The Real Risk Factors for Heart Disease

Monday, April 13, 2009 by Stephen Sinatra
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.

Comments for The Real Risk Factors for Heart Disease

Tuesday, June 9, 2009 by kathy phillips:
I read Dr. Sinatra's newsletter about low homocysteine. I am low and have been on Dr. Robert's website as Dr. Sinatra recommends. I would like to know more about the diet Dr. S recommends for this. And any other insights.
Monday, June 22, 2009 by Dr. Sinatra:
Kathy, the diet mentioned in the newsletter is extremely difficult to follow. I am doing it myself for my own low homocysteine level, as is Dr Roberts. This exclusion-type of eating involves dodging foods that interfere with the complex biochemical pathway involved in low homocysteine. You must avoid sulfites, just as you would if you had a sulfite allergy. Sulfites are everywhere--in wines (even organic ones), baked goods, condiments, junk foods, dairy product substitutes, regular and dried fruits and vegetables, fish and shellfish, grains and pastas, jams and jellies, nuts and nut products, and plant protein products like soy. So, start by reading labels on products you have at home, as well as those you plan to buy. Select the ones that do not list sulfite ingredients. You must also limit, as much as possible, sources of methionine (an amino acid) which are found most abundantly in products from red meat (veal, beef, lamb, game meat, and poultry), sausage and luncheon meat, finfish and shellfish, and ethnic foods. Other foods have lesser amounts. You can Google Web sites for long lists of foods with these ingredients. Essentially, fresh organic produce is the foundation for my diet now. Obviously, there needs to be a better way. Right now I am investigating energy medicine solutions, like bioacoustics, that have the potential to use vibrational frequencies to bypass some of the biochemical pathways involved--similar to how the TENS units block pain pathways. I’ll keep you informed in the newsletter.

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