The health numbers to know – and the ones to ignore
As we get older, our health stats can flag early signs of conditions such as heart disease and diabetes. We explain which ones matter and which don’t.
As we get older, our health stats can flag early signs of conditions such as heart disease and diabetes. We explain which ones matter and which don’t.
“Lose weight” is a perennial New Year’s resolution. And at this time of the year, most of us can reel off our weight to the nearest pound or kilo. But, for all our obsession with the number on the scales, it reveals surprisingly little about our true health.
“We are strangely obsessed with the wrong numbers,” says Dr Robert Galloway, A&E consultant at University Hospitals Sussex NHS Trust and honorary clinical professor at Brighton and Sussex Medical School.
Dr Galloway points out that weight alone is one of the least useful numbers, especially in later life. “It does not reveal where fat is stored, how healthy your heart is, or what is happening inside your blood vessels,” he says.
“Two people can weigh exactly the same and yet have completely different risks of heart disease, diabetes or dementia. In fact, if you had to forget one number, weight would be a good place to start.”
So, what are the numbers we should know? And how can we best monitor them?
WHtR measures the amount of fat around your middle, and is simple to calculate. It’s a far more reliable metric than weight – or even Body Mass Index (BMI), which is useful for populations but less helpful for individuals.
“Fat stored around the abdomen – so-called visceral fat – drives inflammation, insulin resistance and cardiovascular disease, so, unlike BMI, it reflects real risk,” explains Dr Galloway. It’s part of a cluster of linked risk factors (others being cholesterol, BP and blood glucose) associated with a higher risk of heart disease, stroke and type-2 diabetes.
Wrap a tape measure around your waist (midway between the ribs and hips) just above your belly button. Divide that number by your height, sticking to either centimetres or inches for consistency.
Less than half your height.
| Waist-to-height ratio | What it means |
|---|---|
|
0.4 – 0.49
|
Healthy range
|
|
0.5 – 0.59
|
Higher risk of health problems
|
|
0.6–plus
|
Highest risk of health problems
|
One in two strokes and heart attacks are linked to high BP or hypertension, which is the force of blood pushing against your artery walls as your heart pumps it around your body.
BP is measured by two numbers: systolic (top number, the pressure in your arteries as your heart beats) and diastolic (bottom number, the pressure in your arteries between beats).
“High blood pressure often has no symptoms, so the only way to identify it is to measure it,” says Dr Pauline Swift, Chair of Blood Pressure UK.
“That’s because uncontrolled blood pressure quietly damages your arteries and organs over time, increasing the risk of heart attack, stroke, heart failure and kidney disease.”
“You can get an accurate check at your GP surgery or at many community pharmacies, and for most people these are good options,” says Dr Swift. “This is one number where home monitoring can be even better, because it reflects your usual day-to-day blood pressure rather than a single reading taken when you might be feeling rushed or anxious.
“Choose a clinically validated monitor – ideally an upper-arm device, as wrist monitors are more prone to error. Make sure the cuff fits properly, sit quietly for five minutes, keep your arm supported at heart level, then take two readings a minute apart and record the average.”
The ideal is under 120/80. High blood pressure is over 140/90 mmHg (or 135/85 mmHg measured at home). For over-80s, the ideal blood pressure is below 150/90 (145/85 at home).
| BP reading (mmHg) | What it means |
|---|---|
|
90/60 – 120/180
|
Ideal
|
|
120/80 – 140/90
|
Pre-high BP / “high-normal”
|
|
140/90–plus (135/85–plus at home)
|
High BP – highest risk
|
|
90/60 or lower
|
Low BP – usually not serious but may cause symptoms
|
“Total cholesterol is a blunt measure of the health of your heart and blood vessels,” says Dr Galloway.
“Non-HDL (non-high density lipoprotein) cholesterol on the other hand, which captures all the harmful particles that cause atherosclerosis, gives a clearer picture of long-term cardiovascular risk.”
Non-HDL is the sum total of all the “bad” types of cholesterol, together with other artery-clogging particles. It is now considered a more useful measure of “bad” cholesterol than LDL (low-density lipoprotein) alone.
“Too much non-HDL can lead to a build-up of fatty deposits inside the walls of the blood vessels,” explains Emily McGrath, senior cardiac nurse at the British Heart Foundation. “This can lead to a narrowing of the blood vessels and increases the risk of a heart attack or stroke.”
“Ask your GP or practice nurse for a simple blood test. If you’re aged 40–74, cholesterol is checked as part of the NHS Health Check every five years,” says McGrath.
“We don’t recommend home cholesterol testing kits, as accurate results require a high-quality blood sample and professional interpretation.”
| Type of cholesterol | What it means |
|---|---|
|
Total cholesterol
|
5 mmol/L or below
|
|
Non-HDL cholesterol
|
4 mmol/L or below
|
|
LDL cholesterol
|
3 mmol/L or below
|
|
HDL cholesterol
|
≥1 mmol/L (men), ≥1.2 mmol/L (women)
|
|
Total cholesterol:HDL ratio
|
6 or below
|
Cholesterol is a natural fatty substance in your blood. It’s produced in the liver and also found in some foods. Having too much cholesterol in your blood can increase the risk of a heart attack and stroke.
When cholesterol and proteins in your blood naturally combine, they’re called lipoproteins. High density lipoprotein or HDL is good for your health; low density lipoprotein is bad. HDL gets rid of the LDL cholesterol from your blood by taking cholesterol you do not need back to the liver, where it is broken down and removed from your body.
HbA1c is a measure of your average blood glucose over the previous two to three months. It measures how much glucose is attached to haemoglobin, an iron-rich protein present in red blood cells.
“HbA1c shows whether you are drifting towards insulin resistance – when the body makes but is unable to use insulin as it should – years before symptoms of type-2 diabetes appear,” says Dr Galloway. “This is one of our biggest opportunities to prevent disease rather than react to it.”
Ask your GP or pharmacy. Diabetes UK warns that although a finger-prick test using a home testing kit or data from a continuous glucose monitor may reveal high blood glucose levels, it won’t confirm a diagnosis of diabetes or pre-diabetes. For that, you need a blood test sent to a laboratory.
| HbA1c number | What it means |
|---|---|
|
Below 42
|
Normal (no diabetes)
|
|
Below 42
|
Risk of hypoglycaemia (in diabetes)
|
|
42–53
|
Ideal diabetes control
|
|
53–58
|
Acceptable control
|
|
59–75
|
Review management
|
|
Above 75
|
High – increased risk of complications
|
You don’t always need to visit the GP to discover your numbers, says Professor Claire Anderson, president of the Royal Pharmaceutical Society. “Community pharmacies are often a convenient and accessible first place to start a conversation about your health and are increasingly central to preventive care.
“Many pharmacies provide blood pressure checks, and where commissioned locally, also offer cholesterol and blood glucose testing, helping you identify issues early so you can seek support.”
While home testing kits can raise awareness, Professor Anderson says they should be used cautiously. “Results vary in quality and reliability and should never replace professional testing or advice,” she explains. “If a result is high or unexpected, it’s important to follow up with a pharmacist or GP who can interpret the result properly and advise on next steps.”
Many of us pride ourselves on knowing our blood group, but it doesn’t matter a jot, says Dr Galloway. “Outside of pregnancy, transfusion medicine or very specific clinical situations, it’s almost irrelevant to everyday health,” he says. “It doesn’t help prevent disease, guide lifestyle choices or predict longevity – yet people memorise it proudly while ignoring the numbers that actually matter.
“The real shift we need to make is cultural: less fascination with meaningless numbers and more attention to the ones that actually change outcomes. The goal is not simply to collect data about your health, it is to remain around – and well enough – to care about it.”
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