Note there are insurance companies that refuse to pay for cardiac risk factor testing on the basis that it is "experimental" or "investigational."

C Reactive Protein (CRP): This is a marker for inflammation. Usually it is used to assess inflammation in response to an infection. Many labs use a highly sensitive CRP that is useful in predicting a heart attack, vascular disease or stroke. The best treatment for a high CRP level has not yet been defined, although exercise, niacin, smoking cessation, the use of statin drugs, and weight loss all appear to improve CRP.

Homocysteine: Homocysteine is an amino acid that is normally found in small amounts in the blood. Higher levels are associated with increased risk of heart attack and other vascular diseases. Homocysteine levels may be high due to a deficiency of folic acid or Vitamin B12, due to heredity, older age, kidney disease, or certain medications. Men tend to have higher levels.

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Most lab normals are 4 - 15 micromole/l. If you have had previous vascular disease there may be recommended medications to reduce your homocysteine level below 10. You can reduce your homocysteine level by eating more green leafy vegetables and fortified grain products or cereals. The usual treatment is folic acid with or without Vitamin B-12.

Lipoprotein (a) or Lp(a): Elevated Lipoprotein(a) or Lp(a) concentrations are associated with premature coronary heart disease (CHD). The exact mechanism is not yet clear and preliminary research suggests that there is a strong genetic component to elevated Lp(a) levels that correlate with coronary disease. Those with diabetes and a high Lp(a) level appear to be at increased risk of asymptomatic coronary disease.

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