So you're watching what you eat and monitoring your cholesterol to head off a potentially deadly heart attack or stroke. That’s important. But doctors say you should also be aware of these other, lesser-known risk factors for heart disease.
Over the past several years, researchers have been rushing to study what could be the biggest heart-disease risk factor you never knew you had: clonal hematopoiesis of indeterminate potential, or CHIP, a mutation of bone marrow stem cells that increases your chances of dying from a heart attack or stroke by a whopping 40 to 50 percent. Though the condition is normally found through genetic testing for other diseases and isn’t directly treatable at this time, it is helping cardiologists understand why a certain segment of patients — the ones with no other known risk factors — have heart attacks or strokes. The environmentally driven mutation is very common in older people (up to 50 percent of those in their 80s have it), but if you develop CHIP at a younger age, it's worse, increasing your risk of heart attack by a factor of four. While researchers are still sorting out how CHIP leads to artery-blocking plaque, the link seems to be in how mutated bone marrow cells spur the development of a type of white blood cell, which in turn causes inflammation.
The 'Other' LDL
Unlike with CHIP, which they say is still in a study-and-learn phase, top cardiologists are recommending you get tested for high levels of a particle called lipoprotein(a), which attaches to your bad cholesterol and acts a lot like it, too. Too much Lp(a), as it's known, causes heart disease and stroke both by creating the plaque that clogs arteries and by boosting clot formation, says Seth Martin, a preventive cardiologist at Johns Hopkins Medicine. He describes it as the missing link that explains why patients who don't appear to have typical risk factors may suffer heart attacks. "We will see someone who has fine blood pressure and normal cholesterol, but with high Lp(a) these people can get cardiovascular disease — and at earlier ages." Your levels can be determined with a simple and inexpensive blood test, says Martin, who notes that while a reading can provide critical information to guide your treatment, the test is just starting to be incorporated into most clinical practices.