Routine cholesterol tests provide the four following
measurements:
Total cholesterol
Triglycerides
Low-density lipoprotein (LDL, the bad cholesterol),
High-density lipoprotein (HDL, the healthy or good
cholesterol).
The standard cholesterol panel has until now
provided limited information.
It
can identify only about 40% of patients at risk for
coronary heart disease.
Many
risk factors are involved in the development of heart
disease, and for some people, high cholesterol may or
may not be one of them.
The well-known
Framingham Study illustrated that the higher the
cholesterol, the higher the statistical risk of a heart
attack.
A high number of
heart attacks still occur every day in people whose
cholesterol values are seemingly normal.
The
problem has more to do with silent, chronic
inflammation than anything else.
The
American Heart Association reports that 50%
of men and 64% of women who died suddenly of
coronary heart disease had no previous
symptoms.
This clearly emphasizes that
cholesterol is not the whole story. Inflammation and
the cholesterol breakdown are also part of the
story.
Advances in blood testing finally allow
us to better understand these other factors.
Scientists have developed a more
advanced blood test that can far more accurately
assess your risk of heart disease.
The
Vertical
Auto Profile (VAP) test augments the standard
cholesterol profile with additional measurements that
can identify the risk of cardiovascular
disease.
The VAP test not only offers a
comprehensive assessment of cardiovascular risk, but
also supplies vital information that can help you and
your doctor formulate a customized disease-
prevention program and measure its progress over
time.
This powerful diagnostic tool can help
you take the steps necessary to avoid preventable
health catastrophes-like heart attack and stroke-
today.
The VAP test assesses levels of all the blood lipids
measured in a standard lipid profile (total cholesterol,
LDL, HDL, and triglycerides), PLUS subclasses of
lipids
that are known or emerging risk factors for
cardiovascular disease, such as LDL particle size and
lipoprotein(a).
Below is a guide to the various
components of the VAP test and their implications for
the development of cardiovascular disease:
LDL: Low-density lipoprotein; elevated levels are
considered a primary cause of heart disease.
LDL is
the primary cholesterol target in heart disease risk
management.
An LDL level around 100 is
optimal.
HDL: High-density lipoprotein; considered protective
to the cardiovascular system. Low levels are
associated with increased risk for coronary heart
disease.
The optimal HDL is above 60. The
higher the better.
HDL takes LDL (bad
cholesterol) back to the liver for
reprocessing.
VLDL: Very-low-density lipoprotein; the main carrier
for triglycerides. Elevated levels can be an
independent risk factor for heart disease.
Total Cholesterol: The total amount of cholesterol
circulating throughout your body.
All
hormones are made from cholesterol so it is not all
bad. You need a certain amount of cholesterol to have
optimal health.
Triglycerides: Energy-rich molecules needed for
normal functions throughout the body. Elevated levels
are associated with diabetes and cardiovascular
disease.
Non-HDL Cholesterol: The sum of LDL and VLDL;
elevated levels are a better predictor of heart disease
risk than LDL alone.
Lp(a): Lipoprotein(a); an inherited risk factor for heart
disease. It is more dangerous than other types of
cholesterol, and does not respond to traditional LDL-
lowering drugs.
Statin medications that are
used to lower cholesterol may be associated with an
increase of Lp(a).
Medical studies have
shown that Lp(a) can be significantly lowered with
Omega 3 fish oil and Niacin (B Vitamin) on a daily
basis.
This should be done under medical
supervision as liver function tests should be
reevaluated periodically when using Niacin (B
Vitamin) in large doses to lower cholesterol.
IDL: Intermediate-density lipoprotein; an inherited,
independent risk factor for heart disease. It is often
elevated in patients with a family history of
diabetes.
Real LDL: The "real" cholesterol circulating in your
body, it is a component of LDL. Real LDL is calculated
by subtracting Lp(a) and IDL from LDL.
LDL Size Pattern: LDL particles vary in size, ranging
from small, dense "Pattern B" particles to large,
fluffy "Pattern A" particles.
Smaller LDL
particles
are associated with an increased risk for heart
disease. Small, dense LDL ("Pattern B") is associated
with insulin resistance or diabetes.
Metabolic Syndrome: A condition characterized by a
combination of several metabolic risk factors-
including elevated triglycerides, low HDL, and small,
dense "Pattern B" LDL particles-that increase the
overall risk for heart disease.
HDL2\ HDL3: HDL subfractions are used to predict
cardiovascular risk. HDL2 is large and buoyant, and is
the most protective form of HDL. Low HDL2 with
normal LDL is associated with cardiovascular risk.
HDL3 is not as protective as HDL 2.
VLDL3: VLDL3 is the densest VLDL sub-fraction, and
confers a greater risk factor for heart disease than both
VLDL1 and VLDL2.
As you can see, the VAP
provides a great deal of additional information that is
not routinely tested.
Everyone who would like to fully and accurately
understand their cardiovascular risk should consider a
VAP test.
This blood test is the cutting in
assessing cholesterol and heart disease risk factors.I
strongly recommend this test for adults at high risk-
due to family history, previously diagnosed
cardiovascular disease, or conditions such as high
blood pressure, diabetes, obesity, or known lipid
abnormalities.
The advanced information provided by the VAP test
allow doctors and patients to proactively implement
strategies to prevent cardiovascular events and
mortality as part of an Age Management Medicine
program.
