If heart disease runs in your family, or if you’ve had any type of heart or vascular problem in the past, you might want to look into more detailed cholesterol testing to better determine which treatments might be best for you.
“When it comes to assessing risks for cardiovascular disease, it’s important to know that routine lipid (cholesterol) testing doesn’t always tell the complete story,” said Perry J. Weinstock, M.D., a cardiologist and board-certified lipidologist, who heads the division of cardiovascular disease at Cooper University Hospital. Dr. Weinstock will be answering questions about lipids and statins during the May 21st Health eTalk. To find out more or to ask a question, click here: www.cooperhealth.org/etalk.
“For people with a personal or immediate-family history of heart disease, the cholesterol results obtained from traditional lipid testing do not necessarily tell us their true risk. These are the people whose genetic make-up might predispose them to heart disease, and these are the people who could benefit from advanced lipid testing,” Dr. Weinstock said.
Unlike traditional lipid testing, which calculates the level of “bad” LDL (low density lipoprotein) cholesterol in the blood, advanced lipid testing is a laboratory technique that provides direct, detailed information about specific cholesterol particles. It is through the analysis of these particles that doctors can detect abnormalities that may contribute to the development of heart and vascular disease. The tell-tale components of these particles involve their size and density, which is not revealed by routine lipid testing.
Another indicator of your overall risk of heart disease is your non-HDL cholesterol count. This measurement is obtained by subtracting your HDL “good cholesterol” from your total cholesterol. So, if your total cholesterol count is 190 and your HDL cholesterol count is 40, your non-HDL cholesterol is 150.
Knowing your level of non-HDL cholesterol tells you all the bad cholesterol circulating in your blood—not just your LDL cholesterol but your VLDL (very low density lipoprotein) cholesterol and your IDL (intermediate-density lipoprotein) cholesterol, which also affect your cardiovascular health.
The recommended level for non-HDL is no more than 130 for disease prevention, and no more than 100 for people with established coronary artery disease or those at very high risk, such as diabetics or those with evidence of atherosclerosis (hardening of the arteries or clogged arteries).
Another potentially artery-clogging lipoprotein is known as Lp(a). “Lp(a) is a small, dense variant of LDL that, at least in some families, may predispose to early atherosclerosis. The total cholesterol and LDL cholesterol numbers on a standard Fasting Lipid Profile blood test do not give us any information about Lp(a),” Dr. Weinstock noted.
Arteries carry oxygen-rich blood to the heart and throughout the body. Atherosclerosis is a narrowing of the arteries caused by the build-up of plaque and fatty deposits (cholesterol) on the inner surface of the arterial wall. “Often times, people experience no symptoms of this narrowing until the blood flow to their brain or heart is completely blocked, resulting in a stroke or heart attack,” Dr. Weinstock said.
“Clearly,” Dr. Weinstock added, “early identification of such risk factors is the key to prevention. Advanced lipid testing allows us to pinpoint these otherwise hidden risk factors and, ultimately, prescribe individualized therapies to modify the condition and reduce the risk of future coronary and vascular events.”
Of course, the cholesterol abnormalities discussed here represent only a few of the many various and complex lipid disorders capable of detection through advanced lipid testing. “Even the ‘good’ HDL cholesterol has different subclasses, each with different levels of risks or benefits assigned to them,” Dr. Weinstock said.
While the results of traditional lipid testing are important—a baseline, routine cholesterol test is recommended at age 20 for all adults, more advanced lipid testing may be appropriate for people with a personal history of heart disease and people whose parents, siblings or children have or have had heart disease.
“By knowing what to do with the results obtained from advanced lipid testing,” Dr. Weinstock said, “advanced cardiac centers like the Cooper Heart Institute can tailor life-saving treatment plans for these individuals who are most at risk.”
Talk to your doctor about advanced lipid testing and a board-certified lipidologist who can personalize a treatment plan. If you’d like to learn more about this topic, be sure to read the complete transcript from the Health eTalk Dr. Weinstock hosted on May 21 where he answered questions about lipids live on cooperhealth.org.
About Perry J. Weinstock, M.D.
Dr. Perry J. Weinstock is one of only a few hundred physicians nationwide certified by the American Board of Clinical Lipidology, where his status as Diplomate recognizes his successful completion of advanced education and rigorous examination in the field of clinical lipidology. Dr. Weinstock serves on the Board of the American Heart Association, and is an officer on the Board of Directors of the Northeast Lipid Association. He also is a member of the editorial board of the Journal of Clinical Lipidology.
Ikiwa ugonjwa wa moyo unaendelea katika familia yako, au ikiwa umekuwa na aina yoyote ya tatizo la moyo au vascular katika siku za nyuma, unaweza kutaka kuangalia katika vipimo vya cholesterol vya kina zaidi ili kuamua vizuri ni matibabu gani yanaweza kuwa bora kwako. "Kama inakuja kwa kutathmini hatari ya ugonjwa wa moyo na mishipa, ni muhimu kujua kwamba kawaida lipid (cholesterol) kupima haina daima kuwaambia hadithi kamili, ""alisema Perry J. Weinstock, MD, cardiologist na bodi-kuthibitishwa lipidologist, ambaye anaongoza mgawanyiko wa ugonjwa wa moyo na mishipa katika Hospitali ya Chuo Kikuu cha Cooper." "Wakili wa afya wa Marekani, Dr. Weinstock, ametoa taarifa kuhusu ""mfano wa lipid"" na ""statin"" katika kipindi cha mazungumzo ya afya ya 21 Mei." Kwa maelezo zaidi au maswali, tafadhali bonyeza hapa: www.cooperhealth.org <unk>Kwa watu walio na historia ya kibinafsi au ya familia ya karibu ya ugonjwa wa moyo, matokeo ya kolesteroli yanayopatikana kutoka kwa upimaji wa kawaida wa lipid haitoi hatari yao halisi. "Hawa ni watu ambao muundo wao wa maumbile unaweza kuwafanya wawe na uwezekano wa kupata ugonjwa wa moyo, na hawa ni watu ambao wanaweza kufaidika na upimaji wa lipid wa hali ya juu, ""alisema Dk Weinstock." Tofauti na upimaji wa kawaida wa lipid, ambao hukadiria kiwango cha LDL (low-density lipoprotein) cholesterol katika damu, upimaji wa lipid wa hali ya juu ni mbinu ya maabara ambayo hutoa habari ya moja kwa moja, ya kina juu ya chembe maalum za cholesterol. Kwa kuchanganua chembe hizo, madaktari wanaweza kugundua kasoro zinazoweza kusababisha magonjwa ya moyo na mishipa ya damu. Sehemu za kuashiria za chembe hizi zinahusisha ukubwa na wiani wao, ambao haujathibitishwa na upimaji wa kawaida wa lipidi. Kiashiria kingine cha hatari yako ya ugonjwa wa moyo ni idadi yako ya cholesterol isiyo ya HDL. Kipimo hiki hupatikana kwa kuondoa HDL yako <unk>kolesterol nzuri<unk> kutoka kwa kolesteroli yako ya jumla. Kwa mfano, ikiwa kiwango cha cholesterol cha jumla ni 190 na kiwango cha HDL ni 40, basi kiwango cha cholesterol isiyo ya HDL ni 150. Kujua kiwango chako cha cholesterol isiyo ya HDL inakuambia cholesterol mbaya yote inayozunguka damu yako - sio cholesterol yako ya LDL tu lakini cholesterol yako ya VLDL (lipoprotein ya wiani wa chini sana) na cholesterol yako ya IDL (lipoprotein ya wiani wa kati), ambayo pia huathiri afya yako ya moyo. Kiwango cha kawaida cha LDL ni 130 kwa watu walio na ugonjwa wa mishipa ya damu au walio na hatari kubwa ya ugonjwa wa kisukari au wenye dalili za atherosclerosis. Lipoproteini nyingine inayoweza kuzuia mishipa ya damu huitwa Lp(a). Lp (a) ni aina ndogo, yenye unene wa LDL ambayo, angalau katika familia fulani, yaweza kusababisha ugonjwa wa atherosclerosis mapema. "Nambari za jumla za kolesteroli na LDL kwenye mtihani wa kawaida wa damu ya ""Profile ya Lipid ya Fasting"" hazitupe habari yoyote juu ya LpA, ""alisema Dk Weinstock." Mishipa ya damu hubeba damu yenye oksijeni nyingi hadi moyoni na kotekote mwilini. Atherosclerosis ni upungufu wa mishipa ya damu inayosababishwa na mkusanyiko wa plaque na mafuta (cholesterol) kwenye uso wa ndani wa ukuta wa mishipa ya damu. "Mara nyingi, watu hawajapata dalili za kupungua kwa damu hadi mtiririko wa damu kwenye ubongo au moyo wao umefungwa kabisa, na kusababisha kiharusi au mshtuko wa moyo,"" alisema Dakt. Weinstock." "Ni wazi", Dakt. Weinstock aliongeza, "kutambua mapema mambo hayo ya hatari ni ufunguo wa kuzuia. Uchunguzi wa lipid wa hali ya juu unatuwezesha kutambua sababu hizi za hatari zilizofichwa na hatimaye kuagiza matibabu ya mtu binafsi ili kurekebisha hali na kupunguza hatari ya matukio ya baadaye ya coronary na vascular. <unk> Bila shaka, kasoro za cholesterol zilizozungumziwa hapa zinawakilisha tu chache ya matatizo mengi ya lipid mbalimbali na tata yanayoweza kugunduliwa kupitia upimaji wa lipid wa hali ya juu. "Hata kolesteroli ya ""nzuri"" ya HDL ina makundi madogo tofauti, kila moja ikiwa na viwango tofauti vya hatari au faida zilizowekwa kwa ajili yao", alisema Dakt. Weinstock. Wakati matokeo ya vipimo vya kawaida vya lipid ni muhimu, mtihani wa kawaida wa cholesterol unapendekezwa kwa watu wazima wote, vipimo vya lipid vya hali ya juu vinaweza kuwa sahihi kwa watu walio na historia ya kibinafsi ya ugonjwa wa moyo na watu ambao wazazi, ndugu au watoto wana au wamekuwa na ugonjwa wa moyo. "Kwa kujua nini kufanya na matokeo yaliyopatikana kutoka kwa upimaji wa lipid ya hali ya juu, ""Daktari Weinstock alisema, ""vituo vya moyo vya hali ya juu kama Taasisi ya Moyo ya Cooper vinaweza kurekebisha mipango ya matibabu ya kuokoa maisha kwa watu hawa ambao wako katika hatari zaidi." Ikiwa unataka kujifunza zaidi juu ya mada hii, hakikisha kusoma maandishi kamili kutoka kwa HealthTalk, ambayo Dk Weinstock aliandaa mnamo Mei 21, ambapo alijibu maswali juu ya lipids kuishi kwenye CooperHealth.org. Perry J. Weinstock, M.D. Perry J. Weinstock ni mmoja wa madaktari mia chache tu nchini kote waliothibitishwa na Bodi ya Amerika ya Lipidolojia ya Kliniki, ambapo hadhi yake kama Diplomat inatambua kukamilika kwake kwa mafanikio kwa elimu ya juu na uchunguzi mkali katika uwanja wa lipidolojia ya kliniki. Weinstock ni mwanachama wa Bodi ya Chama cha Moyo cha Amerika na afisa wa Bodi ya Wakurugenzi wa Chama cha Lipid cha Kaskazini Mashariki. Yeye pia ni mwanachama wa bodi ya wahariri wa Jarida la Lipidology ya Kliniki.