Heart health requires more than just lipid monitoring, say experts

PUNE: When it comes to assessing cardiac risk, relying solely on a lipid profile to measure cholesterol levels, may not provide the complete picture. Therefore, it is key to consider additional biomarkers like C-reactive protein (CRP) for a comprehensive understanding of one's cardiovascular health, cardiologists have said.
"Inflammation plays a crucial role in the development of cardiovascular diseases.Atherosclerosis, a condition characterized by the buildup of fatty deposits in the arteries, is not only influenced by high cholesterol levels but also by inflammatory processes," senior cardiologist Dr Suhas Hardas said.
While patients might feel reassured if their low-density lipoprotein (LDL) cholesterol, a type of cholesterol that is sometimes called ‘bad' cholesterol, is within normal limits, this alone does not guarantee low cardiac risk, the cardiologists said.
Elevated CRP levels, particularly its high-sensitivity counterpart hs-CRP, can indicate ongoing inflammation in the arteries, contributing to plaque instability and increasing the risk of heart attacks, they warned.
Numerous studies have established the link between elevated LDL and CRP levels and increased heart risk. "This dual approach provides a more accurate assessment," Dr Hardas said.
While cardiologists routinely assess CRP/hs-CRP levels alongside lipid profiles, awareness among general practitioners and family physicians remains limited. "Given that these healthcare providers are often the first point of contact for patients, it is crucial to enhance their understanding of CRP/hs-CRP testing," he said.
Effective treatments are available to manage both cholesterol and inflammation. Statins, such as Rosuvastatin, are well-known for their ability to lower LDL cholesterol. Another important test that must be considered is called serum homocysteine level.
"Hyperhomocysteinemia is a trigger for various medical conditions like atherosclerosis, Alzheimer's disease, heart failure, age-related macular degeneration etc. One of the most common causes of high homocysteine levels (hyperhomocysteinemia) is a B6, B12 or folic acid deficiency," said Ruby Hall's senior cardiologist Dr Abhay Somani.
Lipoprotein ‘a' is an independent and important marker for premature atherosclerosis. Other complex tests that are not routinely performed include myeloperoxidase (MPO) and trimethylamine N-oxide (TMAO).
"Low levels of TMAO are associated with vegetarian diets and a healthy gastrointestinal microbiota balance. High levels of TMAO are associated with endothelial dysfunction (coronary artery disease). Elevated MPO level is associated with risk of cardiovascular disease," Dr Somani said.