Molecular biologists and cardiology researchers are uncovering heart threats all the time. These four are among the most proven, and powerful, attackers.
At higher-than-normal levels, this amino acid — created when the body breaks down proteins in the foods you eat, especially animal proteins — is related to a doubled risk of coronary heart disease. A Norwegian study of 587 women and men with heart disease found that mortality risk was eight times higher in people with high homocysteine levels compared with those with low levels of homocysteine.
The big, unanswered questions: Does hyperhomocysteinemia cause or contribute to heart disease, or is it simply a marker for some other condition? Does lowering it cut risk? Homocysteine may damage artery linings and promote blood clotting, but even the American Heart Association says there’s not enough evidence yet to link it with heart disease — or to recommend trying to reduce it. Normally, your body uses folic acid and vitamins B6 and B12 to break down homocysteine for use as energy. While supplemental folic acid and B vitamins break down more homocysteine, it’s too soon to recommend taking higher amounts than those in a good multivitamin and the foods you eat. Folic acid is now added to wheat flour in the United States and is found in citrus fruits, tomatoes, and veggies.
Are you at risk? Most insurance companies won’t cover the tab for a homocysteine screening test, and most of us don’t need one anyway. However, if you have a personal or family history of heart disease yet lack any traditional risk factors, it may be worth a check.
A renegade variation of LDL cholesterol, Lp(a) is an organic compound found in the bloodstream that can be a trouble- maker for your heart. The particles have cholesterol cores and are robed in a sticky protein coating that seems to promote blood clotting. Lp(a) also binds LDLs more easily to artery walls, hastening the formation of plaque. High Lp(a) is an important risk factor for early atherosclerosis — over 10 years, it increases your heart risk by 70 percent, and it can exist in people with otherwise normal cholesterol levels. While there’s not yet a treatment, knowing you have Lp(a) could spur you to compensate by taking heart-smart lifestyle steps.
Are you at risk? Lp(a) seems to be genetic, although in women, higher levels may be tied to higher body weight. If you have a family history of heart disease, ask your doctor about getting tested. While there’s no standardized healthy level of Lp(a), one large study found that levels above 30 mg/dl doubled heart attack risk for women.
This tiny molecule is a big player in heart health: It keeps blood vessels relaxed, which maintains healthy blood pressure, and discourages atherosclerosis by making artery walls more like Teflon so that white blood cells and clot-producing platelets can’t stick. Nitric oxide, or NO, also suppresses overgrowth of muscle cells in artery walls, which keeps blood vessels from thickening, and it helps cut production of free radicals. NO is found throughout the animal and plant kingdom. It’s the chemical trigger that makes lightning bugs flash their yellow-green lights on summer nights. Eating foods rich in arginine (NO’s building block), such as beans, fish, nuts, and soy, can boost NO production, as can cutting back on saturated fat and getting up off the couch.
Are you at risk? Your artery linings produce their own supply of NO. If the lining’s not healthy, production drops. (Another link: Low NO may be associated with higher levels of inflammation.) There’s currently no widely available lab test for NO levels, but it’s a good bet you aren’t producing as much as you could if you are overweight, inactive, or a smoker, or if you have high levels of cholesterol, homocysteine, and/or Lp(a).
Apo(a) and Apo(b)
Think of apo(a) — a protein transporter that often ferries HDLs through the body — as the white hats and apo(b), which sometimes transports LDLs, as the black hats. You want more a’s and fewer b’s. One major study found that low a’s and high b’s upped the chances of a second heart attack. Researchers suspect these fat-plus-protein particles may be better predictors of heart risk than traditional cholesterol numbers.
Are you at risk? There’s no widely used lab test for this emerging risk factor, either, but doctors are beginning to suspect that it may be a powerful predictor of heart health in women and in people with high triglycerides.