Are you at risk for heart disease? Advanced Cardiovascular Testing (ACT) is the next generation of heart disease risk assessment. It provides a lot of information that helps doctors figure out whether you are at risk or not.
You know that we are experiencing an epidemic of cardiovascular disease (CVD). Almost a million people die from CVD every year. In fact, it is the #1 cause of all deaths.
Almost 2,400 Americans die of CVD every day- an average of 1 death every 37 seconds. More than 148,000 Americans killed by CVD in 2004 were younger than 65 years of age.
Almost 2.5 million new cases are diagnosed every year and about 1 in 3 adults has some form of cardiovascular disease. It is truly an epidemic.
The way we test for heart disease now is by checking total cholesterol, triglycerides, HDL (“good”), LDL (“bad”), and the ratio between the two. This method is not very good because it misses many people who have heart disease and falsely targets many who don’t.
For example, more than 50% of the people who get a heart attack have normal cholesterol levels. And many people with high cholesterol do not have heart disease. In fact, more heart attacks happen in people with cholesterol under 200 than over 300. What is going on?
The answer has to do with lipoproteins. You see, cholesterol, both LDL and HDL travel in the blood attached to proteins. This combination is called lipoprotein (lipo means fat). When talking about cholesterol, most people imagine it as a single piece, but in reality cholesterol circulates in the blood as many thousands of tiny lipoprotein particles.
Each particle has a certain size and in this case size definitely matters. Both LDL and HDL cholesterol come in 2 sizes.
Small and dense LDL particles are worse than medium-sized. Small are bad because they can attach to the lining of the arteries with ease. This can cause inflammation that proceeds to cause plaque. They make your heart disease progress twice as fast and increase the risk of heart attack by 300%! On the other hand, medium particles are pretty harmless.
There are also two sizes in the HDL cholesterol – large and medium. The large one is the most useful. It is like a sponge that soaks up the loose small LDL particles and returns them to the liver for reprocessing. This HDL is a real protector of heart health. On the other hand, medium HDL is not nearly as effective.
There are different types of lipoproteins, depending on what kinds of fat and cholesterol they are carrying. Some of them are worse than others.
For example, Lp(a) (pronounced lipoprotein little a) is the most damaging lipoprotein of them all because it makes small LDL particles extra “sticky” so they hang on to the arterial wall with more tenacity, causing more inflammation and damage.
Lp(a) alone has ten times plaque-causing power than small LDL particles. Too much Lp(a) increases the risk of heart attack by 300% even if there are no other risk factors present. Statin drugs are no help here, in fact they may actually drive the level up.
About 25% of US population has high level of Lp(a), but most of them have no idea because it is not usually checked.
By now, I hope you understand that measuring only total cholesterol, LDL and HDL levels is not helpful at all and can be very misleading. As I mentioned, almost 500,000 people a year have heart attacks even though their doctors gave them a clean bill of health because their cholesterol was “normal.” And millions of people with plenty of large HDL particles take unnecessary statin drugs.
You need to know not just the total amount of cholesterol, but the size and the type of lipoproteins you have. You may have “normal” LDL level, but if most of it is in small dense particles, you are definitely in danger. On the other hand, you may have high LDL, but if it is mostly medium-sized, you don’t have to worry about it and you certainly do not need drugs to lower it.
Similarly, you may think that you are OK because you have high HDL level, but if the HDL particles are small, they don’t really protect you all that well.
What you need is to ask your doctor for the new ACT test. It not only measures the total levels of LDL, HDL, and triglycerides. It provides the size of the LDL and HDL particles (large or small) and a total number of each.
It also checks the level of Lp(a) and other lipoproteins, such as apolipoprotein A1 (good) and apolipoprotein B (bad). Plus, it also measures HS CRP (high sensitivity C-reactive protein) and Lp-PLA2 (lipoprotein-accodiated phospholipase A2), both of which reflect the level of inflammation inside the arteries. Inflammation is what causes the damage to the lining of the arteries, leading eventually to plaques and heart disease.
All in all, the ACT test provides a lot of useful information, which is not available from the typical cholesterol test. It really tells you if you are at risk or not.
For more information on blood tests please click the link below.