Calories, step count and waist size – there’s no shortage of things that can be measured to determine how fit someone is.
But just four are the key to knowing if you’re healthy in middle age, doctors say.
Keeping blood pressure, blood sugar, BMI and cholesterol under control can be the difference between staying healthy or suffering from diabetes, hypertension or a heart attack.
And it’s even more important to keep these “building blocks” of cardiovascular health just right in your 40s.
Here, based in London General practitioner dr. Ann Nainan shares how to track these health metrics and why they’re so important.
Keeping your blood pressure, blood sugar, BMI and cholesterol under control could be the difference between staying healthy or getting diabetes, hypertension or having a heart attack, doctors say
Blood pressure
High blood pressure, also called hypertension, can be a silent killer.
In most cases it is unclear what causes it, although being overweight, eating too much salt and not getting enough exercise are known risk factors.
Because it puts extra pressure on organs, including the blood vessels, heart, and brain, it can increase the risk of heart attacks, strokes, and dementia.
The condition, which affects about one in four adults in the UK, usually causes no symptoms. However, those with a very high reading may experience headaches, blurred or double vision, frequent nosebleeds, or shortness of breath.
A blood pressure test is the only way to get a reading. Those aged 40 to 74 in England are offered a blood pressure check every five years on the NHS.
‘If your blood pressure is high you may not have any symptoms, so it’s worth seeing your GP for your annual checkups,’ says Dr Nainan.
“But if it’s very high, in rare cases you can get a headache, vomiting and dizziness.” You can also experience vision changes if it gets very high.’
Low blood pressure is usually not a problem, but in some cases it can cause fainting and dizziness.
Dr. Nainan added: ‘If your cardiovascular health is poor, things like stroke and heart attack are more likely, along with an overall less healthy life.
‘If you are dizzy and confused and your vision changes, you will also be unable to go about your daily life.
“As you get older, taking care of your heart makes a big difference to things like blood pressure. As you get older, it becomes more important to take care of it because you’re more likely to have elevated blood pressure.”
How is it measured?
Blood pressure is measured in millimeters of mercury (mmHg).
The result is given as two numbers, systolic and diastolic.
Systolic refers to the pressure when the heart pushes blood out and around the body. It is the highest number in a measurement.
Diastolic is the pressure when the heart is resting between beats and pushing blood around the heart. This measurement is the bottom number.
A normal blood pressure reading is considered to be between 90/60 mmHg and 120/80 mmHg.
If it is 135/85 mmHg or higher it is considered high and below 89/59 mmHg it is low blood pressure.
Hypertension has no noticeable symptoms and can be difficult to recognize without testing blood pressure
How do you solve it?
Simple lifestyle changes can help lower blood pressure.
The NHS recommends cutting back on salt, losing weight if you’re overweight, exercising regularly, drinking less caffeine and not smoking.
Dr. Nainan advises patients with high blood pressure to prioritize sleeping, eating a healthy diet, drinking plenty of water, walking and resting to reduce stress.
She added: ‘It’s not just your blood pressure that dictates your heart health, it’s your age, sugar, your cholesterol and your BMI. These are the building blocks of your cardiovascular health.’
Blood sugar
High blood sugar levels can be an indicator of type 2 diabetes.
Excessive thirst, frequent urination, tiredness and blurred vision are all telltale signs of the condition, which affects 4.3 million Britons.
It occurs when the body doesn’t make enough insulin or the body’s cells don’t respond properly to the hormone.
A simple blood test that checks glucose levels is used to detect pre-diabetes and type 2 diabetes.
However, only people with type 2 diabetes symptoms need a blood test to check their levels.
Dr. Nainan said, “Usually you don’t need a blood sugar check unless your GP asks for it.”
Feeling more thirsty than usual, urinating a lot, feeling tired, blurred vision, and losing weight are all symptoms of high blood sugar. Image shows finger prick Glucose blood test
How is it measured?
There are several tests that can check blood sugar levels, both at home and by a doctor.
Glucose blood test shows your current blood sugar level, which can change throughout the day. This is simply done with a finger prick test.
‘The fingerstick test simply shows what your blood sugar level is at that moment. So we don’t usually use it for diabetes diagnosis, we just use it as a clue to that,” says Dr. Nainan.
But the more accurate test is the Hba1C blood test which can calculate average blood glucose over three months.
A normal Hba1C test is considered to be below 42.
Anything between 42 and 47 indicates hyperglycemia or pre-diabetes, if it’s over 48 it could mean you have diabetes.
How do you solve it?
A healthy diet is key to controlling blood sugar.
The NHS tells type 2 diabetes patients to keep sugar, fat and salt to a minimum.
It also suggests exercising, lowering stress levels and losing weight if you are overweight.
Dr. Nainan said: ‘Getting enough sleep, eating a healthy diet, drinking plenty of water and reducing stress can help lower blood sugar levels. But change in diet is one of the most important factors of type 2 diabetes.’
cholesterol
Cholesterol is a fatty substance that can accumulate in the blood.
It is mainly caused by eating too much fat, not exercising enough, being overweight, smoking and drinking alcohol, although it can also run in families.
When levels are too high, the waxy substance can block your arteries, increasing your risk of heart problems or stroke.
However, it can be difficult to recognize without testing.
Dr. Nainan said, “Usually you don’t get any symptoms of high cholesterol. But if you have very high cholesterol and it runs in your family, you can get color changes in the eyes and skin, especially on the face.’
In rare cases, it can cause white rings around the cornea — the clear outer layer at the front of the eye — or a yellow or orange growth on the skin, usually under the eyes.
Too much cholesterol can block your arteries, making you more likely to have heart problems or stroke
How is it measured?
A blood test can usually show your cholesterol levels, and some doctors may ask you to fast beforehand to get an accurate reading.
“When we look at cholesterol, we look at multiple components. Your total cholesterol, which is the amount of good and bad cholesterol you have, we look at the good cholesterol, which is the HDL, and we look at your LDL, which is the good cholesterol,” says Dr. Nainan.
She added, “If you have high total cholesterol, but you have a lot of good cholesterol in your system, we would be less concerned.
‘We could make a ratio of how much good cholesterol you have versus bad.
“For example, many athletes have high cholesterol, but a lot of it is good cholesterol.”
Total cholesterol should be 5 mmoI/L or lower, while the ratio of total cholesterol to HDL cholesterol should be less than six.
HDL, which is a good cholesterol, should be 1 mmoI/L or higher for men and slightly higher, which is 1.2 mmoI/L or higher for women.
The bad cholesterol, known as non-HDL, should be 4 mmoI/L or lower.
How do you solve it?
A change in diet and medication can help bring cholesterol to a healthy level, Dr. Nainan says.
However, if it runs in a family, it can be difficult to lower cholesterol.
But eating healthier, exercising, and reducing stress will help most. Some patients are prescribed drugs to lower it.
Reducing fatty processed foods – such as sausages, cheese, cakes and biscuits – and eating more nuts and fatty fish is recommended.
BMI
Obesity has a domino effect on your health.
‘Being overweight can have an effect on your quality of life, your cardiovascular risk, risk of heart attacks, strokes, diabetes and even some cancers such as colon, thyroid and breast cancer,’ says Dr Nainan.
Weighing too much can also cause an increase in sex and growth hormones and inflammation, which have been linked to 13 types of cancer, says Cancer Research UK.
According to the NHS, it is estimated that one in four adults in the UK is obese.
According to the NHS, it is estimated that one in four adults in the UK is obese
How is it measured?
BMI is the most commonly used method to check whether you have a healthy weight.
It is measured by taking your height and your weight.
But many experts emphasize that this method has its limitations, as it measures whether a person is carrying too much weight, but not too much fat.
Dr. Nainan said: ‘For BMI, we should consider age, ethnicity and gender. It’s not for everyone; it’s more of a rough estimate to give us clues as to where to look. It could just be an indicator.
The NHS says a BMI of 18.5 is underweight, 18.5 to 24.9 is a healthy weight, 25 to 29.9 is overweight and 30 and above is obese.
How do you solve it?
The best way to lower your BMI if you are overweight is to eat a healthy low-calorie diet and exercise regularly.
“If you’re trying to lose or gain weight, always try to take small steps rather than big dietary changes,” says Dr. Nainan.
She added, “Just start small and build on small, steady habits. Drastic overnight changes can be very difficult to sustain in the long run.”