Throughout human history, the heart has long been a symbol of health and vitality. The heart plays an essential role in our physiology, functioning as a pump to circulate nutrients and oxygen-rich blood to all the different parts of our body where it is utilized and collects metabolic waste products to be excreted. The heart is a true workhorse of the body, pumping an average of 5 liters of blood per minute in adults at rest. Due to the constant workload put on the heart daily, it is highly vulnerable to atrophy and loss of function over time and tends to be the root cause of many common diseases. Heart disease is characterized by the irregular function of the heart itself or the arteries and veins that facilitate blood movement to different body parts. As heart disease progresses and the heart’s function continues to deteriorate, individuals become highly prone to fatal cardiovascular events such as heart attacks or strokes. Many factors can increase the risk of heart diseases, such as poor diet, smoking, pollutants, chronic stress, and alcohol consumption. 9 in 10 Canadians have at least one risk factor for heart disease (1). Heart disease is the leading cause of death worldwide, claiming 17.9 million lives annually (2). Fortunately, healthy lifestyle interventions can prevent almost 80% of premature heart disease and stroke.
We are constantly battling against heart disease from the day we are born. Research has revealed that calcification of the arteries begins at birth, with calcium deposition and plaques appearing as early as our teenage years (3). Unfortunately, most common practices for screening and diagnosis only begin after age 40. To further exemplify the limitations of current screening, many of the approaches used today are outdated and can often miss the early signs of cardiovascular disease. Screening for cardiovascular disease begins with investigating the heart. Many of these diseases can stem from heart arrhythmias, irregular heartbeat patterns, or scarring and weakening heart muscles. Doctors can assess the regularity of a patient’s heartbeat using various techniques, including electrocardiogram (ECG), cardiovascular imaging (echocardiogram), or the more traditional approach with a stethoscope. More recently, new technology has made it possible to obtain an ECG measurement anytime and anywhere with a small device that can fit in your pocket. A standard cardiovascular assessment is always accompanied by a measurement of blood pressure, which is an overall indicator of the health of our heart and the arteries and veins that transport blood through the body.
Another key tool in assessing heart health is a standard blood test focused on markers of cholesterol metabolism and arterial inflammation that can strongly indicate the early onset of heart disease. Current methods focusing on LDL cholesterol can be informative in some patients but can also be deceivingly low in patients with poor metabolic health and may misguide treatment decisions (4). A better metric to focus on is not the amount of cholesterol in the LDL particles but the number and size of the particles themselves, as that is the key driving factor for atherosclerosis (5). This link between high cholesterol and heart disease has created a stigma around the consumption of dietary cholesterol. Cholesterol, one of the essential lipids in our body, is required to maintain the fluidity of our cells. The fear of dietary cholesterol is unwarranted, as most of the cholesterol we eat does not get absorbed by our gut. The vast majority of the cholesterol in our body is produced within our cells; therefore, high cholesterol is commonly treated by targeting the processes involved in cholesterol production.
Another risk factor that is widely ignored in most screening approaches is lipoprotein(a), also known as Lp(a). Elevated Lp(a) concentrations are a major risk factor for cardiovascular disease, affecting 1.4 billion people worldwide (6). One of the significant drivers of Lp(a) concentration is genetic variation in the Lp(a) gene. Screening for Lp(a) risk includes an assessment of the genetic variant of Lp(a) and a measurement of Lp(a) levels in the blood, with those having the higher risk variant of the gene commonly exhibiting higher levels of Lp(a) in the blood as well.
At Preventous, our research team is working hard behind the scenes to bring these tests to the clinic as a standard part of our blood testing protocol. Our focus is to provide a standard of care that aligns with the most up-to-date research in cardiovascular disease screening, prevention, and treatment.
Dr. Rohan Bissoondath,