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 100 |
Optimal |
| 100–129 |
Near 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 40 |
Low (undesirable) |
| Greater than or equal to 60 |
High (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.
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.
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.
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