Heart Tests: The Sinatra Smart Zone Scores

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Heart Tests The Sinatra Smart Zone ScoresUndergoing the right combination of tests for heart disease to evaluate your risk is key to maintaining optimal heart health. But once you’ve had those heart tests, particularly your blood workups, you need to know what your scores mean in terms of your heart disease risk. 

The Sinatra Smart Zone is what I consider to be a safe zone in terms of preventive cardiology and smart-medicine practice. When I tailor individual action plans to minimize heart disease risk, the Sinatra Smart Zone is my goal. These heart test scores are usually consistent with what you see as “better than normal” values from the particular lab that you used.

Along with my suggested Sinatra Smart Zone heart test values, the following summary includes a brief list of interventions you and your doctor can discuss and select from if your scores don’t fall within the healthy range.

Coenzyme Q10 (CoQ10)

Heart Test Score: Healthy Zone: 1.0–1.8 ug/mL

My Healthy Solutions: Hydrosoluble CoQ10 50–100 mg twice daily. Therapeutic doses are higher. Aim to reach or improve these CoQ10 blood levels when the following medical conditions are present: 2.0–2.5 ug/mL if you have high blood pressure, mitral valve prolapse (MVP), arrhythmia, diabetes, or periodontal disease; 2.5–3.5 ug/mL if you have mild to moderate congestive heart failure (CHF), chronic fatigue syndrome or angina;> 3.5 ug/mL if you have severe CHF or are waiting for a heart transplant.

C-Reactive Protein (CRP)

Heart Test Score: Healthy Zone: <0.8 mg/dL

My Healthy Solutions: Weight loss, exercise. Low-dose aspirin (1-2 baby aspirin twice daily). Fish oil, 2 g. Antioxidants with mixed forms of vitamin E. Nattokinase, 100 mg. Hydrosoluble CoQ10, 50–100 mg.

Serum Ferritin

Heart Test Score: Healthy Zone: Women <80 ug/L; Men <90 ug/L

My Healthy Solutions: If more than 100 ug/L, donate blood one to three times a year. Do not take more than 500 mg vitamin C a day until your ferritin level has decreased to within normal limits. If your level is more than 400, ask your doctor to check you for genetic hemochromatosis.


Heart Test Score: Healthy Zone: 180–350 mg/dL

My Healthy Solutions: Fish, squid, or algae oil, 1–2 g. Garlic or bromelain 500–1,000 mg. Drink ginger and/or green tea. Nattokinase, 100 mg. Plus, if your levels are too high and you're a smoker, you must seriously consider stopping.


Heart Test Score: Healthy Zone: 7 to 10 umol/L

My Healthy Solutions: Folic acid or metafolin (MTHFR), 400 mcg. Vitamin B6, 40 mg. Vitamin B12, 200 mcg. Eat more beets, broccoli and garlic.


Heart Test Score: Healthy Zone: <30 mg/dL

My Healthy Solutions: CoQ10, 100-200 mg, Fish oil, 1–2 g, Nattokinase, 50 mg twice daily, Niacin, 250–500 mg three to four times daily (it may cause facial flushing), Lumbrokinase (Boluoke) 20 mg one to two times daily. Vitamin C, 500–1,000 mg or more. Avoid foods with trans fatty acids. Women: Consider natural estrogen. Men: Avoid soy and consider testosterone. Bioidentical estrogen and testosterone lower Lp(a).

Total Cholesterol

Heart Test Score: Healthy Zone: 180–240 mg/dL

My Healthy Solutions: Reduce weight. Exercise. Increase fiber. Eat plenty of vegetables, and avoid sugar and high-glycemic foods. Eat a diet designed to lower cholesterol. Chromium, 200 mcg. Hydrosoluble CoQ10, 100–150 mg. Tocotrienol (a form of vitamin E), 50–100 mg. Garlic 400–800 mg. Plant sterols (phytosterols), 500–1,500 mg. Probiotics (healthy bacteria supplement). Flax, 2 Tbsp crushed flaxseed a day in a shake with 8 oz rice or almond milk, or sprinkled on cereal with crushed nuts or on a salad for fiber. I also like a tablespoon or two of chia seeds or organic psyllium. Promotes bowel movements that carry cholesterol out of the body.


Heart Test Score: Healthy Zone: 45–65 mg/dL for women; 40–60 mg/dL for men (Note: Very high HDL over 90 can be dysfunctional)

My Healthy Solutions: Assess for insulin resistance if HDL is low. Reduce weight. Exercise. Eat fewer high glycemic carbohydrates. Niacin, 500–1,000 mg. L-carnitine 500–1,000 mg. CoQ10 50–100 mg. Extra virgin olive oil (EVOO) 1-2 tbsp daily.


Heart Test Score: Healthy Zone: 80–130 mg/dL

My Healthy Solutions: See Total Cholesterol above. LDL cholesterol is not a problem unless it's oxidized. To prevent oxidation, avoid environmental toxins including sugar, processed foods, and foods that contain high fructose corn syrup or preservatives. Squid or fish oil 1-2 grams.


Heart Test Score: Healthy Zone: 50-100 mg/dL

My Healthy Solutions: Weight reduction. Exercise. Restrict carbohydrates. Fish or squid oil, 2–3 g. L-carnitine, 1–2 g. Reduce alcohol intake.

AA/EPA Ratio

Heart Test Score: Healthy Zone: 1.5–3.0

My Healthy Solutions: A heart test score greater than 3 indicates the presence of inflammation. The higher the number, the more inflammation. If your omega-6 to omega-3 fatty acid ratio is too high, as reflected by the levels of arachidonic acid (AA) to eicosapentaenoic acid (EPA), then there’s not enough anti-inflammatory EPA in the body to neutralize the pro-inflammatory AA. I see very unhealthy scores, sometimes as high as 20. Take 2–3 g of fish or squid oil daily to help neutralize inflammation. In some cases, more may be needed.

Fasting Blood Sugar

Heart Test Score: Healthy Zone: <90 mg/dL

My Healthy Solutions: Weight loss. Exercise. Restrict carbohydrates, especially sugary, high-glycemic carbs. Specific supplements: alpha-lipoic acid, 100–300 mg; hydrosoluble CoQ10, 50–90 mg; cinnamon, 1,000 mg; Gymnema leaf extract, 200–400 mg; chromium picolinate, 100–200 mcg; citrus Bergamot, 500-1,000 mg.

Fasting Insulin

Heart Test Score: Healthy Zone: <17 uU/mL

My Healthy Solutions: See Fasting Blood Sugar above.

Hemoglobin A1C

Heart Test Score: Healthy Zone: <6% of total HGB

My Healthy Solutions: See Fasting Blood Sugar above. If weight reduction, exercise, and supplements do not improve percentage, consider pharmaceutical therapy. Ask your physician about Metformin, a glucose-lowering medication.


Heart Test Score: Healthy Zone: 0.5–1.5

My Healthy Solutions: This test will help determine if your thyroid is working properly. If you’re not in the healthy range, work with your doctor to manage the situation.


Heart Test Score: Healthy Zone: <10 mg/dL

My Healthy Solutions: See Total Cholesterol. You can also add 1-2 g fish oil or Calamarine daily and 50-100 mg nattokinase.


Heart Test Score: Healthy Zone: >25 mg/dL

My Healthy Solutions: See Total Cholesterol.


Heart Test Score: Healthy Zone: >15 mg/dL

My Healthy Solutions: See Total Cholesterol.

VIDEO: Dr. Sinatra Debunks the Great Cholesterol Myth! What You Really Need to Know to Protect Your Heart


Dr. Stephen Sinatra

Meet Dr. Stephen Sinatra

A true pioneer, Dr. Sinatra spent more than 40 years in clinical practice, including serving as an attending physician and chief of cardiology at Manchester Memorial Hospital, then going on to formulate his advanced line of heart health supplements. His integrative approach to heart health has changed the lives of hundreds of thousands.

More About Dr. Stephen Sinatra