Dr Keshava R Consultant Interventional Cardiologist Fortis Hospital, Cunningham Road give insights on various risk factors of Heart Disease and how one can be cautions of the disease.

Since the beginning of time things happen in two ways, the usual and the unusual, the expected and the unexpected, the traditional and the non-traditional. People always dread the obvious and when things turn awry they tend not to believe it. The risk for a heart attack also depends on some of the non-traditional factors which at first would sound inexplicable but would kill you if not taken care of.

Heart diseases can happen due to many reasons. Some of them are very common and known to everyone like obesity, family history, ethnicity, age, tobacco exposure, high blood pressure (hypertension), high cholesterol, physical inactivity, diabetes, unhealthy diets, and harmful use of alcohol. These are all the traditional risk factors which causes heart disease and later stroke.

The non-traditional risk factors are high-sensitivity C-reactive protein (hs-CRP), ankle-brachial index (ABI), leukocyte count, fasting blood glucose level, periodontal disease, carotid intima-media thickness (carotid IMT), coronary artery calcification (CAC) score, electron-beam computed tomography (EBCT), homocysteine leveland lipoprotein(a) level.

All non-traditional risk factors are nothing but simply the contributing factors which can lead to traditional risk factors. Thesenon-traditional risk factors are abnormalities of your daily functioning organ, veins, hormone and cells which because of undisciplined life style and ignorance have been affected negatively.

You can never imagine that even these things can lead to a weak heart. Therefore, let’s understand them closely and do what is required to prevent heart issues.

High-sensitivity C-reactive protein

CRP is a protein that increases in the blood with inflammation. Studies have suggested that a persistent low level of inflammation plays a major role in atherosclerosis, the narrowing of blood vessels due to build-up of cholesterol and other lipids, which is often associated with CVD.

People with higher hs-CRP values have the highest risk of cardiovascular disease and those with lower values have less risk.

Ankle-brachial pressure index

The ankle-brachial pressure index (ABPI) or ankle-brachial index (ABI) is the ratio of the blood pressure at the ankle to the blood pressure in the upper arm (brachium). Compared to the arm, lower blood pressure in the leg is an indication of blocked arteries due to peripheral artery disease (PAD).

Leukocyte count

A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood. WBCs help fight infections. They are also called leukocytes. If the count is not sufficient, it means your body’s immune system is weak and outside and inside forces can attack the usual proceedings of the human body and make it vulnerable towards diseases.

Fasting blood sugar level

A higher fasting blood sugar level can lead to diabetes and hence higher risk for CVD.

Periodontal Disease

Gum disease is a risk factor for coronary artery disease; diseases of the blood vessels and arteries. People with gum disease had a higher risk of stroke and there was a direct link between clogged arteries in the legs and gum disease.

Carotid intima-media thickness (carotid IMT)

The carotid intima-media thickness is the thickness of the inner two layers of the carotid artery – the intima and media, which if more can lead to Carotid atherosclerotic vascular disease. The carotid intima-media thickness test (CIMT) is done to find out the thickness. Aging is a contributing factor to increased carotid intima-media thickness. Other risk factors include high lipoprotein levels, high blood pressure, smoking, diabetes, obesity and a sedentary lifestyle.

Coronary artery calcification (CAC)

Coronary artery calcification (CAC) is a risk factor for adverse outcomes in the general population and in patients with coronary artery disease.

CT- Coronary angiogram

A new non-invasive test for the detection of coronary artery disease (CAD). EBCT is designed to measure calcium deposits in the coronary arteries.

In patients with CAD, the plaques which make up the blockages contain significant amounts of calcium, which can be detected with Ultrafast CT. This test will identify calcium in blockages as mild as 10-20%, which would not be detected by standard physiologic stress testing.

Homocysteine Level

Homocysteine is a common amino acid in your blood. You get it mostly from eating meat. High levels of it are linked to early development of heart disease. In fact, a high level of homocysteine is a risk factor for heart disease. It’s associated with low levels of vitamins B6, B12, and folate, as well as renal disease

Lipoprotein Level

Lipoproteins, not cholesterol, cause heart disease.  Lipoproteins are the carriers that transport cholesterol through the blood.  Some lipoproteins (LDL) cause cholesterol to penetrate the artery wall more easily, causing the artery to clog.  These lipoprotein plaques become inflamed and rupture, causing a heart attack.

Who should get the test done?

• Someone who develops coronary heart problem without traditional risk factors
• Those with strong family history of coronary heart disease at young age
• The ones who develop recurrent heart attack despite control of all risk factors