The numbers worth knowing

Cardiovascular disease develops silently over decades. Because there are no symptoms early on, the numbers are the only early warning available.

  • Blood pressure — normal is below 120/80 mmHg. Elevated is 120 to 129 systolic with diastolic under 80. Stage 1 hypertension begins at 130/80, stage 2 at 140/90.
  • Cholesterol — LDL is the main target, and non-HDL cholesterol captures all atherogenic particles in one number. Ask for both.
  • Blood sugar — A1C reflects two to three months of average glucose; diabetes roughly doubles cardiovascular risk.
  • Waist measurement — adds information BMI misses about metabolic risk.
  • Estimated ten-year risk — combines these into a decision about what to do next.

Ask your clinician for your ten-year risk estimate. It converts several numbers into a plan.

What lowers risk most

The interventions with the largest effects are consistent across studies, and several have quantified benefits.

  • Stopping smoking — the largest single change for anyone who smokes; risk falls substantially within a year.
  • Lowering blood pressure — DASH eating produces roughly 8 to 11 mmHg systolic reduction, sodium reduction 5 to 6, regular aerobic activity 5 to 8, and weight loss about 1 mmHg per kilogram.
  • Lowering LDL — through replacing saturated with unsaturated fat, soluble fibre, and medication where risk warrants it.
  • Managing blood sugar — through activity, weight, diet quality, and treatment where needed.
  • Meeting activity targets — 150 to 300 minutes of moderate aerobic activity plus two strength sessions.
  • Reducing alcohol — lowers blood pressure and triglycerides; less is better.

Eating for your heart

Two patterns carry the evidence: DASH, designed and tested to lower blood pressure, and the Mediterranean pattern, with the largest cardiovascular outcome data. They overlap heavily.

  • Build meals around vegetables, legumes, and whole grains.
  • Use olive oil, nuts, seeds, and fish as the main fat sources; eat oily fish twice a week.
  • Keep sodium below 2,300 mg a day, with about 1,500 mg ideal for many adults with high blood pressure.
  • Limit processed meat, refined grain, and sugar-sweetened drinks.
  • Add soluble fibre — oats, barley, beans, lentils, psyllium — which modestly lowers LDL.

Most dietary sodium comes from packaged and restaurant food, so comparing labels on the products you buy regularly achieves more than putting away the salt shaker.

Warning signs and when to call

Reducing risk does not eliminate it, so recognising an emergency matters for everyone.

Heart attack — chest pressure, tightness, or pain, possibly spreading to arm, jaw, neck, or back; shortness of breath; cold sweat; nausea; light-headedness. Presentations can be subtler in women, older adults, and people with diabetes, sometimes mainly breathlessness, nausea, or unusual fatigue.

Stroke — remember FAST: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services. Also sudden severe headache, vision loss, or trouble walking.

  • Call emergency services rather than driving yourself.
  • Note the time symptoms started — it determines which treatments are possible.
  • A reading at or above 180/120 mmHg with symptoms needs emergency care.
  • Chest discomfort that appears reliably with exertion warrants prompt assessment even if it eases with rest.