What Are The Top Blood Tests To Assess Heart Disease?

 The Top Tests To Assess Heart Disease Risk

A question that we get in the clinic, often, is "What tests will show my risk for heart attack, stroke, or other vascular disease?" Yet, while I don't believe there are one or two single markers that can show if someone has heart disease or not, there are five important markers that most people should educate themselves on to complete their healthy eating and exercise habits.

1) hs-CRP

Although is test is highly indicative of systemic inflammation, no single test can really stand along in assessing vascular inflammation.
Patients should look for or ask for an inflammatory panel including:
  • hsCRP,
  • LpPLA2
  • MPO (myeloperoxidase)
Also, to note, urine screening of microalb/creat ratio and F2-Isoprostane are really good tests of inflammation and oxidative stress.  

2) Vitamin D

I check it on everyone.  I have only seen two people in over ten years have really good levels without supplements. 
The goal level to aim for should be 60-80 or 100, not just 30-100 like most lab reference ranges suggest. 
My advice:
Wear your sunscreen if you will be out in the sun for over 30 minutes, respect the sun and take your Vitamin D3 supplement.  I would not want to trade wrinkles and skin cancer for good Vitamin D levels.

3) Omega 3 Index 

I like this test and perform it on my patients, but...
EPA and DHA are not equally protective.  After the REDUCT-IT trial results, it is clear to me that EPA is the cardiovascular protector.  DHA may actually be harmful in some situations.
This topic is highly controversial, so I will save this argument for another day. I still strongly suggest increasing your serum EPA levels.

4) Homocysteine

I love it and use it, but the data is clearly stronger for the protection of brain health and CV health.  I like to protect both. 
My recommendation is to supplement with B vitamins based on a patient's genetic variations on "MTHFR" and whether they need methylated B vitamins or not. 

5) Apo A/Apo B Ratio

Apo A (a marker for HDL particle count, not simply HDL levels) is decent, but not terribly relevant from a clinical prospective.
I am not downplaying HDL, but from a lipid aspect....Apo B is the best predictor of CVD, not LDL.
As a rule of thumb, I want to make sure that my posts respect both sides of medicine (Eastern and Western).  There is absolutely a need for both and one side alone will never afford a patient the optimal/personalized protection they deserve. 
We cannot out-prescribe a bad lifestyle.  In the same breath, there are vegan marathon runners who drop dead of heart attacks.  That's why having a myopic view or stance in regard to health will never result in optimal wellness.
Want to learn more or interested in assessing your heart disease risk?
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