fasting blood sugar testThe fasting blood sugar test will actually tell you more about your risk of heart disease than your cholesterol profile. Are you surprised?

Don’t be! While this is not a “cholesterol test,” it IS an important marker for heart disease risk!

Sugar is intimately involved with inflammation, and as we know, it is inflammation that is the real culprit in heart disease, cholesterol is just along for the ride!

According to Dr. Mark Houston associate professor of medicine at Vanderbilt University, for every additional point above 75 on your fasting blood sugar reading, your risk of heart disease goes up!

This is due to the fact that high blood sugar levels in your blood are an independent risk factor for cardiovascular disease.

The impact of elevated blood glucose levels

Sugar is a killer, a serial killer, where your health is concerned. Medical science is just now starting to figure out how damaging sugar can be in your system when the levels are high.

There are a number of reasons for this:

  • High blood sugar causes increased insulin (which is a pro-inflammatory hormone)
  • Elevated sugar levels make your blood more acidic and it tends to clot more readily
  • Sugar causes stiffening of arteries and blood vessels
  • Sugar decreases the oxygen carrying capacity of your blood
  • Nitric oxide is vital for heart health and high sugar levels lower it
  • High sugar levels also cause glycation which is a hardening of tissues in your heart and arteries

For all the reasons above, it’s important to know what your blood sugar levels are, so that if they are high, you can make the necessary changes that will bring the level down and reduce your risk of heart attacks, strokes, and high blood pressure.

How is the test performed?

A fasting blood sugar test, which is also called a fasting plasma glucose, or FPG test, measures your blood glucose level after you have fasted for at least 8 hours.

It’s a very accurate test, and does not vary by age or how physically active you are. It tends to be a physician favorite because it’s easy to do, cheap, and you get the results relatively fast.

The test is done first thing in the morning (so you can get the results by the afternoon), after at least an 8 hour period with no food, and nothing to drink but water.

A nurse or physician assistant will draw your blood and send the sample to the lab. When the results come back your doctor will discuss with you what the results mean, in terms of your risk for both heart disease and diabetes.

Levels for these tests are expressed in “millgrams per deciliter” (a deciliter is one 10th of a liter). Thus a reading of 100mg/dl is read as 100 milligrams per deciliter.

The threshold for normal fasting sugar levels should be below 100mg/dl, but some experts, most notably Dr. Mark Houston, feel the safe level is 70 -75 mg/dl!

What do the scores mean?

Doctors use what are called “reference ranges” to determine exactly what these tests indicate. All of this is of course relative to the results taken of sample populations to determine what is statistically healthy and what is not.

There are cut off points beyond which a clinical diagnosis is made, and these would appear to be splitting hairs so to speak, but of course the line must be drawn somewhere.  Whatever the result, you will have a much better idea of where you stand, and what you have to do to protect your health in the long term.

If your blood sugar measures between 100 mg/dl to 125 mg/dl, the doctor will probably order a follow-up test to eliminate error. This test result indicates “pre-diabetes” and your doctor may want to discuss steps you can take to bring your sugar levels down and prevent diabetes.

If you score 126mg/dl or above, the doctor will want to test you again to eliminate the chance of some anomaly that might have caused an inaccurate reading. If a follow-up test scores the same result, this will confirm that you are diabetic!

Of course it may seem silly to say that if your result on this test is 125mg/dl you don’t have diabetes and at 126 mg/dl you ARE diabetic, but they had to make a cut off point somewhere.

What is important is that if you are in the range 100-125 you need to make changes to your nutrition and exercise habits to get your blood sugar down to healthy levels.

Insulin is a factor too!

When your blood sugar levels spike, your body produces insulin to lower the sugar level. So if your fasting blood sugar test indicates higher than normal blood sugar levels, you can be sure your insulin levels are high as well.

Insulin is a very pro-inflammatory hormone that causes a lot of problems in your body when it is chronically elevated. This is another reason why you would want to get your sugar levels down to what is considered healthy.

Insulin causes inflammation and damage to the endothelial lining of your arteries, which is how the process of atherosclerosis begins. Thus your sugar levels have a direct bearing on the development of heart disease.

Connection with heart disease

If your blood glucose levels are chronically elevated, a process called glycation comes into play, which causes tissues like the heart and blood vessels to lose elasticity and become stiff.

This stiffening process, along with the damage from inflammation, makes you susceptible to heart attacks, high blood pressure and strokes.

To make it really simple and clear, elevated blood sugar=heart disease! This connection is far more important than cholesterol which does not directly cause heart disease. High blood glucose levels are also a factor in many other chronic diseases as well.

The fasting blood sugar test, by measuring how high your blood sugar is on average gives you a clear indication that your risk for heart disease is elevated, which in turn gives you a chance to lower your risk and avoid heart disease, by bringing your blood sugar levels down.

The PLAC test is a cutting edge medical screening test that identifies arterial The PLAC Testplaque that is in danger of rupturing. This test, used in conjunction with other cholesterol screening tests can pinpoint your risk of a sudden heart attack with a much greater degree of certainty.

The test actually measures levels of an enzyme in your blood known as lipoprotein phospholipase A2. This enzyme is responsible for a process that can cause damage to your endothelial layer and set the stage for atherosclerotic plaques which can rupture and trigger a heart attack.

When your levels of Lp-PLA2 are elevated, it indicates that you have plaque that can rupture and create a blood clot that results in a heart attack or stroke.

The most current information we have tells us that using cholesterol levels to determine your risk of heart attack is not very accurate. However medical science has identified a process where LDLs (low density lipoproteins) and Lp-PLA2 particles undergo oxidation by free radicals.

These oxidized particles then attack the blood vessel wall causing damage and making the plaque deposits hard and brittle. This oxidized brittle plaque can then break off and cause life threatening problems such as a heart attack or stroke.

Lp-PLA2 is actually created in atherosclerotic plaques and thus can serve as a marker for inflammation in the artery wall. People who have heart disease show high levels of this marker (Lp-PLA2) which not only indicates they have plaque buildup, but also that the plaque is oxidized and can cause severe cardiovascular events.

Autopsies on patients who died suddenly of heart attacks showed ruptured plaques and high levels of Lp-PLA2 in their arteries.

This has also been see in patients who undergo surgery for carotid artery atherosclerosis. They show the same high levels of Lp-PLA2 that indicates a danger of rupturing plaque.

Those people who showed atherosclerosis of the carotid artery but did not show symptoms had much lower levels of Lp_PLA2. It’s clear from this evidence that this is a very significant and useful marker for predicting sudden cardiovascular events.

Studies done at the May Clinic also found that Lp-PLA2 was a specific indicator of dangerous plaques even in the absence of other risk factors. This indicates that it is inflammation and not merely cholesterol levels that create the risk of sudden heart attacks and stokes, so it is inflammation that we should address in our efforts to prevent heart disease.

Advantages of the PLAC test:

  • The test more accurately predicts the risk of sudden heart attack or stroke than other lipid screening tests.
  • The test directly measure lipoprotein phospholipase levels, a very accurate inflammation marker.
  • The PLAC test is the only medical screening approved by the FDA that indicates both heart attack and stroke risk in patients.
  • The test is relatively inexpensive and convenient.
  • The test can also be used to monitor a patients response to treatment and lifestyle changes.
  • The test is covered by Medicare and private insurance companies.
  • The test does not have to be taken in a fasting state.
  • The test can be used in patients that are currently using Pravachol, Benadryl, and Tylenol

Who should get the PLAC test and when?

Experts recommend a formula for determining who should get the test based on other risk factors and their estimate risk of sudden heart attack within a ten year period. This makes no sense to me at all. We have a test that can specifically identify people who are a high risk for a heart attack or stroke, before this actually happens and give them a chance to lower their risk.

I believe the PLAC test should be used as a standard cardiovascular screen test, because it targets the process that is actually dangerous, rather than cholesterol levels which don’t really give an accurate measure of your risk. Once the test has been done, all that’s left is to determine how to go about lowering the risk, by reducing the inflammation in your arteries.

As to who should have it done, it makes sense to me that anyone approaching middle age would be a candidate for it. Autopsies of US soldiers killed during the Korean War showed atherosclerotic plaques in the arteries of young men in their 20’s. Based on this it seems reasonable that the test could even be done on people in their early 20’s as a way of identifying people who may be at risk and giving them plenty of time to make the lifestyle changes needed to protect themselves.

People with metabolic syndrome which consists of the following:

  • obesity
  • abnormal blood lipid profile
  • elevated blood sugar
  • high blood pressure

are prime candidates for the PLAC test, as it is known that metabolic syndrome involves inflammation and thus raises the risk of heart disease.

The test can be done at followup intervals to verify the success of lifestyle changes and other interventions in terms of lowering the patient’s risk. While I claim no medical expertise, common sense suggests that this test be done early and the person then adapt their lifestyle, nutritional and exercise habits to mitigate this risk. That approach makes the most sense.

How to interpret the test results:

Even though the Lp-PLA2 test is much different than cholesterol screening tests, the levels are somewhat similar:

The 3 risk levels are:

Low:   under 200 ng/mL

Borderline:  200 to 235 ng/mL

High:  over 235 ng/mL.

Lp-PLA2 levels over 200 to 220 ng/mL indicate a very high risk of endothelial damage which in turn presents a very high risk of atherosclerosis.

Medical Interventions:

The PLAC test can be used to identify the magnitude of risk and also to determine how well the treatments used to combat it are working. This is why followup tests are important.

Statin drugs are said to provide a 20-30% reduction in Lp-PLA2 levels. The risk to benefit ration of statins is something you will have to discuss with your doctor.

Niacin used in combination with statins is reported to provide an additional 5 to 20% further reduction of the Lp-PLA2 enzyme.

Angiotensin-converting enzyme (ACE) inhibitors are also reported to lower Lp-PLA2 levels, and medical scientists have speculated that the effectiveness of all cardiovascular drugs may actually depend on their ability to successfully lower Lp-PLA2 levels

Niacin and omega 3 fatty acids (fish oil) also show an ability to reduce levels of Lp-PLA2.

Tumeric spice (also called circumin) has been found to reduce a form of phospholipase in animals, and thus may be of value to humans in reducing Lp-PLA2 levels, but the study results are not in on this yet. My guess is however that turmeric is most probably of value in human as well.

Conclusion:

Since heart disease is the nation’s number one killer, preventing it is vitally important to a long and health life. Medical screening tests such as blood pressure and cholesterol are not enough to accurately predict who is a risk for a heart attack or stroke.

The PLAC test is relatively inexpensive, non invasive, and very accurate in predicting who is at high risk for a sudden cardiac event like a heart attack or stroke. It really represents a cutting edge approach to identifying people at high risk and helping them make the changes that can save their lives.

A home cholesterol test is one way that you can begin taking more responsibility for your health, and understanding just how your diet and lifestyle affect your cholesterol values. A cholesterol blood test will determine if you have normal cholesterol levels, and if not, the cholesterol test results can be read and further interpreted by your doctor.

Testing in a home environment is just not as accurate as the tests performed in your doctor’s office. Home test kits are just not engineered to replace a full diagnostic lab, but they don’t have to. These tests are meant to help you keep track of your cholesterol values, and make adjustments to your diet and lifestyle when you need to.

Caution: Never substitute a home cholesterol test, or home testing (of any kind) for proper diagnosis and treatment from your doctor. Your physician can measure cholesterol levels much more precisely using lab tests that you can with a home test, so the lab work your doctor orders on your blood samples is the most accurate and best way to establish what your levels really are.

Home tests help you keep track of markers like cholesterol or blood sugar, but they are not meant to be substitutes for a proper medical test or diagnosis!

You need to be tested by your doctor to establish what is called a “baseline,” and once you know what this is, then home testing can tell you whether your levels are going up or down. These measurements are “relative” and their real value is helping you to track how your cholesterol levels are responding to diet and exercise.

Although the home cholesterol test is fairly accurate, it should be calibrated with the cholesterol blood test that you have in your doctor’s office. Take your home test kit with you and test yourself at the same time your doctor draws your blood for the full laboratory test.

That way you can see how the results of the two tests differ, and will be able to get an idea of just how far off the cholesterol test results are between the cholesterol blood test you get in the doctor’s office and the home cholesterol test.

When you buy online, read reviews carefully, do a little research into the product you are buying. Some of these cholesterol testing systems are expensive (over $100.00) dollars, require you to buy a testing unit, and additional test strips for it. This can run well over $100.00 for both.

Obviously you would not use a home cholesterol test as often as you would use a glucose monitor for instance. You are merely trying to track your normal cholesterol levels, and see how they respond to changes you make in your diet and lifestyle.

Here are some brands:

  •     CholesTrak, Home Access Instant Cholesterol Test
  •     Cardio Check (gives you both HDL and LDL level)
  •     Lifestream Personal Cholesterol Monitor (give you both HDL and LDL)

“Cardio Check” seemed to have by far the highest customer satisfaction ratings online.

A home cholesterol test should can run between $10.00 and $150.00 depending on how comprehensive the test is. Some tests only give you total cholesterol, which is not a very useful indicator. It may tell you how your total cholesterol levels is responding to diet or exercise, but it does not indicate real risk factors.

For that you need to know your HDL level, and a test that gives you both LDL and HDL levels will give you the information to assess risk factors more clearly. When you know both your LDL and HDL levels, you can calculate total cholesterol, as well as HDL/LDL ratio which is the best cholesterol values which indicate your heart disease risk.

The home cholesterol test to look for is one that at least gives you both HDL and LDL levels. These should run you about $30-$50 and are available online. Again you will have to check it for accuracy against the cholesterol blood test from your doctor, but if it gives you a somewhat reliable indicator of your cholesterol values, then it’s doing it’s job.

Carotid ultrasound  is a non-surgical and painless test that is used to determine the amount of blockage of your carotid arteries. This is done by using ultrasound to create an image of the inside of the arteries.

carotid ultrasound
This allows the physician to assess the blood flow though your arteries and detect blockages caused by plaque buildup inside the carotid arteries that could put you at risk for a stroke.

This narrowing of the arteries is called “stenosis,” and is considered to be a big risk factor for strokes. There are two such arteries, one on either side of the neck. These arteries carry blood to the brain, and if this blood flow is interrupted, it can result in a stroke.

An ultrasound imaging of your carotid arteries is one of a number of tests that can be done to determine the extent of blockage or stenosis. There are several types of ultrasounds used. If you need this screening procedure, you should discuss with your doctor which version is appropriate for you.

Types of Carotid Ultrasound

There are two main types of tests that are used to image the carotid arteries.

  • Doppler ultrasound: This test actually creates images of the blow flow though the arteries.
  • Standard ultrasound: This test creates an image of the actual structure of the inside of the arteries.

Why are these tests performed?

The doctor may order a carotid ultrasound because he or she suspects there may be blockages or other types of damage to the artery wall that can prevent blood from getting to the brain, causing what is called an ischemic stroke, which is life threatening.

The problem may be a blood clot, or something called an artery dissection which is a damaging split in the artery wall. This condition can impede blood flow, or seriously weaken the artery wall, possibly leading to a stroke.

Another problem can be a narrowing of the artery because of plaque buildup involving bad cholesterol levels, which is called stenosis. This can be indicated by something called a bruit, which is a sound the doctor hears when using a stethoscope to externally examine your carotid arteries.

These abnormal sounds can indicate stenosis, so the doctor uses the carotid ultrasound to further determine just what is happening inside the arteries. There are other things that might cause the doctor to suspect artery disease such as:

  • High blood pressure
  • Advanced age
  • Diabetes
  • Bad cholesterol levels
  • Birth defects that affect the carotid arteries
  • Strokes
  • TIA’s (transient ischemic attacks)
  • Tumors (very rare)

Who would perform the test?

This test is performed by a medical professional called a radiological technician. This is a person trained in both the procedure and preparation for medical imaging scans. The test will sometimes be performed by a doctor called a radiologist. These physicians are experts on performing and analyzing the results of medical imaging scans.

The radiologist will analyze the carotid ultrasound results and give your doctor a diagnosis based on the imaging scans of your carotid arteries.

How carotid ultrasound works

The equipment operated by the radiological technician generates high frequency sound waves that are projected into your body by a hand-held instrument called a transducer. When these sound waves strike your tissue and are reflected back to the transducer, it creates an image of the shape and structure of the tissues being scanned.

The biggest advantage of carotid ultrasound is that it is non-invasive, meaning that no piercing or cutting of the skin surface is necessary, and that the scanning technology uses sound waves which are much safer than other imaging technologies that use ionizing radiation which can damage tissue.

How is this test performed?

This test is usually performed in a hospital or sometimes in an outpatient clinic. It takes about an hour and usually involves the following steps:

1) You dress in a standard patient exam gown sometimes called a Johnny. You can also wear your own clothing as long as the neck area is open and there is no jewelery around your neck.

2) You lie on the exam table, on your back, and the radiological technician applies a gel to your neck that helps the equipment make proper contact with your skin.

3) The tech will then place something called an ultrasound transducer on your skin. This is a hand held instrument that sends the sound waves into your body. As the tech moves it around on your neck it produces an image of your carotid artery and surrounding area. This process is completely painless.

4) When the ultrasound is finished the gel gets wiped off. You will have to wait a few minutes until the tech or radiologist makes sure that the scan is complete, and then they will send you home.

5) Your doctor will then contact you with the results of your scan and the diagnosis he has been given by the radiologist.

The carotid ultrasound is a very valuable test because it allows your doctor to see exactly how much plaque buildup there is in your carotid arteries and then create a treatment protocol based on this precise information. This test could warn you in time to prevent a stroke or other serious medical problem, which makes it one of the most effective tests for prevention there is.

C-Reactive Protein  or CRP,  is what is called an inflammatory marker. It measures levels of a particular protein that indicate increased inflammation in your body. Along with homocysteine, it completes the picture of heart disease risk that begins with your cholesterol profile.

c-reactie proteinWhile optimizing your cholesterol profile is important, medical researchers noticed that half of all heart attack victims had normal cholesterol levels.

They realized that there were risk factors other than just cholesterol. This is where the c-reactive protein test comes in.

The test is a measure of inflammation and infection in your body, both of which are significant risk factors for heart disease that are largely ignored by mainstream medicine. Inflammatory markers like CRP are necessary in order to get an accurate idea of what your heart disease risk really is!

The test is part of that missing piece of the puzzle that explains heart disease risk, beyond just your cholesterol numbers. If your levels are high, then lowering them will definitely lessen your risk of heart disease. When you attempt to lower cholesterol naturally, you will have to pay attention to
CRP as well. The good news is that the same strategies will work for both!

What elevates CRP?

Your levels of c-reactive protein are elevated by increased inflammation in your body. Many things can cause this, so it is important to have the test done when you are feeling well and not suffering from illness or unusual stress, so that you can get an accurate reading of your levels, without
having the level elevated due to some injury, illness, or trauma.

For instance oral bacteria from dental cavities can elevate CRP levels, because those bacteria also cause inflammation. This is why dental health is correlated with heart disease risk. Bacterial infections of any kind will raise inflammation as your immune system attempts to fight off the bacteria.

What are healthy levels of c-reactive protein?

The CRP test measures results in milligrams per liter of blood.

The following guidelines for are recommended by the
American Heart Association (AHA) to determine heart disease risk:

  •     Low risk: CRP is 1 milligram/per liter or less
  •     Moderate risk: CRP is 1 to 3 milligrams/ per liter
  •     High risk: CRP is greater than 3 milligrams/ per liter

Lowering Inflammation

How do you lower inflammation and get the levels on the c-reactive protein test into the healthy range?  Since all these heart disease risk factors respond to the same lifestyle changes, you can address them all by doing a few simple things.

  •     Eating an “anti-inflammatory diet”
  •     Practice good oral hygiene
  •     Getting regular exercise
  •     Grounding
  •     Stress reduction
  •     Proper nutritional supplements

The Bottom Line

All of the various risk factors for heart disease may seem bewildering and overly technical. That is how medical science functions. Every factor must be measured and accounted for. The good part is that when you lower cholesterol naturally, you will be addressing these other factors as well.

However as I mentioned before, all of these factors are related, and they are just various manifestations of inflammation. Lowering inflammation will bring CRP and these other heart disease indicators to a better level. So that should be your goal, to use diet, exercise and nutritional supplementation in lowering inflammation.

C-reactive protein, homocysteine, and cholesterol profile are all necessary tests to precisely and accurately determine what your risk for heart disease really is. Work to lower your inflammatory markers, and you will be much healthier for it!

The VAP cholesterol test is the very latest diagnostic test to determine your risk of heart disease. Standard cholesterol level tests identify only 40% of those at risk for heart disease. In fact, half of all heart attacks are suffered by people with normal levels!

VAP cholesterol testProblems With Traditional Tests

One of the shortcomings of standard tests was that they didn’t measure or identify lipoprotein particles associated with increased inflammation.

Medical science has really caught on to the fact that it’s really the damage that inflammation does to your arteries that causes heart disease.

The old standard for testing was to measure LDL, HDL, and total cholesterol and to use the ratio between LDL and HDL to determine a person’s risk of heart disease. This was fairly accurate for it’s time, but it has been superseded by a new standard for determining your risk.

The old testing protocol produced four measurements:

  • Total cholesterol
  • Triglycerides
  • LDL – Low-density lipoprotein
  • HDL – High-density lipoprotein

Although these four elements do have some value in determining your risk of heart attack, they lack the accuracy of newer test methods in determining risk.

Enter the VAP Cholesterol Test

Medical science has recently developed a newer and more accurate test for heart disease risk called VAP  for (Vertical Auto Profile). This test benefits you in two ways.

  • It is THE most accurate indicator of your risk of heart attack
  • It helps identify various risk factors that you can control to prevent a heart attack

VAP cholesterol test can pinpoint your risk, taking much of the guesswork out of this medical diagnosis. This is very helpful for people who have test results that show normal levels, but who’s true heart attack risk can now be successfully identified.

Not all doctors provide the VAP cholesterol test, but it’s use is increasing as more and more doctors realize their standard testing fails to identify everyone that is at risk.

The VAP test is done the same way as other tests where a nurse or lab technician draws your blood and then sends it to a laboratory which then runs the test and returns the test results to your doctor.

How Does The Test Work?

The test identifies the following:

  • Identifies small dense LDL particles that cause arterial plaque
  • HDL2 and HDL3
  • IDL – Intermediate-density lipoprotein
  • Lipoprotein A
  • (VLDL1, VLDL2, VLDL3) Very low density lipoproteins

These small sub-fractions of cholesterol pose the greatest danger to you. The VAP cholesterol test will identify these particles, their density, and distribution. This information helps your doctor create a customized approach to reducing your risk of a heart attack and strokes.

Standard test results are still valuable as a screening method for heart disease. It is an inexpensive way of determining if you are at increased risk. The addition of the VAP test further clarifies your degree of risk and allows you to make needed lifestyle changes to head off a possible heart attack.

The key is to identify risks early while there is still time to reverse them with diet and exercise rather than drugs such as statins which have toxic side effects. The test really represents an advance in thinking that more accurately gauges how these individual lipoprotein particles affect your overall risk for heart disease.

The VAP cholesterol test will soon become the standard for determining your heart attack risk. This will go a long way toward making heart attacks increasingly rare and survivable! Ask YOUR doctor about the VAP test, and start reducing your risk now!