Lipid Profile

Age, hereditary factors, weight, smoking, blood pressure, physical activities are important in determining cardiac risk. However, the most important indicator for cardiac risk is the lipid profile.

Do you know what the lipid profile is??

The lipid profile measures cholesterol, triglycerides, high density lipoprotein cholesterol (HDL-C or known as ‘good cholesterol’), and low density lipoprotein cholesterol (LDL-C or known as ‘bad cholesterol’)

Table of Lipid Profile Values

	mg/dL	mmol/L
Total Cholesterol
Desirable	< 200	< 5.1
Borderline High	200 - 239	5.1 - 6.1
High	> 239	> 6.1
LDL Cholesterol - The "Bad" Cholesterol
Optimal	< 100	< 2.6
Near/Above Optimum	100 - 129	2.6 - 3.3
Borderline High	130 - 159	3.3 - 4.1
High	160 - 189	4.1 - 4.8
Very High	> 189	4.8
HDL Cholesterol - The "Good" Cholesterol
Low (Undesirable!)*	< 40	< 1.0
High (Desirable!)	> 60	> 1.5
Serum Triglycerides
Normal	< 150	1.7
Borderline High	150 - 199	1.7 - 2.2
High	200 - 499	2-2 - 5.6
Very High	> 499	> 5.6

*The American Heart Association sets different thresholds for HDL cholesterol in men (< 40 mg/dL = low) and women (< 50mg/dL = low), a discrimination that the National Cholesterol Education Program no longer makes.

The values in the above table are indicated in milligrams per deciliter blood (mg/dL) and millimol/liter (mmol/L). The unit mg/dL is common in the US, whereas mmol/L is generally used in the rest of the world.

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CVD DIAGNOSIS

In the past post, we have acknowledge  on how you will get the risk for CVD by knowing the risk factors. Now, let us get to know how the CVD will be diagnosed. When your doctor thinks that you might be developing risk for CVD , those diagnosis will be carried out;

1. Blood test

Blood test is one of the common laboratory test to diagnose most of diseases. This test may detect fat, cholestrol, lipid components in blood including LDL, HDL, Triglyceride and certain protein. Protein markers such as Apolipoprotein A1 and B will help in detection of inflammation that may lead to heart disease. During heart attack, muscle cell die and release protein into the booldstream. Cardiac Troponin-T is one of the protein markers to detect recent heart attack other than fibrinogen and PAI-1, high levels of homocycteine, elevated asymmetric dimethylarginine and brain natriuretic peptide (a.k.a. B-type or BNP).

2. Electrocardiogram (ECG)

This test is used to detect any irregularities on the heart beat and the heart rhythm through the electrical impulses.

3. Echocardiogram

A moving picture showing the size and shape of heart is used to see how the heart work and any injuries caused by poor blood flow. 

4. Stress Testing

This test will need the patient to exercise while the ECG/EKG leads are placed on the body. Exercise use to increase the heart rate. If the patient are not able to exercise due to some constraint, they will receive medicine or pills that may increase their heart rate. Possible signs and symptoms can be observed on the abnormal heart rate or blood pressure, shortness of breath or chest pain and abnormal in the heart rhythm or heart's electrical activity. 

5. Chest X-ray

The image of the heart can be observed to see if there are any abnormalities occur on the structure of the heart that may cause CVD.

6. Coronary Angiography / Cardiac Catherterization

This test is use by using dye that will be injected by using a tube (catheter) into the bloodstream threaded to the coronary artery . An image will be shown on the dye that indicate the flow of blood through heart and blood vessels and this is called coronary angiography. 

7. Cardiac Magnetic Resonance Imaging (MRI)

Cardiac MRI use radio wave, magnetic and computer to produce a 3D image of the heart. A signal will be produced indicate vary of the tissues will help the diagnosis process. 

References:

1. Coronary Heart Disease - Diagnosis 

2. National Heart Lung and Blood Institute : How is Heart Disease Diagnosed?

3. News Medical : Cardiovascular Disease Diagnosis 

4. Mayo Clinic : Heart Disease - Test and Diagnosis 

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Cholesterol Myths vs Reality

Few days ago I share about the MAIN risk factor of CVD which is Cholesterol profile. Since we are talking about cholesterol, thought I share some common myths and the REALITY about Cholesterol. ^^ 

Myth	Reality
Cholesterol is BAD	ALL mammals need cholesterol to SURVIVE
High cholesterol is dangerous	High cholesterol is actually not a problem. But the ratio of “good” to “bad” cholesterol, weight, exercise and family heath history.
People who have heart attacks have high cholesterol	Yes~ High cholesterol is a main risk factor in heart disease, BUT there are people who develop heart disease and heart attacks even their cholesterol levels are normal or even low!
Cholesterol is only available at cholesterol containing food.	WRONG! Our body liver also produces cholesterol.
Eating eggs especially yolk can lead to high cholesterol level.	Several researches have showed that 1-2 eggs a day have LITTLE effect on people with normal cholesterol levels.
Following low-fat diet + exercise will SURELY reduce my cholesterol.	Some people are born with genetic defects causing lifestyle changes alone to have no strong effect on cholesterol level. These people will need the help of medication together with lifestyle changes.
Young people don’t have high cholesterol	EVERYONE from age 20 and above should check their cholesterol. Studies have shown that arteries can start to narrow even in people as young as 20’s.

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