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Heart Attack Prevention

Making lifestyle changes is the most effective way to heart attack prevention. There are 3 main steps you can take to help prevent a heart attack (as well as stroke): eat a healthy, balanced diet, do not smoke.

Lifestyle Changes
  • Stop smoking. If you smoke, quit.
  • Choose good nutrition. A healthy diet is one of the best weapons you have to fight cardiovascular disease.
  • Normalize your lipid profile.
  • Lower high blood pressure.
  • Be physically active every day.
  • Aim for a healthy weight.
  • Manage diabetes.
  • Reduce stress.

So, NICE recommend 150 minutes of moderate intensity aerobic activity per week, or 75 minutes of vigorous aerobic activity. They also advise muscle strengthening activities on two or more days per week. Heart attack prevention program should include reducing saturated fat intake, increasing monounsaturated fatty acids and five portions of fruit and vegetables per day. It’s also suggested a high fibre diet and two portions of fish per week.

cardiovascular risk assessment


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 inflammation1. 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 Americans2 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:


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.

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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 failure3.

The first Joint Working Group of European societies on coronary prevention used a simple risk chart. For their calculations, they considered the following categories:

  • age;
  • gender;
  • smoking status;
  • assessment of total cholesterol;
  • assessment of systolic blood pressure.

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.

Based on the data reflected on it, one can conclude about the level of risk:

  • high risk (above 10%) in the presence of two or more risk factors;
  • moderately high (5-10%) in the presence of two or more risk factors;
  • moderate risk (1–5%) in the presence of two or more risk factors;
  • low risk (below 1%) in the absence of risk factors or the presence of only one.

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:

  • low (risk below 10%);
  • medium (risk from 10 to 20%);
  • high (risk above 20%).

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 scale4. 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.

Risks Calculators
Health Risks Calculators in Healsens App

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 “good” (high-density lipoprotein) cholesterol, hs C-reactive protein level, myocardial infarction in parents under 60 years of age, smoking. You can calculate it yourself on the website http://www.reynoldsriskscore.org/.

For the Reynolds scale, a risk score of 10-15% is considered a moderate risk of cardiovascular disease over the next five years.

If the risk estimate is less than 10%, then the patient is considered to be at low risk of cardiovascular disease for the next five years.

ASCVD (Atherosclerotic Cardiovascular Disease) Risk Score

The Atherosclerotic Cardiovascular Disease Risk Scale (ASCVD) is a national guideline developed by the American College of Cardiology. It calculates the 10-year risk of heart diseases, such as heart attack or stroke. This risk calculator is considered an important step forward in assessing the risk of both heart disease and stroke and provides estimates that are applicable to Blacks / African Americans. It is used among patients with no pre-existing cardiovascular disease aged 40 to 79 years.

ASCVD is also used as a decision making tool. For example, it can help a doctor determine which patients should receive statin therapy for the primary prevention of CVD5. The calculator has also been tested against the final USPSTF guidelines for initiating aspirin therapy6. It is also included in the JNC-8 guidelines for blood pressure management7.

The ASCVD risk score is given as a percentage:

  • A risk of 0 to 4.9 percent is considered low. Eating healthy and exercising will help reduce your risk. Medicines are not recommended if your LDL or “bad” cholesterol level is less than 190.
  • A risk of 5 to 7.4 percent is considered borderline. Statin use may be recommended if you have certain conditions or “risk enhancers”. These conditions can increase your risk of heart disease or stroke. Talk to your PCP to see if you have any risk enhancers.
  • A 7.5 to 20 percent risk is considered intermediate. Moderate statin therapy is recommended.
  • Risk above 20 percent is considered high. It is recommended to start with high-intensity statin therapy.

PROCAM Score (Prospective Cardiovascular Munster Study)

This PROCAM score for cardiovascular risk assessment makes it possible to determine the development of coronary heart disease and its complications – myocardial infarction, sudden death within the next 4–8 years.

This risk calculator takes into account non-modifiable developmental factors (gender, age, family history of myocardial infarction) and modifiable ones (smoking, systolic blood pressure, diabetes, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoproteins). The overall score ranges from 0 to 87 when all risk factors are estimated. At the same time, the risk of cardiovascular diseases is defined as low at less than 20%, and high at more than 20%.

QRISK (QRESEARCH Cardiovascular Risk Algorithm)

The QRISK assesses the risk of developing cardiovascular diseases for the next 10 years, including the risk of myocardial infarction, coronary heart disease, stroke, and transient cerebrovascular accident.

Assessing factors of the QRISK scale: age, gender, smoking, body mass index, family predisposition to cardiovascular diseases, treatment with drugs that reduce high blood pressure. The age for assessing QRISK ranges from 25 to 84 years old. Low risk – QRISK2 score less than 10%. This means that the likelihood of a stroke or heart attack in the next 10 years is less than one in ten. Moderate risk – QRISK2 10-20%. High risk – QRISK2 score over 20%. This means that a person has at least two out of ten chances of having a heart attack in the next 10 years.

Moreover, when a patient is admitted to a hospital, the GRACE scale can also be used. It can be used to assess the risk of nosocomial mortality, mortality and the development of myocardial infarction.

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The 65yo Patient’s CVD Risks

As an example, let’s review the case of a patient who was admitted to the intensive care unit 3 hours before dying of myocardial infarction at the age of 65. His complaints include vomiting, nausea, weakness, and shortness of breath that appeared within an hour of admission to the emergency department. On the eve of the event, the patient several times consulted the doctor about pain in the stomach and uncontrolled vomiting. The main risks include smoking with more than 40 years of experience. The man did not have diabetes or hypertension.

Cholesterol6.43mmol / L
Cholesterol – HDL1.02mmol / L
Cholesterol – LDL4.56mmol / L
Triglycerides1.32mmol / L
C-reactive protein3mg / L
Blood pressure120/80Hg

Based on the health data, the risk assessment of cardiovascular diseases was:

  • ASCVD score – 20.8% (high risk)
  • SCORE scale – 12.7% (high risk)
  • Framingham risk – 18.6% (average risk)
  • according to Reynolds – 19% (high risk)
  • by the PROCAM scale – 60 points or> 40% (high risk)
  • result on the QRISK risk scale – 23.5% (high risk)
  • on the ASSIGN scale – 30 (high risk)

It is important to note that despite the high risks, the man was not offered or received preventive treatment to reduce CVD risks.

Effectiveness of Using CVD Risk Scoring

So, the main factors in the development of CVD are known and there are effective and safe methods of treatment, however, cardiovascular diseases remain the main cause of death and severe disability worldwide. What’s the matter?

The problem is that traditional methods of preventing cardiovascular disease have proven to be insufficient. First, in practice, only 60-65% of cardiovascular diseases are identified using risk calculations8. In addition, the data showed that calculated risks do not always lead to disease development. Conversely, many acute clinical events occur in patients with moderate or no risk. This is most likely due to the fact that many other factors are not included in such calculations. The problem is also that there is no single risk assessment system. Therefore, different organizations offer their own options.

Finally, absolute risk based guidelines for cardiovascular disease (CVD) prevention are poorly used worldwide9! Although the guidelines available, the absolute risk is often not assessed. And even when it is assessed, it is not necessarily used to make management decisions as we see in the above case of a 65-year-old patient.

Finally, we add that studies have unequivocally shown that different CVD risk scales are the best signal for a patient showing it is time to change lifestyle in order to reduce risk factors10. These tools are safe11, which means they can be used everywhere. So that everyone can know their results and understand what changes are needed to reduce risks, Healsens makes calculations for most of the presented calculators, corresponding to the patient’s age. To download the application, follow the links below.

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толщина комплекса интима–медиа сонных артерий


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.


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 studies1 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 studies2 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 damage3.

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 resistance4 in healthy individuals, gallstone disease5, the risk of progression of mild cognitive impairment and even Alzheimer’s disease6.

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 influenced7 and even reversed8 by increasing physical activities and treating it with medications.

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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 report9 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 criteria10:

  • family history of premature CVD in a first-degree relative (men < 55 years old, women < 65 years old);
  • people younger than 60 years old with severe abnormalities in a single risk factor. In the situation where they would not be candidates for pharmacotherapy;
  • women younger than 60 years old with at least two CVD risk factors.

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 risk11. In addition, it was shown that the calculated risks don’t always lead to disease development. Conversely, many acute clinical events occur in patients with moderate or no risk. The most probable reason for this is that many other factors are not included in the calculations.

The Screening for Heart Attack Prevention and Education (SHAPE) Task Force

To solve this problem, an international group of experts created screening recommendations for Heart Attack Prevention (SHAPE). They have already proposed the First SHAPE Guideline in primary prevention of A-CVD.

So, to identify atherosclerosis, a Flow Chart was created based on 2 non-invasive methods. The first one is coronary artery calcium scoring (CACS) with the use of computed tomography. And the second one is carotid intima-media thickness (CIMT), which we have discussed in this article.

Look at the first Screening for Heart Attack Prevention and Education (SHAPE) Guideline.

SHAPE Guideline

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wat zegt crp waarde


C-reactive protein CRP is a protein made in the liver that indicates the amount of inflammation in the body. Like elevated homocysteine, a high CRP level increases one’s vulnerability to cardiovascular disease, Alzheimer’s, and cancer. Such an increase in CRP levels may be caused by infection, inflammation, trauma, diabetes, as well as certain medicines. In the absence of these main factors, elevated CRP indicates future risks of heart attack.

This article was last reviewed on 10 April 2019. This article was last modified on 14 February 2020.

In addition, increased systemic inflammation is a sign of aging. Therefore, C-reactive protein (CRP) can be classified as a marker of healthy aging1.

It has been found that this marker predicts well the risk of developing age-related diseases and human life span2.

What is the difference between CRP and hs-CRP?

As you’ve no doubt guessed, the difference between CRP and hs-CRP is contained in the “hs” abbreviation – “high sensitivity.”


Traditionally, CRP, or C-reactive protein, is measured down to concentrations of 3 to 5 mg/L; hs-CRP is measured down to concentrations of approximately 0.3 mg/L. This improved sensitivity allows hs-CRP to be used to detect low levels of chronic inflammation.

So, high-sensitivity C-reactive protein (hsCRP) lab test is a marker of inflammation that predicts incident myocardial infarction, stroke, peripheral arterial disease, and sudden cardiac death among healthy individuals with no history of cardiovascular disease. Elderly people with high CRP levels are more vulnerable to serious diseases than their relatives with low C-reactive protein levels.

Which level is considered the norm?

Concentrations less than 1 mg/L indicate low risk of cardiovascular disease.
1 to 2,9 mg/L levels suggest average risk. Concentrations above 3.0 mg/L indicate a high risk of cardiovascular disease

Look at the general guidelines for hs-CRP scores:
● Low risk of cardiovascular disease: Less than 1.0 mg/L
● Average risk: 1.0 to 3.0 mg/L
● High risk: Above 3.0 mg/L

A reading above 10 mg / L can signal the need for further testing to determine the cause of this significant inflammation in your body. Moreover, tests showing serum CRP levels above 10 mg / L in apparently healthy men or women should be repeated after a month3. This is done in order to exclude a latent infection or other systemic inflammatory process.

As you can see, a reading above 10 mg/L may signal a need for further testing to determine the cause of such significant inflammation in your body. It’s worth mentioning that levels of hs-CRP less than 10 mg/L are significant for cardiovascular risk stratification. Higher hs-CRP levels may be the sign of acute inflammation, a chronic illness, a trauma, etc.

C-Reactive Protein as a Biomarker of Cardiovascular Disease

In recent years, hs-CRP has been endorsed by several public health organizations as a biomarker of cardiovascular disease risk45.

As for primary prevention, a number of prospective epidemiological studies have shown that the high-sensitivity method in detecting CRP is highly predictive of cardiovascular accidents6, peripheral vascular diseases, ischaemic strokes, and sudden cardiac death risks even if the patient is virtually healthy. Other major studies in the USA and Europe have proven hs-CRP levels to be a better risk indicator than low-density lipoprotein cholesterol levels. Moreover, since hs-CRP reflects a different cardiovascular risk component, a combination of hs-CRP and lipoprotein profile would significantly enhance total risk estimation. Thus, LDLC levels higher than 160 mg/DL and high hs-CRP levels signal a need to discuss “aggressive” primary prevention and lifestyle changes with your doctor and start a drug therapy in case of therapeutic indications.

Do I need to check my hs-CRP levels if I feel well?

Factors that increase hs-CRP levels are quite numerous. They include obesity, elevated blood pressure, diabetes mellitus type 1 and 2, acute situational reaction, sleep disturbances, etc. In order to make allowance for all the major factors, Healsens will provide your physical assessment, generate your individual profile and help determine the necessity and frequency of controlling your hs-CRP levels.

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What if my C reactive protein CRP level is high?

As we wrote above, for hs-CRP values exceeding 10 mg / L, it is recommended to undergo additional testing to find the causes of inflammation. Since such high levels of hs-CRP are associated with acute inflammation, chronic disease, trauma, etc.

For values below 10 mg / L, the good news is that giving up smoking, regular physical activity, as well as weight-reducing treatment, can lower basic hs-CRP level without any medical help. Healthy eating habits7, green tea89, controlled drinking, sufficient vitamin D1011, vitamin C12, and vitamin K13 in your body can also reduce the level of the reactive protein in the body.

In addition, glucosamine may reduce cancer mortality by lowering C-reactive protein levels. Therefore, if C-reactive protein is higher than 1 mg / L and there are no contraindications such as HOMA-IR14 is not increased, then therapy with this substance at a dosage of 1500 mg per day can reduce cancer mortality and overall mortality15. This is due to a decrease in inflammation, which will be reflected in a decrease in the inflammatory marker C-reactive protein, as expected by about 23%.

The same effect can be achieved through certain medications, such as16:

  • cyclooxygenase inhibitors(Aspirin, Rofecoxib, Celecoxib)
  • thrombocyte aggregation inhibitors (Clopidogrel, Abciximab)
  • cholesterol management products (statins, ezetimibe, fenofibrate, nicotinic acid)
  • beta-adrenergic blocking agents and angiotensin
  • converting-enzyme inhibitors (Ramipril, Captopril, Fozinopril)
  • anti-diabetes drugs (Rosiglitazone, Pioglitazone).

In case any medications must be taken, discuss your therapeutic regimen with your doctor.

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checking homocysteine serum levels

Checking Homocysteine Serum Levels

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.

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/L1.

Good” levels of less than 10 µmol/L2. 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 diseases3. 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.

Homocysteine, total

Test Code: 31789
Specimen Type: Blood

Acceptable screening test for disorders of methionine metabolism (congenital hyperhomocysteinemia).

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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 deficit4. The deficit of cobalamine (vitamin В12) may also lead to homocysteine accumulation5. 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 diseases6.


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.

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits

Unlock your health insights with our smart data analysis – the Free Health Tracker app, your reliable medical record!

Drastically reduce the time to detect chronic diseases & inspire healthy habits


Follow us on Facebook|| Instagram || Telegram || Twitter || Youtube

Source: ©️2019 Healsens B.V. All right reserve

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