A wide variety of blood tests measure factors related to heart disease. Some of these tests, however, do a poor job of indicating your chances of heart problems. To understand the true state of your cardiovascular system, you need to ask your healthcare provider for the tests that are proven to indicate your heart disease risk truly.
Misleading Tests
You probably know what your LDL-C (the “bad” cholesterol) and HDL-C (the “good” cholesterol) levels are. The problem, is that these are proving to be poor indicators of inflammation and atherosclerosis. However, when cholesterol becomes oxidized (electrically charged), then it becomes “sticky” and makes a major contribution to the plaque called atherosclerosis. Using HDL-C and LDL-C levels gives us essentially no valuable information regarding cardiovascular risk. They simply miss heart disease so often they cannot be relied upon anymore. Instead, we must measure the lipoprotein (LDL and HDL) particle number and size. We also need to measure how much of the LDL is oxidized.
We know that an electrocardiogram (ECG) can show abnormalities of heart function, but these will be late findings — after the disease has already damaged your heart. The cardiac stress test has been a standard of care diagnostic tool for heart disease for many decades. However, its prognostic coronary artery disease detection will not show any abnormalities in 15 to 25 percent of patients with coronary artery disease. Furthermore, a large percentage of men have a heart attack as their first symptom of cardiovascular disease. Of these men, cardiac stress testing carried out shortly before heart attacks do not predict atherosclerosis in the majority of individuals.
A useful imaging study consists of visualizing the inside lining of the carotid artery in your neck. This test, called the Intima-Media Thickness (IMT) is an ultrasound measurement that reflects atherosclerosis occurring in your heart. To actually visualize arterial narrowing in this way is more than just measuring a risk factor. It actually measures atherosclerotic disease that is present.
Another imaging test you can ask for is called Electron Beam Computed Tomography, which gives you a calcium score. This test quantifies the percentage of calcification in your heart arteries, giving a real picture of atherosclerosis already present.
Blood Pressure
The most simple, cost-effective, and predictive test of heart disease is a resting blood pressure measurement. Current science shows us that even before blood pressure increases, there are markers of inflammation in the blood.
Hypertension is now defined as “a progressive cardiovascular syndrome arising from complex, interrelated causes which features early markers in the blood that are often present before blood pressure elevation is sustained.”
Therefore, when you see high blood pressure, think of one or more of these going on as well:
- Blood vessels are losing their ability to stretch (vessel compliance).
- Atherosclerosis is already developing on the inside of the arteries.
- Abnormal blood sugar and insulin metabolism are occurring.
- Hormones that affect blood vessel and heart health are dysfunctional.
- Kidney function is changing, and less fluid is filtered out of the blood into the urine.
- Sticky ( Oxidized ) cholesterol and platelets are joining to create atherosclerotic plaque.
- Left heart muscle is thickening, which affects heart pumping function.
While there are about 400 known cardiovascular disease risk factors, let’s look at the ones that you can have checked. After checking blood pressure, blood sugar, cholesterol levels and body weight, I’d say it’s time to go to the next level. Now let’s talk about the most useful blood and urine tests used directly to assess cardiovascular risk.
Early Detection Blood Tests
Nuclear magnetic resonance (NMR) spectroscopy measures the number and size of lipoprotein particles, instead of their cholesterol or the triglyceride content. The more LDL particles you have, the more plaque that is being formed. In other words, the higher the number of LDL particles, the greater the likelihood for their entry into the arterial wall where they deposit their contents and form atherosclerotic plaque. Measurement of LDL-cholesterol on traditional lipid panels does not reflect the LDL particle number nor the amount of oxidation of the LDL. The NMR also provides the number of large fluffy particles and the small dense, or problematic, particles.
Serum Iron, TIBC (total iron-binding capacity) and Ferritin (stored iron): Increased iron correlates with increased risk for heart disease, heart attack and stroke due to increased oxidative stress and inflammation it causes when too high.
Microalbuminuria: Finding protein in a spot urine sample can be one of the earliest signs of abnormalities in your vascular system because your kidneys reflect endothelial dysfunction and increased blood vessel permeability. This is highly correlative of progression to future cardiovascular disease, heart attack and stroke.
Fasting blood sugar and insulin levels: The relationship of these tests relate directly to inflammation in the heart.
Free testosterone and DHEA-S: Low testosterone is known to contribute to diabetes and insulin resistance, abnormal blood lipids (cholesterol), increased blood vessel lining inflammation, and central (belly) obesity. Low DHEA (dehydroepiandrosterone) increases the death rate by a heart attack.
Homocysteine levels: A higher level of this amino acid, a byproduct of our metabolism, increases atherosclerosis development.
High C-reactive protein levels: This test for inflammation in the body is equally or more predictive of heart attack risk than cholesterol levels. Even with high levels of cholesterol, if we have low inflammation levels, our risk goes down dramatically.
Lipoprotein (a): This lipoprotein is highly associated with coronary artery disease. It is genetically determined and gives you a good idea of hidden heart disease risk, independent of LDL cholesterol levels.
Fibrinogen: This blood protein enhances clotting. High levels are linked to an increased risk for cardiovascular disease and heart attack.
Oxidized LDL: This test tells us how much of our cholesterol is oxidized. Oxidized LDL is very ‘sticky’ and gets trapped in our blood vessel walls. Once trapped, this oxidized LDL attracts monocytes which form foam cells, or the beginning stages of atherosclerosis.
Omega Check: By now you have heard that omega 3 fatty acids, like fish oils, can be beneficial for the heart. This test measures the amounts of omega 3 and omega 6 in the blood. This test lets us know how much omega 3 we need to take for proper function and protection.
Vitamin D Levels: Vitamin D levels less than 10 mg/mL are correlative with nearly double the risk for heart attack. Optimal levels are between 50 to 85 ng/ml.
Proper testing is the only way we know our true risk status. Once known, this determines what we need to do for optimal health and cardiovascular protection. To determine your risk factors for heart disease, call Doctor’s Nutrition today at 1-800-824-0194 and talk to one of the doctors and determine what testing you may need.
