Comprehensive Cardiovascular Risk Profile

The Comprehensive Cardiovascular Risk Profile is a blood test that will be performed by Great Smoky's Diagnostic Laboratory. You will be provided with a kit that contains everything needed for the performance of the test. You will take this kit with you to the laboratory when you have your blood drawn. It is important that you have been fasting for 12 hours prior to having this test done Please remember, if you are having this test drawn at St. Vincent Hospital at the 86th Street location, you will need to be there before 2:00 p.m.

Although heart disease has been declining in this country in the last 10-15 years, it still represents a primary cause of mortality and morbidity. Individual risk factors, such as genetics and family history, blood pressure, diabetes, and the use of tobacco products are essential for overall risk assessment. There are several other, independent risk factors that can be diagnostically measured through blood testing to gain additional insight on independent metabolic factors that may contribute to overall cardiovascular status and risk of circulatory compromise.

Total cholesterol is a known risk factor in the evolution of heart disease. However, there may be significant differences between absolute and relative statistical value as it relates to elevations of total blood cholesterol as an independent risk factor for heart disease. Also to be considered is the fact that certain types of cholesterol, such as the oxidized forms, may actually play a more significant role in the generation of heart disease than do other forms of cholesterol that are not subject to free radical interaction.

There are also several other, independent risk factors and protective factors that can be measured. The rationale for doing a comprehensive cardiovascular profile is to provide information and better understanding on many of these other factors.

This test will include a measurement of triglycerides, total cholesterol, LDL and HDL. It will also measure other contributing factors that are less frequently done at most doctors' offices including the following:

Apolipoprotein A1 is associated with a protective effect against cardiovascular risk. Levels typically correlate with HDL cholesterol, or what is usually thought to be a good type of cholesterol that has a protective effect on the circulatory system.

Apolipoprotein B level generally correlates with the amount of LDL cholesterol in the body. High levels of Apo-B correlate with the degree of stenosis, or blockage, in the coronary and carotid arteries.

Lipoprotein (Lp-a). Lp-a seems to be under some genetic control and can influence a person's cardiovascular risk. Elevated levels are generally independent of various lifestyle factors, such as smoking, exercise level, obesity and diet. Elevations can be consistent with increasing risks for certain types of cardiovascular disease.

Homocysteine. Elevations of homocysteine correlate with alterations in normal metabolism of the amino acid methionine. Elevations also correlate with increased risk of heart disease. Nutrients, such as vitamin B6, vitamin B12, folic acid and dimethyl glycine have a protective role in reducing levels of homocysteine.

C-reactive protein (CRP). CRP has been shown to be a significant indicator of cardiovascular disease, particularly in areas related to an inflammatory process.

Fibrinogen. Elevated levels of fibrinogen are also associated with increased cardiovascular risk and seem to enhance the tendency of blood to coagulate (or clot) and of blood viscosity (or thickness), which, in turn, can lead to the formation of micro-clots or thrombus formation in the circulation around the heart and the brain. Therefore, elevations can be associated with increased occurrence of stroke and sudden myocardial infarctions. Some habits (such as smoking), stress, use of oral contraceptives, aging, and obesity can modify fibrinogen.

Your test results will be reviewed at your follow-up visit. If you have any questions during the interim, please contact the office.

Dale Guyer, M.D.