Heart Disease Risk: Cholesterol and Other Tests
High cholesterol is a major risk factor for heart disease, the nation's top killer. But newer research shows that this fat-like substance in your blood is just one factor. Experts have learned that other substances in your blood may help your health care provider predict your risk for heart disease.
The level of these substances in the bloods provide more complete information about heart disease risk.
Triglycerides are another fat in the blood. Measuring them is not new. But, many people still don't realize their importance. Health care providers view high triglycerides as a warning sign.
Diet and exercise can help lover triglycerides, just as they do cholesterol. Obesity, inactivity, and high-sugar foods can raise triglycerides. Drugs to lower triglycerides may also be prescribed. The lab test called a lipid panel measures the different types of cholesterol and triglycerides. Talk with your health care provider about your triglycerides.
C-reactive protein (CRP) is a protein in the blood. CRP levels rise when there is inflammation in the body. If your CRP levels are high all the time, this can mean there is inflammation and damage to blood vessels. The American Heart Association recommends against checking CRP levels for everyone. CRP levels may help health care providers decide how to treat some people at risk for heart disease. If you
Lipoprotein a (Lp(a))
Lp(a) tests continue to be studied and may also be used to determine the risk for heart disease. A high level of Lp(a) is a risk factor for developing early atherosclerosis. People with a family history of heart disease may have high levels. Lp(a) may help providers decide how to treat other risk factors, such as high LDL cholesterol.
A high level of cholesterol in the blood is a risk factor for heart disease. The National Heart, Lung, and Blood Institute makes these recommendations for screening and treatment:
If you are 20 or older and of average risk for heart disease, you should have a blood lipid panel at least every 5 years. This test is done after fasting and measures total cholesterol, LDL cholesterol, HDL cholesterol, and triglycerides. LDL is the cholesterol that builds up in the arteries. HDL cholesterol keeps cholesterol from building up in the arteries
People with high LDL levels and with other risk factors are often treated with medications. People with two or more of the following risk factors are considered at higher risk:
A very low HDL level
High blood pressure
A family history of early heart disease (an immediate family member with heart disease before age 55 if a man, or before 65 if a woman)
Age (45 or older if a man, or 55 or older if a woman)
Vascular or blood vessel disease of the aorta, carotid arteries, or peripheral arteries
Metabolic syndrome—a combination of excess fat around the waist, high triglycerides, low HDL, high blood pressure, and a high blood sugar
If you're at risk for heart disease, lifestyle changes are needed.
Cut saturated fats to 7% of your total daily calories.
Lower cholesterol in your diet to less than 200 mg a day.
Eat more soluble fiber and foods with plant stanols or sterols (found in some margarines and salad dressings).
Stick to a healthy weight.
Make exercise a habit.
These changes are hard to make. Talk with your provider or nurse about ways to get help with the changes. They may suggest a dietician or nutritionist, exercise programs, or other resources in your area.
Be sure you understand your risk level. Experts have set up four risk categories. Your doctor can work out your level with a risk assessment tool based on blood tests, blood pressure, and history of smoking.
- Holloway, Beth, RN, M.Ed.
- MMI board-certified, academically affiliated clinician