Novel Risk Factors Are Now Being Used to Identify New Culprits in Heart Disease

We are all well versed in the traditional risk factors for heart attack or stroke – high blood cholesterol, high blood pressure, smoking, physical inactivity and diabetes. But what about people who have none of these risk factors and still have a heart attack or stoke? Four new risk factors have emerged that may be linked to increased risk of cardiovascular disease: C-reactive protein, homocysteine, fibrinogen and lipoprotein.

We are all well versed in the traditional risk factors for heart attack or stroke – high blood cholesterol, high blood pressure, smoking, physical inactivity and diabetes. But what about people who have none of these risk factors and still have a heart attack or stoke? Four new risk factors have emerged that may be linked to increased risk of cardiovascular disease: C-reactive protein, homocysteine, fibrinogen and lipoprotein. C-reactive protein (CRP) is produced by the liver as a response to injury or infection and is a sign of inflammation in the body. Research correlates high levels of CRP with an increased risk of heart attack and stroke. Though the evidence is conflicting, some researchers believe that CRP itself is not a risk factor, but elevated levels of CRP could mean that some part of the cardiovascular system is inflamed, which can lead to stroke or heart attack. Homocysteine is an amino acid normally found in the blood that, when present in above-normal levels, is linked to an increased risk of stroke, heart disease, and disease of the blood vessels in the arms, legs and feet. While the exact reason isn’t clear, too much homocysteine can cause the tissues lining your arteries to thicken and scar, which in turn leads to cholesterol buildup and blood clots. Folate and vitamins B-6 and B-12 help regulate homocysteine levels. Researchers havent reached a consensus on the value of taking these nutrients as supplements. Fibrinogen is a specific protein in the blood and plays a central role in clotting. Too much fibrinogen may lead to excessive clumping of blood cells, causing a clot to form in the artery, which may lead to a heart attack or stroke. Smoking, inactivity, excessive alcohol consumption, and estrogens from birth control pills or hormone replacement therapy may elevate fibrinogen levels. Lipoprotein(a) is a blood fat formed when a low-density lipoprotein (LDL) cholesterol particle attaches to a specific protein. Lipoprotein(a) may disrupt your bodys ability to dissolve blood clots, levels may increase with kidney problems or the hormonal changes that occur with diabetes, pregnancy or menopause. Information about the role of these four substances is still emerging and researchers are looking at other potential risk factors. In the end, no single common cause is likely to account for all heart attacks and strokes. Rather, interactions among emerging risk factors and traditional risk factors are likely to blame.(Source: Mayo Clinic in Rochester: August 2003)