Understanding 4 sets of very important numbers is key in knowing your immediate and long-term risk for Coronary Artery Disease.
Once you understand what these number sets represent and how your individual numbers compare to the set standards for each, you’ll have a much better picture of where your heart and vascular health stand.
Cholesterol plays a major role in the development of CAD. Fatty plaque deposits made from cholesterol build up inside your arteries. Over time, these deposits may come to restrict blood flow through your arteries which increases strain on your heart (making it work harder) and increasing blood pressure.
Diet and exercise play an important role in reducing the likelihood of plaque buildup, but these preventative measures can only go so far if you’ve inherited the predisposition for Coronary Artery Disease.
There are 3 results in your blood test (unfortunately the only way to check your cholesterol levels is through a fasting blood test) for cholesterol that you need to pay close attention to:
- TOTAL CHOLESTEROL – This measurement is a overall view of the amount of cholesterol in your bloodstream. Our bodies produce more cholesterol as we age. Ideally, regardless of your age, your number for total cholesterol should always be BELOW 200.
- HEALTHY NORMAL – Below 200mg/dL
- BORDERLINE HIGH – Between 200mg/dL and 239mg/dL
- HIGH CHOLESTEROL – 240mg/dL and above
- LDL – LOW DENSITY LIPIDS – Low Density Lipids are closely associated with CAD and the development of plaques. You can remember this by thinking of the abbreviation LDL – as being the type of cholesterol you want LOW. L=LOW=Bad Cholesterol.
- HEALTHY NORMAL – Below 100mg/dL
- POTENTIAL RISK – From 100mg/dL to 129mg/dL are acceptable in people with no risk or family history of CAD, but are of concern for those who are at risk.
- BORDERLINE HIGH – From 130mg/dL to 159mg/dL
- HIGH – From 160mg/dL to 189mg/dL
- VERY HIGH – Above 190mg/dL
- HDH – HIGH DENSITY LIPIDS – High Density Lipids are known as the “HEALTHY” cholesterol. Think of the H in HDL as standing for Healthy. The higher this number the better. HDL cholesterol is believed to act as a magnet for LDL, binding to it and helping flush it out of your blood.
- LOW – Below 40mg/dL is considered low and may put you at much greater risk for CAD.
- BORDERLINE LOW – Between 41mg/dL and 59mg/dL
- OPTIMAL – Above 60mg/dL
SOME THINGS TO LOOK FOR:
Inherited heart disease (heart disease that is part of your DNA and was inherited from one or both of your parents) is most often identified through specific patterns in a person’s cholesterol.
If you are active with a normal BMI (Body Mass Index – I’ll explain this below) and your total cholesterol is always near borderline, is borderline, or is high, and you have a higher than desired LDL and lower than desired HDL – there is a good chance you have already developed CAD.
This was me. Very active, exercising daily, with a great/healthy diet, and a BMI of 18; yet my total cholesterol was between 198 and 217, my LDL was always in the 100-120 range, and my HDL was between 25 and 30. This pattern is associated with inherited CAD and despite my healthy lifestyle choices, I had a heart attack at age 46.
ONE MORE TYPE OF FAT IN YOUR BLOOD YOU SHOULD BE AWARE OF – TRIGLYCERIDES
Triglycerides are a form of fat in the body that stores excess energy from the food you eat. Normally these are nothing to be concerned about unless you have borderline or high cholesterol, LDL cholesterol, or low HDL cholesterol. High levels of triglycerides with high (total, LDL) and/or low (HDL) cholesterol is an indication of a much higher risk for a heart attack or stroke.
Blood pressure is the amount of pressure your blood exerts on artery walls as it is pumped through your body.
Blood pressure is expressed as two (2) numbers in a fraction, one over the other.
Systolic blood pressure (the upper number) — indicates how much pressure your blood is exerting against your artery walls when the heart beats.
Diastolic blood pressure (the lower number) — indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
The abbreviation mm Hg means millimeters of mercury. Mercury was used in the first accurate pressure gauges and is still used as the standard unit of measurement for pressure in medicine.
- Normal blood pressure: numbers that are within the normal (optimal) range of less than 120/80 mm Hg.
- Elevated: Elevated blood pressure is when readings are consistently ranging from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control it.
- Hypertension Stage 1: Hypertension Stage 1 is when blood pressure is consistently ranging from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD) such as heart attack or stroke.
- Hypertension Stage 2: Hypertension Stage 2 is when blood pressure is consistently ranging at levels of 140/90 mm Hg or higher. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications along with lifestyle changes.
- Hypertensive crisis: If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and test again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis. If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do not wait to see if your pressure comes down on its own. Call 9-1-1.
Prolonged untreated high blood pressure can lead to irreversible tissue and organ damage. Additionally high blood pressure is closely associated with heart attack and stroke.
Your blood sugar level (also called blood sugar concentration or blood glucose level) is the amount of glucose present in your blood. Glucose is a simple sugar and approximately 4 grams of glucose are present in the blood of a 70-kilogram (150 lb) person.
The body tightly regulates blood glucose levels as a part of metabolic homeostasis (glucose is the primary source of energy and is critical for normal function and 60% of the glucose in your blood is absorbed by your brain for routine functioning).
If you have high blood glucose readings, it may indicate an issue with your body’s ability to regulate blood sugar. This is very serious for if blood sugar levels remain too high many long-term health problems including heart disease, cancer, eye, kidney, and nerve damage may occur. High blood sugar is a primary risk factor in the development of CAD.
- NORMAL: A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L)
- PREDIABETIC: A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L)
- DIABETIC: If it’s 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes and are at much greater risk for heart disease.
Blood glucose levels are maintained by your pancreas and a hormone produced by your body called insulin. In people without the predisposition for inherited diabetes (Type 1 or Type 2), blood sugar can be managed with diet and exercise. Likewise, if you have a healthy diet and you exercise regularly, you are at less risk of developing diabetes if the genes for it run in your family. In many cases diabetes onset is experienced with obesity, lack of physical activity, poor diet, and stress.
The body mass index (BMI) is a value derived from the mass (weight) and height of an individual. BMI is defined as the body mass divided by the square of the body height, and is universally expressed in units of kg/m2, resulting from mass in kilograms and height in meters.
BMI may also be determined using a table (See below) or chart which displays BMI as a function of mass and height using contour lines or colors for different BMI categories (See below), and which may use other units of measurement (converted to metric units for the calculation).
Commonly accepted BMI ranges listed below:
- Very severely underweight = BMI of 15 or under
- Severely underweight = BMI of 15 or 16
- Underweight = BMI of 16 to 18.5
- Normal (healthy weight) = BMI of 18.5 to 25
- Overweight = BMI of 25 to 30
- Obese Class I (Moderately obese) = BMI of 30 to 35
- Obese Class II (Severely obese) = BMI of 35 to 40
- Obese Class III (Very severely obese) = BMI of 40 or above
Click on a table above to view
BMI is an attempt to quantify the amount of tissue mass (muscle, fat, and bone) in an individual, and then categorize that person as underweight, normal weight, overweight, or obese based on that value. There is some debate about where on the BMI scale the dividing lines between categories should be placed.
Understanding the important basics of your own health and well being is vital in reducing your risk for serious, potentially deadly conditions and diseases.
Think of your body as a machine like your car. You have to take care of your car to keep it in working condition. You have to check the oil, change filters, and put fresh gasoline and oil in it, etc… For your body you have to check your blood (cholesterol, blood sugar), check your blood pressure, and make healthy lifestyle choices regarding diet and exercise. When your car is in good mechanical condition you can depend on it getting you where you need to go without fear of it breaking down. Your body is no different.
By understanding the importance of the numbers above and taking the time to have them checked, you are taking an important and necessary step in ensuring you can remain in good health.
DO NOT HESITATE TO DISCUSS ANY OF YOUR NUMBERS THAT MAY BE OUT OF RANGE WITH YOUR DOCTOR! Ask as many questions as you need to feel comfortable that your health challenges are being addressed.
Lastly, the responsibility for your health falls on you. You can choose to ignore signs that there may be a potential problem with you current health choices and lifestyle OR you can make life changes (many are difficult) to change the course you’re on and work to optimize your health.