Heart Disease

NEW RISK FACTORS IN HEART DISEASE.

Darin Eklund, PA-C
Subhash Sahai, MD

There is undisputed evidence that “traditional” risk factors such as high blood pressure, elevated cholesterol, especially LD cholesterol, diabetes mellitus, and cigarette smoking all increase the risk of heart disease and stroke. Recent studies in the Journal of the American Medical Association show that these factors are associated with more than 80% of all significant vascular disease. But what about the other 20%? Newer diagnostic tests are enabling us to look for risk factors in these patients also.

hs-CRP – High sensitivity C-Reactive Protein is a test we can us to measure the level of inflammation in the blood vessels. This inflammation is believed to be important in the progression and rupture of the plaques in the arteries leading to heart attacks.

Lp(a) – LDL cholesterol is the “bad” cholesterol which contributes to the formation of blockages in the arteries. Lp(a) is an LDL - like particle that helps to heal sites of vessel injury and infection, but unfortunately also brings a rich source of bad cholesterol to the area. More importantly, Lp(a) also prevents the breakdown of clot formation at the site. In the presence of high LDL levels, diabetes, hypertension, or other risks for vascular disease, a high level of Lp(a) creates an even greater risk for vascular disease.

Homocysteine is a by-product of protein metabolism. Mild to moderate elevation of homocysteine raises cardiovascular risk because it causes direct damage to the vascular wall, and increases the likelihood of clot formation in the inflamed arteries.

Because the vast majority of patients with cardiovascular disease have the traditional risk factors mentioned above, there is no need to test for these newer, more novel risk factors, in everyone. However if there is a strong family or personal history of cardiovascular disease of the traditional risk factors, or patients have recurrent vascular disease despite well treated for the conventional risks, you should consider having these simple blood tests performed.

This article is intended for informative purposes only, and is not meant to provide specific recommendations for diagnosis or treatment. If you have any questions about your personal risk for heart or blood vessel disease, please contact the Webster City Medical Clinic at (515) 832.6123.