Looking Beyond Cholesterol: Measuring What Truly Drives Cardiovascular Risk
February is nationally recognized as Heart Health Month — a time to reflect on the true drivers of cardiovascular disease and, more importantly, how we can prevent it.
For decades, standard cholesterol panels have been used to assess risk. While helpful, traditional markers such as total cholesterol and LDL alone do not fully capture an individual’s cardiovascular risk. Many patients with “normal cholesterol” still experience cardiac events. Why is this you ask? Because heart disease is far more complex than a single cholesterol number.
At Katallage Wellness, we believe in measuring what truly matters.
Cardiovascular Disease Is an Inflammatory and Metabolic Condition
Atherosclerosis is not simply a cholesterol storage problem — it is a chronic inflammatory and metabolic process involving:
Endothelial dysfunction
Oxidative stress
Lipoprotein particle burden
Insulin resistance
Nutrient status and mitochondrial function
To truly personalize prevention, we have to assess these factors.
The Value of Advanced Cardiovascular Testing
Advanced panels, such as those offered by Cleveland HeartLab through Quest, evaluate cardiovascular risk through a multi-marker approach. Rather than relying solely on standard lipid values, these panels assess:
1.) Inflammation Markers such as hs-CRP (high-sensitivity C-reactive protein) which identifies systemic vascular inflammation and MPO (Myeloperoxidase) which detects plaque instability and active oxidative damage
2.) Oxidative Stress - Oxidized LDL (OxLDL) which measures LDL that has undergone oxidative modification and F2-Isoprostanes – markers of lipid peroxidation.
3.) Advanced Lipids & Fractionation - LDL Particle Number (LDL-P), Small dense LDL particles, ApoB (Apolipoprotein B), Lipoprotein(a) and an NMR LipoProfile for particle size and burden.
These markers often reveal hidden risk, particularly in patients with insulin resistance, metabolic syndrome, or cardiometabolic disease — even when standard cholesterol appears “normal.”
4.) Metabolic Health - Insulin resistance is one of the strongest predictors of cardiovascular disease. Markers such as fasting insulin, HOMA-IR, Triglyceride-to-HDL ratio, HbA1c all provide insight into metabolic health and arterial risk. When triglycerides are elevated and HDL is suppressed, small dense LDL particles often increase, accelerating plaque formation.
Addressing metabolic dysfunction through targeted nutrition, ketogenic metabolic therapy when appropriate, time-restricted eating, following circadian rhythms and movement is foundational in cardiovascular prevention.
Micronutrients & Fatty Acids: Often Overlooked but Clinically Essential
Cardiovascular health is deeply dependent on nutrient sufficiency. We routinely assess:
1.) Vitamin D - Low Vitamin D levels are associated with increased inflammation, endothelial dysfunction, hypertension, higher cardiovascular mortality
2.) Omega-3 Fatty Acids - An optimal Omega-3 Index is associated with reduced arrhythmia risk, lower triglycerides, improved endothelial function
3.) Key Nutrients - Nutrient depletion can impair mitochondrial energy production in cardiac tissue and increase oxidative stress.
· Magnesium
· B vitamins (especially B6, B12, and folate for homocysteine metabolism)
· CoQ10
· Selenium
· Antioxidant status
Personalized Supplement & Lifestyle Strategy
Advanced biomarker testing allows us to move from generalized recommendations to targeted interventions. This precision approach can meaningfully reduce cardiovascular risk over time.
Prevention Is Possible — When We Measure What Matters
Heart disease remains the leading cause of death in the United States, yet much of it is preventable with early detection and targeted intervention. This Heart Health Month, we encourage you to look beyond a basic cholesterol panel and ask are we measuring the true drivers of cardiovascular risk?
At Katallage Wellness, we offer comprehensive cardiovascular assessments that integrate advanced biomarker testing, metabolic evaluation, and personalized nutrition and supplement strategies. If you would like to schedule advanced cardiovascular testing or review your current risk profile, our team is here to support you.