Which Blood Tests Detect Heart Problems?

With one in 12 Canadians aged 20 and older grappling with various forms of diagnosed heart disease — from plaque build-up to late-stage heart failure — it’s crucial to adopt heart disease prevention strategies, including screening tests needed to track your heart health.

Lifestyle changes can halt disease progression and even reverse some of its symptoms — so the earlier you make heart health screening a part of your health routine, the better.

There are many blood tests that use different methods for tracking heart health. Here’s a list of the blood tests that will give you the best insight into how your heart functions and results are interpreted.  

Understanding the importance of blood tests for heart health

By the time you notice symptoms like swollen legs, shortness of breath, or exhaustion, your heart disease may be more advanced. However, the condition can go undetected for years until you get to that point.

Addressing heart disease sooner rather than later may significantly improve outcomes. By adopting lifestyle changes, taking prescription medication or undergoing medical procedures promptly, you increase your chances of managing it effectively. The challenge lies in detecting the condition early enough — which is where investigations come in, like blood tests.

Certain blood tests target key indicators of heart health, like cholesterol and triglycerides. When these deviate from the norm, it signals potential areas of concern and risk for heart health. They can also screen for markers of inflammation which serve as early detectors of damage to the heart muscle.

As a result, blood tests can help you detect heart conditions in their early stages before a serious complication occurs. They can also diagnose a heart attack that may otherwise have gone unnoticed. In either case, they’re vital for making informed decisions and choosing the most effective treatments to keep you healthy.

Common blood tests for detecting heart problems

By flagging elevated levels of certain lipids, enzymes, or other markers, blood tests can help your provider assess your individual risk of heart disease and, if necessary, guide treatment options.

Keep in mind, however, that “normal” ranges depend on many factors including age and gender, as well as variability between different labs, so it’s crucial to have your results interpreted by a healthcare provider.

Here are the most common tests to assess heart health:

High-sensitivity C-reactive protein test

C-reactive protein (CRP) is a marker of inflammation in the body and it’s produced by your liver. High CRP levels may signal an infection or an inflammatory condition in the body. The hs-CRP test detects low levels of CRP, looking for risk of heart disease or stroke.

However, because atherosclerosis (plaque buildup inside the arteries causing them to narrow) is an inflammatory process, capturing elevated protein levels on a high-sensitivity CRP test (hsCRP) may also predict future heart trouble in people with no history of heart disease. 

Cardiac enzyme test

Troponin exists in three types of cells in your body – the heart, fast-twitch muscle, and slow-twitch muscle. Blood tests can differentiate between the three types., In regards to the troponin from heart tissue, it gets released into your bloodstream when cardiac cells are damaged. With normal cell turnover, there will always be a low level of troponin circulating throughout the body, however, a problem is indicated when the troponin levels rise above the 99th percentile of the normal range. Assessing your troponin levels by ordering a cardiac enzyme panel can help your doctor diagnose a heart attack and determine its acuity, as a rise, fall or rise and fall in troponin can indicate an acute cardiac injury. 

Remember that when it comes to “normal,” each lab uses its own range when it comes to this test. As a result, your doctor will interpret your results based on several factors.

B-type natriuretic peptide (BNP) levels

When the heart chambers (ventricles) are stretched or there is more tension on the heart walls, it releases BNP to help compensate. This peptide stimulates your blood vessels to dilate, smooth muscle to relax, and your kidneys to dispose of more salt to lower your blood pressure and decrease how hard your heart has to work.

Elevated BNP levels may indicate that your heart is signaling its need for help. The higher the BNP levels, the higher the likelihood of more damage, though it depends on the setting as elevated BNP measurements can take time to show up following a cardiac event. And there are other factors that may raise the BNP levels like exercise or certain medications like beta-blockers. Some diuretics and certain blood pressure medicines can have the opposite effect and lower the BNP levels. 

Urea and electrolyte tests

When your body’s electrolytes – calcium, magnesium, potassium, and sodium – fall out of balance, they can disrupt electrical signals to the heart, potentially causing serious arrhythmias and cardiac arrest. Consequently, irregular electrolyte levels can indicate a risk of heart problems.

Blood urea nitrogen (BUN) tests how well the kidneys are working. Nitrogen is the waste product of Urea. Urea is made in the liver in response to breaking down protein and is excreted by the kidneys in urine. Elevated levels of BUN may mean your heart isn’t pumping well enough for your kidneys to fully clear urea from your blood. Heart failure, dehydration, or a high-protein diet can increase BUN levels. 

Clotting screen

Fibrinogen, a crucial protein in blood clotting, ensures you can stop bleeding when needed. However, an excess of it can raise your risk of heart issues, including heart attacks. Elevated levels of this protein may indicate that you’re on track for future cardiac problems.

Cholesterol levels and heart health

Running a lipid panel is key to assessing cardiac risk as it measures the amount of fatty substances in your blood — specifically cholesterol and triglycerides.

While not exactly fat, cholesterol is a waxy substance in your body. Despite its bad reputation, cholesterol is used by the body to build cells and make hormones and vitamins. Cholesterol is made in the liver or consumed by the foods we eat and only becomes a health risk when there is too much of it. 

The body moves these waxy substances — fat and cholesterol, through the blood in packed protein-covered particles called lipoproteins. The most important types are low-density lipoprotein (LDL), high-density lipoprotein (HDL), and triglycerides. 

• HDL is known as the good cholesterol because it takes cholesterol from the bloodstream and shuttles it back to the liver
• LDL is considered the “bad” cholesterol because it moves cholesterol out of the liver to the rest of the body, is more loosely packed, bulkier, and can form plaques in arteries leading to atherosclerosis (build-up of plaque and narrowing of the blood vessels) 
• Triglycerides are the body’s main transporter of fats into cells. Too much of a good thing can also be bad.   

Eating saturated fats contributes to higher LDL levels. And, too much LDL can lead to a build-up in your blood vessels, causing them to narrow and eventually become blocked. 

HDL actually carries cholesterol away from your arteries, which is why it’s known as “good” cholesterol. It’s also why you want higher levels of it, especially relative to LDL.

Triglycerides, simply put, are fats. When your calorie intake surpasses what you burn, your body stores the excess as triglycerides. Over time, higher levels of these fats contribute to the risk of developing heart disease or other serious health conditions like pancreatitis.

Therefore, high triglycerides coupled with high LDL and low HDL increases your likelihood of developing heart disease. 

Blood sugar and heart health

Sugar isn’t always the bad guy it’s made out to be. If humans were cars, sugar would be the gas in our tanks since every cell in the body uses it for energy. Sugar naturally occurs in foods containing carbohydrates like fruits, vegetables, grains, and dairy. 

However, issues arise when you consume more sugar than your body can use. With nowhere to go, that excess sugar ends up being converted in the liver and stored as fat, attributing to fatty liver disease. Worse, as it floats around in the bloodstream, it causes oxidation that damages the lining of the blood vessels. 

Over time, this damage means that blood isn’t able to flow as easily through your blood vessels, contributing to a decreased blood supply to the heart. Not only that, but it can also spur autonomic neuropathy, which is damage to the nerves that control your internal organs and regulate things like the digestive system, heart rate, or blood pressure.

Together, these factors can affect your ability to feel a heart attack, impair blood pressure regulation, or even undermine your heart’s ability to manage its own rhythm.

The following tests can help you gauge your blood sugar levels so you can manage them for better heart health if needed.

Fasting glucose levels

Your blood sugar levels rise when you eat and begin to fall a short time later. So it follows that if you fast, i.e. don’t eat for at least 8 hours, your blood glucose levels should be lower. If your fasting glucose levels are higher than expected, it’s an indication that your body isn’t processing glucose the way it should be.

A1C levels

A1C stands for glycated hemoglobin, a more long-term measure of your blood glucose levels than the fasting glucose test.

Hemoglobin is one of the main components of your red blood cells, which are responsible for delivering oxygen throughout the body. The thing about hemoglobin is that it attracts glucose, so higher levels of glucose in your blood mean more glucose molecules attached to your hemoglobin — in other words, more glycated hemoglobin.

Since your red blood cells live for around three months, the amount of glycated hemoglobin in your blood reflects your blood sugar levels over a three-month period. 

Combining blood tests with other diagnostic procedures

Blood tests are a great way of gaining insight into the health of your heart. However, depending on your overall symptoms and history, your doctor may recommend combining them with other measures to provide more specific insights. These measures include:

• Electrocardiogram (ECG or EKG)
• Holter monitor
• Cardiac stress test
• Coronary angiogram
• Cardiac MRI

The final work on cardiac blood test

Heart health isn’t just affected by your lifestyle and diet — it’s also shaped by genetic and hereditary factors.

Since living a healthy lifestyle can’t guarantee that your heart is in perfect shape, embracing preventative blood tests is a non-invasive way of monitoring your heart health.

If you’re concerned about your heart health, talk to your healthcare provider to get a requisition for lab work. However, if you’re one of 6.5 million Canadians without access to a family doctor, Maple can connect you with a primary care provider who can help you get the care you need.

Primary care providers on Maple can provide the lab work requisitions you need to paint a comprehensive picture of your heart.

Information presented here is for educational purposes, and not to replace the advice from your medical professional. Virtual care is not meant for medical emergencies. If you are experiencing an emergency like chest pain or difficulties breathing, for example, please call 911 or go to your nearest emergency room.