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Heart health by the numbers: knowing and managing the measurable risk factors for coronary artery disease can help you keep your heart healthy.

Maintaining a healthy heart and preventing coronary artery disease (CAD) involve well-established steps, such as healthier eating, regular exercise, and quitting smoking. But you can take even greater control of your heart health by keeping track of a few key numbers that are indicators of your CAD risk.

These numbers fall into a range and relate to cholesterol, fasting glucose, blood pressure, and a key CAD risk factor: obesity. Included are your weight, waist circumference, and your body mass index (BMI), a formula that uses your height and weight to determine if you are underweight, healthy, overweight, or obese.

For example, a healthy blood pressure is 120/80 mm Hg or below. A systolic (top number) blood pressure of 120-139 and a diastolic blood pressure of 80-89 is considered prehypertension. Hypertension (high blood pressure) is defined as 140/90 and above; if your blood pressure is at that level, your doctor will probably prescribe an antihypertensive medication. However, your age and conditions such as diabetes and kidney disease can affect your specific blood pressure target.

Goals and targets

"Numbers help patients in terms of trends and knowing whether you're in a danger zone when it comes to some of these risk factors," says Nivee Amin, MD, a cardiologist and assistant professor of medicine at Weill Cornell Medical College. "It helps to have a goal, and numbers give patients targets to work toward."

Blood pressure

Blood pressure is relatively easy to track because you can monitor it at home. Dr. Amin says that if your blood pressure is well controlled, either with or without medication, checking it once a week is probably sufficient. If you're starting a new medication to control your blood pressure or adjusting your medication, a daily check may be appropriate.

"Blood pressure is such an individual thing, so it's important to talk with your doctor and know what your target is," Dr. Amin says. "I want my patients to know those numbers and know how important it is to maintain a healthy blood pressure."

Cholesterol

Keeping track of your cholesterol requires a blood test. Dr. Amin says that, for healthy women, blood work can be done every two or three years. But, if you have CAD or risk factors for CAD, such as hypertension, a family history of diabetes, or high cholesterol, then an annual blood test is advised,

Your cholesterol numbers, which are also called lipid levels, include your LDL ("bad") cholesterol and HDL ("good") cholesterol, as well as your triglycerides, which are a type of fat in your bloodstream. Generally, you want an LDL below 100, an HDL higher than 50, and triglycerides below 150, but again, it's important to discuss your targets with your doctor.

Recent changes in treatment guidelines have downplayed the importance of specific cholesterol targets and replaced them with a heart disease risk profile based on several factors. However, Dr. Amin says that having specific targets is helpful, especially when you're first starting with medications and lifestyle changes.

Blood glucose

Measuring your blood glucose via a blood test reveals how much glucose, or sugar, is in your bloodstream. Elevated levels of blood glucose can raise your risk of heart disease or make existing heart disease more serious.

Blood glucose targets are very specific. A fasting blood glucose level of 70 to 99 mg/dL is considered normal; a level higher than 100 is cause for concern. "A fasting glucose of around 100 can show there may be some metabolic difficulty, and that's a sign you should start making lifestyle changes," Dr. Amin says.

A fasting blood glucose level between 100 and 125 is a sign of prediabetes, and a level of 126 or higher usually indicates diabetes. If your fasting blood glucose is high, your doctor may order another type of blood

glucose test, an HbA1c, that shows your average blood glucose levels for the preceding three months. A normal HbA1c level is less than 5.7 percent, while 5.7 percent to 6.4 percent indicates prediabetes, and 6.5 percent or higher means you probably have diabetes.

Weight, waist, and BMI

Being overweight or obese raises your risk of developing heart disease. Determining your ideal weight isn't an exact science, however. Dr. Amin says BMI isn't a perfect measure, but it's helpful to provide a general target for women trying to lose weight.

"A woman should check her weight at least once a month," Dr. Amin says. "If you're trying to lose weight, you should probably get on the scale every day."

A BMI of 18.5 to 24.9 is normal, while a BMI of 25 to 29.9 is overweight, and 30 and above is obese. For example, a woman who is 5'5" and weighs 140 pounds has a BMI of 23.3, well within the normal range, but if that woman gained 40 pounds, she would have a BMI of 30, signifying obesity.

You also may have obesity-related problems if your waist size is more than 35 inches (assuming you're not pregnant). Losing inches around your waist can be a motivating factor to keep exercising and eating right.

Dr. Amin says that women who track these and other numbers regarding their heart health are often more enthusiastic about their overall health.

"It's really empowering for patients to feel they are part of the team, because they're the ones who have to do the hard work," she says. "The more health literate they are, the more likely they are to live healthier lives."

WHAT YOU CAN DO

All of your key heart health numbers will benefit from these lifestyle choices:

* Follow a dietary plan that includes fruits, vegetables, whole grains, lean proteins (including plant sources such as beans, lentils, nuts, and seeds), and low-fat dairy products.

* Limit your intake of processed, packaged foods; often, they are high in salt, added sugar, and/or refined grains and low in nutrients.

* Get and stay physically active; walking, exercising with hand weights or resistance bands, attending yoga or tai chi classes, and doing household chores all contribute to better health.

TARGET NUMBERS
FOR HEART HEALTH

Blood pressure          120/80 mm Hg or below
LDL cholesterol                  100 or below
HDL cholesterol                   50 or above
Triglycerides                    150 or below
Fasting blood glucose             70-99 mg/dl
HbA1c                    5.7 percent or below
Body mass index                     18.5-24.9
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Publication:Women's Health Advisor
Date:Oct 1, 2015
Words:1055
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