Guest blogger Nancy Beth Jackson, Ph.D., is a New York-based journalist who covers health issues.
Sometimes numbers don’t tell the whole story – such as tallying up your “good” HDL cholesterol that protects you and “bad” LDL cholesterol that puts you at risk for heart attack or stroke. A less common, more comprehensive blood screening may give you a better picture by measuring your LDL directly and zeroing in on how it looks as it travels through your bloodstream.
“Many more practitioners are ordering the advanced panels to gain a more thorough insight into cardiovascular risk and to help guide treatment beyond mono-statin therapy,” said Dr. Bradley Bale, MD, medical director of the Heart Attack, Stroke and Diabetes Center at Grace Clinic in Lubbock, TX. LDL quality as well as quantity counts when it comes to evaluating cholesterol, he stressed.
Just as oil and water don’t mix, oil-soluble lipids – such as cholesterol and fat – don’t mix with blood, which is mostly water. To do its job around the body, cholesterol has to be packaged in envelopes of protein such as lipoproteins. Not all LDL packages look or behave alike. Some are large, fluffy and light; others are small and dense. Big, fluffy ones bounce off artery walls, but dense particles are more likely to penetrate artery walls. People who mainly have small dense particles have triple the risk of coronary heart disease, according to a Johns Hopkins Medicine health report.
Just how necessary is a closer look at your cholesterol? Not everyone agrees, but proponents point out that simply lowering your cholesterol numbers doesn’t always protect you. A 2009 study revealed that more than 75 percent of patients hospitalized with coronary artery disease had LDL levels within current national guidelines.
In Europe, “advanced” lipid panels are already “routine,” Dr. Bale said. The European Atherosclerosis Society recommends screenings for people with moderate-to-high risk of heart disease after a Danish study linked genetically elevated lipoprotein(a), a LDL-like particle, to heart attacks. About 20 percent of us have elevated levels of this lipoprotein.
Because lipoproteins are influenced by genetics, says Dr. Bale, you may want to look into the test particularly if:
1. You have a family history of cardiovascular disease.
2. You have relatives that died early of heart attacks.
Discuss the advanced lipid panel with your doctor and remember to have the standard cholesterol test every five years.
CONNECT THE DOTS
How much do you know about cholesterol? Take a quick quiz to find if you need to brush up on your basics. Mayo Clinic suggests five strategies to help prevent heart disease. Also, see our blog posts: “New Recommendations for Finding High Cholesterol” and “Seven ‘Super Foods’ You Should Be Eating.”
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