If you want to learn your chances of suffering a heart attack, ask your doctor to draw blood for C-Reactive Protein (CRP), the good HDL and the bad LDL cholesterol, and small low-density lipoprotein, Lp(a). He or she will also check your blood pressure.

We used to think that heart attacks were caused primarily by plaques accumulating in arteries because of high cholesterol levels. Now we know that the inner lining of an artery must first be roughed up before plaques form, and infections are the most common cause of damaged inner linings of arteries. C-Reactive Protein is a blood test that measures inflammation or the swelling that occurs in arteries before plaques form. So C-reactive protein is one of the best indicators that a person is headed for a heart attack.

Blood cholesterol levels are still good predictors of heart attacks. Your bad LDL cholesterol should be under 100. If you have had a heart attack, your LDL should be under 70. Having high blood levels of a subfraction of the bad LDL cholesterol called small LDL increases your risk for a heart attack.

Lp(a) is a genetic disorder that causes clots to form and so is a cause of heart attacks, particularly in younger people (men under the age of 40 and women under the age of 60.)

If your C reactive protein is high, you may need to take Zithromax, Dynabec, or Biaxin for nine days. If your good HDL is low or your triglycerides are high, you need to restrict calories and any foods that cause a high rise in blood sugar, such as bakery products, pastas and sugar-added foods; and eat root vegetables and fruits only with other foods, not alone as snacks. You may also need to take medications. If your bad LDL cholesterol is high, you need to restrict saturated fats, partially hydrogenated fats and calories, and you may need to take medication. If your Lp(a) is greater than 40, you need to take the vitamin niacin after every meal in continually raising doses until your Lp(a) is below 40. Diet will not lower Lp(a). If your homocysteine is high, you need to avoid meat and poultry, and eat plenty of whole grains, leafy green vegetables. You can meet your needs for vitamin B12 with seafood and skim milk dairy products, or with B 12 pills. If homocysteine remains above 100, you may need to take folic acid, pyridoxine and B12 (readily available in combination pills such as Foltex or Fol-B.) A heart-healthy diet makes it possible for most people to control cholesterol and blood pressure without drugs; see Diet for Heart Health, Weight Loss and Diabetes Prevention/Control.

Checked 7/23/12