A numbers game

These three numbers are incredibly important for heart health. Do you know yours?

James Young could taste blood as he was shoveling snow in the winter of 2011. “It must be allergies,” he told himself.
By summer, Young was gaining weight daily and having trouble breathing. He was finally at the point where self-treating with online searches and over-the-counter medications just wasn’t cutting it.

He saw a doctor, who immediately ordered a series of tests. The results were sobering: His blood pressure and cholesterol numbers were through the roof. And his high blood sugar had manifested as full-scale diabetes.

Having one of these conditions is a serious red flag for your heart. Young had managed to collect them all.

His heart was functioning at only 30 percent.

A change of heart

“My cardiologist recommended surgery and a pacemaker,” says Young. “I said, ‘What’s option B?’” His doctor told him there was only one other option, something he rarely recommended to patients: Change your life.

“My doctor said people rarely adhere to change,” Young recalls. “He said, ‘I’ll give you two months, and if I don’t see improvements in your heart, we go back to option A.’”

Young set out to prove his doctor wrong.

“I quit drinking,” says Young. “It took me longer to kick the smoking, but I did. I cut the sugary drinks. I started exercising for the very first time. I shifted to more plant-based foods. When I went back to my doctor two months later, he literally couldn’t believe his eyes, or the numbers on the chart.”

Heart disease is the leading cause of death in America. Half of Americans have at least one of three key risk factors for heart disease. Thankfully, almost 80 percent of premature heart disease can be prevented through healthy habits. By simply being aware of what heart-health numbers to watch for, you can keep yourself and your heart happy and strong.

1. Cholesterol

Yasmine S. Ali, MD, a preventive cardiologist, recommends getting cholesterol checked once every five years. Some people may need it checked even more often—speak with your doctor about the right frequency for you.

Know your numbers

Your doctor will give you a personalized target depending on you, your lifestyle, and your medical history. However, in general, you want to hit the following targets, according to the National Lipid Association:

• • LDL (bad) cholesterol (mg/dL):
    <100: Desirable
    100–129: Above desirable
    130–159: Borderline high
    160–189: High
    ≥190: Very high
  • HDL (good) cholesterol (mg/dL):
    <40 (men): Low
    <50 (women): Low

Not all cholesterol is bad. “HDL cholesterol protects against cardiovascular disease,” says Ali. On the other hand, she says, “LDL cholesterol clogs the arteries and raises the risk for heart attack.” To get the full picture, get checked for LDL particle number, size, and density. A high number of small, dense LDL particles presents the highest risk for your heart.

Improve your numbers

One of the most important things you can do for healthier cholesterol numbers is change your diet. Michelle Routhenstein, RD, is a preventive cardiology dietitian. She says eating a more plant-based diet, just as Young did, is the top diet change to consider.

“Swap out red meat and consume more plant-based protein, such as lentils and kidney beans,” says Routhenstein. “Plant-based proteins are … higher in soluble fiber (which prevents plaque buildup) compared to meat. This switch, even once a week, decreases your chances of heart disease.”

2. Blood sugar

Type 2 diabetes is one of the major risk factors for heart disease. It also increases your risk of other heart-health red flags, such as high blood pressure.

But the dangers start long before you have full-blown diabetes. “Consistently high blood sugar levels damage arteries,” warns Ali.

Know your numbers

Americans 45 and older should get their blood sugar checked at least every three years (more often if you have a higher risk of diabetes). Your ideal targets:

• Fasting: less than 100 mg/dL
• Two hours after a meal: less than 140 mg/dL

Improve your numbers

“Once again, diet and exercise play the starring roles here,” says Ali. She recommends avoiding anything that’s refined (such as white bread) or made with added sugar.

Add healthy fats

Eat more healthy fats, such as monounsaturated fats, instead of saturated and trans fats. Monounsaturated fats, which you find in olive oil, avocados, and many nuts and seeds, have been linked to healthier blood sugar levels.

Enjoy more fiber-rich foods

Try whole grains, nuts, and beans. Aim for 30 to 50 g of fiber a day to improve your blood sugar. As an added bonus, high-fiber diets may also help manage blood pressure, control your weight, and lower your cholesterol.

“Oats, barley, flaxseed, and chia seeds contain a high percentage of soluble fiber,” says Routhenstein. “Soluble fiber binds to cholesterol and bile acids in the intestine and promotes their excretion, which helps to decrease the ‘junk’ that can build up in your arteries. Regularly consuming these foods along with a heart-healthy diet can help to prevent heart disease.”

Go for a walk

“In particular, working in a walk after meals has been shown to improve blood sugar levels,” says Ali. One study found that a 10-minute walk after each meal reduced blood sugar better than a single longer 30-minute walk taken at any other point during the day.

3. Blood pressure

When you have high blood pressure, your heart is under extra stress because it has to work harder to pump your blood through your blood vessels.

Get your blood pressure checked at least once a year (many pharmacies have free blood pressure monitors you can use). These machines will print out two numbers: your systolic and diastolic numbers.

Know your numbers

The upper number (systolic) measures the pressure in your arteries when your heart contracts. The bottom number (diastolic) measures the pressure in your arteries between heartbeats.

• Normal blood pressure: <120/<80 (systolic mmHg/diastolic mmHg)
• Elevated blood pressure: 120-129/<80 (systolic/ diastolic)
• High blood pressure (hypertension) stage 1: 130-139 (systolic) or 80-89 (diastolic)
• High blood pressure (hypertension) stage 2: ≥140 (systolic) or ≥90 (diastolic)
• Hypertensive crisis—contact your doctor immediately: >180 (systolic) and/or >120 (diastolic)

Improve your numbers

To take control of your blood pressure, consider the following.

Watch your weight

A weight gain of only 5 lbs has been shown to elevate blood pressure.

Soothe your stress

When you’re stressed, your blood vessels tighten and your heart beats faster, which drives up your blood pressure. From long baths and nature walks to meditation and yoga, experiment with natural, holistic ways to ease your stress.

Get enough sleep (but not too much!)

A 2015 meta-analysis found that getting too little or too much sleep may both be risk factors for high blood pressure. Seven hours of sleep a night was associated with the lowest risk.

It’s your turn

If you, like Young, have one or more risk factors for heart disease, pick one small, easy change and get started today.
“Don’t feel overwhelmed,” says Young. He thinks one reason so many people fail at heart-friendly lifestyle changes is because making all those shifts can be daunting. Remember, you don’t have to do it all at once! “I told myself, ‘You didn’t get here overnight. You’re not getting out of this overnight,’” says Young with a laugh.

“When I wanted to eat healthier, I focused just on breakfasts,” he says. “Instead of bacon and eggs, I would do egg whites with spinach. Once I got comfortable with breakfast, I tackled lunch. And then dinner. And so on.”

Create simple goals that you can hit quickly, whether it’s exercise—maybe start with after-dinner evening strolls instead of signing up for a marathon—or eating plant based just one day a week.

The end results will be worth it. “I lost my dad four years ago to congestive heart failure,” says Young. That was almost his own fate too until he decided to walk a new path and ensure his days were no longer numbered.