Cardiovascular Disease (Heart disease and Stroke) is still the number one cause of death in the world.
Many families are genetically prone to develop these problems. Other people have risk factors that over time lead to early heart attacks or strokes. This is why Doctors often order tests to help detect these problems early before catastrophic health events occur.
What are the major risk factors for cardiovascular disease?
- High Cholesterol
- High Blood Pressure
- Age (Men older than 45, Women older than 55)
- Family History of Coronary Artery Disease (Men younger than 55, Women younger than 65)
- Chronic Kidney Disease
What tests are typically done to evaluate these risks at a check up?
- Cholesterol panel
- Blood pressure measurement
- Fasting blood sugar
- Metabolic Profile (checks kidney function, liver function and electrolytes)
What else can be done to dig deeper and evaluate my risk?
Some Doctors will order Advanced lipid testing. This is a more detailed cholesterol test that may unearth hidden risk. An HsCRP test can tell you if there is low level inflammation in your system that may be due to early heart disease. A Lp(a) test should be ordered if someone has a strong family history of early heart attack or stroke or a personal history of these problems. This high risk particle is not as well known, but confers increased risk and knowing your level can be valuable. An ApoB test can detect high risk cholesterol particles more accurately than a standard cholesterol panel. Checking these “risk enhancers” is suggested in the “2018 American Heart Association/American College of Cardiology Multi-society Cholesterol Guideline.”
What about imaging tests ?( X-rays Ultrasounds etc.)
- An ABI (Ankle Brachial Index ultrasound test) can detect artery disease in your legs, and if abnormal is associated with very high risk.
- A CIMT (Carotid Intimal Medial Thickness ultrasound test) checks the thickness of your Carotid arteries in your neck and looks for early plaque build up.
- A CACS (Coronary Artery Calcium Score) is a high speed cat scan of your heart arteries. This can detect plaque very early and his highly accurate and predictive of future risk.
Other tests may also be recommended depending on your situation.
What is nice about these testing options is that your Doctor can evaluate your risk more accurately and make better recommendations to help you stay healthy for years to come.
I recommend that you talk to your Doctor about these additional screening tests to evaluate you for hidden cardiovascular risk.
James Fretwell, MD, Diplomate of the American Board of Clinical Lipidology.