According to the Centers for Disease Control and Prevention, heart disease is the leading cause of death for women in the United States. This is particularly eye-opening, as many falsely believe that cancer is the bigger "death wish." Yet the reality is that Americans should be protecting their heart health.
The risk factors that can lead to heart disease such as diabetes, obesity, excess alcohol use, poor diet, and lack of exercise, are so rampant and so commonplace in our society that people almost view them as normal when we know they are not.
This begs the question — when should women start receiving regular heart checkups and what numbers should they be looking to improve?
The American Heart Association recommends starting with routine cardiovascular blood work at 20 years of age, and then if those tests are normal, having them done every four to six years.
Most health care providers start testing cholesterol plus other markers such as fasting blood sugar, also known as glucose, every year once a woman turns 40 years old — unless something is flagged as abnormal earlier or if she has risk factors for heart disease.
There are several laboratory tests that can indicate the health of someone’s heart, including the most basic test of all — the blood pressure test.
Every time the heart beats, there are two pressures that are measured – the pressure out to the body known as "systolic" and the pressure into the lungs known as "diastolic."
Over time, as arteries become stiff or full of plaque due to lifestyle choices like smoking or a poor diet, the blood pressure numbers start to rise above the normally accepted 120/80 mm Hg. A blood pressure above 140/90 mm Hg is considered much too high, and is labelled as hypertension.
Sadly, 1 in 3 Americans has high blood pressure, which greatly increases the risk for heart disease, according to the CDC.
Fasting cholesterol markers are made up of total cholesterol, LDL or low density lipoprotein, HDL or high density lipoprotein, and triglycerides. Most health care providers run these standard numbers as part of their screen.
However, more advanced testing will count the number of particles and evaluate the size of those particles. This is important to know for plaque buildup in the arteries and heart disease.
It is generally accepted that the total cholesterol should be under 200 mg/dL, while the LDL — often referred to as the bad cholesterol — should be under 100 mg/dL. The HDL — or good cholesterol — should be above 60 mg/dL.
Triglycerides are a storage form for carbohydrates not used, or burned, by the body. They get transported to the fat cells where they are saved as energy.
If an advanced test is done, a woman does not want her LDL to be considered small and dense.’ The smaller, denser LDL particles are more atherogenic and damaging to her vessels. Some health care providers are testing the Lp(a) which is a genetic marker that, if elevated, will increase the risk of fat deposits developing in the arteries prematurely.
Lastly, blood sugar is an important risk factor for many health conditions. It can be measured as a fasting glucose, 2-hour oral glucose tolerance test, and hemoglobin A1C test.
A normal fasting glucose should not be higher than 100 mg/dL. As the number creeps up towards 100 and further into the double digits, the risk for diabetes increases greatly.
The 2-hour oral glucose tolerance test is a more involved test. A fasting glucose is taken, followed by a special drink with a specific number of sugar and carbohydrates. A glucose is repeated two hours later. The level should not exceed 140 mg/dL at that time.
Finally, a hemoglobin A1C is a marker of glucose for approximately the last two to three months. It is a more long-term marker than a fasting glucose test or 2-hour oral glucose tolerance test. A normal result should be less than 5.7 percent.
If you know that your numbers are elevated or borderline-high, understand that most of the time they can be improved with lifestyle factors. These factors include exercise and improved eating habits. Significant improvement is possible if you stop smoking, reduce your alcohol intake, eliminate stress, and lose weight.
Please don't be a statistic. Talk with your health care provider today about being proactive.
Reviewed February 10, 2016
by Michele Blacksberg RN
Edited by Jody Smith
2) American Heart Association. (2014). Good Vs. Bad Cholesterol.
3) Centers for Disease Control and Prevention. (2015). Heart Disease Facts.
4)Gholipour, B. (2015). Blood Pressure: Highs, Lows and What’s Normal.
5) Lab Tests Online. (2013). LDL Particle Testing.