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Testing for CHD

MagazineApril 2009 (Vol. 20 Issue 1)Testing for CHD

Testing for CHD- C-reactive protein (CRP)Claimed (but not universally agreed) to be more indicative of CHD risk than cholesterol because CRP measures inflammation, a possible key factor in atherosclerosis

Testing for CHD
- C-reactive protein (CRP)
Claimed (but not universally agreed) to be more indicative of CHD risk than cholesterol because CRP measures inflammation, a possible key factor in atherosclerosis. The most accurate test is the hs-CRP. Your CRP level should be less than 1.69 mg/L.
- Homocysteine
Homocysteine is an amino acid thought to promote atherosclerosis. A safe normal range is 4.72-7.00 mmol/L.
- Cholesterol
Confusingly, there are two measures of cholesterol. The US uses mg/dL (milligrams/deciliter) of blood; the UK uses the International System of mmol/L (millimoles/liter). The current guideline figures are:
- Total blood cholesterol
Normal: 5.1 mmol/L (200 mg/dL)
High: 6.2 mmol/L (240 mg/dL)
Normal: 13.3 mmol/L (30 mg/dL)
High: 4.1 mmol/L (160 mg/dL)
LDL(B): should not exceed 0.52 mmol/L (20 mg/dL)
Normal: 1.3 mmom/L (50 mg/dL)
Too low: 1.03 mmol/L (40 mg/dL)
- Ratio of total cholesterol to HDL (more important than raw values) (N Engl J Med, 1999; 341: 410-8)
Above 30 per cent HDL is safe
20-30 per cent HDL is OK
Below 20 per cent is risky.
- Total cholesterol values can be significantly increased in the elderly, as high cholesterol levels are not linked to premature death.
- Lipoprotein(a)
Mainly a hereditary factor, levels should be less than 0.25 mmol/L (10 mg/dL).
- Fibrinogen
A measure of blood coagulation: the 'stickier' the blood, the higher risk of heart attack. A safe normal level is 180-350 mg/dL.
- Tell-tale symptoms of CHD
- Angina: tightness or pain in chest on exercise
- Lightheadedness, nausea or breathlessness
- Fluid retention
- Bluish fingernails or lips
- Unexplained fatigue.

High-fat and heart healthy
- Cretans eat a diet containing 40 per cent fat, but have 5 per cent of the
CHD deaths of the US (Cardiol Prat, 1962; 13: 225-44)
- People in northern India consume 17 times more animal fat, but have seven times less CHD than people in southern India (Ind J Industr Med, 1968, 14: 219)
- The oldest Soviet Georgians eat the highest fat diets (Pitskhelauri GZ. The
Long Living of Soviet Georgia. New York, NY: Human Sciences Press, 1982)
- In the Gascony region of France, where goose and duck liver is a staple part of the diet, the CHD rates are a quarter of that in the US
- The Masai have no CHD, although their diet is primarily animal meat, blood and milk (Am J Epidemiol, 1972; 95: 26-37)
- The East African Samburu consume 10 liters of full-fat milk a day (= 400 g of fat), but have no CHD (Am Heart J, 1962; 63: 437-42)
- Australian Aborigines consume a diet that is 64-per-cent fat, but have very low rates of CHD (Lipids, 1986; 21: 684-90).

A healthy heart naturally

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