Cardiovascular Disease
Cardiovascular disease is the number one cause of death in North America. We all have been taught the typical risk factors. We know to monitor our blood pressure, we know to avoid smoking, to eat a heart healthy diet, exercise, and maintain a healthy stress level. This isn’t always enough. A huge aspect of cardiovascular risk is associated with genetics. Familial cardiovascular disease is not well screened for and the work up the typical patient is offered when they have a prominent family history of heart disease is incomplete. The medical system is built to be more reactive, than proactive. A vital and integral part to the management of heart disease, but, this leaves a gap. In my practice I work to fill this gap and I investigate beyond your general risk factors and typical blood work to determine your risks. We investigate via advanced blood work and advanced imaging to look in depth into things like inflammation (F2-Isoprostanes, ADMA, Lp-PLA2, MPO, Oxidized LDL, hsCRP, homocysteine, TMAO), guy dysfunction, hormones, lipoprotein particle size, nutrient levels, genetics, and calcium deposits/plaque formation. Below you can read further about some examples of these tests.
Examples of some of the tests and what they can show us
Microalbumin
High Levels may indicate metabolic syndrome and/or diabetes, kidney disease, and CVD. Microalbumin is a protein that when found in above normal levels in urine indicates that there is some injury to the inner lining of our microvascular system which can be used as an early detection for heart disease. In a large scale study that was conducted they found in those who had no other signs of heart disease but abnormal microalbumin levels had 3x increased risk for developing cardiovascular disease.
TMAO (trimethylamine N-oxide)
High levels may indicate gut dysfunction and risk for cardiovascular damage. TMAO is a sign that there is guy dysbiosis occurring and TMAO specifically will go and damage our heart vasculature leading to a cascade of unfavorable events leading to a damaging environment to our heart health. TMAO levels ca be easily controlled by dietary interventions.
Omega Check
We want our omega levels optimal to avoid the development and progression of Hypertriglyceridemia, Hypertension, and cardiovascular disease. There is Omega-3 and Omega-6 which are both a type of fatty acid called Polyunsaturated Long Chain Fatty Acids (PUFAs). Our body uses these to maintain function in our brain, cellular membranes, and inflammatory processes. Omega-3s are found in a few forms like EPA, DHA, and DPA. These work to reduce inflammation, reduced blood clotting, and reduce triglyceride levels and we get a good dose through eating oily fish. Omega-6 are found in its primary forms AA (arachidonic acid) and LA (linoleic Acid). We get this mainly from animal and plant oils and can cause an increase in inflammation and blood clotting. In the typical American diet our intake of Omega-6 heavily outweigh our average intake of Omega-3 and this can leave your body in an unfavorable state for developing heart disease. We work to correct this level which results in a reduction of our bad cholesterol, LPA2, and overall inflammation.
F2-IsoPs (F2-Isoprostanes)
This is an inflammatory biomarker where we are more likely to see elevated by our typical risk factors for heart disease like cigarette smoking, unhealthy diet, and sedentary lifestyle. It shows us the oxidative stress in the body and is a risk factor for not only heart disease but certain cancers as well.
Oxidized LDL
Oxidized LDL is a form of cholesterol that is part of the initiation of developing atherosclerosis. LDL is considered our “Bad Cholesterol” is is extra damaging in its oxidized state. Its presence triggers our bodies immune system to “eat it” which then results in the formation of foam cells and inflammation in the vasculature. When We have oxidized LDL around this prevents our body from forming nitric oxide further contributing to the unfavorable environment within our bodies. Statistically if levels are raised one is 3.5x more likely to develop metabolic syndrome within 5 years, and in men a full 4x risk in developing heart disease.
Lipoprotein Profile
This test allows us to investigate beyond our “good” and “bad” cholesterol. We are able to see lipoprotein size and number and treat accordingly. This is a much better test to identify true risk in our patient populations and and allows us to implement much more effective and targeted treatments.
Summary
With heart disease being such a primary cause of death for so many years it is clear that our screening and treatments for heart disease is falling short. This is not good enough and as patients you deserve better. The use of adjunctive treatments and having access to more advanced testing can help us work towards a much needed shift in the care we need and prevention of heart disease.