Test Your Heart

Plenty of well-known risk factors are involved in cardiac problems: smoking, diabetes, obesity, family history, and so on. But predicting who will develop fatal or debilitating heart disease remains an inexact science.

In their quest to better understand who is most at risk, researchers continue to develop tests to detect problems early on. Here are four such tests you may not have heard about. None should replace traditional tests such as cholesterol and blood pressure readings, but all may help paint a better picture of heart disease risk.

C-Reactive Protein

A study in the New England Journal of Medicine of more than 27,000 women suggests high C-reactive protein levels are a strong predictor of future cardiovascular events. Usually called a CRP test, the C-reactive protein test measures inflammation in the body. According to Dr. Katherine Sherif, director of the Center for Women's Health at Drexel University College of Medicine in Philadelphia, inflammation is a general reaction that can indicate anything from heart disease to an infected blister, which is why it's not routinely measured. However, it can be valuable when done regularly to track a trend, rather than as a one-time test.

Lipoprotein A

Lipoprotein a or lp(a) -- which is pronounced "LP little a" -- is a component of your cholesterol, and is often elevated in cases of early heart disease. According to Dr. Lori Mosca, director of preventive cardiology at New York Presbyterian Hospital and author of Heart to Heart: A Personal Plan for a Heart Healthy Family, too much lp(a) interferes with the body's ability to dissolve clots, which can lead to reduced blood flow and heart attack. A recent study published in the European Heart Journal found that women with elevated lp(a) levels had twice the risk of coronary heart disease.


Homocysteine is a compound marker for atherosclerosis (fatty deposits in the lining of the arteries, which may lead to coronary heart disease and stroke). Excess homocysteine produces thickening and scarring within artery tissues. If you have high LDL cholesterol and add high homocysteine to the mix, atherosclerosis is more likely. Elevated levels may be treated with megadoses of folic acid. According to Dr. Mark Applefeld, director of cardiology at Mercy Medical Center in Baltimore, the folic acid reverses the effect of homocysteine on the blood vessel walls.


What is fibrinogen? Too much fibrinogen causes blood to clump. That's a problem because heart attacks are often due to the formation of a blood clot around a break in built-up plaque lining an artery wall. Fibrinogen is not a user-friendly test yet because it is highly variable. Currently, you need to have an average of at least three tests for it to be accurate. If you have a history of heart disease, ask about testing fibrinogen levels along with your other blood tests. When more research determines fibrinogen's usefulness, knowing your numbers could offer clues for future treatments.


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