Four health measurements that assess cardiovascular health

Cardiovascular health refers to the wellbeing of the heart and blood vessels. Cardiovascular diseases (CVDs) are illnesses that attack the heart and blood vessels and include coronary heart disease, stroke, rheumatic heart disease and other conditions. According to the World Health Organisation (WHO), they are the leading cause of death globally, taking an estimated 17.9 million lives per year.

There are four health measurements used to assess cardiovascular health. These include body-mass index (BMI), blood sugar, blood pressure and cholesterol. The four are the building blocks to heart health, according to medical experts.

Dr Alex Blessing, a general physician in Entebbe, says understanding these four building blocks is a great start to great cardiovascular health and general wellbeing. He adds that everyone, especially those aged 40 and above, should understand how all the four are interlinked, how they are measured and how you should keep your body in the right range.

“These four make the basic blood control components since BMI, cholesterol, blood pressure and sugar all have to do with the heart, the most vital organ in the body. They also happen to be the main body suppressors because when any of them is not in check, then there is a real risk of conditions such as heart attacks, strokes and so on,” he says.

Dr Blessing says it is particularly important to keep one’s BMI in check because that way, one’s blood sugar, blood pressure and cholesterol will likely be normal.

Body Mass Index (BMI) is a person’s weight in kilogrammes divided by the square of their height in metres (or feet). To calculate BMI, you divide an adult’s weight in kilogrammes by their height in metres squared.

For example, if you weigh 70kg and your height is 1.73m (around five feet eight inches) tall, you calculate your BMI by squaring your height: 1.73×1.73 = 2.99. Dividing 70 by 2.99 = 23.41.

Underweight: If your BMI is less than 18.5, it falls within the underweight range.

Healthy weight: If your BMI is within the range of 18.5 to 24.9, it falls within the healthy weight range.

Overweight: If your BMI is over 25.0 to 29.9, it falls within the overweight range.

Obese: If your BMI is 30.0 or higher, it falls within the obese range.

It goes without saying that one must know their exact height and weight to be able to calculate their body mass index.

“Whatever the outcome of your measurement, it all begins with nutrition. If you are underweight, you have to eat better and gain some weight and if you are overweight, you have to eat better and lose some weight,” Dr Blessing says, adding that if you are overweight, which is the more common scenario, you will be advised to eat less energy foods (carbohydrates). Eating carbohydrates when your work entails sitting all day is detrimental, according to the doctor, because you attain energy that you will not be able to expend. 

“Some people have a chapatti for breakfast and sit infront of their computer all morning. At lunch time, they eat rice or posho or other sources of carbohydrates and sit again. In the evening, they have another serving of carbs for dinner. What this means is that your body has taken in all that energy but it has not used it in any way. The issue is that the body is made in such a way that whatever we eat in energy form (carbs) and we do not use  is stored as fat. This causes bad cholesterol, which is a risk factor for other heart diseases,” he says.

Dr Blessing recommends eating less carbohydrates if your daily occupation is not energy consuming. One should also exercise regularly, get enough sleep and take enough water, among other measures.

Cholesterol

Cholesterol is a waxy, fat-like substance found in all the cells in your body. As it turns out, your body needs some cholesterol to make hormones, vitamin D, and substances that help you digest food. The body’s cholesterol is mostly made up of a substance called low-density lipoprotein (LDL) but when the levels of LDL are too high (bad cholesterol), your risk of heart disease and stroke increases.

Dr Birungi says bad cholesterol is mainly caused by eating fatty food too often, a sedentary lifestyle with little to no exercise, smoking, drinking alcohol and being overweight. He adds, however, that some people will develop bad cholesterol for no other reason except for the fact that it runs in their family.

When levels are too high, cholesterol can block your blood vessels, increasing the risk of heart problems or a stroke. Just as BMI, bad cholesterol affects the health of the heart.

Testing for cholesterol

Cholesterol is assessed with a simple blood test called a lipid panel. The results are given in milligrams per deciliter (mg/dL). Normal cholesterol should be less than 200 mg/dL. Anything between 200 to 239 mg/dL is too high, according to doctor Blessing.

“You are at a risk of developing heart disease if you have over 240 mg/dL,” he says.

How to avert

The doctor says reducing stress in your life would be one of the most important steps because stress causes high levels cholesterol to be produced. Try and drink less coffee too and eat soluble fibres and a balanced diet. Also, reduce your intake of baked foods, tropical oils, butter, dairy, fried food, beef and fatty foods, among others.

Blood sugar

Blood sugar is the main sugar found in blood. It is the body’s primary source of energy and the body extracts it from the food we eat. The body breaks down most of the sugar we eat into glucose and releases it into your bloodstream to give energy. When it becomes too much, the pancreas releases insulin to bring it to normal again. The extra glucose is stored as fat. In the long run, the fat messes up your BMI.

The level of glucose in the blood is tested by applying a drop of blood to a chemically treated test-strip which is then inserted into a blood glucometer. Dr Blessing says the medical professionals also do fasting blood sugars, which is done after more than 12 hours of not eating anything.

Blood sugar is measured in millimoles per litre or mmol/L. A fasting blood glucose test whose results show between 70 and 100 mg/dL (3.9 and 5.6 mmol/L) is considered normal. When you have not fasted, it will be around be 125 mg/dL (6.9 mmol/L) or lower.

“A blood sugar level less than 7.8 mmol/L is normal and anything above 11.1 mmol/L indicates that you have diabetes,”  Dr Blessing says.

He adds that one may need to check their blood sugar if there is an frequency of thirst, tiredness, blurred vision, dry mouth, needing to pee frequently, unexplained weight loss, recurrent infections, such as thrush, bladder infections (cystitis) and skin infections.

How to normalise

A change in diet is the only way to normalise blood sugar, according to Dr Blessing. He recommends intermittent fasting, eating whole grains instaed of refined grains, walking after meals, strength training and having a protein-rich breakfast.

Blood pressure

Blood pressure is the pressure of blood pushing against the walls of your arteries. Arteries carry blood from your heart to other parts of your body. High blood pressure or hypertension can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease.

Blood pressure is measured by wrapping an inflatable cuff around one’s upper arm and as it gently tightens on your arm, it measures your blood pressure. It is measured in millimeters of mercury or mm/mgH.

Normal blood pressure for most adults should be less than 120/80 mm/mgH.

Dr Blessing says high blood pressure affects the body’s arteries because the force of the blood pushing against the artery walls is consistently too high. He adds that the heart has to work harder to pump blood since the arteries lose elasticity and become too wide.

Medical experts say the exact causes of high blood pressure are not known, but several lifestyle choices may play a role, including being overweight or obese, lack of physical exercise, overconsumption of alcohol, stress and old age, among others.

Dr Blessing says to normalise one’s blood pressure, one must lose weight because blood pressure often increases as weight increases. Eating a better diet, exercising, limiting alcohol and smoking, sleeping more and getting rid of stress may also help.

Where can I get my heart health numbers?

Most adults get their blood pressure checked when they are seen by a doctor or nurse at a primary care checkup. Free web risk assessments are available for diabetes, cholesterol and heart disease, and some organisations may offer free in-person screenings for these conditions. You can also schedule specific heart screenings with doctors who are experts in heart health.