Hidden Heart Disease: Could You Have It and Not Know It?

Could you be at high risk for a heart attack and not know it? Most people are familiar with the common risk factors for heart disease including an elevated cholesterol level, high blood pressure, diabetes, history of smoking, family history, and being overweight or inactive.

Although these risk factors are important for determining the likelihood of developing heart disease, about one in five heart attacks occur in people who have normal cholesterol levels, normal blood pressure, normal blood sugars, and who have never smoked. This makes it difficult to identify all of the people at high risk for developing a heart attack.

Fortunately, more is becoming known about what causes heart disease and heart attacks to occur; and new tests are being developed that can identify the small percentage of people who experience a heart attack and don’t have the commonly recognized risk factors for heart disease.

Heart Disease and Inflammatory Markers: Can Inflammation Lead to Heart Disease?

One key factor in determining heart disease risk in both men and women is the presence of inflammation involving the arteries of the heart. When the arteries become inflamed, they become more susceptible to the build up of dangerous plaque which can lead to a deadly heart attack. This is one reason that statin medications, used to treat elevated cholesterol levels, lower heart disease risk, by decreasing inflammation in the arteries of the heart.

Heart Disease and Inflammatory Markers: How Can Inflammation Be Detected?

Fortunately, blood tests are now available that can detect markers that indicate inflammation is occurring. The most commonly known marker for inflammation is cardiac C-reactive protein, or CRP. Although checking CRP levels through the blood is good way to detect inflammation, it doesn’t necessarily mean inflammation is occurring in the arteries of the heart. It could be occurring elsewhere in the body such as in the joints due to arthritis. Since the inflammation could be anywhere, this test isn’t very specific for detecting heart disease risk.

Heart Disease and Inflammatory Markers: Are There Other Ways to Detect Inflammation in the Arteries of the Heart?

Because measuring CRP levels doesn’t indicate where the inflammation is coming from, more tests are needed to specifically detect inflammation in the arteries of the heart. Recently, blood and urine tests have been developed to identify new markers for inflammation that are more specific to the arteries of the heart. These include a marker known as ACR which can be detected through a urine test, and myeloperoxidase, fibrinogen, and lipoprotein A2 which can be detected in the blood. Although these tests have been approved by the FDA, they aren’t widely used yet.

At the current time, only the test for CRP is widely used to detect deadly inflammation that could be the precursor to a heart attack. Because CRP is so non-specific, these new markers may be a better indicator of heart disease risk. Hopefully, they will be useful in detecting the small percentage of people who are at high risk for a heart attack despite having none of the commonly recognized risk factors.