The 5 Health Metrics Your Cardiologist Wants You to Know

In over 20 years of cardiology practice in San Diego, one pattern stands out clearly: the patients who do best long-term are the ones who know their numbers. Heart disease builds quietly, over years, through small imbalances that go unnoticed. Here are the five health metrics I look at with every patient, and what to do if yours are off.

Blood Pressure

Target: Below 120/80 mmHg

The most common risk factor I see, and one of the most undertreated, because it rarely causes symptoms. You can feel completely fine while your arteries are under chronic stress. What most people don’t realize is how powerfully weight affects this number. I’ve seen patients reduce or eliminate blood pressure medication after losing just 10 to 15 pounds sustainably. That’s not anecdotal; the research is clear on this.

LDL Cholesterol

Target: Below 100 mg/dL; below 70 mg/dL if you have heart disease

LDL is the cholesterol that deposits in artery walls and drives plaque buildup, the process behind most heart attacks and strokes. But LDL alone doesn’t tell the whole story. I also look at HDL (above 40 for men, 50 for women) and triglycerides (below 150 mg/dL).

Excess weight tends to lower HDL, raise triglycerides, and produce a more dangerous LDL pattern. Improving weight moves all three in the right direction at once.

Blood Sugar

Target: Fasting glucose below 100 mg/dL; HbA1c below 5.7%

People with type 2 diabetes have two to four times the cardiovascular risk of those without it. But the damage often starts in the prediabetes range, years before a formal diagnosis. Elevated blood sugar silently damages vessel walls, just as elevated LDL does. By the time someone is diagnosed with diabetes, cardiovascular changes may have been accumulating for years. This is why I always ask about it.

Waist Circumference

Traditional threshold: Below 40″ for men, 35″ for women– but this isn’t the whole story.

Where you carry fat matters as much as how much you carry. Visceral fat, stored deep in the abdomen, drives inflammation, insulin resistance, and arterial damage in ways fat elsewhere doesn’t.

That said, I want to be careful here: fixed cutoffs alone are increasingly recognized as an oversimplification. A consensus statement in Nature Reviews Endocrinology confirmed that waist measurement is most meaningful when considered alongside other markers, not in isolation (1). A 2025 study in the Journal of Clinical Medicine found that the waist-to-height ratio, your waist divided by your height, was actually a stronger predictor of cardiometabolic risk than either waist or BMI alone (2). A useful rule of thumb: your waist should be less than half your height.

Resting Heart Rate

Target: 60–80 beats per minute

A lower resting heart rate means your heart is pumping efficiently. Rates persistently above 90 bpm are associated with increased cardiovascular risk. If you wear a smartwatch, you already have this number; pay attention to it. Regular aerobic exercise and sustained weight loss both bring it down meaningfully over time.

What to Do If Your Numbers Are Off

These five health metrics rarely go wrong in isolation. They share common upstream drivers: excess weight, poor diet, inactivity, and stress. Addressing those root causes moves them all in the right direction at once.

When patients come to me with several numbers out of range, I don’t just layer on medications and send them home. I connect them with the Enara Health program within our clinic, a medically supervised team covering nutrition, exercise, and behavioral support, all coordinated alongside their cardiac care and covered by most insurance plans.

Know your health metrics. Use them as a starting point, not a sentence.

For additional heart-healthy tips and overall wellness advice, check out Scripps AMG articles to stay up to date on effective practices for achieving a healthy lifestyle!

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