The cardiovascular diseases (CVDs) considered been the major cause of morbidity and mortality in India over the last several decades, and are rapidly catching up with this epidemic. The underlying pathology is atheromatous vascular disease, resulting in coronary artery disease (CAD), cerebrovascular disease, and peripheral vascular disease, and the subsequent development of heart failure and cardiac arrhythmias.

However, the focus on high cholesterol as the main cause of heart attacks and strokes is woefully misguided. The clinically proven indicators of cardiovascular disease include elevated levels of triglycerides, insulin, cortisol and C-reactive protein, but not high cholesterol.

What About Cholesterol?

Unfortunately, medical studies show that lowering your cholesterol won’t actually lower your risk of a fatal heart attack or stroke. According to William Castelli, M.D., a former director of the Framingham Heart Study, people with low cholesterol (lower than 200) suffer nearly 40 percent of all heart attacks. In addition, people with low cholesterol (less than 180) have three times as many strokes as the general population.

What are the Real Risk Factors for Heart Attack and Stroke?

The following ten items are some of the most important clinical indicators that show you have a higher risk for heart attack and stroke.

1. Cardiac arrhythmia. This includes atrial fibrillation and other disruptions of the heart’s normal rhythm.

2. Elevated triglycerides, particularly an elevated ratio of triglycerides to HDL cholesterol. Studies have implicated triglycerides in the progression of coronary atherosclerosis (hardening of the arteries).

3. Elevated homocysteine. One study found that men with extremely high homocysteine levels were three times more likely to have a heart attack than others.

4. Elevated insulin.

5. Elevated cortisol levels. High levels of cortisol are associated with hypertension, which increases your cardiovascular risk. Patients with heart diseases exhibit higher cortisol levels than do others.

6. Elevated estrogen with respect to progesterone.

7. Low testosterone (in men). Higher levels of testosterone have been found to offer men greater than five-fold protection against coronary artery disease.

8. High testosterone (in women).

9. Lipid peroxide. Lipid peroxides are the products of chemical damage done by oxygen free radicals to the lipid components of cell membranes. High levels of lipid peroxides are associated with cancer, heart disease, stroke, and aging.

10. Elevated C-reactive protein. C-reactive protein is a marker associated with the production of inflammatory cytokines, which represent a threat to cardiovascular health. Men with CRP values in the highest quartile had three times as many heart attacks and two times as many ischemic strokes as the general population.

Other risk factors include thyroid insufficiency, magnesium deficiency,fatty acid imbalances and lipid fractionation.

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