I try to take care of myself and most of the time I do a good job of it. Getting an annual physical exam is part of my self-care plan. My exam started yesterday and the test results were excellent: very low cholesterol and a normal heart rate of 72 beats per minute. Though I had gained 10 pounds, my weight was still in the normal range.

But my blood pressure was dangerously high. A nurse took a reading just before I saw my doctor. "Your blood pressure is 200," she said, "and that's not good."

My doctor took another reading after my exam and the number was even higher. "We have to get you on medication right away," she said. "Fill these prescriptions on the way home." She asked if I could identify the causes of high blood pressure.

"Two years of non-stop stress have caught up with me," I replied. I cited some of the causes of stress: losing four loved ones (including my daughter), within nine months, dozens of secondary losses, not selling my daughter's house, raising my twin grandchildren, compiling guardianship reports for the court, and the challenge of getting my grandchildren through college and graduate school. No wonder I was stressed.

Health experts refer to hypertension as the "silent killer." Mayo Clinic describes its dangers in a Website article, "High Blood Pressure." The effects of hypertension are alarming and include damage to the cells of your arteries' inner lining, heart damage, heart attack, mini stroke (transient ischemic attack), stroke, brain damage, kidney failure, and damage to your eye vessels.

When I read this list I became even more anxious. Thankfully, the medications my doctor prescribed started to work immediately. In two weeks I will see my doctor again and she will evaluate my treatment plan.

There are things you and I can do to lower our pressure. First, we can exercise regularly. I'm going to re-activate my walking program, which dwindled in the last few months. Second, we can carve out more time for ourselves. This is hard to do if you are grieving for multiple losses or caring for children. We can substitute herbs for salt. If we think a recipe needs salt, we can add the low-sodium kind. Keeping a blood pressure diary is also helpful and many drug stores have free pressure machines.

"High blood pressure can occur in children or adults," notes the American Heart Association. "It's particularly prevalent in African Americans, middle-age and elderly people, obese people and heavy drinkers."

Mourners face many challenges -- planning the memorial service, disposing of a loved one's possessions, tending to financial matters, protecting children, protecting themselves, and dealing with unforeseen secondary losses. Stir these ingredients together and you may have high blood pressure. There are people who need you, so take care of yourself.

Copyright 2009 by Harriet Hodgson