Can your routine blood tests indicate a risk of heart attack?

CHOLESTEROL AND LIPID PROFILE: Usually the values of total cholesterol and low-density lipoprotein (LDL) or bad cholesterol give you an indication of a ten-year risk profile. The total cholesterol number measures high-density lipoprotein (HDL) or “good” cholesterol, LDL and 20 per cent of triglycerides, the most common type of fat in the body that builds plaque too. If you take the total cholesterol number and subtract the HDL, you get non-HDL cholesterol. Now this actually quantifies the risk that we miss by just looking at the LDL or triglyceride counts individually. Non-HDL cholesterol is measured in decilitres of blood. An optimal range for non-HDL in adults would be less than 130 mg/dL. A count higher than this is a risk factor for the heart.

HS-CRP C-REACTIVE PROTEIN TEST: C-reactive protein (CRP) is a protein made by the liver, the high levels of which are a measure of inflammation in the body. A high-sensitivity C-reactive protein (HS-CRP) test is more sensitive and can find smaller increases in C-reactive protein, which are an indirect indication of an inflammation in the heart and a possible narrowing of coronary arteries. The test doesn’t show the cause of inflammation but gives a fairly predictive scenario for people who have a 10 per cent to 20 per cent chance of having a heart attack within the next 10 years. A count of less than 2.0 mg/L indicates lower risk of heart disease while anything higher than that indicates a higher risk of heart disease. However, these values can vary depending on lifestyle interventions or medication that are advised to you.

LIPOPROTEIN (A): This is a denser cholesterol that is not indicated in a normal lipid profile test but is a very good indicator of cardiovascular health. There is no medicine yet for high lipoprotein (a) but if its levels are higher than 50 mg/dl, then the risk of heart attack is high. It is usually found to be high in those with a family disease of heart disease and can build plaque in the walls of your blood vessels. Without specific drugs, people with high levels of this should push down their LDL levels even more. They should keep to their weight, not smoke, choose healthy foods and drinks and get regular physical activity.

HAEMOGLOBIN: Normal ranges for haemoglobin are 13.5 g/dL to 18 g/dL for men, 12 g/dL to 15 g/dL for women and 11 g/dL to 16 g/dL for children. Now marginal swings are okay but if haemoglobin levels plummet low, then there is a demand-supply mismatch in terms of the blood volume required for healthy circulation. If it is too low, there could be a risk of angina.

LIVER ENZYME TEST: Higher levels of this enzyme are an indication of fat deposition in the liver and by extension in the heart arteries. Tests for liver enzymes are known as ALT and AST and measured in units per litre. For ALT, a standard range is 29-33 for men and 19-25 for women. AST levels should be less than 35.

CREATININE TEST: The level of creatinine, a waste product of protein digestion, is a marker of kidney function and an indicator of Chronic Kidney Disease (CKD). This condition overworks the heart as it needs to pump harder to get the blood to help the diseased kidneys. This elevates blood pressure (BP). CKD can also accelerate plaque deposition in the heart arteries, especially if there is an existing burden from the early stages.