February 2008
Assess your risk for heart attack
Apply the results to your heart-disease prevention program
The first step in protecting yourself is determining your individual risk. If you don’t have a known heart condition, you
should have your risk factors assessed by a doctor every five years beginning at age 20.
He or she will probably help you determine your blood pressure and cholesterol levels, as well as ask you questions about other issues related to your heart health—family history, habits, symptoms, and more.
With your blood pressure (diastolic and systolic) and cholesterol (total, LDL and HDL), you can determine how likely you are to have a heart attack within the next 10 years, using the cardiac risk assessment tool developed by the National Heart, Lung, and Blood Institute.
Armed with the results of these tests, you’ll be able to tailor an individualized heart-disease prevention program based on the information on the prevention and management articles listed at left.
Other tests to consider
Half of the people who develop coronary disease have none of the common risk factors, according to a special article in The New England Journal of Medicine. The finding that so many “low-risk” people get heart attacks anyway has set off a search for other factors.
Here are some tests you may consider:
C-Reactive Protein (CRP)
Though chronic inflammation usually produces few obvious symptoms, it’s known to be an important risk factor for heart disease as well as cancer and other devastating illnesses. Doctors use an inexpensive blood test for CRP to gauge the degree of inflammation within blood vessel walls: the higher the level of CRP, the greater the inflammation and the greater the risk for heart disease—even for people with normal cholesterol levels.
Make sure your doctor orders the high-sensitivity (hs-CRP) test, the version used in clinical trials assessing heart risk. A CRP level under 2.5 milligrams per deciliter is considered normal. A level above 3 mg/dl may justify an aggressive approach to lowering “bad” LDL cholesterol, another marker for heart disease.
For more advice, click Control inflammation.
Homocysteine
A diet low in vitamins B6, B12, and folic acid can elevate the blood level of the amino acid homocysteine, as can other causes such as kidney disease and a genetic defect. Such an elevation may indicate vitamin B12 deficiency and may also be a marker for clogged arteries and blood clots, increasing the risk for heart attack and stroke.
Consider asking your doctor about a blood test for homocysteine if you have a personal or family history of coronary disease but none of the usual risk factors, or if you have standard risk factors but it’s unclear how aggressively to treat them.
Boosting the intake of vitamins B6, B12, or folic acid, sometimes through diet alone, can lower elevated homocysteine. For advice about vitamin B supplements, click Eat a heart-healthy diet.
Uric acid
When uric acid accumulates in the blood as a result of an inherited metabolic disorder, chronic kidney disease, or the use of thiazide diuretics, the result is often gout, a painful joint disease. But observational studies have also linked above-normal blood levels of uric acid with an increased risk of cardiovascular death.
While the connection between uric acid and heart disease is unclear, a uric-acid test is usually part of a routine blood profile. Next time your doctor does it, pay attention to the results.
Blood glucose
Screening for sugar in your blood can detect diabetes or pre-diabetes, both major risk factors for cardiovascular disease.
Everyone should have a periodic fasting blood-glucose test. Our medical consultants recommend testing every three years, starting at age 45. People with risk factors for diabetes, such as obesity or a family history of the disease, should undergo annual testing at younger ages.
For more advice, click Be vigilant about blood sugar.
Iron overload
Iron tends to accumulate in the bodies of men and, to a lesser extent, of postmenopausal women, and can theoretically increase the risk of heart attack and stroke. Some, though not all, epidemiological studies have supported that theory.
The serum iron test may help clarify cardiovascular risk in some individuals. People with elevated iron levels should be checked for hemochromatosis, a surprisingly common genetic disease that causes increased iron storage, which can damage several organs, including the liver and the heart.
He or she will probably help you determine your blood pressure and cholesterol levels, as well as ask you questions about other issues related to your heart health—family history, habits, symptoms, and more.
With your blood pressure (diastolic and systolic) and cholesterol (total, LDL and HDL), you can determine how likely you are to have a heart attack within the next 10 years, using the cardiac risk assessment tool developed by the National Heart, Lung, and Blood Institute.
Armed with the results of these tests, you’ll be able to tailor an individualized heart-disease prevention program based on the information on the prevention and management articles listed at left.
Other tests to consider
Half of the people who develop coronary disease have none of the common risk factors, according to a special article in The New England Journal of Medicine. The finding that so many “low-risk” people get heart attacks anyway has set off a search for other factors.
Here are some tests you may consider:
C-Reactive Protein (CRP)
Though chronic inflammation usually produces few obvious symptoms, it’s known to be an important risk factor for heart disease as well as cancer and other devastating illnesses. Doctors use an inexpensive blood test for CRP to gauge the degree of inflammation within blood vessel walls: the higher the level of CRP, the greater the inflammation and the greater the risk for heart disease—even for people with normal cholesterol levels.
Make sure your doctor orders the high-sensitivity (hs-CRP) test, the version used in clinical trials assessing heart risk. A CRP level under 2.5 milligrams per deciliter is considered normal. A level above 3 mg/dl may justify an aggressive approach to lowering “bad” LDL cholesterol, another marker for heart disease.
For more advice, click Control inflammation.
Homocysteine
A diet low in vitamins B6, B12, and folic acid can elevate the blood level of the amino acid homocysteine, as can other causes such as kidney disease and a genetic defect. Such an elevation may indicate vitamin B12 deficiency and may also be a marker for clogged arteries and blood clots, increasing the risk for heart attack and stroke.
Consider asking your doctor about a blood test for homocysteine if you have a personal or family history of coronary disease but none of the usual risk factors, or if you have standard risk factors but it’s unclear how aggressively to treat them.
Boosting the intake of vitamins B6, B12, or folic acid, sometimes through diet alone, can lower elevated homocysteine. For advice about vitamin B supplements, click Eat a heart-healthy diet.
Uric acid
When uric acid accumulates in the blood as a result of an inherited metabolic disorder, chronic kidney disease, or the use of thiazide diuretics, the result is often gout, a painful joint disease. But observational studies have also linked above-normal blood levels of uric acid with an increased risk of cardiovascular death.
While the connection between uric acid and heart disease is unclear, a uric-acid test is usually part of a routine blood profile. Next time your doctor does it, pay attention to the results.
Blood glucose
Screening for sugar in your blood can detect diabetes or pre-diabetes, both major risk factors for cardiovascular disease.
Everyone should have a periodic fasting blood-glucose test. Our medical consultants recommend testing every three years, starting at age 45. People with risk factors for diabetes, such as obesity or a family history of the disease, should undergo annual testing at younger ages.
For more advice, click Be vigilant about blood sugar.
Iron overload
Iron tends to accumulate in the bodies of men and, to a lesser extent, of postmenopausal women, and can theoretically increase the risk of heart attack and stroke. Some, though not all, epidemiological studies have supported that theory.
The serum iron test may help clarify cardiovascular risk in some individuals. People with elevated iron levels should be checked for hemochromatosis, a surprisingly common genetic disease that causes increased iron storage, which can damage several organs, including the liver and the heart.
