To determine your heart health, you have to look at more than just cholesterol. A host of new tests measure inflammation and blood fats (lips) to provide more specific information about your cardiovascular fitness and the level of risk you face from heart disease.
1. High sensitivity CRP. It shows inflammation. C-reactive protein (CRP) only shows up in the blood when there’s an infection; it disappears once the infection is over. A high reading is an independent predictor of heart disease. Get two tests at least two weeks apart to rule out any minor infections or injury.
2. Plac. It shows inflammation. Lipoprotein phospholipase (Lp-PLA2) occurs only within the blood vessels. Elevated levels indicate a greater risk of plaque formation and rupture.
3. Fibrinogen. It shows blood clot risk. Made in the liver, fibrinogen helps clot blood at injury sites by producing fibrin. It also can constrict arteries to reduce blood flow from an injury. High levels increase the risk of clots on ruptured plaque and of heart attack.
4. Homocysteine. It shows inflammation. A by-product of incomplete metabolism of an amino acid, homocysteine not only indicates inflammation, but may also be directly involved in atherosclerosis.
5. Serum ferritin. It shows iron stores. High levels of ferritin indicate excess iron, and that’s been linked to heart attack. A level above 200 ng/ml doubles heart attack risk; 100 ng/1 may be optimal.
6. Lipoprotein (a). This shows atherosclerosis risk. Alas, we can thank our genes for high levels of lipoprotein (a), als called Lp (a). This blood fat contributes to atherosclerosis by promoting the formation of clots and plaques.
7. Calcium heart scan. This shows the presence of plaques. The only time you’ll find calcium in the arteries is when plaques are present. Men with the highest scores have 2½ times the heart attack risk of those with moderate or low scores, and they’re more than 10 times more likely to need angioplasty or bypass surgery.
A FRESH LOOK AT OLD TESTS
1. AA/EPA ratio. This shows inflammation. Arachiodonic acid (AA) is an inflammation-causing omega-6 fatty acid (not all EFAs are good), and its counterbalance is eicosapentaenoic acid (EPA), a beneficial omega-3. We evolved to have a ratio of 1-to-1, but because of the diet we eat, the average American’s ratio is 11 (AA) to 1 (EPA).
2. LDL particle size. This shows the size of cholesterol particles. Small dense LDL particles (pattern B) are associated with higher levels of coronary heart disease than large fluffy ones (pattern A). Genes decide which pattern predominates, but diet, lifestyle echanges, and supplements can convert small particles to large.
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