Tests like electrocardiograms or a blood test for cholesterol offer good measures of heart health.
But the American College of Cardiology’s now recommending another test for a closer look at your risk for coronary artery disease.
Dr. Tu Le, a cardiologist with Texas Health Hurst-Euless-Bedford and Texas Health Physicians Group, talks with KERA’s Sam Baker about the blood test for hsCRP.
Dr. Le: CRP stands for C reactive protein. It's a protein released by the liver anytime the body has any kind of inflammation.
The HS stands for high sensitivity, which references the type of assay that is used to pick up very low levels of CRP.
This is important because we know that atherosclerosis or plaque formation in heart arteries are due to an inflammatory process. And so, if we are able to measure low levels of inflammation, we know that there is active plaque formation going on in the coronary artery.
Baker: Now this is not a new test, correct?
Dr. Le: It is not a new test. Historically ACC has been sort of on the fence about its utilization, but there are more recent trials and studies showing clear links between inflammation and cardiovascular risk and death.
And so, this test has become more widely accepted as a tool and a marker for predicting somebody's risk. And some studies even show that it's equal, if not better, than using LDL cholesterol as a predictor.
At what point though do you ask for the HSCRP?
Dr. Le: The trend now is to do it frontline. If somebody is over the age of forty and looking for a risk assessment or physicians see some predictive risk like they have hypertension, then it is a good baseline single task to order in addition to a lipid profile and measuring their blood pressure to come up with an overall risk assessment in terms of guiding how we're going to move forward in managing these patients.
Is this the kind of test a patient should walk into the doctor's office and ask for, be it during a physical or not, or is this something you want to wait until the doctor sees a need for and recommend it?
Dr. Le: I'm all for patients being informed and I think it's a good discussion to have with your physician, either your primary physician or cardiologist. But I think it's a decision that has to it's an easy test, but it's a test that I think should be left up to the provider with the with an educated discussion with the patient.
Once you know these risk factors, can you then start to minimize them or even eliminate them?
Dr. Le: There's many things you can do to minimize inflammation. You know, what we have now in our repertoire of medications is there's strong data to support statin therapies in reducing inflammation and reducing cardiovascular risk outside of LDL lowering.
When you look at clinical trials with statins, even in patients who have normal LDLs, there has been a reduction in cardiovascular risk and death, mainly through the reduction of inflammation as measured by lowering the high sensitivity CRP.
But what you can do outside of medical therapy is really focusing on lifestyle changes, avoiding high fat diets, incorporating a lot of omega-3 in your diets, eating a Mediterranean or Dash diet with focus on legumes, less on carbohydrates, more on whole wheat, does reduce inflammation.
Exercise is very important if you smoke. Smoking definitely is linked to multiple fold increase in cardiovascular death through inflammation and unstable plaque and sleep is very important as well.
RESOURCES:
