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Know your numbers for a healthy heart

120. 80. 5. 25. Zero. What do these numbers mean? Do you know yours?

Danie Gerber (46), former Springbok centre and national rugby hero, used to be the picture of health. Darting around opponents, sidestepping and counter-attacking, nobody would have suspected that the arteries of his heart were slowly clogging up. Feeling great and fit, he didn't suspect anything.

It was a real shocker when, one day at the age of 43, his world was turned upside down when doctors discovered that several of his coronary arteries were blocked.

It was then when Gerber and his doctors discovered that he was a walking timebomb; that he had been suffering, albeit silently, from high cholesterol and blocked arteries (artherosclerosis) long before his heart disease was diagnosed.

Gerber's artherosclerosis was so severe, and his risk for heart attack so immense, that he had to undergo coronary artery bypass surgery as an emergency measure. He recovered from the surgery, and with cholesterol lowering drugs (statins), daily exercise, a low fat eating plan, and regular check-ups, his heart disease is now controlled.

Many others are not as fortunate as Gerber. Heart disease claims more than 12 million lives around the world each year. South Africa has a very high rate of heart disease: every eight minutes another South African has a heart attack, and every fourth one is fatal.

Are you (unwittingly) heading for a heart attack?

According to the Heart Foundation of South Africa, the six main "health checks" that every South African should consider are:

• blood pressure,
• blood cholesterol levels,
• BMI,
• presence of diabetes,
• whether you smoke or not, and
• your physical activity level.

High blood pressure, raised cholesterol and diabetes can develop without any symptoms, and are often only diagnosed after causing substantial damage to your health - as Gerber discovered.

For good heart health, don't smoke and eat wisely (limit your fat intake and eat four to five portions of fruit and vegetables daily). According to US Surgeon General recommendations, 30 minutes of light exercise which increases the heart rate, every day of the week would prevent heart disease and would also improve the health status of a person who already suffers from atherosclerosis. The exercise need not be continuous, you could do five-minute walks six times a day - as long as it adds up to 30 minutes per day.

This is a good start, but not enough. You should also know your numbers.

1. Blood pressure should be lower than 120/80 mm Hg
One out of four people suffers from high blood pressure (hypertension). Two-thirds of people have no symptoms. Never rely on how you feel as an indicator of blood pressure or cholesterol - the term "silent killer" hasn't been coined for nothing.

All adults should know what their blood pressure is, and should have it checked at least every five years. People with a family history of heart disease, stroke or high blood pressure need to be tested every one to two years.

Blood pressure can be measured relatively cheaply at clinics and pharmacies. It is expressed as the systolic blood pressure over the diastolic blood pressure in millimetres of mercury (mm Hg).

According to the latest classifications, blood pressure can be graded as follows:

Lower than 120/80 - optimal (previously considered low)
120/80 - 140/90: pre-hypertensive (previously considered normal)
>140/90 - high blood pressure (hypertension)
A blood pressure reading of over 130/85 would warrant a visit to the doctor.

American researchers have determined that increased blood pressure is directly related to an increased risk o f heart disease. The following statistics prove this relationship:

Any blood pressure reading of higher than 115/75 mm Hg - previously considered low - is associated with a higher risk of heart disease. The risk of heart attack and stroke doubles for every 20-point increase in systolic pressure or every 10-point rise in diastolic pressure.

People with blood pressure readings of 135/85 mm Hg - until recently considered normal - have twice the risk of heart disease as those with low blood pressure of 115/75 mm Hg.

People with blood pressure higher than140/90 mm Hg have four times the risk of heart disease as people with a low blood pressure of 115/75 mm Hg.

Almost 90 percent of people over the age of 55 will develop high blood pressure, even if they have normal blood pressure up until the age of 55.

High blood pressure can be treated with medication and lifestyle changes such as weight loss, a balanced diet, restricted use of salt, regular exercise and stress management.

2. Cholesterol levels should be lower than 5
High cholesterol levels are often only diagnosed after having caused substantial damage to your health, according to heart specialists.

If Gerber had known his cholesterol reading earlier, preventative treatment and measures could have limited the extent of fatty deposits in his arteries and the resultant blockages.

Blood cholesterol levels can be measured either by taking a blood sample for laboratory analysis or to be analysed on site. Please note that latter is merely a general indicator and not a diagnostic tool, but that it can be done at pharmacies.

The Heart Foundation recommends that your total cholesterol reading should be below 5 mmol/l. The value for HDL (considered "good" cholesterol), should be greater than 1,2 mmol/l, and the value for LDL, ("bad" cholesterol) should be less than 3 mmol/l.

A cholesterol reading of over 7 mmol/l could indicate a need for medication and certainly warrants a visit to a doctor.

Yearly checks are advised if you have high cholesterol.

Raised blood cholesterol levels can be treated with medication and/or dietary changes. Research has shown that lowering intakes of saturated fats and trans-fatty acids could be beneficial. Maintaining a healthy weight will enable you to control your blood cholesterol levels with greater ease.

3. A BMI of below 25 kg/m2 is ideal
Being overweight can lead to high blood pressure, raised cholesterol levels and diabetes. It also puts undue strain on the workload of the heart.

It is important to check your weight and to shake off a few kilos if you are overweight or obese.

The body mass index (BMI) is a useful tool in determining if you have a weight problem. To work out your BMI, take your weight (in kg) and divide it by your height2 (in metres). This is what the figures mean:

<18,5 kg/m2 - underweight
18,5-25 kg/m2 - normal weight
26-30 kg/m2 - overweight
>30 kg/m2 - obese
For example, the BMI of a person of 1,7 m, weighing 75 kg, is 25,95, indicating overweight. As most people struggle with overweight, try your best to keep your BMI below 25.

Keep in mind that fad diets don't work in the long run. Start to make healthier food choices immediately and increase the amount of exercise you do.

4. Presence of type 2 diabetes
High blood glucose levels can damage the blood vessels of the heart. For this reason, diabetics are more inclined to develop atherosclerosis of the coronary arteries, which could lead to angina, a heart attack or heart failure. Keeping blood glucose levels under control helps prevent atherosclerosis.

Normal blood glucose readings are between 3,3 and 6 mmol/l, while fasting blood glucose (blood glucose measured before breakfast) of over 6,7 mmol/l on two separate occasions could indicate a problem.

All people with a family history of diabetes, who are overweight or obese, and have high blood pressure or elevated cholesterol levels, should have their glucose levels tested.

Diabetes can be controlled with medication and lifestyle changes. These may include weight loss, a structured exercise programme and a diet low in fat and rich in fruit and vegetables.

Useful contact number
The Heart Foundation can be contacted on (021) 447 4222.

- (Carine van Rooyen)