One in three Americans has high blood pressure, (HBP) putting them at a higher risk of developing coronary artery disease (CAD). If other conditions, such as elevated cholesterol are also present, the risk for CAD is even higher.
What is high blood pressure?
Blood pressure is the force of blood as it moves through the arteries. High blood pressure can lead to coronary artery disease, heart failure, stroke, kidney failure and other health problems. If left untreated, it can damage the heart, blood vessels, kidneys and other organs. Because there are generally no symptoms associated with high blood pressure, it's often called the "silent killer".
A doctor or nurse can measure your blood pressure in his or her office. People who are being evaluated or treated for high blood pressure may also learn how to measure their blood pressures at home and share the results with their doctors.
Blood pressure is measured in millimeters of mercury, abbreviated mm Hg. Readings are recorded with your systolic pressure on top and your diastolic pressure on the bottom. These two numbers are separated by a line, such as 110/70 mm Hg.
*Systolic pressure (top number): Measures the pressure in your arteries while your heart is pumping.
*Diastolic pressure (bottom number): Measures the pressure between heartbeats.
According to the National Heart Lung and Blood Institute, the criteria for blood pressure are:
- Normal: Systolic less than 120 and diastolic less than 80.
- Prehypertension: Systolic 120-139 or diastolic 80-90.
- Stage 1 High Blood Pressure: Systolic 140-159 or diastolic 90-99.
- Stage 2 High Blood Pressure: Systolic 160 or higher or diastolic 100 or higher.
What is cholesterol? And why is it important to me?
Having high cholesterol is another risk factor for coronary artery disease. As someone diagnosed with high blood pressure, you already have an elevated risk of developing coronary artery disease, so it's important to have your cholesterol levels checked and to take action, if necessary. Over the years, doctors have developed a risk calculator to assist in predicting coronary artery disease. They have learned that in addition to blood pressure readings, there are a number of factors that raise the risk of developing CAD, including gender, whether you smoke, your total cholesterol and your LDL cholesterol number.
Coronary artery disease happens when plaque builds up inside your arteries, and can, over time, narrow your arteries, reducing blood flow to your heart. Pieces of plaque can break off as well, causing clots to develop on the surface of the plaque which can completely block blood flow to your heart, causing a heart attack.
Studies have shown that if you have high cholesterol, lowering it may reduce or even stop the buildup of that plaque in your arteries, lessening your risk of a heart attack. Lowering your cholesterol may also reduce the risk of that plaque breaking off.
How is cholesterol measured?
First, a little about cholesterol. Basic cholesterol tests done in your doctor's office will measure four things:
- High-Density Lipoprotein (HDL): This is the "good" cholesterol. It keeps the LDL cholesterol from getting lodged in your artery walls.
- Low-Density Lipoprotein (LDL): The "bad" cholesterol, which leads to buildup of plaque inside your artery walls, putting you at a higher risk of a heart attack or stroke.
- Total Cholesterol: Measures your HDL plus your LDL as well as other lipid components.
- Triglycerides: Another fatty substance in your blood that affects your risk for heart disease.
Cholesterol screenings involve a small sample of blood being drawn, generally from your arm. That sample is then analyzed in a lab. Fasting tests are the most accurate, and it's generally recommended that you fast for 9-12 hours before the test. Check with your doctor to see what's recommended for you before your test.
The National Cholesterol Education Program recommends all adults age 20 and over should have a fasting cholesterol test done every 5 years. Those who have other risk factors for heart disease may need more frequent testing. Men over age 45 and women over age 50 may also need more frequent tests.
All about numbers
Below are the recommended numbers for healthy people. If you already have coronary artery disease or one of it's equivalents, your doctor may give you different goals.
According to the American Heart Association, for total cholesterol:
- Desirable: Less than 200 mg/dL
- Borderline high: 200-239 mg/dL
- High: 240 mg/dL and higher.
- Note: HDL is the "good" cholesterol and you want higher numbers of this type.
- Low HDL: Less than 40 mg/dL for men and less than 50 mg/dL for women
- High/Optimal HDL: 60 mg/dL and above (This is associated with a lower risk for heart disease.)
- Optimal: Less than 100 mg/dL
- Near or above optimal: 100-129 mg/dL
- Borderline high: 130-159 mg/dL
- High: 160-189 mg/dL
- Very high: 190 mg/dL and above
- Normal: Less than 150 mg/dL
- Borderline high: 150-199 mg/dL
- High: 200-499 mg/dL
- Very high: 500 mg/dL and higher
Your doctor can help you interpret your results and decide what, if anything, you should be doing to improve your health.
How can I lower my cholesterol?
If your cholesterol is high, there are a number of lifestyle changes you can make that may help lower your cholesterol. Some of these you'll probably recognize -- since some are the same recommendations for helping to lower high blood pressure. These include:
- Regular exercise,which can help your body produce more HDL. Always talk with your doctor first before increasing your activity level.
- Reducing the amount of trans fats in your diet,which can also increase HDL.
- Eat a nutritious and balanced diet.
- Stop smoking,and avoid secondhand smoke whenever possible.
- Medications.Some people may need medicine in addition to good lifestyle practices to help lower their cholesterol. Talk with your doctor to see what's right for you.
Since both high blood pressure and high cholesterol are risk factors for coronary artery disease, you should make sure that you know your numbers and that you are following your doctor's recommendations to help lower your risk of a heart attack or stroke.
Created on 12/16/2011
Updated on 12/29/2011
- National Heart Lung and Blood Institute. What is High Blood Pressure?
- Davidson, M. Focusing on High-Density Lipoprotein for Coronary Heart Disease Risk Reduction. Cardiology Clinics. 2011;29(1): 105-122.
- National Heart Lung and Blood Institute. What is Cholesterol?
- American Heart Association. About Cholesterol.