Undetected cardiovascular disease is the greatest health risk facing people today. Heart disease remains the leading cause of death for both men and women in this country; killing more people than the next five leading causes of death combined. About 600,000 people die of heart disease in the United States every year–that’s 1 in every 4 deaths. Coronary heart disease alone costs the United States $108.9 billion each year. This total includes the cost of health care services, medications, and lost productivity.
Although breast cancer may instill greater fear, more than 10 times more women die each year from heart disease. Consider also that men, compared to females, have a 17% higher lifetime risk to suffer a heart attack. Furthermore, for a significant percentage of heart attacks, death is the first indication of the disease. Unfortunately, most of those deaths could have been prevented with a comprehensive evaluation and appropriate guidance and care.
Standard cholesterol tests do not tell the whole picture in gauging an individual’s risk of cardiovascular disease. Approximately 60% of people who have a heart attack have normal cholesterol. Eighty percent of those who have a heart attack or stroke have the same cholesterol numbers as someone that is event-free. Increasingly, general medical consensus views the standard cholesterol testing as only a part of the information needed for true assessment of impending and ongoing risk. Of further importance is that chronic silent inflammation plays a critical role in the genesis of heart disease.
At The Lamkin Clinic, we have developed a unique comprehensive risk-assessment protocol including diagnostics and lab work aimed at early detection of underlying metabolic, genetic, and other silent risk biomarkers for cardiovascular disease.
Your Advanced Cardiovascular Screening may include one or more of the following:
Traditional lipid profile: This basic group of tests to determine risk for cardiovascular and related diseases is a good start but should always be combined with advanced testing to unveil a more accurate picture of total health. As mentioned above, the standard lipid profile is only a small part of your risk. Other biomarkers will elucidate the full picture.
Lipoprotein particle assessment: Lipoprotein particle size and number are increasingly viewed as an essential indicator of risk. These concentrations reveal levels of good and bad cholesterol particles and their relative size. This information is a far better predictor of risk than traditional lipid profiles alone but used in conjunction with a standard lipid profile, add to the completeness of the evaluation. In flow dynamics, larger particles tend to stay in the middle of a vessel while smaller particles naturally will go to the periphery increasing their likelihood of engaging the endothelium or inside lining of blood vessel. If there are cracks and fissures in the vessel lining, the smaller particles are also more likely to enter the vessel lining and initiate a plaque. Almost all vessel linings become cracked and fissured at some point or another. It is the degree with which this happens and the size and number of particles that contributes to risk of plaque development in the artery. More is discussed on these weaknesses in the lining of the vessels in the inflammation discussion below.
Cardiac Function: Advanced tests detect strain or other damage to the heart muscle, which can lead to more appropriate treatment for preventing heart attacks. Specifically, Ischemia (lack of adequate oxygen to the heart muscle), blood turbulence from heart valve disorders, and asymmetries in the cardiac wall motion can lead to elevation of Galectin-3 and NT-proBNP. Any elevation would necessitate a referral for echocardiogram and specialty cardiology consultation.
Genetic predisposition: Genetic markers not only help predict risk for heart attacks and strokes but help guide treatment. Several markers help determine the genetic propensity of an individual to form plaque in their arteries develop clots which lead to heart attacks and strokes.
Inflammatory risk: Inflammation plays a key role in the initiation of the process that leads to poor vessel health and eventual plaque development. Myeloperoxidase, HS-CRP, Lp-PLA2 are all risk indicators of vessel inflammation. Many factors contribute to vessel inflammation and weakness, some of which we do not even full y understand. However, we know diet and nutrition play a role. We assume the environmental toxins play a role. Regardless, identifying inflammation is the first step to correcting it. Most biomarkers are by definition are silent. When they stop being silent often the damage is already done.
Metabolic: Bio-markers of insulin sensitivity and blood sugar control are important indicators that can lead to early detection of diabetes, which increase an individual’s risk for development of heart disease. Spiking insulin levels initiate a cascade of inflammation that contributes to insulin resistance and Diabetes. The process of insulin resistance is insidious and takes years or even decades to manifest as Type II diabetes and mostly reversible if caught early. Overall blood sugar control, insulin sensitivity, and fasting blood glucose are included in this cardiovascular risk assessment.
Omega-3 index: This unique test analyzes the omega constituents of red blood cells providing a longer term indicator of adequate consumption and or supplementation again affecting treatment guidelines.
Nutrition: Health Diagnostic Laboratory offers comprehensive panels of advanced tests that include nutritional markers that can help elucidate the underlying cause of vessel inflammation.
Ankle Brachial Index: The Ankle Brachial Index (ABI) is the ratio of the blood pressure in the lower legs to the blood pressure in the arms. Compared to the arm, lower blood pressure in the leg is an indication of blocked arteries (peripheral vascular disease or PVD). The ABI is calculated by dividing the systolic blood pressure at the ankle by the systolic blood pressures in the arm.
Carotid Artery IMT (Intima media thickness): non-invasive, state-of-the-art, cost-effective diagnostic tool for the earliest detection of cardiovascular disease. The value of carotid IMT has been recognized by the American Heart Association, the American College of Cardiology and the American Society of Echocardiography for the early detection of heart disease in asymptomatic patients. A 2007 article in the journal Circulation confirmed that carotid IMT is a reliable and strong predictor of future stroke and myocardial infarction [heart attack]. This technology won “Most Life Changing Product” at the 2008 BIOCOM conference.
Calcium Score: This is a noninvasive procedure using computed tomography to measure the quantity of calcium deposits in the heart, especially deposits in the coronary arteries. An increase in deposits contributes to narrowing in the arteries and a reduction in heart function, which can lead to a heart attack. The larger the number of deposits the greater the likelihood of a future serious cardiac event.
In-office cardiac stress and pulmonary function test. A monitored stress EKG and pulmonary function will be performed by a technician and under the supervision of Dr. Lamkin.
Body Composition Analysis: Nutrition, exercise and aging may have profound effects on an individual’s body composition. Body composition measurement with dual-energy X-ray absorptiometry (DEXA)* can look beyond weight and the traditional body mass index (BMI) to determine body fat distribution, lean muscle mass, and body fat percentage – an important risk factor in a variety of serious diseases primarily heart disease. Today’s body composition measurement tools can even make athletes make decisions on the training regimens they use to achieve the best performance. In all these cases, body composition measurement contributes to a thorough patient evaluation and helps our physician fully assess and individual’s risk of cardiovascular disease.
Resting metabolic rate: Metabolic rate, or metabolism, is the rate at which the body expends energy. This is also referred to as the “caloric burn rate”. Knowing metabolic rate is vital for weight loss as well as for determining the proper feeding amounts needed to treat various disease states. The MetaCheck from Korr Medical Technologies measures a person’s resting metabolic rate with a simple 10 minute breath test. The technology once reserved for hospitals and universities is now available at The Lamkin Clinic. Testing metabolic rates will determine exactly how many calories a person may eat and still lose or maintain weight. No more charts, averages, or guessing. For the first time in years, there is something truly new for the thousands of people who are trying to lose weight.
“Tilt” Test: The modified “tilt” test is a simple blood pressure and heart rate measurement while laying down, sitting up and standing. The tilt test is a test used to evaluate and diagnose a condition called neurocardiogenic syncope, which is a common cause of lightheaded spells or fainting or passing out which can occur in otherwise normal individuals. The normal heart rate and blood pressure are a balance of the body’s sympathetic tone (adrenaline levels), and the body’s vagal (parasympathetic) tone. The sympathetic tone increases the heart rate and blood pressure, as what happens during exercise. The vagus nerve is activated by the brain and slows the heart and reduces the blood pressure and can be activated by many things. Certain individuals have an abnormality in the body’s reflex control of the heart rate so that the balance between the sympathetic tone (adrenaline) and parasympathetic tone (vagus nerve) becomes abnormal leading to either an abnormally low heart rate or an abnormally low blood pressure. These events can occur at rest, with prolonged sitting or standing, dehydration, and sometimes without known causes and can cause sudden lightheadedness or fainting.
Your Physician Review and discussion: Dr. Lamkin will schedule one hour face-to face time with you to review all of your diagnostic and lab results. This will be an important starting point in your personal exploration of your health. Dr. Lamkin believes that the vast majority of heart disease is preventable. The biomarkers assessed are silent in that they go undetected for years and even decades before they can manifest as a symptom. Once your unique metabolic, genetic, and inflammatory markers are identified, you will feel empowered knowing where your risk lies and better be able to address those areas of concern. This assessment may be part of a larger evaluation depending on your unique circumstances and health goals.
Now it’s time to get to know your TRUE risk for a heart attack or stroke. Don’t get caught by surprise!
Call (405) 285-4762 to schedule your consultation with Dr. Lamkin.