Alex’s father died of heart attack at the age of 59. Alex was determined not to suffer the same fate. Soon after his father’s funeral, he adopted a vegetarian diet. For the next two decades, he carefully watched his weight and blood pressure, checked his cholesterol level yearly and paid for his annual electro-cardiograms. He thought he was doing everything he needed to. But one day he woke with pain in his chest. The heart attack came from out of the blue without prior warning.

What went wrong? Though it may come as a surprise, nothing much at all. About half of all heart attacks strike people who don’t have high cholesterol. But scientists have come to realize that the road to heart disease is not a straight line from high fat foods to a heart attack- not simply a plumbing problem of pipes clogged with grease. They have uncovered other villains – subtypes of cholesterol, inflammation- that also play an important role in heart attacks.

Detecting a pattern:

In the aftermath of Alex’s heart disease, he got angioplasty to open up a blocked artery and cholesterol lowering drugs. But a friend of him kept insisting that Alex look beyond the mainstream and visit another Doctor.

In 1996, a famous cardiologist, Robert Superko found that there are a lot more causes for a heart attack. In Alex’s case the cause was ‘LDL Pattern B’.

What is LDL Pattern B?

Superko and other experts believed that while the amount of bad cholesterol or LDL in your blood can be dangerous, the size of the LDL particle is even more important. IF they are extra small-A trait6 called LDL Pattern B- they are extra likely to produce a heart attack. That may be partly because the smaller particles slip easily in to the walls of the arteries where they more readily become arterial plaque. Pattern B patients also tent to have associated problems including low HDL levels and high triglycerides. Their HDL may be less efficient at its job of ferrying away bad cholesterol. Research on Americans suggests as many as one in three men and one in seven women have genes that predispose them to LDL pattern B. This condition is relatively easy to treat, requiring only diet low in saturated fat, exercise and regular doses of B vitamin Niacin to increase the size of the LDL particles.

An Accessory Villain- Inflammation:

In some people, the immune system launches a misguided attack within the blood vessels. What triggers the assault is not clear, but that smoldering inflammation can lead to the formation of plaque that is especially prone to rupture. When a patch erupts, blood clot can result.

A simple blood test can tell you if you are at risk by measuring the levels of a molecule called C-reactive protein. It is not that hard to rein in high CRP levels. Aspirin helps to reduce them as do the statin drugs used to treat high cholesterol.

The unusual Suspects:

Chlamydia Pneumoniae, a bug that causes respiratory infections has been linked with heart attacks.

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