One third of people with normal Lipid tests at high risk of CVD : SRL analysis

Cardiovascular diseases (CVD) are increasing globally as well as in India where the numbers in rural part of the country are fast catching up with urban due to hyperlipidemia, hypertension, diabetes and oxidative stress. SRL Diagnostics, the most doctor preferred diagnostic chain in India, carried an analysis of data generated from comprehensive coronary risk profile testing done over a five year period.

The analysis was undertaken to explore if routine lipid profile tests viz., total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides (TG) are enough to identify persons at risk of coronary heart disease. This four-test panel is one of the highest prescribed blood test in the world. The analysis revealed that in one-third of the samples (34%) wherein all the four or three of the conventional lipid biomarkers were normal, an abnormal Lp(a) or apolipoprotein was present. The analysis was based on a sample size of 9,933 comprehensive lipid profile tests which were performed at SRL Diagnostics labs across India between August 2013 and July 2018.

Lipoprotein (a) is an advanced marker of cardiovascular disease risk that can accelerate the generation of arterial blockage phenomenon in coronary arteries. On the other hand Apolipoproteins, A1 and B are the protein fragments of HDL and LDL respectively. Correlation of Apolipoproteins was found to be better with the conventional lipid markers. Measuring Lipoprotein(a) levels are recommended in children with a family history of early heart disease or high blood cholesterol levels.

Commenting on the research, Dr B.R. Das, Advisor and Mentor - Research & Development, SRL Diagnostics said, “The burden of cardiovascular disease in India has been growing steadily over the past few decades. While a standard lipid profile includes determination of serum or plasma total cholesterol (TC), high-density lipoprotein-associated cholesterol (HDL-C), low-density lipoprotein-associated cholesterol (LDL-C), and total triglycerides (TG), Lp(a) test is an advanced, independent predictor of heart disease risk and helps to explain heart disease in patients with “normal” blood cholesterols. Lipoprotein(a) also carries cholesterol and is an accomplice in fatty plaque generation within the coronary arteries.It’s important that we include such advanced markers in our routine lipid check panels especially for those who have been having normal lipid levels but are at higher risk of developing coronary heart diseases.”

“Around the world, Lp(a) is found elevated more commonly in African-Americans and in those of Asian descent. All that is needed is to check on this simple blood test that is widely available and not expensive,” adds Dr Das.

Cardiovascular diseases CVD are mainly triggered due to the development fat-laden blockages with blood vessels, and includes coronary heart disease (heart attacks), cerebrovascular disease (stroke), raised blood pressure (hypertension), peripheral artery disease, and heart failure. Common modifiable risk factors which further amplify the prevalence of the Cardiovascular diseases are physical inactivity, unhealthy diet, harmful effects of tobacco and alcohol and other habit forming substances. Standard dietary recommendations such as a low fat diet for weight loss and control of other blood lipids has little effect on serum Lp(a). Substitutions with dietary mono- and polyunsaturated fatty acids in healthy diets are preferable over protein or carbohydrates with regards to Lp(a).