February is here; It‘s Heart Health Month! Do you know your numbers?
We all know we are supposed to know our cholesterol number, but is that enough? Probably not.
It turns out, there is a lot more to determining one’s risk of heart disease that just the cholesterol numbers in a standard lipid panel. A standard lipid panel will provide a total cholesterol, the LDL (“bad”) and HDL (“good”) cholesterol levels, along with the triglyceride level. And although this information is helpful, there is a great deal more information that can be obtained from more advanced testing.
One such test is an NMR lipid fractionation test, which can determine the size and shape of the cholesterol particles which can help further predict risk. A person could have a total cholesterol of 200; but whether that total number is made up of 10 particles, each with a cholesterol of 20 or 50 particles, each with a cholesterol of 4 matters.
The markers of inflammation add a lot of information to the risk assessment, as do some genetic factors, such as Lp(a) and homocysteine. Each of these can be measured, and are particularly useful to assessing one’s risk, especially with a family history of early heart disease.
There is more to heart disease than just the cholesterol, however. Beyond the cholesterol analysis, it is important to consider the entire cardiometabolic status to get a good look at individual risk. The good news is that many of these factors are modifiable. A careful analysis of cardiometabolic health should include the lipids and an expanded lipid profile, as described above, along with other markers of cardiometabolic wellbeing. Some of these markers include a fasting glucose, insulin, and hemoglobin A1c, liver function tests, inflammation markers, uric acid and vitamin D.
Many physicians are starting to use the Coronary Calcium Score test as a way to assess for the presence of plaque build up in the coronary arteries and as a way to help determine the need for medications such as statins.
When we set about to look at our own risk of cardiovascular disease, including heart attack, stroke, peripheral vascular disease, etc, it would serve us well to have a complete analysis of our risk factors. These results, along with our family history of heart disease, can guide the creation of a personalized plan to lower our risk that will include lifestyle factors, such as the right diet, our exercise, appropriate supplements and medications.
So please, in this month when we focus on our heart health; lets expand that and look at our cardiometabolic health and let the numbers, all of them, help us create a personalized program to support our individual wellbeing.
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