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Understanding Cardiovascular Biomarkers

by Laura Hieronymus, MSEd, RN, BC-ADM, CDE, and Genevieve Wortzman-Show, PhD

“Nothing can compare with the activity of the human heart.”
—Denton A. Cooley

Despite considerable advances in the treatment of cardiovascular (heart) disease, it remains the leading cause of death in the United States. Diabetes, particularly Type 2 diabetes, is a major risk factor for cardiovascular disease. In fact, the rate of death from heart disease is two to four times higher in adults with diabetes than in their counterparts without diabetes.

Several factors are known to increase the risk of developing (and dying from) heart disease, including being male, using any form of tobacco, and having higher total and LDL (low-density lipoprotein, or “bad”) cholesterol levels and higher blood pressure. While your health-care provider will most certainly monitor and possibly treat these “classic” risk factors for cardiovascular disease, he may also monitor other biological markers to get a broader picture of what is happening to your heart and blood vessels. While these additional measurements are not as well-researched or closely associated with developing or dying from heart disease, they may provide information that is valuable in certain situations, such as when classic risk factors give mixed or unclear results. This article describes some of the more common tests that may be prescribed to get more information about your cardiovascular risk.

Cardiovascular biomarkers
The National Institutes of Health (NIH) describes a biological marker, or biomarker, as a characteristic that is an indicator of normal body processes, disease-related processes, or responses to a therapeutic intervention. The relationship of any such measurement to health or disease is established through scientific studies involving both healthy and sick individuals. It is thus possible that any of the biomarkers discussed in this article could gain or lose importance in the future, as research on the topic progresses.

Cardiovascular biomarkers may help determine someone’s potential for cardiovascular disease early on, before any classic signs and symptoms of the disease occur. Experts are still trying to determine whether early treatment of cardiovascular disease based on cardiovascular biomarkers is useful in preventing or delaying its onset. Some of the more commonly used cardiovascular biomarkers are high-sensitivity C-reactive protein, B-type natriuretic peptide, albumin-to-creatinine ratio, plasminogen activator inhibitor-1, and adiponectin.

High-sensitivity C-reactive protein. This marker of inflammation may indicate the presence of atherosclerosis, a fatty buildup in the arteries. Of all the biomarkers discussed in this article, the evidence connecting high-sensitivity C-reactive protein at elevated levels to heart disease and future cardiovascular events (such as a heart attack or stroke) is greatest. High-sensitivity C-reactive protein is often elevated in people with diabetes, who are known to have a higher risk of developing cardiovascular disease.

B-type natriuretic peptide. This biomarker is used to help detect and determine the severity of congestive heart failure. When the heart muscle begins to enlarge — which happens, in the case of heart failure, as the muscle tries to respond to its inability to pump blood adequately throughout the body — this substance is secreted into the blood. The amount of B-type natriuretic peptide in the blood therefore tends to correspond to the risk of heart failure. Some studies have suggested that decreases in this biomarker can be beneficial.

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Also in this article:
Cardiovascular Biomarker Tests
Take-Away Tips for Preventing CVD



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