It’s a part of your body that never rests, except between heartbeats! Over a lifetime, it will pump about one million gallons of blood throughout your body. You might take your beating heart for granted, but if you ignore it, it can fail you. In fact, cardiovascular disease and heart failure are still common causes of death in Western countries and they’re related to lifestyle. Even if you have a strong family history of cardiovascular disease, research shows that heart-healthy lifestyle habits can lower your risk. Habits that lower the risk include regular physical activity, a Mediterranean-style diet, not smoking, not drinking too much alcohol, getting enough quality sleep, and managing stress.
Beyond heart-healthy lifestyle habits, there are certain numbers you should follow to keep your heart healthy. Let’s look at the five numbers you should know for cardiovascular health.
Physicians monitor body mass index, or BMI, a measure of weight relative to height as a marker for cardiovascular risk. However, BMI is misleading for athletes who weigh more because they have more muscle mass and the elderly who aren’t overweight but often have a loss of muscle tissue. More relevant in terms of cardiovascular risk is waist size or waist-to-hip ratio.
According to research published by the Journal of the American Heart Association, the waist-to-hip ratio is a better predictor of a future heart attack than BMI. It makes sense because a large waist is a marker for greater visceral fat, inflammatory belly fat stored deep in the pelvic cavity. Based on the findings, we link a waist size of more than 35 inches in women and 40 inches in men with a greater risk of cardiovascular disease and type 2 diabetes. So, monitor your waist size as closely as you follow your body weight and BMI. It’s as simple as investing in a tape measure.
A lipid panel measures LDL-cholesterol, the “bad” form linked with cardiovascular disease, and the “good” form called HDL-cholesterol, the type associated with a lower cardiovascular risk. LDL and HDL refer to the protein carriers that carry cholesterol through the bloodstream. Research shows all LDL-cholesterol particles aren’t the same. Some are large and fluffy, which is a healthier form to have, and others are small and dense, making it easier for them to damage arteries. Advanced lipid testing can tell you which type you have more of. What also matters in terms of cardiovascular risk is the ratio of total cholesterol divided by HDL-cholesterol. A ratio of around 4.4 is consistent with an average risk of cardiovascular disease and 3.3 about half the risk of the average population. A ratio of 7.0 is linked with double the risk of the average population.
Another number you should know and follow from your lipid profile is your triglyceride level, the amount of fat circulating in your blood. A normal triglyceride level is less than 150 mg/dl. Although studies link a high triglyceride level to a greater risk cardiovascular disease, it’s not clear whether it’s because of the elevation in triglycerides or whether such an elevation is a marker of other metabolic factors associated with heart disease. For example, people with type 2 diabetes and metabolic syndrome often have high triglycerides. If your triglycerides are elevated, eliminating sugar, refined carbs, and avoiding trans-fat may lower your level. Regular exercise and consuming omega-3-rich fish may help too.
One measure of blood sugar control is called hemoglobin A1C (HbA1c), a blood test available at most doctor’s offices. It’s an average measure of your fasting blood sugar readings over the past three months and provides more information than an isolated fasting blood sugar level. A high hemoglobin A1C level above 7% is linked with a higher risk of cardiovascular disease, but lower values, between 5% and 6%, may also increase the risk even after accounting for other factors like lipid levels and waist size, and blood pressure. Ideally, you’d like your HGB A1C to be 4.6% or below. If you haven’t had one before, ask your physician to check one and see where you stand.
Waist size is important for cardiovascular risk, but we can’t ignore BMI either. BMI isn’t very reliable for athletic young people or the elderly, but it gives you an idea of cardiovascular risk if you aren’t in these categories. A study published in JAMA Cardiology found that BMI is significantly associated with the risk of cardiovascular disease after looking at 190,672 men and women. People who are overweight or obese are at higher risk of heart disease.
Uncontrolled high blood pressure silently damages the inner walls of arteries, the blood vessels that carry blood and oxygen to tissues. How could it not? When the pressure on the walls of your arteries is high, it places excess stress on them. Plus, when arteries are too tight, the heart must work harder to pump blood to the tissues that need it. Over time, this can weaken the heart and increase the risk of developing heart failure. Uncontrolled high blood pressure can lead to heart attacks, strokes, and damage to organs in the body such as the kidneys and eyes.
What should your blood pressure be? After a recent study showed even tighter blood pressure control reduces death rates, blood pressure recommendations are stricter. If your blood pressure is above 120/80, you are pre-hypertensive and once it rises to 130/90, doctors now call it early stage hypertension. High blood pressure is one of the leading risk factors for cardiovascular disease and stroke. That’s why monitoring is important! It’s best to check it at home at various times of the day. A yearly reading at your doctor’s office isn’t enough. So, do yourself a favor and monitor your own blood pressure at home and show them to your heat care provider. It’s that important!
The Bottom Line
Know your numbers and follow them, as they will change over time as you age. Make sure you’re living a heart-healthy lifestyle too. The health of your heart is tied to how you eat, how much you move, and how you live. So, take advantage of what you can control.
· HeartInsight.com. “Waist size predicts heart attacks better than BMI, especially in women”
· Heart.org. “New guidelines: Cholesterol should be on everyone’s radar, beginning early in life”
· JAMA Cardiol. 2018 Apr 1;3(4):280-287. doi: 10.1001/jamacardio.2018.0022.
· Johns Hopkins Bloomberg School of Public Health. “High Blood Sugar Levels a Risk Factor for Heart Disease”
· Indian J Endocrinol Metab. 2016 Jul-Aug; 20(4): 418–428.
· JAMA. 2019;321(4):347-349. doi:10.1001/jama.2018.20044.
· Heart and Vascular Institute. “Heart Facts”
· Medical News Today. “What is cholesterol ratio and why is it important?”