Proactive heart testing - part 2: Baseline heart testing that goes beyond the basics
What tests are considered the gold standard in proactive heart screening?
Heart health is one the most essential elements of overall health and wellness.
In part one of this series, we explored the importance of proactive heart health testing and how it can help you add years to your life.
Now we will take a closer look at what tests we consider essential to understanding your baseline heart health. Heart health testing is advancing at a rapid pace, and these tests are aligned with the latest clinical guidelines and evidence.
As Medcan Clinical Director of Cardiology Dr. Beth Abramson explains, there are two parts to heart health – arterial health and heart muscle function. The tests you should do annually review both aspects of heart health and are included in our Annual Health Assessment.
Arterial health tests
Arterial health is one of two components (together with heart function) that contribute to your total heart health. Healthy arteries are smooth and flexible and allow for easy blood flow throughout your body.
When plaque made up of fats, cholesterol, calcium and other substances starts to build up inside the arteries, that is a condition called atherosclerosis. It can start with the thickening of the arterial walls themselves and then become more serious as plaque also builds up inside the arteries.
This narrowing of the arteries starts to impinge on good blood flow and can lead to heart disease or even heart attacks, with or without symptoms like chest pain. Interventions such as medication, stents or other procedures might be recommended if the narrowing exceeds 70 per cent. Our goal is to discover any sign of narrowed arteries well before they get to that point.
Here is a visual that describes how arterial clogging / damage works:
4 key baseline tests that evaluate arterial health
In our Annual Health Assessment, Medcan evaluates four key indicators of heart health.
The lipoprotein(a) or Lp(a) test looks for a genetically determined fat-protein molecule that can cause arterial blockages and inflammation. This molecule latches on to cholesterol and can elevate the risk of heart disease even in people who are otherwise in great health. Tennis legend Arthur Ashe is an example of someone who had Lp(a) and had a heart attack when he was in excellent physical condition at age 36. One in five people are estimated to have elevated levels of Lp(a), but, as Medcan cardiologist Dr. Beth Abramson says, “if we don’t look for it, we don’t find it.”
Another biomarker we assess is apolipoprotein B (ApoB), a molecule which carries the lipid particles around your bloodstream. One of those particles is LDL, the cholesterol that leads to plaque buildup in the arteries. The amount of ApoB in the blood is a strong indicator of how much LDL cholesterol you have and is considered to be more precise than typical lipid panels. ApoB does not require fasting and stays accurate even if triglycerides are high.
The third blood test we offer is the high-sensitivity troponin test (hs-troponin) which has become the gold standard for early detection heart issues. This is the same test that would be used to detect a heart attack in the emergency department, but we were the first to incorporate the test as part of proactive heart health testing. We found that in our clinical setting it can identify issues like valve or aorta problems before they become an emergency.
Dr. Abramson says, “We’ve had some real saves because of hs-troponin screening. We saved some people who wouldn’t normally be screened.” In fact, it was this hs-troponin test that proved to be such a valuable tool for discovering cardiovascular risk factors that Dr. Nord and Dr. Abramson published their research findings in the Journal of Cardiology.
Finally, the assessment also includes the Ankle-Brachial Index (ABI), which is a simple, non-invasive test that compares blood pressure in your ankle with blood pressure in your arm. It helps assess the presence and severity of peripheral artery disease (PAD), which is caused by narrowed or blocked arteries in the limbs. A low ABI can indicate PAD and may also be a predictor of future cardiovascular events like heart attack or stroke.
We’ve had some real saves because of hs-troponin screening. We saved some people who wouldn’t normally be screened.
Heart function tests
The other component of heart health is how well your heart works to pump blood throughout your body. A healthy heart is strong with a regular heart rate that can maintain a healthy blood pressure.
Our Annual Health Assessment also includes two tests that look at your heart function. An electrocardiogram (ECG) uses electrodes that stick to your chest to measure the electrical signals in your heart. This tells us how fast your heart is beating and if you have any irregularities in your heart rhythm.
The V02 sub-max test is a fitness test that measures the rate at which you use oxygen during exercise. It provides a good picture of how well your heart and lungs are working. You can also work to increase your VO2 sub-max score over time through exercise which will lower your risk of developing heart disease.
You are in control
The proactive heart health testing you get from your Medcan assessment will give you insights that surpass what most average physicals provide.
If you are apprehensive about learning your risks, be assured that Dr. Abramson says that no test result is a death sentence. “It’s a marker for long-term risk, and we can manage that risk.”
In fact, according to Heart and Stroke, “8 out of 10 cases of premature heart disease and stroke can be prevented through healthy lifestyle behaviours.”
Managing your risk is possible
General guidelines for managing risk factors for heart disease include changes to diet that include eating more fruits, vegetables, whole grains and lean proteins while avoiding processed foods. The Mediterranean and DASH diet are two specific diets that can support heart health.
Other suggestions are to get at least 150 minutes of aerobic exercise per week, maintain a healthy weight, manage stress and avoid unhealthy habits like smoking.
If your test results show an elevated level of risk, we provide you with personalized recommendations specific to your unique needs. This may include lifestyle strategies like changes to your diet or exercise routine, or we may recommend medications or additional or ongoing screenings.
Learn more and take action
To learn even more about heart health testing, read part three of our proactive heart health series: Enhanced heart testing for deeper insights
Ready to take proactive care of your heart health? Start by booking your next Annual Health Assessment. For even more in-depth heart health testing, consider adding the Enhanced Heart Health Assessment.