The ENDOTHELIUM Association
All heart attacks and most strokes are caused by a sick endothelium

A blood test that is often overlooked is the hsCRP (high sensativity) when blood tests are done.

C-reactive protein (CRP) measures inflammation.  Inflammation is part of what happens when the
endothelium calls in the white cells for help and the arteriosclerosis process starts.  The hsCRP can provide
a very good gauge of where you are at the present.  It can also be a very good gauge of how successful
your treatment is. Are the numbers better?  If you are on a diet, the hsCRP will tell you if you are on the
right diet.  If the hsCRP is not returning to normal, the diet needs adjustment,
 Cooke  Esselstyn  Sinatra

Endothelium testing should be as common as blood tests but it is not.  Most insurance companies do
not even cover it.  Non-the-less it is vital information you should have to understand your condition. If you
are doing anything less that making optimal life style changes, your life may well be at risk. You need to
have some idea of what is or is not working for you.

The best tests are located in research facilities where very sophisticated measurement can be done. If you
live in a research area, you may just be able to get into this high tech world.  

The noninvasive Endo PAT 2000 tests blood. Its working end slips over your fingers and tests the
elasticity of the blood vessels at the tip of your finger.  The more elastic your blood vessels,  the healthier
your endothelium is.  Unfortunately this machine is not in wide use. This machine has been tested at Mayo
and many other leading institutions around the world. The results that are reported by the machine are at
the subclinical level.  This enables you to take measures to reverse the degeneration of your endothelium
in an earlier stage well before a crisis. The down side is that as the arteries get stiffer with age, the reading
is distorted. Furthermore, the machine is not widely available.

A simple endothelial function test is used by Dr. Cooke at Stanford Medical School using ultrasound.  A
cuff is placed around the wrist and is inflated so the blood is cut off to the hand.  After five minutes the cuff
is deflated allowing the blood to rush into the hand.  The blood rushing back into the hand causes the
endothelium to make NO.  This causes the artery in the arm to expand. The expansion can be read by an
ultrasound giving you a direct measurement of NO production.

The ankle/arm test is widely used.  A  blood pressure test is made of the arm and the ankle.  The
difference in the reading between the two between the two is calculated.  This is a much more general and
less specific test but it does tests for peripheral artery disease.  If there is much difference, you have a
problem in the arteries to the legs and by inference the rest of your system is in difficulty.
  Cooke    Esselstyn   Sinatra

                    Cardiovascular tests

Electrocardiogram  (EKG) provide information on heart function.  Electrodes are placed on the chest that
provide information with every beat of the heart.  This is done both in a horizontal position and while you
walk on a treadmill.  The horizontal test provides physicians with base line information and the treadmill
shows the heart under stress.  A wide diversity of information is gathered.  Everyone with cardiovascular
problems needs to have them done just to understand your current situation.
 Cooke   Sinatra

Echo and radionuclide stress tests both provide more detailed information about  heart function for
analysis by physicians
Cooke   Sinatra

Carotid  Intima-media Thickness  (CMIT) is a test of the carotid artery using ultrasound or radiographic
technology.  This is some what controversial because all carotid thickening is not atherosclerosis.  This may
provide early warning for the rest of the arterial system and it may also provide information that will enable
physicians to forestall a stroke. .Though controversial, it is now recommended by the AHA.
Sinatra   Wikipedia

Cardiac troponin T, (cTnT), a new test for a cardiac protein in the blood, was found to provide an
independent confirmation of other diagnostic assessments of heart failure or of death in adults 65 or older.  
An increased level, 2 or 3 years after the first test, whether from undetectable to detectable or, when
detectable, to a higher number, indicates greater probability of heart failure or death.

Angiography, the “Gold Standard” for seeking out arterial narrowing, uses a thin tube that enters from
the groin and goes to the heart.  Once there a die that can be seen on an X-ray is injected. The X-ray
picture of the arteries can be very clearly seen.  This test is invasive and thus has a degree of risk
associated with it. Plaque, that is on the interior of the artery, can be knocked loose.  If that were to happen
and the plaque got stuck somewhere in the arterial system, it could be bad news.  
Cooke  Sinatra

This website does not provide medical advice.  The website is for information purposes only.
For medical advice, consult your healthcare provider