Undergoing the right combination of tests for heart disease to evaluate your risk is key to maintaining optimal heart health. But once you’ve had those heart 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 heart 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 heart 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 heart 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.
Coenzyme Q10 (CoQ10)
Heart Test Score: Healthy Zone: 1.0–1.8 ug/mL
My Healthy Solutions: 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.
Heart Test Score: Healthy Zone: <0.8 mg/dL
My Healthy Solutions: Exercise. Low-dose aspirin. Fish oil, 2 g. Antioxidants with mixed forms of vitamin E. Nattokinase, 100 mg. Hydrosoluble CoQ10, 50–100 mg.
Heart Test Score: 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.
Heart Test Score: 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.
Heart Test Score: 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.
Heart Test Score: 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, 50 mg, Boluoke from Canada if Nattokinase is not sufficient, one capsule twice a day. Avoid foods with trans fatty acids. Women: Consider natural estrogen. Men: Avoid soy and consider testosterone. Bioidentical estrogen and testosterone lower Lp(a).
Heart Test Score: 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 almond milk, or sprinkled on cereal with crushed nuts or on salad for fiber. I also like a tablespoon or two of chia seeds or organic psyllium. Promotes bowel movements that carry cholesterol out of the body.
Heart Test Score: Healthy Zone: Greater than 35 mg/dL and less than 95mg/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.
Heart Test Score: Healthy Zone: 80–140 mg/dL
My Healthy Solutions: See Total Cholesterol above. LDL cholesterol is not a problem unless it's oxidized. To prevent oxidation, avoid environmental toxins including sugar, processed foods and foods that contain high fructose corn syrup or preservatives.
Heart Test Score: Healthy Zone: <100 mg/dL
My Healthy Solutions: Weight reduction. Exercise. Restrict carbohydrates. Fish or squid oil, 2–3 g. L-carnitine, 1–2 g. Reduce alcohol intake.
Heart Test Score: Healthy Zone: 1.5–3.0
My Healthy Solutions: A heart test 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.
Fasting Blood Sugar
Heart Test Score: Healthy Zone: <90 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; citrus Bergamot, 500-1,000 mg.
Heart Test Score: Healthy Zone: <17 uU/mL
My Healthy Solutions: See Fasting Blood Sugar above.
Heart Test Score: 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.
Heart Test Score: Healthy Zone: 0.5–1.5
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.
Additional values identified by the Vertical Auto Profile (VAP) test that I regard as healthy:
Heart Test Score: Healthy Zone: <10 mg/dL
My Healthy Solutions: See Total Cholesterol. You can also add 1-2 g fish oil or Calamarine daily and 50-100 mg nattokinase.
Heart Test Score: Healthy Zone: >25 mg/dL
My Healthy Solutions: See Total Cholesterol.
Heart Test Score: Healthy Zone: >15 mg/dL
My Healthy Solutions: See Total Cholesterol.
VIDEO: Dr. Sinatra Debunks the Great Cholesterol Myth! What You Really Need to Know to Protect Your Heart
More Dr. Sinatra Advice on Tests for heart disease
What other heart 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 tests? Check out the Q&A section of my Heart Disease Tests Health Center.