I want to bring the topic of plaque formation front and center as we start scheduling for our quarterly MCG (multifunction cardiogram) testing (see below for more information on this). Let’s not forget that when I say plaque formation, I am not just talking about in your heart. Vascular disease is not just about having a heart attack. It can occur all over the body leading to stroke, dementia, problems walking and even erectile dysfunction. .
Many of my patients argue that they don’t need to address their high cholesterol because they have had a “zero” on their calcium heart score test or because their provider has told them their cholesterol “ratio” is good.
Whoa…hold your horses. The cholesterol ratio really doesn’t spell out what is going on. I have seen many people with good ratios that are in trouble with plaque formation based on the rest of the story! Even with a zero on your heart score you can still have plaque. Just because plaque isn’t forming in the major heart vessels doesn’t mean it is not forming in your carotids, your legs or the small vessels in your heart, your brain and other places. All of this increases your risk of stroke, dementia, peripheral vascular disease and yes even erectile dysfunction for men.
What about those of you with normal cholesterol levels thinking everything is great? You may be at high risk of vascular disease without even knowing it due to other risk factors.
The problem is our testing doesn’t give us good indications this is happening so we have to pay attention to the clues.
READ ON to learn 5 clues you are at risk of forming plaque and 4 easy steps to get on the right path. Guess what… your cholesterol doesn’t even have to be high to form plaque!
Clue #1: Elevated apoB. Apolipoprotein B is a special test not on routine blood work that says you are at higher risk of plaque formation. ApoB is a carrier that takes the lipids to where they are going (basically saying come with me and let’s go make plaque). Because it only transports the so-called bad guys: LDL and VLDL this marker is a better indicator of cardiovascular disease than the other parameters in the standard lipid panel. When this is elevated you are at higher risk of vascular disease anywhere.
Clue #2: Increased blood sugar. It has been shown that increases in blood sugar causes inflammation accelerating plaque formation. This is one of the reasons people who have diabetes are at higher risk of stroke, heart attack and dementia. However, pre-diabetics also have an increased risk especially when combined with inflammation and higher cholesterol levels.
Clue #3: Elevated inflammation markers. hsCRP is a high sensitivity C reactive protein marker indicating inflammation. It does not tell you where it is coming from so it can be a bad joint, bad gut, something bad in the mouth for example. The mouth is such a culprit if we clean up the gut and this marker is still elevated with no other obvious cause I always recommend a special dental exam to make sure there are no hidden abscesses or other surprises in the mouth causing this. Studies indicate prolonged increases in the hsCRP increase the risk of cardiovascular disease, stroke and peripheral vascular disease.
Clue #4: Elevated Lp(a) or lipoprotein (a)– referred to as literally L P little a. This is a genetic test that can be done in routine blood work. Increased Lp(a) is associated with increased risk of vascular disease REGARDLESS of normal cholesterol levels! I hear patients telling me their providers are telling them their cholesterol is ok (yes, even from cardiologists) but when they have an elevated Lp(a) the goal of their LDL should be less than 70 and most lipidologists are now targeting 50 due to this increased risk!!
Clue #5: Combinations. If you have ANY combination of the above 4 then your risk of vascular disease is exponential. Do not ignore this even with a “normal’ calcium heart score.
What do you do about this?
- Know your numbers. Measure all of the above markers and understand what your risks are and address them!
- Do the calcium heart score and if you have any of the above plus any increase on this scan then take it seriously.
- Do the ultrasounds: carotid, aorta, legs. Life-line screening offers an inexpensive way to check this box.
- Do a MCG multifunction cardiogram. This test provides you with a predictive peek into small vessel disease so you can wake up and make some changes. An EKG just tells you what is happening right now but the MCG says – hey – wake up you are going to be in trouble if you don’t do something! Women are particularly prone to small vessel disease in the heart and it is missed on traditional EKG testing until it is too late.
We are offering the MCG test approximately every quarter and are now scheduling for our April 2025 session. Please call our office to schedule.
To your health,
Laura
