Cardiovascular

Cardiovascular

Do you have concerns about your cardiovascular health or have a family history of heart disease? Is your cholesterol elevated, but you do not like the idea of taking medication for the rest of your life? Are your labs normal now, but you are interested in preventing heart disease later in life?

Cardiovascular health and disease is so much more than how high your cholesterol is. Advanced lipid fractionation and cardiovascular inflammatory panels can be drawn right in our office. These blood markers can not only give us a picture of your vessel health but also used as a predictive and preventative measure. Markers often tested are, but not limited to: Lipoprotein A, homocysteine, fibrinogen, C-reactive protein and size particular profiles.For more information see below about the “Cardio IQ” panel.

Let our Doctors help you. We can discuss personal and family history risk factors with you, as well as helping to lower your risks and improve your cardiovascular health through lifestyle and nutritional modification. In addition, we can perform EKG exams and Doppler ultrasound to help evaluate your current cardiovascular health.

Why is it important to get tested?

Almost half of all heart attacks strike people who don’t know they’re at risk – people without well-known risk factors such as fatty diets, hypertension, smoking, or high cholesterol. In fact, most patients report that their first sign of cardiovascular disease was a heart attack! That’s one reason cardiovascular disease is the number one killer in America today, claiming more lives than cancer, accidents, and AIDS combined. However, with our comprehensive cardiovascular assessment, you can find out if other hidden factors may be affecting your heart’s health and take steps to protect yourself.

What kinds of treatment can improve these markers?

The good news is that almost all these hidden factors that affect cardiovascular disease are modifiable. Cholesterol, LDL, HDL, and triglyceride levels can often be managed through an active treatment program that addresses diet, exercise, and stress reduction. C-reactive protein can be reduced using anti-inflammatory agents. And despite being strongly influenced by genetics, homocysteine and Lp(a) can be modified with nutritional therapy. In fact, research evidence confirms that comprehensive lifestyle changes may be able to reduce the effects of even severe heart disease after only one year, without the use of drugs.

Have you been diagnosed with high cholesterol?

Information courtesy of Quest Diagnostics

One of the great mysteries of cardiology is the fact that 50% of people with coronary artery disease have blood cholesterol levels similar to those of people who do not develop the disease. In fact, a recently published study of over 17,000 people with low LDL cholesterol levels showed that a surprising number of them still developed heart disease. In other words, the majority of people at risk of having a heart attack may be unaware of this risk and may not be taking appropriate preventative action. The stories of people surprised by sudden heart attacks are becoming more common and it is perplexing that these patients had not been identified as at risk for heart disease. Obviously, today’s routine cholesterol tests are failing to identify the majority of people who are at risk for heart attacks. The limited focus of these tests on “good” and “bad” cholesterol is simply not good enough when it comes to identifying individuals at risk.

Fortunately, the prevention of coronary artery disease has taken a big step forward. We offer tests that can detect inherited abnormalities that are beyond the reach of conventional HDL and LDL analysis. For the first time, a comprehensive panel of tests can be run that helps doctors to personalize treatment that halts and in some cases reverses the progression of heart disease. Patients also may have access to the 4myheart Program for cardiovascular disease risk reduction at no additional cost or obligation.

How do I know if an advanced cardiovascular test is appropriate for me?

If you have had two or more of the following, testing could be considered:

  • Heart disease or a heart attack (This counts as two)
  • Diabetes (This counts as two)
  • Family history of either heart disease or a heart attack before the age of 55
  • Total cholesterol > 200 mg/dL
  • LDL cholesterol (the bad cholesterol) > 130 mg/dL, or
    LDL cholesterol > 100 mg/dL if you have had a heart attack
  • Triglycerides > 150 mg/dL
  • HDL cholesterol (the good cholesterol) < 40 mg/dL
  • Systolic blood pressure (the top number) > 140 mmHg
  • Diastolic blood pressure (the bottom number) > 90 mmHg
  • Obesity
  • Cigarette smoker
  • Physical inactivity

 

Cardio IQ panel 101

Lipid Subfractionation by Ion Mobility

  • Smaller low density lipoprotein (LDL) particles can contribute to plaque build-up faster than larger LDL particles can
  • Having too many smaller LDL particles is a powerful risk factor for a heart attack
  • Larger HDL particles are helpful with cholesterol removal.  Low levels of the large HDL particles can increase your risk for heart disease
  • Certain medications, proper nutrition, and weight loss with diet and regular exercise can help your body produce fewer small LDL particles and improve large HDL levels

ApoB – LDL Particle Number

  • ApoB is a direct measurement of the number of lipoprotein particles, including LDL (“bad cholesterol”), IDL, and VLDL
  • A high apoB number indicates increased risk for heart disease
  • Certain medications, improved eating habits, increased physical activity, and loss of body fat are some ways to improve apoB

Lp(a) Extended Range

  • High levels of Lp(a) are associated with increased risk of cardiovascular disease and stroke
  • Lp(a) is inherited. Diet and exercise have limited to no effect on lowering Lp(a), however certain medications can lower levels

Homocysteine

  • High levels of homocysteine can cause injury to blood vessel walls,  increasing your risk for heart disease and stroke
  • Nutrition, such as increasing intake of folate-rich foods, plays an important role in reducing levels of homocysteine

Lp-PLA2 – Inflammation in the Artery

  • High levels of Lp-PLA2 can predict risk of a heart attack or stroke
  • When both Lp-PLA2 levels and systolic blood pressure are high, stroke risk increases significantly
  • Certain medications can reduce levels of Lp-PLA2

CRP (hs) – Inflammation in the Body

  • High levels of C-Reactive Protein (CRP) indicate inflammation due to infection or tissue injury
  • If both CRP and Lp-PLA2 levels are high, your risk for a heart attack or stroke increases significantly
  • Certain medications and food may have anti-inflammatory benefits

Fibrinogen – Inflammation Marker and Clotting Factor

  • Fibrinogen is a part of the blood’s clotting process and can be elevated due to inflammation
  • Continual high levels are linked to an increased risk for heart disease
  • Fibrinogen levels can be lowered by stopping tobacco use and losing excessive body fat

Insulin – Hormone

  • Insulin is released from the pancreas to regulate blood sugar (glucose) levels
  • Constant high levels are linked to an increased risk for heart disease, diabetes, and other health conditions
  • High insulin levels can be improved with proper nutrition, exercise, stress management, or certain medications

NT-proBNP – Stress on the Heart

  • NT-proBNP is a hormone released from heart muscle cells in response to ongoing stress or strain on the heart
  • A high level of NT-proBNP is a warning signal that your heart is being overworked
  • The early identification of high levels may help your physician decide on a treatment plan to lower the risk of a heart disease event

Vitamin D – Hormone

  • Low Vitamin D levels are linked to an increased risk of heart disease, stroke, diabetes, hypertension, and heart failure
  • Vitamin D levels may be low for many reasons, such as insufficient sun exposure, eating diets poor in Vitamin D, and obesity
  • If levels are too low, your physician may recommend Vitamin D supplements

Omega-3 – Fatty Acid

  • Low Omega-3 fatty acid levels are linked to an increased risk of cardiovascular disease, including sudden cardiac death
  • Omega-3 levels may be low due to eating diets poor in Omega-3 fatty acids
  • If levels are low, your physician may recommend Omega-3 supplements and/or increased consumption of foods high in Omega-3 fatty acids

4q25-AF Risk Genotype

  • The 4q25-AF Risk Genotype Test can give insight into your risk for atrial fibrillation (irregular heart beat) and risk for stroke caused by atrial fibrillationa
  • People who are 4q25-AF Risk carriers may have a higher risk for atrial fibrillation (AF) and stroke caused by AFb

9p21 Genotype Test

  • The 9p21 Genotype Test can give insight into your risk for certain types of heart disease
  • People who are 9p21 carriers may have a higher risk of a heart attack before the age of 60 years in women and 50 years in men, abdominal aortic aneurysm (AAA), or blocked coronary arteries or a heart attack at any agec

ApoE Genotype Test

  • The ApoE Genotype Test can give insight into your heart disease risk as well as your response to different amounts of dietary fats
  • There are 6 ApoE genotypes:  2/2, 2/3, 3/3, 2/4, 3/4, and 4/4
  • People who have the 3/4 or 4/4 genotype may have a higher risk of heart disease

CYP2C19 Genotype Test

  • The CYP2C19 Genotype Test can give insight into how your body processes the medication clopidogrel (Plavix®)d
  • For people who are Poor or Intermediate Metabolizers, Plavix may be less effective at preventing blood clotse
  • For people who are Ultra-Rapid Metabolizers, Plavix may be overly effective, which may increase the risk of a bleeding probleme

KIF6 Genotype Test

  • The KIF6 Genotype Test can give insight into your heart disease risk as well as your response to the statin medications atorvastatin (Lipitor®) and pravastatin (Pravachol®)
  • People who are KIF6 carriers may have a higher risk of heart disease events (such as a heart attack)f
  • However, for people who are KIF6 carriers, the statin medications atorvastatin (Lipitor) or pravastatin (Pravachol) may help reduce this riskg

LPA-Aspirin Genotype Test

  • The LPA-Aspirin Genotype Test can give insight into your risk for heart disease as well as your response to aspirin
  • People who are LPA-Aspirin carriers may have a higher risk of heart disease events (such as a heart attack)h
  • However, for people who are LPA-Aspirin carriers, low-dose  aspirin may help reduce this riski

LPA-Intron 25 Genotype Test

  • The LPA-Intron 25 Genotype Test can give insight into your risk for heart disease
  • People who are LPA-Intron 25 carriers may have a higher risk of heart disease.