The Top 10 Predictors of Heart Disease

August 31, 2020
senior couple making a heart shape with their hands

Despite all of our cutting edge medical and technological advances, heart disease is still the number one killer in the world. Here’s how you can determine if you’re at risk. Even though we’re in the midst of a pandemic, heart disease has not gone away. In fact, in addition to being the leading cause of death in the US, it’s one of the risk factors for a worse outcome if you become infected with the virus. But with heart disease being a silent killer for most women and some men, we need to look at the 10 most reliable predictors we have for a heart problem on the horizon. And spoiler alert: cholesterol falls pretty far down the list.

The Heart of the Matter – My Top 10 Tests for Heart Disease

1. Inflammation

Back in June, I wrote about how inflammation – not cholesterol – is the main predictor of heart disease. (read the article here) Cholesterol is essential for the health of every cell in your body and is vital to the protective membrane that surrounds each cell. Beyond that, your immune system relies on cholesterol, as does your brain, vitamin D production, and your sex and stress hormones. When cholesterol is elevated in your blood stream and accumulating in your blood vessels, there has to be a good reason for it. Cholesterol is the band-aid sent to protect blood vessels that have been injured. That injury is caused by the presence of inflammation. There are many causes of inflammation in the body, including high blood sugar, high insulin, Advance Glycation End products (AGEs), excess metals, hormone imbalances, nutrient deficiencies, and more. Finding the root cause of the inflammation is essential for your heart health. The number one test I look at for inflammation specific to the cardiovascular system is the cardio-CRP (C-Reactive Protein), also known as the hs-CRP, which I’ve written about before. More than 30 studies have shown a direct correlation between elevated hs-CRP and heart attack. While the lab’s normal range is usually 0-3mg/dL, the optimal range is less than 1.0 mg/dL for women and less than 0.55 mg/dL for men. When the hs-CRP is elevated, I like to boost nitric oxide levels to reduce this inflammation. Citrulline and arginine are two amino acids that are known to increase nitric oxide production and can be easily supplemented. In addition, I recommend UNI KEY Health’s Daily Greens Formula as a good oxygenating, anti-inflammatory greens formula for daily use.

2. Homocysteine

This protein gained fame when the MTHFR gene mutations came to the forefront of functional medicine. When you have one or more MTHFR gene mutations, as up to 50 percent of the population does, your homocysteine levels can rise. Elevated homocysteine by itself has been shown in studies to be a risk factor for early heart disease. You may feel weak, fatigued, and dizzy when levels are high, and have renal disease. Your blood tests may show that you are low in vitamins B6, B12, and folate. High homocysteine is one of the few health issues treated exclusively by supplementing with vitamins. Because it is most commonly caused by the MTHFR gene mutations, supplementing with the methylated forms of vitamins B6, B12, and folate are the fix for this risk factor. UNI KEY Health’s Male and Female Multiple iron-free multivitamins both have the B vitamins you need to restore healthy levels of these vitamins and lower homocysteine.

3. Iron

Another factor that is just as harmful as inflammation in the body is oxidation. Oxidation is what happens to excess iron in the body, which basically “rusts” us on the inside and leads to heart disease, diabetes, Alzheimer’s, arthritis, and more. Iron overload is most common in men and postmenopausal women. It comes from the water we drink, foods we eat, cookware, we use, and the supplements we take. The symptoms of iron overload are very similar to those of anemia, so you can’t go by what you feel as an indicator of your iron status. Included in your yearly blood work should be a Complete Blood Count (CBC), which includes your Hemoglobin and Hematocrit levels, and also a Ferritin level, which is a measure of how much iron is stored in your body. If your hemoglobin is elevated and you have a Ferritin level above 70 ng/mL, then you have excess iron and it’s time to reduce the amount you’re taking in. Filter your water, reduce your alcohol and iron-rich food intake, and make sure your multivitamin does not contain iron. One such multivitamin I would recommend is UNI KEY Health’s Male and Female Multivitamins.

4. TMA for Minerals

Iron is not the only mineral or metal that can be out of balance in your body and contribute to heart disease. Electrolytes like calcium, magnesium, sodium, chloride, and potassium help regulate everything from muscle relaxation to fluid balance and can put stress on the heart when they are either deficient or in excess. While blood tests will pick up the life threatening highs or lows, it’s a hair Tissue Mineral Analysis that will help you find your optimal levels of these important minerals, along with heavy metals that aren’t being efficiently detoxed. This simple test that you do in the privacy of your own home with just a small hair sample could be the missing piece of your heart health puzzle.

5. Fasting Insulin

We are all familiar with insulin as a key player in blood sugar control, but did you also know it’s a marker of inflammation in the body and tied to heart disease? Once you start overproducing insulin as a response to chronic stress or a high carb sugary diet, then it isn’t long before inflammation and weight gain follow. Fasting insulin is also an earlier and more sensitive marker for insulin resistance than the Hemoglobin A1c is. Insulin resistance and diabetes are known risk factors for developing heart disease. The lab range is set specifically for people with diabetes and is much higher than the optimal range. Any value over 5 mIU/L means inflammation and insulin resistance are setting in and lifestyle changes are needed. My New Fat Flush Plan is ideal for combating insulin resistance and its associated weight gain. And my Weight Loss Formula was formulated with berberine from Oregon Grape Root, which is my go-to supplement for elevated insulin or blood sugar levels.

6. Glycosylated Hemoglobin

The Hemoglobin A1c blood test is typically only done as a measure of how well a diabetic is controlling their blood sugar, but it’s also a measure of another very important heart disease risk – the process of glycation. Several studies show that glycation alone is a risk factor for cardiovascular disease – and this process starts with how you cook your food. When you cook your food over high heat, the proteins or fats in those foods react with even small amounts of sugars and form inflammatory molecules through a process called glycation. These toxic, sticky, complex molecules are called Advanced Glycation End Products (AGEs). Once formed, they clump together and accumulate in your tissues. They can travel anywhere, and create plaque-filled blockages and blood clots when it’s your blood vessels they target. The Hemoglobin A1c test is a measure of glycosylated – or glycated – hemoglobin molecules in your blood. So, while this is a measure of your blood sugar control, it’s also a measure of the AGEs you have in your body, and also a good indicator of your risk of heart disease from them. For optimal health, your Hemoglobin A1c should be 5.6% or less.

7. Healthy Fats

We have heard for years about the importance of Omega 3 essential fats for your heart health, but did you know there’s a blood test that measures both Omega 3 and Omega 6 fat levels and calculates the ratio of them for you? This test is a must-have in my book. Not only is it a good way to find out if your diet and supplement protocol is working well for you, but also gives you a good idea of your fat metabolism and fat balance. Make sure you ask for your essential fat levels to be drawn at your next physical, and supplement with UNI KEY Health’s Super-EPA for Omega 3s and GLA-90 for anti-inflammatory Omega 6s.

8. Cholesterol Quality

Not all cholesterol is bad. When your body sends it to help repair injured tissues, your total blood cholesterol may look elevated, when in fact, that cholesterol is sorely needed for healing. A typical cholesterol test only looks at HDL, LDL, and Triglycerides, but more in-depth testing is needed to understand whether the cholesterol you have circulating is actually associated with an increased risk of heart disease. In my article, Super Heart Health Today, I talked about the VAP test, the most accurate cholesterol test available today. It measures 15 different components of blood cholesterol and identifies the patterns associated with an increased risk of heart disease. If you have high levels of LDL-B or Lp(a) fractions, then your risk of heart disease is higher. Mag-Key, CoQ10, D-Ribose, and L-Carnitine are the “Awesome Foursome” of supplements that my friend and esteemed integrative cardiologist Dr. Stephen Sinatra recommends to his patients.

9. Hormones

There are many different hormone imbalances that are risk factors for heart disease. Low testosterone in men, estrogen dominance in both men and women, low thyroid hormones, high cortisol levels, and high insulin levels are all risk factors for heart disease. It’s so important that if you have symptoms of any of these hormone imbalances that you get the testing and support healthy hormone levels with supplements like Thyro-Key, Adrenal Formula, and ProgestaKey when needed.

10. Coronary Calcium Score

If one or more of the above tests comes back with concerning levels, and you have a personal history, family history or genetic predisposition to heart disease, then I recommend getting a Coronary Calcium Score done. This inexpensive and very quick CT scan of your heart measures the amount of calcium deposition that’s in each of the main arteries to your heart. The total of all the calcium built up is then your calcium score, and the higher the number is, the higher your risk is of heart disease. Follow up with a good sweat in the sauna or a salt and soda detox bath for the small radiation exposure from the test.

More Information

Interested in more heart health information? Check out my First Lady of Nutrition Podcast, specifically Episode 30 with Dr. Barry Tan where we deep-dive into some often overlooked vitamins that are very heart-healthy.

Related Articles and Podcasts

Ann Louise Gittleman, PhD, CNS, is an award-winning New York Times bestselling author of more than thirty books including The Fat Flush Plan series and her latest book, Radical Metabolism. She’s been rewriting the rules of nutrition for more than 40 years and is internationally recognized as a pioneer in the field of diet, detox and women’s health issues. 

For a FREE daily dose of tips and strategies for maintaining healthy weight, conquering insomnia, and much more…check out my Radical Health Tips.

I’d like to meet and greet you on my Facebook groups, so won’t you check us out at the Radical Metabolism RevolutionFat Flush Nation, or my Inner Circle!


  1. Polly S.

    This is amazing information. My husband had a very minor heart attack 2 years ago and seems to be fine ever since. I think he needs to take all of these tests and make sure he is really healthy in these areas. Thank you!

  2. Althea S

    I will give this blog to my mother. She had a heart attack recently.I appreciate all your information.

  3. Shelly

    I had no idea that a low thyroid could be associated with heart risk. I’ve had this condition for a very long time. I’ll check in to that Thyro-Key you mentioned.

  4. Brigitte

    In Australia, Dr’s won’t send you for any ‘worthwhile’ tests’ unless you are showing signs of serious illness. I’ve had to go to Functional Medicine Clinic (at great expense). I wanted to get an overall picture of my health snf work on anything BEFORE something serious develops..’sigh’


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