Cardiovascular Disease Prevention

Background
Cardiovascular disease is the number one cause of death in the United States, with nearly 1,000,000 people suffering heart attacks and 795,000 suffering strokes annually, of which about 144,000 are fatal. Years of research, however, have provided physicians with effective tools to help prevent the development of the disease in patients. The first step is to evaluate risk for the disease via a comprehensive risk assessment.

Traditional risk factors
There are several factors that raise a person’s risk of suffering a heart attack and stroke, including high cholesterol, high blood pressure, obesity, diabetes, smoking and physical inactivity [1]. The more risk factors a patient has the greater the risk of having a heart attack or stroke. Some risk factors are inherent and can not be changed, such as increasing age, family history, and gender. Several risk factors, however, can be addressed with lifestyle changes such as exercise and diet, as well as medications. It is these risk factors that doctors target to reduce through customized treatment regimens.

Uncovering hidden risk: novel risk markers
In addition to assessing the traditional risk factors noted above, a growing body of clinical research indicates physicians must also keep other risk factors in mind when examining patients as traditional risk factor assessment alone fails to identify many people at risk [2]. Approximately 50 percent of all coronary events strike in people with low-to-moderate cholesterol levels, and about 20 percent occur in individuals with none of the four major modifiable risk factors (high cholesterol, high blood pressure, smoking, or diabetes). Hidden cardiovascular risk is prevalent and there is a critical need to look beyond traditional risk factors.

Fortunately, now there is a simple blood test that goes beyond traditional risk factors to help identify individuals at increased risk of heart disease and stroke. The PLAC^® Test is the only FDA-cleared blood test that aids in assessing risk for both coronary heart disease (CHD) and ischemic stroke associated with atherosclerosis [3].

The PLAC Test measures levels of lipoprotein-associated phospholipase A₂ (Lp-PLA₂), a vascular-specific inflammatory enzyme implicated in the formation of vulnerable, rupture-prone plaque. Used in conjunction with the clinical evaluation of traditional risk factors, the PLAC Test helps identify people who may benefit from more aggressive treatment programs.

Classifying risk to prescribe customized treatment
Physicians use information gathered from comprehensive risk assessment to categorize patients into low, moderate, high and very high risk groups. From there, physicians tailor treatment regimens for patients. For example, patients in the high risk group have an LDL-C (“bad cholesterol”) goal of less than 100 mg/dL; whereas patients in the low risk group have an LDL-C goal of less than 160 mg/dL. To achieve these goals, physicians may prescribe diet restrictions, exercise recommendations, lifestyle modifications as well as prescribe drug therapy such as statins; statins reduce LDL-C levels and are proven to prevent heart attacks and strokes.

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