156 JoelFuhrman, M.D.the LDL or lower the HDL, the greater the risk of heart disease. So
the ratio of LDL to HDL, or the ratio of total cholesterol to HDL, is a
better measure of heart disease risk. For example, the typical man in
the Framingham study had a total cholesterol:HDL cholesterol ratio
of about 5.0, and the typical woman about 4.4.^29 The typical woman
who had a heart attack in the Framingham study had a ratio of total
cholesterol:HDL cholesterol of about 4.6-6.4, while the typical man
had a ratio of about 5.5-6.1. Physicians who ran in the Boston
Marathon had an average ratio of 3.4. My patients frequently
achieve what would be considered spectacular ratios following my
dietary recommendations. It is not unusual for me to see total cho-
lesterohHDL ratios below 2.0 in those truly eating healthfully. The
majority drop below 3.0 after a few years on the program.
Your Doctor Lied: You Do Have High Blood Pressure
and High CholesterolI know you were told that if your blood pressure is below 140/90, it
is normal. Unfortunately, this is not true, either. It is average — not
normal. This number is used because it is the midpoint of adult Amer-
icans older than sixty. The risk for strokes and heart attacks starts
climbing at 115/70.
In societies where we do not see high rates of heart disease andstrokes, we do not see blood pressure increase with age. In rural
China the healthy elderly had the same low blood pressure readings
as they did when they were kids. Almost all Americans have blood
pressure that is unhealthfully high. At a minimum, we should con-
sider blood pressure higher than 125/80 abnormal.
Numerous scientific investigations have shown that the follow-ing interventions have some degree of effectiveness in lowering
blood pressure:^30
- Weight loss
- Sodium restriction
- Increased potassium intake
- Increased calcium and magnesium intake
- Alcohol restriction
- Caffeine restriction
- Increased fiber intake
- Increased consumption of fruits and vegetables
- Increased physical activity or exercise