About a month ago, I wrote to you about a host of markers for assessing your risk of heart disease – and about how the mainstream’s sole focus on cholesterol puts thousands of people in danger. At that time, I talked about homocysteine, coenzyme Q10, platelet-activating factor, and thromboxane, all substances that can be detected in blood tests to help provide a more comprehensive picture of your true risk. Now new research is adding another factor to that list – and suggesting that the addition might provide the most powerful predictor of all.
Neither total cholesterol nor LDL is the best heart attack predictor
In a new Swedish study, researchers tracked a total of 175,553 men and women for an average of five and a half years. The average age of the male participants was 47 years, while the females’ average age was 49. The researchers measured each participant’s total cholesterol, LDL and HDL cholesterol, and triglycerides, all of which are conventional markers for heart disease risk. They also measured concentrations of apolipoproteinB (apoB) and apolipoproteinA-1 (apoA-1), two relatively new discoveries in the world of heart disease prediction. Apolipoprotein is actually a subset of total cholesterol; it’s the molecule’s protein component. ApoB is the protein found in LDL (commonly called “bad” cholesterol), while apoA-1 is found in HDL (or “good” cholesterol).
Over the course of the study, 864 men and 359 women died from acute myocardial infarction (heart attack). And when the researchers compared their blood results to the rest of the participants’, they made some interesting observations. ApoB and apoA-1 were the strongest predictors of heart attack death among all of the markers, and they were the ONLY markers that remained consistent over all age groups.
A bad apo ratio can QUADRUPLE your risk of a fatal heart attack
Just as HDL and LDL are often expressed as a ratio, this study found that apoB and apoA-1 are best explained when expressed in relation to each other. In this case, men with the highest levels of apoB AND the lowest levels of apoA-1 were nearly FOUR TIMES as likely to have a fatal heart attack than those with opposite values. (ApoB levels ranged from .90 to 1.80 grams per liter, while apoA-1 levels were between 1.12 and 1.65 g/L.) Women with similar ratios had three times the risk. Most importantly, the predictive power of the apo ratio was seen even when total cholesterol, LDL cholesterol, and triglycerides were within normal ranges. The study also showed that the apo ratio remained a strong marker in patients over age 70. This is significant because total cholesterol and LDL cholesterol lose much of their predictive power in patients over the age of 70.
HSI medical advisor tests for apo in his patients – and explains how you can, too
At HSI, we’ve always said that most doctors’ conventional analysis is just not enough to accurately assess your risk of a heart attack. Our medical advisor, Martin Milner, N.D., agrees – and carries out that belief in his recommendations to his own patients. Dr. Milner routinely tests his patients’ apoB and apoA-1 levels, as well as their apo ratios. But that’s not all – his complete approach also measures c-reactive protein (a marker for systemic inflammation) and fibrinogen (a globulin that affects blood coagulation), as well as homocysteine, total cholesterol, HDL and LDL. That may seem like a lot of tests, but Dr. Milner has found one comprehensive test that can assess all these important heart health predictors from just one blood sample. It’s called the Comprehensive Cardiovascular Report (CCR), and it’s available from Great Smokies Diagnostic Laboratories (GSDL).
Talk to your doctor about requesting the CCR test from Great Smokies Diagnostic Laboratories. Physicians can find out more by calling GSDL at 1-800-522-4762 or visiting their web site at gsdl.com. Or, if you’d prefer, you can contact the lab directly and ask for a referral to a registered provider in your area. Once the test is complete and returned to GSDL, you’ll receive your full report in seven to 10 business days. It will provide your score on each important marker, and, in clear language, what your scores tell about your risk.
The traditional cholesterol analysis may be “good enough” for the mainstream. But when it’s your own life at stake, “good enough” just isn’t enough. This study proves once again that the focus on total cholesterol, and even LDL cholesterol, still leaves many people at risk for a fatal heart attack. But you can take steps TODAY to find out your true risk. Armed with the right information, you’ll have a much better chance to address your high-risk areas – and live a long, healthy life.
Source: Lancet 358:2026-2033,2001
Copyright 1997-2002 by Institute of Health Sciences, L.L.C.
