8 Better Tests for Heart Disease Than Cholesterol

Blood tests

As a marker for the presence and severity of Heart Diseases, total cholesterol and the division of cholesterol into good HDL and bad LDL is out of date.  There are at least 8 tests that have higher significance and show better correlation with heart disease.

“Eating cholesterol has very little impact on the cholesterol levels in your body. This is a fact, not my opinion. Anyone who tells you different is, at best, ignorant of this topic. At worst, they are a deliberate charlatan. Years ago the Canadian Guidelines removed the limitation of dietary cholesterol. The rest of the world, especially the U.S., needs to catch up.”

– Peter Attia, MD

misunderstood cholesterol

Cholesterol levels are not a good indicator of heart disease.

This has been known for years but widespread misinformation has its own momentum, especially when that misinformation serves deep pockets getting deeper.  Here is another doctor who was clued in way back in 2007.  Here is another article of mine about the cholesterol issue.

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Top causes of death (US, CDC 2012)

  1. Heart Disease (596,339)
  2. Cancer ( 575,313)
  3. Respiratory dis (143,382)
  4. Cerebrovascular dis (128,931)
  5. Accidents (122,777)
  6. Alzheimer’s dis (84,691)
  7. Diabetes (73,282)
  8. Influenza (53,667)
  9.  Nephritis (45,731)
  10. Suicide (38,285)
  11. Septicemia (35,539)
  12. Liver disease (33,539)
  13. Hypertension (27,477)
  14. Parkinson’s (23,107)

Top causes of death – 2017 update (from 2015 data):

  1. Heart disease: (633,842)
  2. Cancer: 595,930
  3. Chronic lower respiratory diseases: 155,041
  4. Accidents (unintentional injuries): 146,571
  5. Stroke (cerebrovascular diseases): 140,323
  6. Alzheimer’s disease: 110,561
  7. Diabetes: 79,535
  8. Influenza and pneumonia: 57,062
  9. Nephritis, nephrotic syndrome, and nephrosis: 49,959
  10. Intentional self-harm (suicide): 44,193

What are good indicators of heart disease?

Hypertension, high triglycerides, and a high ratio of triglycerides to HDL are all better predictors than total cholesterol levels.  By the way all of these values are elevated by sugar, specifically fructose!

Looking at individual total HDL good and LDL bad values totals only provides marginally better information than a total reading.  Both types of cholesterol have a number of different subtypes that complicate the picture. To make a long story short, high values of LDL “bad” cholesterol values are really only bad when the molecule sizes have been shrunk due to disease processes. See the LDL Particle Size Test for details.

Here then are some tests and some associated information:

The Coronary Calcium Scan

calciumWhat is it?   A test that looks for calcification in the walls of the coronary arteries.
Why?  Calcifications in the coronary arteries are an early sign of coronary heart disease which is the process of a waxy buildup of plaque builds up in the coronary arteries.
Plaque can harden or rupture over time, and plaque narrows the coronary arteries, reducing the flow of oxygen-rich blood to the heart.   This can cause chest pain, discomfort, and angina.
Men develop calcifications about a decade or so earlier than women!
Generally, cholesterol makes up about 3% of arterial plaque while calcium makes up 50%! So you see why this test is more important than a cholesterol test.
Procedure: You’ll lie down in the scanner machine for about 10 minutes while it takes X-Ray pictures of your heart.
Specific Test Name(s) & target value(s): You should score less than 10 on the Agatston test; 100-400 is increased risk, and over 400 is not good at all.


What is Interleukin-6?  Secreted by T cells and macrophages to stimulate immune response, e.g. during infection and after trauma, especially burns or other tissue damage leading to inflammation. IL-6 also plays a role in fighting infection.  It stimulates the liver to produce CRP (C-Reactive Protein, explained below).

Why is it a good test for heart disease?  Basically, it has a strong association with Heart diseases and asthma through the inflammatory process.

Specific Test Name(s) & target value(s): Should be between 0 to 12.0 pg/mL


heart healthWhat is it? An amino acid.  A high level of homocysteine makes a person more prone to endothelial injury, which leads to vascular inflammation.   The body breaks it down with folic acid, B12, and B6 so elevated levels might also indicate malnutrition issues.

Why?  It has been shown to have a direct correlation with Heart disease and stroke.  Contributes to atherosclerosis, reduces flexibility of the blood vessels and makes pletelets stickier slowing down the blood flow!

Specific Test Name(s) & target value(s): 7-9 micro mol/L


What is it?  A type of cholesterol carrying molecule that contain one LDL molecule; it carries out repair and restoration work on damaged blood vessels.  The protein part of it promotes blood clotting.

Why?  The more repair you need on arteries, the more Lp(a) is used and concentrated at the site of the damage, binding with amino acids and leading to inflammation.    A very high percentage of heart attacks happen to those with high Lp(a) levels (and btw, statin drugs raise Lp(a) levels!)

Specific Test Name(s) & target value(s):

Serum Ferritin

causes of raises ferritinWhat is it?  is a protein that stores iron and releases it in a controlled fashion. The amount of ferritin stored reflects the amount of iron stored.

Why test it? Iron is highly susceptible to oxidation and iron in body is stored in muscles and other tissue.  Iron overload contributes to heart disease and is especially risky for post-menopausal women.

Specific Test Name(s) & target value(s): less than 80 mg/L for women and less than 90 mg for men;  if levels are high consider donating blood!


What is it?  Synthesized in the liver, its a protein that determines the stickiness of your blood.  You need adequate levels to stop bleeding when injured, …

Why test it? Can get elevated in any kind of inflammation and has been identified as an independent risk factor for cardiovascular disease.  Women who smoke, take oral contraceptives, or are postmenopausal usually have elevated fibrinogen levels.

Specific Test Name(s) & target value(s): Normal levels are around 200-400 mg/dL.  There is the Clauss method, the FiF (better).

CRP (C-Reactive Protein)

crp as heart disease indicatorWhat is it?  A marker for inflammation; directly associated with overall HT and cardiovascular health.

Why test it? High levels correspond to infections, high blood sugar, excess weight, sticky blood, all sorts of inflammatory conditions.  High correlation to heart disease.

Specific Test Name(s) & target value(s):  less than .8 mg/dL; high sensitivity (hs-CRP) is a good test via blood draw.

LDL Particle Size Test

What is it?  A variety of LDL cholesterol, which come in several shapes and sizes.  This is a very important test!

Why test it?  The small LDL particles are much more likely to become oxidized, slip through the wall of the arteries and begin the inflammation process.  Ultimately they cause plaque which is a big part of the heart disease picture.

Specific Test Name(s) & target value(s):  NMR LipoProfile, Lipoprint, Berkeley, VAP, LPP


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