Cardiovascular disease (CVD), also referenced as heart disease, is a leading cause of death worldwide for both men and women. While traditional risk factors such as high blood pressure, high cholesterol and smoking play a crucial role in this area, there are often hidden contributors that can increase your risk of heart disease. 

Today we are going to explore five different tests that can be both informative and pivotal in assessing and managing individual risk for the development of diseases of the heart and blood vessels. As a functional medicine practice, we like to delve deeper into each of our client’s situations to truly understand their family and personal history and lifestyle. But before suggesting any modifications, it’s important to assess benchmarks. Here are five suggested tests that can help prevent heart disease.

Lipid Profile

A lipid profile is generally the first test looked at when assessing cardiovascular disease risk. Sometimes called a cholesterol panel, this is a standard blood test that measures various components of your blood lipids, including total cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides. This is a fundamental tool in assessing the risk of cardiovascular disease, and is often a starting point at both functional and traditional practices.  

The American College of Cardiology suggests an initial check between ages of nine and 11 and then again between ages 17 and 21 (1). Based on your test results and your family history, your medical provider can help determine a testing protocol moving forward.

Lipoprotein (a), ApoB

Lipoprotein(a) and Apolipoprotein B (ApoB) are specific biomarkers that play roles in assessing cardiovascular disease risk, and tests that we recommend getting. 

Lipoprotein (a): High levels of Lp(a) are associated with an increased risk of heart disease and stroke. Of importance: Lp(a) levels are largely genetically determined. This means that some individuals have inherently high levels of Lp(a) due to their genetic makeup, making them more susceptible to cardiovascular disease. Identifying high Lp(a) levels through blood tests can provide valuable information for both the patient and the healthcare provider as elevated Lp(a) levels are linked to a higher risk of atherosclerosis and the formation of arterial plaque. Knowing an individual’s Lp(a) levels can influence management decisions; if these levels are elevated, more aggressive treatments may be suggested.

ApoB: Traditional cholesterol biomarkers have limitations, as they provide information on the total amount of cholesterol in the blood, however they do not take into account the particle size or other lipid particles that can contribute to CVD risk. This is where ApoB comes into play. 

ApoB provides information about the number of atherogenic (or the process of forming plaques) particles present in the blood. This is important because it has been shown that the number of these particles, rather than just the amount of cholesterol they carry, can be a better predictor of CVD risk (2). 

Inflammatory Markers to Assess in Heart Disease Prevention

While most people associate heart disease with factors such as high cholesterol or hypertension, chronic inflammation is increasingly recognized as a significant risk factor in the disease’s progression 

There are specific markers in the body, to include high-sensitivity C-reactive protein (hs-CRP), Lipoprotein-Associated Phospholipase A2 (LP-PLA-2) and Myeloperoxidase. 

C–reactive protein is a substance produced by the liver and released in the bloodstream as part of the body’s natural response to inflammation that can occur because of infection or injury. However, if your hs-CRP levels are elevated, you are more prone to heart attacks; this is especially true in women.

LP-PLA-2 measures disease activity within the artery wall. Elevated Lp-PLA2 levels can help predict the development of coronary artery disease and the risk of future adverse cardiac and cerebrovascular events. 

Myeloperoxidase (MPO) levels should also be measured and monitored to identify the risk of heart disease.

At our functional medicine clinic in Charlotte, North Carolina, we measure these inflammatory markers with a Cleveland Heart Lab test, which is a simple blood test. This test also measures Lp(a) an Apo(B) and can be repeated every 1-2 years or as suggested by your medical provider. 

CIMT

Carotid Intima-Media Thickness (CIMT) is a non-invasive imaging technique that measures the thickness of the carotid artery’s intima and media layers, which are the innermost and middle layers of the artery wall. It is used as a diagnostic tool to assess the risk of cardiovascular disease (CVD) and to predict atherosclerosis, a condition characterized by the buildup of fatty deposits in the arterial walls. 

CIMT can detect signs of arterial wall thickening and atherosclerosis at an early stage, often before symptoms or significant blockages occur. Early detection allows for timely intervention and preventive measures, which can be highly effective in reducing the risk of heart disease and stroke.

This is an easy test to do–it’s done by ultrasound, involves no radiation, and the price point in our area (Charlotte, North Carolina) is under $100. 

Coronary Calcium Score 

The Coronary Calcium Score, also known as the Coronary Artery Calcium (CAC) Score, is another valuable tool in heart disease prevention and risk assessment. 

The Coronary Calcium Score measures the amount of calcium deposits in the coronary arteries. These deposits, called coronary artery calcification, are an early sign of atherosclerosis, the buildup of plaque in the arteries. Detecting this calcification helps identify the presence of subclinical atherosclerosis, often before symptoms or significant blockages occur.

This is another non-invasive test that is relatively quick, making it a practical tool for assessment. Additionally, the fact that a score is given at the end of the test can be motivating for individuals. It can be a wake-up call for individuals at risk, encouraging them to make positive changes to their lifestyle, and it can also provide relief and reassurance to those with an in-range number to stay the course of action they are on. From the provider’s standpoint, they can assess whether the individual is in a low, medium or high risk category and further assist with lifestyle modification or medication suggestions or other treatments when deemed necessary. 

Other Factors to Consider to Keep Your Heart Healthy

It’s important to remember that while these five diagnostic tests can be helpful in assessing risk of cardiovascular disease, one’s lifestyle cannot be overlooked. 

Sleep, stress management and movement all play a role in prevention of cardiovascular disease. Having a heart-healthy diet, and avoiding refined oils and processed products can also be helpful. And along that note, because what we eat affects our gut health, the gut microbiome can impact inflammation and potentially cardiovascular disease. Let’s also not forget detoxification, hormone balance or weight management.

These five tests are ones that we recommend to many of our clients who want to proactively address cardiovascular disease prevention and serve as excellent starting points. You can reduce the risk of complications with early diagnosis and treatment. Talk with your health care team if you have any concerns, and please reach out to us if we can help. 

References

1. Updated cholesterol guidelines offer more personalized risk assessment, additional treatment options for people at the highest risk
2. Physiological Bases for the Superiority of Apolipoprotein B Over Low‐Density Lipoprotein Cholesterol and Non–High‐Density Lipoprotein Cholesterol as a Marker of Cardiovascular Risk