By Sari Harrar
1. Do a Wheeze Check
Untreated asthma leads to 1.8 million ER visits and 4,000 deaths a year.
Asthma can make exercising a struggle and everyday activities a challenge. But it’s often overlooked, especially in adults. In one recent study of more than 4,000 African American men and women, 10 percent had signs of undiagnosed asthma. Experts say that about the same proportion of people over age 65 have the disease without knowing it. “You may think you’re just having breathing problems because you’re getting older,” says researcher Paul Enright, MD, of the University of Arizona. “But don’t downplay it. Undiagnosed asthma can make life more difficult and could even be deadly.”
Ask yourself these two questions used to assess respiratory health in a pair of studies involving nearly 27,000 people. The questions are simple, but they can identify 90 percent of people with asthma:
1. Do you wheeze sometimes?
2. Do you experience shortness of breath while you’re exercising or exerting yourself?
Your Next Step
If you answered yes to one or both questions, ask your doctor to check you for asthma, Dr. Enright says. Your physician may prescribe an inhaled asthma medication to see if it helps. Or she may perform what’s known as a spirometry test and, if that signals asthma, an inhalation challenge—both of which help your doctor gauge your lung function.
2. Read Your Palms
Iron deficiency leaves you exhausted and can reduce immunity, but your hands hold a clue.
Iron is your body’s “energy” mineral, grabbing oxygen from every breath you take and delivering it to cells throughout your body. If you don’t have enough, you can develop bone-weary fatigue, concentration problems, even shortness of breath and an irregular heartbeat. Unfortunately, deficiencies aren’t uncommon: It’s estimated that 20 percent of women (half of all pregnant women) and 3 percent of men have low iron. “It’s very common to be anemic and not be aware of it, because it comes on slowly and insidiously,” says family practitioner Lloyd P. Van Winkle, MD, at the University of Texas Health Science Center at San Antonio.
Spread your palm wide. Are the creases pale? “No matter what your natural skin color, unusual paleness of your palm creases, or of your gums and the inside of your eyelids, is a sign of reduced circulation in small blood vessels near the surface of your skin due to low iron,” Dr. Van Winkle says.
Your Next Step
Ask your doctor if you should have a hemoglobin or hematocrit test to check levels of iron-rich hemoglobin in your blood. Your physician should also examine your red blood cells (small and pale could mean trouble). A serum ferritin test, which measures levels of a protein that helps store iron, is good at flagging early signs of iron deficiency.
3. Tap Your Toes
Heart rhythm troubles trigger as many as 20 percent of all strokes. This simple test can help prevent one.
Off-rhythm heartbeats—the flutters and crazy palpitations of atrial fibrillation (AFib)—are responsible for up to 140,000 strokes each year in the United States alone. Seventy percent are fatal. Most could be avoided if it weren’t for the fact that about a third of the estimated 2.2 million Americans with atrial fibrillation don’t realize they have the condition.
“AFib isn’t just the occasional missed heartbeat. You have extremely irregular rhythms,” says Eric Prystowsky, MD, director of the Clinical Electrophysiology Laboratory at St. Vincent Hospital in Indianapolis. “The upper chambers of the heart just quiver. That lets blood pool briefly in the heart, which can allow a clot to form. When a beat pushes the blood out, the clot can go right to the brain.”
Tap your foot to the rhythm of your pulse (find it by placing a finger on your neck or wrist) for one minute. In several studies, this test alerted doctors to over 90 percent of people with atrial fibrillation, as confirmed by heart monitoring. “If the beat is so irregular that you can’t tap along, relax for an hour and check again,” Dr. Prystowsky says. “If it’s still extremely uneven, mention it to your doctor.”
Your Next Step
After listening to your heart, your family doctor or cardiologist may order an electrocardiogram, which gives a detailed look at how your heart is beating. Some people with atrial fibrillation take blood thinners to prevent a stroke; sometimes other medicines or procedures are needed to control heart rate and rhythm.
4. The Two-Minute Diabetes Q&A
Uncontrolled diabetes doubles your risk of heart disease and shortens life by 10 to 15 years. Here’s how to know if you’re headed for trouble.
Shockingly often, doctors miss opportunities to test people at high risk for diabetes. The result: According to a Centers for Disease Control survey, just 4 percent of people with prediabetes have been told by their doctors that they have the condition. And another 5.7 million are living with undiagnosed diabetes.
So grab a pencil—this self-check is easy, says study author Heejung Bang, PhD, of Weill Cornell Medical College, but it can find nine out of ten people at risk for dangerous blood sugar problems.
Circle your answers, then add up the points.
1. How old are you? (Under 40: 0 points; 40–49: 1; 50–59: 2; 60 or older: 3)
2. Are you a woman (0) or a man (1)?
3. Does a family member (parent, brother, or sister) have diabetes? (No: 0; yes: 1)
4. Do you have high blood pressure or are you on medication for high blood pressure?(No: 0; yes: 1)
5. Are you overweight or obese? (Normal weight: 0; overweight: 1; obese: 2; extremely obese: 3)
6. Are you physically active? (No: 0; yes: -1)
Your Next Step
“If your total score is 4 or higher, there’s a good chance you have prediabetes,” Bang says. “If it’s 5 or higher, you’re at high risk for diabetes. See your doctor for a blood sugar test.”
5. Bend and Stretch
Stiff blood vessels make your heart work harder. This low-tech test may help you prevent a heart attack.
Like birthday party balloons, healthy blood vessels are flexible, widening and narrowing as needed throughout the day. But when arteries stiffen—due to aging, extra pounds, a buildup of plaque in artery walls, a sedentary lifestyle, or diabetes—blood pressure rises. And so does your risk for fatal strokes and heart attacks.
Testing for stiffness usually requires high-tech equipment found in research labs. But now you can get a sense of whether your arteries are as supple as a silk stocking—or as inelastic as an old bicycle tire—just by sitting on the floor. In a recent study of 526 women and men, researchers found that those who were the most flexible on a sit-and-reach test also had the most supple arteries, as measured by a pulse-wave pressure test.
What’s the connection? Artery walls are made up of the same components—smooth muscle cells and connective tissue—as the muscles in your hips and back, notes lead researcher Kenta Yamamoto, PhD, of the University of North Texas Health Science Center at Fort Worth. So whatever stiffens one will have the same effect on the other.
Sure enough, there’s some evidence that activities that keep big muscles pliant, such as stretching, may “soothe” nerve activity that also affects artery flexibility. And another recent study found that adults who started a program of regular stretching significantly increased the flexibility of the walls of their carotid artery— the vessel that supplies the brain with blood.
Sit on the floor with your legs straight out in front of you, toes pointed toward the ceiling. Bend forward from your hips and stretch your arms toward your feet. Try to touch your toes.
Your Next Step
If you can’t reach your toes, you may be at increased risk for arterial stiffness. If you haven’t had your blood pressure checked in the past year, do it now. “You should get your blood pressure checked at least every other year,” Yamamoto says. Adding some stretching exercises to your routine just might limber up your muscles and your arteries, he adds.
6. Measure Your Middle
With an oversize waist, your risk of an early death shoots up—even if you aren’t overweight.
A bulging middle is a signal that you have lots of visceral fat, the thick, yellow fat deep in the abdomen that pumps fatty acids, appetite-stimulating hormones, and inflammation-fueling chemicals into the bloodstream.
In a recent study of 360,000 people from nine European countries, big waistlines predicted disaster even for people who weren’t overweight—increasing the risk of premature death 79 percent for women and doubling it for men. A big middle is particularly hard on the heart, tripling the risk of fatal heart disease in a Harvard School of Public Health study of 44,636 women.
Even so, experts say, doctors frequently fail to measure the waists of normal-weight patients— which means they’re likely to be missing “ab fat” in these otherwise slender patients.
Bare your torso and stand in front of a mirror. Circle your waist with a tape measure, then move it down until the bottom of the tape rests at the top of your hip bones. This is the position recommended by the National Institutes of Health. Don’t hold your breath or cinch the tape too tight. Write down your number.
Your Next Step
For men, risk for diabetes and heart disease begins to rise with a reading of 37 inches; a measurement of 40 inches and up is considered high risk. For women, 32 inches is the danger threshold, and 35 inches is high-risk terrain. Best ways to shrink visceral fat? Exercise and a Mediterranean-style diet (plenty of produce, grains, fish, and monounsaturated fat from olive oil and nuts). Because visceral fat is more metabolically active than fat on your hips or elsewhere, it’s actually apt to come off relatively fast as you start to lose weight.
7. The Two-Second Depression Quiz
Depression is bad for your heart, memory, and more.
Television is jammed with commercials for antidepressants. Celebrities from actress Ashley Judd to astronaut Buzz Aldrin have revealed their struggles with gloom. Even so, about 70 percent of America’s 15 million depressed women, men, and children get no help for their condition.
That’s due at least in part to doctors who fumble the ball. When psychiatrist Alex J. Mitchell, MD, of the University of Leicester in the United Kingdom, analyzed 41 studies involving 50,000 people from around the world (including the United States), he found that doctors missed depression 50 percent of the time. That’s an important oversight, since undiagnosed depression is linked to higher risk for diabetes, heart disease, and other chronic health conditions, plus suicide.
It can be tricky to figure out if you’re just a little down or depressed enough to ask for help. But when New Zealand family doctors asked 421 men and women a couple of questions, they spotted 97 percent of those suffering from depression, say researchers from the University of Auckland. The quiz isn’t perfect; like other depression screening tests, it turns up lots of false positives. Consider it a doctor-patient conversation starter:
1. During the past month, have you often been bothered by feeling down, depressed, or hopeless?
2. During the past month, have you often been bothered by having little interest or pleasure in doing things?
You Next Step
“If you answered yes to one or both questions, it’s worth talking with your doctor,” says psychologist Marian R. Stuart, PhD, a professor emeritus at the University of Medicine and Dentistry of New Jersey–Robert Wood Johnson Medical School. “The good news is that there’s a lot of help available, including counseling, exercise, gratitude journals, and, if you need them, antidepressants. The first place to go is to your family doctor, who hopefully knows you and the circumstances of your life.”