Want to know how healthy your heart really is? A routine cholesterol test may not provide the complete picture. Dr Sanjay Bhojraj, MD, Integrative Cardiologist, in his August 14 Instagram post, highlights nine blood tests that can offer insights into cardiovascular risk, metabolic health, inflammation and cardiac strain. “If I wanted to know how healthy your heart is, these are the blood tests I’d order first,” Dr Bhojraj said while sharing his recommendations.
1. ApoB
Apolipoprotein B, or ApoB, measures the number of cholesterol-containing particles that can contribute to plaque buildup in the arteries. Dr Bhojraj describes it as a test that “measures artery-clogging cholesterol particles.” ApoB can provide additional information about cardiovascular risk beyond a standard LDL cholesterol measurement.
2. Lipoprotein(a) [Lp(a)]
Lp(a) is a type of lipoprotein that is largely influenced by genetics. Bhojraj says the test “reveals inherited cardiovascular risk.” Elevated Lp(a) levels are associated with a higher risk of cardiovascular disease, making it a useful marker for understanding an individual’s underlying risk.
3. hs-CRP
High-sensitivity C-reactive protein, or hs-CRP, is a marker of inflammation. Dr Bhojraj describes it as a test that “detects hidden inflammation in the arteries.” Higher hs-CRP levels can be associated with an increased risk of cardiovascular disease, although the test needs to be interpreted alongside other health factors.
4. Fasting Insulin
Fasting insulin can provide clues about how the body is responding to insulin and may help identify early metabolic dysfunction. According to Dr Bhojraj, the test “shows early signs of metabolic dysfunction.” It is generally interpreted alongside blood glucose and other metabolic markers rather than being used on its own.
5. Hemoglobin A1c
Hemoglobin A1c, or HbA1c, measures average blood sugar levels over the previous two to three months. Dr Bhojraj describes it as a test that “measures long-term blood sugar exposure.” Persistently elevated blood sugar is associated with an increased risk of cardiovascular complications, particularly in people with diabetes.
6. Omega-3 Index
The Omega-3 Index measures levels of the omega-3 fatty acids EPA and DHA in red blood cells. Dr Bhojraj says it “assesses heart-protective fatty acid levels.” The test can provide an indication of longer-term omega-3 status and may be considered as part of a broader assessment of cardiovascular health.
7. Triglyceride-to-HDL Ratio
The triglyceride-to-HDL ratio compares blood triglyceride levels with HDL cholesterol. Dr Bhojraj calls it “a simple marker of metabolic health.” While it can provide additional information about metabolic health, the ratio should be interpreted alongside other cholesterol, blood sugar and cardiovascular risk markers.
8. Vitamin D
Vitamin D levels have also been linked with cardiovascular health. Dr Bhojraj notes that “low levels are associated with higher cardiovascular risk.” However, an association between low vitamin D and cardiovascular disease does not necessarily mean that vitamin D supplementation prevents heart disease. Test results should therefore be assessed in the context of an individual’s overall health.
9. NT-proBNP
NT-proBNP is a biomarker that can indicate stress or strain on the heart. Dr Bhojraj says it “can reveal early signs of cardiac strain before symptoms appear.” Doctors commonly use NT-proBNP when evaluating possible heart failure and other conditions involving cardiac strain.
Dr Sanjay Bhojraj is a board-certified cardiologist with over 20 years of experience in traditional cardiology and a certified practitioner of Functional Medicine.
