Transcription
People with normal cholesterol also get heart attacks. Even people with low cholesterol get heart attacks. Why is that? Half of all heart attacks are from people with normal cholesterol.
Hi, I'm Dr. Kevin Han from Vancouver, Canada. Cholesterol is a gold standard in which doctors measure to assess your risk of whether you get a heart attack or stroke, whether you have heart disease. Cholesterol, especially LDL cholesterol, which stands for low density lipoprotein, otherwise known as the bad cholesterol, is the culprit blame for plaques in your arteries. But that doesn't tell you the whole picture.
Because why do people with low or normal LDL cholesterol get heart attacks? And some people have really high LDL cholesterol and they don't get heart attacks and they don't have plaques. So this has been a mystery. But before I explain that in another episode, I want to tell you the three blood tests that you can do that gives you a much better measure of your risk of heart attacks or strokes.
Number three is something called C reactive protein. Short abbreviation is CRP. This is a protein made in your liver and it is a measure of general inflammation in your body. Systemic inflammation. Now why is inflammation important? Because if you do have plaque when you are highly inflammatory then that plaque is unstable and it can make your plaque burst because it's unstable. And when it does burst, it creates a blood clot that then blocks the rest of your blood vessels, stopping blood flow and causing heart attack or stroke. 70% of heart attacks are actually caused because of unstable plaque. They don't obstruct the artery very much because they're early unstable plaque in an inflammatory environment. The obstructed plaque, you are already seeing signs of whether you have shortness of breath, weakness, symptoms. So that is more predictable and the signs are there but that's only 30% of plaque and those are stabler harder obstructive plaque. So the CRP if your number is greater than three it means you are highly inflammatory and so you're at high risk and if it's less than one you're very low inflammation and lower risk. I've gotten my CRP down to 0.2 that's almost zero.
The number two best blood tests to see if you are at risk of heart attacks is something called lipoprotein A. So LPA because some people have normal cholesterol. They are genetically predisposed for producing more lipoprotein A. So lipoprotein A is a type of LDL with a little protein extra attached to it called apoprotein A. Therefore lipoprotein A. And if your lipoprotein A is high, even if your LDL is low or normal, this is a dangerous type of lipoprotein that does cause plaque, can cause plaque, gives you a high risk of plaque and therefore heart disease. I thought I had high lipoprotein A because I had such severe plaque in my arteries here, in my heart, in my neck. Lipoprotein A was actually normal. So I was surprised. It was mostly my bad diet in my teenager years 20s up until early 50s where I stopped eating fried food. So lipoprotein little you should get measure at least once to see where it is. And this one is much harder to change by diet or exercise or any lifestyle. It is possible but it requires uh specialized knowledge and the best measure to predict your heart disease is apo.
So apol lipoprotein B. Now why is this the best measure? Because LDL is just measuring the concentration of cholesterol inside these LDL the low density lipoprotein. It's like instead of measuring all the cars on the highway, it's just an average number saying there's only one passenger per car. It's only telling you a concentration of cholesterol in your LDL. Apo B, what it does is actually numbers how many cars are on the highway. How many apo lipoprotein B? This apo B is in every type of lipoprotein that can cause plaque. So it's a much better measure than the average concentration versus the actual particle count of lipoproteins that can cause damage and plaque. So the more cars are on the highway, there's a higher risk of car accidents. There's only one car on the highway. it's virtually impossible to have a car accident. And so the higher number of Apo B particles there are, you have a higher risk. So this is probably the number one test you can get to assess the risk of getting plaque and therefore heart attacks and strokes.
So again, what are the three best tests that are much better than total cholesterol, LDL cholesterol, HD cholesterol, triglycerides? Number three, inflammation marker, CRP, C reactive protein. Number two is lipoprotein A, which is a genetic risk factor for lipoproteins that cause plaque and hard to modify by lifestyle. And the best measure if you had to just choose one is apo lipoprotein B or apo B for short. Now if you ask your family doctor or doctor to measure any one of these tests, they might not know because they're so used to just measuring LDL, HDL, and total cholesterol and triglycerides, what we call the lipid panel. But if you really want more accurate measure, these are the three blood tests to ask your doctor to get.