Written By: Dr. Sidra Mehmood
Concerned about your heart health? Simple blood tests can now play a vital role in identifying individuals at risk for cardiovascular disease (CVD), the leading cause of death worldwide. These painless tests offer a proactive approach to preventing heart problems before they strike. By understanding the results of these tests, you and your doctor can work together to create a personalized plan to safeguard your heart health.
Homocysteine Test: Uncovering a Hidden Risk Factor
Homocysteine test is the blood test which tells about the amount of amino acid known as cysteine in our blood. It exists in very small amount in our body. And it is broken by the vitamin B12, B6 and B9. They change it into other substances and this process leaves very small amount of it in the blood. But if they don’t work due to many reasons cysteine start accumulating and it’s quantity becomes higher than normal. And it becomes to accumulate in arteries and increase the risk of cardiovascular diseases.
Normal Range:
- Normal value: < 15.1 micromol/L of blood
- Moderate: 15-30 micromol/L
- Intermediate: 30-100 micromol/L
- Severe: more than 100 micromol/L
There are many reasons due to which it’s level rises in our body some of them are following:
- Renal disease
- Psoriasis
- B6, B12 or B9 deficiency
- Malnourishment
- Can not absorb enough dietry vitamins
- Hypothyroidism
- Alzheimer’s disease
- Different medications
- Smoking history
- It can also be inherited this condition is called Homocystinuria. It happens if a person gets recessive gene known as Methlenetetrahydrofolate Reductase from both parents.
When it’s level becomes high in blood it causes different diseases and increases the risk of heart disease. It can cause:
- Blood clots
- Coronary artery disease
- Atherosclerosis
- Heart Attack
- Stroke
- Peripheral vascular disease
- Deep veins embolism
- Venous thrombosis
- Damages artery lining
Some studies shows that it damages innermost layers of vessels. And 10% elevation in homocysteine increase nearly the same risk of coronary artery disease. Some studies also shows that it is 20% more common among the women with following complications:
- Pregnancy complications
- Preeclampsia (elevated bp in pregnancy)
- Recurrent pregnancy lost
- Giving birth to low weight babies called intrauterine growth restriction
- Placental abruption
- Giving birth to baby with neural tube defects (Spinabifida and anencephaly) etc
So in short increase in Homocysteine is risk factory of different cardiovascular diseases and a medical professional can diagnose it with help of homocysteine blood test
Blood Glucose Test
Blood glucose test is test which is done to measure the level of sugar(glucose) in our glucose is the main source of energy for our body cells it is building block of carbohydrates. They are found in fruits, cereals, bread etc and converted into glucose in our body. Different hormones in our body control the level of blood sugar. Not only increase but also decrease of blood sugar level causes different cardiovascular diseases. Its normal value in our blood is 120-140 mg/dL And 80-90 mg/dL in fasting state.
First we will discuss about increase in blood sugar level it’s causes and effects on our body.
Causes of High blood sugar; There are different causes of increase in blood sugar level some of them are following:
- Overactive thyroid
- Pancreatic cancer
- Stress due to trauma, stroke, heart attack, surgery etc.
- Rare tumors
- Cushing syndrome
- Pheochromocytoma
- Glacogonoma
Effects: High blood sugar damages the blood vessels and it causes serious heart complications in result of damaging vessel walls. Actually our body doesn’t use all sugar properly most of it sticks to the red blood cells and build up in our blood. And it block and damage the vessels carrying blood to and from the heart and thus causing of starving of heart of oxygen and nutrients and can cause heart attack, stroke, ischemia, Coronoy heart disease etc.
Lowering of blood sugar: Lowering of blood sugar also causes serious effects on our body.
Causes:
- Hypopituitarism
- Underactive thyroid or adrenal gland
- Insulinoma
- Too much insulin
- Too little food
- Vigorous exercise
- Weight loss after weight loss surgery
- Liver or kidney disease
Effects: This condition is known as hypoglycemia it stimulate automatic nervous system and causes following effects
- If it is 58-69 mg/dL then it results in release of epinephrine, glucagon this secretion increases blood flow to brain to prevent neuroglycogeina and increases gluconeogenesis to restore blood sugar.
- If it is 43-54 mg/dL then it results in decreased evoked response and electroencephalo graphic changes.
- If it is below 27 mg/dL then it causes Coma, loss of convulsions, systolic blood flow increases in myocardium and Heart attack.
So In this way blood sugar test can also help to determine the risk of cardiovascular diseases.
Lipid Profile
Lipid Profile test measures the fat in blood and determines the risk of having heart attack and other heart diseases. It includes the measurement of total cholesterol and total cholesterol includes
- Triglycerides
- density lipoprotein
- High density lipoprotein
- Very low density lipoprotein
It is also used to identify dyslipidemia ( various disturbance of cholesterol and triglycerides level) which may cause various cardiovascular diseases .it assess an individual’s risk for heart attack but some how we can’t totally rely upon iit. It’s normal to high values in our blood are:
- Borderline high: 150-199mg/dL
- High: 200-499 mg/dL
- Very High:
Total cholesterol may be
- Good Cholesterol (HDL)
- Bad cholesterol (LDL and triglycerides)
High level of LDL and triglycerides and low level of HDL are linked to Heart diseases.
LDL: Low density lipoprotein stick to walls of arteries and causes blockage of them are make plaques which causes Atherosclerosis. And reduce or block the flow of blood to the heart which causes heart attack, chest pain etc.
Triglycerides: High levels of triglycerides is associated with heart disease. They build up plaques and store in fat cells. And also causes Coronary heart disease And also influences inflammatory process as well as function of leukocyte, vascular and cardiac cells therefore impacting on vessels and heart.
HDL: Low levels of high density lipoprotein causes risk of heart disease. Because they are involved in removal of LDL from body
So lipid profile test helps to diagnose the risk of cardiovascular diseases.
C – Reactive protein test:
CRP is test which measures the C- reactive protein level in our blood. Normally it is in low level but when there is inflammation it’s level rises . High level of CRP means one have serious health condition that causes inflammation. Inflammation can be acute and temporary. But chronic inflammation damages healthy tissues. A CRP test tells about inflammation in your body but it doesn’t tell about the causes and location of inflammation.
And it is correlated with lipid profile test because research shows only 50% of the people who suffer heart attack has high LDL values . Do many doctors suggest CRP test in collaboration with lipid profile test.
C- reactive protein is produced by liver .LDL not only coats walls of arteries but also damages them and this damage causes the inflammation then body tries to heal it by sending a response team of proteins called acute phase reactants. C- reactive protein is one of them.
According to a research:
- Less than 1mg/L of it is associated with lower risk of heart disease.
- 1-3mg/L is associated with moderate risk of heart disease
- Greater than 3mg/L is associated with highest risk of cardiovascular diseases.
CRP test may be
- Standard CRP
- Highly sensitive CRP
Standard CRP: Standard CRP teste measures about 10-100mg/L protein in blood. It can help to diagnose different diseases which that cause inflammation by measuring high levels of protein in blood . So it is not very helpful in diagnosis of cardiovascular diseases.
Highly sensitive CRP: Highly sensitive C- reactive protein test measures lower elevated levels of protein which can signal the risk of heart diseases. It measures about less than 1 mg/L of blood. Higher levels of protein indicates that inflammation in arteries which can cause many cardiovascular diseases it can cause following diseases:
- Stroke
- Peripheral arterial diseases
- Sudden cardiac death
- Coronary artery diseases
However it is very non – specific test about diagnosis cardiovascular diseases but it helps to find out the risk of cardiovascular diseases in an individual.
Complete Blood Count (CBC):
CBC is complete Blood count test which tells about the number of different blood cells in our body. It gives information about
- blood cells
- White blood cells
- Platelets
- Hemoglobin etc.
It also gives information about various cardiovascular and other diseases depending upon the number blood cells in an individual. It is a tool to detect congestive heart failure. It can detect anemia which is known to induce congestive heart failure.
Red blood cells:
Normal range of red blood cells in men is 4-5.8 million per milliliter cube of blood and in women about 3.8-5.2 million per milliliter cube of blood.
Lack in red blood cells is known as anemia and it is linked to Heart diseases because heart has to pump harder to pump more blood and oxygen to the body. It occurs when body has not enough red blood cells that transport hemoglobin and oxygen through out the
body and oxygen through out the body and anemic body doesn’t get enough oxygen that it needs.
Symptoms:
- Weakness
- Fatigue
- Headache
- Irritable mood
- Chest pain
- Pale appearance etc
When it becomes more severe heart has to pump harder and faster to compensate for decreased oxygen levels. And thus it causes heart diseases. UpTo 48% people have heart failure are anemic .
Increase in the red blood cells is called polycythemia. It occurs in various cardiovascular diseases such as congenital heart disease, heart failure to compensate the low oxygen levels . So that it also gives information about risk of cardiovascular diseases and their diagnosis.
White blood cells:
Normal range of white blood cells is 4500 – 11000 per microliter of blood. Increase in leukocytes is independent risk factory for Coronary heart disease. And directly associated with incidence of coronary heart disease and ischemic stroke and atherosclerosis. Because they cause the inflammation which proteolytic and oxidative damage to endothelial cells, play microvasculature and induce hyper coagulability and promote infarct expansion and these directly associated with cardiovascular diseases.
White blood cells are good predictors of stroke, heart attack and fatal heart disease especially in women.
Platelets:
Platelets are disk shaped cells in our blood involved in formation of blood clots. Their normal range is about 150000-450000 per microliter of blood. They play important role in heart attack, stroke and peripheral vascular diseases.
In cardiovascular diseases abnormal clotting occurs than can result in heart attacks or stroke. Blood vessels injured by smoking, cholesterol or high blood pressure build up cholesterol plaques that line blood vessels. These plaques can cause platelets to form a clot. Even though no bleeding is occurring. Platelets sense plaque rupture and are confused thinking that injury has taken place that will cause bleeding. Instead of sealing vessel to prevent bleeding as would as occur with a cut , a clot formation in an intact vessel causes blockage of blood flow a d without blood a portion of heart muscle can die leading to heart attack.
So in this way CBC helps to diagnose risk of different cardiovascular diseases.
BNP:
BNP is the B-type Natriuretic peptide test and it provides the information about how heart is working and measures the level of BNP protein in blood.
BNP is one of several proteins that help to regulate blood circulation throughout the body. Heart makes it and left ventricle is main organ which makes it and pumps blood to all body. It is also called Brain natriuretic peptide because it was first found in brain. And it prompts to kidneys to relieve salt and water hence named natriuretic.
When heart has to work harder and it stretches due to load or stress from injury more BNP is produced and it’s level rises. Heart muscles response to stress by producing BNP to unload heart.
Higher BNP is the sign of heart failure and it means heart is not working well and not pumping enough blood . So this test is used for checking the cardiovascular diseases.
Its normal value is about less than 100 pg/mL of blood. And greater than 100pg/mL of blood is sign of heart attack.
Signs of heart failure
Signs of heart failure are following
- Cough
- Dyspnea
- Delirium
- Fatigue
- Dizziness
- Nausea
- Fatigue
- Urinating at night
- Edema in legs, ankles and feet
There is another pro hormone of BNP which is known as aminoterminal pro B-type Natriuretic peptide. And it is 5 to 10 times higher than B. its normal is different at different ages .
- Less than 125pg/mL below 75 years
- Less than 450mg/mL above 75 years
- Over 900mg/mL causes heart failure
So in this way this test is used to find the risk of cardiovascular disease and also for how heart failure treatment are working
Conclusion:
The BNP and pro-BNP tests are valuable tools for assessing heart function and diagnosing heart failure. These relatively simple blood tests can help doctors identify and manage heart problems effectively.
References:
- https://web.archive.org/web/20050315055938/http://www.broadcasting- history.ca/networks/networks_CBC_Radio.html
- Arnett DK, et al. 2019 ACC/AHA guideline on the primary prevention of cardiovascular disease: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2019; doi:10.1161/CIR.0000000000000678.
- Filippo C, et al. C-reactive protein in cardiovascular disease. https://www.uptodate.com/contents/search. Accessed July 13, 2024.