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SMOKING CESSATION It's time to quit! Smoking kills-plain and sim- ple.  It doesn't matter if it's cigarettes, cigars or a pipe. It doesn't matter if the prod- uct is low tar or not. Approximately 50 million Americans still smoke, and annually the United States spends 23 billion dollars in related medical costs (9). Smoking, which kills thou- sands of Americans each year, negatively impacts nearly all organs in the body. Of its many effects on the cardiovascular system, smoking does raise blood pressure-at least in the short term.  This rise in blood pres- sure is considered secondary to the nicotine-related release of body chemicals such as adrenaline, which causes the blood vessels to constrict.  In fact, like hyper- tension, smoking by itself leads to an increased risk of stroke, due to an acute decrease in blood flow to the brain (10).   While some data have sug- gested that smoking cessa- tion results in higher diastolic blood pressure, this is believed to be related to the weight gain that frequently accompanies stopping smok- ing.  However, the advan- tages of quitting far outweigh any negative effects of con- tinuing.   HERBAL SUPPLEMENTS Consider a natural addition to your traditional medica- tions. Potassium:  This supple- ment, commonly found in many fruits and vegetables, is felt to have a positive effect on lowering blood pressure (3).  The exact mechanism for this reduc- tion is unknown.  However, it has been suggested that daily consumption of 48 to 90 milliequivalents(mEq) of potassium may benefit peo- ple with hypertension (11,12).  An analysis of 33 studies examining the effect of potassium in lowering blood pressure was con- ducted at Johns Hopkins Medical School (13).  This research found that patients who consumed at least 60 mEq of potassium per day lowered their systolic blood pressure an average of three points and their dias- tolic blood pressure an aver- age of about two points. While the decline in blood pressure is minimal, there may be select groups of people who benefit more. For instance, African Americans may be one such group.  In a study of 87 African Americans random- ized to receive either potassium supplementation or placebo (14).  Those who received potassium had a mean decline in their systolic blood pressure of 7 mm Hg and mean decline in their diastolic blood pressure of 3 mm Hg.  Before considering a potassium supplement, it is very important to consult your healthcare provider. Excessive potassium can lead to dangerous heart rhythm disorders. Magnesium:  In limited research this supplement has been demonstrated to have an important role in regulating blood pressure and, therefore, potentially in treating mild to moderate hypertension (15-18).  Other trials have suggested little benefit to magnesium sup- plementation (19).  It is, how- ever, important to point out that persons with low mag- nesium levels may not be able to replete low potassium stores (20). As a result, while magnesium may or may not be useful in the treatment of hypertension, its deficiency may contribute to the loss of other electrolytes such as potassium which may play a more meaningful role of this condition. A dosage of 600 to 1000 mg of elemental magnesium has been used for patients with mild to moderate

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