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Atherosclerosis

Atherosclerosis is a disease in which plaque builds up inside your arteries. Arteries are blood vessels that carry oxygen-rich blood to your heart and other parts of your body. Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

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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