What your cholesterol test isn't telling you
Heart disease has become the number one killer of men and women in the United States, killing more than 500,000 people each year. Being heart-healthy is priority one for many health-savvy women. But this fact might surprise you: nearly half of the people who have heart attacks have normal cholesterol levels. While it's easy to think eating the good stuff, getting to the gym and passing your cholesterol test with flying colors puts you at lower risk for heart disease, that's not always the case. But take heart, a new test called the Vertical Auto Profile (VAP) offers a more detailed look into your lipid profile and may even save your life.
What is the VAP Test?
The Vertical Auto Profile (VAP) is an advanced lipid test that is more accurate than the routine cholesterol screen. It was developed by Atherotech, Inc., a cardio-diagnostic company, and offers patients a more useful diagnostic test to assess cholesterol levels and risk for heart disease than routine screenings. The VAP includes 15 separate components of blood cholesterol rather than the usual four included in the standard cholesterol work up.
Why delve so deeply into your cholesterol profile? Two words: early prevention and treatment. The VAP identifies more lipid abnormalities (the #1 risk factor of heart disease) than the standard version. And according to Atherotech, it's the only cholesterol test that identifies markers for metabolic syndrome, a precursor for diabetes. Early and accurate diagnosis helps reduce risks of both heart disease and diabetes.
The VAP routinely reports all three lipoprotein parameters the American Diabetes Association and the American College of Cardiology consider necessary, based on expert consensus guidelines. Forbes included the VAP test in their list of "Ten Ways to Live Longer" and it was named one of "Five Tests Worth Paying For" by the Wall Street Journal.
VAP Offers Details that Routine Cholesterol Tests Don't
Routine blood cholesterol screenings only measure overall levels of the "good" HDL cholesterol (high density lipoproteins), the "bad" LDL cholesterol (low density lipoproteins), and triglycerides. The VAP is more sensitive in that it identifies more than 90 percent of people at risk for cardiovascular disease, compared to 40 percent for routine cholesterol screenings.
In addition to the standard four measures, the VAP includes the following subclasses:
- Very low density lipoprotein (VLDL)
- Intermediate density lipoprotein (IDL)
- Lp(a): LDL plus the apo(a) protein
What the VAP will tell you
The VAP doesn't just give you cholesterol levels, it provides even more life-saving details.
The size and pattern of your LDL cholesterol. LDL can occur in an A, A/B or B pattern. The LDL cholesterol pattern affects how easily the body can remove these harmful particles. In an A pattern, the LDL molecules are larger, less dense allowing them to move more easily through the body. In an A/B pattern, the LDL molecules are a mixture of light and dense. In the B pattern, there are mostly small, high density LDL molecules, making it harder for the body to eliminate them. You want an A on this test because someone with a B pattern has four times the risk of developing heart disease.
The amount of the most beneficial HDL. The VAP test also breaks down the HDL "good" cholesterol into HDL-2, the most heart protective form of HDL and HDL-3, the less heart protective form. You can increase HDL levels with aerobic exercise, quitting smoking, cutting out trans fatty acids found in many prepared foods (look for partially hydrogenated oils), increasing monosaturated fats (MUFA) with healthy oils, nuts and seeds, avocado, olives and dark chocolate, and by upping your omega-3 fatty acids (fish oil).
Who Should Get the VAP Test?
If you are at an increased risk of heart disease, the VAP test is a good idea.
The following factors put you at an increased risk of heart disease:
- Tryglycerides greater than 50
- HDL lower than 40
- LDL greater than 130
- Total cholesterol greater than 200
- Diabetes or family history of diabetes
- High blood pressure
- Thyroid problems
- Obstructive liver disease
- Kidney failure
- Abdominal obesity
Talk to your doctor about a VAP test if you have risk factors for heart disease, and even if you are at low risk, you might consider a VAP test as a preventive measure.
VAP Not Yet Routine
Some doctors won't order the VAP if a patient has "normal" cholesterol levels and no apparent cardio risks. Dr. Anderson M. Morris, M.D head of The Heart College program in Birmingham Alabama explains the importance of changing how physicians view standard lipid profiles, "Particle size also is very important. If a patient's numbers are 'normal' but their particle size is small and dense, that person has a high risk for heart disease. Also, a patient can have a high level of HDL, but if it's primarily HDL3, then it's not beneficial."
Dr. Morris says physicians are sometimes hesitant to adopt a new technology particularly when routine lipid profiles have been used for so long. "Physicians sometimes resist new technologies because they're very busy, which makes it hard to sit down and focus on a new concept," he said. "Doctors also are conservative by nature and require a lot of information before they implement a new technology, so the learning curve is somewhat challenging." In addition to the diagnostic benefits, the VAP's expanded cholesterol profile may help researchers develop heart disease risk-lowering drugs.
Getting a VAP blood test is easy. Your doctor can refer you to a local clinical lab. You also can obtain a VAP test by ordering one through HealthCheckUSA's Web site at www.healthcheckusa.com, from Wellness Centers listed by Atherotech, or by contacting Atherotech. The VAP Test is reimbursed by many insurance carriers and Medicare and Medicaid.