Cardiovascular Health: A Deeper Picture
- Rylee Sigwarth
- 3 days ago
- 2 min read
When it comes to cardiovascular disease (CVD), what most people really want me to tell them is their risk for a heart attack or stroke. At your annual physical, most people are familiar when we discuss the HDL, “good cholesterol,” and LDL, “bad cholesterol,” but many are not familiar with additional markers we can check that are more accurate and can better determine your risk for heart attack and stroke.
The traditional lipid panel uses an estimated calculation of LDL, known as LDL-c (for LDL-calculated). While this is a decent marker and used in the risk assessment calculators of cardiovascular disease, getting a particle number of LDL and size of the particles can further assess risk that these particles bury into your blood vessels to cause plaques that build or break off and form a clot. These are tested in a fractionated lipid panel. Additional markers I check include apolipoprotein B, lipoprotein a, hs-CRP, fasting insulin, uric acid. I may also assess homocysteine, fibrinogen, oxidized LDL, LP- PLA2, and GGT based on your interest and risk factors. Apolipoprotein B is the carrier protein of LDL and a more sensitive marker. Lipoprotein a, AKA Lp(a), is a hereditary marker that indicates increased CVD risk. The other markers round out the picture of metabolic health, inflammation, and oxidation that all contribute to risk.
Lab values, vitals, family history, the ASCVD risk calculator, and the Mayo Clinic Statin Decision Aid are all tools to build a picture of risk. Once we establish a more comprehensive snapshot of CVD risk, we can optimize lifestyle, supplements, and/or pharmaceuticals based on your preference to reduce risk. I am passionate about working with you to optimize levels and meet your health goals.
~Rylee Sigwarth, PA-C
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