Did you know that in 2004, 1152 people each day had a potentially fatal heart attack despite their cholesterol levels being normal?
The following is a guide to extra tests for independent heart disease risk factors not normally tested for, as well expert recommended protocols for each factor. These are all simple tests that can be carried out through your physicians office. It is worth finding out if you might be at risk.
Risk Factor: Homocysteine
What: Homocysteine is a toxic type of protein, produced in the body from methionine, found in high levels in animal proteins, before being ‘methylated’ or converted to safer substances. This conversion requires a combination of B-vitamins, the mineral zinc, and choline. Homocysteine causes its deadly effects through damaging the lining of the blood vessels leading to the heart, damaging cholesterol in the artery wall, increasing inflammation and promoting abnormal blood clotting.
Why Test?: To reduce the risk of a heart attack, homocysteine levels should ideally be 8 nmol/L or below. According to a study in the New England Journal of Medicine, if your score is 8, you are nearly seven times less likely to die of a heart attack or other cardiovascular complications than if your score is 15 or above! Some otherwise healthy people have a genetic alteration that raises their risk even higher; only by testing will you know if this is you.
What to do if your score is high: Depending on how high the homocysteine level is, doctors recommend taking a combination of vitamins B2, B6, B12, folic acid, zinc and choline (in the form of betaine or TMG).
Risk Factor: C-Reactive Protein (CRP)
What: CRP travels through the bloodstream, stirring the immune system into producing an inflammatory response, a response that, again, damages the artery wall, promotes blood clotting and also contributes to rupture of coronary plaque. This is the moment before a heart attack when plaque is pushed into the artery causing a potentially fatal blockage.
Why Test?: Even when cholesterol levels are normal to low, a high CRP level will increase your risk of a heart attack by a factor of between three and six.
What to do if your score is high: Experts say the fish oils EPA and DHA at 1-2g daily and vitamin E (200-400 IU) will help to control high CRP levels.
Risk Factor: Fibrinogen
What: Fibrinogen is another protein, produced by the liver, levels of which in the blood have a crucial impact on blood clotting. Too much fibrinogen can cause blood clot formations that precede a heart attack or stroke. Think about those runners that you hear of having had an unexplained heart attack, despite being apparently fit and healthy. This is likely to be caused by an abnormal clotting response to the small abrasions that occur during a run, with elevated fibrinogen a possible culprit.
Why Test?: The huge Physicians’ Health Study found that physicians with a fibrinogen levels higher than 343mg/dL were at a doubled risk of a heart attack compared to those whose levels were lower. In another study fibrinogen was found to be the best predictor of the risk of dying bar none, following a heart attack.
What to do if your score is high: Doctors recommend fish oils (EPA and DHA) at doses of 3000mg daily and vitamin C at 2000mg daily in divided doses. Olive oil has also been shown to lower fibrinogen levels.
Risk Factor: Lipoprotein(a) (also called Lp(a)).
What: Some scientists theorise that the illness is caused by a deficiency of vitamin C in the artery wall, leading to lipoprotein deposits and, eventually, plaque build-up (“clogged arteries”) and a heart attack. Although this single-cause theory has not been validated, Lp(a) is certainly a serious marker to consider when looking to lower heart attack risk.
Why Test?: Lp(a) is not only a risk factor in itself, being a cause of the build-up of plaque deposits in the artery wall, it also increases the susceptibility of being effected by other risk factors. According to an article in the Journal of the American Medical Association Lp(a) levels below 30mg/dL are known to significantly reduce the risk of a heart attack.
What to do if your score is high: Experts say eating nuts and seeds daily, particularly almonds and flaxseeds, as well as taking vitamin C at 2000mg in divided doses and 2000mg of L-Carnitine, again in divided doses, will help to reduce elevated Lp(a) levels.
Risk Factor: Low testosterone
What: Many people associate testosterone with bodybuilders taking steroids, but adequate natural levels of testosterone are also crucial for normal heart muscle function.
Why Test?: Testosterone levels begin to decline rapidly after the age of around 40. In one study, published in the journal Metabolism, researchers measured blockage in the coronary artery (the main vessel supplying blood to heart) and found that low testosterone levels were stronger predictors of this bloackage than blood pressure, cholesterol, diabetes or smoking.
What to do if you score is low: Some physicians recommend the use of medical testosterone patches. Others recommend herbs such as muira puama, which gently inhibit the enzyme that prevents testosterone from being broken down in the body.
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