Spring Maintenance
Chester J. Zelasko, Ph.D. | May 10, 2006

Spring has arrived and it’s time to perform some spring maintenance--not on your lawn mower or your car, but on your body. It’s a bit more complicated than just checking fluid levels, but the essence is the same: checking basic measures to find out where you are and what you need to work on.

Here are some health measures you should get checked, why it’s important, and what the numbers should be. Most of these measures have been covered in prior Newsletters.

Blood Pressure
Blood pressure is a measure of the force exerted on your arteries while the heart is beating (systolic) and resting (diastolic.) When blood pressure is high, it can cause damage to arteries due to shearing forces, cause the heart to become larger in an unhealthy way, and lead to kidney damage, among other things. Here are your targets:

Normal systolic BP: Less than 120 mm Hg
Normal diastolic BP: Less than 80 mm Hg

Recent research has demonstrated that if BP is taken in the doctor’s office, you should be sitting quietly and comfortably for at least five minutes (1). If not, readings can be up to 14 mm Hg higher--and that’s often high enough to trigger a diagnosis for hypertension. For the latest recommendations for BP, check out the Better Life Newsletter of May 20, 2003.

Cholesterol
Cholesterol is transported in the body in little protein packages; it’s a waxy substance that is essential for good health. The problem is that when we eat too many saturated fats, we make too much LDL-cholesterol. The LDL-cholesterol is the bad cholesterol--often called lethal cholesterol--and should be as low as possible. The HDL-cholesterol is the good cholesterol; it’s sometimes called the healthy cholesterol and should be as high as possible. Triglycerides are not really cholesterol, but they’re reflective of how much fat is being transported in your blood. High total cholesterol and LDL-cholesterol increases the risk of cardiovascular disease (CVD). These are the numbers to shoot for:

Total cholesterol: Less than 200 mg/dl
LDL-cholesterol: Less than 100 mg/dl, and closer to 70 mg/dl
HDL-cholesterol: Greater than 60 mg/dl
Triglycerides: Less than 150 mg/dl

The blood test should be performed on blood collected via a venous sample--it’s less subject to measurement error. If the numbers are high or low in the case of HDL cholesterol, have the test repeated. For further information on how to lower your cholesterol, check out the Better Life Newsletter from January 14, 2005.

hs-CRP
High sensitivity C-reactive protein is a protein that reflects inflammation in the body. It’s not something you can feel but when elevated for long periods of time, it’s associated with an increased risk of CVD. These are the risk levels for CVD associated with hs-CRP:

Low risk: Less than 1.0 mg/L
Average risk: Between 1.0 and 3.0 mg/L
High risk: Greater than 3.0 mg/L

If hs-CRP is elevated, the test should be repeated before a course of treatment is outlined. Because inflammation is naturally higher during infections, do not have hs-CRP tested while you have a cold or the flu. For more information on hs-CRP, read the Better Life Newsletter from December 13, 2005.

Blood Glucose
When you eat any kind of carbohydrates, they’re broken down into sugars such as glucose to be transported in the body to wherever they’re needed. Glucose does not stay in the blood very long--insulin helps remove it for use as fuel in cells. However, impaired glucose metabolism will increase the blood glucose levels. Often, insulin resistance is one of the metabolic consequences of obesity, and blood glucose can rise. On the other hand, blood sugar can be too low resulting in a condition called hypoglycemia. Here’s the number to look for:

Blood glucose: Between 60--100 mg dl

Blood glucose should be assessed after an overnight fast. Interestingly, blood glucose may not be the first indication that a person is pre-diabetic.

Insulin
Insulin is a hormone made by the pancreas and is responsible (with glucagon) for maintaining normal blood glucose levels. When you eat anything with absorbable carbohydrates, the body breaks the carbohydrates into smaller sugars, which are absorbed into the bloodstream. Then insulin is released to allow the body to utilize the sugar as a fuel.

If someone is insulin resistant, often associated with obesity and a sedentary lifestyle, they make plenty of insulin but their body doesn’t use it effectively. That eventually leads to an increase in blood glucose, but that can take years. It’s important to ask your doctor to check serum-insulin levels--this is the first indication you’re insulin resistant. Especially if you’re overweight and sedentary, this is something you should have done; this test should be performed after an overnight fast. Your goal:

Insulin level: Between 8-10 mM/ml

There you have it--your spring maintenance checklist. In addition to gender-specific tests such as Papp smears for women, mammograms for women over 40, and Protein Specific Antigen (PSA) tests for men over 50, these simple measurements can indicate the state of your health before a problem develops. Call your healthcare provider and schedule your spring checkup today.

References:
  1. Turner, M. et al. Presented at the Preventative Cardiovascular Nurses Association National Conference. Denver, CO. 2006.
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