When it comes to heart health, things can get complicated. There are many more risk factors for heart disease than people may initially be aware of, but that doesn’t mean they don’t matter. More importantly, we don’t have control over all of our risk factors. The ones that we can change are called modifiable risk factors, such as blood pressure and diet. The ones we can’t, such as our age and family history, are called non-modifiable risk factors. Knowing some important information about your risk profile for heart disease can help you frame your outlook on how aggressive you should be about preventing it. One thing is certain… prevention works!
Here are five numbers you should know about yourself to help define your risk. Furthermore, they are the numbers you should try to work toward to optimize your risk and not become just a statistic.
There has been more recent evidence from research studies looking at what the best blood pressure is. To summarize the current train of thought for how low you should go, you must ask yourself, “How low can you go? Can you go down low?” We’re not talking about the dance floor here, but a blood pressure of less than 120/80 is ideal.
Checking blood pressure is easy and since it fluctuates throughout the day, the more data points you have, the better idea you’ll have of what your “real numbers” are. Just checking at your doctor’s office might not be enough to give an accurate representation of what your blood pressure is when it comes to how it affects your risk of heart disease. Automatic blood pressure cuffs are reasonably priced and could help keep you on top of your health game.
There are a few different types of cholesterol hat doctors will check for to fully understand your risk, but in general you want a total cholesterol less than 200, an LDL less than 130 (or lower if you have other risk factors), and an HDL over 40 for men or 50 for women. If you have other health issues such as diabetes or a history of heart disease, your target numbers might be lower.
The best way to check for diabetes is to check a blood test called hemoglobin A1c (HbA1c). This test gives a sense of how high your blood sugar has been over the past 3 months. Type I diabetes, or the kind that people get diagnosed with as children is fundamentally different than type II diabetes, which is the more common type that more often affects people in middle-age or later. This is how type II diabetes happens.
It’s normal for blood sugar levels to fluctuate depending on whether you eat or are fasting, but the range of blood sugar should not be that wide. Insulin is something that our bodies make that comes from the pancreas and is responsible for allowing the cells in our body to use blood sugar for energy or store it for a later time. Just like the boy who cried wolf, if blood sugar remains high for long periods of time, our cells become less sensitive to the insulin our body is making, which results in the sugar staying in our blood stream. Insulin levels rise as blood sugar remains high to attempt to get cells to take up the excess circulating sugar. However, the cells in our body are trying to ignore the insulin because they don’t need any more sugar than they already have. When this imbalance of circulating sugar levels that get too high gets to a certain point, we call it diabetes. The more sugar there is sticking around in the bloodstream, the more it will cause changes to the cells in the blood. That’s exactly what we measure with the HbA1c. It’s essentially measuring the amount of “sugar-coating” on red blood cells, which are always circulating. A HbA1c less than 5.7% is ideal. Between 5.7% and 6.4% is called pre-diabetes, which is an at-risk category. More than that is when we diagnose diabetes.
BMI, or body mass index, is a calculation that gives a measure of how you weigh relative to your height. The formula is:
BMI = Weight (in kilograms) / [height x height] (in meters)
A BMI of 18.5-24.9 is normal. 25-30 is considered overweight and above 30 is obese. If you’re a bodybuilder and have a lot of muscle mass, the BMI equation doesn’t account for that. For most people though, it’s a reasonably good estimate at deciding whether you weigh too much, too little (yes, that’s not a good thing either), or just right.
Uh oh… yes, I said it. Exercise is an important part of having good heart health. Research shows that about 8% of deaths and $117 billion of spending could be prevented by meeting the exercise guidelines recommended by the American Heart Association. The new guidelines allow you to choose your own adventure, so-to-speak. If you’re a go big or go home kind of person, you can do as little as 75-150 minutes of strenuous aerobic exercise that incorporates some type of strength training (such as circuit training) each week. If you prefer to enjoy the journey, you can do 150-300 minutes of moderate intensity aerobic exercise spread throughout each week incorporating strength training on at least 2 days each week. The choice is yours, but the recommendation is important.
It may seem daunting to have to think about all these numbers and what they mean for you. The good news is that it’s not the snapshot of these numbers at any one point in time that’s the be-all-end-all for someone. The important part is what these numbers, along with other risk factors for heart disease, do over time. Heart disease usually takes decades to get to the point of a heart attack or stroke. That means you have plenty of time to work on your health and invest in making the future you the best version yet!