Myocardial infarction is the medical term used to describe a heart attack. “Myo” means muscle, “Cardial” refers to the heart, and an infarction is death due to lack of blood supply. Thus, the term means death to heart muscle due to a lack of blood flow.

The vessels that supply the heart with blood are called the coronary arteries. One of these arteries is pointed out in the picture to the right. When this artery becomes blocked, the muscle looses its blood supply and begins to die. If a large enough portion of heart muscle dies, you will not survive.

In addition to heart attacks, the other major cardiovascular concern deals with stroke. A stroke is caused when a plaque or clot within you blood vessels breaks loose. When this clot make it to your brain it causes a disruption of blood flow. The brain cells quickly lose function and die. This is called a stroke.

Scientific research has identified a number of risk factors for heart disease and stroke. Many of these have become household names to most of us. These include elevated cholesterol, high blood pressure, smoking, and obesity just to name a few.

The vast majority of consideration for treating cardiovascular disease has been given to cholesterol. Cholesterol has been demonized beyond belief and is the main topic of conversation when you go to your doctor for a general physical exam. Those of you who are familiar with my writings know that I strongly feel that the cholesterol picture has been blown way out of proportion. I strongly urge you to read Cholesterol: Angel or Devil, which can be found on www.ZimmerNutrition.com, to get further information about this important molecule.

Cholesterol considerations are not by any means the only important factors to consider when trying to reduce your risk of a cardiovascular event. Statistics show that almost 50% or one-half of all cardiovascular events occur in people with normal to low cholesterol. It makes good sense, then, that whatever is causing the events in the 50% with normal cholesterol can be having an effect in those with elevated cholesterol. Cholesterol is obviously not the only game in town.

I want to introduce you to a risk factor for cardiovascular disease that you may not have heard of until now. The risk factor is the amino acid known as HOMOCYSTEINE (hōmō-sis-tēēn). I guarantee that if you have not yet heard about homocysteine as a major risk factor for cardiovascular disease, you will in the very near future. Many studies show that homocysteine is an important risk factor for cardiovascular disease. In fact, it may prove to be as important as cholesterol, high blood pressure, or obesity in some people.

Homocysteine is produced in your body as a by-product of the metabolism of another amino acid known as Methionine. If you would like to know the chemistry behind the making of homocysteine, give me a call and then call your counselor. You need help.

Joking aside, homocysteine can be very toxic to your cardiovascular system. It has been shown to damage arteries in a number of ways. This damage leads to atherosclerosis which is the thickening of artery walls. When this occurs in the coronary arteries, your risk for a heart attack is greatly increased because the blood flow to heart muscle can be significantly decreased. When this occurs in the brain, your risk of stroke has significantly increased.
Because of these risks, your body can naturally rid itself of homocysteine in a number of ways. These pathways of changing homocysteine into other non-harmful substances rely heavily on three B-vitamins. These are folic acid, vitamin B-12 and vitamin B-6.

This is the exciting news about controlling homocysteine levels in your blood. Treatment does not rely on some potentially harmful pharmaceutical drug or complicated medical regimen for correction. Supplementation with folic acid, vitamin B-12, and/or vitamin B-6 in most cases will bring levels into the normal range.

In light of the above information, the question that begs to be answered is why routine blood tests do not include measurements for homocysteine levels. The answer is that modern medicine reacts very slowly to implementing procedures for what they consider to be newer information. The fact that I completed my Master’s thesis on cardiovascular disease and homoscyteine almost a decade ago attest to the fact that this is not newer information.

I also believe that there is another reason for the lack of testing for homocysteine and its slow rise to attention among doctors. I can best illustrate this reason by asking one question. What drug can you take to reduce your levels of homocysteine? The answer is NONE and there never will be one. That is because the basic B-vitamins do the job exceptionally well without side-effects. Since doctors get the vast majority of their knowledge and procedures from the pharmaceutical industry, they are way behind in their knowledge of risk factors that do not have drugs available for their treatment.

The fact that doctors do not give this amino acid attention, however, does not diminish the importance of testing for homocysteine levels in persons with high cardiovascular disease risk. Studies show that you are at risk for high levels of homocysteine in your blood if you smoke, drink coffee or alcohol, if you are a male or a female past the age of menopause, or if you have diabetes. You may, however, have elevated levels of homocysteine even if you are not included in any of the above categories due to genetics.

My strong suggestion to you is to make sure that your doctor includes an order for homocysteine in his/her order for your next blood test. There are no special procedures that have to be done.

I will give you one warning about how homocysteine levels are reported. The upper range of normal accepted amounts of homocysteine is 13. The experts who study homocysteine universally agree that this number is way too high. Do not accept an answer of your levels were normal from your doctor. Find out what the number was. I like to see levels below 10 in healthy individuals and below 8 if you have any cardiovascular concerns or neurological problems.

In addition to homocysteine, there is another risk factor that can be measured in your blood called highly sensitive C-reactive Protein (hs-CRP). It is also known as Cardio CRP. This is a protein released into your blood when there is inflammation occurring within the body. New studies suggest that hs-CRP may be a more important indicator of potential cardiovascular events than the dreaded “bad cholesterol”, LDL. Your level of hsCRP should be below 1.0 mg/L.

It is interesting that doctors are much more aware of hs-CRP as a risk factor than they are with homocysteine. I believe that one of the reasons is that statin drugs which lower cholesterol have also been shown to decrease hs-CRP. In fact, many experts believe that it is this quality of statin drugs that show the most benefit in the prevention of cardiovascular disease. I guarantee you that your doctor’s pharmaceutical representative has made your doctor aware of this statin benefit.

However, hs-CRP can be reduced naturally by eating a diet high in fresh fruits and vegetables. It can also be reduced by taking a combination of antioxidant supplements.

In addition to homocysteine and hs-CRP, it is important for you to have your insulin levels checked. This does not include simple glucose tests which are included in a normal blood panel. The reason is that insulin may be high while glucose levels are normal. High insulin coupled with high triglycerides and low HDL suggests a condition known as Metabolic Syndrome. This syndrome significantly increases the risk for heart disease. It is missed in many patients simply because doctors only look for high glucose instead of high insulin.

So, to summarize, the risk factors for cardiovascular disease go way beyond cholesterol. Surprisingly, doctors continue to ignore the many other risk factors for these deadly diseases without good reason. It is up to you to take charge of your own health. Start by asking your doctor to include testing for homocysteine, hs-CRP, and insulin in addition to the normal cholesterol testing. This will give you a much more complete picture of your potential risks of developing one of the deadly cardiovascular diseases.

If you find out that you do indeed have elevations in any of these risk factors, it is time to make a change in your lifestyle. Start by increasing exercise, changing diet, and taking supplements. If need-be, consider taking drugs as a last resort.