These 7 simple tests can protect your heart ♥️

Knowing the results of these blood tests for heart health can save your life. Unless you ask, you probably won’t get two of them. Learn what these numbers should be and how to get them closer to healthy!

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I asked ChatGPT what Americans fear most. Her top answer was cancer. (Sure, ChatGTP can be female.) Other top worries include financial stability, crime, and cybersecurity.

Often people tell me they’re afraid of flying, public speaking, developing cancer, and gaining weight.

What concerns me most though – for your health and mine – is heart disease. No matter how you slice it, heart disease is the top killer in developed countries.

Some scary statistics

• Heart disease is the number 1 killer of people with diabetes.
• Heart disease is the number 1 killer of American women.
• Heart disease is the number 1 killer of American men.
• Heart disease is the number 1 killer of African Americans, Hispanics, and whites living in the United States.

7 Numbers to Save Your Heart

I’m worried because most people haven’t gotten two crucial blood tests.

Age, gender, family history, weight, smoking history, kidney disease, diabetes, and so many things affect your risk for heart disease. Obviously, you can control some risk factors, but not others. Fortunately, you have some power over your blood pressure and 5 of the following 6 blood tests for heart health.

If any of these put you in the high-risk category, take action today.

Even small changes go a long way to help prevent heart disease.

Talk to your healthcare provider about these numbers and about preventing heart disease.

1. Blood Pressure

You know lots of people with high blood pressure (aka hypertension). Nearly half of adults in the US have it. Unfortunately, plenty of them don’t know it, and only about 25% of people with high blood pressure have it under control.

According to the American Heart Association, normal blood pressure is less than 120/80. So high blood pressure is 120/80 and above. If either number is elevated, you have high blood pressure.

What is your blood pressure level?

How to lower your blood pressure

• Cut back on alcohol, sodium, and saturated fat.
• Add foods with potassium such as baked white and sweet potatoes, tomatoes, oranges, salmon, dry beans like Great Northern beans, bananas, spinach, peaches, cantaloupe, and many other fruits and vegetables.
• Eat foods with magnesium such as nuts, pumpkin seeds, dry beans, spinach, and whole grains
• Seek out foods with calcium such as yogurt, and low-fat milk.
• And keep moving! Exercise is important.
• Read this: What to eat with high blood pressure. You’ll find which fruits and vegetables to add to your shopping list, if beet juice is critical, and how dairy fits in.

2. Low-Density-Lipoprotein (LDL) Cholesterol

People often refer to LDL-cholesterol as the bad cholesterol.

Remember this: L stands for low. It’s good to lower LDL cholesterol. And there seems to be no level that’s too low. LDL-cholesterol is the primary type that promotes atherosclerosis or scaring of the blood vessels. The higher your LDL level and the longer it’s been elevated, the greater your risk of heart disease and stroke.

• In general,  an LDL-cholesterol level >  100 mg/dl is a risk factor for heart disease.

If you have multiple risk factors, your provider may want your LDL-cholesterol below 70 mg/dl and perhaps much lower.

How to lower your LDL-cholesterol level

• Cut back on saturated fats, particularly lard, bacon grease, coconut oil, and any solid or semi-solid fat at room temperature.
• Add foods with viscous fibers such as dry beans, oats, barley, and citrus fruits.
• Consider taking a phytosterol supplement.
• Read this: Best fats for diabetes and the heart. Find common sources of saturated fats, understand monounsaturated and polyunsaturated fats, and how to use oil instead of butter when baking.

3. Apo B (aka apolipoprotein B)

LDL-cholesterol isn’t the only bad actor.

For a better picture of the fats that damage your blood vessels, ask your provider for an apo B blood test. This blood test is not routine. Apolipoprotein B escorts damaging fats throughout the blood vessels. Where there is apo B, there is blood vessel-damaging fat. Many experts consider less than 90 mg/dl optimal.

How to lower apo B

• The best information we have today is to follow a heart-healthy diet emphasizing the strategies for lowering LDL-cholesterol identified above.

4. High-Density-Lipoprotein (HDL) Cholesterol

Sometimes we call HDL-cholesterol the good cholesterol.

Remember this: H stands for high. Most people will benefit from making their HDL cholesterol higher.

In general, men with HDL-cholesterol levels <  40 mg/dl and women with levels <  50 mg/dl are considered at higher risk for heart disease.

Having both low HDL-cholesterol and high triglyceride levels signals insulin resistance, a hallmark of prediabetes and type 2 diabetes.

How to raise your HDL-cholesterol level

• Most importantly, don’t smoke! Smoking pushes HDL cholesterol levels down.
• Be active. All physical activity is good for you. To raise your HDL cholesterol, aim for moderate-intensity aerobic exercise like biking and fast walking.
• Eat foods with more unsaturated fats like olive and canola oils, avocados, and nuts.
• Cut back on foods with saturated fats like coconut oil, butter, and fatty meats.
• Limit overly processed carbohydrate foods like pretzels, snack bars, and candy.

It’s hard to move HDL-cholesterol levels because they’re largely set by your genetics.

5. Triglycerides

This fat is not a type of cholesterol, but your provider gets your triglyceride levels along with your cholesterol blood test.

In general, your fasting triglycerides should fall below 150 mg/dl.

How to lower your triglyceride level

• Limit your alcohol intake.
• Avoid sugary drinks like sodas, sweet teas, and lemonade.
• Limit added sugars in packaged foods like cereals, yogurt, crackers, salad dressings, and sauces.
• Cut back on highly processed starchy foods macaroni and cheese, chips, white rice, biscuits, and the like.
• Get some exercise, of course.
• If your blood sugar is high, work with your healthcare team to manage it. Your triglycerides will likely improve as your blood sugar is better managed.

6. Lipoprotein(a) aka Lp(a) aka lipoprotein little a

I both hate to talk about this and feel compelled to talk about this.

Scientists have only recently identified lipoprotein(a) as a strong risk factor for heart disease. It’s genetically inherited, and I have it. How foolish of me to think my heart-healthy lifestyle would protect my blood vessels and my heart even though my father died of a heart attack when he was only 49.

Like LDL-cholesterol, Lp(a) gathers in the blood vessel walls and forms plaque. Unlike LDL-cholesterol, however, Lp(a) does not respond to diet or other lifestyle changes. Also distressing, we currently have no drugs targeting Lp(a) levels.

If your Lp(a) falls below 75 nmol/L, your risk is low.  According to the National Lipid Association (NLA), the higher the number, the greater your risk. They recommend that all adults measure their Lp(a) levels at least once. Since Lp(a) is genetically determined, your level is unlikely to shift significantly from year to year.

What to do about Lp(a)

• Ask your provider for this simple blood test. If your level is elevated, tell your family members and encourage them to get the test as well.
• Optimize all of your modifiable risk factors. The NLA report tells providers to treat people with elevated  Lp(a) levels earlier and more aggressively. I no longer settle for an LDL-cholesterol level approaching 100 mg/dl. The lower I can get it, the better. Certainly, it needs to be at least below 70. I feel good about taking an active role in my healthcare, but horribly regret not asking for an Lp(a) test years ago. So don’t wait!

7. Blood sugar

More than 1/3 of American adults have blood sugar levels in the prediabetes or diabetes range.

Know this: People with diabetes have at least twice the risk of heart disease as people without diabetes. People with prediabetes also have a greater risk.

Here is how the disorders are defined.

Test	Prediabetes	Diabetes
Fasting Plasma Glucose (FPG)	100 - 125 mg/dl	> 126 mg/dl
2-hour OGTT (oral glucose tolerance test)	140 - 199 mg/dl	> 200 mg/dl
Random plasma glucose in an individual with symptoms of diabetes such as excessive thirst and urination	Not done to diagnose prediabetes	> 200 mg/dl
A1C (an indicator of your average blood glucose level over the past three months)	5.7 - 6.4 %	> 6.5%

How to lower your blood sugar

I have dozens of articles about lowering blood sugar on this site, so spend some time looking around. Below are just a few.

Read these:

• 12 ways to manage your blood sugar without being cranky
• Science of reversing prediabetes
• Sleep and your blood sugar
• Lifting weights lowers your blood sugar in more than 1 way
• Learn how food affects your blood sugar

Your routine cholesterol or lipid panel includes only LDL-cholesterol, HDL-cholesterol, and triglycerides. Depending on your age, you probably have your blood sugar tested every year or two. Your provider likely measures your blood pressure at each visit. Make sure you know your numbers, and ask if it makes sense to measure your apo B and lp(a). Each of us must be our own best advocate.