It’s still the number one killer of both men and women in Western countries. According to the Centers for Disease Control and Prevention, one in four deaths in the United States is related to cardiovascular disease.
Why is the risk of heart disease so high? As you might expect, lifestyle is a factor. Eating a diet high in sugar and processed foods, living a sedentary lifestyle, smoking, and consuming too much alcohol are all associated with a greater risk of cardiovascular disease. Plus, two other risk factors, obesity, and diabetes, now impact the lives (and disease risk) of millions of people and both of these conditions are strongly linked to heart disease. The coexistence of diabetes and obesity is aptly named “diabesity.”
What’s reassuring about heart disease is that you can lower your risk by altering your lifestyle. Although genetics is a factor, experts believe lifestyle plays an even more important role in whether heart disease ultimately develops. Plus, it’s vital that you know your risk of developing cardiovascular disease, so you can make the appropriate changes to your lifestyle as early as possible.
For years, health care professionals have used lipid testing and markers like blood pressure and blood sugar to estimate a person’s risk. These are all important factors and ones that you should follow, as each provides information about your personal risk of developing heart disease. However, cardiologists at UT Southwestern Medical Center have identified five tests that are even BETTER indicators of an individual’s risk of cardiovascular disease. Let’s look at each one.
C-Reactive Protein For Detecting Cardiovascular Disease
One factor strongly linked with cardiovascular disease is inflammation inside the walls of arteries, the blood vessels that carry blood away from the heart and to the tissues of your body. When arteries are inflamed, they become damaged. This damage triggers an immune response and a series of events takes place that ultimately leads to plaque formation and, potentially, plaque rupture. When a plaque ruptures, it interrupts blood flow to the heart and leads to a heart attack.
How do you know if you’re inflamed? Fortunately, there’s a blood test that can measure it and it’s called a c-reactive protein level. C-reactive protein, or CRP, is produced by your liver. Higher levels in the blood are a marker of inflammation. By measuring your CRP level, you get more information about the level of inflammation in your body and your risk of cardiovascular disease. This test is widely available but isn’t routinely carried out, so you’ll need to ask your health care professional about it.
Electrocardiogram
You probably know an electrocardiogram best as an EKG. An EKG is a tracing of the electrical activity of your heart. Changes in electrical activity and in the tracing that results can indicate problems like an enlarged chamber of the heart or insufficient blood flow to a portion of the heart. Even better than a resting electrocardiogram is a stress electrocardiogram where you measure the electrical activity while you’re exercising, usually walking on a treadmill. Most physician offices are set up to do EKGs and can easily refer you for a stress electrocardiogram as well.
Coronary Calcium Scan
What is a coronary calcium scan? It’s a CT scan of your heart. This test uses a low dose of radiation to look for calcium build-up inside the walls of your coronary arteries. The accumulation of calcium inside the walls of arteries is an early sign of heart disease. Based on the results, you get a score called an Agatston score that estimates how much calcium you have in your arteries. Based on the score, you’ll have a better idea of your risk of a future heart attack. This test, too, is widely available and only takes about 15 minutes, although doctors don’t typically do it in their office. The drawback is this test requires exposure to radiation.
Hormone NT-proBNP
Hormone NT-proBNP stands for N-terminal pro b-type natriuretic peptide and it’s a peptide hormone. The level of this hormone goes up when the heart is forced to work harder to pump blood. If your heart muscle stretches because it has to work harder, your heart muscle releases more of this hormone and you can detect it with a blood test. Health care professionals sometimes use it to diagnose and determine the severity of heart failure. An elevated level can also be an early sign that your heart is under stress.
High-Sensitivity Troponin T
Troponin T is another blood test that’s sensitive to damage to the heart muscle. When your heart is injured or stressed in any way, it releases troponin T into your bloodstream and you can measure the level via a blood test. In an emergency room setting, the staff uses this measurement to rule out a possible heart attack.
High-sensitivity Troponin T is a variation of the Troponin T test that’s even more sensitive. It can detect damage to the heart muscle at much lower levels than the standard troponin T test. This makes it a useful marker for picking up early or mild heart injury that could precede a heart attack. When you have an elevated level, it may mean you’re at risk for future heart problems.
Potential Benefits
As the researchers point out, these tests provide useful information and the scores are additive. An abnormal result on several of these tests adds up to a greater risk of cardiovascular disease and heart attack. For example, they determined that having an abnormal result for all five tests was linked with a 20-times higher risk of heart disease relative to a normal score on all five tests. So, these tests may be helpful in determining heart disease risk and offer information beyond what you get from routine monitoring.
How can you use this information? If you have a strong family history of cardiovascular disease and your lipid panel and blood pressure are normal, these tests may pick up early signs of inflammation or heart damage that could ultimately lead to heart disease or a heart attack. By having this knowledge, you may be able to intervene or make lifestyle changes early on. Ask your health care provider about these tests and whether one or more would be right for you.
References:
Centers for Disease Control and Prevention. “Heart Disease Facts”
Science Daily. “These Five Tests Better Predict Heart Disease Risk”
National Heart, Lung, and Blood Institute. “Coronary Calcium Scan”
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J Geriatr Cardiol. 2013 Mar; 10(1): 102–109. doi: 10.3969/j.issn.1671-5411.2013.01.015.
Am J Clin Nutr February 2006 vol. 83 no. 2 456S-460S.
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