What do I need to know about my upcoming test?
Please refer to the “Services” section in the menu. These pages cover the most common diagnostic tests, including preparation and common questions.
Where can I get bloodwork done?
You can visit any of the UNC Rex laboratories, which are listed here. You do not need an appointment or any paperwork (the orders are in the computer).
How long does it take to get test results?
You should receive a MyChart message or phone call within one to two business days of the test.
How do I get medication refills?
You can call us at 919-787-5380 (Raleigh) or 919-387-3260 (Cary), or you can send us a MyChart message. Indicate if you’d prefer 30 or 90 day prescriptions.
Who should I contact to ask a question?
You can call us at 919-787-5380 (Raleigh) or 919-387-3260 (Cary), or you can send us a MyChart message.
How do I sign up for MyChart?
Visit UNC MyChart. Of note, we strongly recommend maintaining an active MyChart account, since it makes it much easier to communicate with us.
How much exercise should I get?
Most adults should engage in regular exercise. The American Heart Association and American College of Cardiology make the following recommendation:
Adults should engage in at least 150 minutes per week of accumulated moderate-intensity physical activity or 75 minutes per week of vigorous-intensity physical activity.
Moderate-intensity activities include brisk walking (2.4–4 mph), biking (at 5–9 mph), ballroom dancing, active yoga, and recreational swimming.
Vigorous-intensity activities include jogging/running, biking (≥10 mph), singles tennis, and swimming laps.
If you have heart disease, it is usually safe to continue exercise. Only avoid exercise if you have an unstable or progressive heart condition, or you have been specifically told to take it easy.
Do you recommend any specific diet?
The best diet is one you can maintain long-term. There are many popular diets out there, like the Paleo and Keto diet, that offer quick results but can be difficult to maintain. You are welcome to try those diets, but if you’re having difficulty, just stick to the following key principles:
- The average adult needs only ~2,000 – 2,500 calories per day. Most eat more than that.
- Eat fruits and vegetables every day.
- Protein should account for about a third of your total calories. Ideal sources include fish, chicken, beans, peas, soy, nuts, and seeds.
- Carbohydrates should account for about half of your total calories. Ideal sources have a low glycemic index, like whole grains, fruits, and vegetables. Avoid added sugars and simple carbohydrates (like white bread and candies).
- Avoid trans fats, and try to avoid saturated fats.
- The effects of red meat on health are not clear, but to be safe, try to reduce your intake to one or two servings per week at the most.
How much sodium should be in my diet?
The recommended dietary sodium intake for the general population is less than 2300 mg per day. You don’t need to obsess over this if you’re in good health and have normal blood pressure, but it’s a good general parameter to follow. If you have high blood pressure, you should aim for less than 1500 mg per day. You can flavor food using sodium alternatives, like spices (e.g., Mrs. Dash).
How much alcohol can I drink?
It is possible that moderate alcohol consumption has cardiac benefits for the average adult; however, (1) this benefit has not been conclusively proven, (2) any benefit might be outweighed by an increased cancer risk, and (3) people with certain heart conditions should avoid alcohol.
The average, healthy adult can probably consume one alcoholic drink per day without adverse health consequences. Men can probably get away with two drinks per day. This is a daily allowance with no “roll-over”; having one glass of wine per day is not the same as having seven glasses of wine once per week. The latter is known as binge drinking and is clearly harmful to health.
If you have atrial fibrillation or heart failure, you should limit alcohol intake to one or two drinks per week.
What counts as one drink? Less than most people think. The official standard is: 12 ounces of regular beer, 5 ounces of wine, or 1.5 ounces of liquor.
What is a healthy weight for me?
You should check your body mass index (BMI) and aim for a BMI of 25 or less. If your BMI is >35-40, you may be a candidate for weight loss (bariatric) surgery.
What's a healthy blood pressure?
Normal values are less than 130 / 80 – i.e. the top number (systolic pressure) is less than 130 and the bottom number (diastolic pressure) is less than 80. Young, healthy people (particularly young, thin women) often have the top number down in the 90s-100s range.
Borderline values are 130 / 80 to 140 / 90 – i.e., the top number is 130 – 140 or the bottom number is 80-90.
Elevated values are above 140 / 90 – i.e., the top number is > 140 or the bottom number is > 90.
Severely elevated values are above 200/120, especially if you have a headache, vision disturbance, or another new symptom.
Low values are less than 90/60, especially if you’re also feeling lightheaded or faint.
If you have severely elevated or low blood pressure and feel off, go to the emergency room.
If you have severely elevated or low blood pressure but otherwise feel completely fine, wait a few minutes and recheck your blood pressure. If your pressure remains very low, drink some water and have a snack, then reassess your pressure after 10-15 minutes. If in contrast your pressure remains very high, and you haven’t yet taken your daily medications, take them and reassess your pressure after an hour. If your pressure remains very abnormal despite these basic interventions, go to the emergency room.
Should I check my blood pressure at home, and how?
You should check your blood pressure if it is confirmed or suspected to be high.
You’ll need an accurate cuff. We recommend cuffs that are placed on the upper arm, rather than the wrist, like this one.
Check your blood pressure about 2-3 times per week, more if it’s not stable.
The best time to check your blood pressure is in the morning or evening when you are calm and relaxed.
Do not check your blood pressure within thirty minutes of exercise of alcohol consumption. Before checking your pressure, empty your bladder, and sit in a chair with your feet flat on the ground. After resting for five minutes, press the button to inflate the cuff. If your pressure is elevated, wait five minutes and check it again. Record the lowest number that you obtain.
What lifestyle changes will lower blood pressure?
If you have high blood pressure, you should make the following lifestyle changes, even if you are also taking medications to lower your pressure.
- Lower your daily sodium intake to 1500 mg or less. Consider the DASH diet.
- Exercise for about 30-45 minutes a few times per week, focusing on aerobics (cardio).
- Lose weight, if you can. Your pressure can go down by about one point per pound lost.
- Avoid alcohol and caffeine.
If your blood pressure is only mildly elevated, you can try these changes before starting medications.
Of note, these changes may fail to get your blood pressure down into the target range. Don’t be too hard on yourself. Part of the problem is your genetics, which you can’t change.
What's a healthy cholesterol?
Your cholesterol panel contains a few different measurements: low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides, and total cholesterol.
LDL is the bad cholesterol that increases the risk of heart attacks and stroke. HDL is the good cholesterol that reduces that risk. Triglycerides have a weaker association with heart attack and stroke and must be measured while fasting. The total cholesterol is equal to LDL + HDL + (triglycerides / 5).
You want a low LDL and high HDL. A healthy diet and regular exercise will nudge these numbers in the right direction, though genetics play a major role as well. You can be a thin, vegan athlete with high cholesterol if you were dealt the wrong genes at birth.
Individuals meeting any of the following criteria should take a statin to lower their LDL value and, hence, their risk of heart attack and stroke:
- LDL > 190 mg/dl
- Prior heart attack or stroke
- Established coronary, carotid, or peripheral arterial disease
- Diabetes and age > 40 years
- Calculated 10-year risk of heart attack or stroke > 7.5%
- The calculator considers age, cholesterol panel, blood pressure, current medications, smoking history, and (if performed) calcium score.
The goal LDL level on statin treatment is < 100 mg/dl. If you had a heart attack or stroke, we often pursue a more aggressive goal of < 70 mg/dl. If you can’t reach your goal on a statin, you may need additional or alternative medication.
Meanwhile, those with fasting triglyceride levels > 500 mg/dl, as well as those with established vascular disease and a fasting triglyceride level > 150 mg/dl despite a statin, should consider medications to lower triglycerides.
Finally, there is no evidence that taking medications to raise HDL affects outcomes such as heart attack, stroke, or death. Therefore HDL is viewed as a risk marker, not as a target for therapy.
What lifestyle changes will lower my cholesterol?
You can lose weight, eat more high-fiber foods (such as whole grains, fruits, and vegetables), and reduce meat intake. The Mediterranean diet and DASH diet are particularly helpful. You should also try to lose weight. Of note, cholesterol is only partially determined by lifestyle. Genetics also play a major role. Therefore, medications may be required to lower your risk, even if you make all of the above lifestyle changes.
Should I take supplements?
In most cases, no. Supplements do not meet the same quality control and safety standards as prescription medications. As a result, pills can contain a variable amount of active ingredients — and, in some cases, none at all.
In addition, most people do not actually need dietary supplements, with a few exceptions:
- Omega-3 fatty acids provide cardiovascular benefits in select populations, but the best preparations require a prescription.
- Iron supplements are required in certain types of anemia.
- Folate supplements are required in pregnancy.
- Vitamins are required after bariatric surgery and in certain gastrointestinal conditions.
- Calcium is often recommended among older women.
Cardiac supplements such as vitamin D, red yeast rice, and niacin have not been shown to reliably improve health, particularly when compared with prescription alternatives, and are therefore generally not recommended.
Should I take baby aspirin?
A daily baby aspirin (81 mg) is recommended if you have:
- Established coronary artery disease (e.g., prior heart attack, stent, or bypass surgery)
- Established carotid artery disease
- Prior stroke or TIA (mini stroke)
A daily aspirin may be recommended if you do not have the above conditions, but you have diabetes and a high risk of developing one of them.
In most other cases, daily aspirin is usually not needed, and may increase the risk of bleeding. Please talk with Dr. Kelly before starting or stopping aspirin.