Monday, July 7, 2014

Heart Disease and Genetics- Why you need further testing!

Heart disease is genetic. If your father, mother, grandparents, or siblings had the disease chances are you will too. Certain factors will increase your odds. I am certain you have heard all of these before: smoking, diabetes, a diet high in saturated and trans fats, lack of exercise, excessive alcohol consumption, high stress careers, and high blood pressure to name a few. However, do you realize how important genetics and advanced lipid testing are in the treatment and diagnosis of heart disease?

Genetics plays such a large part that you can be perfectly healthy, a good weight, good diet, exercise every day and you could still have a heart attack. So if genetics can fight against even the healthiest people than what is the motivation for living a healthy lifestyle?

The simple fact is that if you carry the genes that lead to heart disease and you don't follow healthy practices you will have a heart attack and your likelihood of that heart attack being fatal is largely increased.

Currently, my family members are being checked for the factors that cause heart disease. The results aren’t good and they now have to face several decisions. They already show signs of early heart disease, one of these key factors is inflammation in the artery walls. This is a relatively new predictor of heart disease. Health Diagnostic Laboratories is a laboratory that believes in testing all facets of heart disease and diabetes. Since diabetes and heart disease go hand in hand, early prediction of diabetes may also give insight into the prevention of heart disease.

Heart disease is no joking matter. It doesn’t just happen to old people. You may die of a fatal heart attack or you may suffer over many years with angina, high blood pressure, extreme swelling, high pulse rates and slowly kill yourself. 

Early prediction right now is your best bet. You can find out if you have genetic markers for heart disease, you can find out if you have early inflammation you can even find out if your beta cells are pumping out too much insulin thus leading to diabetes and heart disease. You can start on a path, today, before too much damage is done and save yourself the worries, frustration and pain of heart disease. 

You may appear to be in perfect health, however, the different types of lipids that run through your arteries may all be bad. While there are the ‘good’ (HDL) cholesterol and the ‘bad’ (LD) cholesterol, there is more detail involved. Just because your good number is good and your bad number is good doesn’t mean you aren’t at risk of heart disease. Lipoprotein particles play a key role in determining your heart disease risk.

  • Small, dense LDL - these atherogenic particles easily penetrate the arterial endothelium causing plaque
  • RLP (Remnant Lipoprotein) - very atherogenic lipoprotein with similar composition and density as plaque
  • Lp(a) - builds plaque and causes plaque to rupture
  • HDL2b - positively correlates with heart health because it is an indicator of how well excess lipids are removed. 
Over 20% of the population has cholesterol-depleted LDL

This is a condition in which a patient's cholesterol may be "normal" but their lipoprotein particle number, and hence their actual risk, would be much higher than conventional cholesterol tests would indicate. This is especially common in persons whose triglycerides are high or HDL is low. In a cholesterol-depleted patient, there can be up to a 40% error in risk assessment.

I suffer from low HDL (good) cholesterol. This is a genetic factor. My body doesn’t produce this cholesterol as it should. There is no medication that will increase this number. Exercise will help it rise, however, in someone like me with genetic factors exercise cannot help raise it to the necessary levels needed to protect my heart. 

I also suffer from Small, Dense LDL particles. So although my LDL (bad) cholesterol numbers read normal on a traditional test, when the lipoprotein subgroups were tested it was found that my Small Dense LDL was off the charts, which explained my second heart attack.

I also carry an Lp(a) LDL particle. This is an LDL (bad) cholesterol particle with a ‘corkscrew’ protein attached. High levels of this increase the risk for heart attack and stroke and it is a genetic factor. Diet and exercise do not lower this; medication only helps in certain patients. The only way to reduce a heart attack risk from this particle is by trying to keep other risks well controlled. 

These types of tests are not conducted in traditional lipid panels. There are several laboratories across the United States that will do these advanced testing but you need see a specialist to have them ordered. This type of specialist is called a lipidologist. 

Lipid specialists reduce deaths related to high cholesterol and other lipid disorders. It is the goal of lipid specialists to enhance the practice of lipid management in clinical medicine and to reduce the morbidity and mortality associated with atherosclerotic disease. The specialty of “lipidology,” a multidisciplinary branch of medicine focusing on lipid and lipoprotein metabolism and their associated disorders, is still in its infancy and continues to evolve with the field of medicine as a whole.

The National Lipid Association defines “clinical lipidology” as “a multidisciplinary branch of medicine focusing on lipid and lipoprotein metabolism and their associated disorders.” The field is growing rapidly in response to demographic trends that place an increasing number of Americans at risk for coronary heart disease (CHD) and epidemic levels of obesity concurrent with a surge in new cases of diabetes mellitus. (Information Credit to: The Foundation of the National Lipid Association.) 

If you are in your thirties, overweight, smoke, drink more than 2 drinks per day, suffer acute angina attacks (chest pain for no reason), have a sedentary lifestyle and yet have ‘normal’ cholesterol levels it may be time to take action and seek out a lipid specialist

Heart disease manifests over time and it takes years for plaque to grow but the body shows signs ten years before a fatal attack. You can get have these advanced tests done NOW and see what your risks are, you can evaluate your numbers while you still have a chance to do something about it. Research shows that people who have these corkscrew proteins and small dense LDL’s are at higher risk for heart attack. Finding out these numbers now may save your life. For more information on what the advanced lipid tests mean follow this link: 

EVEN if you have been to a doctor recently for chest pain and they say your EKG and lipid panel are normal your body may still be suffering from early signs of heart disease. I had four stents placed in my heart and a year later, I started having chest pain and trouble breathing. However, EVERY SINGLE ONE of my heart tests were completely normal. My traditional lipids were normal. I looked like a great heart patient, one who had followed the system and was beating heart disease. I felt terrible though and when my cardiologist wouldn’t do anymore I sought out another doctor at the University of Chicago. I had another blockage, I needed another stent. 

At that point I was referred to a lipidologist for advanced testing of my lipids.
The advanced testing was necessary to my still being here today. I would have had fatal heart attack if not for this in depth testing. When searching for a lipidologist make sure the physician is certified in clinical lipidology, a certification from the American Board of Clinical Lipidology is essential. Also, verify when making the appointment the physician practices advanced lipid testing. 

Do not let your current doctor tell you that your heart tests are all normal or that you suffer from anxiety. If your chest is hurting whether it’s at rest or upon exercise, seek out a lipidologist. I was perfectly normal. My numbers were great. I had lost weight, I was eating well, I was exercising and I had already had one heart attack so I was extremely in tune with my habits, yet I had another heart attack and more serious heart disease than originally thought.

YOU are in charge of your health. Your doctor is not going to seek out all the avenues needed for your care. If the “numbers” look good to him it’s not going to occur to him to go deeper but if your immediate family members have heart disease, if you have risk factors and/or you suffer from chest pains- make an appointment with a lipidologist ASAP or start planning for your death. It’s that simple and that harsh.
As always, Live, Laugh, Love!

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