Heart Attack Risk: The Top 5 Numbers You Need to Know

Just as your bank balances and credit score paint a picture of your financial health, there are several readings that give an indication of your physical health. And when it comes to having a healthy heart, few select numbers are crucial to managing heart attack risk.

“To make the numbers work for you, the two most important things to know are what the numbers mean and where you fall in relation to the normal range,” says Jonathan Fialkow, M.D.,  ^[1]medical director of clinical cardiology at Miami Cardiac & Vascular Institute.  “Like most diagnostic tests, the results mean different things to different people and depend on each person’s physical make up, medical history and any preexisting medical conditions.”

Here are the five numbers you need to know to minimize heart attack risk and maintain a healthy heart:

1. Body Mass Index

The Body Mass Index (BMI) provides an estimate of body fat based on height and weight. The BMI is used to determine a patient’s weight category and to identify patients who may be at risk for certain problems.

Normal BMI is from 18.5 to 24.9.

A BMI less than 18.5 signals underweight.

Patients with a BMI between 25 and 29.9 are overweight, and obesity may be diagnosed in patients with a BMI greater than 30.

Dr. Fialkow notes that there are limitations to the BMI. “For example, patients with significant muscle mass or fluid retention may have an elevated BMI, but not actually be overweight or obese,” he says.

2. Blood Pressure

Blood pressure is composed of two measurements: systolic pressure and the diastolic pressure. The systolic pressure (top number) is the pressure in the arteries when the heart beats, and diastolic pressure (bottom number) is the pressure in the arteries when the heart is resting and filling between beats.

Normal blood pressure is less than 120/80.

The pre-hypertension category includes systolic pressures between 120 and 139, and diastolic pressures between 80 and 89.

Hypertension, or high blood pressure, is diagnosed after several readings over time are greater than 140/90.

“Adults should be screened for hypertension at least every two years,” said Dr. Fialkow, who also is a Executive Medical Director of the Baptist Health Quality Network ^[2].

3. Blood Sugar

Fasting blood sugar and hemoglobin A1C readings are used to identify elevated risk for developing type 2 diabetes.

A fasting blood sugar from 70 to 99 is considered normal.

Readings from 100 to 125 fall in the pre-diabetic range.

Diabetes is diagnosed when someone has two readings greater than 125.

Surprised to see blood sugar listed as a key indicator for determining heart attack risk?

“We are starting to see more and more of a trend in studies that find sugar is bad for you,” Dr. Fialkow commented in the recent blog about the dangers of sugars ^[3].  “Sugar and its properties help escalate weight and increase the risk of cardiovascular disease.

4. Hemoglobin A1C

The hemoglobin A1C, a measure of glucose coating red blood cells, can also be used to identify abnormal blood sugar. It provides an indication of the average blood sugar level over the previous three months.

A normal A1C is less than 5.7

Readings ranging from 5.7 to 6.4 are consistent with pre-diabetes, indicating an elevated risk for developing type 2 diabetes.

Two readings of 6.5 and above are consistent with ­­­a diagnosis of diabetes.

“It’s not just about how many calories you take in, but how different people handle different kinds of calories. For example, some people can metabolize sugar better than others,” said Dr. Fialkow.

5. Lipids

A standard lipid panel is composed of measurements of total cholesterol, HDL (high-density lipoprotein) and triglycerides. LDL (low-density lipoprotein) is then calculated according to a formula. It is desirable to have high levels of HDL and low levels of LDL and triglycerides. The HDL particle transports cholesterol from the arteries to the liver, where it is broken down. The LDL particle may carry cholesterol to the arteries, where it can cause a buildup of plaque that can clog the arteries and possibly lead to a heart attack or stroke.

Desirable HDL is higher than 50 for women and higher than 40 for men.

Management of LDL depends not just on the level, but also on risk factors such as history of heart disease or diabetes, hypertension and smoking.

Triglycerides are a combination of sugar and fat that the body uses as energy. They can be elevated due to physical inactivity, smoking, excess consumption of alcohol or carbohydrates or in some genetic conditions. Triglycerides are often elevated in patients who are overweight, obese or diabetic.

A triglyceride level below 150 is considered desirable.

Overall when it comes to lowering the possibilities of having a heart attack, Dr. Fialkow emphasizes that everyone is different, and there are many factors that determine risk.  “Regular screenings and exams with your doctor are key to optimizing your health,” he said.

Free Heart Health Screenings offered by Miami Cardiac & Vascular Institute

During American Heart Month in February, Miami Cardiac & Vascular Institute is offering several free heart health screenings throughout Miami-Dade County. Screenings include glucose (blood sugar), blood pressure, Body Mass Index (BMI), cholesterol and pulse.  Click here ^[4] for locations, dates and times and registration, or call 786-596-3812.

To compute your BMI online, access the National Heart, Lung and Blood Institute’s free online calculator here ^[5].