Heart & Wellness Package

VAP (Vertical Auto Profile) Cholesterol Test
State of the Art Cholesterol Test

The VAP cholesterol test improves you cholesterol risk assessment by combining a more accurate LDL (bad) cholesterol measurement with cholesterol subclasses that play important roles in the development of heart disease. The VAP test is the only cholesterol profile that tests for all the present and emerging risk factors identified in the National Cholesterol Education Program (NCEP) guidelines. This additional information allows your doctor to improve the detection of heart disease risk from about 40 percent to 90 percent, according to the scientists who developed this test.

The VAP test includes all the components of the standard Lipid Panel: total cholesterol, LDL cholesterol, triglycerides, HDL cholesterol and VLDL cholesterol. The VAP Test measures the LDL (bad) cholesterol directly, which is more accurate than the standard lipid profile test which relies on estimations (high triglycerides levels decrease the accuracy of LDL estimates in the standard lipid profile).

The VAP test also includes tests that are not included in the standard lipid panel:

• LDL particle size
• HDL subfractions (HDL2-C, and HDL3-C)
• Lipoprotein (a)
• VLDL subfractions (VLDL 1+2, VLDL3)
• Intermediate Density Lipoprotein

The Cardiac C-Reactive Protein Test

A protein present in the blood when certain inflammatory processes are occurring. It is now known that arteriosclerotic plaques in the coronary arteries are an inflammatory process that correlates with C-reactive protein, and it is believed to be a good prognosticator of heart disease. The test can help estimate your chance of developing cardiovascular disease, and your risk of having a sudden heart attack. This blood test was redesigned from the traditional C- Reactive Protein test to be sensitive enough to detect chronic low-level inflammation. Test results are independent of cholesterol, family history, and other traditional risk factors for cardiovascular disease. The test can be used in conjunction with traditional tests, such as cholesterol, to determine your risk. Recent illness or tissue injury, and chronic inflammation from arthritis can increase C-RP levels and falsely influence the risk rating for heart disease from this test.

Metabolic Panel

This blood test is also referred to as the Comprehensive Metabolic Panel or the CMP 14 (as opposed to the Basic Metabolic Panel or BMP 8). This is a 12 hour fasting test (check with your physician before fasting if you are diabetic and/or pregnant). This test include the following:

Liver

• Albumin, Globulin and Total Protein: Measures the amount and type of protein in your blood. They are a useful index of overall health and nutrition. Abnormal results are an indicator of under nutrition, liver or kidney disease, cirrhosis, multiple meyloma, sarcoid, amyloid, lupus, and/or major infections. Globulin is the "antibody" protein important for fighting disease. If one of these values is high, but the other values are within expected ranges, the result is probably not significant, but only your physician can confirm this.
• Bilirubin: Primary pigment in bile. It is derived from hemoglobin and processed by the liver, and builds up when the liver is functioning poorly or when some other disorder reduces the normal flow of bile. It is increased also when there has been destruction of red blood cells.
• AST & ALT: Injury to cells releases these enzymes into the blood. Liver disease and heart attacks, as well as serious physical injury can cause elevation of these values. Low values are probably not significant, but can only be confirmed by your physician.

Diabetes

• Glucose

Kidney Panel

• Urea Nitrogen (BUN): A waste product of the liver excreted by the kidneys. High values may indicate kidney malfunction and/or dehydration
• Creatinine: This is a waste product of muscle metabolism that is discarded by the kidney. It is elevated in kidney disease, muscle wasting disease, and sometimes the day after strenuous physical exercise.
• BUN/Creatinine Ratio: Both BUN and creatinine are elevated in kidney failure, but they are elevated differently depending on the cause of the failure. This ratio helps determine the type of kidney failure.

Fluids & Electrolytes

• Carbon Dioxide: Part of the electrolyte pane used to detect, evaluate and monitor electrolyte imbalances.
• Sodium, Potassium, and Chloride: "Electrolytes" help make up the salt balance and acid/base balance in the body. They can be affected by diuretics or water pills, high blood pressure, heart failure, kidney and lung disease. The balance among these elements is important for proper functioning of the heart and brain.
• Alkaline Phosphatase: A bone and liver enzyme. High values are associated with liver and gall-bladder disease. Expect to see higher values in adolescents and pregnant or breast feeding women. Low values are probably not significant, but can only be confirmed by your physician.

Complete Blood Count

• White Blood Cell Count (WBC) - The infection fighting cells of the immune system found in the blood. Lowered or elevated levels may be associated with a disease process.
• Red Blood Cell Count (RBC) - Measures the number of oxygen-carrying cells in the blood. Lowered levels associated with anemia, elevated levels associated with smoking and several diseases.
• Hemoglobin (HGB) - Measures the amount of oxygen-carrying protein in the RBC. Significant increases or decreases can be seen in anemia or RBC disease.
• Hematocrit (HCT) - Measures the oxygen-carrying capability of the blood by measuring the percentage of blood made-up of red blood cells. Significant decreases are one indicator of anemia.
• MCV, MCH, MCHC, RDW - Collectively called ?indices?, these tests measure size and other characteristics of the red blood cells. They can be used to further define the causes of an anemia state. An isolated abnormal value probably has little clinical significance, but can only be confirmed by your physician.
• Platelet Count - These are small packages of clotting materials in the blood. Too many cause problems with unnecessary clotting; too few may cause excessive bleeding. Certain conditions alter this count.
• Lymphocytes, Monocytes, Neutrophils, Eosinophils - Different types of WBCs. They may be used to evaluate allergic reactions or differentiate between bacteria, viral or parasitic infections.

Urinalysis

A health screening profile consisting of 10 or more component tests that is routinely ordered as part of an annual physical exam. This test can be used to screen for and monitor diseases and conditions, such as kidney stones, diabetes, urinary tract infections, and liver disease. This is not a drug test.

Preparation: You will be asked to provide a urine specimen at the Patient Service Center. At the Patient Service Center, a technician will provide you with a container and a private lavoratory for the collection.

Urinalysis component tests include these tests:

• Color: reddish brown urine may be caused by certain medications, diet, or blood.
• Clarity (turbidity): clear is normal; bacteria, blood, mucus, crystals can produce cloudy urine.
• Odor: E. coli can cause foul odor, diabetes can cause sweet, fruity odor.
• Specific Gravity: indicates how well the kidneys are able to adjust the level of water in urine.
• pH: urine pH may be adjust by certain types of treatment, e.g. in prevention of kidney stones.
• Protein: none is normal, protein can be caused by exercise, fever, pregnancy or kidney disease.
• Glucose: none or little is normal, higher levels can be due to diabetes or kidney problems.
• Nitrites: presence may indicate urinary track infection (UTI).
• Leukocyte esterase: detect WBC & may indicate UTI.
• Ketones: large amounts could indicate diabetic ketoacidosis; also low carb diet can cause this.
• Red or White Blood Cells: normally not in urine, requires follow-up to determine cause.
• Casts: presence may indicate kidney disease.
• Crystals: large amounts may indicate kidney stones, metabolism problem.
• Bacteria: normally none, presence may indicate infection.

For more Information on any of your lab test results

• Consult your physician
• Review the information on the independent, non-profit web site: labtestsonline.org.

These are not intended as diagnostic comments, but only to give you sufficient information for further discussion with your physician. It is important that you promptly consult your physician regarding any abnormal findings.

codes: 804500, 120766, 322000, 005009,003772

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