Heart Disease Risk Factors
In addition to the well known
risk factors for heart disease,
cholesterol, blood pressure, tobacco use and family history there
are several very important risk factors that are not as well known.
LDL Subclasses
We now recognize that there are seven subclasses of LDL, and that some of these subclasses are worse than others. So LDL is the bad cholesterol but there are some subclasses of ‘not-too-bad bad cholesterol’ and subclasses of ‘worse bad cholesterol’.
There are times when this distinction can be important, and we use the Berkley HeartLab LDL Segmented Gradient Gel Electrophoresis test to test this. As an example, if your LDL is not too bad, say 115 mg/dl (goal is less than 100 mg/dl) and you have a family history of heart disease BUT your LDL subclasses are all in the ‘not-too-bad’ range then we might not need to use prescription medications.
HDL Subclasses
We now recognize that there are seven subclasses of LDL, and that some of these subclasses are worse than others. So HDL is the good cholesterol but there are some subclasses of ‘not-so-good good cholesterol’ and subclasses of ‘better good cholesterol’.
There are times when this distinction can be important, and we use the Berkley HeartLab HDL Segmented Gradient Gel Electrophoresis test to test this.
Lipoprotein (a)
Lipoprotein (a) (Lp(a) spoken as ‘L P little-a’) is an LDL particle with an abnormal protein attached to it. High levels of Lp(a) are associated with higher risk of developing heart disease. This might be helpful if your LDL was not too high but your Lp(a) was high. In this example we would consider your LDL as more dangerous and might start medication.
Apoprotein B
Apoprotein B (Apo B) is the major apolipoprotein associated with LDL. Higher levels of Apo B will signify increased risk of heart disease even when LDL is not in the high-risk range.