Speaker 1: 0:01

Welcome to the Health Pulse, your go-to source for quick, actionable insights on health, wellness and diagnostics. Whether you're looking to optimize your well-being or stay informed about the latest in medical testing, we've got you covered. Join us as we break down key health topics in just minutes. Let's dive in.

Speaker 2: 0:26

Welcome to the Deep Dive. We're your shortcut to being truly well-informed. Today we're diving into something pretty fundamental about heart health, Something that might just change how you think about it. Get this stat from the American Heart Association Nearly half the people who have a heart attack they actually have cholesterol levels considered normal.

Speaker 3: 0:47

Yeah, it's a statistic that really stops you in your tracks, doesn't it? It challenges well decades of thinking. For so long, the story was all about cholesterol, specifically LDL, you know the bad one. But the science, the newer research, it's giving us a much more complete picture and, honestly, a more hopeful one too. It's giving us a much more complete picture and, honestly, a more hopeful one too. It's really pointing towards inflammation as the actual underlying driver behind atherosclerosis.

Speaker 2: 1:09

Atherosclerosis. Ok, that's the plaque buildup inside your arteries.

Speaker 3: 1:12

Exactly that slow, progressive buildup and inflammation seems to be the real spark.

Speaker 2: 1:17

So if it's not just about cholesterol, what's actually happening? This is already making me rethink things.

Speaker 3: 1:23

Right, it's not simply about high LDL numbers floating around causing trouble on their own. Atherosclerosis really seems to start when inflammation damages that delicate inner lining of your blood vessels. It's called the endothelium, and that damage it sort of creates the sticky surface, almost like Velcro. It lets cholesterol particles, yeah, but also immune cells and other debris latch on, and that kicks off a whole cascade of immune reactions. It lets cholesterol particles, yeah, but also immune cells and other debris latch on, and that kicks off a whole cascade of immune reactions. It's like starting a fire inside your arteries. The result is those hardened, narrowed vessels, and that explains why someone can have significant heart risk, even with normal cholesterol.

Speaker 2: 1:58

Okay, right, let's really dig into this then. This deep dive is all about giving you the insights to understand what really drives heart disease. So we're going to explore what atherosclerosis truly is, how inflammation sparks it and what makes it worse, which lab markers you might need to go beyond just the standard cholesterol test and, maybe most importantly, how you can start addressing the root cause, not just chasing a symptom like high cholesterol, because if you've only been focusing on cholesterol numbers, you're probably missing a huge part of the picture. We want to help you see it clearly.

Speaker 3: 2:30

Absolutely. Let's start with that basic idea. Atherosclerosis it's just the medical term for that plaque buildup inside arteries. Think of your arteries like I don't know clean, flexible pipes that carry oxygen-rich blood everywhere in your body. But over time this plaque builds up, it narrows those pipes, restricts the blood flow and that dramatically increases the risk for things like a heart attack or a stroke. And it's not just a simple blob of fat either. It's this complex sticky mix cholesterol, sure, but also calcium, dead immune cells, fats, other cellular junk, all sort of sticking together. And you know this doesn't happen overnight. It's a slow burn. It can start silently, maybe years, even decades, before you feel anything.

Speaker 2: 3:12

And for so long the old view was pretty straightforward LDL cholesterol the bad stuff was the enemy. Just lower it, maybe with medication, and you reduce your risk. Simple Seems simple, but here's where it gets tricky and, like you said, maybe more interesting. Up to half of people having heart attacks have LDL levels that are technically normal or even optimal. Clearly, that old view just doesn't capture everything.

Speaker 3: 3:33

Exactly, and what's really fascinating is how the modern view has shifted. It's quite different Now. Atherosclerosis isn't really seen as starting with cholesterol. It starts with damage to that inner lining, the endothelium, and that damage it's often caused by things like chronic inflammation, yeah, but also high blood pressure, toxins from the environment, even just frequent blood sugar spikes.

Speaker 2: 3:56

Ah, okay, so the lining gets damaged first.

Speaker 3: 3:59

Right. And once that barrier is compromised, then LDL particles can slip into the artery wall, but it's in the wall that they become oxidized. Think of it like they rust. They rust. Yeah, essentially. And that oxidation that's what triggers the big alarm for your immune system. It calls in immune cells. Think of them like tiny cleanup crews, macrophages mainly. These cells then gorge themselves on this damaged, oxidized LDL and they become these bloated things called foam cells.

Speaker 2: 4:26

Foam cells I've heard that term.

Speaker 3: 4:28

And those foam cells. They're basically the first building blocks of plaque. That's why atherosclerosis is really being recognized more and more as an inflammatory disease at its very core, not just a simple cholesterol storage problem.

Speaker 2: 4:41

So, wow, it's less about just having cholesterol around and way more about how it gets changed or transformed by inflammation. That feels like a critical turning point. It's like, ah, cholesterol is maybe the bricks, but inflammation is the architect, the construction crew and maybe even the fire that hardens the structure. Is that a fair way to think about it?

Speaker 3: 5:03

That's actually a great analogy, a really powerful one. Modern cardiology, you know the thinking now widely accepts atherosclerosis as this immune-driven inflammatory process. Every time that endothelium, that lining, gets hit with high blood sugar, oxidative stress, toxins, high pressure, it gets injured, it gets inflamed.

Speaker 4: 5:40

And this triggers the release of inflammatory signals. Things we can actually measure like high sensitivity C-reactive protein or HSCRP.

Speaker 3: 5:46

Also specific cytotimes like IL-6 and and over time the whole process leads to thicker artery walls, less blood flow, higher risk of clots forming and eventually a higher chance of that plaque rupturing and causing a heart attack. So it sounds like we really need. That is a crucial distinction. Yes, not all LDL is inherently bad or created equal. The real troublemaker isn't just the LDL molecule itself. It's what happens when it gets oxidized and that oxidation process. It's heavily fueled by inflammation, often from a poor diet and general oxidative stress in the body. This oxidized LDL is highly atherogenic, meaning it's very good at causing atherosclerosis, and you almost always find it in those unstable plaques, the kind most likely to break open and trigger a heart attack.

Speaker 2: 6:35

That makes so much sense now.

Speaker 3: 6:36

Yeah, and it explains why you can see patients with perfectly normal LDL numbers, but if their inflammation is high, they still develop serious heart disease. Just focusing on total cholesterol or even just standard LDL, it completely misses this root issue and it raises a really important question, right? If atherosclerosis is essentially a chronic immune disorder you know where the immune system is constantly reacting to what it sees as an injury inside the arteries well then, our prevention strategies need a fundamental shift.

Speaker 2: 7:03

That is a huge shift, wow. So, instead of just lower cholesterol, lower cholesterol, it sounds like we need to be thinking about calming the immune system down, reducing that inflammation, protecting that vascular lining, and I guess, for those wanting to track our own risk, the standard cholesterol tests just aren't going to cut it, are they?

Speaker 3: 7:20

You're absolutely right. If you're only testing total cholesterol and maybe LDL, hdl, you're really only seeing a tiny piece of the whole cardiovascular puzzle. So many people with normal lipids still develop heart disease precisely because their inflammation markers are high, and those markers are what truly drive the process. Functional and preventative medicine labs offer a much deeper look under the hood, so to speak. For instance, hs-crp, high sensitivity C-reactive protein. It's a well-known marker of just general systemic inflammation, and elevated levels correlate really strongly with heart risk, even in people who have normal LDL.

Speaker 2: 7:55

OK, so HS-CRP, what level should people aim for?

Speaker 3: 7:59

Ideally you want that below 1.0 milligel. Lower is generally better.

Speaker 2: 8:03

Got it Below 1.0. What else Beyond HS-CRP, what gives us that fuller picture?

Speaker 4: 8:07

Well, we can actually measure oxidized LDL directly, which, as we've been saying, is that more dangerous form, strongly linked to those on the stable plaques. Then there's LPA, lipoprotein. It's kind of a tricky one. It's not so genetic, it's an LDL-like particle, but it not only promotes inflammation, it also makes your blood more likely to clot. Oh wow.

Speaker 2: 8:27

A real double whammy then.

Speaker 4: 8:33

Exactly, it's a real double whammy for heart risk.

Speaker 3: 8:34

And guess what? It's not even included in standard cholesterol panels, but having high LPA significantly bumps up the risk of early heart disease, especially if you also have high CRP or high oxidized LDL.

Speaker 2: 8:44

Okay, lpa, that feels really important to know about, especially if it's genetic.

Speaker 4: 9:08

Stay even lower, maybe seven or eight.

Speaker 3: 9:11

Then there's fibrinogen. That's a clotting factor. High levels can indicate increased risk of thrombosis, blood clots, but also coins towards inflammation. And you know, for digging even deeper into metabolic health, which is often driving the inflammation, we look at markers like fasting insulin and calculate home AIR. These directly measure insulin resistance.

Speaker 2: 9:32

Ah, okay, because insulin resistance is a big driver of inflammation itself.

Speaker 3: 9:36

A major driver. Yes, and for the most advanced picture, you can even measure the direct signals of immune activation specific cytokines like IL-6 and TNF-alpha. These basically tell us how loud those inflammatory distress calls are inside the body.

Speaker 2: 9:51

Wow. So these labs, they go way beyond just seeing if cholesterol is building up. They help show why it might be building up and like how active that whole inflammatory fire is. It really changes the perspective. And this all comes back to well, our daily lives, doesn't it? Our choices, especially diet, I imagine.

Speaker 3: 10:07

Oh, absolutely. Atherosclerosis doesn't just happen in a vacuum, and one of the most powerful drivers maybe one we underestimate is diet, specifically a diet heavy in refined carbs, added sugars and certain processed seed oils. These foods directly fuel insulin resistance, oxidative stress and immune dysfunction. They basically create the perfect storm for inflammation inside your arteries.

Speaker 2: 10:31

So OK, those sugary drinks, the white bread, the pastries, the processed snacks, they're not just about weight, they're actively fueling inflammation in our blood vessels.

Speaker 3: 10:39

That's exactly it. Think about it Meals high in sugars and refined starches cause these big blood sugar spikes. Your body pumps out insulin to handle it, but over time, doing that again and again leads to insulin resistance. Your cells just stop listening properly to insulin, so you end up with high, fasting insulin levels, chronic, low-grade inflammation. Your body starts producing more inflammatory cytokines like IL-6 and CRP, and it leads to more oxidation of those LDL particles we talked about. In fact, studies clearly show that people who are insulin resistant tend to have more inflamed arterial plaques, even if their LDL levels are exactly the same as someone who isn't insulin resistant.

Speaker 2: 11:18

That's huge. That insulin resistance piece seems absolutely critical.

Speaker 3: 11:22

It's a massive piece of the puzzle.

Speaker 2: 11:23

Yes, and I keep hearing more and more about gut health being connected to everything. Does the gut play a role here too?

Speaker 3: 11:30

It absolutely does. It's a critical connection. Your diet doesn't just mess with blood sugar, it profoundly shapes your gut microbiome and your gut bacteria are major players in your cardiovascular health.

Speaker 2: 11:41

How so.

Speaker 3: 11:42

Well, when your gut gets out of balance maybe from too much sugar, alcohol, stress, processed foods, antibiotics that protective gut barrier can weaken. It gets leaky and this allows bacterial toxins, things like lipopolysaccharides or LPS, to leak from the gut into your bloodstream.

Speaker 2: 11:58

Leaking from the gut into the blood. That sounds bad.

Speaker 4: 12:01

It is. The process is called metabolic endotoxemia. Think of it like a slow, constant loop of inflammatory triggers coming from your gut and circulating throughout your body, including your arteries. This is now recognized as a really significant contributor to atherosclerosis, especially in people who aren't metabolically healthy. That LPS triggers immune activation, ramps up vascular inflammation and can even make existing plaque more unstable, more likely to rupture.

Speaker 2: 12:28

Wow, it really is all connected, isn't it? You've got health directly impacting your heart risk. Yeah, who knew? And I guess if we're eating a lot of those highly processed foods, we're probably not getting enough of the good stuff either.

Speaker 4: 12:40

That's spot on. Diets high in processed carbs and sugars are almost always low in key anti-inflammatory nutrients, Things like omega-3 fatty acids, magnesium, vitamin D, antioxidants like CoQ10, glutathione. These nutrients are vital. They help reduce oxidative stress. They improve insulin sensitivity. They protect that delicate endothelial lining. So yeah, the bottom line is pretty clear you really can't separate your diet from inflammation and you can't separate inflammation from your cardiovascular risk.

Speaker 3: 13:08

Even if your LDL is perfect. Poor metabolic health driven by diet can be Okay, but here's the crucial part then, the good news that is absolutely the most hopeful part of this whole shift in understanding yes, chronic inflammation is reversible. By targeting these root causes the diet, the gut health, the insulin resistance, the stress you can significantly improve your vascular function. You can help stabilize existing plaques, make them less dangerous and lower your overall risk for a heart attack or stroke.

Speaker 2: 13:49

So where do we start? What's the most impactful thing?

Speaker 3: 13:52

One of the biggest levers you can pull is definitely anti-inflammatory nutrition. Focusing your diet on whole, unprocessed, anti-inflammatory foods can make a massive difference. Different approaches work for different people. Things like low-carbohydrate or even ketogenic diets have strong data showing they lower insulin, reduce blood sugar spikes and decrease inflammatory markers like HSCRP. The Mediterranean diet is another great one, rich in those healthy fats like olive oil, omega-3s from fish, lots of colorful plants, full of polyphenols and fiber. It's consistently shown to improve endothelial function and reduce heart events. But maybe the most critical first step for many people getting rid of the ultra-processed stuff, especially anything high in added sugars, those refined seed oils like soybean or corn oil and refined starches. Just cutting those out can make a huge difference. And then, yeah, adding certain supplements can help too, Things like high-quality omega-3s, magnesium. They can further help calm down that inflammatory cascade.

Speaker 2: 14:52

So it's about taking out the bad stuff, but also strategically putting in the good stuff Makes sense. What about beyond diet, lifestyle stuff?

Speaker 3: 15:00

Lifestyle factors are just as crucial, absolutely. For example, poor sleep, not getting enough quality sleep, consistently that can significantly raise your CRP, your TNF-alpha, your cortisol levels, all driving inflammation.

Speaker 2: 15:14

Sleep matters.

Speaker 3: 15:15

Big time and chronic, unmanaged stress. Same thing. It activates your fight or flight nervous system, promotes vasoconstriction, tightening of blood vessels and messes with your immune regulation. And, of course, regular physical activity. Moderate exercise is key. It's proven to reduce CRP, improve insulin sensitivity and boost nitric oxide production.

Speaker 2: 15:33

Nitric oxide. That helps keep vessels flexible right.

Speaker 3: 15:35

Exactly Essential for good vessel health and flexibility. So movement is medicine too.

Speaker 2: 15:40

And for anyone who's really serious about tackling this, tracking progress with those advanced labs seems critical. It sounds like QuickLab Mobile is making that part easier.

Speaker 3: 15:48

It really is. Monitoring your inflammation shouldn't be guesswork, right, it should be data-driven. You can use tests like HSCRP and oxidized LDL to actually track your vascular inflammation levels over time, see if your changes are working. Fasting insulin, hniot, glucose those are essential for tracking your metabolic health, your insulin sensitivity, and then for that really personalized deep dive into risk, you'd look at things like lipid particle size and number, lpa, homocysteine and yeah, services like QuickLab Mobile are helping people access many of these advanced labs more easily. They offer convenient, often at-home, blood collection. It makes it much more feasible to test for that silent inflammation, the insulin resistance, the oxidized cholesterol, the endothelial damage. It really gives individuals, gives you the beta and the visibility to understand what's truly driving your heart health and make informed changes.

Speaker 2: 16:40

OK, so let's recap this deep dive then. For gosh decades really, cholesterol was kind of painted as the main villain, the undisputed bad guy behind heart disease. But the science, now it's giving us a much clearer picture and, honestly, a more hopeful one. The big aha moment here. The key takeaway is that atherosclerosis isn't just a cholesterol problem. It's primarily an inflammation problem.

Speaker 3: 17:04

Precisely that chronic inflammation is what damages the blood vessel lining, it's what oxidizes the LDL, it recruits the immune cells and it builds up those dangerous unstable plaques that can lead to heart attacks and strokes. And if we connect this to the bigger picture that inflammation usually stems from factors that are, you know, not only measurable but crucially modifiable Right Things we can actually change Exactly. We're talking about things like insulin resistance, a pro-inflammatory diet, maybe gut dysfunction, unmanaged chronic stress. So by shifting your focus from just I need to lower my LDL number to actively lowering inflammation, well, you unlock a much more powerful, much more personalized approach to protecting your cardiovascular health. And that's why these advanced inflammation and metabolic tests are so vital and why services like QuickLab Mobile, making at-home testing easier, are so helpful. They give you the results, the data that can drive real, meaningful lifestyle change.

Speaker 2: 18:01

You know, heart disease is often talked about like it's just bad luck or inevitable with aging. But this deep dive really shows it's largely preventable if you know what to actually look for and you know which levers to pull. So here's a final thought to leave you with Consider how your daily choices what you eat, how you sleep, how you manage stress, how you move, how are those choices constantly sending signals to your body's incredibly complex systems? Are they fueling that fire of inflammation or are they helping to calm it, protecting your cardiovascular health for the long haul? Something to think about.

Speaker 1: 18:37

Thanks for tuning into the Health Pulse. If you found this episode helpful, don't forget to subscribe and share it with someone who might benefit. For more health insights and diagnostics, visit us online at wwwquicklabmobilecom. Stay informed, stay healthy and we'll catch you in the next episode.