Homocysteine:
Homocysteine is a naturally occurring amino acid. Homocysteine level can be measured in the blood. The relationship between coronary artery disease and homocysteine is not fully understood but homocysteine levels above 14 correlate to a higher risk of heart disease. Factors contributing to elevated homocysteine include inherited disorders, low vitamin B intake in the diet, or kidney disease. Very high homocysteine values can be due to pernicious anemia and this should be worked up before starting treatment.

The recommendation to prevent elevated homocysteine is to meet the daily requirements for folate, B6, and B12 through dietary sources (see nutrition section, Heart Protective Diet). The treatment for an elevated homocysteine level is supplemental vitamins.

C-Reactive Protein (CRP):
There is growing evidence that atherosclerosis is an inflammatory process. High sensitivity CRP is a reflection of the inflammatory state. Studies of healthy men and women have shown that those with elevated CRP levels have an increased risk of heart attack and stroke. CRP blood levels are not routinely measured. The benefit to measuring CRP is in identifying people at high risk. It is felt that aspirin and statin drugs may exert an anti-inflammatory effect and may lower CRP levels.

Other emerging risk factors:
When overwhelming evidence correlates a factor to increased coronary risk, that factor is incorporated into the standard guidelines. Through science and research new information is constantly emerging. There is evidence that several other factors involving lipid (cholesterol) makeup influence cardiac risk. Current studies will help us understand the effects of female hormones on cardiac risk and if using medication to raise HDL cholesterol reduces risk. The availability of information from numerous sources makes it imperative to be a discerning consumer.

Before making lifestyle changes or adding treatments check information through a reliable source such as The American Heart Association, The National Heart, Lung, and Blood Institute, or a reputable institution such as the Mayo Clinic or the Cleveland Clinic. The Harvard Heart News Letter is an excellent source of current information.