Certain blood components, such as cholesterol, triglycerides, and fibrinogen, are indicators of heart health. Coronary Artery Disease A blood test to assess coronary heart disease risk is a proactive strategy for heart health. Consult your doctor to review the results and determine the best strategy.
How are blood tests used to determine your risk of heart disease?
Your healthcare provider may order blood and urine tests to determine your risk of heart disease. Some results, such as high levels of low-density lipoprotein (LDL), indicate an increased risk of heart disease. Your test results and medical history will help your healthcare team develop the best treatment plan.
When do I need blood tests to determine my risk of cardiovascular disease?
Your healthcare provider might mention blood tests to determine your risk of cardiovascular disease, such as coronary artery disease (CAD), if:
- You eat an unhealthy diet.
- You have a family history of CAD (especially if diagnosed at age 50 or younger).
- You are stressed or overweight.
- You don’t get enough physical activity.
- You smoke or use tobacco.
- You have other underlying conditions or diseases, such as diabetes, high blood pressure, or a history of heart attack or stroke.
Who performs the blood tests?
Blood is usually drawn by a healthcare professional called a phlebotomist or phlebotomy technician. The technician analyzes the blood sample with a machine that determines the results.
What blood components are measured in cardiovascular risk tests?
To determine your risk of heart disease, healthcare professionals consider:
- Total cholesterol (TC): Your total fat is directly related to your risk of heart disease. Triglycerides (TG): Triglycerides are associated with heart and blood vessel disease. Eating sugars and simple carbohydrates, a high-fat diet, and drinking alcohol can increase TG levels. Exercising can help lower them.
- High-density lipoprotein (HDL): This test measures good cholesterol. High levels are related with a lower risk of heart disease.
- Low-density lipoprotein (LDL): LDL is bad cholesterol. High levels are associated with an increased risk of heart disease.
- Complete blood count (CBC): This test provides information about the different components of blood, such as red blood cells, white blood cells, and platelets. It can also detect anemia (low red blood cell count).
- Lipoprotein(a) or Lp(a): Lp(a) is a low-density lipoprotein (LDL) bound to a protein called apo(a). High levels of Lp(a) increase the risk of heart attack, stroke, blood clots, fatty deposits in the veins after coronary artery bypass surgery, and narrowing of the coronary arteries after angioplasty.
High Lp(a) levels often run in families
Your doctor might order this test if you have a family history of heart disease at a young age.
- Apolipoprotein B (ApoB): ApoB is the main protein that makes up cholesterol. Research suggests that ApoB may be a more accurate overall risk marker than LDL alone.
- Homocysteine (Hcy): Hcy is an amino acid. High levels increase the risk of heart and blood vessel disease.
- Hemoglobin A1c (HbA1c): This blood test helps diagnose diabetes, which increases the risk of coronary heart disease. It reflects your regular blood sugar heights over two to three months.
- Fasting blood glucose (fasting blood sugar): This test actions your blood sugar levels after an overnight fast. The test can detect prediabetes and diabetes, which increase the risk of heart disease.
- Creatine kinase (CPK): CPK is a muscle enzyme. Levels may be elevated if you take cholesterol-lowering medications.
- Aspartate aminotransferase (AST) or SGOT: This is another liver enzyme. Levels may be elevated if you take cholesterol-lowering medications.
Fibrinogen
This test measures protein levels in the blood. Fibrinogen helps blood clot, but too much increases the risk of heart attack.
- Thyroid-stimulating hormone (TSH): This test measures the functioning of the thyroid gland. Thyroid dysfunction has been linked to heart disease and abnormal heart rhythms.
- Ultrasensitive C-reactive protein (US-CRP) or high-sensitivity CRP: This test indicates inflammation of the blood vessels. Higher levels indicate an increased risk of heart and vascular disease.
- Urine albumin-creatinine ratio (UACR): This test looks for protein in the urine. A small amount of protein in the urine is a risk factor for heart and vascular disease.
- MPO: This test shows inflammation. High levels are associated with an increased risk of heart attack, stroke, and the need for coronary artery bypass grafting. High levels may also indicate worsening heart disease.
Vitamin D
This fat-soluble vitamin regulates calcium and phosphate levels in the body. Calcium and phosphate help maintain healthy bones. Low levels of vitamin D are associated with various health risks. Low levels may also indicate problems tolerating statins.
- Trimethylamine N-oxide (TMAO): This substance is produced by gut bacteria. High levels are found in meat, eggs, and dairy products. Consuming choline, lecithin, L-carnitine, and other supplements can increase TMAO levels. High levels of TMAO in the blood increase the risk of heart disease, heart attack, stroke, and blocked arteries.
Results and Follow-up
What results will I get and what do they mean?
Results vary depending on the different components of your blood. Your healthcare provider will explain the results and the next steps in your care.
This list includes results related to your risk of heart disease:
- Total cholesterol (TC): Your results may vary depending on your age and other risk factors. Ideal results based on age:
- 20 years and younger: 75 to 169 mg/dL.
- 21 years and older: 100 to 199 mg/dL.
- Triglycerides (TG): The ideal result is less than 150 mg/dL. A very high result (over 500 to 1000 mg/dL) increases the risk of pancreatitis.
- High-density lipoprotein (HDL): The higher the HDL level, the better. Ideal values depend on your sex:
- Men: More than 45 mg/dL.
- Women: More than 55 mg/dL.
- Low-density lipoprotein (LDL): Ideal results depend on your current health status:
- Less than 70 mg/dL if you have heart or vascular disease, diabetes, or a very high risk of cardiovascular disease.
- Less than 100 mg/dL if you have metabolic syndrome or more than one risk factor for cardiovascular disease.
- Less than 130 mg/dL if you have a low risk of coronary heart disease.
- Complete blood count (CBC): Normal values include:
- White blood cell count: 5,000 to 10,000.
When will I receive my blood test results?
Your blood test results may take a few days or longer. Consult with your healthcare provider about how long they may take.
When should I call my healthcare provider?
Call your healthcare provider if you haven’t received your blood test results within a few weeks. Your healthcare provider will explain the next steps in your care.
Overview
While blood tests help your healthcare provider better assess your risk for heart disease, they are not a definitive diagnosis. If your blood test results show an increased risk, your healthcare provider may recommend additional testing. Discuss any questions or concerns you have about this process with your healthcare provider.