Key Numbers for Heart Health

3 numbers that can change your life.

From the WebMD Archives

We live our lives by the numbers: phone numbers, PIN numbers, stock market numbers.

But do you know the heart health numbers that could literally save your life? There are three key numbers you need -- including one surprisingly easy one that could give you a lifesaving preview of your cardiac risk.

  1. Your blood pressure
  2. Your cholesterol levels
  3. Your waist size

Healthy numbers mean a healthy heart. If you follow a healthy lifestyle -- eat a balanced diet, get regular exercise, and avoid smoking -- you can even turn bad numbers around.

Small changes can make a big difference, says Lori Mosca, MD, director of the Columbia Center for Heart Disease Prevention in New York City.

"For every point you raise your HDL -- that's the 'good' cholesterol -- you reduce your risk of coronary disease by 2%," she says. "So just raising HDL by five points cuts your heart disease risk by 10%!"

When measuring your heart health numbers, don't just look at where you are -- look at where you're going.

"Trend lines are important," says Mosca. "If your blood pressure is below the cutoff point for high blood pressure, that's good, but if it's been going up, it's still a concern." On the other hand, if your cholesterol is high, but on the way down, pat yourself on the back (and keep working out).

Here's a quick guide to your heart-health numbers:

1. Blood Pressure: Key to Heart Health

Your doctor tells you your blood pressure numbers, or you hear the doctors on ER shout "pressure's dropping!" Do you actually know what that means?

Blood pressure consists of two numbers. Your systolic pressure measures the pressure of blood against artery walls when the heart pumps blood out during a heartbeat, while the diastolic pressure measures the same pressure between heartbeats, when the heart fills with blood. "Both of these numbers are important," says Mosca. "Just because one is normal doesn't mean you're off the hook."

  • Normal blood pressure is below 120/80.
  • Pre-hypertension is 120 to 139 (systolic) and/or 80 to 89 (diastolic).
  • Hypertension – also known as high blood pressure -- is 140 or higher (systolic) and 90 or higher (diastolic).

One in three adults in the U.S. -- about 74 million people -- has high blood pressure or pre-hypertension. Between 1996 and 2006, the number of deaths from high blood pressure rose by more than 48%.

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2. Cholesterol: Predictor of Heart Attack

Cholesterol isn't all bad -- it's a type of fat that's actually a nutrient. But as you've probably heard, there's "good" cholesterol and "bad" cholesterol. When we measure cholesterol and blood fats, we're really talking about three different numbers: HDL, LDL, and triglycerides. They combine to give you a "lipid profile" score, but the three individual scores are most important.

Here are the numbers to strive for:

  • Total cholesterol of 200 mg/dL or lower.
  • HDL ("good" cholesterol) of 50 mg/dL or higher, if you're a woman, or 40 mg/dL or higher, if you're a man.
  • Optimal LDL is 100 or lower, says Mosca. If you have other major risk factors, like pre-existing cardiovascular disease or diabetes, your doctor may want your LDL closer to 70.
  • Triglycerides of less than 150 mg/dL.

LDL is the number most doctors and heart health programs focus on in particular, says Mosca. "Every single point of LDL decrease makes a difference," she says. "If your LDL is at 140 and you get it down to 130, that's great, even if you haven't reached optimum levels yet."

Adults 20 and older should get a lipid profile every five years.

3. Waist Size: The Connection to Heart Disease

If you can only remember one number, your waist size is the one to know. Why? Because better than your weight or your BMI, your waist size predicts your heart disease risk, says Mosca. If your waist size is equal to or more than 35 inches in women and equal to or more than 40 inches in men, it increases your risk of cardiovascular disease, diabetes, metabolic problems, high blood pressure and abnormal cholesterol.

It's easy to measure yourself. Just get a non-elastic tape and measure around your belly button.

"If patients lose even 1 inch off their waist, we see improvements in all the other heart health numbers," Mosca says. "Conversely, if they gain even 1 inch, we see worsening in those numbers. It's a much better indicator than weight, because you can be gaining weight and still losing waist size if you're working out and gaining lean muscle mass."

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Special Numbers for People With Type 2 Diabetes

If you have type 2 diabetes, there are two other numbers you need to watch: your blood sugar and your hemoglobin A1c levels.

  • A normal fasting blood sugar is less than 100 mg/dL.
  • Prediabetes is a fasting blood sugar of 100 to 125 mg/dL or an A1c of 5.7%-6.4%
  • You may have diabetes if your fasting blood sugar is 126 mg/dL or greater or your A1c level is 6.5% or higher – and you've gotten these results two or more times

But because spot glucose checks can vary dramatically, HbA1c levels are a better measure of whether your diabetes is under control. Here, there has been some controversy.

"Doctors like to see a HbA1c level of less than 7," says Mosca. "But recent research has shown that when we're more aggressive with diabetics and get the number below 6, they actually have more problems. We're still learning -- for example, aggressive management in a frail elderly person with a lot of medical problems may not be the best idea, while in an otherwise healthy young person, it might be. It's important to talk to your doctor as to what's best for you."

No matter what your numbers, the most important thing to know is that they can all be helped by healthy lifestyle choices. "Even small changes in your physical activity, your nutrition, and your smoking habits can have a major impact on your heart health," Mosca says.

WebMD Feature Reviewed by Brunilda Nazario, MD on March 22, 2010

Sources

SOURCES:

Lori Mosca, MD, director, Columbia Center for Heart Disease Prevention, New York City.

American Heart Association: "High Blood Pressure Statistics" and "What Your Cholesterol Levels Mean."

National Heart, Lung and Blood Institute: "What Is High Blood Pressure?"

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