Heart Disease Risk and Screening

Heart Disease Risk and Screening

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Almost 50% of patients who suffer a heart attack have normal cholesterol levels.  How can that be?  This is a common area of confusion for patients, so let’s talk about cholesterol, as well as some of the lesser-known risk factors and screening tests for heart disease. 

Fun fact: Cholesterol measurements are often referred to as a “lipid panel”, or more simply, “lipids”!

When your primary care provider runs a lipid panel, it is often reported as total cholesterol, HDL cholesterol, and LDL cholesterol.  LDL is the “bad” cholesterol, and HDL is the “good” cholesterol.  With this information, a “Framingham Risk Score” can be calculated which includes other risk factors such as smoking, diabetes, high blood pressure, family history, age, and sex.  The score is reported as a percent, which corresponds to the percent risk of heart disease over the next ten years. If your score is less than 10% you are considered low risk. Moderate risk is between 10% and 20%, and high risk is above 20%.  

While the Framingham Risk Score is convenient, it does not account for other known risk factors for heart disease:
– Excess body weight
– Physical inactivity
– Excess alcohol consumption
– Excess iron accumulation
– Excess inflammation
– High stress
– Depression
– Unhealthy diet
– Exposure to harmful toxins

In order to get a comprehensive risk assessment for my patients, there are a variety of useful tests and measurements (beyond cholesterol) that I frequently use:
– homocysteine: an amino acid in the blood that can independently predict risk of cardiovascular disease
– ferritin: a reflection of iron stores in the body
– hs-CRP (highly sensitivity C-reactive protein): a measure of inflammation in the body
– fasting insulin and glucose: used for assessing insulin resistance
– Other lipid/cholesterol parameters including ApoB, V-LDL, Triglycerides, Lp(a), LDL particle size and counts; some of which have a strong genetic influence
– body composition assessment: utilization of bio impedance analysis to measure percent body fat, muscle, and visceral fat
– pulsewave analysis: estimates arterial stiffness, an early sign of cardiovascular disease
– toxic element analysis to assess levels of lead, cadmium, arsenic, and mercury
– vitamin D: low levels are associated with increased cardiovascular risk

With this additional information, I can recommend more targeted treatment strategies to reduce heart disease risk.  For example, 
– specific dietary recommendations; what foods to incorporate and which foods to avoid to lower your cardiovascular risk
– physical activity/ exercise requirements as well as what types of exercise to incorporate
– lifestyle counselling to address stress, sleep, depression, and other factors
– which nutraceuticals or dietary supplements offer the most benefit 
– other treatments that are specific to your laboratory findings

How do we know if the treatment plan is working?  Follow-up testing is especially important to reassess measurements, track progress, make adjustments, and most importantly it helps the patient stay motivated.  So take control of your health, and get a more comprehensive look at your heart disease risk!

– Dr. Tim

Selected references:
PMID 31065045
PMID 30158148
PMID 31905706
PMID 28327451
PMID 20054195
PMID 22689009
PMID 19509380
PMID 31980747
PMID 30453617
PMID 18706278

Vive Health is a forward thinking Calgary Naturopathic medical clinic with services and programs that fill one simple goal – to help you get better and stay better! We hope this site will help you discover how we are different and how we can help you find and keep your best health. We invite you to browse our website to learn more about how we can help you, and look forward to meeting you to introduce you to a new kind of health care experience.
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