The Dirty Dozen Risk Factors for Heart Disease

If you think high cholesterol levels means getting heart disease, think again! On this page, I tell you what I consider to be the top 12 risk factors for heart disease and having high cholesterol isn’t one of them!

In my video above and in this brief article, I lay out the most important risk factors for cardiovascular disease – “the dirty dozen,” I call them – that my research and decades of clinical experience had led me to believe. You may be surprised what’s missing...cholesterol! You won’t find it on my list.

Here are the factors you should really be concerned about:

Risk Factor # 1 High Blood Sugar, High Insulin

Elevated insulin is the result of eating too many refined carbohydrates, sodas, and sweets. A typical diet high in processed carbohydrates stresses the body, causes excess sugar in the blood and excess insulin to be released in response by the pancreas. This scenario sets up obesity, diabetes, inflammatory damage to blood vessels, and cardiovascular disease. If refined carbohydrates are a diet staple for you, you're headed straight for the cliff unless you change your dietary direction. My re-route is an anti-inflammatory diet.

Risk Factor # 2 Toxic Blood

Your blood carries oxygen, nutrients, and an A-to-Z of molecules. When certain elements become elevated, they can create sick, thick, sticky, clot-prone inflamed blood that contributes to arterial inflammation and plaque formation. These elements include:

homocysteine, an amino acid that builds up as a result of vitamin B-6, B-12, and folic acid deficiency;
lipoprotein a, a small, dense inflammatory lipid that becomes dangerous as a result of genetics, vitamin C deficiency, and eating excess sugar, and trans fats;
C-reactive protein, an inflammatory substance produced by infections, excess fat and blood sugar, and antioxidant deficiencies;
fibrinogen, a clot-regulating protein overproduced in smokers;
ferritin, an indicator of iron storage in the body.

These elements can be monitored by medical blood tests.

Risk Factor # 3 Oxidative Stress

Unstable atoms, missing electrons, are called free radicals. Smoking, high sugar intake, chronic infections (see risk factor # 5), metal toxins (# 6), intense physical stress (as in too much exercise) and emotional stress (#7), trans fats (#11), medical radiation (#12), and certain drugs produce an excess of free radicals that can cause inflammation, tissue damage, premature aging, and disease. Earthing and antioxidant supplementation can help you counteract oxidative stress.

Risk Factor # 4 Poor Bioenergetics

When the blood can’t deliver enough oxygen and nutrients to the cells of the body, including the critical heart cells that operate around the clock, energy-producing structures inside the cells called mitochondria can’t do their job. The whole body, including the heart, suffers from the energy deficit, and a cardiovascular crisis may ensue. Arterial disease, stress, weak immunity, and general inflammation are common causes. Read up on “the awesome foursome” for a tried and true remedy that boosts mitochondrial activity and energy.

Risk Factor # 5 Bacteria

Don’t kid yourself. Local infections, such as in the gums, can spread bacteria throughout the whole body. In 1998, the American Academy of Periodontology issued a strong warning that gum infections raise the risk for heart disease and stroke. Gum disease is an infectious inflammatory condition caused by bacteria. Half of American adults have it to one degree or another. Regular dental checkups are a must. Click here to learn more about the heart-mouth connection.

Risk Factor # 6 Toxic Metals

Certain environmental metals – lead and mercury, for example – are toxic to the body. Lead exposure comes from paints, batteries, and drinking water flowing through lead-lined pipes. Mercury is found in the air, seafood, and dental fillings. These, and other toxic metals, damage the body in many subtle ways, and over time, can contribute to loss of bone density, hypertension, mitochondrial dysfunction, and cardiac problems. You’ll find some ideas for minimizing your toxic exposure here.

Risk Factor # 7 Emotional Stress

This is a big one. Some people equate stress to drinking too much coffee, but emotional stress is magnitudes of disturbance to the body compared to a bit of overcaffeination. It can definitely make you sick by draining your immune system. It can trigger high blood pressure. It can definitely shorten your life. Many heart attacks occur as a result of stress. Types of stress include anger, resentment, anxiety, and depression – toxic emotions. We all have stress in our lives. We all have to learn how to handle it and minimize it before it destroys our health. Here are some good ideas for doing so that I have shared with my patients over the years.

Risk Factor # 8 Gender Factors

As we age, the body’s sex hormones decline, and with it, we lose degrees of cardiac protection. Estrogen in women and testosterone in men are good for the heart. Typical pharmaceutical hormonal replacement strategies may have side effects, so it is best to consult with anti-aging specialists who use bio-identical hormones (usually made from soy) and weigh whether this is a good option for you. You can find a specialist near you through the American Academy of Anti-Aging Medicine.

Risk Factor # 9 Trans-Fatty Acids

Trans fats are bad for you. Plain and simple. These are man-made hydrogenated oils used by food manufacturers to give their products long shelf life. About 75 percent of foods eaten in the standard American diet contain them: packaged baked goods, fried snacks, frozen products like fish sticks and French fries, commercial salad dressings, some peanut butters, and pancake mixes, just to name a few. These fats stoke oxidative damage, raise Lp(a) and lower HDL. Also, the high heat in frying creates trans fats out of the cooking oil. Restaurants have been eliminating trans fats. You need to do the same. Read labels and avoid products that have them.

Risk Factor # 10 High Blood Pressure

If you think high blood pressure is just a man’s thing, I’ve got news for you. Nearly half the adults with this common, and often symptomless condition, are women. High blood pressure is even on the rise among kids! Have no doubt: uncontrolled high blood pressure is the No. 1 risk factor for heart attack and stroke. If your doctor says your blood pressure numbers are too high, you better do something about it. If bad enough, you may need medication for control, but addressing body weight, diet, physical activity, and stress, and taking selected supplements, can often return you to normal. Check out my blood pressure tips in these articles and, if you are really serious about doing something, get a copy of my book on lowering blood pressure in eight weeks here.

Risk Factor # 11 Genetics

We all have genetic differences and those differences make some of us more predisposed to certain conditions, such as cardiovascular disease. If you have a family history of early-onset illness, it behooves you to ask your doctor about genetic testing that may shed light on your vulnerabilities and treatment options. Genetic testing, which has come a long way, shouldn’t be overlooked as a diagnostic tool, particularly in tough, resistant cases.

Risk Factor # 12 Radiation

Medical imaging provides important information to doctors. But you can definitely have too much of a good thing. The number of cardiac imaging procedures is on the rise and has produced much discussion in the cardiology community. The problem is that doctors don’t really know how much is too much. Radiation has the potential to damage DNA in cells, including the cells in sensitive linings of arteries. I regard any radiation as inherently toxic to the body unless proven otherwise. I have seen many patients who underwent breast cancer or other cancer radiation who then later developed coronary artery disease, cardiomyopathy, or pericarditis. My advice is to only have radiation, including X-rays, when absolutely necessary. If you do need to undergo radiation treatment, make an effort to protect your body by stepping up intake of antioxidant nutrients like CoQ10, alpha lipoic acid, and vitamin C. Eat some seaweed, such as wakame and dulse; they contain sodium alginate, a natural compound that helps counteract radiation in the body.

Learn More

Are you at risk for heart disease? Take this simple questionnaire to find out!

Learn more about heart disease and ways you can protect against it by visiting the Heart Health, Blood Pressure, and Cholesterol sections here at HMDI. Here are some other related articles:

You might also want to read up on heart health at Drsinatra.com.

References and Additional Resources:

Sinatra ST, Bowden J. The Great Cholesterol Myth (Fair Winds Press, 2012).
Sinatra ST, Bowden J. The Great Cholesterol Myth Cookbook (Fair Winds Press, 2014).
Sinatra ST, Roberts J, Zucker M. Reverse Heart Disease Now (John Wiley & Sons, 2007).
Sinatra ST. The Sinatra Solution - Metabolic Cardiology (Basic Health, 2011).
American Academy of Periodontology. CDC: Half of American Adults Have Periodontal Disease. Perio.org, accessed July 11, 2014.
American Academy of Anti-Aging Medicine (A4M) web site

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