Forget Cholesterol, This is More Damaging to Your Heart!

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Scott: So, when we go to the doctor and get a routine checkup, one of the numbers that everybody knows is our cholesterol number.  Is that important?

Dr. Bradley Bale: Sure.  Cholesterol is important.  There's no question in our opinion about that.  But what's more important is how inflamed is the artery wall.  And we have great tests that will tell you how inflamed it is.  Because if your cholesterol is a bit high, and the artery's not inflamed, that tennis court is not inflamed, it's working real well, it isn't going to matter,it can't get through.  So the tests that we monitor and look at on a routine basis are the blood and urine test that tell us if the artery wall itself is inflamed or we like to tell it to our patients, is your artery on fire?  If your artery's on fire, you're in trouble, even if you have a low cholesterol level, because some of it can still seep through.  And now that we have a lot of therapy out there for cholesterol, and it's getting clobbered, especially in patients that have already had a heart attack.  A lot of the heart caths and heart attacks that are occurring now are in people who have LDL, bad cholesterol levels that are excellent.  Under 70.  So its inflammation that matters, more than anything else.  So we do, there's a urine test called microalbuminuria.  And basically its measuring how much of a protein called albumin is getting into the urine.  And the way we explain that to patients is look, this albumin its a huge protein.  And when it's so big that when it lands on your tennis court, it shouldn't be able to get through.  But if your tennis court's inflamed or not working well, then it starts seeping through and those little arteries in your kidney and showing up in your urine.  And in the Framingham Study, which is extremely well known, there were all sorts of biomarkers, including one that a lot of people are familiar with, the highly sensitive CRP.  And they looked to see if any of these biomarkers independently predict the risk of heart attack.  And when they say independent, they mean they adjust for everything.  Like how far did you go in school, how old are you, what's your income, what's your cholesterol, what's your blood pressure, etcetera.  So there were only two of those tests that met that criteria.  One was the albumin in the urine, and that makes sense.  The CRP was not an independent predictor.  The other one was what we call brain natriuretic peptide.  But one of the ones that was independently predictive is really the best test we have to tell you how well the tennis court's working and is it inflamed?  And that's albumin in the urine. 



Dr. Bradley Bale discusses heart health in this video. Find out what tests you might want to look into to find out an important factor of your heart health. He says cholesterol is certainly something that should be looked at, but there's something else that's much more important to the health of your heart!

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