Here’s a fact from the American Heart Association: About 49 percent of African American women ages 20 or older are at risk for heart disease, meaning they already have some plaque buildup in their arteries.


Some of that risk might come from a genetic link tied to the way their bodies process sodium, says Dr. Brandon Allport-Altillo, an assistant professor in the departments of population health and internal medicine at Dell Medical School at the University of Texas and a primary care internal medicine specialist at Lone Star Circle of Care.


Some of it might be about cultural food traditions, but it also might be access to medical care and a mistrust of doctors. “It’s a mix of things,” he says. “There are cultural barriers to care. The way people are treated when they do go to the doctor, the racism, the stigma and the bias.”


Allport-Altillo says he’s trying to develop more community-based ways for people to become more involved in their health care, including setting up more screenings, and working on empowering communities to seek health care.


People may not realize that heart disease and strokes are the same disease, he says; the both affect arteries. He talks about stroke and heart disease together and recommends the same prevention steps for both.


One of his patients, Diana Hargrove, 55, had a stroke Sept. 12. “I noticed when I tried to get out of bed, my right arm was twisted,” she says. Then she got up, and she fell. She tried to get up again and fell again. “I was in shock. I couldn’t believe it was happening to me.“


A friend called for an ambulance. She spent four days in the intensive care unit and 26 days in the hospital. The right side of her body is not really working, she says, and she is walking with a limp. Sometimes her speech is slurred.


Her biggest lesson, she says, is how important it is to take her blood pressure and cholesterol medicine every day. Her previous doctor had died, and she couldn’t afford care from a different doctor. She went without.


“That changed everything,” she says of the stroke. “That was a wake-up call. ... It has changed me. I can’t do what I used to do. I need help.”


Allport-Altillo educates his patients about eating less salt and recognizing hidden sodium in food such as sauces and in canned or packaged foods, “even bread,” he says.


He talks to them about good nutrition such as avoiding saturated fats, avoiding developing diabetes by watching sugar intake, and eating more vegetables, fruits and whole grains.


He recommends to his patients that they eat less than 2,300 milligrams of sodium a day, but knows that can be a struggle, so he’s happy with 3,000 milligrams.


“It’s hard to avoid,” he says. It’s in the food we’re used to eating “that’s delicious.”


Of course, smoking is one of the biggest risk factors, too, but hasn’t been as big a risk factor in this community, he says, though it is on the rise.


Allport-Altillo talks to his patients about how physical activity helps protect against heart disease.


“You can go for a walk, but you want your heart rate up a little bit,” he says. “You want to be able to have a conversation but feel a little bit like you’re out of breath.”


He recommends exercising 30 minutes a day five days a week, or a total of 150 minutes per week. “That’s the goal,” he says, but if that’s hard for people, he would be happy with 10 minutes of walking three times a day, if that’s more than what they are doing now. Make it a family event with children, spouses or significant others, he says.


Some of his female African American patients talk to him about the issue of sweating and hair. “We don’t have solutions for that,” he says. “We need to realize that it is an issue, and we need to find ways to deal with that. It’s a thing we need to talk about in the medical community.”


To see if you’re at risk, Allport-Altillo recommends getting a screening. One blood pressure check is not enough. You want to get at least two readings a week apart to see the pattern.


And don’t skip your regular checkup with a doctor.