Test your heart IQ – know your cholesterol
and blood pressure numbers!
About 6
million South Africans suffer from high blood pressure and out of all these
people only 26% of men and 51% of women knew that they had hypertension. The
number of people with high blood cholesterol levels is similar, 5 million South
Africans suffer from high cholesterol. These two key risk factors for
cardiovascular disease (CVD) are often called the ‘silent killers’ because there are no visible symptoms when
levels are raised and if left untreated can lead to a heart attack or stroke.
On Get Tested Day,21 June, the Heart and Stroke Foundation
SA (HSFSA) would like to remind all to have your cholesterol and blood pressure
checked. By knowing your numbers and assessing your
risk now, you can significantly reduce the chances of developing cardiovascular
disease or of having a second event.
CHOLESTEROL
The most common cause of high blood cholesterol levels is
eating too much fat, especially saturated and trans fats. However some people
have high cholesterol levels even though they follow a healthy diet (e.g. people
who have a rare hereditary condition called familial hypercholesterolaemia, or
those who have an under-active thyroid gland, long-term kidney problems or who
drink too much alcohol).
Who should get tested
and how often?
All adults over the age of 20 should
have a fasting lipogram once every five years, but more often if your
total cholesterol is above 5mmol/L, you’re a man over age 45 or a woman over 50
or if you have other risk factors for heart disease and stroke. For a
fasting blood test you would need to fast (usually for at least 9 hours) before
the test.
The process of atherosclerosis (build up of fatty
plaque in arteries) starts in childhood and progresses slowly into
adulthood. So some children may
need to have their cholesterol checked as well - particularly those from
high-risk families (who have parents with high cholesterol, or parents/grandparents
with heart disease at 55 years or younger).
“Good’ or “Bad”
cholesterol and Triglycerides
Not only do you have to be aware
of your total cholesterol level, but you also need to know your HDL and LDL
cholesterol numbers and your triglyceride level.
Your blood cholesterol consists mainly of two kinds of cholesterol. LDL
(low-density lipoprotein) is the “bad” cholesterol because when too much of it
circulates in the blood, it can slowly build up in the walls of the arteries to
the heart or brain. HDL (high-density lipoprotein) is the “good” cholesterol that
helps to remove “bad” cholesterol from arteries and prevent fatty blockages.
Triglycerides are a type of fat made in your body and also comes from food.
People with high triglycerides often have a poor cholesterol profile (high
total cholesterol, high LDL cholesterol and a low HDL cholesterol level).
These are the levels
you should aim for:
·
total cholesterol below 5 mmol/L (if you have CVD or
diabetes, then below 4.5 mmol/L)
·
LDL cholesterol below 3 mmol/L (if you have CVD or
diabetes, then below 2.5 mmol/L)
·
triglyceride
level less than 1.7 mmol/L
·
HDL
cholesterol above 1 mmol/L for men and 1.2 mmol/L
for women
How can cholesterol be
lowered?
To keep
your cholesterol levels in the low-risk range, you would need to choose a heart-healthy diet (low in
saturated fat, trans fat and cholesterol), do at least 30 minutes of
moderate vigorous physical activity five days of the week and stay away from
tobacco products. If lifestyle changes alone don’t lower your cholesterol
level, speak to your doctor about medication. If you’re already on medication,
remember that you still need to follow a heart-healthy lifestyle and take your
medication exactly as prescribed.
BLOOD PRESSURE
In the majority of people, the cause of high blood pressure
is not known. In fact, you could have high blood pressure for years without
knowing it. Even though you may not know the cause, you can take
steps to control it and reduce your risk for stroke, heart disease, kidney
failure or problems with your eyesight. Some people may be “salt sensitive,” so
eating a lot of salt (or sodium) worsens their high blood pressure. Salt increases
fluid retention in your body and puts an added burden on your heart. As little
as one extra gram of salt could raise blood pressure as much as 5 mmHg in
people who are salt sensitive. It is important to cut down on your salt/sodium
intake e.g. in canned foods, baking soda, cheese, dried or cured foods and even
certain medications!
Who should get tested
and how often?
All adults should have annual blood
pressure checks especially if they have stressful occupations or a family
history of hypertension. All patients who have been diagnosed with
hypertension, should have regular blood pressure checks as directed by their
doctor. It may be a good idea to have blood pressure levels checked from an
earlier age, as even children as young as 6 can have high blood pressure. Children
should start having their pressure checked from their teen years, especially if
they are overweight.
At what level is blood pressure high?
Ideally,
your blood pressure should be lower than 120/80 mm Hg. Readings from 120/80 – 139/89
mmHg are considered pre-hypertension. A systolic blood pressure (top reading) of 140
or higher or a diastolic pressure (bottom reading) of 90 or
higher is considered high and should be evaluated by your doctor. Avoid complications
from high blood pressure by aiming for levels:
·
Less than 140/90 mmHg
·
Less than 130/80 mmHg (if you have CVD or diabetes)
How to decrease blood pressure levels
To keep your blood pressure in a
healthy range, you need
to maintain a healthy weight, eat a diet low in salt and saturated fat, eat
adequate potassium-rich foods (fruit, vegetables, nuts, low fat or fat free
milk), get 30 minutes of physical activity on most or all days of the week and
limit your alcohol intake to no more than one drink a day for women or two
drinks per day for men.
What should you know
about high blood pressure medication?
If lifestyle changes don’t get your blood pressure down to a
normal level, your doctor may prescribe medication, which you will have to take
EXACTLY as recommended. Remember that high blood pressure is a lifelong disease
– it cannot be cured, but it can be managed by taking your blood pressure medication EVERY
DAY - not just under certain “conditions” (such as when you’re feeling bad or
stressed). Decreasing the dosage or not taking the medication at all is
dangerous (your blood pressure will rise, putting you at risk for heart attack,
stroke, heart failure and kidney failure).
Be aware
of the possible dangers of taking certain cold, cough and flu medications.
Decongestants have been reported to increase blood pressure and may interfere
with blood pressure medications, so choose cold and flu medications that don’t
contain decongestants. Also be careful of various herbs or herbal supplements
which can cause fluctuations in blood pressure and interact with
antihypertensive medication. Some medications that may interfere with the
effectiveness of antihypertensive drugs include steroids, nonsteroidal
anti-inflammatory drugs (NSAIDs), diet pills, cyclosporine, erythropoietin,
tricyclic antidepressants, monoamine oxidase inhibitors and oral
contraceptives. If in doubt, consult your doctor or pharmacist about drug
interactions and before taking any over-the-counter medication or supplements.
Contacts
For more detailed advice about
lowering your cholesterol and blood pressure levels, or general heart health contact
the Heart Mark Diet Line on 0860 223 222, email heart@heartfoundation.co.za
or visit www.heartfoundation.co.za.
Written by Erika Ketterer, Registered Dietitian at the Heart
and Stroke Foundation S.A.
