Your heart beats about 100,000 times a day. It doesn’t take time off or vacations, and it doesn’t complain, until it really, really has to. Heart disease doesn’t usually start with chest pain or other symptoms. Instead, it starts quietly in the background - Inflammation, oxidized lipids, endothelial dysfunction, insulin resistance, calcification. These can start years before symptoms appear or a cardiovascular event occurs. Unfortunately, these too often go unchecked and  cardiovascular disease (CVD) is the leading cause of death in the US. 

The good news is that CVD is also one of the most well-known and modifiable health risks we face. The earlier you address the issue, the less invasive the intervention needs to be later. This article contains key, lesser-known information to empower you to keep your heart beating happily and healthily.

1️⃣ LDL Isn’t the Whole Story 

You can have a "normal" LDL cholesterol level and still carry cardiovascular risk. Why? Because LDL cholesterol is usually calculated from HDL and total Cholesterol and does not measure particle number, inflammation, lipoprotein size, oxidative stress.

Since plaque formation is driven by much more than just the percentage of LDL circulating in your blood , it is important to test for more than just the basic lipid panel. 

The single best test currently available that looks at the total number of atherogenic lipoprotein particles (LDL, VLDL, IDL, and Lp(a)) circulating in your blood is an Apolipoprotein B blood test. If ApoB is elevated, risk is elevated, even if LDL looks acceptable.

2️⃣ Lipoprotein (a) - an under-tested genetic risk marker 

Lipoprotein(a), or Lp(a), is a specialized LDL-like particle that carries an additional protein called Apolipoprotein(a). It more easily leads to plaque formation so elevated levels of Lp(a) are associated with an increased risk of heart attack and stroke

What makes it different? Lp(a) is largely determined by genetics and remains relatively stable throughout life, regardless of diet and exercise. 

About 1 in 5 people have high Lp(a), if you do, prevention strategies should be more aggressive. We highly recommend you consult our Wellness Team who are experienced with high Lp(a) protocols. 

3️⃣ Your Blood Vessels Are an Organ 

The walls of your blood vessels are lined with tissue called the Endothelium. These specialized cells regulate: Blood pressure, clotting, inflammation, and Nitric oxide production. When damage occurs to this lining and endothelial function declines, disease progression rapidly accelerates. Exercise strengthens the endothelium and a diet high in antioxidants and polyphenol and low in oxidized fats also protects the endothelium. 

4️⃣ Insulin Resistance Damages Arteries 

Consistently elevated glucose and insulin put strain on the body, including the cardiovascular system by increasing oxidative stress, promoting more small particle LDL formation and accelerating vascular inflammation. Read our blog on Blood Sugar Control for a complete functional guide. 

5️⃣ Coronary Calcium Is a Lagging Indicator

A CAC score shows calcified plaque, the most advanced stage. It does not show inflammation, endothelial damage, oxidized lipids or non-calcified plaque - critical stages for preventative intervention. Calcified plaque is a sign that cardiovascular disease has been present for years. 

6️⃣ Muscle Mass Is Protective Against Heart Disease

Higher lean mass correlates with better insulin sensitivity, improved inflammation response, and improved lipid metabolism. Age-related muscle loss (Sarcopenia) increases cardiovascular risk. Exercise and weight lifting plus adequate protein intake helps maintain your muscle mass. 

7️⃣ Sleep Affects Arterial Health Too

We mostly think of sleep affecting brain health and energy, but poor sleep can also raise blood pressure, increase inflammatory markers, and reduce insulin sensitivity. Chronic short sleep is associated with higher cardiovascular risk. Read our Guide to Better Sleep, the foundation to better health. 

8️⃣ Inflammation Can Be Silent

You can feel fine, have normal ApoB and Lp(a), and exercise regularly and still carry inflammatory risk. Silent inflammation can still be stressing your body. Specialized blood tests such as C-Reactive Protein and MPO can be useful tools to look for inflammation. Talk to our team (for free) if you are interested in learning more about blood test options or to discuss your results for free.