Global Courant
Are you at risk for heart disease? Advanced Cardiovascular Testing (ACT) is the next generation of heart disease risk assessment. It provides a lot of information that helps doctors figure out if you are at risk or not.
You know that we are living through an epidemic of cardiovascular disease (CVD). Nearly one million people die of cardiovascular disease every year. In fact, it is the number 1 cause of death.
Nearly 2,400 Americans die of CVD each day — an average of 1 death every 37 seconds. More than 148,000 Americans who died from CVD in 2004 were under the age of 65.
Nearly 2.5 million new cases are diagnosed each year, and about 1 in 3 adults have some form of cardiovascular disease. It really is an epidemic.
The way we now test for heart disease is by checking total cholesterol, triglycerides, HDL (“good”), LDL (“bad”) and the ratio between them. This method is not very good because it fog many people who have heart disease and wrongly goals many who don’t.
For example, more than 50% of people who have a heart attack normal cholesterol levels. And many people with high cholesterol do not have heart disease. In fact, more heart attacks occur in people with cholesterol below 200 than above 300. What’s going on?
The answer has to do with lipoproteins. You see, cholesterol, both LDL and HDL travel in the blood attached to proteins. This combination is called lipoprotein (lipo means fat). When talking about cholesterol, most people imagine it to be one piece, but in reality, cholesterol circulates in the blood as many thousands of tiny lipoprotein particles.
Every particle has a certain size and in this case the size definitely matters. Both LDL and HDL cholesterol come in 2 sizes.
Small and dense LDL particles are worse than medium ones. Small are bad because they can easily stick to the lining of the arteries. This can cause inflammation that causes plaque. They make your heart disease worsen twice as fast and increase the risk of a heart attack by 300%! On the other hand, medium particles are quite harmless.
There are also two sizes in HDL cholesterol – large and medium. The large is the most convenient. It is like a sponge that soaks up the loose small LDL particles and carries them back to the liver for reprocessing. This HDL is a true protector of heart health. On the other hand, medium HDL is not nearly as effective.
There are different types of lipoproteins depending on the types of fat and cholesterol they contain. Some of them are worse than others.
For example, Lp(a) (pronounced lipoprotein little a) is the most harmful lipoprotein of all because it makes small LDL particles extra “sticky” so they stick to the arterial wall with more tenacity, causing more inflammation and damage .
Lp(a) alone has ten times more plaque-causing power than small LDL particles. Too much Lp(a) increases the risk of a heart attack by 300%, even if no other risk factors are present. Statins don’t help here, in fact they can actually raise levels.
About 25% of the US population has high levels of Lp(a), but most of them have no idea because it is usually not monitored.
I hope you understand by now that measuring only total cholesterol, LDL and HDL levels is not helpful at all and can be very misleading. As I mentioned, nearly 500,000 people have a heart attack each year, even though their doctors gave them a clean bill of health because their cholesterol was “normal.” And millions of people with lots of large HDL particles use statins unnecessarily.
You need to know not only the total amount of cholesterol, but also the amount mate and the type lipoproteins you have. You may have “normal” LDL levels, but if most of it is in small dense particles, you’re definitely at risk. On the other hand, you can have high LDL, but if it’s mostly medium then you don’t have to worry about it and you certainly don’t need any medication to lower it.
Likewise, you might think you’re fine because you have high HDL levels, but if the HDL particles are small, they don’t really protect you very well.
What you need is to ask your doctor about the new ACT test. It doesn’t just measure total levels of LDL, HDL, and triglycerides. It gives the size of the LDL and HDL particles (large or small) and a total number of each.
It also controls the level of Lp(a) and other lipoproteins, such as apolipoprotein A1 (good) and apolipoprotein B (bad). In addition, it also measures HS CRP (high-sensitivity C-reactive protein) and Lp-PLA2 (lipoprotein-assisted phospholipase A2), both of which reflect the degree of inflammation in the arteries. Inflammation is what causes the damage to the lining of the arteries, ultimately leading to plaques and heart disease.
All in all, the ACT test provides a lot of useful information, which is not available with the typical cholesterol test. It really tells you if you are at risk or not.
Click on the link below for more information about blood tests.
Advanced Cardiovascular Testing – Best test of your heart risk and cholesterol
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