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Overview
50% of cardiovascular (CVD) events occur in patients with near, or at optimal LDL-C.
Despite aggressive LDL-C lowering, 60-70% of CVD events still occur.
Getting patients to LDL-C goal is not enough. There are other risk factors/markers that need to be addressed. How do you identify patients at risk? What do you do once they are identified? Boston Heart Lab can help you identify and manage those patients!
Cardiovascular Disease
Cardiovascular diseases (CV) accounts for about half of all deaths and a large part of disability in our society. CVD is caused by atherosclerosis, a lipid disorder with an inflammatory response. It is in many ways a preventable disease. By knowing the risk factors involved in the disease, you can take proper action to reduce the risk.
Patients at Risk
Certain patient populations are at higher risk than others. These include patients with:
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prior CHD events |
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male gender |
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increased age (men over 45 years, women over 55 years) |
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high blood pressure (over 140 mmHg of systolic blood pressure) |
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diabetes (fasting glucose over 125 mg/dl) |
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cigarette smoking |
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increased blood levels of low density lipoprotein (LDL) cholesterol (> 160 mg/dl for men and women) |
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low high-density lipoprotein (HDL) cholesterol (< 40 mg/dl for men and < 50 mg/dl for women) |
LDL Cholesterol
Patients with heart disease often have increased low-density lipoprotein (LDL) cholesterol or bad cholesterol, due to increases in small dense LDL. In practice, LDL cholesterol is normally calculated by subtracting the sum of HDL cholesterol and triglycerides, then dividing by 5 from total cholesterol. This calculation of LDL cholesterol, known as the Friedewald formula calculation, is not accurate if subjects are not fasting or their fasting triglyceride is increased (>250 mg/dl or definitely >400 mg/dl). Our laboratory offers new assays for direct LDL and HDL cholesterol analysis that better predict heart disease than calculated LDL and HDL cholesterol (currently the major treatment target). We also offer markers of cholesterol absorption and synthesis. We can tell whether a patient is a hyper absorber or a hyper synthesizer – whether a cholesterol absorption inhibitor or a statin will be most effective.
Click here to read more.
HDL Cholesterol
Low HDL cholesterol (< 40 mg/dl in men and < 50 mg/dl in women) is also a significant CHD risk factor. Women have 25% higher levels than men, which protect them from heart disease. However, as many women die of heart disease as men, except that their average age of heart disease onset and death is about 7 years later than for men. This fact accounts for the enhanced longevity of women over men. The same risk factors apply to both men and women.
We sub fractionate and measure five, more or less atheroprotective, sub particles of HDL, the good cholesterol with our Boston Heart HDL MapTM technology. This HDL particle analysis provides for significantly better risk assessment than HDL cholesterol alone. Heart disease patients are often missing large HDL particles that serve to bring cholesterol from tissues, including the artery wall, back to the liver for removal from the body. CHD patients most often also have elevated levels of the prebeta-1 particle, the smallest of the HDL particles. Boston Heart Lab is the only laboratory that measures this sub fraction.
For additional detail on our testing, please go to ”The Science Behind”.
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