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Condition and Nutrition Assessment Table
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Cardiovascular Health - Blood
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Overview
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Clinician Info
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CPT Codes
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Kit Instructions
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Sample Reports
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Interpretive Guide
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References
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Avoid Becoming a Statistic and Assess Your Patient's Risk for Heart Disease
 
Additional Resources:
The Cardiovascular Health Profile combines innovative nutritional and metabolic markers, along with conventional blood lipids to provide a comprehensive risk assessment of cardiovascular disease (CVD). Many of the multiple metabolic risk factors for cardiovascular disease can be reduced or eliminated with forward looking, individualized integrative therapies.
Markers Used to Assess Risk of Cardiovascular Disease
Lipoprotein Factors
- Total Cholesterol
Elevated levels have long been associated with increased CVD risk in large population studies.
- HDL Cholesterol (direct)
A low HDL level accelerates the development of atherosclerosis due to impaired reverse cholesterol transport.
- LDL Cholesterol (direct)
LDL is the most atherogenic of the lipoproteins. Major prevention trials have demonstrated a linear relation between LDL levels and the coronary event rate.
- Triglycerides
Elevated levels are linked to coronary heart disease. Elevated triglycerides may also be a consequence of other disease, such as untreated diabetes mellitus.
- Lipoprotein(a) [Lp(a)]
High Lp(a) is a risk factor for coronary heart disease,
cerebrovascular disease, atherosclerosis, thrombosis, and stroke.
Lipoprotein Ratios
- LDL/HDL Ratio
Lowering the LDL/HDL ratio is associated with a lower incidence of cardiovascular disease events, even in patients with a high HDL level.
- Total Cholesterol/HDL Ratio
The higher the ratio the greater the risk. The goal is to keep this ratio below 5:1, with the ideal being below 3.5:1.
Chronic Inflammatory Markers
- C-reactive Protein (hs-CRP)
A general marker of inflammation which is important in the development of atherosclerosis. Scientific studies have found that higher hs-CRP levels lead to higher risk of a first heart attack. The risk in people in the upper third of hs-CRP levels is twice that of those in the lower third.
- Ferritin
The best measure of iron deficiency, elevated ferritin is also an important maker of cardiovascular health. High levels are found in ischemic heart disease, iron overload, and hemo-chromatosis.
- Fibrinogen
In states of tissue injury/inflammation, elevated fibrinogen is correlated with early CVD, and is a better marker of risk for a coronary event than is elevated cholesterol.
Oxidant Stress Factors
- Homocysteine
Elevated levels indicate higher risk of coronary heart disease, stroke and peripheral vascular disease. Elevated homocysteine responds to doses of B6, B12, and folate.
- Coenzyme Q10 (CoQ10)
Critical to mitochondrial ATP generation and known to be highly concentrated in heart muscle. Studies support the use of CoQ10 in congestive heart failure.
- Lipid Peroxides
As the products of chemical damage done by oxygen free radicals to the lipid components of cell membranes, assessment of serum lipid peroxides monitors the balance between sufficient oxygenation and oxidative stress.
- Vitamin E
Now measured with two markers, alpha-tocopherol and gamma-tocopherol, vitamin E is well recognized for its cardioprotective antioxidant role. It is thought to help prevent the oxidation of LDL.
Other Important Nutritional and Hormonal Indicators
- RBC Magnesium
Magnesium (Mg) plays many vital roles in preventing CVD, controlling blood pressure, and improving HDL levels. RBC magnesium is the most precise way to assess intracellular Mg status, and has been show to be inversely related with hypertension. Mg supplementation may be a healthier alternative to calcium channel blockers.
- Insulin
Insulin insensitivity and the ensuing Syndrome X condition is now recognized as a major contributing factor to the development and progression of CVD. Fasting insulin is a good predictor of this problem which can be improved with dietary changes and exercise.
- Testosterone
Normalization of testosterone levels improves cardiac function and many known CVD risk factors.
- Sex Hormone Binding Globulin (SHGB)
Free Androgen Index
Calculation of the free androgen index from total testosterone and SHGB gives a very accurate approximation of free testosterone. The free androgen index is increasingly recognized as a critically important factor linked with almost every major aspect of heart disease in both men and women.
Why use the Metametrix Cardiovascular Health Profile?
- Combination of conventional and innovative markers to evaluate risk for cardiovascular disease.
- The most comprehensive evaluation available, going beyond blood lipid markers to include markers of nutrition, oxidative damage, inflammation, and hormone imbalances.
- Offers customizable options for treatment based on each patient�s risk profile.
| Test name: |
0161 - Cardiovascular Health Profile 0361 - Cardiovascular Health Profile NY
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| Description: |
The Metametrix Cardiovascular Health Profile is unique because
it combines both traditional and cutting-edge indicators of
cardiovascular health. The Cardiovascular Health Profile analyzes risk factors for cardiovascular disease (CVD), including such parameters as cholesterol, lipoproteins, triglycerides, fibrinogen, C-reactive protein, homocysteine, lipid peroxides, vitamin E, magnesium, coenzyme Q10, insulin, total testosterone, free androgen index, sex hormone binding globulin, and ferritin. Abnormal levels of these analytes often can be corrected with nutritional intervention.
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| Method: |
Spectrophotometry, Chemiluminescence, HPLC, ICP/MS |
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| Turnaround time: |
10-14 days, 12 days average |
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Analytes:
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LIPOPROTEIN FACTORS
Total cholesterol HDL cholesterol Direct LDL Triglycerides Lipoprotein(a)
CHRONIC INFLAMMATORY MARKERS
Ferritin Fibrinogen* c-Reactive protein (HS)
OXIDANT STRESS FACTORS
Coenzyme Q10 Vitamin E Lipid peroxides Homocysteine
OTHER IMPORTANT INDICATORS
RBC magnesium Insulin Testosterone Sex hormone binding globulin Free androgen index (calc)
*Not available in New York
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| 82465 |
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Total cholesterol |
| 83718 |
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HDL cholesterol |
| 83721 |
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Direct LDL |
| 84478 |
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Triglycerides |
| 83695 |
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Lipoprotein(a) |
| 83090 |
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Homocysteine |
| 86141 |
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C-reactive protein |
| 85385 |
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Fibrinogen |
| 83735 |
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Magnesium (RBC) |
| 82491 |
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Coenzyme Q10 |
| 84446 |
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Vitamin E |
| 82491 |
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Lipid peroxides |
| 84270 |
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Sex hormone binding globulin |
| 84403 |
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Testosterone, total |
| -------- |
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Free androgen index (calculation) |
| 83525 |
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Insulin |
| 82728 |
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Ferritin |
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ReferencesCardiovascular Health
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A Triglyceride/High-Density Lipoprotein Ratio >/=3.5 Is Associated With an Increased Burden of Coronary Artery Disease on Cardiac Catheterization.
Ostfeld R, Mookherjee D, Spinelli M, Holtzman D, Shoyeb A, Schaefer M, Doddamani S,
Spevack D, Du Y. J Cardiometab Syndr. 2006 Winter;1(1):13-15.
Relation of plasma lipoprotein levels with low-grade inflammation in white men without clinical evidence of myocardial ischemia.
Rivera JJ, Nasir K, Campbell C, Carvalho JA, Blumenthal RS, Santos RD. Am J Cardiol. 2007 Aug 1;100(3):450-4. Epub 2007 Jun
Correlates of plasma fibrinogen (FG) levels in a random sample of community-dwelling elderly.
Kostka T, Para J, Kostka B. Arch Gerontol Geriatr. 2007 May 25
Lipoprotein (a) and Venous Thromboembolism in Adults: A Meta-Analysis.
Sofi F, Marcucci R, Abbate R, Gensini GF, Prisco D. Am J Med. 2007 Aug;120(8):728-33.
Oral magnesium therapy, exercise heart rate, exercise tolerance, and myocardial function in coronary artery disease patients.
Pokan R, Hofmann P, von Duvillard SP, Smekal G, Wonisch M, Lettner K, Schmid P,
Shechter M, Silver B, Bachl N. Br J Sports Med. 2006 Sep;40(9):773-8. Epub 2006 Jul 6.
The relationship between testosterone levels, the metabolic syndrome (by two criteria), and insulin resistance in a population of men with organic erectile dysfunction.
Guay A, Jacobson J. J Sex Med. 2007 Jul;4(4 Pt 1):1046-55.
Endogenous testosterone and serum lipids in middle-aged men.
Mäkinen JI, Perheentupa A, Irjala K, Pöllänen P, Mäkinen J, Huhtaniemi I, Raitakari OT. Atherosclerosis. 2007 Jun 21;
Low serum testosterone in men is inversely associated with non-fasting serum triglycerides: The Tromsø study.
Agledahl I, Skjærpe PA, Hansen JB, Svartberg J. Nutr Metab Cardiovasc Dis. 2007 Jun 7
Vitamin E: inflammation and atherosclerosis.
Singh U, Devaraj S. Vitam Horm. 2007;76:519-49.
Tocotrienols: the emerging face of natural vitamin E
Sen CK, Khanna S, Rink C, Roy S.
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