Prakash Chandran (Host): Welcome to BayCare HealthChat. I'm Prakash Chandran. And in this episode, we'll be talking about key markers of health, like cholesterol, blood pressure, blood sugar and body mass index, and how to keep them within a healthy range. Joining us to discuss is Dr. Ernest Gilmore, an internist with BayCare Health System. So Dr. Gilmore, thank you so much for joining us today. We really appreciate your time. I wanted to get started by asking why exactly is it so important to know your health numbers?

Dr. Ernest Gilmore: Well, thank you for inviting me. I think the main reason to know some important health numbers is because many of them correlate well with long-term health outcomes, as well as risk for long-term complications and also severity of different disease processes.

Host: That makes sense. So when we talk about the health numbers, can you talk at a high level around the most important ones to track?

Dr. Ernest Gilmore: Yes. Every visit to your doctor will start off with a measurement of vital signs, which will include a blood pressure measurement. So, that's probably where I would start. But also, blood sugar, another blood test called the hemoglobin A1c, which is a marker for diabetes. And then, things like body mass index, which correlates well with weight and long-term outcomes from obesity are just some of the numbers.

Host: Yeah. It's like taking your car in for a checkup. You want to check the oil levels, you want to check the tire pressure, you want to check things of that nature. In that same way, you want to do the same thing with the human body, right?

Dr. Ernest Gilmore: That's correct. Yeah, they provide a lot of helpful information.

Host: Okay. So, you know one of the first things that you mentioned was blood pressure. Can you tell us what healthy blood pressure numbers are?

Dr. Ernest Gilmore: Yeah. By the current guidelines, which were sort of rewritten in 2017 by the American Heart Association, American College of Cardiology, normal blood pressure is 120 on the top number, systolic number; and 80 on the bottom, so less than 120/80. Whereas elevated is 120 to 129 over 80. Stage one high blood pressure is 130 to 139 over 80 to 89. And stage two is greater than 140/90.

Host: Okay. And what are some of the contributors to high blood pressure?

Dr. Ernest Gilmore: Yeah, that's a great question. So, a number of things and a number of interventions can be done to sort of reduce blood pressure. But things that can be associated with high blood pressure are weight, excess body weight correlates. The higher the weight generally, the higher the blood pressure. Alcohol intake, generally greater than two drinks a day for a man or one drink a day for a woman can contribute to high blood pressure. High salt intake can contribute to high blood pressure.

Host: Okay. That's helpful to know. So, you were talking about these lifestyle decisions and making sure that you are healthy. That healthy range that you're talking about 120/80 or somewhere around there is probably where you want to aim for. Is that correct?

Dr. Ernest Gilmore: That's correct, yes.

Host: Okay. Let's move on to your cholesterol levels. Talk to us about what that means and what's a healthy level.

Dr. Ernest Gilmore: Cholesterol is a substance found in many body tissues and it's necessary. But when it’s high in the blood, it correlates with the risk of cardiovascular disease. And the main two things it probably contributes to that people are aware of are heart attack and stroke. So, the normal cholesterol is less than 200 and high is greater than that, but it's broken down into LDL. LDL is low density lipoprotein. I think of it as lousy. That's the one that contributes to plaque formation. HDL is the healthy type. And then, there's the triglycerides. Those usually are the four things that come when you get a lipid panel checked by your doctor. And so, the goal, generally speaking, and it depends on whether or not you have a history of heart disease or underlying vascular disease to start with, but generally speaking, you would want to shoot for a total cholesterol less than 200 and an LDL cholesterol less than 130.

Host: Okay. So when we talk about controlling your cholesterol levels, what does that look like? Is that the healthy lifestyle that you were talking about earlier? Maybe let's discuss that for a second.

Dr. Ernest Gilmore: Yes. Again, there are a number of things that people can do to lower their cholesterol. Probably the most important things are proper diet, and that would be a diet that tends to be low in what's called saturated fats and diets higher in fruits, vegetables, whole grains, things like that. All that can help lower cholesterol. Regular exercise, and it doesn't necessarily have to be a specific type of exercise as long as a person is consistent in staying with it four to five times a week that can both lower the bad or LDL cholesterol and increase the HDL or healthy cholesterol.

Host: Got it. Okay. Now, moving on to the third thing you talked about, which was blood sugars. Talk to us about what blood sugars are and what the healthy range should be there.

Dr. Ernest Gilmore: Okay. So, blood sugar generally should be less than 100 fasting. And the other main number people will know or should know there, especially if have a family history of diabetes or at risk for diabetes is a number called the A1c, as that number is almost as if we could average up blood sugars for three months and get an average blood sugar over the previous three months. So, the blood sugar should be less than a hundred, 100 to 126 is considered prediabetes. And then, greater than 126 fasting would be consistent with diabetes. And the A1c number people should know is that number normal is less than 5.7. Prediabetes is 5.7 to 6.4. And then, diabetes is 6.5 or greater.

Host: And then finally, we talked about the BMI levels. You know, there's all of these different numbers that we're talking about, whether it ranges from blood pressure all the way to blood sugar. But BMI is a little bit different. Can you talk about what BMI is and what it indicates?

Dr. Ernest Gilmore: Yeah. BMI is a number called the body mass index, and there are tables, you can calculate, you can just do an internet search and you can enter in your height and weight and find out your BMI. And the reason BMI is important is it correlates well with long-term health outcomes and risk for certain disease. A normal BMI would be 18.5 to 24.9. And then, overweight is 25 to 29.9. And then you get obesity which is greater than 30. And obesity is divided into three different classes. Class 1, which is 30 to 34.9; 2, which is 35 to 39.9; and class 3 or severe obesity, which is 40 or greater.

Host: Okay. So, you've mentioned like a lot of these healthy ranges across all of the different health numbers that we're talking about. Does that change with age or does that remain relatively consistent?

Dr. Ernest Gilmore: That's a good question. I would say the one that does typically change more with age, independent of anything else, is high blood pressure increases with age, hardening of the arteries contributes to high blood pressure. So, you do get some increase in that with aging. I would say not necessarily diabetes and cholesterol, that would be much more probably stable over a period of years if the weight and diet and exercise patterns remain stable.

Host: Okay. Understood. And finally, just before we close, you know, we've talked about all these healthy ranges here today, if there's one thing that you know to be true that you wish more people would know about their health numbers, what would that be?

Dr. Ernest Gilmore: I think probably just given it's been termed an epidemic of obesity in the United States, I would say the BMI and the risk that an elevated BMI can carry to the health. I mean, obviously, there's an increased cardiovascular risk, increased risk for heart attack and stroke, increased risk for diabetes, it correlates well with blood pressure. And in fact, lowering blood pressure, really for about every two pounds of weight loss, the blood pressure will lower one to two millimeters. And elevated body mass index can also be associated with a number of different slight increase risk in a number of different types of cancer. So, I think trying to shoot for maintaining an ideal body mass index is very important. All of them are important, but that probably would be the biggest overarching message I would give.

Host: Well, Dr. Gilmore, I think that is the perfect place to end. Thank you so much for your time today.

Dr. Ernest Gilmore: Thank you so much for having me.

Host: And that wraps up this episode of BayCare HealthChat. Head on over to our website at BayCare.org for more information and to get connected with one of our providers. Please remember to subscribe, rate and review this podcast and all other BayCare podcasts. For more health tips and updates, please follow us on your social channels. Thanks again for listening. My name is Prakash Chandran. Stay well.