Heart Disease Testing

Heart disease remains the leading cause of death worldwide.

Yet most people still rely on a standard cholesterol panel to assess their cardiovascular risk.

The problem?

A standard cholesterol test only tells part of the story.

Many people suffer heart attacks despite having “normal” cholesterol levels, while others live long healthy lives despite elevated cholesterol.

If you want a true understanding of your cardiovascular health, you need to look deeper.

Step 1: Start With The Right Blood Tests

HsCRP: The Inflammation Marker

Heart disease is not simply a cholesterol problem.

It is an inflammatory disease.

High sensitivity C-reactive protein (HsCRP) is one of the most widely studied markers of systemic inflammation and cardiovascular risk.

Research shows that cardiovascular risk begins to rise as HsCRP increases, even when cholesterol levels appear normal.

Many preventative health practitioners aim for:

HsCRP below 0.5 mg/L

A raised HsCRP can indicate ongoing inflammation from poor metabolic health, excess body fat, infections, poor sleep, environmental toxins, smoking, or chronic stress.

Triglyceride To HDL Ratio

This simple calculation can reveal underlying insulin resistance long before diabetes develops.

When triglycerides rise and HDL falls, it often indicates metabolic dysfunction that is silently damaging blood vessels.

For Australians using mmol/L measurements, many practitioners aim for:

Triglyceride:HDL Ratio below 0.9

Optimal is often considered below 0.7.

This ratio frequently provides more insight into metabolic health than total cholesterol alone.

Fasting Insulin

One of the biggest mistakes in preventative medicine is waiting for blood sugar levels to rise before taking action.

Blood glucose and HbA1c can remain normal for years while insulin levels steadily increase.

Elevated insulin contributes to:

• Endothelial dysfunction

• Oxidative stress

• Inflammation

• Plaque development

Many longevity practitioners aim for:

Fasting insulin below 5 mIU/L

By the time fasting insulin reaches double digits, vascular damage may already be occurring.

ApoB

ApoB measures the number of cholesterol-carrying particles capable of entering the artery wall.

Rather than estimating risk, ApoB provides a direct count of potentially atherogenic particles.

Many cardiovascular specialists now consider ApoB superior to LDL cholesterol alone.

Targets commonly used include:

Optimal: Below 0.8 g/L

Higher risk individuals often target below 0.65 g/L.

Lipoprotein(a)

Lipoprotein(a), often called Lp(a), is one of the most important cardiovascular markers that many people have never tested.

Unlike most cholesterol markers, Lp(a) is largely genetic.

People with elevated Lp(a) can develop cardiovascular disease despite excellent lifestyle habits and otherwise favourable blood work.

Because Lp(a) is genetically determined, it only needs to be measured once in most individuals.

Step 2: Move Beyond Blood Tests

Blood markers tell us about risk.

Imaging tells us whether disease is already present.

This is where modern cardiovascular diagnostics become invaluable.

Coronary Artery Calcium Score (CAC)

The CAC scan measures calcified plaque within the coronary arteries.

Unlike cholesterol measurements, it provides direct evidence of existing atherosclerosis.

A CAC score of zero generally indicates very low short-term cardiovascular risk.

As scores rise, cardiovascular risk rises substantially.

Many experts consider CAC one of the most powerful tools available for preventative cardiology.

CT Coronary Angiography (CTCA)

CT Coronary Angiography takes assessment one step further.

Rather than measuring calcified plaque only, it visualises both:

• Calcified plaque

• Soft plaque

Soft plaque is particularly important because many heart attacks originate from unstable, non-calcified plaque.

CTCA can identify narrowing long before symptoms appear.

Coronary Angiography

This remains the gold standard for identifying significant coronary artery blockages.

A catheter is inserted into the coronary arteries and contrast dye is used to visualise blood flow.

It is generally reserved for individuals with symptoms, abnormal stress testing, or suspected significant disease.

Additional Useful Assessment

Other tools include:

• Echocardiography

• Exercise stress testing

• Cardiac MRI

• Advanced lipid testing

• Endothelial function testing

Summary

Cholesterol and cardiovascular health testing is becoming more and more advanced. The standard testing panels most doctors order are out of date. You need to be proactive in asking your doctor for the right tests to determine your risk.

Then it becomes a matter of setting the right diet and lifestyle measures to minimise the risk. This is where we come in and can provide you with the right advice how to improve your health as you age.