By James M. Rippe

Research continues to identify factors that may increase or decrease your risk for developing CHD. Among the many potential factors being researched, the following potential risks factors illustrate the type of inquiries. Because the following have received considerable media attention, discussing them with your physician may be worthwhile:

  • Homocysteine: Homocysteine is an amino acid that serves as a building block of proteins in the body. However, some studies show that elevated concentrations of homocysteine in the blood can be associated with increased risk of CHD. Currently, research also focuses on other chronic diseases for which homocysteine may be a marker.

    Fortunately, relatively simple measures, in particular making sure that your diet contains foods rich in folic acid (also referred to as folate), can reduce elevated levels of homocysteine. The recommended daily value is 400 micrograms of folate per day. Good food sources of folic acid include fruits, green leafy vegetables, tomatoes, whole grains, and low-fat dairy.

    Although daily consumption of 400 mcg of folic acid may be a reasonable health decision where the risk of developing heart disease is concerned, it is absolutely mandatory for women of childbearing age, because it helps prevent birth defects related to brain and spine development, including spina bifida. Discuss this issue with your doctor.

  • Low levels of antioxidants in the blood: In recent years, antioxidants have been hyped by the popular media as the cure du jour for several conditions, including risk of heart disease. Several studies have supported the concept that low levels of antioxidants in blood may increase the risk of developing CHD.

    These findings have led to clinical trials of supplementary antioxidants such as vitamin E, vitamin C, and/or beta-carotene (vitamin A). Results of trials to date do not confirm any benefit for supplementation of vitamins E and C, and some findings indicate potential harm from beta-carotene supplementation. Current advice is to turn first to whole foods as the best source for antioxidants and to discuss the issue with your doctor about what is right for you.

  • Abnormal blood clotting: Substantial evidence has emerged indicating that how your blood clots is part of the process of acute coronary heart disease. Certain rare clotting abnormalities clearly increase the risk of coronary heart disease for some individuals. But at this time, using blood-clotting parameters to determine an individual’s risk of developing heart disease is highly experimental. If you have questions about whether this rare problem relates to you, discuss it with your physician.

  • Markers or factors for specific heart conditions: Beyond continuing research on the contribution of major risk factors to heart disease, some of the most promising current research concerns identifying specific markers, or factors that may indicate an increased risk of developing a specific condition or event. In addition to discovering how such markers work physically, researchers are exploring the potential clinical use of such markers to help diagnose and treat patients.

    The following examples give you an idea of the nature and promise of such research:

    • Elevated C-Reactive Protein: Elevated blood levels of C-Reactive Protein (CRP), a marker that increases during systemic inflammation (inflammation that affects the whole body), are associated with increased heart attacks and other heart events caused by blood clots. Studies consistently show that higher levels of CRP predict a higher risk of heart attack.

      High CRP is associated with the increased occurrence of new heart events and a lower survival rate in individuals who have unstable angina or have had a heart attack. CRP may also prove useful in predicting a higher risk of heart attack for healthy individuals who don’t have elevated cholesterol or CHD symptoms.

      In addition to broadening the populations studied beyond men and women of European heritage, ongoing research continues to explore ways in which CRP levels may provide indicators that are useful in preventing, diagnosing, and treating various manifestations of cardiovascular disease.

    • Lp(a) cholesterol: This genetic variation of LDL cholesterol (the bad guys) is clearly associated with a greater risk of prematurely developing CHD. Research into how this marker may be useful diagnostically is one aspect of ongoing research.

    • Factor V Leiden: About 2 to 7 percent of persons of European descent have this variation of the factor V gene, a variant that promotes the formation of blood clots in blood vessels. Persons with V Leiden are at greater risk of developing heart attack, stroke, and deep vein thrombosis. But risk among individuals with this variant appears to vary widely. Current research into gene modifiers is exploring ways to accurately identify individuals who are at greatest risk.