A Numbers Game Worth Playing

content provided by the Faculty of the Harvard Medical School

A numbers game worth playing

Knowing the numbers for a few key risk factors is good for your heart and overall health.

Between PINs for automated teller machines, Web site passwords, and programmable car locks, you probably don't need any more numbers to remember. Every so often, though, it makes sense to tally up a few that can help you track, and even improve, your health.

Articles about heart health often talk about these key numbers, but usually not all at the same time. So we thought it might be useful to highlight 12 numbers worth knowing for your heart's health and give you a chance to see how they stack up against recommended levels. Some of these, like cholesterol and blood pressure, won't come as a surprise. Others, like your waist size and blood sugar, might.

Lipids is a catchall term for the fats in your bloodstream. The most important of these are LDL (bad) cholesterol and HDL (good) cholesterol. The lower your LDL, the lower your chances of having a heart attack or stroke. (Next month, we will explore how low you should go.) The more HDL you have in circulation, the better. Total cholesterol is a useful general indicator. Triglycerides may pose a problem, especially when combined with excess weight, diabetes, and low HDL.

Your blood pressure is composed of two numbers: systolic pressure (the top number of a blood pressure reading) and diastolic pressure (the bottom number). The higher each one is, the greater the odds your arteries are suffering damage, and of you having a heart attack or stroke.

Excess weight influences heart health. Body mass index (BMI) is a measure of weight in relation to your height. (To calculate your BMI, multiply your weight in pounds by 703. Divide that number by your height in inches. Divide again by your height in inches.) An easier-to-gauge measure of weight is waist size, your circumference where the sides of your waist are narrowest, usually somewhere around the navel.

Diabetes, which is characterized by high blood sugar, is a chronic disease that injures the heart and blood vessels. Fasting blood sugar gives you an instant snapshot of your baseline blood sugar, while hemoglobin A1c offers a time-lapse look over several weeks. Although these blood sugar tests have traditionally been reserved for people with diabetes, some doctors are also recommending them for people at risk for diabetes and heart disease.

An elevated C-reactive protein (CRP) signals active, low-grade inflammation, a process linked with heart disease.

Putting it all together

Tools such as the Framingham risk score or Your Disease Risk, developed by the Harvard School of Public Health, use your numbers to estimate heart attack risk in the next 10 years.

Your doctor or nurse should be able to calculate your Framingham risk score during an office appointment. Or visit . The much longer Harvard version is only available on the World Wide Web, at .

Everyone can benefit from making healthy changes. But the urgency and intensity of such changes depend on how close you are to the top of the heart attack risk list. The greater your risk, the greater the payoff from prevention efforts.

Don't assume that taking steps to prevent a heart attack or stroke after you've already had one is like closing the barn door after the horse has bolted. In fact, this is when prevention efforts are extra important, since the chances of having a repeat heart attack or stroke are higher than the chances of having a first one.

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Last updated:	August 22, 2006