Tests for InflammationMPO – measures levels of myeloperoxidase, an enzyme secreted by white blood cells that kills harmful bacteria but when elevated in your blood can cause a host of problems. MPO reduces the effectiveness of good cholesterol, which can lead to arterial plaque build-up. It also releases a bleach-like substance that erodes the arterial walls, causing the plaque in the arteries to become unstable and possibly rupture. When a rupture occurs, the body forms a clot to patch the area; however, a clot can impede blood flow, causing a heart attack or stroke. CardioMPO is 95 percent accurate for predicting a heart attack, the need for aggressive treatment or a heart-related death within six months.
Lp -PLA2 (The PLAC® Test) – measures the accumulation of cholesterol inside of the arteries; a high level indicates a risk for a heart attack or stroke.
hsCRP – measures the levels of C-reactive protein, an indicator of general inflammation in the body due to injury and infection. High levels are a sign of heart disease and predictor of future cardiovascular events.
Urinary Microalbumin – measures the amount of albumin, a protein that circulates in the blood and is filtered through the kidneys. Inflammation can damage the kidneys' filtering ability, leading to albumin in the urine. This is called microalbumin and it is usually a complication of diabetes, but it is also linked with other conditions such as high blood pressure and heart failure.
Why Does Inflammation Matter?Studies suggest that inflammation is a primary culprit in cardiovascular disease. Inflammation is an immune system response to an irritant. As soon as you prick your finger, come in contact with an allergen or catch a cold, your immune system activates, sending an army of white blood cells to fight off “foreign invaders” like bacteria, allergens and viruses. Even injuries like a sprained ankle, tennis elbow and tendonitis cause inflammation as white blood cells flood injured areas to remove bacteria and dead cellular debris. Sometimes inflammation is noticeable (redness and swelling that appears in an injured area); this is referred to as acute inflammation. Chronic inflammation, however, occurs on a deeper, more internal level and is usually invisible, leaving us unaware that an underlying, potentially dangerous health issue like heart disease may be brewing.
Diet can also promote inflammation that can lead to heart disease. For example, eating refined foods like white flour products, sugary foods and drinks, and fried foods can raise blood sugar levels, triggering proteins called cytokines to send inflammatory messages to the immune system. Further, excessive alcohol consumption can raise the level of C-reactive protein, a marker of inflammation in the body. Click here for an overview of the Mediterranean Diet, deemed by experts as the ultimate anti-inflammatory eating plan »
Advanced Tests for CholesterolThe VAP® Test – measures the cholesterol concentrations in lipoproteins, which are protein particles that shuttle blood fats (lipids) like cholesterol and triglycerides around the body. The cholesterol content and size of various lipoproteins may predict increased risk of cardiovascular disease.
NMR Lipid Profile – screens for the number of low-density lipoproteins (bad cholesterol) particles.
ApoA1 and ApoB – measure the type and number of apolipoproteins that bind proteins to lipids and form lipoproteins. Apo-A1 sits on the surface of high-density lipoproteins (good cholesterol), and high levels suggest a decreased risk of heart disease. Conversely, Apo-B sits on the surface of low-density lipoproteins (bad cholesterol), and high levels indicate a higher risk for heart disease.
The Cholesterol and Cardiovascular Disease LinkIn the case of cardiovascular disease, many scientists believe that inflammation stems from cholesterol. Elevated levels of low-density lipoproteins (LDLs or bad cholesterol) can damage the endothelium (cellular lining of blood vessels). This enables the LDLs to enter into the arteries and accumulate along the wall. Because cholesterol does not belong on the arterial wall, the body perceives it as a foreign invader and signals the immune system to send white blood cells into the area. When the white blood cells mix with the cholesterol, a plaque is formed that narrows the blood flow and raises the risk of a heart attack and stroke.
Plaque is classified as stable or unstable. And just as it sounds, stable plaque is less likely to rupture and is the safer of the two. This is because it is comprised of collagen (a protein that strengthens connective tissue), a small fatty core and topped off with a thick fibrous cap. On the contrary, unstable plaque is large amounts of accumulated LDLs with a thin fibrous cap. As the fat expands beneath the surface of the cap, it begins to wear it away and releasing enzymes, which further accelerate the erosion of the cap. Once the fibrous cap has weakened, the plaque is vulnerable to rupturing.
Although a high cholesterol level is a reliable predictor of heart disease, studies suggest that only half of those who suffer from a heart attack had an elevated cholesterol level. In fact, the number of people having heart attacks with total cholesterol over 300 and total cholesterol under 200 are equal. Further, at least one in five people whose LDL levels are controlled by medication still have a heart attack or stroke. Recent research revealed that LDL particles come in different sizes. Larger particles are relatively harmless, while smaller particles can cause damage as it is easier for them to slide through the endothelium of arteries. Smaller particles also tend to oxidize easier than larger particles. Oxidation occurs when oxygen is metabolized. The process creates a by-product known as free radicals, which steal electrons from other molecules, damaging cells, blood fats and DNA.
Tests for OxidationOxidized LDL (OxLDL) - measures the amount of oxidized bad cholesterol. High levels of OxLDL increase the risk of cardiovascular disease and prediabetes.
CoQ10 – measures the levels of coenzyme Q10, a vitamin-like substance found in every cell that has various functions, such as assisting with cellular growth, maintenance and repair, as well as helping cells produce energy and protecting the heart. CoQ10 also functions as an antioxidant, helping minimize oxidation-related damage. Low levels of CoQ10 suggest low levels of high-density lipoproteins (good cholesterol) and/or ApoA1 (good apolipoprotein transporter), which raise the risk of cardiovascular disease.
F2 –Isoprostanes (F2 – IsoPs) – measures the levels of oxidation due to the metabolism of arachidonic acid, an omega-3 polyunsaturated essential fatty acid found in foods such as corn, soybean and sunflower oil and nuts and seeds. Omega-6 fatty acids are necessary for proper brain function, building muscle and normal growth and development. Although a healthy diet balances the intake of omega-3 and omega-6 fatty acids, the American diet typically contains between 14 and 25 times more omega-6 than omega-3 fatty acids. This imbalance of omega-6 fatty acids promotes inflammation and can lead to health issues. Besides heart disease, this test can also predict the risk of cancer.
What is OxidationOxidation occurs when oxygen is metabolized. This process creates a by-product known as free radicals, which steal electrons from other molecules that can damage cells, blood fats and DNA. Oxidation deteriorates the body and has been linked with cardiovascular disease, liver conditions and some cancers. Foods high in antioxidants like vitamins C and E and beta-carotene can protect the body and offset some of the damage caused by oxidation and free radicals. Staying current with standard cardiovascular disease screenings and tests can help you manage your heart health. However, adding advanced tests that can determine your inflammation level, cholesterol particle size and oxidation damage can more accurately predict your risk for heart disease and are more effective in helping you prevent a heart attack or stroke.
Carotid Intima Media Thickness
Using the results from your annual wellness services is one of the most effective methods of preventing or controlling cardiovascular disease. This is because the wellness exam provides more than just diagnoses; it is actually a launching pad for you and your MDVIP-affiliated physician to use when developing your personalized wellness plan. Click here to continue reading about the recent American Heart Disease/American College of Cardiology heart disease prevention guidelines »