Answers to Common Questions

Know Your Numbers

Find out which numbers and levels everyone should know and what they can tell us about our heart health.

  • What is a healthy waist circumference?
  • Waist circumference is an important tool used to assess an individual’s weight. A healthy waist circumference is less than 35 inches for women and less than 40 inches for men. Having too much fat in the waist and abdomen has been linked to increased risk for heart disease and other serious conditions, so maintaining a healthy waist circumference is important to promoting good health.
  • At what age should I worry about my cholesterol?
  • More than one-third of Americans have high cholesterol and risk for high cholesterol increases with age. However, high cholesterol can be a problem at any age. It’s estimated that 22% of adults in their 20s have high cholesterol and 62% of adults in their 50s have high cholesterol. It’s important to have cholesterol checked regularly and make healthy lifestyle choices like eating healthy and staying active, which help control cholesterol levels.
  • What is hypertension?
  • Hypertension, often referred to as high blood pressure, occurs when the force of blood against the artery walls is too high. High blood pressure is often referred to as the “silent killer,” because it often causes no symptoms and if left uncontrolled, increases risk for heart attack and stroke.
  • What is a cardiovascular risk estimate?
  • To identify patients at increased risk for heart disease, doctors use tools to estimate a person’s short and long-term risk of heart disease. These tools take into account factors closely related to cardiovascular risk, such as age, sex, cholesterol and smoking status, to estimate risk of developing heart disease in a given time period. Most estimates calculate short-term risk (risk of developing heart disease in the next 10 years) or long-term risk (risk of developing heart disease in an entire lifetime).
  • How can I reduce my risk for heart disease?
  • Healthy lifestyle choices are key to reducing risk for heart disease. By eating a heart-healthy diet and staying physically active, you can help significantly reduce heart disease risk. Knowing your numbers—body mass index, blood pressure, cholesterol, and blood sugar—and family history is also important so that you can address any risk factors you may have for heart disease.
  • Why is it important to know your BMI and waist circumference?
  • BMI can be helpful in determining if you’re a healthy weight or not, but it’s not 100% accurate. If you have very little or very high amounts of muscle, your BMI will be skewed. Also, research has shown that how we carry weight is more important than our BMI when it comes to risk for heart disease. Belly fat is a known risk factor for heart disease and carrying excess weight around the midsection raises cardiovascular risk, regardless of BMI.
  • What is depression?
  • Clinical depression is a mood disorder that causes feelings of sadness, loss and anger to interfere with one’s daily life. Although the cause for depression is generally unknown, depression is often treated with antidepressants and/or talk therapy with a professional.
  • What if I have tried to learn more about my health but still have trouble understanding?
  • Patients who have trouble understanding their health conditions should ask for help from their health care team, whether it's a doctor, nurse or counselor. Health care providers can help point patients to a variety of resources that can cater to individual needs.
  • How are liprotein-a levels tested?

  • Lipoprotein-a can be measured with a simple blood test, similar to blood tests for other types of cholesterol.
  • How do risk factors that we can't control affect lifetime risk of heart disease?

  • Risk factors like blood pressure, cholesterol, smoking status and diabetes status  are controllable through lifestyle changes and working with your doctor. Although there are risk factors that are out of our control, such as family history, patients can still greatly reduce their cardiovascular risk by addressing risk factors that they can control.

  • How do home blood pressure monitors work?

  • There are two main types of home blood pressure monitors that patients can use to track their blood pressure on their own—manual and automatic. Manual blood pressure monitors are similar to those that doctors might use to take your blood pressure, while automatic monitors are electronic monitors that can report your numbers digitally and even integrate with other digital health tools. Both can be very easy to use and useful in helping monitor blood pressure in between doctor visits.

  • What is the difference between hypertension and prehypertension?

  • Those considered “prehypertensive” have blood pressure levels greater than what’s considered “normal,” but not high enough to be considered hypertensive. For most adults, normal blood pressure is a systolic (top number) less than 120 and a diastolic (bottom number) less than 80.
  • What factors impact lipoprotein-a levels?

  • Research has shown that lipoprotein-a is genetic, and some are predisposed to have very high levels while others have very little. Although no medications have been proven to lower lipoprotein-a, lifestyle changes and medications, such as statins, can still help lower cardiovascular risk in high risk patients.
  • Who is at risk for high blood pressure?
  • Risk for hypertension increases with age, and most adults will eventually be affected by this condition at some time in their lives. However, diabetes, obesity, stress, high sodium intake, tobacco use and excessive alcohol use can greatly increase risk for high blood pressure.
  • Why is hypertension so common in older individuals?

  • As arteries harden with age, systolic blood pressure increases, which measures the amount of pressure exerted on arteries and vessels by blood pumping through the body. The normal range for systolic blood pressure is 90-120mmHg in adults, and under 140mmHg in older individuals.
  • How accurate is nutritional information in fast-food and sit-down restaurants?

  • A recent study found that nutritional information is more accurate in fast-food restaurants than sit-down restaurants. Experts suggest that fast-food nutritional information may be more accurate because the food is in exact portion sizes, often in containers. In sit-down restaurants, food is served on a plate with less-regulated portions. They also found that foods with lower-stated caloric content had higher actual caloric content, while foods with higher-stated caloric content had lower actual calorie content. Interestingly, side dishes in sit-down restaurants tended to have more calories than stated, rather than the entrees they accompanied.
  • Why should blood pressure be measured on at least three separate occasions to diagnose hypertension in older individuals?
  • There are many factors that can impact blood pressure measurements in older individuals. For example, white-coat hypertension is common among older individuals, where blood pressure temporarily increases in patients due to the stress of being seen by a healthcare provider. At least one type of home blood pressure monitoring is recommended to rule out this phenomenon. Other factors that can affect blood pressure in older individuals include taking measurements while patient is standing vs. sitting, as well as the time allowed for the patient to rest before taking blood pressure.
  • What do my blood pressure numbers mean?
  • Your blood pressure reading has two parts. The top number (systolic) represents the pressure of the blood against your arteries when your heart contracts. The lower number (diastolic) is the pressure between beats when your heart muscle relaxes. Both numbers are important.  Your doctor or nurse can check your blood pressure during an office visit. You can also measure your blood pressure yourself with a home device. Keep in mind that your blood pressure will rise and fall depending on the time of the day and how active you are.  It is more accurate to look at overall trends rather than a single number.

    Blood pressure is directly associated with the risk of cardiovascular disease.  Ideal blood pressure is below 120/80. Your risk goes up proportionally as your blood pressure rises above that level.  If your blood pressure is elevated, your doctor will recommend that you make changes to your diet and exercise habits. You may also need to take blood pressure lowering medicines.


    Systolic (mm Hg) 

    Diastolic (mm Hg)



    less than 120

    less than 80





        Stage 1



        Stage 2

    160 or higher

    100 or higher

  • Are there any differences observed in lifetime heart disease risk trends between men and women?

  • Researchers have found that having fewer risk factors earlier in life can help greatly reduce long-term cardiovascular risk until the age of 80, regardless of gender. However, the level of risk reduction varied by each outcome, such as heart attack or stroke. For example, men were more likely to have a heart attack than women, while women were more likely to have a stroke than men. However, among both men and women alike, having an optimal risk profile earlier in life greatly reduces risk of all cardiovascular outcomes in comparison with having two or more risk factors.
  • What else can I do to control my blood pressure?

  • Making dietary changes to reduce sodium intake is a big part of blood pressure control.  But, there are other things you can do to help lower your blood pressure and improve your heart health.  Here are a few:

    • Lose weight if you’re overweight.
    • Get regular exercise
    • Limit alcohol to no more than one drink per day for women or two drinks a day for men.
    • Check your blood pressure regularly and work to stay within your target range.
    • Take your blood pressure medicine the way your doctor has directed.
  • What is a healthy blood pressure?

  • For adults, a healthy blood pressure is less than 120/80 mmHg. Blood pressure is considered elevated between 120–139 mmHg systolic (top number) or between 80–89 mmHg diastolic. Chronic high blood pressure, known as hypertension, occurs when systolic blood pressure is more than 140 mmHg or the diastolic systolic blood pressure is more than 90 mmHg.
  • How often should I see my primary care doctor?

  • Most guidelines suggest that individuals of all ages should see their primary care provider once each year, at a minimum. However, those with family history of conditions, such as heart disease, or pre-existing health conditions may need to see their healthcare provider more often.
  • How can Americans help reduce their cardiovascular risk?

  • There are a variety of ways that Americans can reduce their cardiovascular risk. Given the obesity epidemic among children, increasing physical activity and improving diet are key for weight reduction and control. Among adults, lifestyle changes such as exercise, improved diet, stress reduction and quitting smoking are important. And for those with risk factors such as high blood pressure or diabetes, it is important to work with a health care provider to manage these conditions.
  • Does cardiovascular risk differ among different races or ethnicities?

  • Yes. Research from 2012 shows that African-American adults have among the highest rates of hypertension in the world (44% vs. 33.5% of U.S. adults). African-Americans, Mexican-Americans, Hispanic/Latino individuals and other ethnic minorities are also disproportionately affected by diabetes, and Mexican-American and African American children are disproportionately affected by overweight and obesity.