Sisters on a Health Mission – Hypertension Management and Control

Meet Carolyn and Celeste, two lovely sisters who have made the commitment to improve their health TOGETHER! This sister duo hails from the South side of Chicago (not far from where Michelle Obama grew up). As the “family health advisor,” Carolyn encouraged Celeste to join her in the Institute for the Advancement of Women's Health (IAWH) Self-Measured Blood Pressure (SMBP) hypertension control program and they are both glad they did.

They hold each other accountable for their health by sending each other reminders to do regular blood pressure checks, drink water, choose healthy foods, and track activity levels. Both sisters want to spread the word that adapting a healthy lifestyle doesn’t happen overnight and takes time and persistence. Read their full profile below.

Q: Tell us about yourself. For example, where were you born, what you do for a living, your hobbies/interests/activities, how long have you lived where you live now? If you are not native to where you currently live, what brought you there?

A (Carolyn): I was born in Chicago. My family lived on the South side of Chicago-not far too far from where Michelle Obama grew up. My family moved to Pennsylvania due to my father's job when I was in junior high school. I finished high school in Downingtown, PA.

I am in transition as far as my career. I have worked in the field of education, floral design, health care and social work. I am currently working as a substitute teacher. I have many hobbies. I like to garden, dance, especially Latin dancing, music and swimming. My newest hobbies since COVID - I like to cycle and have reacquainted myself with African drumming (Djembe drum). I am very passionate about holistic health. I will look at all health options before taking a pill.

I came to D.C. in 1977 to attend Howard University. I left D.C. in 1983 to join the Peace Corps (Dominican Republic) and returned to D.C. in 1987 and have been here ever since.

A (Celeste): Hello! My name is Celestine Woods-Wright. Most people call me Celeste because as a child I did not like my name. I wanted a simple, more common name like Mary or Debbie or Lisa. Now I love my name, Celestine, because it is more unique. I'm trying to decide what my last name should be since I am now divorced. I am still figuring out who I am.

I too was born in Chicago in 1961 during the era of the race riots. My parents George and Gertrude Woods had relocated to Chicago during The Great Migration. Both were college educated professionals. My father's company told him he would have to relocate to Pennsylvania or lose his job so when I was 12 our family moved to Exton, Pa, an all white suburb of Philadelphia. What culture shock! More confusion of who I am. I assimilated well into my new home and culture but often felt bad about myself because besides being Black, I was fat and already developed and the other girls were not. I did well in school because that was what was expected of me. I was an avid reader and learned how to play tennis. I played tennis and worked at McDonalds all through high school and was involved in many activities. Even though I was active I was heavier than my peers. I went to college with lackluster aspirations of becoming a dentist (that's what my mother wanted.) I graduated with a degree in Education and began my teaching career, which led me to live and teach in Philadelphia, PA. I retired in 2020 after 37 years of teaching. During that time I married and had 2 daughters and divorced.

These days most of my time and energy is spent with my 5-month-old puppy (Maisie) but I still try to take my daily walks. Besides walking, some of other activities I enjoy include church and Overeaters Anonymous (OA) attendance, swimming, traveling, painting, dancing, reading, painting and needle work and spending time with friends and family, as COVID restrictions permit. I hope to take up piano, voice and sewing and more traveling during my retirement.

Q: When were you first diagnosed with hypertension? Many people immediately vow to make changes in their lives and to their lifestyles to avoid taking medication. Some people are shocked and had no idea that they had high blood pressure. What was your reaction?

A (Carolyn): I read an article recently that discussed how women who are post menopausal never knew they had high blood pressure. As I think about it-, that was me! I began menopause at 47 years old. I was never told that I had high blood pressure until I started to work with a holistic vegan doctor in my late 50s. My doctor gave me a prescription for Lisinopril but I refused to take it. I thought I would do everything besides take the blood pressure medication. My blood pressure improved with exercise, but in March of 2021 things came to a halt! I started to have slight chest pain while in graduate school for Acupuncture. My primary care provider (PCP) immediately referred me to a cardiologist and told me to begin taking the blood pressure medication. I began taking Amlodipine. My gynecologist had previously prescribed Hydrochlorothiazide. I never took the medication.

A (Celeste): My new primary care provider expressed concern about my blood pressure in 2016. I was 55 and menopausal. (I may have gone undiagnosed because I did not have a regular doctor for at least 10 years.) I did not believe it! I was in shock! I had always had low blood pressure so I thought it was an isolated incident. I remember one day in 2013 when I was at a health fair, I swore I did not have high blood pressure so I ate a bag of chips and then had my pressure taken to prove I did not have hypertension. Surprise, surprise. It was high! I still thought it was an isolated incident and I should just be careful with the chips, but I was shaken. I don't remember medication being discussed at that time maybe because it was my first visit to this PCP, but I know I would not have agreed to take it. I was so proud of myself for taking care of myself not needing any medication. I was unwilling to make any more dietary eliminations because I already limit my foods to those containing no flour or sugar to help manage my weight. I thought I was set. I went un-medicated for at least 2 years trying to lose weight to lower my pressure but it didn't work so I eventually chose to go on medication.

Q: Were you surprised by your diagnosis of hypertension? Do you have a family history of hypertension or other chronic conditions? Do you know anyone else diagnosed with hypertension?

A (Carolyn): I was surprised when I was told that I had hypertension in 2017. We have a deep family history of hypertension and other chronic conditions. Our deceased parents both had hypertension and all of my siblings (2 brothers and my sister- Celestine ) have hypertension. My parents also had diabetes and high cholesterol challenges. My father passed from heart and kidney failure and our mother passed from lung cancer. My mother also had obesity challenges. Many aunts, cousins, grandparents and uncles all had/have hypertension as well.

A (Celeste): I was very surprised by my diagnosis of hypertension especially considering my blood pressure historically was low when the medical assistant would take my vitals. For a year or so it was textbook 120/80. Hypertension is common in my family. Both of our parents suffered from hypertension as well as our grandparents, our siblings, aunts and uncles and most of our cousins. We also have a history of heart disease, diabetes, high cholesterol and several types of cancer. We had family members pass away this past year of pancreatic cancer, untreated diabetes, Crohn’s disease, and liver failure. Almost all of them also had hypertension. I am realizing, however, that genetics definitely play a part in our health. Take my sister Carolyn. She is vegan. She is an avid walker, biker, gardener and some swimming as well as carrying less weight than I do and she still struggles with her blood pressure. I think even if we are predisposed to hypertension we must still make the choice to have a healthy lifestyle to combat the disease. Sadly most of our relatives do not opt for a healthy lifestyle.

Q: What steps did you initially take (with or without your health provider) to get your hypertension under control? Were these methods at all successful? Often health providers provide basic information on health conditions. Where did and do you look for information to learn more and stay current on hypertension control?

A (Carolyn): Initially, I really only attempted to limit my intake of fried food and watch my salt intake. I also attempted to increase my exercise. These methods were partially successful. I still needed to drink water and get proper sleep which I was not doing either. I still was in denial that I had high blood pressure. I look for information from many sources - YouTube videos, Physicians Committee for Responsible Medicine (PCRM), nutritionfacts.org, book-How Not to Die. I listen to health related talk shows, podcasts etc. to obtain information on how to support myself in releasing hypertension from my body.

A (Celeste): When my new PCP first told me my blood pressure was high (2016) she of course suggested I lose some weight and watch what I eat. She gave me some nutritional information and told me to keep exercising. I figured I would be ok because I was a regular walker. I had just started cross fit. I am on a food plan that is devoid of any flour or sugar and I was not a big salt user, so I thought my food was on track and I was maintaining a 40-pound weight loss. I stayed active and on my food plan, but my weight stayed the same and my BP remained high. Finally in early 2018 my PCP said it was time for me to go on medication. I cried. I felt embarrassed. I was a failure. But I did not want to take any more chances with my health. I could still aim for a healthy lifestyle and hopefully get off the medications. I was prescribed Lisinopril. I was given the medication in March but did not start taking it until June.

I don't always trust medication with all the side effects so I hesitate to take it. A side effect of Lisinopril is coughing. I coughed and coughed all through my Mediterranean cruise that summer. When I returned home I called my PCP and I went through several medications all which produced various side effects. In 2019 I was referred to a cardiologist who eventually put me on 2 medications (Valsartan-hctz and Amlodipine) and I have been on them ever since. My BP still runs high. At the time it was averaging about 135/80 which I thought wasn't too bad but now know that is stage one hypertension. As far as finding information about blood pressure control, I get my information from friends who also suffer from hypertension or my sister who is a seeker and sharer of copious amounts of information on health and well-being. And currently I get helpful information from my participation in IAWH's SMBP Program.

...to spend time with my sister is a blessing!

Q: How has your lifestyle changed since? (What was your diet before diagnosis vs. after? Has your physical activity changed? How has your awareness and knowledge about your health changed?)

A (Carolyn): My lifestyle has changed drastically. I am now more consciously aware of the correlation between my blood pressure and exercise, healthy diet choices, sleep, stress and water intake. I was transitioning to a plant based diet before my diagnosis. I had some resistance to a plant based lifestyle before my diagnosis and still after my diagnosis. I also knew that I did not want to take blood pressure medication like my parents and all of my siblings (2 brothers and 1 sister). I was going to beat high blood pressure without medication. I am always seeking to find a holistic modality (acupuncture, herbs, etc.). I increased my physical activity after my diagnosis to include more brisk walking, cycling and swimming.

A (Celeste): One main change in my lifestyle is that I began to take my blood pressure reading every morning and now I take it in the evening as well. Sometimes I take my blood pressure 3-4 times a day because it fluctuates. It is high first thing in the morning, but in the afternoon it is normal. Then it is high at my 6 pm reading, but if I take it later it is lower. My activity level is somewhat lower than 2 years ago because of the pandemic, my retirement and some physical problems. I no longer dance or do cross fit nor can I walk as far as I used to but I still walk as much as I can and I will start back swimming soon since it is warmer.

I also have an Apple watch that keeps me accountable for staying active. I am intentional about moving so that I close all my rings every day. Some days I don't make it but most days I do. Basically my diet is the same since 1997- no flour or sugar and I weigh and measure my food. What's new is that I watch my salt (especially pork) intake. I used to hear my relatives talk about how pork raised their pressure, however, I did not understand their plight at the time. I understand now. I loved and still eat my bacon, sausage, ribs, and ham, but I know if I choose to eat pork my numbers are off the chart! Now I am wary of pork products and eat them maybe once a month. I make healthier choices now like turkey or chicken options. I also try to limit eating out because prepared food always has more salt.

Q: How did you learn about IAWH’s SMBP Program? What made you interested in participating? What have you gained from this program?

A (Carolyn): I learned about the program after on Dr. Ted Watkins' radio show (WPFW-89 FM). I immediately wrote down the information and emailed my sister Celestine and over 30 women to tell them about the SMBP Program. I became interested in the program because I knew I needed support with my blood pressure. My PCP had asked me repeatedly over a few years to take my blood pressure at home 1-2 times a day and I was not very consistent with his request. I thought this program would support me in becoming consistent in taking my blood pressure and sharing with other like minded women who are on the path to release their hypertension. I have gained from this program camaraderie from other women who are on their hypertension journey and I have become consistent in taking my blood pressure every day!

A (Celeste): My sister told me about IAWH’s SMBP Program. She was going to enroll and asked if I would like to join her. She went as far as to contact IAWH to ask for special permission for me to join since I do not live in the targeted area. I decided to participate because I am trying to develop a habit of saying yes to things that are good for me or make me uncomfortable (like agreeing to participate in this interview).

Since I'm not in the habit of researching ways to improve my overall health I thought learning about managing my blood pressure would be a good start since hypertension is rampant in my family and the Black community in general.

Participating in this program has been informative. Just tracking my blood pressure and discussing it monthly with a health professional has been useful. There have been some Lunch and Learn speakers that have been knowledgeable and motivating. Dr. Yola comes to mind. Many articles were shared. The article correlating hypertension and menopause was very interesting given that’s when my blood pressure began to elevate. Also, I got a lot of good information from the other participants during the small group sessions. Hearing from others who share my disease is very helpful. I wish I lived closer to the DC area so I could participate in the in-person activities. The ladies (and one gentleman) in the group have been lovely. So intelligent and insightful. So much to offer in their sharing. I could feel a kinship.

Q: How and why did you decide to do this program together?

A (Carolyn): I decided to do the program and shared the program details with my sister, Celestine. I thought the program could be supportive to both of us in releasing our hypertension.

A (Celeste): I decided that I needed to practice self-care and take a leading role in my health. When I was working I was too busy to take time for myself so my health declined. I want to be around for as long as I can. Also this pandemic has left me feeling a bit isolated so I jumped at the opportunity to engage in some like-minded human interaction, and any chance to spend time with my sister is a blessing!

Q: Do you hold each other accountable for SMBP and/or other things about your health? Do you give each other reminders? How? Give some specific examples.

A (Carolyn): My sister and I do not hold each other accountable on a regular basis however my sister will remind me sometimes to take my blood pressure. She has shared her "hacks" that have supported her to remind her to take her blood pressure twice a day. My sister sets her alarm/phone to remind her to take her blood pressure twice a day.

A (Celeste): Carolyn and I discuss our health concerns and we encourage each other when we have anxiety producing doctor visits. We often discuss our blood pressure readings and remind each other to take our blood pressure. I suggested to Carolyn that she set an alarm to take her evening reading because she often forgets. And I send her reminders in gif form to drink water because she is not a water drinker but notices that her pressure improves when she drinks water. She shares with me that when she eats beans she notices that lowers her blood pressure. I am helping her set up her Apple watch to help her track all the walking and biking she does. She encourages me to eat plant based food for one day each week or at least one meal.

I am now more consciously aware of the correlation between my blood pressure and exercise, healthy diet choices, sleep, stress and water intake.

Q: How are you different in your approaches to managing high blood pressure?

A (Carolyn): My sister and I are both in agreement and aware that exercise, sleep, stress and eating out affects our blood pressures. We do not agree on our diet approaches to managing high blood pressure. I choose to eat a plant based diet to manage my high blood pressure. My sister chooses to eat a different way that supports her lifestyle.

A (Celeste): One big difference in our BP management approach is that I am blessed to be retired and that decreases my stress whereas Carolyn is still working which can be stressful. We all know stress raises our blood pressure. Typically I follow the suggestions of my doctor when it comes to prescribed medication. My sister usually takes her medication when her pressure is high. She also incorporates holistic methods such as acupuncture and takes herbs and oils said to lower BP. Carolyn is completely plant based whereas I eat portion controlled healthy foods including meat and animal products. We both try to walk daily, however, she walks further and faster than me. Sometimes Carolyn avoids taking her pressure reading if she feels she ate something that will elevate her pressure. I feel that way too sometimes but I take it anyway so I know because if it is high it is going to be high whether or not I take a reading. That way I know my patterns. Ignorance is not always bliss, especially when it comes to our health. Knowledge is power.

In 5 years, I will have released blood pressure medication completely from my life, have an A1C under 5.6 and a total cholesterol under 200.

Q: What have you gained from participating in this SMBP program? (What knowledge has been validated? What is something new that you learned or gained?

A (Carolyn): I have become consistent in taking my blood pressure daily. I also learned reasons why my blood pressure is higher in the morning than at night. I also have finally accepted the idea that beans do really bring down my high blood pressure. I have known about the power of beans for many years however I was not consistently eating them regularly. I have seen the results of a lower blood pressure when I eat beans. Also, my doctor reduced my blood pressure medication of Amlodipine Besylate from 5 mg to 2.5 mg. when he saw that I had lower blood pressure readings.

A (Celeste): Well I got a new blood pressure monitor that syncs with my phone/watch so I no longer have to input my BP measurements. I tried taking my BP medication at night as suggested at one of the small group meetings and one of the speakers but it did not seem to work for me. I am back to taking my meds in the morning but I am intentional about taking them at the same time each day as suggested. Since I take more than one reading a day now I am more aware of the patterns of fluctuations in my pressure. For example I knew that first thing in the morning my reading would be the highest but I did not realize it also is high in the evening around dinner time. It is lower in the afternoon and right before bed. The knowledge that my pressure goes up when I eat out or eat pork has been validated. And I notice that after prayer and meditation, drinking water or an active day my pressure is down. One very interesting thing I learned was the stages of hypertension. Pressure falling into the 120-129 range is considered elevated. I always thought I was doing well when my pressure fell between those parameters. This has been an enjoyable and informative experience for me and I would recommend it to persons wanting to increase their knowledge about blood pressure control.

Q: Where would you like to be health wise in five years?

A (Carolyn): In 5 years, I will have released blood pressure medication completely from my life, have an A1C under 5.6 and a total cholesterol under 200. I will have released 30 pounds and continue to practice consistent daily exercise to include regular biking and will be able to swim a mile-70 or 72 laps. Further, meditation, consistent water intake and healthy plant based eating will also support me to keep my blood pressure in a normal range.

A (Celeste): In five years I would love to be released from BP and cholesterol medication and have given away 25 pounds. I want to be able to complete a 10K race and ride my bike 25-50 miles. I also want to be able to swim 72 lengths which is a mile. (I swim about 45 now). I want to include stretching and meditation as part of my daily practices.

Q: What advice would you give to others who may be considering, just beginning, restarting, or continuing on a health improvement or a hypertension control journey?

A (Carolyn): I first would say be gentle with yourself. Practice daily compassion and take one day at a time. Remember, "Rome was not built in a day" and taking gentle steps is progress! I also would remind others that our bodies are our body temples which we MUST love. If we do not love our bodies, who will? I also would advise others to do your own research on hypertension and have an open discussion with your doctor for a plan that best suits you personally.

A (Celeste): Again I say Knowledge is Power! Put on your big girl pants and find out/face the truth about your blood pressure. They say high blood pressure is a silent killer because it often has no symptoms but it is manageable. If you are diagnosed with hypertension don't delay treatment. Find a qualified doctor with whom you feel comfortable and you trust to help you make informed health decisions, then come up with a plan. Above all, take your health and self-care seriously. You are worth it! If you don't have your health you don't have anything. Be gentle with yourself.

I am reminded of a bulletin board a colleague once displayed- "The Power of Yet!” I can't do this...yet. I don't understand this...yet. I can't read, write, add, subtract, etc ...yet. Adapt the power of ..."yet" as you develop your healthy lifestyle. I can't walk a mile or ride a bike 5 miles or swim a lap...yet. I don't know how to prepare healthy foods...yet. This is not working...yet. We can change our health mindset by adding one little word.-yet! Adapting a healthy lifestyle that manages hypertension is a journey that we take one day at a time.

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Executive Directors Writer/Editor

Janine E. Payne, MPH Melissa Kluczynski, MS

Cheryl J. Thompson, M.S.P.H.