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CHOLESTEROL SCREENING…THE NEXT LEVEL!
After my husband was recently diagnosed with coronary artery disease, it was recommended by his cardiologist that he should have an advanced cardiovascular disease (CVD) risk assessment done by Berkeley HeartLab (Alameda, CA). The Berkeley Advanced CVD Profile is a comprehensive risk assessment and monitoring baseline which includes proprietary testing for LDL and HDL subclasses that are far more informative than standard “good” and “bad” cholesterol. The Berkeley subclass testing is derived from technology originally developed at the Lawrence Berkeley National Laboratory (UC- Berkeley, CA) for researchers to perform the first characterizations of LDL and HDL lipoprotein subclasses.
According to the Berkeley HeartLab, “Surprisingly, about 80% of individuals who are destined to have heart attacks have the same blood cholesterol values as those who do not develop CAD.” It is possible to have a standard cholesterol screening with all your numbers in the target range, but still have an LDL particle number that increases your risk for cardiovascular disease. Current cholesterol screening is limited as it does not provide detailed information about the small, dense LDL particles which more easily penetrate into blood vessels walls, thereby, increasing the risk for atherosclerosis. .
Unlike routine cholesterol screening; advanced tests such as the Berkeley and the Vertical Auto Profile or VAP test (Atherotech, Birmingham, AL) provide a more accurate assessment of the underlying risk of cardiovascular disease by identifying the predominance of certain LDL particles and their size. According to the Berkeley HeartLab, “A much better assessment of CAD risk is achieved by enlarging the spectrum of testing to include additional disorders, such as a predominance of small, dense particles within the LDL family (small LDL trait) and low levels of HDL2b, the most heart-protective type of HDL.”
Ashish Mateur, Executive Director of the South Asian Heart Center (SAHC) at the El Camino Hospital in Mountain View, California says that, “Standard screening tests do not address the high rate of premature heart attacks in South Asians. Tests such as the Berkeley should be considered for South Asians who in general have a higher incidence of heart disease.” The mission of the SAHC is to provide a comprehensive, culturally- appropriate program incorporating education, advanced screening, lifestyle changes, and case-management. Its goal is two-fold. On the one hand, to change how healthcare providers screen and assess for heart disease with the local, national and global South Asian community. On the other, to change how insurance companies view advanced CVD testing (such as the Berkeley test) by getting them to accept coverage for these tests at a younger age for the South Asian population.
In my husband’s case, the Berkeley test indicated a high level of the smaller dense (more harmful) artery clogging LDL particles while his general cholesterol screening had indicated “normal” LDL values. This proves that we should not breathe a sigh of relief if our cholesterol values are normal especially if there is a family history of heart disease. Even though your “bad” cholesterol might be in the normal range, establish if you have a family history of heart disease, be proactive, and then with the help of your health care provider, find out if your level is really normal, or is there silent damage being done to your heart beyond what the numbers on paper indicate?
Material from this article was obtained from the Berkeley HeartLab and the South Asian Heart Center website with permission. For more information regarding the Berkeley test, please consult with your healthcare provider or visit www.bhlinc.com. For more information on the South Asian Heart Center and its services, please visit www.southasianheartcenter.com.
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