Know Your Numbers
As part of the Heart health program Program, we perform several blood tests, beginning with a baseline test, to look at your cholesterol levels and several other risk factors that can be measured in your blood. Here’s what the tests measure and the most important target numbers to keep in mind.
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Total Cholesterol
Total cholesterol numbers can be misleading. You can have a total cholesterol level of below 200 – considered average in the US – but if your levels of bad cholesterol (LDL) are high and levels of good cholesterol (HDL) are low, you are still at risk for heart attack. On the other hand, if your HDL levels are very high and your LDL levels relatively low, your total cholesterol can be high – but you are at lower risk of heart attack. So, in general, we pay little attention to this number. However, studies do show that the lower your total cholesterol, the lower your heart attack risk.
LDL Cholesterol
This is a very important number.
Your Goal: LDL Cholesterol under 100 mg/dl, preferably 70-80 mg/dl.
The harmful plaque that can plaster and eventually block your arteries is made up partly of LDL cholesterol, which accelerates the plaque-forming process by burrowing into and scarring the smooth inner lining of your arteries.
HDL Cholesterol
Your Goal: HDL Cholesterol over 40 mg/dl, the higher the better
Even if your LDL cholesterol is somewhat high, having high levels of this good cholesterol can decrease your risk of heart disease. HDL works like a cleaning crew in your arteries, removing LDL before it has the chance to stick to and damage your arteries.
Triglycerides
Your goal: Triglycerides should be under 150 mg/dl
This is the blood fat your body uses for energy. Triglycerides represent the amount of fat that is directly related to the carbohydrates your body is processing. High triglycerides can be a separate risk factor for heart attack, especially if combined with low HDL.
C-Reactive Protein
Your Goal: CRP numbers vary with each lab. The test is only especially useful if the value is under 4; very high levels may suggest that a non-cardiac source of inflammation may be playing a role.
High levels of this protein in the blood signals inflammation. The CRP test is used to diagnose arthritis; the special cardiac CRP is a far more sensitive test and while it doesn’t indicate location of inflammation, high levels are associated with increased risk of heart attack.
Blood Pressure
Your goal: Systolic pressure less than 140 and diastolic pressure less than 85.
High blood pressure, or hypertension, is the most common cardiac disease, affecting about one in every four Americans.
High blood pressure can damage blood vessels in your heart, brain, eyes and kidneys. If you have high blood pressure you are at far greater risk for heart attack, stroke and congestive heart failure than people with normal blood pressure. It can also accelerate the advance of atherosclerosis – hardening of the arteries — as you age.
Blood Sugar
Your Goal: A fasting blood glucose level of under 100 mg/dL. A fasting blood sugar between 100-124 mg/dL can suggest pre-diabetes, metabolic syndrome or insulin resistance. Another test, called Hemaglobin A1C, can measure the effects of blood sugar over a period of months, and is often useful to help detect the presence of diabetes.
When it is high, your blood sugar – also called glucose – is a symptom of diabetes, a serious risk factor for heart disease. There are two types of diabetes:
Type I, which often occurs in young people, is caused when the pancreas produces little or no insulin, the hormone your body needs to direct glucose into your cells for use as energy
Type II, once called “adult-onset diabetes,” is caused when your body both produces less insulin and is unable to respond to the insulin you have. Type II, the most common, is considered a lifestyle disease, triggered by obesity, a high-fat diet and lack of exercise. Family history also boosts your risk. If you have diabetes, you’re at increased risk for both vascular and coronary artery disease.
Weight
Your Goal: A BMI of less than 25.
Your weight can be measured in many different ways. The scale tells you how much weight you’re carrying in pounds. But two other gauges — the Body Mass Index (BMI) and waist-to-hip circumference – may be better at helping determine your health risks.
Body Mass Index (BMI)
The BMI is a mathematical formula that will give you the relationship or ratio of your weight to your height. The BMI is more strongly correlated to the amount of body fat you have than any other measure of height and weight. Adults who have a BMI of 25 or higher are at risk for dying prematurely and being disabled.
Waist-to-Hip Ratio
Men who are at risk have a waist measurement greater than 40 inches. Women who are at risk have a waist measurement greater than 35 inches.
Your Goal: For men, a ratio of .90 or less is considered optimal; for women a ratio of .80 or less is considered optimal.
What makes this measurement so important is that it assesses belly fat, which is an independent risk factor for heart disease, stroke and other illnesses associated with obesity. Carrying excess weight around your middle, the classic “apple” shape, is more dangerous than being overweight in hips and thighs; the classic “pear” shape (although being obese overall is still more risky than carrying weight around your waist.)
Dangerous waist sizes vary for men and women:
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