Are You Low or High Risk for a Heart Attack or Stroke? Find out!

Let me ask you a question: What would you do differently now if you knew you had a high risk for a heart attack later in life?

They say that knowledge is power, yet ignorance is bliss. When it comes to heart attack or stroke risk, would you rather know your status, or wait for it to happen?

Heart disease is the second leading cause of death in Canada, and it claims the lives of about 12 Canadians over 20 years old each hour! Heart disease may be primary, or the consequence of damaged blood vessels in unmanaged diabetes. According to Statistics Canada, diabetes has reached epidemic proportions, with new annual diagnoses around 2.0 million cases!  Here’s a scary fact- half the people who have heart attacks have normal cholesterol. On the other hand, those with high total cholesterol might not actually be at high risk for a cardiovascular event like a heart attack. Sound confusing?

Let’s clarify. Heart disease risks are numerous, and a person’s overall risk comes from a combination of factors, including lifestyle habits, such as exercise, smoking, diet and fat levels, but also internal markers of inflammation and stress. Genetics play a small role, but the way one lives his or her life will ultimately determine if their genetic predisposition comes true.

Measuring cholesterol and blood pressure are just 2 markers that point to elevated risk, and not all cholesterols pose equal threats. You may have heard of good, or HDL cholesterol, and bad, or LDL cholesterol, as well as triglycerides.  Problems occur when there is inflammation and damage inside the blood vessels, and sticky and small cholesterols get caught in the damaged blood vessel, followed by plaque build up. LDL, or low density lipoproteins, have been named “bad cholesterol”, but there are actually 4 types and only 2 are sticky and small, or “BAD”.  So while the diagnosis of high cholesterol or high LDL can be scary, if you have the non sticky, floating types of LDL, or very high HDL (the good stuff), and don’t have other high risk traits or habits, you may be low risk.  According to the National Cholesterol Education Program (NCEP), only about half of the variability in heart disease risk can be attributed to conventional risk factors (i.e. LDL, HDL and triglyceride levels), whereas other markers, such as Lp(a) (the inherited high cholesterol making gene- oh no!), play a huge role in risk status. And just because you have the genetic high cholesterol doesn’t mean medication is your destiny. There is so much you can do! But you’ll need knowledge. 

The bottom line is that basic cholesterol tests don’t really tell you about your cardiovascular risk. 

Did you know that you can measure your current heart disease risk through biomarkers (measurements of your body and blood tests) and know your current risk status quite simply?  Wouldn’t you want to know if you inherited the high cholesterol production gene?

What would you do with that knowledge?

Most often when told they have high risk for a cardiovascular event like stroke or heart attach, patients will be motivated to take action!  those who learn their risk is low despite a few borderline or high markers are usually relieved, and still will be motivated to live healthily.  

Spectracell Laboratories provides a test called The Cardiometabolic Assessment that uses your height, weight, waist measurement and two small vials of your blood to check up on your cardiovascular system heath and many factors involved in overall heart disease risk. 

I recommend this test to anyone concerned about their cardio risk factors.  Ideally it is repeated every 2-5 years if normal or more often if actively treating cardiovascular disease. 

Below is a list of the highlights of the Cardiometabolic Assessment:

• Fasting Glucose – a snapshot of blood sugar at time of blood draw, too high means diabetes risk
  
• Fasting Insulin – speaks to the efficiency with which a person can metabolize carbohydrates; high fasting levels indicate insulin resistance and possible pre-diabetes
  
• Hemoglobin A1C – long term (2-3 months) marker of glycemic control; also considered a marker of accelerated aging 
  
• A detailed Cholesterol Panel that differentiates the size and stickiness of all molecules, HDL and LDL
  
• Metabolic syndrome traits – A diagnosis of metabolic syndrome is confirmed if any three of the following six traits exist in a patient: (1) high triglycerides (2) high glucose (3) low HDL (4) high blood pressure (5) high waist circumference or (6) increased small dense LDL
  
• Lp (a)- Lipoprotein(a) is an LDL particle with an apolipoprotein(a) attached to it. It is involved in the formation of plaque and is a very strong independent risk factor for cardiovascular disease.  Lp(a) is largely inherited, and is known as the “genetic cause of high cholesterol production”. Evidence suggests that Lp(a) may serve as the link between thrombosis and atherosclerosis. Because Lp(a) is a small, very dense LDL, it can easily penetrate a damaged arterial lining, become oxidized and build plaque, contributing to atherosclerosis.
  
• hs-CRP- High Sensitivity C-Reactive Protein reflects the presence of inflammation in the body. For some time now, hs-CRP levels have been known to be associated with risk for developing cardiovascular disease.  Levels below 1 mg/L are associated with the lowest risk, levels between 1 and 3 mg/L are at average risk and levels above 3 mg/L are associated with highest risk. However, there is more to the story. Recent studies have shown that low grade inflammation is also associated with the risk of developing type 2 diabetes and that chronic low grade inflammation is a part of the insulin resistance syndrome and strongly related to features of metabolic syndrome. 
• Homocysteine– high levels of homocysteine are associated with red blood cell stickiness and a higher cardiovascular risk. Although no direct cause and effect relationship has been identified, high homocysteine is associated with low levels of vitamin B6, B12 and folate. It is most likely an indicator of poor lifestyle and diet.
• Leptin– is a hormone released by fat cells that helps control body weight through its effect on the appetite centers in the brain. It’s explanation is a bit confusing!  Increased caloric intake as well as increased body fat lead to high leptin levels which, correspondingly, cause a decrease in hunger, and consequently lower caloric intake. Elevated leptin levels normally tell the body to stop eating, yet it has been observed that obese people may continue to eat, despite having consumed sufficient calories. This paradox is called “leptin resistance”. In many obese people, leptin levels are chronically high and after a while the brain starts to ignore or become resistant to its effects. Without the normal effect of leptin, the appetite controlling factor that tells the body that it is full and not hungry is absent.  In other words, too may fat cells make a hormone that messes up the satiety message, and creates chronic overeating.   When obese individuals reduce caloric intake and decrease body fat, leptin production decreases and appetite increases, as does the feeling of satiety, or being full. 
  
• Adiponectin – a hormone that enzymatically controls metabolism; high levels are beneficial and indicate efficient cellular energy production

The knowledge of high risk traits motivates us to make positive changes to stay well, and it can be reassuring to learn that risk is low (despite some elevated cholesterols).  For more information on the Cardiometabolic Panel visit: http://naturalmedicine.mb.ca/laboratory-testing/cardiovascular-risk-assessment.cfm

Knowledge is power.  Test your body, change your destiny, and enjoy your health!

To learn more about SMARTer cardio health or to register for your Cardiometabolic test, contact Smart Health today at (204) 510-4268 or fill out our request form here.