In the month of *hearts* I thought it would be smart to talk about keeping our hearts healthy! I receive many inquiries about how best to “screen” for heart disease, or the risk factors for heart disease, and here are the items that I think are most important:
- Check weight, height and body mass index (a ratio of the two), or even better: body composition (a simple 5 minute test using bioelectric impedance).
- Check blood pressure. It remains one of the most important risk factors for heart disease and if it’s high, be sure you check it at home at different times throughout the day to see what your average blood pressure is.
- Check fasting glucose, hemoglobin A1C (long term measure of average glucose), or even better, fasting insulin to look for signs of pre-diabetes.
- Check a detailed cholesterol panel, a VAP panel, that also screens for genetic markers for lipid risk and examines particle size to help determine risk.
- Check an hsCRP (C-reactive protein) that measures inflammation, particularly as concerns the cardiovascular system. This blood test is the MOST associated with risk of heart attack.
- Check a homocysteine level. An elevated homocysteine increases cardiac risk and reflects an issue with folic acid metabolism.
These are the basic tests that I consider in anyone that I want to help prevent heart disease. In someone who already has risks for heart disease, we may also want to consider an EKG or an echocardiogram (an ultrasound of the heart that can look at heart size and function). Even more sensitive is an EKG and echocardiogram performed during exercise (a stress ECHO). I generally reserve that test for those that are undergoing a significant stress (for example, surgery) or those in whom I am concerned about imminent heart disease. Another screening test that should be considered is a coronary calcium score—which is an x-ray that can calculate the amount of calcium deposited into the coronary (heart) vessels. This reflects the degree of atherosclerosis, or hardening of the arteries, and can be a great motivator to behavioral change when elevated.
Keep in mind that getting more love in your life, reducing stress, exercising, stopping smoking and generally enjoying your life will all make your heart happy and less vulnerable to disease.
In this season, a big hug from my heart to yours and I hope we all take good care of our own hearts and the hearts of those we love.