There’s a good reason why we cardiologists are focused on trying to get your numbers in line—specifically your blood pressure, blood sugar and bad (LDL) cholesterol numbers. Levels that are out of line can put you at greater risk for heart disease, especially if you have diabetes.
A new study from the Heart Disease Prevention Program at the University of California, Irvine School of Medicine, confirms that only 7 percent of participants with diabetes in three major heart studies had met recommended levels, putting them at higher risk for heart disease.
The findings of this study demonstrate the need for persons with diabetes to better manage their blood pressure, blood sugar and LDL cholesterol levels, all prime indicators of future heart disease. The participants who had diabetes surveyed in the UCI review were enrolled in three heart studies between the late ’80s and early 2000s, when treatment was not as good as it is now. Still, more recent data show that only 25 percent of Americans with diabetes achieve all three of these targets.
The good news is that those in the heart studies who did control all three factors had a 62 percent lower risk of developing heart disease. Even effectively managing just one of these risk factors translated to a 36 percent lower risk for heart disease, and managing two was linked to a 52 percent lower risk.
So what are the target numbers we’re looking for when you come in to see the cardiologist, especially if you have diabetes?
• Blood pressure—under 130/80 mgHg—While blood pressure can fluctuate from minute to minute with changes in posture, exercise, stress or sleep, it should normally be less than 120/80 mm Hg (less than 120 systolic AND less than 80 diastolic) for an adult age 20 or over. About one in three U.S. adults has high blood pressure.
• Blood sugar (HbA1c (glycated hemoglobin)—under 7 percent—This test measures your average blood glucose control for the past two to three months. It is more convenient because no fasting is required. An HbA1c of 5.7 percent to 6.4 percent means you are at high risk for the development of diabetes and you have prediabetes. Diabetes is diagnosed when the HbA1c is 6.5 percent or higher.
• LDL cholesterol (bad cholesterol)—less than 100 mg/dL— LDL cholesterol contributes to plaque, a thick, hard deposit that can clog arteries and make them less flexible. This condition is known as atherosclerosis. If a clot forms and blocks a narrowed artery, heart attack or stroke can result. Another condition called peripheral artery disease can develop when plaque buildup narrows an artery supplying blood to the legs. Ideally, we would like to see this number between 35 and 70, an ideal cardioprotective range.
This research confirms that tightly managing these numbers for individuals diagnosed with diabetes can greatly reduce the risk for heart disease. For some patients, we can manage these numbers organically through diet and exercise alone. But for many people, healthy numbers can be hard to achieve.
If your numbers don’t measure up, and it’s tough for you to reach them through diet and exercise alone, we have many effective medications to manage blood pressure, blood sugar and cholesterol. Importantly, we have medications that not only improve your numbers, but also make you live longer, and prevent heart attacks, heart failure and strokes. See your cardiologist or your primary care physician to determine your risk for heart disease and diabetes, and discuss the best strategies to get your numbers in line.
Dr. O’Keefe is a cardiologist with Saint Luke’s Cardiovascular Consultants, located in Lee’s Summit at 20 N.E. Saint Luke’s Blvd., Suite 110, 816-931-1883. Also read Dr. O’Keefe’s newsletter, From the Heart, online visit: http://www.saintlukeshealthsystem.org/saint-lukes-cardiovascular-consultants-newsletter.