What is special about the cholesterol and heart disease prevention service at London Medical?

We first investigate your risk as your treatment needs to be tailored to the extent of your arterial disease and the threat of an early cardiovascular event. We do this using a combination of advanced lipoprotein analysis using nuclear magnetic resonance spectroscopy (NMR) to obtain particle numbers of total LDL and HDL cholesterol and the particularly atherogenic small dense LDL particle numbers as well as the increasingly important lipoprotein (a) particle numbers. Inflammatory markers include the high sensitivity CRP, the myeloperoxidase and the Lp-PLA2. We use Europe’s first 3D ultrasound probe to quantify the volume of plaques seen in the common carotid arteries and define the intima media thickness, a measurement we pioneered in the UK and which is the gold standard for assessing the progression or regression of atherosclerosis with time. We also get information from the coronary artery calcification score. Using this information, and with the help of specialist dietitians, a full array of cardiac tests, expert consultant cardiologists, vascular surgeons, diabetes consultants, and fantastic new drugs for lowering cholesterol including the PCSK9 inhibitors, we can demonstrate regression and improvement in the cardiovascular outlook for many of our patients at high risk. Patients who have difficulty or side effects taking statins have access to expertise for gene testing and alternative therapy. Treatment to reduce the risk of heart disease needs to be formulated specifically to an individual’s metabolic status.

We get quantitative measures of risk using imaging with a unique intima media and 3D plaque carotid ultrasound study and the coronary artery calcification score. We then integrate this information, including rates of progression or regression of atherosclerosis using regular data from monitoring, with family history, smoking history, menopausal status, weight, blood pressure and the presence or risk of diabetes to help arrive at a treatment recommendation more appropriately linked to risk.