The Hidden Heart Risk: Why Lp(a) Should be Included in Your Lab Panel

Recently, we spoke with Dr. Fanny Elahi, a neurologist and member of Radence’s Clinical Advisory Board, about what early detection really means when symptoms have not yet appeared.

Her view was direct:

“I don’t think early detection is only valuable if we can do something about it. Detection with great precision in of itself has value.”

That challenges a common expectation that information only matters if it leads to an immediate intervention. Dr. Elahi framed it differently. Some people want the earliest possible insight, even when the science is still catching up to what we can change. Others do not. She described that as a personal choice about how someone wants to live with uncertainty.

In her words, it is not for everyone. And it should not be.

Dr. Elahi made an important distinction. Early detection is not simply finding disease earlier in the symptomatic phase.

She described the real frontier as preclinical detection. Detecting biological perturbations that may be associated with future loss of function, before someone is getting lost, struggling with memory, or unable to interact with the world the way they used to.

That shift changes the tools we rely on.

She pointed to several that are rapidly advancing:

She also emphasized that people have good days and bad days, and natural fluctuations in function. The goal is not to overreact to a single data point. It is to understand biology in context, across time.

A central theme in the conversation was that neurodegeneration is not just a brain story.

Dr. Elahi spoke at length about the role of vascular biology and the smallest blood vessels in the brain, and how age-related changes in vascular function can quietly accumulate over time. This is one reason her lab focuses on vascular pathologies. Her underlying point was simple: the health of the vasculature is deeply tied to the health of the organ it serves, including the brain.

She also noted that the field is moving beyond rigid diagnostic “buckets.” Her hope is for a future where biomarkers help identify precise biological perturbations, such as disruptions in lipid metabolism or immune function, and guide more personalized strategies for restoring balance and resilience.

One of the most human parts of the conversation was her perspective on aging itself.

Dr. Elahi drew a bright line between disease and normal evolution. Dementia and progressive brain degeneration are not acceptable outcomes. Those are problems to detect early and prevent where possible.

But she also challenged the idea that optimal aging means staying the same. She described looking forward to the ways the brain evolves with experience, and she rejected the cultural obsession with an “eternal 20-year-old brain.”

Her point was not that decline should be ignored. It was that sensitive tools will force more nuanced questions:

If you choose to engage in early detection, you are not committing to constant action.

You are choosing to see biology earlier, and to make decisions with more information over time.

Dr. Elahi’s perspective reinforces something we believe at Radence: as detection becomes more sensitive, interpretation matters more. The goal is not to chase every signal. The goal is to identify pathological perturbations early, understand what they may mean, and support thoughtful choices as science continues to progress.

How and whether you engage with uncertainty should always remain your choice.

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In today’s rapidly evolving medical landscape, physicians are increasingly called upon to balance innovation with evidence, patient expectations with system constraints, and emerging tools with deeply rooted traditions. For Dr. Julie Chen — a leader in genomic precision medicine, board-certified in internal medicine, and fellowship-trained in integrative medicine — that means reclaiming what medicine was always meant to be: comprehensive, compassionate, and grounded in science.

“We all went into medicine to help people heal,” said Dr. Chen. “But many of us find ourselves navigating systems that are optimized for disease management, not for prevention. That isn’t a personal failing. It’s a systems problem.”

Dr. Chen currently serves as Chief Medical Officer at Radence, a company pioneering a multimodal precision-based model of care. At its core, Radence seeks to identify and intervene on disease risk earlier than traditional models allow — not in response to pathology, but in anticipation of it.

“Most of what we see in chronic disease is not sudden,” Dr. Chen said. “It’s a long, progressive breakdown of physiologic resilience. Our job is to understand that trajectory and to act on it early, when the patient still feels ‘fine,’ but the biology is already shifting.”

Dr. Chen has tremendous respect for the goals of current conventional medicine. However, she sees it as incomplete.

“Our traditional system is remarkable at acute intervention,” she said. “But it’s less equipped to manage early disease interception of the slow-developing dysfunctions that characterize so many of our biggest health challenges — cancer, cardiovascular disease, neurodegeneration, metabolic dysfunction.”

She points to constraints many physicians know well: 15-minute visits, fragmented specialty care, limited tools for subclinical disease, and a reactive rather than predictive infrastructure.

“It’s not that doctors don’t care about prevention or early detection,” Dr. Chen said. “It’s that the system doesn’t always give them the time or tools to do it well.”

What Radence offers is a framework to augment what clinicians are already doing. Its platform brings together genomics, imaging, metabolomics, advanced blood work, and wearable data to generate a comprehensive picture of an individual’s health trajectory.

“We use high-resolution tools to pick up signals that traditional workups might miss. But more importantly, we translate those findings into real-world decisions. We help people understand their risk and take steps to modify it,” Dr. Chen said.

That process is deeply collaborative. Radence doesn’t seek to replace a patient’s care team. It works in partnership with referring clinicians, offering extended assessments and evidence-based recommendations that complement existing care plans.

“This is not about displacing primary care or specialists. It’s about supporting them with another layer of data and insight,” Dr. Chen said. “We know that no one understands the patient better than their own doctor. Our role is to enhance that relationship, not compete with it.”

One concern often raised about precision or concierge medicine is equity—that these models only serve the affluent. Dr. Chen sees this differently.

“Early adopters always pave the way for broader access,” Dr. Chen said. “Every major medical advance — from medications to whole-genome sequencing — started in specialized settings before becoming standard. What we’re building now will eventually become more scalable. But someone has to lead, and that’s where Radence comes in.”

To that end, the company is investing in outcomes research, clinical validation, and real-world evidence to support its protocols. “We’re not just innovating,” she said. “We’re validating. We’re contributing to the science so this model can expand.”

Despite Radence’s technological sophistication, Dr. Chen emphasizes that data is only as powerful as the context it’s given.

“We’re not just handing people dashboards,” she said. “We’re walking them through it. We pair high-resolution diagnostics with meaningful conversation. That’s where trust is built. That’s how change happens.”

The result is more than early detection testing. It’s engagement.

“When patients understand their physiology, when they see the why behind a recommendation, they are more likely to act,” Dr. Chen said. “We’re not just changing lab values. We’re changing behavior.”

Radence begins by focusing on the survival layer — the four disease categories responsible for the majority of premature mortality and morbidity: cancer, cardiovascular disease, metabolic dysfunction, and neurodegeneration. These are not isolated silos, Dr. Chen noted. They are deeply interconnected through shared pathways of inflammation, oxidative stress, metabolic regulation, and genetic risk.

“If you have insulin resistance, you’re not just at risk for diabetes. You’re at increased risk for dementia and cardiovascular disease,” she said. “We take a systems-level view of risk. That means we can intervene in ways that impact multiple domains simultaneously.”

From there, the platform expands to assess autoimmune risks, hormone regulation, immune function, and more.

“We meet the patient where they are, and then we grow with them,” Dr. Chen said. “It’s dynamic. It’s continuous. And it’s deeply personal.”

For Dr. Chen, one of the most innovative aspects of Radence is the partnership.

“We want to work with clinicians who are curious, collaborative, and committed to pushing the standard of care forward,” Dr. Chen said. “Whether you’re a cardiologist, internist, neurologist, or family physician, there’s a place for you in this model. We need your insight. Your experience. Your trust.”

She knows that change is never easy, especially in a field as high-stakes and evidence-driven as medicine. But she also knows that physicians are problem-solvers.

“We’re not asking people to abandon conventional care,” Dr. Chen said. “We’re inviting them to build on it. To extend it. To make it better.”

In an era where both patients and clinicians are demanding more — more answers, more support, more continuity, Dr. Chen sees Radence as a blueprint for what’s possible.

“This is the future of care: science-led, system-aware, patient-centered, and clinician-empowering,” Dr. Chen said. “We’re not starting over. We’re starting ahead.”