I shouted as I stood up fully from the bed, ” Hey be careful , remember you aren’t fine yet” He drew me back to the bed gently. ” Alvana, you are Jason the thief?” I asked , his smile suddenly faded away. ” I am not a thief” he defended himself, ” But you..” He interrupted me, ” I never stole anything , I was implicated” He sat on the bed. ” I won’t believe that, you wrote a letter to your girlfriend promising her …” He interrupted again. ” I didn’t write the letter” He said smiling as he got up, ” Why would I believe that?” I asked him, ” Didn’t you write a letter to Adanna when you were in Newriton?” He asked me while I opened my mouth in shock and surprise. ” yes I did” I told him, ” What was the content of the letter?” He asked smiling and opening a wooden made drawer in his room. ” I professed my love to her, I also told her that my coming back might be extended” I explained to him, he smiled and nodded as he brought three piece of papers from his bag. ” Take” he handed one piece to me. ” Was that the letter you wrote?” He asked with a smile as I took a glance at the letter.
1, Madu street.
Atata.
Adanna,
How are you, I hope your parents are doing great, and how is Atata. I only want to use this medium to clear your mind from all tiles you might think is between us, i would be a sinner if i continue to lead you on. I have a fiance in the city, so please dont think there is anything between us, i love my fiance and wont want to leave her for any girl, not even a village girl. I have nothing for you, I only played along with the moment. Go get married, remember, you are growing older by the day.
Gabriel Omiyi
” I didn’t draft this!” I shouted in anger as I sprang up from the bed, ” But this was the letter that got to Adanna” Alvana smiled. ” No, it can’t be, if this sort of letter go to her, then why didn’t she tell me when I got back home?” I asked him in anger. ” Because I asked her not to tell you, I managed to convince her that you didn’t draft this, you can ask her when you leave here” he explained with a smile while I scratched my head. ” wait!” I stood up, ” I wasn’t the one that submitted the letter to be posted that day” I said while he opened his eyes in surprise, ” Who did?” He asked. ” My friend Israel, he is my room mate” I explained but he just hissed. ” Israel wasnt around during my time” he said silently. ” What does the letter have to do with your time?” I asked him. ” Because the same person who changed your letter also altered my letter” he handed me another piece of letter, I stared at the letter where he was promising his girlfriend to bring some money for her. The strange thing was that the letter had exactly the same hand writing. ” Yes that was the letter that implicated me, I only posted a letter telling my girlfriend I would be coming back soon” He explained, there was tears in his eyes. ” Sorry about that bro, but I think this is a headway, the person is someone I know and you also know” I told him and he nodded. For once, Alvana didn’t smile, tears dropped his eyes. ” I knew you were from Newriton when I saw the mark, I was only unlucky not to have completed my trainings ” he told me while I nodded. ” How did the money get into your room?” I asked him, ” My card was cloned, someone cloned the card” he sat down still holding a piece of paper in his hand.
” Why will someone want to implicate you that way?” I asked, ” I was the best fighter in my set, a lot of people wanted to be the best so they wanted to dismiss me, many also wanted to be the best but they couldn’t get it when I am still there” he explained further. ” That’s bad, but why will the person change my own letter?” I asked him, ” Maybe that person wanted Adanna” He said but I found it hard to believe. ” Why did you kill the chief priest?” He suddenly asked, I looked at him in surprise, does Alvana know everything? ” I didn’t…” He interrupted me. “Remember that night, when you thought you heard footsteps behind you and you immediately turned with your gun, I was the one following you” he smiled while I opened my mouth in shock. ” I wasn’t actually following you” he started, ” I was going to the chief priest place to make my own investigations, I had always suspected him” he said. ” I had been earlier worried about I was to enter into his inner house with violence, and then you came and helped me distract him” Alvana continued. ” I dont get you” I said relaxing on the bed. ” My mission that night was to search the chief priest house which is at the back of the shrine, I wanted to see if I could get any suspicious exhibit. Your coming was of advantage because you helped me distract him, I took cover among the bushes and found my way to the small back shrine house. I heard your discussions with him and how you finally shot him. Gabriel, you are a spy, you should learn to always take things easy and keep calm, its step by step” he stared at me while I nodded. ” So what did you find out?” I asked him and he handed me the last piece of paper. I stared at it and all I could see were names, ” That is the name of the people the serial killer had planned to kill, look well, your name and Adanna’s are among them, I got it from the chief priest place, there was also a bag of money, the chief priest us being paid to make the people believe that Anu kills its people” Alvana explained, ” the names isn’t what got my attention about the letter” Alvana continued as he collected the previous letters he had given me, ” The fact that the three letters have the same handwriting is what to be suspicious about” Alvana added. I looked well again and he was right, the three letters were written by the same person. ” Now Alvana, am confused” I said to him, he only smiled. ” let’s leave the letters alone, you said israel posted your letter, we should try talk to him ” He stood up and walked around. ” Maybe someone might have seen him posting the letter” Alvana added. ” I will talk to him” I assured him, ” Now, how do we get the killer?” I asked and he smiled. ” We will use the list, the latest person he killed was Eneda, now, the next on his list is who?” He asked as he opened the list himself, ” Whoa, the next on his list is Mbe ” he concluded and laughed, ” I would have loved Mbe to be killed” I also stood up, ” Even I myself, but that’s not what Newriton portrays” he sat down . ” Okay, what we have to do is to watch Mbe the cat secretly, the killer might attack soon” Alvana added. ” Hmm, please I would need that my letter for investigations” I pointed at the letter with him, ” Sure” he nodded
AS NARRATED BY ADANNA
Coming to the stream that morning, I had only one intention, to see Gabriel. I was surprised and down casted when I didn’t see him among his friends, I didn’t bother to ask because I knew he must be fine. We had to gist deal with Mbe before going to fetch water with the city girl, Morgana. The city guy israel was behind us like a guard as we walked back home, he might probably be watching out for Mbe the cat or has Alvana might have put it, Mbe the Dog. ” I dont think I can remember anything about the guy” I had told the city girl when she asked me what I remembered about the night I had an encounter with the man in black. ” Are you sure there is nothing you can use to describe him, anything at all” she pressed forward while I stood for a while to think, ” Nothing” I finally said since I could remember nothing. ” Okay then” She said and we walked home.
°°
” Now, I think you have to go home and prepare” Alvana told me, ” You see, some of my friends from the city are here with me in the village, I mean fellow spies like me” I told Alvana as he handed me my white T-shirt which he had washed for me. ” That’s great, they can also be of help but can you trust them?” He asked me and I nodded. “Okay then, get them prepared” he tied a wrapper around his body and carried a cutlass. ” let me lead you out, I am also going to the farm ” He walked out and I followed him. His house was surrounded with bushes, it was the only house in the environ, Alvana had certainly lived a life of stigmatization. ” You live in a bush?” I asked him, ” No, this is my own estate” He smiled as we found our way through the bush path. ” Wait, dont you think the chief priest might have fortified the killer?” I asked him and he bursted into laughter, ” Who killed the chief priest?” He asked me, ” I did” I simply replied, ” Didn’t the gun kill him? Why wasn’t he fortified? Didn’t he call on Ani that day? Why did the bullets kill him?” Alvana asked me as we walked along, ” That simply means Ani doesn’t exist” Alvana concluded and silence fell upon us until we got to the main village. It was still morning and people had not started coming out, so I quickly found my way home. ” Oyinbo, where are you coming from looking so rough?” My father who was sitting on his arm chair asked on seeing me, ” I went for a little adventure dad” I replied trying to smile, ” is that why your face is also rough and swollen?” He added, ” it looks like you have been beaten” He said . ” papa, am tired, where are my friends?” I asked him walking towards the house. ” They are inside, they have really been good in helping us” He smiled , I nodded and went into my room. I met Morgana and israel pacing the room with worried expressions on their faces. ” Fool, must you play with everything, where have you been?” Israel asked on sighting me, Morgana took a deep breath and fell into the bed. ” I had an encounter with him, or let me say them” I started, ” who is him or them?” Morgana asked as she sat up on the bed, ” The serial killer and Jason” I said , the expressions on their faces showed they were interested In the discussion. ” I went to the forest of Ani as I had planned, I saw the body of the dead girl and true to our thoughts, there wasn’t any other body in the forest. I hid myself in the bush hoping to see what will happen and I saw people come to take her body away, where they took her to, I dont know. I was happy on my discovery but never knew the killer was behind me, I only noticed when he talked. We both ended up in a fight, he was stronger than I had prepared for. Nothing I did worked on him, he was able to defeat me and about to cut me with the sword. I tried punching him and then he angrily hit my head with the back of the sword and that was all I could remember. When I woke up again, I was in a room, on a bed, Jason’s house” I concluded, they were all listening attentively. ” Did you see his face? I mean Jason? ” israel asked while I nodded, ” I saw him, he even happens to be someone I know, he is my village friend” I explained. ” You see, we can’t also trust this Jason, remember he is a thief” Morgana stood up from the bed and started pacing around. ” He isn’t a thief” I defended and they both turned to me waiting for an explanation. ” He was implicated with a letter, a letter he never wrote ” I started, ” I dont understand” Israel chipped in, ” Israel, remember that day you helped me post a letter, was this the letter you posted?” I asked handling the letter to Israel, he took it and read through it. ” No, I didn’t post this” Israel laughed, ” But this was what got to Adanna” I said while they both stared at me in disbelief. ” Wait, there was one person with me that day I had posted the letter” Israel said placing his left fingers across his lips, ” Who?” I and Morgana asked in union.
who? ” I asked again, ” Christiana, she was going for jogging that morning ” israel said. ” But this isn’t Christiana’s writing” Morgana looked at the letter again, ” I know but only Gabriel, me and Christiana know I posted a letter, no one else does” Israel said while I reached for my phone. ” Yes, Christiana, how are you doing” I started as I placed the phone on speaker, ” Hey Gabi, am fine, I am in my house, am enjoying myself here with family” Christiana laughed happily over the phone. ” Oh, nice, I lost my sister” I told her, while she paused for some seconds, ” Was she sick?” She asked me, ” No she wasn’t, didn’t I tell you about the serial killer in Atata?” I asked, ” Yeah, I kind of heard you talked about it once, you weren’t telling me directly” She answered. ” The serial killer killed her” I said” Oh God, am sorry bro, I think you need to report this to Sir Ajan, we need to work on this” her voice was filled with sorrow. ” We dont need sir Ajan, Israel and Morgana are already here with me” I said, ” Oh no wonder I didn’t see them before leaving Newriton ” she said, ” Yeah, we are on the verge of getting the killer now, but we only need you for something ” I told her calmly. ” I will do anything for you on this case” she assured me. ” Okay, do you remember any day , about some weeks ago when you saw israel going to post a letter?” I asked. ” Yes, I remember seeing israel once going to post a letter, I asked him who it was for and he had replied Adanna” She explained. ” Did you do anything with the letter, did you go back to take the letter, dont lie to me” I said calmly while she took a deep breath.
AS NARRATED BY CHRISTIANA
I am Christy, a trained spy from Newriton. I still live with my parent in Enugu , I am 22 years of age. When I got to Newriton , I met this young handsome guy, Gabriel Omiyi. He was a strong, Jovial spy. If am not mistaken, he was the best of us all but he had one problem, he was never patient. I won’t lie to you guys, right from the first day I saw him, I fell in love with him. Yeah, I fell in love with but as you all know, the girl doesn’t go to the boy, the boy comes to the girl. So I had to hide my feelings but still loved him secretly. As time went on, I started noticing him falling for me also but he never talked about it, if he was scared or shy, I dont know. I knew he was crushing on me with the way he behaved, he always wanted to be with me , he was always fond of me. It continued this way until he finished his training and went home, it was there he met this girl they call Adanna. I dont know her but whosoever she is, she succeeded in taking my guy from me. I got to know her name on the day we were having an instruction class on our upcoming mission, a long time spy, Daniel was the one teaching us. In his class, he had made a statement , ” So, this isn’t something we should rush, it might end up becoming a mission to be accomplished in Years, Gabriel, dont worry or think about Adanna” Daniel had said that day, I had asked Gabriel who Adanna was and Gabriel has simply told me ” Ask him” which I did, at the end of the class that day, I went to Daniel to ask him. ” Hey, good morning” I greeted as he went out the hall that day, ” Hey, good morning” he greeted back ” You see, I wanna ask you s….” He interrupted , ” You wanna know who Adanna is” he smiled surprising me, ” Hey, dont be shy, I know you love Gabriel, anyways, Adanna is his village girlfriend, or better put, the village girl he loves” he explained while I breathed out in anger, ” Hey, dont be sad, love is like a game, you are free to compete for him, it like the survival of the fittest” He had told me that day , he made me have trust in him, he told me he was going to help me get Gabriel if i want and that he is always available if I need his help. On one fateful morning, I had been lucky to see Israel posting a letter, ” Hmm, who are you posting to?” I had ask him and made to jog to the field, ” It is for Gabi, I am posting it to his girlfriend, Adanna” He explained. I nodded and jogged away, not to the field but to a corner where I watched him till he was out of sight. I then came out and opened the post box, I took the letter. The time was 7:00am, the post men will come take the letter by 11:00am so I had time. I took the letter to my room, I made to change the content with a new paper but I stopped. Gabriel will surely know my handwriting when he sees the letter if he goes back to Atata, I needed someone else to do it for me, Daniel was the perfect person. I went to his quarters and surprisingly, he was willing to help me change it. He did a perfect Job and I was happy with myself. No lady will see this and still want to continue with the guy. I posted the letter before 11:00am and that was how the letter was changed. I waited to see any change but no I didn’t see one. It was during our mission that I met this guy in Kendrick club, he showed me love and in no time, I forgot Gabriel. Though I forgot Gabriel, I couldn’t help to think of the fact that I spoilt his own relationship. I always wanted to tell him of what I did but I never got the chance, I hope one day, he will find out and I will open up. When he called me today and brought the topic about the letter, I thought it was the opportunity to tell him of what I had done. ” I swapped the letter, Daniel wrote it for me, please forgive me” I told him in a calm voice. ” you said who wrote it for you?” He asked, ” Daniel, he wrote it for me, see, am really sorry, it was out of jealousy , please forgive me” I told him again but the line was dead.
°°
” She said Daniel wrote the letter for her” I turned to Israel and Morgana, the news was like a shocking revelation, I had never liked Daniel but I always prayed it wasn’t him. ” So how does Daniel changing the letter make him a serial Killer?” Israel asked as he sat on the ex with Morgana, ” it has a lot to do with it” I said and narrated everything to them. ” This is a shocking revelation ” Israel exclaimed after the story, ” According to Newriton, he isn’t guilty until we get him red handed ” Morgana stood up holding her waist. ” so we have to protect that foolish cat of a guy, we almost fought this morning” Israel lamented, ” I myself won’t have loved to protect him” I said as I brought out a gun from my briefcase. ” I will love to meet this Jason” Morgana turned to me, ” Yes, he will be with us soon ” I assured her. They got up and got their guns and knives ready , there is surely gonna be a big fight anytime soon. ” Dont you think we involve sir Ajan in this?” Morgana asked, ” No!! We dont want to finish this in five years time” israel objected while I bursted into laughter.
• ” So guys, meet Alvana, sorry, Jason” I said to Israel and Morgana as we sat on a bench that evening with Alvana, he was just returning from the farm and he decided to branch. ” Nice meeting you guys” Alvana smiled, ” At last, I am standing face to face with the famous Jason ” Israel shook hands with him, he hugged Morgana. ” Gabi told us everything, he told us how you saved him, thank you” Morgana smiled while Alvana nodded with a smile. ” so now, let’s go straight to business” I stood up and squatted on the ground. ” It is a clear fact that the serial killer attacks by night, so our duty is to watch Mbe by night” I said looking up to them, ” Say something we dont know” Israel shouted and they bursted into laughter. ” We start this night, there is every possibility that he might want to strike this night, for one reason or the other, he seems to be in an hurry” Alvana added while we nodded, ” Mbe house is of this shape” Alvana drew a kind of structure on the ground, ” It is surrounded with bushes. That is where we are gonna take cover. We can’t use guns so as not to kill Mbe” Alvana continued, ” Guns doesn’t even have effect on him, he is on a bullet proof” I chipped in. ” One way or the other, one of us have to gain access into Mbe house, the serial killer might visit him at home” Alvana continued. ” We dont need to be afraid, we are 4 and he is only one, we can do this” Alvana concluded. ” Wait, we ain’t killing him, we are to expose him” Israel said. ” Do you think its better to lead him into a trap?” Morgana started and we all turned to her, ” I can distract him, I can lead him to you guys, you guys should be somewhere, I can bring him to you ” She suggested. ” I think her plan is better” Alvana smiled again, ” Thanks” Morgana blushed.
AS NARRATED BY MORGANA
With the help of Jason, I was able to locate Mbe’s house, he was outside his house when I got there that evening, he was eating Akpu and soup. ” Good evening” I greeted, I was in a black trouser and a white top, I wasn’t with any weapon other than a knife in my high heel shoe. ” Are you not the maiden I saw at the stream today?” He asked with a smile as he rubbed his hand on his wrapper, ” yes I am” I smiled back. ” What brings you to the abode of the great cat?” He asked as he cleaned the bench for me to sit, I checked the time and it was 6:00pm, the killer might come soon. ” Why dont we go inside?” I asked crossing my legs, ” Whoa, you want to come inside? ” He led the way while I followed him. ” So tell me why you have come to my abode” he stared at me. ” Because I like you, you were saying something about me this morning but my foolish city friend stopped you, the truth is that I actually like you too” I smiled , his face was full of happiness, I wished he knew I have nothing for him, I hate guys like him. ” That’s why I have come to be with you till tomorrow” I told him again. ” Unbelievable, you mean you will stay with me through the night?” He asked while I nodded, ” I heard the city people are free but never believed till now, you can stay for eternity” He shouted happily as he rushed out to bring the bench in.
• It was now around 12:15am, Mbe wasn’t sleeping so also was I not sleeping. He had been disturbing him to get intimate with him but all to no avail. I had managed to pull off my trouser leaving me alone with my bomb short, I allowed him romance me but nothing more. He was still in the act of romance when we heard movement around the house, I sprang up immediately. ” What is that? ” I asked him, ” I dont know ” he replied as he also stood up from the bed. I moved away from him and stood beside the door while Mbe searched for his machete. Suddenly, the door was forced opened by a single kick, and a man in black walked in quietly and stood face to face with Mbe. ” The cat, Ani has come to kill you ” The man in black said, Mbe machete fell off his hands. ” Hello Daniel” I said from behind and he turned sharply to face me, ” Morgana ” his voice depicted that he was shocked. ” Yes Daniel, are you surprised I know you? don’t be bro, that’s the way the girl does her thing” I smiled. ” Then, it is time to know how the boy does his thing” He replied and brought out his sword from its s---t. ” Sorry bro, I have to let the whole world know” I said and dashed out of the house, he followed me immediately. It was a tough race, I knew he mustn’t get me else am done for. I dashed into the bush surrounding Mbe’s house, I was actually heading to the forest of Ani where the rest must have been waiting, we already picked a spot where the show will take place. I ran out of the Bush and then into the quiet dusty road of Atata, I could feel Daniel following me. In the darkness of the night, two people could be seen running along the red , dusty road of Atata, Daniel and Morgana.
I took a sharp turn into the forest, the birds of the night sang with their sonorous voices while the crickets backed it up. I found my way through fallen woods, I made sure I did not fall, the fact that I was with just a bomb short and a shirt made me more flexible, I suddenly got to the spot which was filled with tall trees, that was where my friends were, I quickly took cover behind a tree, I felt he stopped, he might be surprised where I haf entered.
°°
We were on the top of trees, i, Israel and Alvana, we were on tree top waiting fruitfully for the arrival of Morgana. We were prepared and ready to die, we were dressed in all blacks like shadows. We saw Morgana come into the woods, she took cover behind one of the trees, ” Why was she with a bomb short?” Was the first thing I asked myself. Later on after her arrival, we saw the man in black stop among the woods, he was probably confused. ” Coward, I know you are here” he shouted as he moved around, ” Morgana!!! Your ancestors are ready to accept you “he shouted again. He suddenly turned back abruptly, some one had jumped down, it was Alvana. ” Hello Daniel” Alvana greeted while Daniel stood in shock, Morgana also came out ” Am ain’t a coward, here I am” She said laughing. I and Israel jumped down at the same time, none of us was on mask. ” Daniel, why?” Alvana asked, ” Jason?” Daniel called out as his sword fell off his hands. ” No time for familiarities ” Israel threw a knife at his leg, the knife caught him well and he fell to his knee with a cry. Alvana walked up to him and took off his mask, it was no one else but Daniel. ” Is it about the money?” Alvana asked as he threw him down heavily.
*
*
Act Of Faith
Epilogue
°°
Daniel wasn’t killed, he was taken to Newriton and locked up alongside young Carl, young Carl was the guy who cloned Alvana’s card, they were to die in jail with everyday toture. Alvana was later given the mark of Newriton and sir Ajan was happy to have him back. As time went on, something like chemistry could be seen between Alvana and Morgana, they fell in love. I later got to know that Morgana never stayed in port Harcourt, she was an orphan whom sir Ajan had picked from the club. One day, Morgana decided we go greet her friend, the city nurse, Mama. It was there we discovered that she was Alvana’s mother, what a happy reunion.
• Some months later, the only catholic church in Atata could be seen crowded with cars of different kind, there wasn’t space in the whole church as it was crowded with people, it was my wedding day with Adanna. She was dressed in a white gown, while I was in a blue suit so also was all my friends, Jason, Sir Ajan, Morgana, Christiana, Matt and Israel who was busy supervising those cooking. My mom, dad, and Adanna’s parent were all seen happily dressed and seated at the front of the church. ” Now I proclaim you, Gabriel Omiyi and Adanna Mologwu husband and wife” the priest voice echoed, ” Now you may kiss your bride ” he added while I unveiled the white cloth covering Adanna’s face to reveal my ever beautiful Adanna, I moved my lips slowly to her’s and soon our lips joined, the church went into wide jubilation . ” Israel, get away from the front, let me camera this thing, Gabriel kiss those lips well, she made you suffer too much ” it was Alvana, he was the camera man of the day. We broke the kiss and Adanna rested her head on my shoulder, while the whole church went wide into jubilation, the old men could be seen hitting their walking sticks, Israel was scattering the dance floor with Morgana until Alvana came to push him away. Mbe the cat could be seen battling with his piece of meat. At last, its over, we were able to unravel the mystery of the serial killer, we were able to get Daniel. The people of Atata later turned to worship the true God after they heard that someone was behind the killings, but they never knew those who were behind their salvation except Mbe who knew about Morgana but kept it to himself. Although we got Daniel, we weren’t able to get Sir Jude Ike, but one day we hope we he will run into the long hands of Newriton, its just a matter of time and faith, its an act of Faith. For anyone who has had a stroke, working to prevent a second one should be Job No. 1. Keeping blood pressure under control is an important part of that job.
A study published yesterday in the journal Stroke shows that good blood pressure control after a stroke cuts the chances of having a repeat stroke by more than half. But it also brought some bad news: less than one-third of stroke survivors in the study managed to get their blood pressure under control.
In the report, researchers from the University of California crunched data from the Vitamin Intervention for Stroke Prevention (VISP) Trial. This trial had found that taking a daily pill that contained high doses of three B vitamins — folic acid, B6, and B12 — did nothing to prevent a second stroke. But the data collected as part of this trial has been a great resource for other research.
The volunteers in VISP had their blood pressure checked in a doctor’s office multiple times during the course of the two-year trial. Only 30% of the volunteers were able to keep their blood pressure in a good range (under 140/90) on 75% or more of the measurements. Meanwhile, more than one-third of the participants had controlled blood pressure less than 25% of the time.
The odds of having a second stroke were directly related to blood pressure control — better control, fewer strokes; poorer control, more strokes. The same held true for the connection between blood pressure control and having a heart attack or dying from heart disease.
Check BP at home
High blood pressure damages artery walls throughout the body. This damage can lead to stroke or heart attack. People who have survived a stroke or heart attack are at very high risk of having another of the same — or the other. The new study in Stroke shows that controlling blood pressure is a good way to reduce that risk.
There are many ways to control blood pressure. One advance that has been extremely helpful is the ability to check blood pressure at home. When the VISP trial ended in 2003, just about the only way to check blood pressure was in a doctor’s office, so the participants had their pressures checked a few times at the beginning of the trial and then once every six months. What happened in between is anyone’s guess. Today, home blood pressure monitors are readily available and relatively inexpensive. Instead of a twice-a-year snapshot, you can now get a more reliable look at your blood pressure. Knowing the numbers is a big step toward controlling blood pressure.
Lifestyle changes for all
Making changes to your lifestyle can help a lot to lower blood pressure or keep it under control. These changes can also help prevent a heart attack or stroke, and can strengthen your body in other ways.
Exercise often — at least 30 minutes five times a week. More is better.
Lose weight if needed.
Eat more fruits, vegetables, and whole grains, and less processed or highly refined food.
Cut back on salt.
Include foods rich in potassium in your diet (unless you have kidney disease).
If you drink alcohol, keep it moderate — no more than two drinks a day for men, no more than one a day for women.
Don’t smoke.
Medications may be needed
Many people need medicine in addition to lifestyle changes to lower blood pressure. There are a number of proven options for medications that lower blood pressure. Recent guidelines suggest the following:
If you are black and you have normal kidney function, start with a low daily dose of a thiazide-type diuretic (water pill) such as chlorthalidone or hydrochlorothiazide, or a calcium-channel blocker. Another option is a pill that contains low doses of both drug types.
If you are not black and you have normal kidney function, start with a low dose of one of these drug types:
angiotensin-converting–enzyme (ACE) inhibitor
angiotensin-receptor blocker (ARB)
thiazide-type diuretic
calcium-channel blocker
A pill that contains low doses of two different drug types
If your kidneys aren’t working as well as they should, your doctor might recommend that you start on a low dose of an ACE inhibitor or ARB (but not both together). These types of drugs help protect the kidneys from further damage.
How low should you go?
Normal, healthy blood pressure is anything under 120/80. For years, people with high blood pressure were urged to get their pressure under 140/90. New recommendations suggest that for some people, it’s okay to let blood pressure drift a bit higher, to under 150/90. The thinking is that driving it down further could cause problems like feeling lightheaded when standing up or getting out of bed, which could cause falls. And lower pressure usually means more medications, which can cause harmful side effects.
The new Stroke study and others provide strong evidence that keeping blood pressure under 140/90 is the best goal for stroke prevention. I plan to use a blood pressure goal of less than 140/90 for my most of my patients. The exceptions will be older individuals with high blood pressure when sitting or lying down but low blood pressure when they stand up.
If you have high blood pressure, aim for getting at least 75% of your blood pressure readings under 140/90 — as long as you don’t get dizzy when you stand up. If you do, or your blood pressure continues to stick above 140/90, let your doctor know.
1, Madu street.
Atata.
Adanna,
How are you, I hope your parents are doing great, and how is Atata. I only want to use this medium to clear your mind from all tiles you might think is between us, i would be a sinner if i continue to lead you on. I have a fiance in the city, so please dont think there is anything between us, i love my fiance and wont want to leave her for any girl, not even a village girl. I have nothing for you, I only played along with the moment. Go get married, remember, you are growing older by the day.
Gabriel Omiyi
” I didn’t draft this!” I shouted in anger as I sprang up from the bed, ” But this was the letter that got to Adanna” Alvana smiled. ” No, it can’t be, if this sort of letter go to her, then why didn’t she tell me when I got back home?” I asked him in anger. ” Because I asked her not to tell you, I managed to convince her that you didn’t draft this, you can ask her when you leave here” he explained with a smile while I scratched my head. ” wait!” I stood up, ” I wasn’t the one that submitted the letter to be posted that day” I said while he opened his eyes in surprise, ” Who did?” He asked. ” My friend Israel, he is my room mate” I explained but he just hissed. ” Israel wasnt around during my time” he said silently. ” What does the letter have to do with your time?” I asked him. ” Because the same person who changed your letter also altered my letter” he handed me another piece of letter, I stared at the letter where he was promising his girlfriend to bring some money for her. The strange thing was that the letter had exactly the same hand writing. ” Yes that was the letter that implicated me, I only posted a letter telling my girlfriend I would be coming back soon” He explained, there was tears in his eyes. ” Sorry about that bro, but I think this is a headway, the person is someone I know and you also know” I told him and he nodded. For once, Alvana didn’t smile, tears dropped his eyes. ” I knew you were from Newriton when I saw the mark, I was only unlucky not to have completed my trainings ” he told me while I nodded. ” How did the money get into your room?” I asked him, ” My card was cloned, someone cloned the card” he sat down still holding a piece of paper in his hand.
” Why will someone want to implicate you that way?” I asked, ” I was the best fighter in my set, a lot of people wanted to be the best so they wanted to dismiss me, many also wanted to be the best but they couldn’t get it when I am still there” he explained further. ” That’s bad, but why will the person change my own letter?” I asked him, ” Maybe that person wanted Adanna” He said but I found it hard to believe. ” Why did you kill the chief priest?” He suddenly asked, I looked at him in surprise, does Alvana know everything? ” I didn’t…” He interrupted me. “Remember that night, when you thought you heard footsteps behind you and you immediately turned with your gun, I was the one following you” he smiled while I opened my mouth in shock. ” I wasn’t actually following you” he started, ” I was going to the chief priest place to make my own investigations, I had always suspected him” he said. ” I had been earlier worried about I was to enter into his inner house with violence, and then you came and helped me distract him” Alvana continued. ” I dont get you” I said relaxing on the bed. ” My mission that night was to search the chief priest house which is at the back of the shrine, I wanted to see if I could get any suspicious exhibit. Your coming was of advantage because you helped me distract him, I took cover among the bushes and found my way to the small back shrine house. I heard your discussions with him and how you finally shot him. Gabriel, you are a spy, you should learn to always take things easy and keep calm, its step by step” he stared at me while I nodded. ” So what did you find out?” I asked him and he handed me the last piece of paper. I stared at it and all I could see were names, ” That is the name of the people the serial killer had planned to kill, look well, your name and Adanna’s are among them, I got it from the chief priest place, there was also a bag of money, the chief priest us being paid to make the people believe that Anu kills its people” Alvana explained, ” the names isn’t what got my attention about the letter” Alvana continued as he collected the previous letters he had given me, ” The fact that the three letters have the same handwriting is what to be suspicious about” Alvana added. I looked well again and he was right, the three letters were written by the same person. ” Now Alvana, am confused” I said to him, he only smiled. ” let’s leave the letters alone, you said israel posted your letter, we should try talk to him ” He stood up and walked around. ” Maybe someone might have seen him posting the letter” Alvana added. ” I will talk to him” I assured him, ” Now, how do we get the killer?” I asked and he smiled. ” We will use the list, the latest person he killed was Eneda, now, the next on his list is who?” He asked as he opened the list himself, ” Whoa, the next on his list is Mbe ” he concluded and laughed, ” I would have loved Mbe to be killed” I also stood up, ” Even I myself, but that’s not what Newriton portrays” he sat down . ” Okay, what we have to do is to watch Mbe the cat secretly, the killer might attack soon” Alvana added. ” Hmm, please I would need that my letter for investigations” I pointed at the letter with him, ” Sure” he nodded
AS NARRATED BY ADANNA
Coming to the stream that morning, I had only one intention, to see Gabriel. I was surprised and down casted when I didn’t see him among his friends, I didn’t bother to ask because I knew he must be fine. We had to gist deal with Mbe before going to fetch water with the city girl, Morgana. The city guy israel was behind us like a guard as we walked back home, he might probably be watching out for Mbe the cat or has Alvana might have put it, Mbe the Dog. ” I dont think I can remember anything about the guy” I had told the city girl when she asked me what I remembered about the night I had an encounter with the man in black. ” Are you sure there is nothing you can use to describe him, anything at all” she pressed forward while I stood for a while to think, ” Nothing” I finally said since I could remember nothing. ” Okay then” She said and we walked home.
°°
” Now, I think you have to go home and prepare” Alvana told me, ” You see, some of my friends from the city are here with me in the village, I mean fellow spies like me” I told Alvana as he handed me my white T-shirt which he had washed for me. ” That’s great, they can also be of help but can you trust them?” He asked me and I nodded. “Okay then, get them prepared” he tied a wrapper around his body and carried a cutlass. ” let me lead you out, I am also going to the farm ” He walked out and I followed him. His house was surrounded with bushes, it was the only house in the environ, Alvana had certainly lived a life of stigmatization. ” You live in a bush?” I asked him, ” No, this is my own estate” He smiled as we found our way through the bush path. ” Wait, dont you think the chief priest might have fortified the killer?” I asked him and he bursted into laughter, ” Who killed the chief priest?” He asked me, ” I did” I simply replied, ” Didn’t the gun kill him? Why wasn’t he fortified? Didn’t he call on Ani that day? Why did the bullets kill him?” Alvana asked me as we walked along, ” That simply means Ani doesn’t exist” Alvana concluded and silence fell upon us until we got to the main village. It was still morning and people had not started coming out, so I quickly found my way home. ” Oyinbo, where are you coming from looking so rough?” My father who was sitting on his arm chair asked on seeing me, ” I went for a little adventure dad” I replied trying to smile, ” is that why your face is also rough and swollen?” He added, ” it looks like you have been beaten” He said . ” papa, am tired, where are my friends?” I asked him walking towards the house. ” They are inside, they have really been good in helping us” He smiled , I nodded and went into my room. I met Morgana and israel pacing the room with worried expressions on their faces. ” Fool, must you play with everything, where have you been?” Israel asked on sighting me, Morgana took a deep breath and fell into the bed. ” I had an encounter with him, or let me say them” I started, ” who is him or them?” Morgana asked as she sat up on the bed, ” The serial killer and Jason” I said , the expressions on their faces showed they were interested In the discussion. ” I went to the forest of Ani as I had planned, I saw the body of the dead girl and true to our thoughts, there wasn’t any other body in the forest. I hid myself in the bush hoping to see what will happen and I saw people come to take her body away, where they took her to, I dont know. I was happy on my discovery but never knew the killer was behind me, I only noticed when he talked. We both ended up in a fight, he was stronger than I had prepared for. Nothing I did worked on him, he was able to defeat me and about to cut me with the sword. I tried punching him and then he angrily hit my head with the back of the sword and that was all I could remember. When I woke up again, I was in a room, on a bed, Jason’s house” I concluded, they were all listening attentively. ” Did you see his face? I mean Jason? ” israel asked while I nodded, ” I saw him, he even happens to be someone I know, he is my village friend” I explained. ” You see, we can’t also trust this Jason, remember he is a thief” Morgana stood up from the bed and started pacing around. ” He isn’t a thief” I defended and they both turned to me waiting for an explanation. ” He was implicated with a letter, a letter he never wrote ” I started, ” I dont understand” Israel chipped in, ” Israel, remember that day you helped me post a letter, was this the letter you posted?” I asked handling the letter to Israel, he took it and read through it. ” No, I didn’t post this” Israel laughed, ” But this was what got to Adanna” I said while they both stared at me in disbelief. ” Wait, there was one person with me that day I had posted the letter” Israel said placing his left fingers across his lips, ” Who?” I and Morgana asked in union.
who? ” I asked again, ” Christiana, she was going for jogging that morning ” israel said. ” But this isn’t Christiana’s writing” Morgana looked at the letter again, ” I know but only Gabriel, me and Christiana know I posted a letter, no one else does” Israel said while I reached for my phone. ” Yes, Christiana, how are you doing” I started as I placed the phone on speaker, ” Hey Gabi, am fine, I am in my house, am enjoying myself here with family” Christiana laughed happily over the phone. ” Oh, nice, I lost my sister” I told her, while she paused for some seconds, ” Was she sick?” She asked me, ” No she wasn’t, didn’t I tell you about the serial killer in Atata?” I asked, ” Yeah, I kind of heard you talked about it once, you weren’t telling me directly” She answered. ” The serial killer killed her” I said” Oh God, am sorry bro, I think you need to report this to Sir Ajan, we need to work on this” her voice was filled with sorrow. ” We dont need sir Ajan, Israel and Morgana are already here with me” I said, ” Oh no wonder I didn’t see them before leaving Newriton ” she said, ” Yeah, we are on the verge of getting the killer now, but we only need you for something ” I told her calmly. ” I will do anything for you on this case” she assured me. ” Okay, do you remember any day , about some weeks ago when you saw israel going to post a letter?” I asked. ” Yes, I remember seeing israel once going to post a letter, I asked him who it was for and he had replied Adanna” She explained. ” Did you do anything with the letter, did you go back to take the letter, dont lie to me” I said calmly while she took a deep breath.
AS NARRATED BY CHRISTIANA
I am Christy, a trained spy from Newriton. I still live with my parent in Enugu , I am 22 years of age. When I got to Newriton , I met this young handsome guy, Gabriel Omiyi. He was a strong, Jovial spy. If am not mistaken, he was the best of us all but he had one problem, he was never patient. I won’t lie to you guys, right from the first day I saw him, I fell in love with him. Yeah, I fell in love with but as you all know, the girl doesn’t go to the boy, the boy comes to the girl. So I had to hide my feelings but still loved him secretly. As time went on, I started noticing him falling for me also but he never talked about it, if he was scared or shy, I dont know. I knew he was crushing on me with the way he behaved, he always wanted to be with me , he was always fond of me. It continued this way until he finished his training and went home, it was there he met this girl they call Adanna. I dont know her but whosoever she is, she succeeded in taking my guy from me. I got to know her name on the day we were having an instruction class on our upcoming mission, a long time spy, Daniel was the one teaching us. In his class, he had made a statement , ” So, this isn’t something we should rush, it might end up becoming a mission to be accomplished in Years, Gabriel, dont worry or think about Adanna” Daniel had said that day, I had asked Gabriel who Adanna was and Gabriel has simply told me ” Ask him” which I did, at the end of the class that day, I went to Daniel to ask him. ” Hey, good morning” I greeted as he went out the hall that day, ” Hey, good morning” he greeted back ” You see, I wanna ask you s….” He interrupted , ” You wanna know who Adanna is” he smiled surprising me, ” Hey, dont be shy, I know you love Gabriel, anyways, Adanna is his village girlfriend, or better put, the village girl he loves” he explained while I breathed out in anger, ” Hey, dont be sad, love is like a game, you are free to compete for him, it like the survival of the fittest” He had told me that day , he made me have trust in him, he told me he was going to help me get Gabriel if i want and that he is always available if I need his help. On one fateful morning, I had been lucky to see Israel posting a letter, ” Hmm, who are you posting to?” I had ask him and made to jog to the field, ” It is for Gabi, I am posting it to his girlfriend, Adanna” He explained. I nodded and jogged away, not to the field but to a corner where I watched him till he was out of sight. I then came out and opened the post box, I took the letter. The time was 7:00am, the post men will come take the letter by 11:00am so I had time. I took the letter to my room, I made to change the content with a new paper but I stopped. Gabriel will surely know my handwriting when he sees the letter if he goes back to Atata, I needed someone else to do it for me, Daniel was the perfect person. I went to his quarters and surprisingly, he was willing to help me change it. He did a perfect Job and I was happy with myself. No lady will see this and still want to continue with the guy. I posted the letter before 11:00am and that was how the letter was changed. I waited to see any change but no I didn’t see one. It was during our mission that I met this guy in Kendrick club, he showed me love and in no time, I forgot Gabriel. Though I forgot Gabriel, I couldn’t help to think of the fact that I spoilt his own relationship. I always wanted to tell him of what I did but I never got the chance, I hope one day, he will find out and I will open up. When he called me today and brought the topic about the letter, I thought it was the opportunity to tell him of what I had done. ” I swapped the letter, Daniel wrote it for me, please forgive me” I told him in a calm voice. ” you said who wrote it for you?” He asked, ” Daniel, he wrote it for me, see, am really sorry, it was out of jealousy , please forgive me” I told him again but the line was dead.
°°
” She said Daniel wrote the letter for her” I turned to Israel and Morgana, the news was like a shocking revelation, I had never liked Daniel but I always prayed it wasn’t him. ” So how does Daniel changing the letter make him a serial Killer?” Israel asked as he sat on the ex with Morgana, ” it has a lot to do with it” I said and narrated everything to them. ” This is a shocking revelation ” Israel exclaimed after the story, ” According to Newriton, he isn’t guilty until we get him red handed ” Morgana stood up holding her waist. ” so we have to protect that foolish cat of a guy, we almost fought this morning” Israel lamented, ” I myself won’t have loved to protect him” I said as I brought out a gun from my briefcase. ” I will love to meet this Jason” Morgana turned to me, ” Yes, he will be with us soon ” I assured her. They got up and got their guns and knives ready , there is surely gonna be a big fight anytime soon. ” Dont you think we involve sir Ajan in this?” Morgana asked, ” No!! We dont want to finish this in five years time” israel objected while I bursted into laughter.
• ” So guys, meet Alvana, sorry, Jason” I said to Israel and Morgana as we sat on a bench that evening with Alvana, he was just returning from the farm and he decided to branch. ” Nice meeting you guys” Alvana smiled, ” At last, I am standing face to face with the famous Jason ” Israel shook hands with him, he hugged Morgana. ” Gabi told us everything, he told us how you saved him, thank you” Morgana smiled while Alvana nodded with a smile. ” so now, let’s go straight to business” I stood up and squatted on the ground. ” It is a clear fact that the serial killer attacks by night, so our duty is to watch Mbe by night” I said looking up to them, ” Say something we dont know” Israel shouted and they bursted into laughter. ” We start this night, there is every possibility that he might want to strike this night, for one reason or the other, he seems to be in an hurry” Alvana added while we nodded, ” Mbe house is of this shape” Alvana drew a kind of structure on the ground, ” It is surrounded with bushes. That is where we are gonna take cover. We can’t use guns so as not to kill Mbe” Alvana continued, ” Guns doesn’t even have effect on him, he is on a bullet proof” I chipped in. ” One way or the other, one of us have to gain access into Mbe house, the serial killer might visit him at home” Alvana continued. ” We dont need to be afraid, we are 4 and he is only one, we can do this” Alvana concluded. ” Wait, we ain’t killing him, we are to expose him” Israel said. ” Do you think its better to lead him into a trap?” Morgana started and we all turned to her, ” I can distract him, I can lead him to you guys, you guys should be somewhere, I can bring him to you ” She suggested. ” I think her plan is better” Alvana smiled again, ” Thanks” Morgana blushed.
AS NARRATED BY MORGANA
With the help of Jason, I was able to locate Mbe’s house, he was outside his house when I got there that evening, he was eating Akpu and soup. ” Good evening” I greeted, I was in a black trouser and a white top, I wasn’t with any weapon other than a knife in my high heel shoe. ” Are you not the maiden I saw at the stream today?” He asked with a smile as he rubbed his hand on his wrapper, ” yes I am” I smiled back. ” What brings you to the abode of the great cat?” He asked as he cleaned the bench for me to sit, I checked the time and it was 6:00pm, the killer might come soon. ” Why dont we go inside?” I asked crossing my legs, ” Whoa, you want to come inside? ” He led the way while I followed him. ” So tell me why you have come to my abode” he stared at me. ” Because I like you, you were saying something about me this morning but my foolish city friend stopped you, the truth is that I actually like you too” I smiled , his face was full of happiness, I wished he knew I have nothing for him, I hate guys like him. ” That’s why I have come to be with you till tomorrow” I told him again. ” Unbelievable, you mean you will stay with me through the night?” He asked while I nodded, ” I heard the city people are free but never believed till now, you can stay for eternity” He shouted happily as he rushed out to bring the bench in.
• It was now around 12:15am, Mbe wasn’t sleeping so also was I not sleeping. He had been disturbing him to get intimate with him but all to no avail. I had managed to pull off my trouser leaving me alone with my bomb short, I allowed him romance me but nothing more. He was still in the act of romance when we heard movement around the house, I sprang up immediately. ” What is that? ” I asked him, ” I dont know ” he replied as he also stood up from the bed. I moved away from him and stood beside the door while Mbe searched for his machete. Suddenly, the door was forced opened by a single kick, and a man in black walked in quietly and stood face to face with Mbe. ” The cat, Ani has come to kill you ” The man in black said, Mbe machete fell off his hands. ” Hello Daniel” I said from behind and he turned sharply to face me, ” Morgana ” his voice depicted that he was shocked. ” Yes Daniel, are you surprised I know you? don’t be bro, that’s the way the girl does her thing” I smiled. ” Then, it is time to know how the boy does his thing” He replied and brought out his sword from its s---t. ” Sorry bro, I have to let the whole world know” I said and dashed out of the house, he followed me immediately. It was a tough race, I knew he mustn’t get me else am done for. I dashed into the bush surrounding Mbe’s house, I was actually heading to the forest of Ani where the rest must have been waiting, we already picked a spot where the show will take place. I ran out of the Bush and then into the quiet dusty road of Atata, I could feel Daniel following me. In the darkness of the night, two people could be seen running along the red , dusty road of Atata, Daniel and Morgana.
I took a sharp turn into the forest, the birds of the night sang with their sonorous voices while the crickets backed it up. I found my way through fallen woods, I made sure I did not fall, the fact that I was with just a bomb short and a shirt made me more flexible, I suddenly got to the spot which was filled with tall trees, that was where my friends were, I quickly took cover behind a tree, I felt he stopped, he might be surprised where I haf entered.
°°
We were on the top of trees, i, Israel and Alvana, we were on tree top waiting fruitfully for the arrival of Morgana. We were prepared and ready to die, we were dressed in all blacks like shadows. We saw Morgana come into the woods, she took cover behind one of the trees, ” Why was she with a bomb short?” Was the first thing I asked myself. Later on after her arrival, we saw the man in black stop among the woods, he was probably confused. ” Coward, I know you are here” he shouted as he moved around, ” Morgana!!! Your ancestors are ready to accept you “he shouted again. He suddenly turned back abruptly, some one had jumped down, it was Alvana. ” Hello Daniel” Alvana greeted while Daniel stood in shock, Morgana also came out ” Am ain’t a coward, here I am” She said laughing. I and Israel jumped down at the same time, none of us was on mask. ” Daniel, why?” Alvana asked, ” Jason?” Daniel called out as his sword fell off his hands. ” No time for familiarities ” Israel threw a knife at his leg, the knife caught him well and he fell to his knee with a cry. Alvana walked up to him and took off his mask, it was no one else but Daniel. ” Is it about the money?” Alvana asked as he threw him down heavily.
*
*
Act Of Faith
Epilogue
°°
Daniel wasn’t killed, he was taken to Newriton and locked up alongside young Carl, young Carl was the guy who cloned Alvana’s card, they were to die in jail with everyday toture. Alvana was later given the mark of Newriton and sir Ajan was happy to have him back. As time went on, something like chemistry could be seen between Alvana and Morgana, they fell in love. I later got to know that Morgana never stayed in port Harcourt, she was an orphan whom sir Ajan had picked from the club. One day, Morgana decided we go greet her friend, the city nurse, Mama. It was there we discovered that she was Alvana’s mother, what a happy reunion.
• Some months later, the only catholic church in Atata could be seen crowded with cars of different kind, there wasn’t space in the whole church as it was crowded with people, it was my wedding day with Adanna. She was dressed in a white gown, while I was in a blue suit so also was all my friends, Jason, Sir Ajan, Morgana, Christiana, Matt and Israel who was busy supervising those cooking. My mom, dad, and Adanna’s parent were all seen happily dressed and seated at the front of the church. ” Now I proclaim you, Gabriel Omiyi and Adanna Mologwu husband and wife” the priest voice echoed, ” Now you may kiss your bride ” he added while I unveiled the white cloth covering Adanna’s face to reveal my ever beautiful Adanna, I moved my lips slowly to her’s and soon our lips joined, the church went into wide jubilation . ” Israel, get away from the front, let me camera this thing, Gabriel kiss those lips well, she made you suffer too much ” it was Alvana, he was the camera man of the day. We broke the kiss and Adanna rested her head on my shoulder, while the whole church went wide into jubilation, the old men could be seen hitting their walking sticks, Israel was scattering the dance floor with Morgana until Alvana came to push him away. Mbe the cat could be seen battling with his piece of meat. At last, its over, we were able to unravel the mystery of the serial killer, we were able to get Daniel. The people of Atata later turned to worship the true God after they heard that someone was behind the killings, but they never knew those who were behind their salvation except Mbe who knew about Morgana but kept it to himself. Although we got Daniel, we weren’t able to get Sir Jude Ike, but one day we hope we he will run into the long hands of Newriton, its just a matter of time and faith, its an act of Faith. For anyone who has had a stroke, working to prevent a second one should be Job No. 1. Keeping blood pressure under control is an important part of that job.
A study published yesterday in the journal Stroke shows that good blood pressure control after a stroke cuts the chances of having a repeat stroke by more than half. But it also brought some bad news: less than one-third of stroke survivors in the study managed to get their blood pressure under control.
In the report, researchers from the University of California crunched data from the Vitamin Intervention for Stroke Prevention (VISP) Trial. This trial had found that taking a daily pill that contained high doses of three B vitamins — folic acid, B6, and B12 — did nothing to prevent a second stroke. But the data collected as part of this trial has been a great resource for other research.
The volunteers in VISP had their blood pressure checked in a doctor’s office multiple times during the course of the two-year trial. Only 30% of the volunteers were able to keep their blood pressure in a good range (under 140/90) on 75% or more of the measurements. Meanwhile, more than one-third of the participants had controlled blood pressure less than 25% of the time.
The odds of having a second stroke were directly related to blood pressure control — better control, fewer strokes; poorer control, more strokes. The same held true for the connection between blood pressure control and having a heart attack or dying from heart disease.
Check BP at home
High blood pressure damages artery walls throughout the body. This damage can lead to stroke or heart attack. People who have survived a stroke or heart attack are at very high risk of having another of the same — or the other. The new study in Stroke shows that controlling blood pressure is a good way to reduce that risk.
There are many ways to control blood pressure. One advance that has been extremely helpful is the ability to check blood pressure at home. When the VISP trial ended in 2003, just about the only way to check blood pressure was in a doctor’s office, so the participants had their pressures checked a few times at the beginning of the trial and then once every six months. What happened in between is anyone’s guess. Today, home blood pressure monitors are readily available and relatively inexpensive. Instead of a twice-a-year snapshot, you can now get a more reliable look at your blood pressure. Knowing the numbers is a big step toward controlling blood pressure.
Lifestyle changes for all
Making changes to your lifestyle can help a lot to lower blood pressure or keep it under control. These changes can also help prevent a heart attack or stroke, and can strengthen your body in other ways.
Exercise often — at least 30 minutes five times a week. More is better.
Lose weight if needed.
Eat more fruits, vegetables, and whole grains, and less processed or highly refined food.
Cut back on salt.
Include foods rich in potassium in your diet (unless you have kidney disease).
If you drink alcohol, keep it moderate — no more than two drinks a day for men, no more than one a day for women.
Don’t smoke.
Medications may be needed
Many people need medicine in addition to lifestyle changes to lower blood pressure. There are a number of proven options for medications that lower blood pressure. Recent guidelines suggest the following:
If you are black and you have normal kidney function, start with a low daily dose of a thiazide-type diuretic (water pill) such as chlorthalidone or hydrochlorothiazide, or a calcium-channel blocker. Another option is a pill that contains low doses of both drug types.
If you are not black and you have normal kidney function, start with a low dose of one of these drug types:
angiotensin-converting–enzyme (ACE) inhibitor
angiotensin-receptor blocker (ARB)
thiazide-type diuretic
calcium-channel blocker
A pill that contains low doses of two different drug types
If your kidneys aren’t working as well as they should, your doctor might recommend that you start on a low dose of an ACE inhibitor or ARB (but not both together). These types of drugs help protect the kidneys from further damage.
How low should you go?
Normal, healthy blood pressure is anything under 120/80. For years, people with high blood pressure were urged to get their pressure under 140/90. New recommendations suggest that for some people, it’s okay to let blood pressure drift a bit higher, to under 150/90. The thinking is that driving it down further could cause problems like feeling lightheaded when standing up or getting out of bed, which could cause falls. And lower pressure usually means more medications, which can cause harmful side effects.
The new Stroke study and others provide strong evidence that keeping blood pressure under 140/90 is the best goal for stroke prevention. I plan to use a blood pressure goal of less than 140/90 for my most of my patients. The exceptions will be older individuals with high blood pressure when sitting or lying down but low blood pressure when they stand up.
If you have high blood pressure, aim for getting at least 75% of your blood pressure readings under 140/90 — as long as you don’t get dizzy when you stand up. If you do, or your blood pressure continues to stick above 140/90, let your doctor know.
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