En español | Debby Schrecengast knows she should have seen the warning signs. When she looks back at 2014, the year she suffered a stroke, Schrecengast, 56, sees a “stubborn old donkey” in denial about her health. “I had let my blood pressure go uncontrolled, and I remained overweight for so long,” she says.
Schrecengast, who lives in LaFargeville, N.Y., joined an American Heart Association program, sponsored by her hospital, that eased her into an exercise routine. She took nutrition classes, dropped 30 pounds and no longer needs blood pressure medication.
Of course, it’s easy to measure how much weight you’ve lost or how much faster you can jog a mile. It’s harder to calculate whether your heart is getting healthier. But if you know what markers to keep an eye on with your doctor, you can tell whether your ticker is getting stronger or weaker as time goes by. Here are the numbers you need to know.
The body produces two main types of cholesterol: LDL, the “bad” cholesterol, and HDL, the “good” type. Measured together, along with 20 percent of your triglyceride score, they add up to your total cholesterol level. An ideal cholesterol score is 200 or less; between 200 and 239 is borderline high. Go over 240, however, and you have high cholesterol.
In most cases your physician will be focused on tamping down your LDL, which can clog up arteries — including those that feed your heart and brain. The good cholesterol can help eliminate the bad, but only to a degree.
You know the diet drill: Limit red meat and full-fat dairy foods, and eat more whole grains and produce. To make it easier, try celebrating Meatless Monday. Originally conceived to aid the war effort in World War I, it was revived by health advocates in 2003 to fight a different enemy. Just one meatless day a week will help; next week, see if you can make it two. And get more exercise. Exercise appears to enhance your muscles’ ability to use blood lipids for energy. Studies suggest that the ideal workout plan consists of 30 minutes of exercise five days a week, combining moderate aerobic activity and moderate- to high-intensity resistance training.
Blood pressure is the force of blood pushing against the walls of your blood vessels. When it runs consistently high, it strains the heart and arteries. High blood pressure, or hypertension, is often called the silent killer because it usually lacks obvious symptoms. Yet nearly half of all U.S. adults have high blood pressure; when left uncontrolled, it is a major risk factor for heart attack, stroke, heart failure and kidney disease. Blood pressure is defined as high if the top number is 130 or above, or the bottom number is 80 or higher.
You’re familiar with the link between sodium and blood pressure, and why it’s important to cut down on salt. What you might not know is that more than 70 percent of your sodium intake comes from food prepared outside the home—ordered in a restaurant or bought in a package. Cooking with simple, healthy ingredients is the biggest dietary step you can take toward lowering your blood pressure and improving your heart health. While you’re at it, look for sources of potassium, a mineral found in many fruits and vegetables, especially sweet potatoes, bananas, spinach and avocados. Increasing your potassium can help to lower your sodium level.
Resting heart rate
Your resting heart rate is simply how many times your heart beats per minute while you’re at rest. A lower resting heart rate is associated with a lower risk of death. That’s because a lower rate is usually a sign of greater cardiovascular fitness. Athletes, for example, are more likely to have a low resting heart rate because they’re in better physical shape. (Certain medications, including beta-blockers used to control blood pressure, can also lower heart rate.) A condition known as bradycardia, in which the heart rate is too slow, occurs most often in older people.
A good time to check your resting heart rate is first thing in the morning, before getting out of bed. Check it regularly; an exercise monitor can help, but you can do it easily without one. Just take your pulse for 15 seconds and multiply by 4. If you notice that the rate is beginning to trend upward, you may need to boost how much you’re exercising. A rise in resting heart rate over a 10-year period was associated with an increased risk of death, according to a study of more than 29,000 participants that was published in the medical journal JAMA.
For most people, a resting heart rate between 60 and 100 beats per minute is considered normal, but stress, hormones and medication can affect your rate. Although taking a brisk walk, swim or bike ride raises your heart rate temporarily, these activities make the heart more efficient over time. They may also help you lose weight, which can reduce your risk. If you are overweight or obese, your heart has to work to pump extra blood through your larger frame. Over time, an overworked heart muscle gets thicker, which can lead to heart failure.
Blood glucose level
Your blood sugar level can fluctuate depending on the time of day, what you eat and when you eat. That’s why a fasting blood glucose test is the most commonly used way to take a reading. You want to see a number less than 100. The body’s inability to regulate blood glucose is the primary component of diabetes. As the digestive system breaks down food into sugar, insulin — a hormone made by the pancreas — helps transport blood glucose into your cells. Diabetes develops when there is too much sugar in the blood because the body either fails to make enough insulin or because the body’s cells become resistant to it. Your doctor may also order an A1c blood test, which is the primary screening used in diagnosing and managing diabetes. The A1c test measures a person’s blood sugar levels over the previous three months, and a normal A1c reading is below 5.7 percent. A low-fat, low-sugar, high-protein diet with plenty of fruits, vegetables and whole grains is the best dietary prescription for keeping blood sugar in check. Ensuring you get enough vitamin D is also critical; in studies, those with the highest levels of vitamin D in their bodies had the lowest risk of developing diabetes. Consider taking a D supplement of between 800 and 2,000 IU per day, and focus on eating high-protein foods such as dairy products fortified with vitamin D.
Body mass index
Body mass index, or BMI, is a screening tool often used to determine body fat. It’s a ratio of weight to height that, when too high, can classify someone as overweight or obese. The higher the BMI, the greater the risk for heart disease, stroke, high blood pressure, certain cancers and other chronic illnesses. The National Heart, Lung, and Blood Institute offers an online calculator to estimate your BMI. Generally, a BMI score between 18.5 and 24.9 indicates normal weight. Someone with a BMI between 25 and 29.9 is considered overweight; a score of 30 or higher is considered obese, a major risk factor for heart disease.
But BMI doesn’t always accurately reflect a person’s body composition. Athletes and other people with very muscular builds may have a high BMI but little body fat. On the other end of the spectrum, BMI may underestimate body fat in older individuals who have lost a lot of muscle mass.
If your BMI is too high, set realistic short- and long-term goals for dropping the excess pounds through healthy eating and exercise. Shedding as little as 5 percent of your body weight can result in significant changes to your health.
Some experts consider waist circumference a better way to measure body fat than relying on BMI alone, and people who carry fat around their abdomen, instead of on the hips or elsewhere, are at greater risk for heart disease and type 2 diabetes. To measure your natural waist, grab an old- fashioned tape measure and stand without pushing out or sucking in your belly. Wrap the tape measure around your torso just above your hip bones. (If you lean to one side, a crease forms at the point of your natural waist.) Exhale, then measure. In general, men should aim for a waist circumference of less than 40 inches, while women should shoot for less than 35 inches.
Studies have found that mixing brief bouts of fast walking, running or biking with longer stretches of slower-paced exercise is more effective at burning abdominal fat than only steady-state exercise.
Unless you’re an athlete, you’ve probably never been tested for VO2 max. But this measurement can give you a unique perspective on your aerobic fitness. The higher the number, the healthier your overall cardiovascular system. (The numbers above represent the 50th percentile of fitness for 70-year-olds in the United States.)
VO2 max is typically measured by having the subject run on a treadmill to the point of exhaustion. But researchers have developed a calculator that allows you to plug in numbers such as your waist circumference and resting heart rate to determine your VO2 max at home. When the researchers tested their calculations against participants’ actual VO2 max tests, the results were remarkably accurate. The online calculator at worldfitnesslevel.org will tell you both your VO2 max score and your “fitness age,” giving you an idea of whether you’re as young as you feel.
Any kind of cardiovascular exercise — whether it’s running, biking, even weight training — done at a high enough intensity will help to improve your overall VO2 max score.
Hearty Head-Scratcher Quiz
Many foods that seem similar deliver different nutrients. Knowing that difference may help you improve your dietary health without much effort. Nutrition experts at the American Heart Association put together a quiz to help boost your nutrition IQ. Which is better for your heart?