The Sinatra Smart Zone Scores for Heart Disease Tests

Find out the Sinatra Smart Zone values you should aim for during your heart disease screening

Undergoing the right combination of tests to evaluate your risk of heart disease is key to maintaining optimal heart health. But once you’ve had those tests, particularly your blood workups, you need to know what your scores mean in terms of your heart disease risk. So here I’ve included a summary of the tests likely to be part of your blood workups, along with my suggested optimum scores, which I refer to as the Sinatra Smart Zone.

The Sinatra Smart Zone is what I consider to be a safe zone in terms of preventive cardiology and smart-medicine practice. When I tailor individual action plans to minimize heart disease risk, the Sinatra Smart Zone is my goal. These test scores are usually consistent with what you see as “better than normal” values from the particular lab that you used.

Along with my suggested Sinatra Smart Zone test values, the following summary includes a brief list of interventions you and your doctor can discuss and select from if your scores don’t fall within the healthy range.

I encourage you to put this information to work for you. Print it out, fill in your own scores in the space provided, and track your progress against the Sinatra Smart Zone for optimal heart health.

Sinatra Smart Zone

CoQ10 CRP Ferritin Fibrinogen Homocysteine Lp(a) Total Cholesterol HDL LDL

Triglycerides AA/EPA Ratio Fasting Blood Sugar Fasting Insulin Hemoglobin A1C TSH VLDL3 HDL2 HDL3

CoQ10

Your Level:

Healthy Zone: 1.0–1.8 ug/mL

My Healthy Soutions: Hydrosoluble CoQ10 50–100 mg. Therapeutic doses are higher. Aim to reach or improve these CoQ10 blood levels when the following medical conditions are present: 2.0–2.5 ug/mL if you have high blood pressure, mitral valve prolapse (MVP), arrhythmia, diabetes, or periodontal disease; 2.5–3.5 ug/mL if you have mild to moderate congestive heart failure (CHF), chronic fatigue syndrome, or angina;> 3.5 ug/mL if you have severe CHF or are waiting for a heart transplant.

Back to Top

CRP

Your Level:

Healthy Zone: <0.8 mg/dL

My Healthy Solutions: Statin drugs. Exercise. Low-dose aspirin. Fish oil, 2 g. Antioxidants with mixed forms of vitamin E. Nattokinase, 100 mg. Hydrosoluble CoQ10, 50–100 mg.

Back to Top

Ferritin

Your Level:

Healthy Zone: Women <80 ug/L; Men <90 ug/L

My Healthy Solutions: If more than 100 ug/L, donate blood one to three times a year. Do not take more than 500 mg vitamin C a day until your ferritin level has decreased. If your level is more than 400, ask your doctor to check you for genetic hemochromatosis.

Back to Top

Fibrinogen

Your Level:

Healthy Zone: 180–350 mg/dL

My Healthy Solutions: Fish or squid oil, 1–2 g. Garlic or bromelain 500–1,000 mg. Drink ginger and/or green tea. Nattokinase, 100 mg.

Back to Top

Homocysteine

Your Level:

Healthy Zone: 7 to 10 umol/L

My Healthy Solutions: Folic acid, 800 mcg. Vitamin B6, 40 mg. Vitamin B12, 200 mcg. For individuals with genetic defects in folic acid metabolism, use Metafolin, a patented and highly absorbable form of folic acid. Eat more beets, broccoli, and garlic.

Back to Top

Lp(a)

Your Level:

Healthy Zone: <30 mg/dL (Standard blood test) <10 mg/dL (VAP test)

My Healthy Solutions: Niacin, 250–500 mg three to four times daily (it may cause facial flushing). Vitamin C, 500–1,000 mg or more. Fish oil, 1–2 g. Nattokinase, 100 mg. Avoid foods with trans fatty acids. Women: Consider natural estrogen. Men: Avoid soy and consider testosterone. Bioidentical estrogen and testosterone lower Lp(a).

Back to Top

Total Cholesterol

Your Level:

Healthy Zone: 180–250 mg/dL

My Healthy Solutions: Reduce weight. Exercise. Increase fiber. Eat plenty of vegetables, and avoid sugar and high-glycemic foods. Eat a diet designed to lower cholesterol. Chromium, 200 mcg. Hydrosoluble CoQ10, 90–120 mg. Tocotrienol (a form of vitamin E), 50–100 mg. Garlic 400–800 mg. Plant sterols (phytosterols), 500–1,500 mg. Probiotics (healthy bacteria supplement). Flax, 2 Tbsp crushed flaxseed a day in a shake with 8 oz rice or goat milk, or sprinkled on cereal or salad for fiber. Promotes bowel movements that carry cholesterol out of the body.

Back to Top

HDL

Your Level:

Healthy Zone: Women 40–120 mg/dL; Men 35–120 mg/dL

My Healthy Solutions: Assess for insulin resistance if HDL is low. Reduce weight. Exercise. Eat fewer high glycemic carbohydrates. Niacin, 500–1,000 mg. L-carnitine 500–1,000 mg. CoQ10 50–100 mg.

Back to Top

LDL

Your Level:

Healthy Zone: 80–140 mg/dL

My Healthy Solutions: See Total Cholesterol above. LDL greater than 130 in presence of documented coronary artery disease in men ages 50–75 indicates that statin therapy is needed.

Back to Top

Triglycerides

Your Level:

Healthy Zone: <100 mg/dL

My Healthy Solutions: Weight reduction. Exercise. Restrict carbohydrates. Fish oil, 2–3 g. L-carnitine, 1–2 g. Reduce alcohol intake.

Back to Top

AA/EPA Ratio

Your Level:

Healthy Zone: 1.5–3.0

My Healthy Solutions: A score greater than 3 indicates the presence of inflammation. The higher the number, the more inflammation. If your omega-6 to omega-3 fatty acid ratio is too high, as reflected by the levels of arachidonic acid (AA) to eicosapentaenoic acid (EPA), then there’s not enough anti-inflammatory EPA in the body to neutralize the pro-inflammatory AA. I see very unhealthy scores, sometimes as high as 20. Take 2–3 g of fish oil daily to help neutralize inflammation. In some cases, more may be needed.

Back to Top

Fasting Blood Sugar

Your Level:

Healthy Zone: <95 mg/dL

My Healthy Solutions: Weight loss. Exercise. Restrict carbohydrates, especially sugary, high-glycemic carbs. Eat lower-glycemic carbohydrates, such as broccoli, chick peas, or lentils, to lower insulin levels. Specific supplements: alpha lipoic acid, 100–300 mg; hydrosoluble CoQ10, 60–90 mg; cinnamon, 1,000 mg; gymnema leaf extract, 200–400 mg; chromium picolinate, 100–200 mcg.

Back to Top

Fasting Insulin

Your Level:

Healthy Zone: <17 uU/mL

My Healthy Solutions: See Fasting Blood Sugar above.

Back to Top

Hemoglobin A1C

Your Level:

Healthy Zone: <6% of total HGB

My Healthy Solutions: See Fasting Blood Sugar above. If weight reduction, exercise, and supplements do not improve percentage, consider pharmaceutical therapy. Ask your physician about Metformin, a glucose-lowering medication.

Back to Top

TSH

Your Level:

Healthy Zone: 0.1–2.8

My Healthy Solutions: This test will help determine if your thyroid is working properly. If you’re not in the healthy range, work with your doctor to manage the situation.

Back to Top

Additional values identified by the Vertical Auto Profile (VAP) test that I regard as healthy:

VLDL3

Your Level:

Healthy Zone: <10 mg/dL

My Healthy Solutions: See Total Cholesterol.

Back to Top

HDL2

Your Level:

Healthy Zone: >25 mg/dL

My Healthy Solutions: See Total Cholesterol.

Back to Top

HDL3

Your Level:

Healthy Zone: >15 mg/dL

My Healthy Solutions: See Total Cholesterol.

Back to Top

More Dr. Sinatra Advice on Heart Disease Tests

What other heart disease tests should you consider? Get information on the array of heart disease tests I use when evaluating and treating my own patients.

Want to read detailed questions and answers about different heart disease tests? Check out the Q&A section of my Heart Disease Tests Health Center.