Stopping Heart Disease: Seven Lifesaving Blood Tests Your Doctor Doesn’t Order!

By Steven V. Joyal, MD

Consider a beautiful Sunday afternoon in springtime, the smell of flowers, trees, and grass emerging from a long winter.

Now, imagine the sudden onset of crushing pain across your rib cage, shortness of breath, and a cold sweat across your face and back. A beautiful spring day, interrupted by the classic symptoms of a heart attack!

If you don’t want this to happen to you, prevention is critical, and an important part of an over-all prevention strategy is to detect risk factors for heart disease early in the course of the disease. Although the symptoms of an acute heart attack may appear suddenly, the underlying disease (called coronary atherosclerosis) that ultimately results in a heart attack occurs over many years.

Heart disease is the leading cause of death in the United States, and about every 25 seconds one of us will suffer a heart attack.  Annual blood testing plays an important role in helping to identify risk factors early in the course of vascular disease. Regrettably, many doctors are not aware of several blood tests that offer great benefit at detecting cardiac risk factors beyond those detected with typical, routine testing. At your next physical, be sure to take this list of seven lifesaving blood tests with you so that you and your doctor can help identify heart disease risk factors early, rather than too late. 

1. HbA1c

Elevated blood sugar is a significant risk factor for heart disease, even if you don’t have diabetes. Routine testing usually includes a fasting blood sugar level, but a far more accurate measurement of your blood sugar control over a three-month period of time is the hemoglobin A1c (HbA1c) test. This test is usually given only to diabetics, yet all of us need to fully understand the risks associated with high blood sugar.  If your HbA1c level is not optimal (over 5.7), you need to achieve better control over your blood sugar levels. Weight loss, exercise, and diet are three time-proven strategies of achieving better blood sugar control. Nutrients like cinnamon, soluble fiber, and the exotic-sounding Indian Ayurvedic herbal medicine Gymnema sylvestre can help, too.

2. Fibrinogen

Increasingly, scientists have discovered that inflammation plays a deadly role in most degenerative diseases.  Fibrinogen levels increase in response to inflammation in our body.  Recent studies suggest that elevated fibrinogen levels are an independent risk factor for heart disease and stroke in patients with decreased vascular circulation (peripheral artery disease).  If your fibrinogen levels are elevated, weight loss and physical activity can help. Also, consider fish oil, niacin, and folic acid, in addition to vitamins A and C, to support healthy fibrinogen levels.

3. Homocysteine

Elevated levels of homocysteine are associated with an increased risk of heart attack, stroke, bone fracture risk, and cognitive function including depression.  If your blood tests reveal elevated homocysteine levels, B-vitamins like folic acid, B12, and B6 can help support healthy homocysteine metabolism.

4. C-reactive protein

Elevated levels of C-reactive protein indicate your body is under assault from inflammation. This important test can help you ward off some of the most lethal diseases before they begin.  Studies suggest that C-reactive protein is a risk factor for a host of diseases including cardiac disease, macular degeneration and arthritic conditions.  For those with elevated CRP, a low dose of daily aspirin can be helpful.  Also, natural therapies like fish oil, L-carnitine, and soluble fiber can help support healthy levels of C-reactive protein.

5. TSH

Our thyroid gland is the master metabolic regulator of our key body functions.  Signs and symptoms of a significantly overactive or underactive thyroid are easy to recognize for most physicians. Studies show that mild thyroid disease can increase the levels of cholesterol in the blood, contribute to weight gain, and increase the risk of heart rhythm disturbances.  A screening test for thyroid stimulating hormone (TSH) starting at age 35, and every five years thereafter, is a good strategy to identify subtle thyroid malfunction early.

6. 25-hydroxy vitamin D

The remarkable benefits of vitamin D extend across the entire health spectrum. Produced in the skin during exposure to sunlight in the ultraviolet-B spectrum, vitamin D is also available as a low-cost dietary supplement (vitamin D3, cholecalciferol). Over thirty different cell types, including bone, vascular, brain, muscle, and immune system cells contain receptors for activated vitamin D. Recent scientific studies show that low levels of vitamin D are associated with an increased risk of certain types of cancer (e.g. breast, prostate), cardiovascular disease, and even the flu. Despite the enormous health benefits associated with optimal vitamin D status, the vast majority of us are insufficient, with some research suggesting as much as 80% of the population may not have optimal blood serum levels. A simple blood test can detect your vitamin D status. If you avoid sun exposure out of concern over skin cancer and premature skin aging, the latest research suggests that you will need somewhere between 2,000-8,000 IU of supplemental vitamin D3 daily to achieve optimal serum levels.

7. Advanced lipoprotein profiling

The information you obtain with advanced lipoprotein testing provides a wealth of detail on important parameters of heart disease risk, much more than the standard cholesterol profile.  For example, we know that small, dense LDL-cholesterol particles are far more plaque-producing than large, fluffy LDL-cholesterol particles. A standard cholesterol test does not differentiate between small, dense LDL and fluffy, buoyant LDL. Another example is the so-called “good” cholesterol, HDL. Standard cholesterol tests do not tell us if you have more of the favorable HDL2 subclass of particles or the less favorable HDL3, while advanced lipoprotein tests evaluate for HDL2 and HDL3 cholesterol. Several different types of advanced lipoprotein tests are available based upon your individual needs.