Cardiovascular Health

Looking Beyond Cholesterol: A Root-Cause Approach to Heart Health

Cardiovascular disease (CVD) remains the leading cause of death globally. It includes conditions such as coronary heart disease, hypertension, stroke, heart failure, peripheral vascular disease, and cardiomyopathies.

Although these diagnoses differ, they share a common underlying process: atherosclerosis

Atherosclerosis Begins Early

Atherosclerosis is a chronic inflammatory condition that often begins in childhood and progresses silently for decades. Over time, it leads to:

  • Plaque buildup in arteries
  • Arterial stiffness
  • Reduced circulation
  • Increased risk of heart attack and stroke

Cholesterol Is Only Part of the Picture

Approximately 38% of adults have elevated cholesterol. Lowering LDL cholesterol remains the conventional focus of heart disease prevention. However, many patients continue to have cardiovascular events even when LDL is controlled.

Why? Because atherosclerosis involves more than lipid accumulation. It is also influenced by:

  • Chronic inflammation
  • Oxidative stress
  • Lipoprotein particle quality
  • Vascular dysfunction
  • Insulin resistance and metabolic imbalance

Our goal is not just to manage cholesterol — but to support whole-person cardiovascular resilience

Advanced cardiovascular testing may include:

Marker What it measures Why it matters
Total Cholesterol Overall cholesterol in blood Basic screening marker; context matters
HDL Cholesterol (HDL-C) “Protective” cholesterol Low HDL can increase risk
LDL Cholesterol (LDL-C, calculated) “Bad” cholesterol estimate Traditional risk marker; doesn’t show particle quality
Triglycerides (TG) Blood fats tied to sugar/carbs metabolism Often elevated with insulin resistance
VLDL Cholesterol (calculated) Triglyceride-rich particles Elevated VLDL is associated with atherosclerosis
Non-HDL Cholesterol (calculated) All atherogenic cholesterol Stronger risk marker than LDL in diabetes or high TG
Small Dense LDL (sdLDL-C, calculated) Smaller, more damaging LDL particles Higher arterial penetration + oxidation risk; linked to CVD + diabetes
Oxidized LDL (oxLDL) “Damaged” LDL from oxidation Strong marker of oxidative stress and active plaque formation
Lipoprotein(a) [Lp(a)] Genetic “sticky” LDL variant Raises plaque and clot risk even with normal LDL
Apolipoprotein B (ApoB) Number of atherogenic particles Often predicts risk better than LDL-C
Apolipoprotein A1 (ApoA1) Main protein on HDL particles Reflects protective HDL particle number
C-Reactive Protein (hs-CRP) Low-grade inflammation Independent predictor of heart attack/stroke risk
PLAC® (Lp-PLA2 Activity) Arterial inflammation + plaque instability Sensitive marker of active atherosclerosis and plaque vulnerability
Homocysteine Methylation + vascular stress marker Can reflect B-vitamin/methylation issues; linked to vascular dysfunction
Glucose (fasting) Baseline blood sugar Elevated values suggest insulin resistance/diabetes risk
Insulin (fasting) Early insulin resistance marker Often abnormal years before glucose rises
1,5-Anhydroglucitol (1,5-AG) Short-term glucose spikes (past 1–2 weeks) Detects post-meal sugar spikes that A1C can miss
Leptin Satiety hormone linked to body fat High leptin suggests leptin resistance; linked to inflammation + CVD risk
Adiponectin Insulin sensitivity & anti-inflammatory hormone Low adiponectin is strongly linked to metabolic syndrome, diabetes, and CVD
Leptin : Adiponectin Ratio Metabolic inflammation index A sensitive predictor of insulin resistance and cardiometabolic risk
Creatinine with eGFR Kidney filtration estimate Kidney health is closely linked to blood pressure, diabetes, and CVD risk
Cystatin C Early kidney filtration marker Often detects early decline sooner than creatinine/eGFR

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