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Getting a True Picture of Your Heart Health

There are lots of numbers out there; which are the most important?

What to Do About It?

C-reactive protein and other markers may reflect what’s going on with your cardiovascular system, says cardiologist Donald Belmont, M.D., but the things to focus on are the actual causes of heart disease—especially those you can control, like cholesterol, blood pressure, smoking and obesity.

“Heart attack or stroke is the cause of death for half of all Americans,” he says, “but that’s not true in the rest of the world, and it doesn’t have to be true here. Lifestyle makes the difference.” In other words, go ahead and get those useful tests—but there’s no substitute for healthy eating, regular exercise, quitting smoking and keeping your weight under control.

Can a simple cholesterol test give you an accurate picture of your cardiovascular health? Or do you need to know HDL, LDL, triglycerides, body-mass index—not to mention the latest thing, C-reactive protein?

Here are the answers, from Lehigh Valley Hospital and Health Network cardiologists Donald Belmont, M.D., and Robert Biggs, D.O.

Start with a blood pressure test. “High blood pressure, or hypertension, afflicts some 50 million Americans,” Biggs says, “and the majority
are not even aware they have it. Because there are no symptoms, it is extremely important to get a yearly blood pressure test, especially if you have other heart disease risk factors.”

Numbers to Aim For

Blood pressure Below 120/80
Total cholesterol Below 200
HDL (high-density lipoprotein) Above 40
LDL (low-density lipoprotein) Below 130

If you have heart disease Below 100

Triglycerides Below 150

Cholesterol is also very important, but the “total” may not be worth much. It doesn’t tell you the proportions of HDL (“good” cholesterol) and LDL (“bad” cholesterol)—and that makes all the difference, Belmont says. “Let’s say your total is above the recommended 200. It could be because you have high LDL and low HDL—a bad thing—or because you have low LDL and high HDL, which is a good thing.”

Make sure your cholesterol test gives an HDL/LDL breakdown. Get tested by age 30 (males) or 40 (females), earlier if there’s heart disease in your family. If you have risk factors, you need a cholesterol test yearly; if not, every five years or so.

Triglycerides are a useful measure. “The combination of high triglycerides and low HDL is especially dangerous for the development of coronary artery disease,” Biggs says.

Waist measurement may tell you as much as body-mass index, and it’s a lot simpler. That’s what the American Heart Association says in its latest guidelines for preventing heart attacks and strokes. Men should have a waistline of 40 inches or less, women, 35 inches or less. A large waistline puts you at higher risk for heart disease.

Homocysteine testing isn’t for everyone. Homocysteine is a byproduct formed when your body breaks down protein. High levels may be linked with heart disease. “If you had a heart attack at a young age with no identifiable risk factors, homocysteine levels should be checked,” Biggs says. “Ask your doctor.”

C-reactive protein (CRP) is an intriguing new way to look at heart health. “This protein circulates in the blood at times of inflammation, and researchers are exploring whether inflammation is the final trigger of heart attacks,” Belmont says. The American Heart Association and U.S. government just issued guidelines on CRP testing—but no one is recommending routine screenings yet. “There are indicators that CRP may be very important to know,” Biggs says. “CRP may be especially useful for patients with borderline LDL readings in deciding who to treat with drugs that affect inflammation and cholesterol.”

Heart Disease Risk Factors

Smoking, including secondhand smoke
Obesity
Diabetes
Family history of heart disease, especially in males under age 55 or females under age 65
High blood pressure
High cholesterol

Want to Know More about controlling your blood pressure? Call 610-402-CARE.

This page last updated 2/12/08 04:08 PM

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Lehigh Valley Hospital has campuses in Allentown and Bethlehem, Pa. and serves the Pennsylvania communities of Easton, Doylestown, Quakertown, Hazelton, Lehighton, Perkasie, Pottstown, Pottsville, Reading, Scranton, Wilkes Barre, Stroudsburg, and the Poconos and also Phillipsburg and Flemington, N.J., and western New Jersey. You don't have to travel to Philadelphia or New York for quality health care.