Is Your Heart Older Than Your Actual Age?

February is “American Heart Month,” which the CDC calls in the “Strong Men Put Their Health First” post as “a great time to commit to a healthy lifestyle and make small changes that can lead to a lifetime of heart health.”

While I agree making changes that can lead to a lifetime of heart health is important, why the CDC wrote this post about men is beyond me. Especially because heart disease is THE NUMBER 1 KILLER OF WOMEN in the US. Though this is frustrating, I provided a link to the CDC male-oriented page because there’s useful general info there. And here’s a link to About Heart Disease In Women – and as a reminder, heart attack symptoms can be different for women – jaw pain or heartburn in women as opposed to crushing chest pain, for example!  Read more in my blog post, Heart Attack Symptoms In Women.

The CDC also has an initiative called “Million Hearts” (@MillionHearts) and their main online page has a great “Additional Resources and Events” section with links to info on preventing heart disease, physical activity, and heart-healthy recipes. There are Facebook and Twitter links to follow, and something called HOW OLD IS YOUR HEART in both video and online calculator form.

This ‘How Old Is Your Heart’ thing intrigued me, so I clicked on the video which explains that your heart can be older than your actual age. While slightly amusing, the more important bit, IMHO, is the CDC’s actual ‘heart health calculator.’ (Note, the calculator is only for people 30-74 with no history of heart disease.)

I was surprised that to use the CDC’s Heart Health Calculator you need only two inputs: your systolic blood pressure (the top number) and your BMI. No cholesterol input at all! And, not to worry that you don’t know your BMI – you can quickly calculate it with the simple online BMI calculator (this is the official one from the National Heart Lung and Blood Institute – frankly, googling ‘BMI calculator’ nets one that’s easier to view.)

As I said, I was stunned to see not one mention of cholesterol.

OK, I thought. Let me give it a go anyway – even with no cholesterol input. Given that I am not a smoker, and don’t have diabetes (the other inputs on this heart age calculator), I expected that my calculated heart age would be lower than my actual age, because I’m fit, with normal blood pressure.

I was stunned to find heart age using this calculator exactly equalled my actual age.

How could that be? If my all-pretty-positive inputs into the calculator resulted in a ‘same as age’ heart age result, that must mean that many (most?) using this calculator must end up with a calculated heart age OLDER than their actual age.

Really?  Could that be true?

And why isn’t cholesterol figured into the ‘heart age’ equation?

Puzzled, I played with the inputs to see what causes the heart to ‘age’ most in this calculator.  It’s not the BMI (mine is a pretty low/normal 22) – changing that a few points didn’t affect heart age much. Turns out, the key measure must be blood pressure because changing the systolic blood pressure by just a few points had a pretty drastic effect on heart age. Thus, it seems that – at least for this ‘heart age calculator’ – high blood pressure is the most dangerous condition / ages your heart the most. Certainly more than the not-even-mentioned cholesterol.

Maybe cholesterol is missing because the medical community is still at odds over the changed 2013 Guidelines for Cholesterol Treatment (and the faction who is behind this calculator doesn’t believe cholesterol is a big deal?) Or maybe I’m reading too much into all this…

Net, while I’m not entirely positive what the key takeaway here is, it does seem prudent to continue to monitor cholesterol along with blood pressure. Because frankly, a lo-co lifestyle – exercise and diet to lower cholesterol – will also help keep blood pressure down!

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How Much Exercise For Boosting Heart Health?

Exercise is one of the key methods for lowering cholesterol – and blood pressure, my new concern — without medications. So to reduce my blood pressure and to continue to keep my cholesterol in check without any meds, I’ve been wondering just how much, how hard, and how often I need to exercise.

In researching, I found this nifty chart from the American Heart Association. It’s a little busy, but the key is the bottom-most graphic, which is for lowering cholesterol and blood pressure (how handy that they are together goal-wise!)

Apparently, to lower cholesterol and blood pressure, one needs to exercise for an average of 40 minutes at a ‘moderate-to-vigorous-intensity aerobic activity’ 3-4 days each week.

AHA Exercise Guidelines

Which sounds like kind of a lot, people.

I mean, I can jog for 20 minutes before my knees hurt – but certainly not 40 minutes (I was awed when my 21 year old son ran the Chicago marathon in 3 hours and 49 minutes. I still can’t believe he did that / that anyone can run for that long!).  So, um, 40 minutes of ‘moderate-to-vigorous’ exercise 3-4 times a week sounds like a LOT to me.

So obviously, the key question is – what is ‘moderate-to-vigorous-intensity’ aerobic activity?

To me, moderate-vigorous seems like it’d be exercise that gets my heart rate to hit at about 70-85% of my Max Heart Rate (for me, that’s 140-154 or so). If you want to know more about setting a personal heart rate goal, read How To Set A Simple Heart Rate Goal. But is that moderate or is that vigorous?

Luckily, the American Heart Association had a post that answered that exact question: Moderate to Vigorous – What is your level of intensity?  The AHA defines moderate and vigorous exercise as follows (link to the article for more detailed, pretty interesting info):

Examples of Moderate Intensity:

  • Walking briskly (3 miles per hour or faster, but not race-walking)
  • Water aerobics
  • Bicycling slower than 10 miles per hour
  • Tennis (doubles)
  • Ballroom dancing
  • General gardening

Examples of Vigorous Intensity:

  • Race walking, jogging, or running
  • Swimming laps
  • Tennis (singles)
  • Aerobic dancing
  • Bicycling 10 miles per hour or faster
  • Jumping rope
  • Heavy gardening (continuous digging or hoeing)
  • Hiking uphill or with a heavy backpack

Whew. I can walk quickly for 40 minutes to count as heart-healthy exercise. Yay – that’s one I can actually do!  But walking is kind of boring to me – and 40 minutes still feels like a lot of time.

So I need another option. One that’s vigorous but doesn’t eat into my day. Which is why I’m intrigued by High-Intensity Interval Training. In fact, this explanation of HIIT from Karen Reed of Positive Health Wellness was music to my ears, “Thanks to the non-stop, high-intensity pace of the workout, you can fit in both aerobic (cardio) and anaerobic (resistance training) exercise in just 15 to 25 minutes.” For more details, read her article, “All The Benefits of High Intensity Interval Training Workouts.”

I’d rather ramp up my exercise plan than go on blood pressure or cholesterol meds, so I’m looking at trying out High-Intensity Interval Training and/or scheduling more – or longer – aerobic exercise into my week. How about you?

 

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New Year’s Exercise Resolutions and Heart Health

If you’re like most Americans, getting more exercise is on your list of New Year’s resolutions.

And for good reason: exercise is one of the key methods for lowering cholesterol – and blood pressure, my new concern — without medications.  Oh, and that dropping weight side-benefit (ha ha) is kind of fantastic, too.

So to reduce my blood pressure and to continue to keep my cholesterol in check without any meds, I’ve been wondering just how much, how hard, and how often I need to exercise.

In researching, I found this nifty chart from the American Heart Association.  It’s a little busy, but the key is the bottom-most graphic, which is for lowering cholesterol and blood pressure (how handy that they are together goal-wise!)

Apparently, to lower cholesterol and blood pressure, one needs to exercise for an average of 40 minutes at a ‘moderate-to-vigorous-intensity aerobic activity’ 3-4 days each week.

AHA Exercise Guidelines

Which sounds like kind of a lot, people.

I mean, I like exercise and exercise more frequently than most people I know, and that sounds like a lot to me.

So obviously, the next question is – what is ‘moderate-to-vigorous-intensity’ aerobic activity?

Luckily, the American Heart Association had a post that answered that exact question: Moderate to Vigorous – What is your level of intensity?  The AHA defines moderate and vigorous exercise as follows (link to the article for more detailed, pretty interesting info):

Examples of Moderate Intensity:

  • Walking briskly (3 miles per hour or faster, but not race-walking)
  • Water aerobics
  • Bicycling slower than 10 miles per hour
  • Tennis (doubles)
  • Ballroom dancing
  • General gardening

Examples of Vigorous Intensity:

  • Race walking, jogging, or running
  • Swimming laps
  • Tennis (singles)
  • Aerobic dancing
  • Bicycling 10 miles per hour or faster
  • Jumping rope
  • Heavy gardening (continuous digging or hoeing)
  • Hiking uphill or with a heavy backpack

I found this useful, but prefer a more specific goal: for me, moderate-vigorous means my heart rate hits at about 70-85% of my Max Heart Rate (for me, that’s 140-154 or so).  If you want to know more about setting a personal heart rate goal, read How To Set A Simple Heart Rate Goal.

Since the only thing I do for exercise that lasts more than 30 minutes is walking or spin class, all this means I need to be a bit more, um, diligent about working out. Sure, I play tennis 2-3 times per week, power walk on nice days (3 miles at about 4 mph) and take spin classes – but I’m pretty clear that I’m not hitting the 40 minutes part of the 3-4 days per week goal.

One option to boost exercise without it taking too much time is High-Intensity Interval Training. This explanation of HIIT from Karen Reed of Positive Health Wellness was music to my ears, “Thanks to the non-stop, high-intensity pace of the workout, you can fit in both aerobic (cardio) and anaerobic (resistance training) exercise in just 15 to 25 minutes.” For more details, read her article, “All The Benefits of High Intensity Interval Training Workouts.”

I’d rather ramp up my exercise plan than go on blood pressure or cholesterol meds, so I’m looking at trying out High-Intensity Interval Training and/or scheduling more – or longer – aerobic exercise into my week. How about you?

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Cholesterol Results 2014

So I finally bucked up and got my cholesterol tested in November and the results were surprising.  First of all, my cholesterol – after a year of reasonably careful eating and a lot more exercise, but no Metamucil or Fish Oil pills – actually moved in the right direction.

Details in a second.

Not only that, my new cardiologist (again, more in a sec on why I needed to finally see a cardiologist) actually called my cholesterol results “enviable.”

Enviable, people.

This shocked me. Especially because I gave up on the fish oil pills which apparently now, in a total turnaround from past belief, don’t help much with cholesterol. (It’s frustratingly difficult to keep up with what’s recommended –  and what is no long considered effective – for managing cholesterol without statins.)

That said, in the face of a genetic predisposition toward high cholesterol, I’ve managed through diet and exercise to avoid cholesterol medication.  Though truth be told, that’s more likely due to the American Heart Association’s 2013 revised Guidelines For Managing Blood Cholesterol than anything I’ve done… if the Guidelines hadn’t been revised, I’d probably still be having the statin conversation with my doctor.

In any case, here are my exciting (ha ha) cholesterol results.

My overall cholesterol is UP and now measures 246 – which used to be considered high but is apparently now not so big a deal.  Not a big deal, I guess, because my LDL (bad) cholesterol keeps falling (“goal” is less than 130 and mine is now 123) and my HDL (good) cholesterol keeps rising (“goal” is higher than 46 and mine shot up to 95).

NOTE: I put “goal” in quotes because these goals are no longer really in line with the new Guidelines; I find it fascinating that they are still reported as “goal” when the only goal according to the new guidelines is LDL (bad) cholesterol over 190 along with other heart disease risk factors that have nothing to do with cholesterol results.  Bizarre that this is still ‘outdated’ a year later.  Or maybe not bizarre, just sad.

In any case, I’m excited about the results.  Here’s a chart for those who prefer graphs.  If that’s not you, skip to cardiologist discussion 2 paragraphs below!

KLS Chol Trend Thru 2014

You’ll see the red line of total cholesterol is still high and rising – but no one seems worried about that, since the green line of LDL (bad) cholesterol is falling along with the purple triglyceride line … and because the blue line of HDL (good) cholesterol is rising.

Things certainly do change – I’m so glad I never started on a statin back in 2010-2011 when my numbers looked like a statin was in order.

Now, on to cardiologist.  My cholesterol results were surprising – and nicely so. But at same blood test I found I am positive for a blood clotting disorder, so that was a major bummer.  It’s not treated – and not dangerous unless you take hormones (which of course I was) so that had to stop immediately.

And then it turns out my blood pressure has risen quite dramatically.

Likely the stress of this past year – along with wondering and worrying about the blood clotting disorder.  Hence my doctor-referred trip to the cardiologist.

So my new cardiologist and primary care doctor are sorting out how to deal with my (hopefully short-lived) blood pressure issue … and on the plus side, I really liked the new cardiologist.  And when we discussed cardiac risk and my cholesterol trends and family history, he also thought that getting a handle on what my cardiac risk really looks like is a good idea.  So I had two more blood tests – and YAY – these are the very tests I’ve written about thinking made sense for me in Cholesterol Tests Your Doctor Hasn’t Told You About.  Finally!

So I had blood tests for both C Reactive Protein (CRP is a measure of inflammation in the body and high levels have been associated with heart disease) and also a full lipid analysis that will measure LDL density, ApoB and more.  I am really relieved to finally be getting a handle on cardiac risk.  Lastly, am debating about getting a Coronary Calcium test done – it’s a CT test so there’s radiation involved (and Aetna denied coverage) so I’ll likely wait until the blood test results come back to decide.

So on plus side, my cholesterol tests are now ‘enviable’ but am waiting for the blood test results to come back and really help hone in on cardiac disease risk. Oh, and trying to figure out how to get my blood pressure back to normal.

So I’ll end 2014 with a question for you: how’s your cholesterol? And, um, blood pressure? If you don’t know, please resolve in 2015 to have them checked.

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