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Blood tests can provide early alert to heart disease

Tuesday, February 12, 2002

By Virginia Linn, Post-Gazette Staff Writer

To better assess your risk of heart disease, you can ask your doctors to perform blood tests beyond the basic cholesterol screening.

These tests -- generally covered by insurance -- can alert you early to make lifestyle changes that may prevent the onset of heart disease.

"The younger the person, the more insistent we should be to see that all screening tests are performed," said Dr. Tony Farah, medical director of the Cardiac Catheterization Laboratory at Allegheny General Hospital. "This is important because more and more younger women are developing heart disease."

The American Heart Association recommends that people start getting blood lipid tests at age 20. These measure total cholesterol and HDL, or "good" cholesterol and LDL, or "bad" cholesterol, as well as triglycerides.

Cholesterol is generally tested every five years until doctors see problems, then it may be checked more frequently.

At the same age, women should start getting tested for high sensitivity C reaction protein, or CRP. Inflammation is thought to occur with arteriosclerosis, or hardening of the arteries, and this test checks for early inflammation.

"At least half of people who have coronary disease don't have high cholesterol," Farah said. "In seemingly healthy people, this test could be very valuable."

High results may prompt doctors to start patients on a daily regimen of aspirin or statin drugs or to take other preventive steps, he said.

Two other tests are:

Homocysteine: This is an amino acid normally present in everyone, and there is some evidence showing an association between high levels of homocysteine and heart disease. Because low levels of folic acid and vitamins B6 and B12 lead to elevated homocysteine levels, vitamin supplementation may reduce risk of heart disease, although this has not been proven.

Lipoprotein(a): This component of cholesterol promotes the build-up of plaque. Elevated levels are associated with an increased risk of premature coronary artery disease. This test provides more information when combined with the total cholesterol profile test.

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