It likely comes as no surprise that your heart is one of the most vital organs in your body. Each and every day of your life the relatively small but mighty organ beats on average 100,000 times and pumps about 2,000 gallons of blood through your body. Beyond its fascinating non-stop expansion and contraction, a person's cardiovascular health can often indicate a lot about their health and wellbeing in general.
In the United States, heart disease continues to be the leading cause of death for Americans. While we know many of the common risk factors associated with heart disease include things such as smoking, high blood pressure, high cholesterol, diabetes, limited physical activity, and poor diet, a recent study found that even groups traditionally thought of as “low risk” for having metabolic and heart health issues had shockingly high levels of poor metabolic health – with less than a third of adults of a normal weight being deemed “metabolically healthy”.
These findings suggest it takes more than just mitigating risk to truly optimize our metabolic and heart health . Given the resources and technology we now have to better track our heart rate, blood sugar, blood pressure, and other early warning signs of cardiovascular disease, there are many ways to stay on top of preventing heart disease:
One of the best ways to understand your heart health and how it is changing over time is by getting comprehensive labs drawn regularly (more than just the standard one time per year). Labs help improve the detection of heart disease by analyzing your blood for substances that normally are not present or measure markers that can indicate the early signs of or presence of disease in the body.
Having more frequent data points for heart health such as your cholesterol levels, low-density lipoprotein (LDL), high-density lipoprotein (HDL), C-reactive protein (CRP), homocysteine, fasting insulin, fasting blood sugar, hemoglobin A1C, and triglycerides can paint a thorough picture for your physician regarding what your metabolic health and markers looks like . At Parsley Health , our clinicians may recommend getting labs drawn a few times throughout the year and they look at specific measures of heart health that many doctors don’t include in standard labs. For example, we look at small dense LDL particles— which tell a different story than just LDL in general. These denser particles are associated with a two to three-fold increased risk of CVD. Having more regular data points around the picture of your heart health and more comprehensive markers to track heart disease precursors can help your physician stay ahead of early signs of CVD and increase the likelihood of catching heart disease before it progresses.
Your resting heart rate, when considered in the context of other heart health markers such as your blood pressure, blood sugar, and cholesterol, can help identify potential health problems. A normal resting heart rate for adults is about 60 to 100 beats per minute. In general, a lower heart rate at rest implies more efficient heart function and better cardiovascular fitness, which is associated with reduced rates of cardiovascular events such as heart attacks. For those at the high end of the 60-100 beats per minute range, research suggests that there may be an increased risk for cardiovascular disease and even early death. In a recent study, high resting heart rate was correlated with elevated blood pressure, less physical activity, and increased body weight.
Measuring your resting heart rate can be as simple as placing your index and third fingers on your neck or thumb side of your wrist (wherever you feel a stronger pulse) and using a watch to count the number of beats you feel in 60 seconds. For a more ongoing and accurate monitoring of your resting heart rate, however, wearable tracking devices provide heart rate monitoring features that can help you to understand your heart rate more regularly throughout the day and in response to things like stress, alcohol consumption, sleep habits, and exercise.
In addition to your heart rate, some wearables feature a special measure called heart rate variability (HRV) which refers to the variation in time between each heartbeat. Beyond just understanding what your heart rate is at any given minute, heart rate variability may help to paint a more comprehensive picture of your heart health. In general, high HRV is associated with general fitness and sufficient recovery, and low HRV is associated with too much stress or overtraining. Research suggests that exercising is one of the best ways to improve HRV. Many fitness wearables make it easy to track HRV such as the Oura Ring and Whoop strap .
Patterns in your blood sugar can say a lot about your risk for developing heart disease . Blood sugar levels refer to the amount of glucose in your blood and when these levels remain elevated over time, this increase in glucose in the bloodstream can cause diabetes and damage the blood vessels and nerves that control your heart.
Basic blood work ordered by most primary care physicians will usually include a test for hemoglobin A1C, which can indicate how well your body has regulated blood sugar on average over the last 90 days. Levels above 5.7% indicate a high level of glycation and poor insulin control. However, many people aren’t getting their labs taken often enough to understand how their blood sugar might be changing over time – especially considering blood sugar levels can change every three months. Beyond that, hemoglobin A1C doesn’t tell the full story of someone’s blood sugar which is why at Parsley Health we also test for fasting glucose and fasting insulin at least once if not twice a year, both of which can reveal a blood sugar issue long before an A1C test will.
Beyond lab testing, continuous glucose monitoring is also an option to help see how your food intake, sleep, stress, and physical activity is actually impacting your blood sugar on a more granular level. A continuous glucose monitor is a device used to track blood sugar throughout the day and night typically over a 2-week period. This offers you the opportunity to see patterns and trends to better manage your glucose levels in real time. Our doctors consider optimal ranges for glucose readings to be a fasting morning glucose between 75 and 85 mg/dL and post-meal sugars to ideally be less than 140 mg/dL one hour after a meal and less than 120 mg/dL two hours after a meal. Post meal blood sugars are one of the best ways to indicate your risk for diabetes and heart disease.
Elevated blood pressure, also known as hypertension, is known as a major risk factor for developing heart disease. As a general guide, normal blood pressure is considered to be between 90/60mmHg and 120/80mmHg. At Parsley Health our clinicians consider optimal blood pressure to be about 110/70mmHg. For those that have less than optimal blood pressure levels, our clinicians may recommend keeping a blood pressure diary to help paint a better picture of understanding blood pressure patterns. Oftentimes a single datapoint at an annual visit tells us very little about your blood pressure in general – especially when confounded with white coat syndrome, the phenomenon that blood pressure is more likely to be elevated in a medical setting than in other settings.
To keep a blood pressure diary, our providers recommend members take their blood pressure at home before bed and immediately upon waking two to three times per week for at least a month. These numbers should then be logged and discussed with your clinician at your next visit. At-home blood pressure cuffs are readily available at your local pharmacy, a medical supply store, and online for purchase. Similar to all the tracking tools above, having ongoing monitoring of important heart health factors such as blood pressure can be instrumental in optimizing heart health and preventing heart disease.
If your blood pressure does seem to be persistently elevated, your clinician can help you to lower your blood pressure safely while making the appropriate supplement and/or medication suggestions. Additionally, your health coach can support you in making evidence-based lifestyle changes that can help to improve blood pressure such as adopting a whole foods based diet rich in minerals such as potassium and magnesium, reducing alcohol consumption, learning better tools to manage stress such as meditation and deep breathing exercises, reducing caffeine intake, and engaging in more regular physical activity.
Important measures of heart health such as your heart rate, blood sugar, blood pressure, and heart-related lab values can be tracked more regularly and consistently to keep a closer eye on key factors that help to detect early signs of cardiovascular disease. At Parsley Health , providers do a deep dive into your lab tests, recommend blood sugar and blood pressure monitoring when appropriate, and make actionable and targeted recommendations to your specific diet and lifestyle based on data unique to you. By keeping an eye on these measures, and making appropriate lifestyle changes, you can improve your heart health and potentially prevent disease, rather than treating it after it develops.
Kelly Johnston is a registered Dietitian Nutritionist with six years of experience in the health and wellness field, four of which have been spent right here at Parsley Health supporting members with everything from gut issues and autoimmune disease to cardiometabolic health concerns and fertility. She holds a Master's of Science in Nutrition from one of the leading science-based natural medicine schools in the country, Bastyr University, and completed her dietetic internship at Sea Mar Community Health Center in Seattle, WA.