I don't smoke and have normal cholesterol
and blood pressure - am I still at risk for
a heart attack?

Yes! About 25% of all heart attacks occur
in people without conventional risk factors
such as high cholesterol, elevated blood
pressure, or smoking.

What if I monitor my cholesterol?

While monitoring is important, approximately
35% of heart attacks occur in people with
normal total cholesterol levels.

What is coronary heart disease?

Coronary heart disease is a gradual process
that begins with damage to the inner lining
of the coronary arteries and progresses
until the arteries become blocked. Advanced
coronary heart disease causes heart attacks.

How are arteries damaged in the first place?

Multiple factors contribute to arterial injury.
These factors facilitate the accumulation
of cholesterol, inflammatory cells, end
fibrous tissue in the wall of the blood vessel.

Does this process also damage arteries
outside the heart?

Yes, people with coronary heart disease
are also at risk for stroke and damage to
the arteries of their arms and legs.

What is HOMOCYSTEINE?

Homocysteine is a substance produced as
the body digests protein. While our bodies
require normal levels of homocysteine to
build and maintain tissues, excess levels
can be associated with heart disease and
stroke.

How does HOMOCYSTEINE increase the risk
of coronary heart disease and stroke?

High levels of homocysteine may contribute
to arterial wall injury produced by cholesterol
and other substances. Arteries damaged by this
process are more likely to narrow or close
completely.

How does the body regulate HOMOCYSTEINE?

Under normal circumstances, excess
homocysteine is rapidly eliminated. With the
help of essential vitamins, the liver changes
homocysteine into an amino acid the body
can use or break down for excretion.

How does high HOMOCYSTEINE compare
with other cardiovascular risk factors?

It has been estimated that high homocysteine
levels can increase the risk of heart disease
as much as smoking or high cholesterol.

Should my HOMOCYSTEINE level be measured?

You should discuss this question with your
doctor. However, the American Heart Association
suggests homocysteine measurements for
selected patients with a personal or family
history of cardiovascular disease.

How do I find out my HOMOCYSTEINE level?

Blood tests are available. Ask your doctor.

If my HOMOCYSTEINE level is high, how did
it happen?

Elevated levels of homocysteine may result
from a deficiency of certain essential vitamins.
In addition, many people have a mild genetic
defect in the pathway of homocysteine
metabolism. People with this relatively
common abnormality require a diet that
meets or exceeds all of the recommended
dietary allowances for folic acid, vitamin B6,
and vitamin B12.

Can I control my HOMOCYSTEINE level?

In most cases, elevated levels of
homocysteine are easy to control.
Simply make sure that you eat a
well-ballanced diet that includes
green leafy vegetables, citrus fruits,
beans, meats, fish, and fortified grains
and cereals. If you have questions about
your diet, talk with your doctor.