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Do You Know Your Numbers?
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By Christine Haran

Cholesterol, blood sugar, body mass index, blood pressure—there are a lot of risk factors to keep track of if you want to avoid many of the diseases associated with aging, such as heart disease, stroke and diabetes. And if it seems like the cut-off for what cholesterol or blood sugar or blood pressure level is considered healthy keeps dropping, that's because guidelines for managing many of these risk factors have been revised.

Most recently, the National Cholesterol Education Program (NCEP) guidelines on cholesterol management were changed. The update, published in the July 13 issue of Circulation recommended that people at very high risk of cardiovascular disease lower their level of LDL, the "bad" cholesterol, to less than 70 mg/dL, down 30 points from the prior guidelines' suggested goal of less than 100 mg/dL. The NCEP defines very high-risk patients as those who have had coronary heart disease and have multiple or poorly controlled risk factors.

For high-risk patients, including those with coronary heart disease, disease of the blood vessels to the brain or extremities, or diabetes, or multiple risk factors such as smoking and hypertension, the goal is still an LDL level of less than 100 mg/dL. If your LDL level is between 100 and 129 mg/dL, the guidelines advise you and your doctor to consider adding a cholesterol-lowering drug, or increasing the dose you are currently taking. People at moderately high risk may now opt for a lower LDL goal as well: They can aim for under 100 mg/dL, rather than 130 mg/dL.

"The studies demanded this change in the guidelines," says Adolph M. Hutter, Jr., MD, a cardiologist at Massachusetts General Hospital in Boston. "There's probably no LDL level that's too low for people with coronary heart disease." Dr. Hutter said that reaching the new LDL goals would require the use of cholesterol-lowering statin drugs in many cases. The NCEP report also stressed the importance of a healthy lifestyle that includes a nutritious diet and exercise, and maintaining a healthy weight.

Below is a compilation of some of measurements important to your health that you and your physician should track. These numbers are estimates: Keep in mind that you and your physician should set your own personal targets based on your individual needs.

Cholesterol Levels for People with Low to Moderate Risk of Heart Disease:
Having a lot of cholesterol in the blood leads to build-up in the walls of the arteries and can cause arteries to narrow and harden, blocking blood flow to the heart. While LDL cholesterol is the primary source of cholesterol build-up, HDL cholesterol, or the "good" cholesterol, helps to prevent LDL build-up.

LDL Cholesterol in mg/dL:
Less than 100Optimal
100–129Near optimal
130–159 Borderline high
160–189 High
Greater than or equal to 190 Very high

Total Blood Cholesterol in mg/dL:
Less than 200 Desirable
200–239 Borderline high
Greater than or equal to 240 High

HDL Cholesterol in mg/dL:
Less than 40Low (undesirable)
Greater than or equal to 60High (desirable)

Body Mass Index (BMI):
The BMI is a measure of body fat based on height and weight that applies to adult men and women. To calculate your BMI use the formula below or use the BMI calculator on the Web site of the National Heart, Lung, and Blood Institute. It is a more reliable indicator of a person's body fat than their weight alone.

Weight in Pounds
BMI =   
  x 703
(Height in inches) x (Height in inches)

Underweight Less than 18.5
Normal weight18.5–24.9
Overweight 25–29.9
Obese 30 or greater

Blood Sugar:
In diabetes, blood sugar, or glucose, levels are above normal. There are a number of tests used to measure blood sugar levels, though the fasting plasma glucose (FPG) test is generally considered the most reliable.

Plasma Glucose in mg/dL
99 and below Normal
100 to 125 Prediabetes
126 and above Diabetes

Blood Pressure:
Blood pressure is defined as the pressure exerted by blood on the walls of blood vessels. When blood pressure is taken, the top number (systolic pressure) is the pressure when the heart beats and the lower number (diastolic pressure) refers to the pressure when the heart is at rest. High blood pressure increases risk for heart disease and stroke.

BP in mm/Hg
Less than 120/80 Normal
120–139/80–89 Pre-hypertension
140–159/90–99 Stage 1 high blood pressure
160 or higher/100 or higher Stage 2 high blood pressure

Published on: July 22, 2004
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