1. Blue Cross and Blue Shield of Nebraska is an Independent Licensee of the Blue Cross and Blue Shield Association. Know your numbers

2. So Many Numbers! Bank accounts, PIN numbers, stock market, phone numbers, etc. 2

3. Life-Saving Numbers Blood pressure Cholesterol levels Glucose (blood sugar) Body mass index (BMI) 3

4. Blood Pressure What is blood pressure? – When blood is pumped out of your heart, it exerts a force on the walls of your arteries. – This force, along with the resistance your arteries exert as the blood passes through them, is what makes up your blood pressure. 4

5. What Do the Numbers Mean? Blood pressure is typically recorded as two numbers, written as a ratio. – Systolic pressure The first or top number is a measurement is the blood pressure in your arteries at its highest, or when your heart beats. – Diastolic pressure The second or bottom number is a measurement of your blood pressure at its lowest, or when your heart is at rest between beats. 120 mm Hg 80 “Read as 120 over 80 millimeters of mercury.” 5

6. What is a Normal Number? Systolic mm Hg (upper #) Diastolic mm Hg (lower #) NormalLess than 120andLess than 80 Prehypertension120 – 139or80 – 89 High Blood Pressure (Hypertension) Stage 1 140 – 159or90 – 99 High Blood Pressure (Hypertension) Stage 2 160 or higheror100 or higher Hypertensive Crisis (Emergency care needed) Higher than 180or Higher than 110 Source: American Heart Association 6

7. How Often Should I Have It Checked? You should have your blood pressure checked by a doctor at least every two years. If you know you have hypertension (high blood pressure) or pre-hypertension, you should have it measured more frequently. Consult your doctor as to how often. 7

8. Why Blood Pressure Matters High blood pressure (HBP) is sometimes called "the silent killer" because it has no symptoms. Uncontrolled HBP takes a toll on your arteries, heart and other organs. 8

9. Why Blood Pressure Matters Possible complications when HBP is left untreated include: – Heart and artery damage including heart attack, heart disease, congestive heart failure, aortic dissection, and atherosclerosis – Stroke – Kidney failure – Vision loss 9

10. Why Blood Pressure Matters Individuals with blood pressure higher than 140/90 mm Hg often become patients treated for serious cardiovascular problems. 77% of Americans treated for a first stroke have blood pressure over 140/90 69% of Americans who have a first heart attack have blood pressure over 140/90 74% of Americans with congestive heart failure have blood pressure over 140/90 Source: American Heart Association 10

11. Cholesterol What is cholesterol? – It may surprise you to know that cholesterol itself isn't bad. – In fact, it is one of the many substances created and used by our bodies to keep us healthy. – It is used to form cell membranes, some hormones, Vitamin D, bile acid, etc. Source: National Heart, Lung and Blood Institute 11

12. Other Cholesterol Facts Cholesterol cannot dissolve in the blood. Therefore, it is transported to and from the cells by special carriers called lipoproteins. – The most important lipoproteins are: Low-Density Lipoprotein (LDL or ‘bad’) High-Density Lipoprotein (HDL or ‘good’) The above, plus triglycerides and Lp(a) cholesterol, make up your total cholesterol. 12

13. More Cholesterol Facts Cholesterol comes from two sources: – Your body Your liver and other cells in your body make about 75 percent of blood cholesterol – Food The other 25 percent comes from the foods you eat. Cholesterol is only found in animal products. 13

14. The Why and the Who Why should you care? – Cholesterol plays a major role in your heart health. High blood cholesterol is a major risk factor for coronary heart disease and stroke. Who should be tested? – All adults age 20 or older should have a fasting blood profile once every five years. – You may need to have your cholesterol checked more often than every five years if one or more of these situations applies to you: Your total cholesterol is 200 mg/dL or more. You are a man over age 45 or a woman over age 50 Your HDL (good) cholesterol is less than 40 mg/dL You have other risk factors for heart disease and stroke – Your test report will show your cholesterol levels in milligrams per deciliter of blood (mg/dL). 14

15. Cholesterol Break-Down LDL (bad) cholesterol – When too much LDL (bad) cholesterol circulates in the blood, it can slowly build up in the inner walls of the arteries that feed the heart and brain. – Together with other substances, it can form plaque, a thick, hard deposit that can narrow the arteries and make them less flexible. This condition is known as atherosclerosis. – If a clot forms and blocks a narrowed artery, heart attack or stroke can result. 15

16. Cholesterol Break-Down HDL (good) cholesterol – HDL cholesterol is known as "good" cholesterol, because high levels of HDL seem to protect against heart attack. – It grabs onto the bad cholesterol (LDL) and removes it from the body. – Low levels of HDL increase the risk of heart disease. 16

17. Cholesterol Break-Down Triglycerides – A form of fat made in the body. – Elevated triglycerides can be due to: overweight/obesity physical inactivity cigarette smoking excess alcohol consumption a diet very high in carbohydrates – People with high triglycerides often have a high total cholesterol level, including a high LDL (bad) level and a low HDL (good) level. – Many people with heart disease and/or diabetes also have high triglyceride levels. 17

18. What are Desirable Numbers? Profile ComponentDesirable Level Total cholesterolLess than 200 mg/dL HDL (good) cholesterol60 mg/dL and above LDL (bad) cholesterolLess than 100 mg/dL TriglyceridesLess than 150 mg/dL Total cholesterol/HDL ratioBelow 5:1; optimal 3.5:1 18

19. Why Cholesterol Matters As blood cholesterol rises, so does risk of coronary heart disease. – When other risk factors (such as high blood pressure and tobacco smoke) are present, this risk increases even more. Your cholesterol level can be affected by your age, gender, family health history, and diet. 19

20. Glucose (Blood Sugar) What is glucose? – Your body's main source of energy. – During digestion, your body breaks down foods into a variety of sugar molecules, one of which is glucose. – Shortly after you eat, glucose is absorbed directly into your bloodstream, but it is unable to enter your cells and tissues without the help of insulin. 20

21. What is Glucose – When your blood sugar increases after you eat, your pancreas also increases insulin production. – This extra insulin "unlocks" your cells so that sugar in your bloodstream can enter them. This provides your body with energy and maintains a healthy blood sugar level. 21

22. The Why and the Who Why should you care? – If your glucose (blood sugar) level is too high, you could develop type 2 diabetes. If it's too low, you may have hypoglycemia. Who should be tested? – The American Diabetes Association recommends that people 45 and older have their glucose checked every three years. If your glucose levels are borderline or high, you should have a fasting blood sugar test performed once every year. However, because type 2 diabetes is becoming more prevalent among younger people, including children, it is wise to have your glucose level checked starting in your twenties. – Your glucose test will be measured in milligrams per deciliter (mg/dL) of blood. 22

23. What is a Healthy Glucose Level? Fasting Glucose Level 70 mg/dL to 99 mg/dLNormal 100 mg/dL to 125 mg/dLPre-diabetes 125 mg/dL or higherDiabetes A fasting blood glucose level cannot alone indicate the onset of diabetes, but a level higher than 125 mg/dL coupled with another symptom can be a strong indicator of type 2 diabetes. Symptoms for diabetes include increased thirst or appetite, frequent urination, weight loss, or blurred vision. 23

24. Why Glucose Matters There are serious long-term complications that can develop from years of living with uncontrolled blood sugar levels. Some of these include: Nerve damage Kidney damage Eye damage Cardiovascular disease High cholesterol Infections Alzheimer's disease Because there are such serious risks associated with the disease, people with diabetes must devote special attention to their health. If you have type 2 diabetes, consult your healthcare provider for an individualized plan to manage your diabetes. 24

25. Body Mass Index (BMI) What is BMI? – a number calculated from a person's weight and height. – a reliable indicator of body fatness for most people and is used to screen for weight categories that may lead to health problems. – Use the BMI calculator on the BlueHealth Advantage website. BlueHealth Advantage website 25

26. What Do the Numbers Mean? If your BMI is:You are considered: Less than 18.5Underweight 18.5 to 24.9Normal 25 to 29.9Overweight 30 or higherObese Please note: BMI is used as a screening tool to identify possible weight problems for adults. However, BMI is not a diagnostic tool. To determine if excess weight is a health risk, a healthcare provider would need to perform further assessments. 26

27. Why BMI Matters Excess body weight puts you at an increased risk for many diseases and health conditions, including the following: – High blood pressure – High LDL cholesterol – Low HDL cholesterol – High levels of triglycerides – Type 2 diabetes – Coronary heart disease – Stroke – Gallbladder disease – Osteoarthritis – Sleep apnea and respiratory problems – Some cancers (endometrial, breast, and colon) 27

28. What Can You Do About It? Good habits make a big difference. Healthy lifestyle choices are essential in reducing your risk for acquiring chronic conditions and helping control your numbers. 28

29. Eight Things You Can Do to Maintain or Improve Your Health 1.Eat a healthy diet with 5 to 9 servings of fruits and/or vegetables every day. 2.Enjoy regular physical activity by getting 30 minutes per day at least 5 days per week. 3.Maintain a healthy weight by knowing your target weight and sticking with it. 4.Manage stress by learning new habits to clear the mind clutter. 5.Avoid all forms of tobacco and secondhand smoke. Smoking is the most important preventable cause of premature death in the United States. 6.Comply with medication prescription. 7.If you drink, limit alcohol. No more than two drinks per day for men, and no more than one drink per day for women. 8.Be informed and... KNOW YOUR NUMBERS! 29

30. For More Information Blue Health Advantage Wellness Website www.BlueHealthAdvantageNE.com www.BlueHealthAdvantageNE.com American Heart Association - www.heartorg.orgwww.heartorg.org American Diabetes Association www.diabetes.orgwww.diabetes.org Centers for Disease Control and Prevention www.cdc.gov www.cdc.gov 30