By Margaret T. Bowers DNP, FNP-BC, AACC, FAANP, FAAN
As a nurse practitioner (NP) with more than 22 years of experience caring for patients with cardiovascular disease, I focus on trying to shift the attention from treatment to prevention. The recommendations for cardiovascular health are to undergo screening for high blood pressure (BP), elevated lipids, cholesterol and blood glucose — conditions you can treat before they cause symptoms. According to the American Heart Association Know Your Numbers campaign, the ideal numbers for blood pressure are 120/80 mm Hg, a fasting blood sugar no higher than 100 mg/dl and a body mass index of 25 kg/m2.
Reducing elevated BP and cholesterol levels may reduce your risk of myocardial infarction (MI), stroke and peripheral vascular disease. If you are between the ages of 18 and 40, you should get your BP evaluated every three to five years, and annually after age 40. The elevated BP range is 120-129/less than 80 mm Hg. If your BP falls within this range, you should strongly consider home BP monitoring to evaluate for worsening elevation. Hypertension (high blood pressure) is diagnosed when BP is above 130/80 on more than one occasion. Early detection and treatment are paramount to reducing your risk and improving your cardiovascular health.
Familial risk of premature cardiovascular disease is one factor to consider when determining how soon to screen for elevated cholesterol. For example, the National Heart, Lung and Blood Institute (NHLBI) supports initiating screening in children aged 1-4 years who have a positive family history of elevated lipids or other cardiac risk factors. Adult screening should be done starting at age 20. Use of a risk calculator can be helpful in determining the 10-year risk of a cardiovascular events in patients 40 years of age and older. Keeping your cholesterol, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) in the normal range through diet, exercise and appropriate medications may reduce your risk of a heart attack or stroke.
Starting at age nine, children should have a fasting blood glucose drawn to screen for diabetes. Adults 45 years of age and older should be screened annually for diabetes. A fasting glucose level of 100-125mg/dl indicates prediabetes, and a fasting blood glucose level over 126 mg/dl confers a diagnosis of diabetes. Early detection provides an opportunity for early intervention and possible reversal of prediabetes.
Effecting change in your body mass index (BMI) can be challenging. Rather than focusing only on diet and exercise, think about nutrition and movement to get your BMI into the recommended zone. BMI is comprised of age, gender, height, weight and body frame, and it can be monitored using a calculator. Waist circumference is another indicator to consider, even if you are at a healthy weight. Individuals in all BMI categories with a high waist circumference are at increased risk of developing diabetes, dyslipidemia and hypertension.
What can you do to improve your heart health? Exercising as little as 35 minutes per day for five days a week, or 60 minutes a day for three days a week, can boost your mood and improve your fitness. Are you limited by weather or residence? Consider how to keep active using shorter intervals — 15 minutes of activity four times in one day will help you hit your daily 60-minute mark!
Focus on nutrition and think about swapping food cravings for other activities. Carbohydrates trigger dopamine in the brain and provide a source of pleasure. Ask yourself, am I hungry or just bored? Choose an alternative snack like fruits or vegetables that are fresh or frozen. Prepare healthy snacks when you get home from shopping, so they are on hand when your craving strikes. Make sure you are getting enough protein in your diet to feel satisfied; this will reduce your desire to snack.
Take the time during American Heart Month to know your numbers and see your NP to ensure that you and your family have followed the screening recommendations needed to maintain your cardiovascular health.