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Heart Diseases

hdl-cholesterol waarde

How To Increase Good Cholesterol

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Dietary strategies to lower levels of bad LDL cholesterol can negatively affect HDL cholesterol, which is quite common, unfortunately. However, it’s important to know how to increase good cholesterol to maintain a healthy heart. Therefore, there are a number of clinical strategies for treating atherosclerosis and boosting HDL cholesterol levels. Let’s take a look at some of these strategies and also explore what foods can help with increasing good cholesterol. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 5 April 2022. How does HDL cholesterol affect cardiovascular disease? We have written more than once about the importance of a healthy lipid profile, if, in the future, you do not want to experience atherosclerosis, coronary heart disease, and stroke. But why did we decide to write specifically about good HDL cholesterol? Let’s start with numbers. In prospective epidemiological studies, each 1 mg/dL increase in HDL is associated with a 2–3% reduction in risk of coronary heart disease. This ratio is not affected by the level of bad LDL cholesterol and triglycerides due to the ability of good HDL cholesterol to reverse cholesterol transport. Let’s see what it means. So, reverse cholesterol transport (RCT) is a pathway through which cholesterol is transported from the artery walls to the liver so it can be excreted from the body. It is through this process that the body reduces the amount of plaque buildup in vessel walls and reverses atherosclerosis. Not surprisingly, data from the Framingham Heart Study showed that people with the highest HDL levels have the lowest risk of developing heart disease. IN THIS ARTICLE 1 How does HDL cholesterol affect cardiovascular disease? 2 How to increase good HDL cholesterol? 3 Diet Plan to Increase HDL 4 Aerobic exercise RELATED ARTICLES HDL Normal Range In Adult Treatment Panel III (ATP III) guidelines, the HDL cut-off for healthy individuals has been increased to at least 40 mg/dl in men and to 50 mg/dl in women. In general, the following HDL normal range was announced: <40 mg/dL ≥60 mg/dL Low HDL cholesterol High HDL cholesterol There are several factors that lead to low HDL cholesterol, namely: In our previous articles, we talked about ways to reduce bad cholesterol. Now it’s time to talk about how to increase good HDL cholesterol. Let’s start with the analysis of drug treatment. How to increase good HDL cholesterol? Medication to increase HDL Nicotinic Acid or Niacin The most widely used drug to increase HDL levels is nicotinic acid or niacin. Niacin is thought to reduce the risk of cardiovascular disease by lowering LDL cholesterol and increasing good HDL cholesterol. Therefore, niacin is often recommended for patients with low HDL cholesterol levels. One study reports that niacin can increase HDL levels by 25-35% at the highest doses. And if we talk about the situation of atherogenic dyslipidemia, then studies show a strong trend towards a decrease in the risk of coronary artery disease. It should be remembered that atherogenic dyslipidemia is characterized by low levels of high-density lipoprotein (HDL), high levels of triglycerides, and a high number of low-density lipoprotein (LDL) particles. Despite the apparent ability of niacin to increase HDL levels and lower LDL, not everything is so rosy. Studies have also shown that niacin can cause serious adverse events. Thus, among participants who received niacin/laropiprant tablets, there was a 55% increase in diabetes control disorders that were considered serious. » Discover how to lower your “bad” cholesterol. Ezetimibe Another drug that affects reverse cholesterol transport is ezetimibe. In a recent study, ezetimibe was shown to enhance macrophage reverse cholesterol transport in hamsters. However, as with niacin, ezetimibe as a primary agent has not been shown to improve patient outcomes. The ezetimibe and simvastatin ENHANCE study was designed to show that ezetimibe can reduce the growth of fatty plaques in the arteries. Patients with genetically high cholesterol were given only statins or ezetimibe plus simvastatin. The doctors then measured their LDL cholesterol levels and examined their arteries to measure plaque growth. As a result, LDL cholesterol decreased more with combination therapy, it did not improve the condition of the arteries. In fact, after 2 years of therapy, intima-media thickness increased more in the ezetimibe/simvastatin group. However, it is worth noting that patients with high cholesterol due to genetics may not represent the entire population. One way or another, but further studies of these drugs are currently being conducted. The results will help doctors conclude whether these drugs are an effective strategy for treating atherosclerosis. In any case, for people with high risk for CVD, who have excess weight, diabetes, metabolic syndrome, or a family history of CVD, it is worth discussing medical options with a cardiologist. Diet Plan to Increase HDL One of the most intriguing areas of research within treating atherosclerosis and heart disease is dietary intervention, including how to increase good cholesterol. Most doctors agree that diet is one of the most effective ways to prevent atherosclerosis, and that making dietary changes can help improve HDL cholesterol levels. This is true in reverse as well. Thus, additional research confirms that a Western diet high in meat, butter and dairy products plays a large role in the high rate of death from cardiovascular diseases. The most common dietary intervention is the consumption of fish. This is primarily because fish is correlated with an improved omega-3/omega-6 ratio and cardiovascular health. For example, a summary of dietary data showed that saturated fatty acid intake increased good HDL cholesterol without increasing bad LDL cholesterol. Other researchers have taken this idea further and even attempted to reverse cardiovascular disease through dietary interventions. The effect of plant-based nutrition on HDL cholesterol Vegetables and a vegan diet play a big role in normalizing your lipid profile and prevent atherosclerosis. The American Heart Association have released specific diet guidelines to prevent cardiovascular disease: In addition, studies show that a plant-based diet can help with regression of stenoses. So, in the study, 22 patients with severe coronary heart disease were observed

what is metabolic syndrome

What Is Metabolic Syndrome?

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Metabolic syndrome is an unhealthy metabolism that leads to fatal diseases such as heart attacks, diabetes, and cancer. Moreover, this condition affects more than a fifth of the US population and about a quarter of the European population. Even though its prevalence in South-east Asia is lower, it is still rapidly moving towards the rates of the western world even there. It should be understood that metabolic syndrome is a problem for not only overweight people. So, in 40 out of 70 percent of people with normal weight, doctors diagnose metabolic disorders. This is at least related to an increase in waist circumference or visceral obesity. So what is metabolic syndrome? How do you know if you are at risk? How can lifestyle help prevent this condition and what is the treatment aimed at? This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 4 September 2021. What is Metabolic Syndrome? Essentially, metabolic syndrome is the simultaneous presence of several conditions, such as obesity, hyperlipidemia (abnormal levels of cholesterol and / or lipoproteins), diabetes and / or hypertension. This combination was first described back in the late 1960s. Nowadays, medical organizations say that even a few of the risk factors are sufficient. Let’s take a look at which conditions are referred to as metabolic syndrome and which of the factors are more influential. Metabolic Syndrome Criteria The NCEP ATP III panel identified 3 of 5 risks of the next metabolic syndrome criteria: At the same time, the International Diabetes Federation names narrower ranges: IN THIS ARTICLE 1 What is Metabolic Syndrome? 2 What causes metabolic syndrome? 3 Metabolic Syndrome treatment 4 Supplements or Nutraceuticals for Metabolic Syndrome RELATED ARTICLES These are recommendations for the European race. For Chinese, Japanese and South Asians, a waist circumference of ≥90 cm for men is at risk. Note that weight is not taken into account, just the waist circumference. This is no accident. In the next chapter, we will review in detail why so much attention is paid to waist circumference. Other risk factors include the following indicators: 2) elevated triglycerides (≥150 mg/dl);  3) low HDL cholesterol (<40 mg/dl in men, <50 mg/dl in women);  4) hypertension (≥130/≥85 mmHg); and  5) impaired fasting glucose (≥110 mg/dl). The American Heart Association reports a level of risk fasting glucose levels at ≥100 mg / dL. At the same time, the pathophysiology of this syndrome remains a subject of continuing controversy. However, despite the lack of knowledge, researchers have identified visceral obesity and insulin resistance as the most important causative factors. Central obesity or visceral obesity is readily assessed at waist circumference and is independently associated with each of the other components of metabolic syndrome. The second significant factor in the development of this disease is an increase in glucose levels (hyperglycemia). However, even a small increase, both on an empty stomach and after a meal, increases the risk of cardiovascular disease and mortality. In addition, a prospective Quebec study has found that even with no increase in blood sugar, elevated insulin levels (i.e., insulin resistance) are associated with a risk of coronary heart disease. In addition, insulin resistance also contributes to the development of hypertension due to the loss of the vasodilator effect of insulin and vasoconstriction. What causes metabolic syndrome? The pathogenic mechanisms of MetS are complex and yet to be fully elucidated. However, the wide variation in geographic distribution of MetS emphasizes that the consumption of excess calories and lack of physical activity are the major contributors to the development of the disease. Moreover, visceral obesity is the key trigger for most pathways involved in metabolic syndrome. It is worth saying here that visceral fat may not be visible to the naked eye, but it is the fat that envelops the heart, liver and other organs, representing a real threat. By itself, visceral fat behaves very differently from subcutaneous fat. For example, visceral fat deposits contribute to insulin resistance. This is due to the fact that the visceral process of lipolysis leads to an increased supply of free fatty acids (FFAs) to the liver. This, in turn, increases synthesis of triglycerides and production of apolipoprotein B, the carrier of “bad cholesterol”. Ultimately, the “bad” particles become smaller, denser and much more numerous and easily penetrate the vascular endothelium, where they cause irreparable damage. Very high levels of “bad” LDL cholesterol and low levels of “good” cholesterol are indirect effects of insulin resistance. If you add to this an increase in triglycerides (atherogenic dyslipidemia), then even at a normal weight, you will get central obesity with the same high risk of death as obesity. Thus, as you can see, visceral fat, elevated insulin levels, and an unhealthy lipid profile (unhealthy cholesterol levels) are linked to each other. And all this leads to problems with cardiovascular diseases, diabetes, hypertension. It is not a surprise why in Healsens, in addition to monitoring weight, we recommend monitoring waist circumference. Metabolic Syndrome treatment Exercise As previously described, MetS results from increased caloric intake out of proportion to metabolic requirements. That is why lifestyle changes are imperative to manage the main risk factors. The first step in reducing risk factors is maintaining ideal body weight. Accordingly, if BMI is increased, then weight loss is an important preventive and therapeutic strategy. However, weight loss doesn’t have to be a goal by itself. As we wrote above, people whose weight within the normal range may have visceral obesity, which can be measured by checking the circumference of the waist. In this case disease prevention will imply reducing visceral fat without losing weight. The good news is that numerous studies show that it suffice to add physical activity to help the problem. In fact, physical exercise can reduce visceral adipose tissue by 6.1%. Moreover, exercise itself is effective in maintaining muscle mass and facilitating mobility. As for exercise, if there is nAs for exercise, if there is no personal trainer to consult, 30-60 minutes of moderate-intensity exercise per week will

cardiovascular risk assessment

CARDIOVASCULAR RISK ASSESSMENT

CARDIOVASCULAR RISK ASSESSMENT Read More »

Cardiovascular diseases such as ischemic heart disease, thrombosis, arterial hypertension with its complications – myocardial infarction and stroke – constitute a dynamic multistep process that is closely related to inflammation. It is well-known that CVD diseases rank first among all other diseases of mankind. Traditionally for making an accurate diagnosis, the patient must undergo a series of procedures, undergo lab tests so that the doctor can prescribe the necessary treatment. However, there is another way. Doctors can use cardiovascular risk assessment tools aimed at detecting the disease at an early stage. This time, not only will we consider different methods / risk calculators that are now used in clinical practice, but we will also make the corresponding calculations using a real example of a patient’s history. And, of course, let’s talk about why, given the presence of such intelligent systems, the CVD problem is still relevant. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on December 15, 2020. Why do you need cardiovascular risk assessments? Before proceeding to describe various calculation methods, let’s find out why they are needed at all. To begin with, we shall that most heart diseases develop completely asymptomatically over many years. In practice, it means that if one doesn’t feel any health problems, he or she simply does not go to the doctor unless a critical condition occurs. So, according to some estimates, 3.7 million Americans remain with undiagnosed heart disease. At the same time, the highest proportion of undiagnosed CVDs, which led to death from cardiovascular diseases, is among people aged 18–59 years. This is especially true when you consider that obesity, type 2 diabetes, and other risk factors are becoming more common at a young age. Second, understanding the risks allows for early diagnosis of CVD and, accordingly, preventive lifestyle interventions or treatment as needed. And thirdly, the assessment of risk factors can clearly demonstrate how the total risk changes if you switch to a healthier lifestyle. That is why, as early as in 1948, the Framingham Heart Study was initiated under the direction of the US National Heart, Lung, and Blood Institute. It was an ambitious medical research project that changed the medicine we know. As part of this study, the main risk factors for cardiovascular disease were identified. These include the following indicators: IN THIS ARTICLE 1 Why do you need cardiovascular risk assessments? 2 SCORE Risk Chart (Systematic Coronary Risk Evaluation) 3 Framingham Risk Score 4 Reynolds Risk Score 5 ASCVD (Atherosclerotic Cardiovascular Disease) Risk Score 6 PROCAM Score (Prospective Cardiovascular Munster Study) 7 QRISK (QRESEARCH Cardiovascular Risk Algorithm) 8 The 65yo Patient’s CVD Risks 9 Effectiveness of Using CVD Risk Scoring RELATED ARTICLES Valuable information has also been obtained on the role of cholesterol, age, gender, and psychological problems. During this time, the risk assessment has changed and developed significantly. In this article, we will analyze what cardiovascular risk assessment means and what calculators are used now in medical practice. SCORE Risk Chart (Systematic Coronary Risk Evaluation) The European guidelines for cardiovascular disease (CVD) prevention recommend the use of modified SCORE risk charts. SCORE estimates the 10-year risk of fatal and non-fatal CVDs such as myocardial infarction, cerebrovascular disease, and congestive heart failure. The first Joint Working Group of European societies on coronary prevention used a simple risk chart. For their calculations, they considered the following categories: Then, the diagram became more complex in order to assess risks more accurately. So, in addition to total cholesterol, the ratio of cholesterol to HDL cholesterol was also taken into account in risk assessments. In addition, given the geographic variability in cardiovascular risk across Europe, two SCORE charts have been developed for countries with high and low CVD risk. Countries with low risk include countries such as Andorra, Austria, Belgium, Cyprus, Denmark, Finland, France, Germany, Greece, Iceland, Ireland, Israel, Italy, Luxembourg, Malta, Monaco, Netherlands, Norway, Portugal, San Marino , Slovenia, Spain, Sweden, Switzerland and the United Kingdom of Great Britain and Northern Ireland. Countries at high risk of CVD: Bosnia and Herzegovina, Croatia, Czech Republic, Estonia, Hungary, Lithuania, Montenegro, Morocco, Poland, Romania, Serbia, Slovakia, Tunisia and Turkey. And the group of countries with a very high risk (note that the diagrams may underestimate the risk in these countries) included such countries as: Albania, Algeria, Armenia, Azerbaijan, Belarus, Bulgaria, Egypt, Georgia, Kazakhstan, Kyrgyzstan, Latvia, North Macedonia , Moldova, Russian Federation, Syrian Arab Republic, Tajikistan, Turkmenistan, Ukraine and Uzbekistan. Due to this SCORE scale, the following cardiovascular diseases can be detected: stroke, myocardial infarction, pulmonary embolism, dissecting aortic aneurysm. Framingham Risk Score The Framingham Risk Scale (FRS) determines the presence of diseases such as angina pectoris, coronary heart disease, myocardial infarction, stroke. Like the SCORE scale, this system opens the door for making a forecast for the next 10 years. This scale was developed in North America. Thus, NCEP 4 recommends the Framingham Risk Score for cardiovascular risk assessment. You can also calculate it by yourself. The total risk on the Framingham scale is defined as: A value over 30% indicates a very high risk of cardiovascular disease. A 10-year risk estimate can be obtained as a percentage, which is then used to make decisions about disease prevention. This assessment is also evolving. For example, in 2009 CCS added additional risks to the Framingham risk scale. It included a family history of coronary heart disease in a first-line relative. It takes into account male first-degree relative younger than 55 years and female first-degree relative younger than 65 years old. For elderly patients, sensitive C-reactive protein results can also help to reclassify risks. Reynolds Risk Score If you are healthy and do not have diabetes, the Reynolds Risk Score is designed for your cardiovascular risk assessment. It may predict your risk of heart attack, stroke, or other serious heart diseases over the next 10 years. The risk calculation is designed for people aged 45 and over. The scale assesses the following risk factors: gender, age, systolic blood pressure, total and

Lower your cholesterol

LOWER YOUR CHOLESTEROL

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Even with these new ideas that inflammation is the cause of heart disease, cholesterol, and its constituents still account for heart problems in most cases. So this time, we’ll discuss what you can do if your lipid level test results exceed optimal levels. We’ll start by looking at how to lower your cholesterol without pills. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on July 24, 2021. However, before getting down to this fascinating topic, let’s remember what problem we are solving. ☝️ Heart disease is the main cause of death. ☝️ 3.9 million people die from heart attacks in Europe every year. And the cause of heart disease is the inflammatory process. This inflammatory process begins with an excessive amount of LDL (“bad” cholesterol) particles appearing on the walls of the coronary arteries and causing subsequent oxidation. In turn, HDL particles (“good” cholesterol) reduce the risk of heart disease. So, they move excess LDL back to the liver and thus prevent inflammation and oxidation. We already discussed this topic in our article about the lipid profile. There is yet another independent risk factor for heart disease: triglyceride (unbound fat) levels. Excessive amounts of high glycemic carbohydrates in the diet, as well as alcohol abuse, are common causes of elevated triglyceride levels. How then can you lower your cholesterol? The first step to normalizing your cholesterol and triglyceride levels is following a healthy diet. IN THIS ARTICLE 1 How to Lower Your Cholesterol Naturally 2 Quit smoking 3 Normalize weight 4 Exploring Food Supplements to Help Lower Your Cholesterol Levels RELATED ARTICLES How to Lower Your Cholesterol Naturally Removing trans fats There are two main types of trans fats in food: naturally-occurring and artificial trans fats. Let’s figure it out. Naturally-occurring trans fats are produced in the guts of some animals. Artificial trans fats (or trans fatty acids), on the other hand, are created in an industrial process. And for this, hydrogen is added to liquid vegetable oils to make them more solid. It’s worth knowing that trans fats make us fatter than any other food with the same amount of calories. But that’s not all. Researchers at Wake Forest University have found that trans fats increase the amount of fat around the belly. That happens not only because new fat is added, but also because fat from other areas moves to the abdominal area. Of course, trans fats raise LDL (bad) cholesterol and lower HDL (good) cholesterol. So it is obvious that it increases the risk of heart disease and stroke. This is why the American Heart Association recommends reducing foods containing partially hydrogenated vegetable oils. And in November 2013, the FDA tentatively determined that partially hydrogenated oils were no longer considered safe. Therefore, it is recommended to choose foods where the trans fat content is 0. Let’s find out which foods can contain trans fats! Unfortunately, trans fats can be found in many foods, such as donuts and pastries, cakes and pie crusts, cookies and frozen pizzas, margarine and other spreads. You can determine the amount of trans fat by looking at the Product Facts label. However, if “0 grams of trans fat” is indicated, it doesn’t mean that there are no trans fats there. According to the rules, they can still contain between 0 and less than 0.5 grams of trans fat per serving. You can also identify trans fats by reading the ingredient list and looking for ingredients called “partially hydrogenated oils.” Reducing saturated fat There is nothing more important to a healthy heart than reducing your intake of trans and saturated fats. They are critical to the effectiveness of the diet. And none of the other nutrients in the diet raises LDL levels like saturated fat. Foods high in saturated fats include: In addition, many baked goods and fried foods can contain high levels of saturated fats. Health advocates have repeatedly suggested the use of policy instruments to influence consumer behavior. For example, in 2011, Denmark even introduced a tax on saturated fat in food. But a year later, this tax was canceled, although studies have shown its effectiveness in changing consumer behavior. It should be said that a healthy body is able to maintain normal lipid levels, regardless of cholesterol intake. In other words, our liver does an excellent job of regulating blood cholesterol levels. However, if you passed the test and saw that you need to lower your cholesterol, then, probably, these mechanisms of cholesterol metabolism have begun to work incorrectly. To prevent this problem, it is recommended to choose foods with less than 10% D.V* saturated fat per serving. The question naturally arises, what are the alternatives to saturated fats? *For a 1,500-calorie diet, your daily DRI would be: Total fat: 33 to 58 grams. Saturated fat: No more than 15 grams. Cholesterol: No more than 200 to 300 grams. What then to eat? To get the nutrients you need, eat a diet that emphasizes: You should replace foods high in saturated fat with foods high in monounsaturated and / or polyunsaturated fats. This means eating foods made with liquid vegetable oil, but not with tropical oils. It also means eating fish and nuts. You can also try replacing some of the meat you eat with beans or legumes. Fruits and vegetables aren’t just good for reducing your intake of trans and saturated fats. Soluble fiber, most of which is found in fruits and vegetables, also inhibits fat absorption. And this helps to lower the level of bad cholesterol (LDL). It is useful enrich your menu with legumes, oats (oat bread, porridge, oat bran in smoothies, and bread crumbs), and ground flax seeds, which can be sprinkled on almost anything. Quit smoking Smokers are two to four times more likely to develop a heart attack than non-smokers. There are 4,000 toxic substances in tobacco and tobacco smoke, many of which accelerate the processes leading to heart attacks. Cigarette smoking significantly increases the overall level of inflammation in the body and dramatically

толщина комплекса интима–медиа сонных артерий

Carotid Intima-Media Thickness Test

Carotid Intima-Media Thickness Test Read More »

Although countries are focusing on fighting cardiovascular disease (CVD), the burden of coronary artery disease continues to rise globally. Atherosclerosis, the precursor of CV events, keeps progressing insidiously without symptoms. Let’s take a look at the reasons why this is happening, as well as at the solutions for the problem. Among other things, we will introduce some proposals from the expert group of Heart Attack Prevention and Education (SHAPE). We will also dwell on a simple non-invasive test, TCIM (Carotid Intima-Media Thickness), which appeared on the list of recommendations. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 7 February 2020. We will start by looking back in history. So, the thickness of the intima-media of the carotid artery as a marker of atherosclerosis appeared not so long ago. It wasn’t until 1986 that Italian investigators decided to compare the arterial wall thickness aorta to common carotid arteries. They described the results and came to the conclusion that this approach may be useful. Since then, calculation of carotid IMT (CIMT) has been widely used as non-invasive measure of atherosclerosis. The Essence of Carotid Intima-Media Thickness Test Carotid intima-media thickness (CIMT) is a screening test for atherosclerosis. In adults, CIMT is predictive of myocardial infarction and stroke. In children and adolescents, CIMT is used to assess vascular changes in the presence of CVD risk factors. IN THIS ARTICLE 1 The Essence of Carotid Intima-Media Thickness Test 2 The relation between carotid intima-media thickness and diseases 3 Who is recommended to take this test? 4 How to calculate cardiovascular risk 5 The Screening for Heart Attack Prevention and Education (SHAPE) Task Force RELATED ARTICLES To understand what is measured with this test, let’s look at the structure of the coronary artery wall. It consists of three layers. The inner layer is called intima, the middle layer is called media, and the outer one is known as the adventitia. The layers of intima and media lie the deepest. So an increase in their thickness can be a sign of plaque formation. It is the thickness of the intima-media complex of the carotid neck arteries which feed the brain that is usually measured. Clinical Note CIMT screening is easily, safely, reliably, and inexpensively done with ultrasound. The relation between carotid intima-media thickness and diseases Interestingly, some studies have shown that cIMT is strongly and linearly related to age. Up to 25 years, the thickness is not higher than 0.6 mm. But by the age of 45 years, the CMM is on average higher than 0.8 mm. Some other studies have also indicated that CAIMT <0.8 mm is associated with normal healthy individuals, and value of CAIMT at or above 1 mm is associated with atherosclerosis and a significantly increased cardiovascular disease risk in any age group. Meanwhile, in the ESH/ESC hypertension guidelines (2013), carotid IMT > 0.9 mm has been reconfirmed as a marker of asymptomatic organ damage. The American Society of Echography (ASE) task force recommends that IMT ≥ 75th percentile is considered a high cardiovascular risk. Values from the 25th to the 75th percentile are an average cardiovascular risk. And values ≤ 25th percentile are considered low risk. Moreover, the CMM thickness is also associated with insulin resistance in healthy individuals, gallstone disease, the risk of progression of mild cognitive impairment and even Alzheimer’s disease. In other words, the larger CIMT the greater the risk of cardiovascular disease. The process is also associated with aging. However, you should not think that since aging is inevitable, then there is no point in measuring CIMT, since the good news is that recent studies suggest this process can be influenced and even reversed by increasing physical activities and treating it with medications. Who is recommended to take a carotid intima-media thickness test? Despite the many benefits and a wealth of information, screening for IMT has not yet been added to the CVD prevention guidelines. In early 2007, Circulation magazine published a report with the conclusion that IMT of the carotid arteries is a serious factor in the development of stroke and heart attack. Nevertheless, a few months later, the American Preventive Task Force recommended asymptomatic people not to undergo an IMT test regularly. Therefore, the traditional approach involves identifying people at risk of CVD. In this case, if you fall into a risk group (it also matters how great this risk is), then you are recommended to take this test. And vice versa, respectively. Moreover, the problem is that there is no uniform risk assessment system. Therefore, different organizations offer their own options. We’ve already reviewed different Cardiovascular Risk Assessment approaches but let’s take a look at some of them once more. How to calculate cardiovascular risk? As we mentioned above, there is currently no unified risk assessment system. At the same time, there are various risk calculators such as Framingham scores, Reynolds risk scores, ASCVD, SCORE, etc. So, the European guidelines on cardiovascular disease prevention suggest taking this test to people with moderate cardiovascular risk. Most asymptomatic middle-aged adults fall into this category. You can calculate this risk using the Healsens application, or on your own. At the same time, the NCEP recommends estimating the risk using the Framingham risk score. You can calculate it as well. On the other hand, the American Society of Echocardiography recommended adding the following extra criteria: We wrote more about various risk calculators separately. But what is their importance? Why are we looking at these tools in such detail? The answer is simple. Based on the calculated risk, the doctor will decide whether to initiate preventive treatment. Indeed, as we wrote above, atherosclerotic cardiovascular disease can be prevented. However, cardiovascular disease remains the leading cause of death and severe disability worldwide. What’s the matter? What’s the problem with the traditional approach? It turned out that traditional methods of preventing A-CVD have proven largely insufficient. Indeed, studies indicate that traditional risk calculations explain only 60-65% of CVD risk. In addition, it was shown that

CORONARY ARTERY CALCIUM SCORE TEST

CORONARY ARTERY CALCIUM SCORE TEST Read More »

Cardiovascular disease is the leading cause of death worldwide, coronary artery disease (CAD) accounting for half of all such deaths. And at least 25% of patients experiencing nonfatal acute myocardial infarction or sudden death had no previous symptoms. Do you know that a 1999 study confirmed that coronary artery disease is ubiquitous between the ages of 17 and 34 years? The disease process at this stage is too early to cause coronary events but heralds their onset in the decades to follow. All of these facts make it clear how crucially important is to identify asymptomatic individuals for implementing preventive strategies. This is exactly the main focus of the Healsens platform. In this article, we will talk about another medical test that allows you to determine the presence of cholesterol deposits in the arteries. We’re talking about Coronary Artery Calcium Score Test or CAC test. This article was last reviewed by Svetlana Baloban, Healsens, on January 24, 2020. This article was last modified on 7 February 2020. Cardiovascular Disease Risk Assessment Models To assess the risk of heart disease it’s very useful and highly recommended to apply “Total risk scores” as the initial method of stratification. Although it is only able to predict only 65-80% of future cardiovascular events. The Framingham risk score is one of the most widely used methods and is also calculated by Healsens. The Framingham Risk Score was first developed based on data obtained from the Framingham Heart Study, to estimate the 10-year risk of developing coronary heart disease There are other estimates of risk stratification assessment algorithms such as the PROCAM score or the European SCORE-system for an individual’s global 10-year risk of acute coronary events. So, pursuing the goal of preventive care and screening, which means finding problems long before they bring about health issues, and continuing the topic cardiovascular diseases, we take into account the assessment and correction of fats (such as cholesterol) in the blood, as well as such critical risk factors as homocysteine levels ​​and CRP, which are often overlooked. Taking into account all these tests let describe when and why Coronary Artery Calcium Score Test will be relevant and more preferred to the personal preventive program. IN THIS ARTICLE 1 Cardiovascular Disease Risk Assessment Models 2 Interpretation of the Сoronary Artery Calcium test result 3 Use of the Coronary Artery Calcium test in people with diabetes 4 Do I Need a Coronary Calcium Score? 5 How to reverse the growth of the calcium index 6 Enhanced external counterpulsation (EECP) RELATED ARTICLES Despite the fact that the majority of heart attacks are caused by soft, or unstable, plaques, the presence of hard, calcified plaques in your coronary arteries is a very important factor. So, there is a direct correlation between the content of hard and soft plaque in the arteries. This dependence is determined by the fact that the body isolates unstable plaques using calcined deposits, therefore, the rate of formation of hard plaque is also related to the number of soft plaques. You can find out how much hard plaque and indirectly much more dangerous soft plaque you have by using ultrafast or electron beam computed tomography (CRT). This study is also known as the Сoronary Artery Calcium Index or CAC test. CAC test takes cross-sectional images of the vessels that supply blood to the heart muscle, to check for the buildup of calcified plaque, which is composed of fats, cholesterol, calcium and other substances in the blood. This calcium is different from the calcium in bones and has nothing to to with too much calcium in a diet. The measurement can help a doctor identify who is at risk of getting a heart disease before that person shows any signs or symptoms. So, this screening test should be assigned in an early detection program. Below we can determine the criteria for adding this test to a personal preventive medicine list. The CAC score was studied in association with other traditional risk score systems, especially the Framingham risk score, showing the following advantages: independent added value in the prediction of all-cause mortality and mortality due to coronary disease in asymptomatic individuals; and shifting in the category of coronary artery disease risk-60% of atherosclerotic coronary events occur in patients categorized as being at low or intermediate risk according to the Framingham risk score. As an example, among patients at intermediate risk according to the Framingham risk score and with a CAC score > 300, which would place them in a high-risk category, the 10-year event frequency therefore is approximately 28%. And that means, the CAC score adds value to the Framingham risk score and to other methods, providing a substantial increase in the accuracy of the risk stratification. The CAC score is also an independent predictor of the risk of major cardiovascular events, with demonstrated superiority over the Framingham risk score, C-reactive protein level, and carotid intima-media thickness. Interpretation of the Coronary Artery Calcium test result The values obtained from the CAC score can be interpreted and classified in two ways: The result of the test is usually given as a number called an Agatston score. The score reflects the total area of calcium deposits and the density of the calcium. Normal Coronary Artery Calcium Score Based on the Agatston method, the percentile can be calculated on the MESA website (http://www.mesa-nhlbi.org/Calcium/input.aspx) by inserting the patient CAC score, age, gender, and ethnicity. Patients diagnosed with a cardiovascular disease (acute myocardial infarction, angina, stroke, or atrial fibrillation), those using nitroglycerin, and those with a pacemaker, as well as those having undergone angioplasty, myocardial revascularization, or any other cardiac/arterial surgery, along with those under treatment for diabetes, should not be included in this analysis, given that they were not included in the MESA population. National Cholesterol Education Program guidelines recommend intensification of low-density lipoprotein (ldl) cholesterol reduction in patients with multiple risk factors and a CAC score above the 75th percentile. Other studies have correlated CAC scores with the use of statins and aspirin in primary prevention. Use of the

checking homocysteine serum levels

Checking Homocysteine Serum Levels

Checking Homocysteine Serum Levels Read More »

Homocysteine is produced in our body (it is not contained in food) through the metabolism of an essential amino acid called methionine. Normally, formed homocysteine quickly turns into other, harmless substances – vitamins B6, B12, and folic acid are needed for these transformations. But in elevated concentrations, homocysteine provides a whole range of adverse effects, which we will discuss in detail below. Also, Also, this article describes who and why may benefit from checking homocysteine serum levels in terms of improving health. Firstly, it can directly damage vascular walls by making them loose. Thus, the damaged surface is subject to cholesterol and calcium depositing, which form an atherosclerotic plaque. Thus, blood coagulation is activated, and this, in turn, leads to the development of atherosclerosis, arterial and venous thromboses. Secondly, folic acid deficiency, which almost always accompanies an increase in homocysteine, can lead to gross malformations of the fetal nervous system during pregnancy – anencephaly (lack of the brain), and neural tube failure. It is for the prevention of these defects that all pregnant women are prescribed folic acid preparations. IN THIS ARTICLE 1 Which level of Homocysteine passes for normal? 2 Causes for High Homocysteine Levels 3 How Often Should You Check? RELATED ARTICLES Thirdly, homocysteine in high concentrations has a direct toxic effect on trophoblast cells, from which the placenta is subsequently formed, causing their death and a decrease in the production of hCG – the pregnancy hormone. This can lead to termination of pregnancy (usually in the first trimester) or to impaired placental development, which further increases the risk of placental insufficiency, fetal growth retardation, preeclampsia, placental abruption, pregnant hypertension, and kidney damage. Elevated homocysteine levels are also associated with increased thrombus formation, as well as higher risks of heart attacks, cerebral accidents, peripheral arterial diseases, and fractures. Doctors measure homocysteine levels as a possible cardiovascular risk factor, to diagnose homocystinuria, thrombosis, diabetes mellitus, senile dementia and Alzheimer’s, and obstetric pathology. The testing is necessary in a number of situations since elevated homocysteine levels are cytotoxic. Which level of Homocysteine passes for normal? The “ideal” homocysteine level levels of about 5-7 µmol/L. “Good” levels of less than 10 µmol/L. So, homocysteine > 10 μmol/L is associated with some risk factors like peripheral microvascular endothelial dysfunction (PMED), higher major cardiovascular events, etc. The normal range of homocysteine levels are less than 15 micromoles per liter (mcmol/L). Higher levels are: Moderate (15 to 30 mcmol/L); Intermediate (30 to 100 mcmol/L); Severe (greater than 100 µmol/L). Any higher than 15 and you will want to work with your Health Coach to further investigate the cause. The latest studies show that homocysteine is an independent risk factor of cardiovascular diseases. Clinical research shows that a 5 umol/L elevation in homocysteine concentration in blood plasma increases the vulnerability to cardiovascular disease and total mortality by 1.3 – 1.7 times. Lowering of elevated homocysteine levels in blood plasma can prevent cardiovascular complications. If levels of homocysteine are found to be elevated, it is advisable to measure the levels of creatinine, thyroid stimulating hormones, folacin, cobalamine to define probable causes of hyperhomocisteinemia and suggest appropriate treatment. Causes for High Homocysteine Levels At first, don’t panic if your homocysteine level is above the norm values. Just because you have high homocysteine doesn’t mean you will develop heart disease or a neurological condition tomorrow, next week or even next month. That’s the beauty of functional lab tests; they often allow us to catch patterns of disease and imbalance in the body before they become chronic or diagnosable. And if you’re already dealing with a chronic disease, then by examining your homocysteine levels, you’ve gotten one big step closer to uncovering the root cause and getting your health back on track. It’s worth mentioning that smokers are more vulnerable to hyperhomocysteinemia. Moreover, high coffee consumption is one of the most powerful factors increasing homocysteine in blood. Those who drink more than six cups of coffee a day have 2-3 umol/L higher homocysteine levels than people who drink no coffee. Elevated homocysteine levels are often associated with a sedentary lifestyle. So, moderate physical activity lowers homocysteine levels in case of hyperhomocysteinemia. Vegan diet can also decrease its levels by 13% without any supplements. However, the most frequent cause of high homocysteine levels is folacin deficit. The deficit of cobalamine (vitamin В12) may also lead to homocysteine accumulation. However, the effectiveness of using vitamins is a subject of debate among researchers. Several major randomized experiments showed that relatively easy lowering of homocysteine levels through taking supplements did not result in lowering vulnerability to cardiovascular diseases. How Often Should You Check? As with all lab work, how often to re-test is highly individual. Yet, there is a number of indications for investigation, such as: – cerebral accident, heart attack, thrombosis, atherosclerotic cardiovascular disease in family history;– blood-clotting disorder;– neurological disorders in childhood;– preparation for IVF, pregnancy;– chromosomal abnormality of the fetus, congenital defects, complications;– smoking;– age higher than 75 years old. Typically, if your levels are on the high-side your Health Coach will recommend re-testing after about 6 months. In conclusion, some estimates suggest that if homocysteine levels decreased by 40% would lead to an extra 8 years of life per 1000 men, and 4 years of life per 1000 women. Ordering Blood Tests in the Netherlands If you are interested in checking your Homocystein level, you can easily purchase a blood test kit from Healsens. 1 Download the Healsens App from Google Play or the App Store, depending on your device. 2 Complete the registration process in the app. 3 Go to the “Profile” page via the bottom menu of the application. 4 Tap on the test you need — ”List of Available Tests” 5 Find the Cholesterol Pack & Tap on the “Add to Cart” button. Proceed with the ordering process. » Discover how to check and improve your health with Healsens preventive checkup plan. Note If you want to assess your homocystein level but are not residing

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