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"New biomarkers have allowed us to uncover 90 percent of hidden risk; the old biomarkers -- total cholesterol and good and bad cholesterol -- looked at 40 percent of the risk," said Dr. Michael Ozner, medical director of the Center for Wellness and Prevention at Baptist Health South Florida and author of the new Heart Attack Proof: A Six-Week Cardiac Makeover for a Lifetime of Optimal Health (BenBella; $19.95).

Doctors are now paying more attention to plaque particles that can line the artery walls and rupture, which can cause sudden heart attack. The plaque particles oxidize, are retained and fueled by a calorie dense, nutrient-depleted diet of highly processed foods with too much sugar, high fructose corn syrup, trans and saturated fats, along with a lack of physical exertion.

"We thought it was the 90-percent blockage with high risk to worry about. Now we understand the vascular biology of why people develop sudden heart attacks. By being able to measure the particle number [with an LDL-P blood test] and measure inflammation in the artery walls and the ability to measure other markers like Vitamin D level, Omega 3 blood levels -- which we can do today -- we can tell who is at risk and prevent and reverse this disease," Ozner said.

These particles are like taxis transporting necessary levels of cholesterol and triglycerides to areas of the body where they are needed. But the number of "passengers," i.e. the cholesterol and triglycerides, aren't as important as the number of "taxis" causing traffic jams in the arteries. Too many particles form pimples in the artery walls and build up as plaque, which can rupture and cause cardiac arrest. The body has the ability to get rid of these pimples in the artery wall if you stop fueling the particles. Ozner likens it to a fireplace which stays stoked so long as you throw in the logs. Stop fueling the fire with logs, it goes out. Same thing with plaque particles.

"Once you stop fueling them in the artery walls these bad particles, the ones getting retained and kicking off more inflammatory cells, it will go out like in a fireplace," he said.

Get screened

Agatston also stresses getting screened if there is any instance of heart disease in the family -- even if one's cholesterol scores are in a good under-200 range. "The atherosclerotic process is present and progresses for 20-plus years before it causes a heart attack or a stroke. The earlier you indentify the process, the easier it is to halt or even reverse. If you have heart disease or diabetes in your family, the time to get screened is now," he said.

Reversing the process before a first heart attack is paramount since the damage a heart attack does to surrounding muscle can lead to later congestive heart failure -- 19 percent of men and 26 percent of women over age 45 die within one year of that first attack, reports the American Heart Association.

Gillinov cites the 2004 global Interheart study, led by a Hamilton, Ontario researcher from Michael DeGroote School of Medicine, that found that 90 percent of the risk factors are controllable and can be managed. The Interheart study looked at nearly 30,000 people in 52 countries.

"Basically everyone has a family history for heart disease," Gillinov said. "It's not so much our genes but diet, lack of exercise, high blood pressure, those are the usual suspects. They vastly outweigh genetics.

"Its a dawn of a new era," Ozner continued. "We have the opportunity and ability to right the ship or we can go down the pathway of business as usual. Don't wait until you have a cardiovascular disaster."