HEART DISEASE

Heart disease is the No. 1 killer in the U.S., killing more people than cancer,
infectious diseases, and homocides combined.
Nearly a third of all victims will not survive their first symptom.
Half of all victims won't reach the hospital alive.

Atherosclerosis is a leading cause of death and impairment in America today. It affects close to 60 million Americans. Generally, few symptoms arise with the disease and the first symptom of heart disease is often sudden death. Nearly a third of all victims will not survive their first symptom.

Due to the high mortality of the disease, widespread suffering, and huge economic impact doctors screen for risk factors such as high cholesterol, high blood pressure, family history and lifestyle risk factors such as lack of exercise, obesity and smoking. When they determine that there is a significant risk of heart disease they prescribe medications.

Blood Tests

Cholesterol
Cholesterol has a role in hormone and bile production, and is a building material for body cells. However, excess cholesterol is associated with an increased risk of heart disease. Over 50% of the total population has elevated cholesterol levels.

Total Cholesterol Level:
Desirable <200 mg/dl
High 200-239 mg/dl
Dangerous >240 mg/dl

The total cholesterol is made up cholesterol subtypes:
LDL: low density lipoprotein, or "bad cholesterol"
Your health can be adversely affected when too much cholesterol in the form of LDL is present in your blood. LDL is one of the two main carriers for cholesterol and seems to play a role in the deposition of fat in arteries. These deposits result in blockages called plaque.
HDL: high density lipoprotein, or “good cholesterol”
Acts more favorably in the bloodstream by attaching itself to the plaque deposits and removing them, thereby helping to clear the arterial pathways. Elevated levels of HDL, then, are very desirable because they help clear blockages in the arteries, reduce LDL, and decrease blood pressure.

Low Density Lipoprotein (LDL), or "bad cholesterol." Optimum range: 65-120 mg/dl (<130)
High Density Lipoprotein (HDL), or “good cholesterol” Optimum range: 60-85 mg/dl (>40)
Total cholesterol : HDL Optimum range: <3.2 mg/dl (<4.7)

Recently, techniques have been developed that further define each of the cholesterol subclasses and their contribution to heart disease. Having predominantly large buoyant LDL subclasses (pattern A) is preferable to having predominantly small dense LDL subclasses (pattern B). Pattern B is associated with three times the risk of heart disease than pattern A. Pattern B characterizes a metabolic trait that is associated with higher levels of triglyceride-rich lipoproteins and lower levels of HDL.

Desired LDL subclass: Pattern A

Homocysteine
Heart disease is a multifactorial inflammatory disease, and the role of homocysteine may be more important than cholesterol.
Homocyteine is an independent risk factor for heart disease. It is produced in the body during metabolism of the amino acid methionine. If the right cofactors are present, it will eventually convert to cysteine and other beneficial compounds. If the cofactors are lacking, it will build up to toxic levels. Excess homocysteine can be converted back into methionine. This requires folic acid, vitamin B12, vitamin B6 and trimethylglycine (TMG).

Optimum range: 4-7

C-Reactive Protein (CRP)
If the CRP is elevated this tells us that there is inflammation. An anti-inflammatory protocol should be followed.
CRP: <0.4 mg/dl

Triglycerides
Triglycerides are lipids normally found in increased levels in the blood following the digestion of fats in the intestine. The exact role that triglycerides play as an independent risk factor in heart disease is not yet clear, but tests to measure triglycerides are included when determining a patient's risk profile.
Triglycerides: 70-110 mg/dl (<150)

Mechanism

The most common form of heart disease is caused by atherosclerosis, a hardening and/or thickening of the arteries. Exactly how atherosclerosis begins or what causes it isn't known, but some theories have been proposed.

Inflammation of the blood vessel wall is believed to be the first stage in the formation of arterial plaques. The innermost layer of the artery, can become damaged by free-radical reactions, homocysteine, elevated levels of oxidated serum cholesterol, triglycerides or fibrinogen, high blood pressure, cigarette smoke and environmental pollutants.

Once inflamed, cholesterol enters the blood vessel wall where it can accumulate if the conditions are favorable. This causes a “lump” in the artery wall. This cholesterol-rich "lump" is covered by a scar, or hard shell, known as a plaque.

The plaque buildup narrows the space in the coronary arteries through which blood can flow, decreasing the supply of oxygen and nutrients to the heart. If not enough oxygen-carrying blood can pass through the narrowed arteries to reach the heart muscle, the heart may respond with a pain called angina. The pain usually happens with exercise when the heart needs more oxygen. It is typically felt in the chest or sometimes in other places like the left arm and shoulder.

Dietary Influence

Low Fat Diets
Although most Americans consume too much fat and the wrong type of fat, it is important to remember that certain fats are good and others are essential. Good fats such as olive oil, avocado and raw nuts and seeds help you to feel full and stop the blood sugar from fluctuating. Essential fats such as flax seed, evening primrose and fish oils are anti-inflammatory and are needed for brain and nerve function. Diseases associated with a deficiency of essential fats include heart disease, memory loss, dementia, depression, Alzheimer’s, arthritis, eczema, PMS, obesity, diabetes and cancer.

The essential fatty acids linoleic acid and alpha-linolenic acid can be converted into gamma-linolenic acid and eicosapentaenoic acid respectively. However, conditions that prevent this conversion are common in our modern lifestyles, making us dependent on dietary sources.

Polyunsaturated (omega-6) fats such as safflower, sunflower, corn and soy oil have become popular in recent years instead of saturated fats. However, heating damages these unstable oils and they are not recommended for frying or for stir-fry.

Damaged (hydrogenated and trans-fatty acids) are found in most margarine, artificial creamers, artificial whipped cream, mayonnaise, canned soups, salad dressings, frozen foods, cookies, cakes, carob candy, chips and french-fries. Saturated and damaged fats should be avoided since they increase LDL cholesterol level more than anything else in the diet.

Cholesterol
Although the body makes cholesterol itself, dietary cholesterol intake is believed to be important. According to the Centers for Disease Control eating too much saturated fat and cholesterol-rich foods such as eggs is the main reason for high levels of cholesterol and a high rate of heart attacks in the United States. However, others believe that cholesterol rich diet switches off cholesterol production in the body and actually results in a reduction in cholesterol levels.

Fiber
Fiber absorbs fat and cholesterol in the digestive tract, allowing them to be excreted through the bowel. Include soluble fibers in the diet such as oats, apples, citrus fruit, lima beans and psyllium husks.

Weight
Excess weight tends to increase LDL cholesterol level. If you are overweight and have a high LDL cholesterol level, losing weight may help lower it. Weight loss also helps to lower triglycerides and raise HDL. Conversely, it is now accepted that even small increases in weight may increase cholesterol and the general risk of cardiovascular disease.

Alcohol
A moderate alcohol intake can increase HDL cholesterol, but does not lower LDL cholesterol. However, drinking too much alcohol can damage the liver and heart muscle, lead to high blood pressure, and raise triglycerides. Because of the risks, doctors don't recommend alcoholic beverages as a way to prevent CHD, yet the consumption of just one glass of red wine or other alcoholic beverage statistically reduces the risk of heart attack and stroke without causing other health problems for most people.

Stress
Stress reduction, breathing exercises and yoga have been shown to reduce blood pressure and prevent heart disease.

Benefits of Vitamin Supplementation

Benefits of Vitamin E
There is plenty of evidence that vitamin E protects against the development of atherosclerosis. Vitamin E is a fat-soluble antioxidant and can prevent the oxidation of LDL cholesterol in the arterial wall.

Benefits of CoQ10
Coenzyme Q10 is a fat-soluble vitamin-like substance. There have now been numerous studies in various countries detailing the use of coenzyme Q10 as a treatment in heart disease.

Benefits of B Vitamins
Homocysteine levels can be normalized by supplementation with moderate doses of vitamins B6, B12, folic acid and TMG.

Benefits of Niacin (vitamin B3)
Niacin is used at pharmaceutical levels to treat high cholesterol.
It reduces LDLcholesterol and triglyceride levels, as well as increasing HDL cholesterol.
CAUTION: Some side effects from niacin consumption may be encountered such as flushing, itching, and minor gastrointestinal upset. Measurement of liver enzyme levels every 3 to 6 months via a blood test is mandatory because high-dose niacin can cause liver damage in a minority of people. Those with liver disease such as hepatitis C cannot use niacin.

Benefits of Omega-3 Oils
Healthy fatty acids work by lowering triglyceride levels, reducing chronic inflammation and inhibiting abnormal blood clotting. These include fish oils and flax seeds.
CAUTION: Only use top quality oils that are free of heavy metals and are not oxidized.

Garlic
Garlic protects against cardiovascular disease by preventing abnormal blood-clot formation, protecting LDL cholesterol against oxidation, and protecting the endothelial lining of the arterial system against oxidation. Higher doses can reduce cholesterol and triglyceride levels.

Antioxidant Trace Minerals
Trace elements such as selenium, zinc and copper are involved in the activity of antioxidant enzymes.
Evidence linking marginal intakes of the trace elements chromium, copper, zinc and selenium with abnormal lipid metabolism and ultimately cardiovascular diseases is accumulating from both animal and human studies.
Additionally, chromium may increase HDL cholesterol and decrease triglycerides and total cholesterol, whilst selenium may be involved in platelet aggregation.