Assessing your risk of heart attack or stroke

Are you at risk of heart attack or stroke? Risk factors include:

1. Age and sex. Men aged 45+ and women aged 55+ are at higher risk
2. Ethnicity. South Asian, African or African-Caribbean descent have a higher risk of heart attack.
3. Weight and height. Shorter, heavier people may be at greater risk.
4. Smoking. Smoking increases your risk of cardiovascular disease.
5. High blood pressure. Over time, high blood pressure can damage the arteries that feed your heart. High blood pressure that occurs with other conditions, such as obesity, high cholesterol or diabetes, increases your risk even more.
6. High blood cholesterol or triglyceride levels. A high level of low-density lipoprotein (LDL) cholesterol (the “bad” cholesterol) is most likely to narrow arteries. A high level of triglycerides, a type of blood fat related to your diet, also ups your risk of heart attack. However, a high level of high-density lipoprotein (HDL) cholesterol (the “good” cholesterol) lowers your risk of heart attack.
7. Obesity. Obesity is associated with high blood cholesterol levels, high triglyceride levels, high blood pressure and diabetes. Losing just 10 percent of your body weight can lower this risk, however.
8. Diabetes. Not producing enough of a hormone secreted by your pancreas (insulin) or not responding to insulin properly causes your body’s blood sugar levels to rise, increasing your risk of heart attack.
9. Metabolic syndrome. This occurs when you have obesity, high blood pressure and high blood sugar. Having metabolic syndrome makes you twice as likely to develop heart disease than if you don’t have it.
10. Family history of heart attack or cardiovascular disease. If your siblings, parents or grandparents have had early heart attacks (by age 55 for male relatives and by age 65 for female relatives), you might be at increased risk.
11. Lack of physical activity. Being inactive contributes to high blood cholesterol levels and obesity. People who exercise regularly have better cardiovascular fitness, including lower high blood pressure.
12. Stress, blood pressure and cholesterol levels. All contribute to increased risk of heart disease.
13. Illicit drug use. Using stimulant drugs, such as cocaine or amphetamines, can trigger a spasm of your coronary arteries that can cause a heart attack.
14. A history of preeclampsia. This condition causes high blood pressure during pregnancy and increases the lifetime risk of heart disease.
15. An autoimmune condition. Having a condition such as rheumatoid arthritis or lupus can increase your risk of heart attack.

Atherosclerosis – hardening of arteries

Arteries are blood vessels that supply oxygen-rich blood to your heart and other parts of your body. Atherosclerosis is a potentially serious condition where arteries become clogged with a fatty substance called plaque.

Plaque is made up of fat, cholesterol, calcium, and other substances found in the blood. Over time, plaque hardens and starts to accumulate on your artery walls, narrowing them. This limits the flow of oxygen-rich blood to vital organs increases the risk of blood clots that could potentially block the flow of blood to the heart or brain resulting in a heart attack or stroke.

If left to get worse, atherosclerosis can potentially lead to a number of serious conditions known as cardiovascular disease (CVD). There will not usually be any symptoms until CVD develops.

Types of CVD include:

• Coronary heart disease – the main arteries that supply your heart (the coronary arteries) become clogged with plaques
• Angina – short periods of tight, dull or heavy chest pain caused by coronary heart disease, which may precede a heart attack
• Heart attacks – where the blood supply to your heart is blocked, causing sudden crushing or indigestion-like chest pain that can radiate to nearby areas, as well as shortness of breath and dizziness
• Strokes – where the blood supply to your brain is interrupted, causing the face to droop to 1 side, weakness on 1 side of the body, and slurred speech
• Transient ischaemic attacks (TIAs) – where there are temporary symptoms of a stroke
• Peripheral arterial disease – where the blood supply to your legs is blocked, causing leg pain when walking

Arterial plaque is the main cause of heart attacks and stroke

The majority of heart attacks and strokes are caused by arterial plaque – and testing for this plaque is a good way to detect potential problems as early as possible. (If you’re at risk of heart attack, a cholesterol test is not enough. 50% of heart attacks occur in patients with normal cholesterol.)

Atherosclerosis does not tend to have any symptoms at first and many people may be unaware they have it, but it can eventually cause life-threatening problems, such as heart attacks and strokes, if it gets worse.

Exactly why and how arteries become clogged is unclear.

The PLAC test

There are two broad categories of atherosclerotic plaques: stable and unstable (or vulnerable). Unstable plaques are more likely to rupture causing a blood clot that blocks the supply of blood to the heart, triggering a heart attack; or the brain, triggering a stroke. Our artery health test measures the levels of Lp-PLA2 in your blood. High levels of Lp-PLA2 are present in unstable rupture-prone plaques and Lp-PLA2 is released from these plaques into your blood.

The PLAC Test provides additional information that, when combined with standard cholesterol tests and an exam, can help determine whether or not you are at an increased risk for a heart attack or stroke.

A PLAC test can be useful if you have two or more of the following risk factors:

• Male 45 years or older or female 55 years or older
• Family history of early heart disease or stroke
• Diabetes
• Obesity
• Smoker
• Borderline high or elevated cholesterol levels

Order an Artery Health (Heart Attack/Stroke Risk) Test Kit

Order an Artery Health (Heart Attack/Stroke Risk) Test Kit. The Artery Health test kit – or ‘PLAC’ test checks the level of inflammation in your coronary artery walls. This is associated with hardening or furring of your arteries known as atherosclerosis.

Get the convenience of home testing with the reassurance of professional clinical analysis. Your results are delivered quickly and securely online.

This Artery Health (Heart Attack/Stroke Risk) Test is advised if you:

• are overweight or obese (have a high BMI)
• are, or have been, a smoker
• have diabetes, or impaired glucose tolerance
• have family history of heart disease
• have high cholesterol
• have, or have had, high blood pressure
• want the convenience of home testing without waiting for a GP appointment
• need a high quality, clinically accredited test done in a professional clinical laboratory

What is tested?

1. The enzyme lipoprotein phospholipase (Lp-PLA2). This enzyme indicates the possibility of plaque accumulation in your arteries which increases your risk of heart attack or stroke.

Treatment for atherosclerosis

There are not currently any treatments that can reverse atherosclerosis, but the healthy lifestyle changes suggested above may help stop it getting worse.

The good news is that the condition is largely preventable with a healthy lifestyle, and treatment can help reduce the risk of serious problems happening.

The main ways you can reduce your risk are:

• stop smoking
• have a healthy diet
• exercise regularly
• maintain a healthy weight
• moderate your alcohol consumption

Sometimes additional treatment to reduce the risk of problems like heart attacks and strokes may also be recommended, such as:

• statins for high cholesterol
• medicines for high blood pressure
• medicines to reduce the risk of blood clots
• dietary changes and medication for diabetes
• a surgical procedure to widen or bypass an affected artery