Q: I am 45 years old. My mother died of heart attack at 56, my sister had a severe heart attack at 60 and my brother has just had a heart attack at 50. All three of them smoked but I do not. I have just had an ECG which the doctor says is picture perfect and hence draws the conclusion that there are no problems at the moment. I have just started on Lipitor and fully intend to lose 10 lbs. Given the good results from the ECG and the lipitor programme, can I be confident that I do not have any CAD or CHD? Is there a good chance that I can still get stroke or heart attack?

A:Keeping cholesterol levels very low (LDL cholesterol less than 100 mgs) by using statins, keeping BP below 120/80 mms Hg, maintaining an ideal body weight, regular exercise programme, eating heart healthy diet rich in fruits and vegetables and keeping away from tobacco are very effective means of preventing heart attacks. A normal ECG is good and indicates absence of any injury to the heart but does not rule out blocks in the coronary arteries. A stress ECG or a stress echcardiography is a much better prognostic test, especially in high risk individuals like you.