March 19, 2013

Know your numbers II

By  Mark M. Ryan

Don’t know what your blood pressure or LDL-cholesterol level is? Managing your health is very similar to managing a business – you cannot change and improve what you do not measure. You need to know your numbers.

www.markmryan.com

Patients often ask me, “Doc, how is my cholesterol?”  In my experience, what patients really want to know is “Doc, am I going to have a heart attack?”  Historically, physicians have been unable to consistently predict which of their patients would have a heart attack or stroke, but science has made tremendous advances in the past ten years.  We now know that certain attributes of a patient make them more or less likely to develop cardiovascular disease, i.e, suffer a heart attack or stroke.  By compiling patient specific risk factors – age, gender, cholesterol, blood pressure, and history of diabetes or smoking – I can calculate my patient’s risk of suffering a heart attack or stroke in the next 10 years and work with the patient to develop a treatment plan to lower their risk score.

Here is a link to an online version of the Framingham Cardiovascular Risk calculator, where you can calculate your own risk.  Before you start, you need to first know your numbers, or basic health indicators like age, blood pressure, and cholesterol.

Maybe it has been some time since your last physical, so let’s talk about some of these numbers:

Blood pressure –
◦ Normal value: 120/80
◦ How often should I measure?
▪ Every two years if your last blood pressure was <120/80
▪ Every year if either your last systolic pressure was 120-139 or diastolic was 80-89

Cholesterol –
◦ Normal value:
▪ HDL (“good” cholesterol) goal is > 40 mg/dL
▪ LDL (“bad” cholesterol) goal is < 100 mg/dL
◦ How often should I measure?
▪ Every five years
▪ Every year if you have a history of abnormal cholesterol levels, diabetes, high blood pressure, or heart disease

Diabetes –
◦ Normal value:
▪ Fasting blood glucose should be < 100 mg/dL
▪ Hemoglobin A1C should be < 5.7%
◦ How often should I measure?
▪ Start screening at age 45 and check every three years if your BMI is < 25 m/kg2 and you have no risk factors for diabetes
▪ Start screening annually at age 18 and repeat annually if your BMI is > or = 25 m/kg2 and you have one or more risk factors for diabetes

Why are these particular numbers important?  Because some risk factors can be changed or modified whereas others are beyond our control.  Your blood pressure, cholesterol, and diabetes numbers are all risk factors that you can control with a combination of diet, exercise, and medication.  People with a management background know that you cannot change do not measure.  It is the same principle here.  Knowing your numbers is the first step toward developing a plan to reduce your risk of heart attack or stroke.  So pick up the phone, make the appointment, and know your numbers!

If you are looking for more information, a reliable and unbiased reference site is MedlinePlus.gov

Filed under: Cardiovascular Disease

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