If you want to learn your chances of suffering a heart attack, ask your doctor to draw blood for C-Reactive Protein (CRP), the good HDL and the bad LDL cholesterol, small low-density lipoprotein, Lp(a), homocysteine. He will also check your blood pressure.

We used to think that heart attacks were caused primarily by plaques accumulating in arteries because of high cholesterol levels. Now we know that the inner lining of an artery must first be roughed up before plaques form, and infections are the most common cause of damaged inner linings of arteries. C-Reactive Protein is a blood test that measures inflammation or the swelling that occurs in arteries before plaques form. So C-reactive protein is one of the best indicators that a person is headed for a heart attack.

Blood cholesterol levels are still good predictors of heart attacks. Your bad LDL cholesterol should be under 100. If you have had a heart attack, your LDL should be under 70. Having high blood levels of a subfraction of the bad LDL cholesterol called small LDL increases your risk for a heart attack.

Another test called homocysteine also predicts heart attacks. When your diet does not provide you with adequate amounts of the vitamins B12, pyridoxine and folic acid, blood levels of homocysteine rise, damaging the walls of the arteries and causing plaques to form.

Lp(a) is a genetic disorder that causes clots to form and so is a cause of heart attacks, particularly in younger people (men under the age of 40 and women under the age of 60.)

If your C reactive protein is high, you may need to take Zithromax, Dynabec, or Biaxin for 9 days.

If your good HDL is low or your triglycerides are high, you need to restrict calories and any foods that cause a high rise in blood sugar, such as bakery products, pastas and sugar-added foods; and eat root vegetables and fruits only with other foods, not alone as snacks. You may also need to take medications.

If your bad LDL cholesterol is high, you need to restrict saturated fats, partially hydrogenated fats and calories, and you may need to take medication.

If your Lp(a) is greater than 40, you need to take the vitamin niacin after every meal in continually raising doses until your Lp(a) is below 40. Diet will not lower Lp(a).

If your homocysteine is high, you need to avoid meat and poultry, and eat plenty of whole grains, leafy green vegetables. You can meet your needs for vitamin B12 with seafood and skim milk dairy products, or with B 12 pills. If homocysteine remains above 100, you should take folic acid, pyridoxine and B12 (readily available in combination pills such as Foltex or Fol-B.)

A heart-healthy diet and lifestyle makes it possible for most people to control cholesterol and blood pressure without drugs.

Gabe Mirkin, M.D.

Dr. Gabe Mirkin has been a radio talk show host for 25 years and practicing physician for more than 40 years; he is board certified in Sports Medicine and three other specialties.

Dr. Mirkin's daily features on fitness have been heard on CBS Radio News stations since the 1970's. He has written 16 books including The Sportsmedicine Book, the best-selling book on the subject that has been translated into many languages. His latest book is The Healthy Heart Miracle, published by HarperCollins.

Dr. Mirkin is a graduate of Harvard University and Baylor University College of Medicine. A Boston native, Dr. Mirkin did his residency at the Massachusetts General Hospital. He has served as a Teaching Fellow at Johns Hopkins Medical School, Assistant Professor at the University of Maryland, and Associate Clinical Professor in Pediatrics at the Georgetown University School of Medicine. He has run more than forty marathons and is now a serious tandem bicycle rider with his wife, nutritionist Diana Mirkin.