Take an inventory of the major risks for coronary disease and determine which apply to you. Major risk factors are family history, increasing age, diabetes, high total cholesterol, low HDL cholesterol, high LDL cholesterol, elevated blood pressure, smoking, physical inactivity, stress, and other aspects of lifestyle. There are newer risk factors under investigation, including an abnormal LDL cholesterol called Lp (a), elevated blood homocysteine, and tests that indicate chronic inflammation.

You may have heard the saying, "pick your parents very carefully." This tongue-in-cheek advice emphasizes the importance of heredity in so many or our illnesses. When the Human Genome Project is complete, and the functions of the important genes identified, medicine will be able to implant a "chip" that will reveal diseases to which a person is susceptible. In that way, preventive therapy can be tailored to the individual and treatments begun long before diseases appear. But we can get clues before the new millenium, for as we tell our medical students, "a good family history is a poor man's gene test." So if anyone in your family had heart, vascular disease or stroke, pay particular attention to the risk factors that follow.