As we get older, we’re more likely to face health problems like heart disease, dementia, diabetes, and kidney disease. These are often called  the ‘diseases of aging’ and although they may seem unrelated, they share a common risk factor called atherosclerosis. In this article, we’ll explain what atherosclerosis is, what causes it, and how our tailored heart health biomarkers assess your risk.

Atherosclerosis, which literally means “pasty hardness”, occurs when cholesterol and other substances build up inside your blood vessels. This makes it more difficult for blood to flow through our blood vessels and reach all the cells in your body.  

Why is this a problem? Every cell in your body - whether in your brain, kidney, or stomach - needs oxygen and nutrients to survive. Blood picks these up from your lungs and digestive system and delivers them where needed.

If cells do not get enough oxygen and food from the blood they die, and the consequences of this depends on where those cells are. For example, if this happens in the brain, it can lead to a stroke, and if it occurs in the heart, it can cause a heart attack. In both cases, the problem is the same: not enough blood is reaching those cells.

Your arteries have a protective inner layer, but when this layer becomes damaged—due to things like high blood pressure—fat and cholesterol can start to build up. Immune cells try to clean up this buildup, but they can get stuck too, making the problem worse. Over time, this buildup turns into thick plaque, which narrows the artery and gradually blocks blood flow.  

Getting less blood makes it harder for our cells to work properly. Over time, this can lead to the gradual onset of problems like kidney disease or some types of dementia. 

If blood flow gets completely blocked, it can lead to strokes and heart attacks. Unfortunately, for many people, this sudden event is the first sign they have atherosclerosis. By then, it may be too late to fix the damage, which can make it harder to live life fully and flourish. This is why we make sure that our heart health panel gives as full a picture of atherosclerosis risk as possible.

So, how do we assess your risk of atherosclerosis?

Our heart health panel is an evidence-based set of tests designed to measure biomarkers specifically linked to atherosclerosis. By "evidence-based," we mean that each biomarker is carefully selected because it either contributes to atherosclerosis or is found at higher levels when the condition is present. Each test helps piece together an accurate picture of your individual risk for atherosclerosis.

Everyone is different, so we designed our heart health panel to reflect this. By testing a variety of biomarkers, we create a fairer and more personalized assessment for each person. Some familiar tests included are LDL and HDL cholesterol. Additionally, we measure other important markers, such as ApoB and ApoA1. These extra tests provide a more accurate and personalized risk assessment than cholesterol alone. Sometimes, LDL and HDL levels might seem normal, but elevated ApoB and ApoA1 levels can reveal hidden risks that common tests may miss (see here for a deep dive on lipoproteins and cholesterol).

Atherosclerosis is not just about cholesterol deposition though. Factors like inflammation and blood sugar levels also play a role so we monitor these as well. One of the most interesting findings we came across in our research was that one the tests in our metabolic panel (GGT), is also a very strong predictor of death by heart attack or stroke.  

Another really important aspect of your heart health which we think about is your overall fitness level. In particular, having a higher VO2 max in particular has been shown to significantly reduce the risk of dying from heart disease as well as having many other health benefits. 

By reducing your risk of atherosclerosis, you're not only lowering your chances of developing diseases like heart disease, dementia, and chronic kidney disease, but also boosting your overall well-being, allowing you to stay active, energized, and able to enjoy the things you love for longer.

To learn more about the heart health panel and how it helps us make tailored preventative care recommendations have a look at our sample dashboard here. 

Key Resources

• Information on cholesterol testing from the Canadian Cardiovascular Society: https://ccs.ca/cholesterol/
• More information on atherosclerosis from the charity Heart&Stroke:  https://www.heartandstroke.ca/heart-disease/conditions/atherosclerosis 

All the views expressed here are based on careful research conducted by the research team at Niahealth. However, in some places we have omitted certain details for the sake of clarity and simplicity. If you have any questions about our research or the content of this blog email our head of research Dr Robin Brown at : robin@niahealth.co