The Real Risk Factors for Heart Disease

by Dr. Stephen Sinatra
Filed Under: Heart Health
Last Reviewed 02/06/2014

If you've read my recent posts about cholesterol, you probably have some questions. And the biggest one may be, "Doc, if cholesterol isn't dangerous, then what heart risk factors should I keep an eye on?" It's a good question--and one that anyone who wants to minimize their odds of developing cardiovascular problems should ask.

First off, I would say that you should address some basic lifestyle issues that have been shown to increase risk of heart attack and stroke. For example, if you smoke, stop. If you're carrying some extra weight, lose 5 or 10 pounds. When you shop for food, choose items that are fresh--not processed or prepackaged--and emphasize fruits, vegetables, whole grains, and healthy fats (essentials for good cardiovascular nutrition). Finally, make a habit of exercising regularly and finding healthy outlets for stress. If you're doing these things, then you're already managing some of the biggest risk factors that can lead to trouble.

As far as blood work goes, there are some specific blood components that I do recommend monitoring. All of them have a direct impact on cardiovascular health, and many of them won't cause any symptoms even when they're at troublesome levels. So, it makes sense to have your doctor measure them at least once a year. Here they are:

1. CoQ10. This naturally occurring compound is essential for cellular energy production, especially in the heart. Healthy zone: > 0.6 ug/mL.

2. C-reactive protein (CRP). The level of this protein indicates the presence of inflammation in the body. Healthy zone: < 0.8 mg/dL.

3. Ferritin. This substance reflects the amount of iron in your blood. Healthy zone: women, < 80 ug/L; men, < 90 ug/L.

4. Fibrinogen. This protein is converted into fibrin, which promotes healthy clotting. Too much fibrin thickens the blood and can lead to clots. Healthy zone: 180-350 mg/dL.

5. Homocysteine. This amino acid causes free radical damage to blood vessels and promotes inflammation. Health zone: 7-10 umol/L. (Having homocysteine levels of less than 7 can cause just as much harm as levels greater than 10.)

6. Lp(a). This highly inflammatory form of LDL cholesterol also contributes to the formation of blood clots. Healthy zone: < 30 mg/dL if measured using a standard blood lipid test; < 10 mg/dL if measured using a VAP or LPP test.

7. AA/EPA ratio. This is the ratio of inflammatory arachidonic acid to anti-inflammatory eicosapentaenoic acid in the blood. Its level also reflects the degree of silent inflammation in your body. Healthy zone: 1.5-3.0.

8. Fasting blood sugar. This is the measure of how much glucose (sugar) is in the blood at the time of sample collection. Healthy zone: <100 mg/dL.

9. Hemoglobin A1C (HbA1c). This is a form of hemoglobin (red blood cells) that has become glycated, or joined with a glucose molecule. This measures the average amount of sugar in your blood over the past 2-3 months and can be used to help diagnose insulin resistance. Healthy zone: < 6% of total HGB.

When considered as a whole, these heart risk factors can be used to more accurately determine your overall risk and to identify problems in need of intervention. Just be sure to tell your doctor that you want them tested before you have your blood drawn, because he or she may need to order additional tests. Not all of them are part of traditional lipid panels.

For more information on risk factors for heart disease, visit www.drsinatra.com.

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