A New Way to Measure Heart Health
Emerging evidence supports a change in the way we measure and assess lipid and cholesterol levels to better predict heart health. While there is a lot we know about ‘good’ [HDL-C] and ‘bad’ [LDL-C] forms of cholesterol to assess heart health, it is also true that many individuals afflicted with heart disease have these measures within the normal range. We also know that the traditional measures of lipids have historically been taken during the ‘fasted state’, usually first thing in the morning. We are now learning that new measures of cholesterol (called ‘remnant cholesterol’) that can be calculated from samples taken during the day (non-fasted state), provide much more information about how well an individual can metabolize fats. Poor (high) measures of remnant cholesterol can indicate fat intolerance and a reduced ability to metabolize lipids and cholesterol, especially those fats being absorbed from the diet.
Measurements of blood cholesterol in the non-fasting state (taken during the day with normal eating patterns) has proven to be far more informative when calculating risk of heart disease. Large scale epidemiological studies originally undertaken in Europe suggest that measures of remnant cholesterol are more powerful than other classic measures of blood lipids. Clinical guidelines in Europe and now in Canada are moving towards using non-fasting measures of blood cholesterol in order to gather more information on values of remnant cholesterol.
Diagnosing Risk Factors in Youth and those with Obesity
Traditional blood lipid measures have not been particularly useful in younger adults and youth during puberty in identifying those who may have early risk of heart disease. Hormones that are present during puberty often influence the blood concentration of total and LDL cholesterol rendering them unreliable during periods of growth development. Recent evidence suggests that blood measures of cholesterol taken during the day may be more informative for those who are younger. More importantly, it appears that remnant cholesterol and fat intolerance is more prevalent in youth with obesity than previously thought.
New Apps and Technologies
Portable handheld diagnostic devices (similar to a glucose monitor) are now available for cholesterol measurements and may offer a unique way to help fight against heart disease. Measuring cholesterol levels during the day may prove to be made easier with the ease of novel handheld lipid monitors. Physicians will be able to test lipid and cholesterol levels at their clinics and receive an immediate result, removing the need for visits to the diagnostics laboratory.
Helping Canadian Hearts
Emerging data from Canada suggests new measures of remnant cholesterol may be just as effective here as it has been in Europe. Innovative clinical studies here in Canada that have included blood tests taken during the day (non-fasted state) have recently enabled assessments of heart disease risk and remnant cholesterol.