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Uncover Hidden Risks for Stroke and Heart Attack

by Nancy Russell, M.D.


We all want to age well, but far too many young Americans are having heart attacks or strokes and many are life-ending events. Check out the statistics: 2200 people die from heart disease in the United States each day. Many of those never make it to a hospital. Someone in the U.S. has a heart attack every 43 seconds. 50 percent of people who have a heart attack or stroke have normal cholesterol levels.


Heart disease and stroke are not only the leading causes of death in the U.S,, but can make it impossible for some adults to return to work and enjoy their favorite activities. According to the Center for Disease Control, there are more people under age 65 who are dying from preventable heart disease and strokes than those older than 65 years. Once thought to be a “man’s disease”, heart attacks and strokes kill more women each year than the next four causes of death combined, including cancer.


The blood vessels that feed your heart muscle and brain are called arteries. These arteries carry blood that is the fuel supply you need to live. The arteries that feed the heart muscle are called coronary arteries and provide blood to the heart muscle so it can pump blood to the body. When cholesterol and inflammation build up within the walls of your coronary arteries, it’s called coronary artery disease.


A heart attack can occur when a coronary artery becomes blocked and blood can no longer get through to feed the heart muscle. The blockage is caused by a buildup of cholesterol in the wall of the artery and forms a plaque with a large lipid or fatty core. The plaque can become inflamed and then rupture or breaks open causing a clot to form. If there is an abundance of cholesterol with added inflammation, the cap on the top of the plaque can become very thin and unstable. When the thin cap is damaged and the inflamed cap breaks open, your body tries to repair the damage by forming a clot. The combination of the clot and the plaque together can completely block off the coronary artery and cause a sudden heart attack or sudden death. If this process occurs in an artery that brings the blood supply to the brain, a stroke can occur.


The inner lining of your arteries are damaged by things like smoking, diabetes, high blood pressure and poor lifestyle habits. This damage allow cholesterol in your blood to more easily enter the walls of your arteries, leading to disease. If you have normal cholesterol levels, you may assume you are not at risk for a heart attack of stroke. This is not always true. Researchers now understand that heart attacks and strokes happen because of inflammation in the artery. Measuring cholesterol without inflammation markers and genetics may only tell part of the story.


It is possible to uncover your true risk of heart disease and stroke by going above and beyond routine tests to advanced cardiovascular testing. The areas of testing can include inflammation markers, lipoprotein fractionation, metabolic markers, vitamin levels, fatty acid levels, coagulation function and genetic markers.


Inflammation markers to measure are hs-CRP for general and heart inflammation and also Lp-PLA2 activity for more specific blood vessel inflammation. Other inflammation markers can assess for flexibility of the lining of blood vessels. Lipoprotein fractionation breaks down the LDL particles (bad cholesterol), HDL particles (good cholesterol) numbers and assesses the LDL pattern of either A or B pattern. Pattern A is more favorable as well as having low LDL particles and high HDL particles.


Metabolic markers assess for diabetes and insulin resistance with a hemoglobin A1c and fasting insulin as well as a homocysteine level which is a marker for an amino acid that can damage blood vessels. Vitamin levels that are related to blood vessel health include folate, vitamin B-12, vitamin D, ferritin and coenzyme Q10 which can also be tested with advance cardiovascular testing.


Fatty acid testing assesses the omega-3 fatty acids and the breakdown into EPA and DHA to assess whether fish oil supplementation can be needed. Omega-6 levels are also tested, which occur as bad fats in processed foods such as crackers, fries, chips, etc. Coagulation function is tested by obtaining the fibrinogen antigen.


Also important are the genetic markers for heart and brain disorders that include MTHFR mutations C677T and A1298C and Apo E genotype denoted by 3/3, 3/4, 2/4 or 4/4. MTHFR mutations can affect folate and B-12 metabolism and cause the body to not readily process these vitamins, increasing the risk for cardiovascular disease as well as affecting detoxification pathways.


Advance cardiovascular testing helps you take steps to improve your health with life style changes, preventative supplements or medications and to see if further testing is needed. It may uncover other things that could increase your chances of having a heart attack or stroke. It looks beyond smoking, high blood pressure, obesity, family history, stress and routine blood tests. A standard lipid panel doesn’t always predict poor heart health. This advanced cardio vascular blood testing may help give you and your health care provider a more complete picture of your heart health.


Kansas City

Evolving Magazine


Nancy Russell, M.D., is a holistic Internal medicine physician, blending traditional and alternative medicine in her Kansas City northland practice for over 30 years. For more information on getting to know Dr. Russell, visit her website, or call her office at Nurturing Optimal Wellness at 816-453-5545.



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