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Weekly Feature: Coronary Heart Disease – Patient Targets


13 Nov 2015

It’s the final day in our CHD feature week, read on to find out what targets patients should be aiming for when managing their health.

Target levels

It’s all very well to tell patients they need to get their glucose or cholesterol levels under control, but what should they be aiming for?

  • Blood pressure in those on hypertension treatment should be below 140/90mmHg if under 80 years of age, or below 150/90mmHg if older. For others, a BP in excess of 160/100mmHg usually warrants medication, anyone with a reading in the range 140/90-160/100mmHg requires medication if they have other risk factors for cardiovascular disease or should try lifestyle measures if they haven’t. While 120/80mmHg is considered ‘normal’, anything below 130/80mmHg is not usually considered a problem. Anyone in the range 130/80-140/90mmHg should be monitored once a year or so and take self-care steps to try and bring it down.
  • Blood glucose before meals should be in the range 4-6mmol/l, and after meals no higher than 10mmol/l. A glycated haemoglobin level (HbA1c) below 48mmol/mol generally means diabetes is well controlled.
  • Total cholesterol levels should be 5mmol/l of less for healthy adults, and 4mmol/l or less for those at high risk of complications. The target low density lipoprotein (LDL) cholesterol is 3mmo/l or less for healthy adults, and 2mmol/l or less for those at high risk. HDL cholesterol should be above 1mmol/l, with a total cholesterol to HDL ratio of below four.
  • BMI is the most widely used way to classify whether someone’s weight is healthy in relation to their height. In adults, a BMI of 19-24.9 is healthy, 25-29.9 is overweight, 30-39.9 signifies obesity, and over 40 denotes severe obesity. Because BMI in isolation can sometimes be misleading – a very muscular person may have a high BMI with no fat to spare – it is sometimes considered in conjunction with waist circumference. In men, a waist measurement of 94cm or more is considered a problem, whereas in women, anything upwards from 80cm is regarded as unhealthy.

Note: Every patient is different, and target levels should be individualised so the figures given above should be used as a guide only.

 


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