Know Your Numbers

Authors: Alan Gatz, MD and Kendria Holt-Rogers, MD, University Medical Center Primary Care Physicians

Today, many people are aware of the need to focus on the effect of risk factors and life choices on overall health and wellness. Health professionals speak to patients about cholesterol, blood sugar, blood pressure, BMI (body-mass index), and hemoglobin A1c, but many individuals become overwhelmed and do not totally understand all of the information as presented.

Here’s a condensed and simplified description of the above-mentioned health determinants.

Cholesterol

This term actually should be changed to lipids, which includes the entire family of proteins sub-divided into three major subcategories:

1. LDL (low-density lipoprotein) cholesterol
2. HDL (high-density lipoprotein) cholesterol, and
3. Triglycerides (TG).

The two numbers the majority of people need to remember are their LDL and HDL levels.

A simple way to understand the concept of reducing heart and vascular disease is to keep the low and high. LDL level above 150 mg% increases the risk of developing blood vessel blockage while HDL above 50 mg% helps protect against the development of this problem.

High triglycerides also can affect a person’s health including the development of pancreatic disease. Any intervention – including lifestyle changes and medications – that will improve the overall cholesterol readings will also improve the total TG.

Interventions to improve the cholesterol numbers and reduce risk of cardiac disease:

• Exercise – 30-45 minutes 3 times per week
• Diet – increase fiber, reduce fat and sugar
• Weight loss – even 5 pounds will affect the level
• Medication – effective but comes with the risk of side effects

Blood sugar (Glucose)

Important in the proper functioning of almost all body systems, if the blood level is too high, many of the major organs can be damaged irrevocably, most notably the heart, kidneys, circulatory system, and eyes. Normally, people think of getting a blood sugar reading by having their finger lanced to obtain a drop of blood. This “spot” reading will give an idea of the current glucose level but the Hemoglobin A1c (Hgb A1c) is much better at allowing us to determine the average blood sugar level over several weeks.

Without getting too scientific, the higher the average blood sugar, the higher the level of Hgb A1c. In general we strive to get the level below 7%.

Ways to improve Hgb A1c :

• Take your medications as prescribed
• Prescribed exercise program
• Improve diet and control your weight

Body Mass Index

This number is determined by a patient’s height and weight.

The ideal BMI is between 18.5 and 25. Below 18.5 is considered underweight with 25-30 being overweight.

Those individuals above 30 are classified obese. The importance of BMI lies with the effects of stress on the heart, circulatory system, joints, muscles, and metabolism. Severe obesity with BMI greater than 36 increases the individual’s risk for hypertension, myocardial infarction (heart attack), stroke, diabetes, degenerative arthritis, decreased independence. Obviously, we cannot affect the BMI by growing taller but anything we can do to reduce weight will improve the BMI.

Blood Pressure

The measurement of blood pressure is important in determining the stress the heart experiences pumping the blood through the thousands (approximately 60K) of miles of blood vessels in the body. Like a bodybuilder the heart, if faced with greater weight (pressure), will grow to meet the challenge. But, also like the bodybuilder, there can be too much growth (the heart becomes muscle bound) which results in the heart failing to “lift the weight”. The result is heart failure which many times causes permanent disability and death.

We don’t have the time or space to discuss the effects of blood pressure on the kidneys but suffice it to say untreated blood pressure is a leading cause of kidney failure and the need for dialysis.

Remember these numbers – Systolic 135, Diastolic 80.

If your readings fall above these numbers you should seriously consider speaking with your health care provider about intervention.

Interventions to improve blood pressure:

• Reduce weight
• Reduce alcohol intake
• Reduce salt in the diet
• Exercise with emphasis on aerobic activity
• Adequate rest – sleep 6-8 hours/night
• Stress reduction – yoga, meditation, therapeutic massage

Hopefully, this primer will help you manage your health with greater confidence and purpose.

Dr. Gatz and Dr. Rogers look forward to being your partner in wellness. To schedule an appointment, call the clinic at 504-332-8184. Visit www.umcno.org/primary-care to learn more about University Medical Center’s Primary Care Center and its services.