Written by: Cameron Rosario
Medically reviewed by: Rob Philibert MD PhD
Coronary heart disease (CHD) is common and most of us are vulnerable to it. Therefore, being committed to regular exercises and proper nutrition is important to almost everyone for lowering your risk for CHD. Many accomplish this goal by carefully tracking the heart healthy numbers that indicate their state of health. By doing this under-appreciated yet powerful step, the next time you visit your local doctor’s office, you may be better able to communicate your progress towards a “healthier you” to your healthcare provider!
1. Blood Pressure
Blood pressure is the force of your blood against the walls of your arteries. Healthcare providers assess this pressure via several key numbers. The first number is the systolic blood pressure (SBP) which is the peak pressure produced by the contraction of the heart. The second key number is the diastolic (DBP) blood pressure which is the pressure during the rest phase of the heart. Finally, pulse pressure (PP) is the difference between the systolic and diastolic pressures and represents the contractile force rendered by the heart muscle.
Normally, SBP is calculated over DBP and can be seen in a ratio format (i.e. SBP/DBP). The key values to remember are:
- ~120/80 for a normal blood pressure
- ~120/80 for pre-hypertension
- Above 140/90 for hypertension
Despite a larger emphasis being placed on calculating your SBP and DBP, some recent studies have investigated the relevancy of SBP, DBP, and PP in estimating cardiovascular risk. Specifically, a study published in 2018 found that ambulatory PP was higher in diabetic and athersclerotic patients as compared to non-diabetic and non-atherosclerotic patients, despite mean SBP and DBP variability being similar. Due to the difference, the study concluded that PP may potentially be more relevant in patients with type 2 diabetes and atherosclerotic cardiovascular disease.
Another value that needs to be considered is the effect of diurnal variation or time of day on blood pressure. Typically, you can expect your blood pressure to rise before you wake up and lower as the evening/night time hits. Your heart’s daily pattern can be disrupted by numerous lifestyle factors including, but not limited to, smoking, obesity, stress/anxiety and deprivation of blood pressure medication.
High blood pressure is a major risk factor for cardiovascular disease because it puts a strain on your heart and arteries. Over time, this strain can cause your heart to become weak and arteries to become stiff and less able to move blood throughout the body. Over time, this can lead to heart attacks, heart failure, and stroke.
2. Resting Pulse
Resting pulse rate is the frequency in which your heart beats while one is sitting still during a one-minute timeframe. Ideally, one should be seated for at least five minutes before attempting to measure the resting pulse rate.
A resting pulse for the average person ranges from 60 to 100 beats per minute. However, it may be a little bit lower than 60 if you are physically active and have good “cardiac tone.” Additionally, medications like beta blockers can slow down heart rate by inhibiting the release of the stress hormones – adrenaline and noradrenaline – which normally increase heart rate. If your resting pulse is under 40 (abnormally low) or you have frequent sudden increased heart rate, it would be best to consult your doctor to check for bradycardia or tachycardia, respectively.
Resting pulse can be easily obtained without taking a trip to your local doctor’s office. Some of the easiest ways to find your pulse are to either press two fingers against the side of your neck, inside of your wrist/elbow, or on top of your foot. Then set a timer for 60 seconds and start counting the number of times you feel your heartbeat.
3. Body Mass Index
Body Mass Index (BMI) is a unit of measurement that represents the amount of body fat a person has in relation to their height (m) and weight (kg). The formula used to calculate BMI is weight (kg) / [height (m)]2.
The key weight categories identified when screening are:
- Less than 18.5 = underweight
- 18.5 to 24.9 = normal weight
- 25 to 29.9 = overweight
- 30 or greater = obese
Since BMI is correlated with a range of metabolic and disease outcomes, it is commonly used to screen for weight categories that are associated with health issues, including cardiovascular disease. In the United States, around 40% of the population has been found to have a BMI value of 30 or greater, therefore, categorizing a majority of the population as obese. Particularly, abdominal obesity caused by the central disposition of adipose tissue is a risk factor for cardiovascular disease worldwide as it is linked to hypertension, dyslipidemia, diabetes and insulin resistance. It can also increase the risk beyond common coexisting risk factors such as family history and smoking.
Nevertheless, BMI is merely a tool for screening and does not fully represent the overall health of an individual. Further assessments made by your primary care physician must also be made to obtain the optimal understanding.
4. Blood Sugar Level
Blood Sugar Level, also known as your blood glucose level, is displayed in units of mg/dL or mmol/L and represents the amount of sugar present in your bloodstream. Like blood pressure, your blood sugar levels fluctuate depending on external factors such as diet. This is why you are asked to fast for 8-12 hours before a blood test to ensure the test obtains a value closest to your natural blood sugar level. These blood tests are used to assess serious diseases, most notably diabetes.
The key blood sugar level ranges you should know are:
- Less than 100 mg/dl = normal
- 100 to 125 mg/dl = prediabetes
- 126 mg/dl or higher = diabetes
When an individual is diagnosed with diabetes they must pay attention to their blood sugar level since poor control of blood sugar can make them more susceptible to cardiovascular disease. Excess levels of blood sugar can cause reduced elasticity and narrow arteries, which hinder the blood flow throughout the body. This process is associated with the development of other conditions such as high blood pressure and high triglycerides that increase one’s risk for cardiovascular disease.
Even if you are not diagnosed with diabetes, maintaining a normal blood sugar level is still crucial in maintaining proper heart health. In a study that analyzed the relationship between admission blood glucose levels in nondiabetic patients with heart failure, it was shown that better glucose control could improve a hyperglycemic (participants with a high admission blood glucose levels) patient’s prognosis. The authors speculated that this was because hyperglycemia can exacerbate heart failure through independent mechanisms including the impairment of endothelial function, altered expression/function of sarco endoplasmic reticulum calcium–adenosine triphosphatase (SERCA) and cardiac structure.
5. Total Cholesterol Level
A total cholesterol level is a measurement that takes into consideration an individual’s high density lipoproteins (HDL), low density lipoproteins (LDL), and triglyceride levels. Cholesterol is known to be a soft waxy substance that is essential in digestion and hormone production. Knowing the functions of the types of cholesterol and triglycerides within the bloodstream can help you prevent plaque buildup in arteries.
Your total cholesterol, measured in mg/dL, includes:
- High Density Lipoproteins (HDL): known as “good” cholesterol as it reduces the levels of “bad” cholesterol (LDL) in your body that causes plaque buildup.
- Low Density Lipoproteins (LDL): known as “bad” cholesterol as it encourages plaque buildup in arteries.
- Triglycerides: a type of fat that is linked to plaque buildup.
To determine your total cholesterol levels, a blood test can be taken to retrieve these key results:
- 200 mg/dL or lower = normal
- 200 – 239 mg/dL = borderline high
- 240 mg/dL or higher = high
If an individual has a high total cholesterol level, it means that their “bad” cholesterol and fat has attached itself onto the inner lining of an artery along with other cellular waste products, calcium and fibrin. Ultimately, this leads to the hardening and thickening (due to inflammation) of arteries that we understand as being key parts of atherosclerosis. Over time, this buildup and narrowing of arteries can accumulate to cause a blockage that reduces blood flow and oxygen supply leading to a heart attack or stroke.
To start tracking each of these key numbers, start by visiting your local doctor’s office or attending a community heart screening event. By monitoring these heart healthy numbers, you can help ensure that you are engaging in meaningful conversation with your doctor while informing yourself on the necessary steps you can take to work towards the healthiest you.
References:
- Barsheshet, A., Garty, M., & Grossman, E. (2006). Admission Blood Glucose Level and Mortality Among Hospitalized Nondiabetic Patients With Heart Failure. Arch Internal Med., 166(15), 1613-1619. https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/410791
- Buda, V., Ciobanu, D., & Roman, G. (2018). Pulse pressure is more relevant than systolic and diastolic blood pressure in patients with type 2 diabetes and cardiovascular disease. Clujul Med., 91(4), 408-413. https://medpharmareports.com/index.php/mpr/article/view/972
- Franklin, S., Larson, M., Khan, S., Wong, N., Lelp, E., Kannel, W., & Levy, D. (2001). Does the Relation of Blood Pressure to Coronary Heart Disease Risk Change With Aging? Circulation, 103, 1245-1249. https://www.ahajournals.org/doi/full/10.1161/01.CIR.103.9.1245
- Heart and Vascular Institute. (2017). You Need to Know These 5 Heart Health Numbers. UPMC. https://share.upmc.com/2017/05/5-heart-health-numbers/
- Lopez-Jimenez., F. (2021). Blood Pressure: Does it have a daily pattern? Mayo Clinic https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/expert-answers/blood-pressure/faq-20058115
- National Institute of Diabetes and Digestive and Kidney Diseases. (2017). Diabetes, Heart Disease, and Stroke. NIDDK. https://www.niddk.nih.gov/health-information/diabetes/overview/preventing-problems/heart-disease-stroke
- Penn Medicine. (2019). Three Ways Obesity Contributes to Heart Disease. Penn Medicine. https://www.pennmedicine.org/updates/blogs/metabolic-and-bariatric-surgery-blog/2019/march/obesity-and-heart-disease
- Premier Health. (2017). 5 Numbers to Know for a Healthy Heart. Premier Health. https://www.premierhealth.com/your-health/articles/women-wisdom-wellness-/5-numbers-to-know-for-a-healthy-heart