3-n-butyl phthalide, which has been shown to lower blood pressure. Aim to eat 4 stalks of celery every day, organic if possible. Celery is good in salads, stir-fry or with hummus/salsa. Garlic and onions have sulphur-containing compounds that also help to lower blood pressure in hypertensive individuals, so use them liberally in your cooking!

Oily fish, such as mackerel, salmon, tuna and sardines have a very high Omega 3 "good fat" content. Omega 3 has been shown to help thin the blood and reduce blood pressure. Aim to eat oily fish at least three times a week (baked or grilled, not fried) or consider supplementing Omega 3. However, please consult your GP before supplementing your diet with Omega 3 oils as some medical conditions (e.g. epilepsy) and drugs (e.g. blood thinners such as Warfarin) are contraindicated with the use of Omega 3.

Saturated fats cause the blood to become thick and sticky, encouraging the formation of clots. Avoid saturated, hydrogenated and trans fats ? such as those found in fried foods (e.g. KFC, chips), margarines, cookies, full fat dairy produce, red meat, cakes, pastries, creamy sauces and other processed foods. As animal proteins are higher in saturated fats than vegetable proteins, experiment with some vegetarian dishes.

Many of the steps here overlap with the steps for lowering cholesterol. You may have seen the cholesterol lowering steps last week, but if you missed them, email me and I'll send them to you.

Being overweight is another risk factor for heart disease as the excess weight puts too much pressure on your heart. However, even if you are on target, exercise is still crucial for controlling blood pressure.

I can't emphasise enough how important this is. Stress always exacerbates any health condition, but is especially harmful to those with heart disease as it causes an increase in blood pressure via the flight of flight response.

Stress also depletes magnesium, which works with potassium to pump excess sodium out of cells. Try relaxing forms of exercise, massage, and counselling ? anything that you find relaxing or uplifting.