There is now abundant scientific evidence that chronic inflammation is linked to cardiovascular risk, both in patients who have diagnosed inflammatory disorders and in individuals with elevations of “nonspecific” inflammatory markers. Inflammatory testing is therefore an integral part of the assessment of cardiovascular risk. Markers tested are C-reactive protein (hs-CRP), Homocysteine, sedimentation rate (ESR), fibrinogen, and interleukins 1 and 6 (IL-1 and IL-6), with advanced testing available on an individual basis. If these markers are elevated, we devise a plan with our team of colleagues to minimize risk. If an inflammatory disease is diagnosed, we work closely with rheumatologists at The Hospital for Special Surgery who provide expert care of Rheumatologic Disorders.
The “Metabolic Syndrome” is also associated with high cardiovascular events and mortality. We screen all individuals for the metabolic syndrome, which includes assessment of waist circumference, body mass index, blood pressure, advanced lipids as above, hemoglobin A1-c (a better screen for diabetes and insulin resistance than the glucose level alone), vitamin B and D levels, fatty acid profile, and other individualized markers as required based on family and personal history.