![[WSJ.com]](../images/print-wsjie.gif){kind=small}
June 22, 2001
By TARA PARKER-POPE
Staff Reporter of THE
WALL STREET
JOURNAL
IF YOU THINK regular cholesterol checks will help stave off heart problems, consider this: Half the people who have heart attacks have normal cholesterol.
Amid the recent hype about the government's new, stricter cholesterol guidelines, the fact that cholesterol screening fails to detect a significant portion of those with heart disease frustrates doctors and government health officials.
High cholesterol is still an important risk factor for heart disease, and cholesterol-lowering drugs have been proved to reduce the risk of heart attack. The problem is recognizing that high cholesterol doesn't always mean you have heart disease, and a low reading doesn't necessarily put you in the clear.
![[Illustration of upper torso and heart]](../images/2f_health06212001212915.gif)
"If you follow the guidelines, you may be treating people who will never get coronary disease and you may not be treating people with coronary disease," says Carlos Ayers, director of the University of Virginia's vascular medicine and preventive cardiology program.
Indeed, for 150,000 people each year, the first symptom of heart disease is death. As a result, doctors and researchers have developed a number of new tests to detect heart disease sooner.
ELECTRON BEAM tomography (EBT) scans artery walls for calcified plaque buildup, an early sign of heart disease. Blood tests can monitor c-reactive protein, fibrinogen, homocysteine and Lp(a) levels, all of which may signal heart disease. Advanced cholesterol screening methods can also provide more information.
But using the new tests to screen for heart disease is controversial. One drawback is that insurance companies often won't pay for the tests if other risk factors, such as a family history of heart disease, aren't present. In addition, some of the new tests may indicate the presence of certain risk factors for heart disease, but there may not be anything doctors can do to lower those risk factors.
Valentin Fuster, director of the cardiovascular institute at Mount Sinai School of Medicine in New York, is among the leading researchers looking for the hidden causes of heart disease, but he doesn't believe the new tests should be used to screen everyone. He worries patients may end up getting a positive result on at least one of the tests, leading to unnecessary and sometimes invasive procedures.
"I can assure you that one of these tests will be positive," Dr. Fuster says. "Then the problem begins -- what do you do from there?"
Others say that heart disease is so deadly that the potential negatives of the new screening methods are a small price to pay. "The way the diagnosis is made now, you might as well flip a coin to determine if people have heart disease," says Harvey Hecht, director of preventive cardiology at the Heart and Vascular Institute in Morristown, N.J.
The Journal of the American College of Cardiology this month published Dr. Hecht's study of 304 women who underwent cholesterol screening and EBT scans. Cholesterol screening failed to identify nearly half the women over 55 who had signs of heart disease on the scans. In women under 55, cholesterol screening failed about 40% of the time.
EVEN SO, CRITICS say the plaque deposits identified by EBT scans may not be the type most likely to cause heart attack. Advocates, including Dr. Hecht, say the scans simply are better than cholesterol screening at finding high-risk patients. One benefit of scans is that patients who see the plaque buildup in their arteries are more motivated to lose weight, stop smoking or take preventive medication.
A recent study published in the Journal of the American Medical Association reported that c-reactive protein and fibrinogen levels in the blood are strong indicators of heart disease. But before you rush to the doctor to order the tests, you should know that it's difficult to treat either risk factor. Lifestyle changes, cholesterol-lowering statin drugs and other drugs may help, but not always.
Another increasingly popular way to screen for heart disease involves a homocysteine blood test. Elevated homocysteine can be reversed with vitamin B12, vitamin B6 and folic acid.
"I feel like I'm a voice crying in the wilderness because even a lot of doctors haven't heard of homocysteine," says B.P. Loughridge, a University of Oklahoma clinical associate professor and author of "The Cardiac Surgeon's Diet & Health Design." Dr. Loughridge suggests patients ask their doctors to check homocysteine at the same time they do routine cholesterol screening.
Dr. Ayers and others advocate more-precise "next generation" cholesterol testing such as the VAP test, which uses a high-speed centrifuge process that can identify 21 lipid "subclass" readings.
The problem with routine cholesterol testing is that it uses a formula to calculate LDL (the bad cholesterol). If certain factors are present, that formula is unreliable.
The VAP test, on the other hand, not only gives an actual reading of LDL levels, but it breaks down LDL, HDL and triglycerides even further, identifying lipid subclasses that might be a factor in heart disease. Someone could have a normal LDL reading, for example, but a VAP test could show the patient has an inordinately high Lp(a) reading, which is often elevated in young people who have heart attacks.
URL for this Article:
http://interactive.wsj.com/archive/retrieve.cgi?id=SB993160781938357450.djm
Hyperlinks in this Article:
(1) mailto:healthjournal@wsj.com
Copyright © 2001 Dow Jones & Company, Inc. All Rights
Reserved.
Printing, distribution, and use of this material is governed by your Subscription Agreement and copyright laws.
For information about subscribing, go to http://wsj.com
If you missed it, you can go to either a SHORT explanation of the whole story, or a detailed explanation on ONE PAGE. On this page you are getting more detail on one part of the story, but on either of those pages you can get the broad picture. Don't miss reading one of them. You can actually spend many hours on this web site, depending on the depth of research and reading you want to do. There are an amazing 4,000 pages here -- more information on these general subjects than almost all other web sites combined! At some point along the way you will probably say, "Karl's crazy," and leave never to return to this site, or you will say "I want to try some of that oral chelation formula he writes about!"
|
I promise to answer your message -- click here to send me a personal message
|
SUBSCRIBE: The Wednesday Letter is a free electronic monthly newsletter written and published by Karl Loren. You can view more than 50 back issues of this publication by clicking here. The Wednesday Letter subscription list is maintained on a secure server, no name is ever given or sold to anyone, and it is never used except for this Newsletter. It is automatically published on the Tuesday night just before the first Wednesday of every month. You can subscribe to this free monthly electronic letter by entering your eMail address and name below. You will then automatically receive a request for confirmation, sent to whatever address you have entered. If you do NOT receive this confirmation request, then you will not be subscribed. There may have been an error with your address and you should resubmit. The letter is never sent twice to the same address -- so you do not have to worry about a duplicate subscription. When you receive this confirmation request you must reply to it, or your subscription will not become active. No one can subscribe your name, and address, without you being notified, and if you get an unwanted notice of subscription you only need to DO NOTHING and the subscription will NOT be active.
REMOVAL: You can remove yourself from the subscription list in several different ways. Click here to read about this entire newsletter system. Every edition of The Wednesday Letter is delivered to your address with YOUR name and address in view on the letter, with a link that allows you to remove THAT name from the subscription list. If you try to send this removal message from an address different from the one you used to send in your original confirmation, then you will get a warning notice first, sent to the subscription address, asking you to confirm that you want to be removed from the list -- by replying to THAT request for confirmation, you will then be automatically removed. Thus, no one else can unsubscribe you, from some other computer, without your knowledge. But, if you send in the unsubscribe notice from the same machine used to receive the Letter, then the removal from the subscription list is automatic.
Personal Message: When you send a personal message to Karl Loren, you will receive a personal reply as per his instructions. Karl pledges that every personal message will get a personal answer. When you provide your mail address, we will send you free information including our free catalog and a cassette tape lecture by Karl Loren about heart disease, no charge, by mail, even if outside the US. You can select particular information you would like to receive, along with the free cassette tape and catalog.
You can reach Vibrant Life in many ways, including by mail to Vibrant Life, 2808 N. Naomi St., Burbank, CA 91504. Within the US and Canada, use the toll free number: (800) 523-4521, the local number: (818) 558-1799, the FAX: (818) 558-7299, eMail to kimberly@oralchelation.com or any one of the hundreds of message forms throughout the 50 web sites. Vibrant Life normally ships the same day we get an order. There are message forms on each of the 100,000+ pages on this and other sites where you can communicate with Vibrant Life. Check out our companion site, at: http://www.oralchelation.net where Karl's 2000 page book is published. Karl Loren is the author and webmaster for this BOOK, as well as for another web site about ORAL CHELATION. His personal philosophical articles are at PHILOSOPHY.
Copyright © May 20, 2008 6:25 AM by Karl Loren on behalf of Vibrant Life, ALL RIGHTS RESERVED. Permission is granted for non-commercial downloading, copying, distribution or redistribution on two conditions: One, that some form of copyright notice is included in every copy distributed or copied, showing the copyright belonging to Vibrant Life, Burbank, CA, at www.oralchelation.com . The second condition is that the material is not to be used for any purpose contrary to the purposes and objectives of this site. This permission does not extend to materials on this site which are copyrighted by others.
