Blood tests for heart disease

By Mayo Clinic Staff

Introduction

Your blood offers many clues about your heart health. For example, high levels of "bad" cholesterol in your blood can be a sign that you're at increased risk of having a heart attack. And other substances in your blood can help your doctor determine if you have heart failure or are at risk of developing plaque deposits in your arteries (atherosclerosis).

It's important to remember that one blood test alone doesn't determine your risk of heart disease. The most important risk factors for heart disease are smoking, high blood pressure, high cholesterol and diabetes.

Here's a look at some blood tests you may have to diagnosis and manage heart disease.

Cholesterol test

A cholesterol test, also called a lipid panel or lipid profile, measures the fats (lipids) in your blood. The measurements can indicate your risk of having a heart attack or other heart disease. The test typically includes measurements of:

  • Total cholesterol. This is a sum of your blood's cholesterol content. A high level can put you at increased risk of heart disease. Ideally, your total cholesterol should be below 200 milligrams per deciliter (mg/dL) or 5.2 millimoles per liter (mmol/L).
  • Low-density lipoprotein (LDL) cholesterol. This is sometimes called the "bad" cholesterol. Too much of it in your blood causes the accumulation of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaque deposits sometimes rupture and lead to major heart and vascular problems.

    Your LDL cholesterol level should be less than 130 mg/dL (3.4 mmol/L). Desirable levels are under 100 mg/dL (2.6 mmol/L), especially if you have diabetes or a history of heart attacks, heart stents, heart bypass surgery, or other heart or vascular conditions.

  • High-density lipoprotein (HDL) cholesterol. This is sometimes called the "good" cholesterol because it helps carry away LDL cholesterol, keeping arteries open and your blood flowing more freely. Ideally, your HDL cholesterol level should be over 40 mg/dL (1.0 mmol/L) for a man, and over 50 mg/dL (1.3 mg/dL) for a woman.
  • Triglycerides. Triglycerides are another type of fat in the blood. High triglyceride levels usually mean you regularly eat more calories than you burn. High levels can increase your risk of heart disease. Ideally, your triglyceride level should be less than 150 mg/dL (1.7 mmol/L). The American Heart Association (AHA) states that a triglyceride level of 100 mg/dL (1.1 mmol/L) or lower is considered "optimal."
  • Non-HDL cholesterol. Non-high density lipoprotein cholesterol is the difference between total cholesterol and high-density lipoprotein cholesterol (HDL-C). Non-HDL-C includes cholesterol in lipoprotein particles that are involved in hardening of the arteries (atherosclerosis). This includes low-density lipoprotein (LDL), lipoprotein (a), intermediate-density lipoprotein and very-low-density lipoprotein.

    Non-HDL-C fraction may be a better marker of risk than LDL cholesterol.

High-sensitivity C-reactive protein

C-reactive protein (CRP) is a protein your liver produces as part of your body's response to injury or infection (inflammatory response).

CRP is a sign of inflammation somewhere in the body. However, high-sensitivity CRP (hs-CRP) tests can't pinpoint where in the body this may be happening or why it's happening. Inflammation plays a central role in the process of atherosclerosis, in which fatty deposits clog your arteries.

Measuring CRP alone won't tell your doctor your risk of heart disease. But factoring in hs-CRP test results with other blood test results and risk factors for heart disease helps create an overall picture of your heart health.

Because there's variability in CRP levels, the test should be done twice, two weeks apart. An hs-CRP level above 2.0 milligrams per liter indicates a higher risk of heart disease.

This test screening isn't currently recommended for people without symptoms or a known risk of heart disease.

Cholesterol-lowering statin medications may reduce CRP levels and decrease your heart disease risk.

Lipoprotein (a)

Lipoprotein (a), or Lp(a), is a type of LDL cholesterol. Your Lp(a) level is determined by your genes and isn't generally affected by lifestyle.

High levels of Lp(a) may be a sign of increased risk of heart disease, though it's not clear how much risk. Your doctor might order an Lp(a) test if you already have atherosclerosis or heart disease but appear to have otherwise normal cholesterol levels.

Lp(a) is often tested if you have a family history of early-onset heart disease or sudden death.

Drugs are in development to lower Lp(a), but it isn't yet clear what effect lowering Lp(a) will have on heart disease risk. People with high Lp(a) are generally advised to keep a low LDL cholesterol level.

Plasma ceramides

This new test measures levels of ceramides in the blood. Ceramides are produced by all cells and play a significant role in the growth, function and ultimately death of many types of tissue. Ceramides are transported through the blood by lipoproteins and are associated with atherosclerosis.

Three specific ceramides have been linked to plaque buildup in the arteries and insulin resistance. Elevated levels of these ceramides in the blood indicates a higher risk of cardiovascular disease within one to five years.

Natriuretic peptides

Brain natriuretic peptide, also called B-type natriuretic peptide (BNP), is a protein that your heart and blood vessels produce. BNP helps your body eliminate fluids, relaxes blood vessels and funnels sodium into your urine.

When your heart is damaged, your body secretes high levels of BNP into your bloodstream to try to ease the strain on your heart. BNP levels may also rise if you have new or increasing chest pain (unstable angina) or after a heart attack.

Your BNP level can help in the diagnosis and evaluation of heart failure and other heart conditions. Normal levels vary according to age and gender and whether you are overweight. One of the most important uses of BNP is to try to sort out whether shortness of breath is due to heart failure.

For people who have heart failure, establishing a baseline BNP can be helpful and future tests can be used to help gauge how well your treatment works. A variation of BNP called N-terminal BNP also is useful in diagnosing heart failure and in some laboratories is used instead of BNP. N-terminal BNP may also be useful in evaluating your risk of a heart attack and other problems if you already have heart disease.

A high level of BNP alone isn't enough to diagnose a heart problem. Your doctor will also consider your risk factors and other blood test results.

Jan. 09, 2019 See more In-depth

See also

  1. Air pollution and exercise
  2. Angina
  3. Atkins Diet
  4. Automated external defibrillators: Do you need an AED?
  5. Blood Basics
  6. Bradycardia
  7. 4 Ways to Prevent Heart Attack
  8. Fact or Fiction? Debunking Exercise & Nutrition Myths for Preventing Heart Disease and Risk Factors
  9. Freezing Heart Muscle
  10. Healthy Heart Numbers
  11. Heart disease in women
  12. Mayo Clinic - Holiday Heart Attack and Stroke Risk
  13. New Route to the Heart
  14. Screenings of newborns and athletes for genetic heart disease
  15. Sports Cardiology Program
  16. Supraventricular Tachycardia
  17. Transplant Advances
  18. Butter vs. margarine
  19. Calcium supplements: A risk factor for heart attack?
  20. Can vitamins help prevent a heart attack?
  21. Cardiac ablation
  22. Infographic: Cardiac Ablation
  23. Cardiac amyloidosis — Treatment options
  24. Cardiac amyloidosis — What is amyloid and how does it affect the heart
  25. Cardiac catheterization
  26. Cardioversion
  27. Chelation therapy for heart disease: Does it work?
  28. Chest X-rays
  29. Complete blood count (CBC)
  30. Control your portions, control your weight
  31. Coronary angiogram
  32. Coronary angioplasty and stents
  33. Coronary artery spasm: Cause for concern?
  34. Coronary bypass surgery
  35. Cough
  36. CT scan
  37. CT scans: Are they safe?
  38. Daily aspirin therapy
  39. Dizziness
  40. Don't get tricked by these 3 heart-health myths
  41. Dyspnea
  42. ECG at Mayo Clinic
  43. Echocardiogram
  44. Electrocardiogram (ECG or EKG)
  45. Exercise and chronic disease
  46. Fasting diet: Can it improve my heart health?
  47. Fatigue
  48. Flu Shot Prevents Heart Attack
  49. Flu shots and heart disease
  50. Foot swelling during air travel: A concern?
  51. Grass-fed beef
  52. Hand swelling during exercise: A concern?
  53. Is chocolate healthy?
  54. Healthy eating: One step at a time
  55. Healthy Heart for Life!
  56. Healthy heart for life: Avoiding heart disease
  57. Heart arrhythmias
  58. Heart attack
  59. Heart attack prevention: Should I avoid secondhand smoke?
  60. Heart attack symptoms
  61. Heart Attack Timing
  62. Heart disease
  63. Heart disease in women: Understand symptoms and risk factors
  64. Heart disease and oral health
  65. Heart-healthy diet: 8 steps to prevent heart disease
  66. Heart murmurs
  67. Heart transplant
  68. Supplements and heart drugs
  69. Holter monitor
  70. Implantable cardioverter-defibrillators (ICDs)
  71. Leg swelling
  72. Limit bad fats, one step at a time
  73. Mediterranean diet
  74. Mediterranean diet recipes
  75. Menus for heart-healthy eating
  76. MUFAs
  77. Need a snack? Go nuts!
  78. NSAIDs: Do they increase my risk of heart attack and stroke?
  79. Nuclear stress test
  80. Numbness
  81. Nuts and your heart: Eating nuts for heart health
  82. Olive oil
  83. Omega-3 in fish
  84. Omega-6 fatty acids
  85. Infographic: Organ Donation Donate Life
  86. Organ transplant in highly sensitized patients
  87. Pacemaker
  88. Pericardial effusion
  89. Polypill: Does it treat heart disease?
  90. Protein: Heart-healthy sources
  91. Pseudoaneurysm: What causes it?
  92. Pulmonary edema
  93. Put fish on the menu
  94. Red wine, antioxidants and resveratrol
  95. Shortness of breath
  96. Silent heart attack
  97. Sitting risks: How harmful is too much sitting?
  98. Mediterranean diet
  99. Vegetable recipes
  100. Guide to gourmet salt
  101. Sodium nitrate in meat: Heart disease risk factor?
  102. Sodium: Smarten up
  103. Heart disease prevention
  104. Stress symptoms
  105. Stress test
  106. Tachycardia
  107. Testosterone therapy side effects: What are the heart risks?
  108. Infographic: The blueprints to your heart
  109. The Last Brother's Heart
  110. The power of a plant-based diet for heart health
  111. Integrative approaches to treating pain
  112. Lifestyle strategies for pain management
  113. Nutrition and pain
  114. Pain rehabilitation
  115. Self-care approaches to treating pain
  116. Treating pain: Conventional medical care
  117. Treating pain: Overview
  118. Understanding pain
  119. Trans fat
  120. Triathlete Transplant
  121. Trouble breathing
  122. Coronary angioplasty
  123. Video: Heart and circulatory system
  124. Can having vitamin D deficiency cause high blood pressure?
  125. What is meant by the term heart age?
  126. Whole grains for a healthy heart
  127. Infographic: Women and Heart Disease