Blood Tests to Better Predict Cardiovascular Risk

Blood tests routinely ordered by mainstream doctors do not provide information needed to fully assess cardiovascular risk.

More detailed tests can pinpoint cardiac risks—and perhaps save your life.

This article describes blood tests to evaluate vascular health status before one develops symptoms of a heart attack or ischemic stroke.

Doctors Fail to Test Critical Factors

Most cardiovascular disease is hidden until chest pain (angina) or a stroke manifest.

Standard blood tests for total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) provide a partial picture of cardiovascular risk.

Missing from most cardiac tests is the number of small LDL particles circulating in your blood.

Small LDL cholesterol can be serious because the smaller particle size enables it to penetrate the arterial wall and start the process of plaque formation.

Small LDL is also more susceptible to oxidative damage.¹

Knowing your LDL particle count provides crucial information beyond total cholesterol and LDL.

A blood test called the NMR LipoProfile® provides this information using nuclear magnetic resonance (NMR) spectroscopy to directly measure particle size and particle count.

NMR LipoProfile®

The NMR LipoProfile® blood test measures:

• LDL-P—this is the count of LDL particles, and
• Small LDL—this is the count of small LDL particles.

If either of these is high, it is an indicator of an elevated risk of an atherosclerotic disease.

The NMR LipoProfile® determines the size of the LDL particles in your blood. Larger and more buoyant LDL particles do not pose the same risk as small LDL.

The NMR LipoProfile® test also provides a measure of HDL-P. This is the particle count for HDL, the "good" cholesterol. You want this number to be high.

Another test included in this panel is the LP-IR score, which you want to be low. This is a marker for insulin resistance—the higher the number, the greater the probability of developing diabetic-related disorders.

Knowing this may allow you to take corrective action before type II diabetes manifests and with it, the much greater risk of cardiovascular disease.

Some researchers have found that insulin resistance is associated with an increased risk for cancer.^2,3

But how can you confidently interpret your numbers?

Included with the results of the NMR LipoProfile® test is a chart that helps identify your particular risks for coronary heart disease.

Results from an NMR LipoProfile® blood test arm you with a more comprehensive picture that you can discuss with your doctor.

Oxidized LDL Test

Oxidized LDL cholesterol is more dangerous than non-oxidized cholesterol. Small cholesterol particles are notorious for oxidizing faster.

Oxidized LDL particles penetrate arterial walls (endothelium) and start a cascade of inflammatory events that lead to the formation and buildup of foam cells and plaque. (Foam cells are immune cells engorged with fatty LDL.)

These structural changes account, in part, for atherosclerotic disease and risk of heart attack, stroke, and other cardiovascular disease.⁴

There are tests available that measure oxidized LDL and its related markers of inflammation to provide a better idea of what is happening inside your arteries.

Assessing Vascular Inflammation

The MPO blood test is important for individuals who have a family history of cardiovascular disease or who make poor lifestyle choices.

When white blood cells attack the arterial wall, they release an enzyme called myeloperoxidase or MPO.

This process is dangerous when it occurs in response to oxidized LDL cholesterol. It creates foam cells that contribute to atherosclerotic plaque and narrowing of arteries.

MPO amplifies inflammation and causes problems that increase arterial plaque. Often, the plaque that MPO boosts is of the worst type—soft, vulnerable plaque that is prone to rupture.^5,6

Making matters worse, MPO itself can also oxidize LDL cholesterol, further promoting plaque.⁷ It can even oxidize HDL cholesterol—the "good" type of cholesterol—which renders HDL dysfunctional.

C-Reactive Protein (CRP)

High sensitivity C-reactive protein (CRP) detects changes in inflammatory levels throughout the body.

CRP rises quickly after an inflammatory attack but should soon return to normal levels. When CRP remains high, however, it is an indication of chronic inflammation.

Elevated CRP levels indicate risk of heart attack, stroke, and death from cardiovascular disease – even in apparently healthy people.⁸

A study of over 50,000 individuals found that the higher the CRP levels, the greater the risk of cardiovascular disease and heart attack.⁹

And in addition to being a marker, CRP itself may contribute directly to cardiovascular and diabetes risk.^8,10 Elevated CRP levels have also been linked to cancer risk.^11,12

Apolipoprotein B

Apolipoprotein B (ApoB) is a primary protein constituent of all non-HDL cholesterol particles.

When apolipoprotein-B-containing particles penetrate the inner arterial wall (endothelium), they spark the initiation and progression of atherosclerosis, setting the stage for eventual blockage of blood flow.^13-15

Apolipoprotein B proteins are now "widely accepted as the most important causal agents of atherosclerotic cardiovascular disease."¹³

A study found that even when total cholesterol and HDL are within healthy ranges, high levels of apolipoprotein B can increase coronary heart disease risk by about 60%.

When total cholesterol and HDL are in unhealthy ranges, high levels of apolipoprotein B can boost coronary heart disease risk by a frightening 160%.¹⁶

A review of 27 studies found that lowering apolipoprotein levels resulted in a reduction in existing arterial plaque.¹⁷

The apolipoprotein B blood test is an often-overlooked indicator of cardiovascular risk.

Other Heart-Disease-Related Blood Tests

Several other blood tests can help round out an evaluation of your risk for cardiovascular disease.

Homocysteine

Elevated levels of homocysteine may directly damage the delicate cells that line the inside of your arteries (endothelium), resulting in vascular inflammation, blood clot formation, and greater risk of stroke.

Vitamin D 25-Hydroxy

Low levels have now been found to be associated with increased risk for cardiovascular disease.^18,19

More than 70% of Americans have either deficient or insufficient blood levels of vitamin D.²⁰

Life Extension® supporters have long been advised of the importance of maintaining an optimal vitamin D level between 50-80 ng/mL.

CBC/Chemistry Profile

This test includes a complete blood count (CBC) to indicate general and immune health. It also tests platelets for clotting status, as well as hemoglobin for oxygen-carrying capacity. The chemistry panel measures glucose, electrolytes, important liver enzymes, kidney markers, calcium, and uric acid levels.

HbA1c

High blood levels of glucose are a major cause of long-term health issues, from cancer to heart disease. Practically all tissues in the body are negatively impacted by high blood sugar.

A hemoglobin A1c test is a superior way to screen for glucose problems because it shows what levels have looked like over the past two to three months. The higher the level, the more severe the problem with blood glucose control.

In addition, studies have shown that high levels of hemoglobin A1c are an important predictor of risk for heart disease, even in individuals who do not have metabolic syndrome or diabetes.²¹

Omega-3 Index

In June 2019, the FDA affirmed a new, qualified health claim for fish oil, noting that consumption of the omega-3 fatty acids EPA and DHA may reduce the risk of high blood pressure and coronary heart disease.²²

A simple, finger-stick test provides a wealth of information about omega-3 and omega-6 fatty acids’ status in your blood.

One study found that those with an omega-3 index of 8% or greater, compared to those with levels below 4%, were estimated to have about a 30% lower risk of death from coronary heart disease.²³

Interpreting Your Results

The Wellness Specialists at Life Extension® are available seven days a week to help you understand your blood test results at no charge. But as a quick rule, the very best results would be:

• Low LDL-P (low LDL particle count),
• Low small LDL-P (low small LDL particle count),
• Large LDL size (large and buoyant is the best kind of LDL),
• Low LP-IR (lower means better insulin sensitivity),
• Low oxidized LDL (oxidized LDL is more atherogenic),
• Low MPO (lower MPO indicates reduced vascular inflammation),
• Low HbA1c (high levels indicate elevated blood sugar and greater prediabetes or type II diabetes risk), and
• Omega Index 8%-11% (some data indicate 8% and above is ideal).

Results from these laboratory tests provide "reference ranges" that are helpful, but Life Extension® often recommends improvements beyond conventional guidelines to lower risk of cardiovascular diseases.

Summary

Mainstream doctors seldom order a complete panel of technologically advanced blood tests to assess risk of cardiovascular disease events.

Levels of total cholesterol, LDL, and HDL do not paint the full picture of heart disease and stroke risk. While important, they are the tip of the iceberg of potentially important information.

Advanced, more detailed blood tests can better pinpoint risk of atherosclerosis, heart attack, and stroke.

If you have any questions on the scientific content of this article, please call a Life Extension® Wellness Specialist at 1-866-864-3027.

References

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