Definitions of Cardiovascular Disease Risk Factors
Total cholesterol
Cholesterol is a waxy fat like substance. Total cholesterol refers to the sum of the different sub-fractions of cholesterol that are measured in the blood. Total cholesterol is an independent risk factor for cardiovascular disease. The National Cholesterol Education Program says 240 is considered high. A person with this level has twice the risk of heart disease compared with someone whose cholesterol is 200 mg/dL. Total cholesterol 200-239 is borderline high cholesterol. Any cholesterol level of 200 mg/dL or more increases your risk. (More than half the adults in the United States have levels above 200 mg/dL).
LDL cholesterol
Low density lipoprotein (LDL): A subfraction of total cholesterol. (Like oil and vinegar, cholesterol and blood do not mix well. So, for cholesterol to travel through, it is coated with a layer of protein to make it a lipoprotein. Hence the name LDL-cholesterol) LDL is the 'bad' or athrogenic cholesterol fraction. More directly correlated with riskfor CVD then total really. Excess LDL builds up in your arteries (simplistically). The higher the level of LDL, the greater your risk for heart disease. Generally above 130 is considered high, but some high risk individuals should have that even lower.
HDL cholesterol
High density lipoprotein: a subfraction of total cholesterol. The 'good' or non arthrogenic cholesterol fraction. General thought that the higher the better as it appears to 'pick up' or remove athrogenic LDL from the bloodstream.Triglycerides
Another type of fat carried in the blood. Most of the body's fat tissue is in the form of triglycerides, stored for use as energy. High triglyceride levels also are associated with increased CVD risk.Cholesterol/HDL Ratio (tChol/HDL-C)
A ratio of the two and an independent predictor of CVD. Generally tracks with LDL, but not always. You can see that you can have a very high HDL and a modestly elevated Cholesterol, and still have a good ratio. What is a good ratio? Most literature suggests 4 is an excellent number to shoot for.Triglyceride/HDL Ratio (TG/HDL-C)
This one is not as well known, but it is also an independent predictor of CVD. Probably even more important,it seems to be a good predictor of insulin resistance or Metabolic Syndrome, and has been used by some (importantly Gerald Reaven) as a surrogate marker for insulin resistance. What's good? Less then 3.5 would be considered good.
Fat Mass
% body fat is pretty self explanatory. Once a woman goes over about 30% fat, there is a dramatic correlation with illness and disease. Weight scales can't determine the lean-to-fat ratio of that weight. An individual can be "over-weight" and not "over-fat." A bodybuilder, for example, may be 8% body fat, yet at two hundred and fifty pounds may be considered "over-weight" by a typical height-weight chart. Therefore, these charts are not a good indication of a person's ideal body weight for optimal health.Fat loss/Lean mass Ratio
From the preceding you can see that losing more fat then lean is highly desirable, and so a greater change in this ratio is a good thing.High sensitivity C-reactive protein (hs-CRP)
A very sensitive marker of systemic inflammation in the body. It's actually an inflammatory mediator producedin the liver. This sensitive test measures 'sub acute' inflammation. That is, someone with rheumatoid arthritis would have a very high level. That's not sub acute. However, if this marker is used to measure inflammation in individuals who don't have overt inflammatory conditions it can pick up sub acute 'smoldering' if you will. It could
be anything smoldering, but there has been a lot of work done in the past 10 years that suggests that many people with no overt inflammatory condition and who have elevated levels (not as high as RA mind you) are at increased risk for CVD. Hence this is an independent risk factor for CVD and the general acceptance that CVD is in part an inflammatory mediated condition.
Homocysteine
Another metabolite measured in the blood. Homocysteine is actually a by product of certain normal metabolic amino acid breakdown and processing. However, if it is elevated it suggests a 'sluggish' conversion or reconversion from one amino acid to another. (This conversion is controlled by enzymes and these enzymes are driven in part, by certain vitamins that act as cofactors. Hence you can often drive or quicken this process with folic acid, B6, B12 etc.) The problem here is that homocysteine, akin to LDL cholesterol, appears to be athrogenic, i.e. it damages the vessel wall. Thus high levels are independently associated with CVD. Additionally high levels appear to be independently associated with strokes and dementia as well as other things.Hemoglobin A1C (HbA1C)
This is a measure of long term blood sugar control. It is actually measuring changes in the hemoglobin molecule brought about by bouncing against glucose in the blood stream. Essentially glucose in the blood is bumping up against red blood cells (which contain hemoglobin). The more glucose 'bumps' against RBC's the more 'pock marks'it makes on that molecule. You can measure these marks as HbA1C. So you can see the higher the number, the higher glucose is overall in the blood. Since RBC's stay around for 120 days, you can get a good assessment of long term blood sugar control. It is generally used in diabetics; however, it is now very clear that even modestly elevated HbA1C-within the normal range-is actually an increased risk for CVD.
Fasting insulin
Insulin is a hormone secreted by the pancreas in response to glucose levels in the blood. Insulin's main actionis to open up, or unlock the cellular 'door' to allow glucose to get into cells. Glucose needs insulin to get into a cell. In Insulin resistance (Metabolic Syndrome) insulin is not working efficiency and so the pancreas pours out more insulin. This is good, because then in many people their blood sugar remains in the normal range. However
it is also bad as insulin has various other metabolic effects-it causes, increased triglycerides, decreased HDL, increased blood pressure etc. So higher levels of insulin are associated with Metabolic Syndrome and CVD
Blood Pressure
Pressure exerted by the blood upon the walls of the blood vessels, measured by means of a sphygmomanometer (BP cuff), and expressed in millimeters of mercury. The numerator is the maximum pressure that follows systole (pumping) of the left ventricle of the heart and the denominator the minimum pressure (that accompanies cardiac diastole). (Adult) blood pressure is considered normal at 120/80 where the first number is the systolic pressure and the second is the diastolic pressure. Hypertension (there are different stages) starts at greater then 140/90.Fasting glucose
The level of glucose or 'blood sugar.' Fasting, anything below 100 mg/dl is considered normal, 100-125 is considered 'impaired glucose tolerance' (IGT) and 126 or greater is considered diabetic. IGT just means, as with many things, there is a continuum, and this is in the danger zone. Some people consider this 'prediabetic.'Therapeutic Lifestyle Changes (TLC)
Therapeutic Lifestyle Changes (TLC) are recommended as a first line treatment for a variety of common healthproblems by many national health organizations, including:
- National Institutes of Health (NIH)
- National Cholesterol Education Program (ATP III Guidelines)
- American Diabetes Association
- North American Menopause Society
- American Heart Association
- American Association of Clinical Endocrinologists
- And many others
Lifestyle-related, chronic health problems:
- Elevated Cholesterol Elevated Blood Pressure
- Cardiovascular Disease Overweight/Obesity
- Type 2 Diabetes Insulin Resistance or Metabolic Syndrome
- Osteoporosis Osteoarthritis
- Conditions related to aging
Most importantly, patients get results with the FLT program. Many are able to achieve their risk-reduction goals without medication in as little as 12 weeks on FLT.
Moderate Risk Reduction
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- CardioauxinTM - 2 tablets twice daily
a unique combination of synergistic nutrients that proved to significantly lower low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), while raising protective high-density lipoprotein cholesterol (HDL-C).
Therapeutic Lifestyle Change
- Low Glycemic Index diet (see FirstLine Therapy® Diet)
- Exercise - 150 min/wk of aerobic exercise (e.g. walking 30 min/day at 5 days/wk).
Severe Risk Reduction
- FirstLine Therapy® Program
effective than low fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
- UltraMeal® Plus 360- 2 scoops twice daily
nutritional support for patients with metabolic syndrome and cardiovascular disease by supplying a combination of acacia extract, reduced iso-alpha acids (RIAA), plant sterols, and heart-healthy soy protein and isoflavones.
- EPA-DHA Extra Strength® - 2 to 4 softgels twice daily
- CardioauxinTM - 2 tablets twice daily
- Red Yeast Extract - 1 capsule three times daily
levels in hyperlipidemic individuals.
Clinical Note
If your patients are on cholesterol lowering drugs (e.g. statins), consider adding:CoQ-10 ST-100TM - 1-2 softgels daily
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10) manufactured to achieve exquisite quality, purity, and bioavailability
The depletion of the essential nutrient CoQ10 by the increasingly popular cholesterol lowering drugs, HMG CoA reductase inhibitors (statins), has grown from a level of concern to one of alarm. With ever higher statin potencies and dosages, and with a steadily shrinking target LDL cholesterol, the prevalence and severity of CoQ10 deficiency
is increasing noticeably. An estimated 36 million Americans are now candidates for statin drug therapy. Statin- induced CoQ10 depletion is well documented in animal and human studies with detrimental cardiac consequences
in both animal models and human trials. This drug-induced nutrient deficiency is dose related and more notable
in settings of pre-existing CoQ10 deficiency such as in the elderly and in heart failure.1
Published data already indicated that statins can cause myopathies and rhabdomyolysis with renal failure. Moreover, on May 1, 2000, the FDA issued a warning about liver failure as an adverse reaction of statin use, based on reports that more than half of 62 patients with liver failure died. An estimate claims that the drugs can cause liver and muscle injury in up to 1% of users. For the US this will equal up to 130,000 patients with liver and muscle toxicity symptoms. Moreover, statins use is also implicated the increased incidence of cataracts, neoplasia, peripheral neuropathies, and some psychiatric disturbances.2
Statin-induced CoQ10 deficiency is completely preventable with supplemental CoQ10 with no adverse impact
on the cholesterol lowering or anti-inflammatory properties of the statin drugs.1
References:
1. Langsjoen PH, Langsjoen AM The clinical use of HMG CoA reductase inhibitors and the associated depletion of coenzyme Q10. A review of animal and human publications. Biofactors 2003;18:101-111
2. Bliznakov E. Lipid lowering drugs (statins), cholesterol, and coenzyme Q10: the Baycol case - a modern pandora's box. Biomed Pharmacother,
2002;56:56-9.
Congestive Heart Failure
Congestive heart failure (CHF), occurs as a result of impaired pumping capability of the heart and is associated
with abnormal retention of water and sodium. The condition ranges from mild congestion with few symptoms to life-threatening fluid overload and total heart failure.
CHF results in an inadequate supply of blood and oxygen to the body's cells. The decreased cardiac output causes
an increase in the blood volume within the vascular system. Congestion within the blood vessels interferes with the movement of body fluids in and out of the various fluid compartments, and they accumulate in the tissue spaces, causing edema.
Clinical symptoms: Left-sided heart failure produces dyspnea of varying intensity. In the early stages, shortness
of breath occurs only when the patient is physically active. Later, as the heart action becomes more seriously impaired, the dyspnea is present even when the patient is resting. In advanced cases, the patient must sit up in order to breathe (orthopnea). Attacks of breathlessness severe enough to wake the patient frequently occur during sleep. These attacks usually are accompanied by coughing and wheezing (cardiac asthma), and the patient seeks relief by sitting upright. Orthopnea and cardiac asthma or paroxysmal nocturnal dyspnea are related to congestion
of the pulmonary blood vessels and edema of the lung tissues. They are aggravated by lying down because in the prone position quantities of blood in the lower extremities move upward into the blood vessels of the lungs.
Fluid retention is another common symptom of CHF. In left-sided failure there is higher than normal pressure
of blood in the pulmonary vessels. This increased pressure forces fluid out of the intravascular compartment and into the tissue spaces of the lungs causing pulmonary edema. Right-sided failure causes congestion in the capillaries of the peripheral circulation and results in edema and congestion of the liver, legs, and feet, and in the sacral region of bedridden patients.
Medical treatment: Medical management of congestive heart failure is aimed at improving contractility of the heart, reducing salt and water retention, and providing rest for the heart muscle. Drugs used to accomplish these goals include digitalisglycosides to slow and strengthen the heart beat, vasodilators, such as nitroprusside and phentolamine, to reduce resistance to the flow of blood being pumped from the heart, and diuretics to assist in the elimination of water and sodium in the urine.
Nutrients Involved
Coenzyme Q10, magnesium, taurine, potassium
Suggested Nutritional Supplementation
Moderate
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- CoQ10 ST-100 - 1 capsule 1-2 times daily with meals.
- Mag Glycinate - 2 tablets 2 times daily with meals.
that is designed to enhance absorption and intestinal tolerance of magnesium.
- Research indicates myocardial and serum magnesium deficiency in congestive heart failure. Supplementation may assist in the correction of muscle potassium deficiencies as well as in correction of the disturbed relation between extra and intracellular electrolytes.
- Cardiogenics Intensive Care - 1-2 tablets twice daily between meals.
- Pure Taurine - 3 capsules 2-3 times daily between meals with juice. Taurine has been demonstrated to be beneficial in congestive heart failure.
Severe
- FirstLine Therapy® Program
and nutritional supplements. New research has shown that low glycemic diets are more effective than low
fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
- UltraMeal® Plus 360° - 2 scoops twice daily
Cardiovascular Disease
- EPA-DHA High Concentrate LiquidTM - 1 teaspoon 1-3 times daily.
- CoQ10 ST-100 - 1 capsule 1-2 times daily with meals.
- Cardiogenics Intensive Care - 1-2 tablets twice daily between meals.
If potassium deficient (due to prescription diuretic use), add:
- MG/K Aspartate - 1 tablet 3 times daily with meals.
Dietary Suggestions
- FirstLine Therapy® Diet
Homocysteine (high)
First identified by Kilmer McCully, M.D., as a significant risk factor in vascular disease. Homocysteine is a natural amino acid metabolite of dietary methionine at low concentrations. Excess accumulation of homocysteine has been documented to lead to vascular damage and early stroke, atherosclerosis, and coronary heart disease. It has also been associated with systolic hypertension, rheumatoid arthritis, Alzheimer's disease, and depression.
"An estimated 10-20% of all cardiovascular disease is caused by excessive plasma homocysteine concentrations."
- Kilmer McCully, M.D.
Homocysteine Trends In U.S. Population
- Normal range 4-17 micromoles/L of blood
- Desirable level 4-8 micromoles/L of blood
- Low risk < 12 micromoles/L of blood
- Medium risk 12-17 micromoles/L of blood
- High risk > 17 micromoles/L of blood (21% of population: > 16.8 HIGH RISK)
- Reference: Rimm et al, JAMA 1998 Feb 4: 279 (5): 359-64
Causes of High Homocysteine
- Inadequate dietary folate, B12, B6, choline, betaine (TMG)
- High protein intake - methionine loading
- Age - homocysteine increases with advancing age
- Enzyme defects: Cystathionine synthase, methyltetrahydrofolate homocysteine methyltransferase, methylenetetrahydrofolate reductase (12% homozygous in U.K.)
- Gastrointestinal disorders that reduce B12 uptake
- Gastric acid inhibitors (i.e., Tagamet, etc.) that reduce availability of intrinsic factor
- High homocysteine is associated with renal disease
Risk Factors For High Homocysteine
- Low fruit and vegetable diet
- High protein intake
- Age (over 50)
- Enzyme defects (approximately 12% of population)
- Hypochlorhydria
- Ulcer
- Use of antacids / gastric acid inhibitors
- Postmenopausal
- Elderly and institutionalized
- High stress
- Smoking
- Renal disease
- Hypothyroidism
- Family history or personal history of: atherosclerosis, peripheral artery disease, cerebral vascular disease, Alzheimer's disease, diabetes, or high homocysteine
- Vessel Care - 1-2 tablets daily with food.
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- CardioauxinTM - 2 tablets twice daily
a unique combination of synergistic nutrients that proved to significantly lower low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG), while raising protective high-density lipoprotein cholesterol (HDL-C).
NOTE: Retest homocysteine levels in 6-8 weeks. When normalized, move to preventive maintenance
program.
Ongoing Maintenance
- Glycogenics - 2 tablets daily with food.
Dietary Suggestions
- FirstLine® Therapy Diet
Hypertension (High Blood Pressure)
Blood pressure consistently higher than 140/90 mm Hg. NOTE: Acute Hypertension (>150 mm/Hg), or lower blood pressure accompanied by symptoms such as headache, visual disturbance, or lethargy indicate need for immediate crisis intervention.
The treatment of hypertension is a complicated problem confronting the clinician. Medications currently used for blood pressure management include beta-blockers, diuretics, and other medications that have negative side effects. According to a four year study of hypertension published in JAMA "study findings demonstrated thatNUTRITIONAL THERAPY may substitute for drugs in a sizable proportion of hypertensives or, if drugs are still needed, can lessen some unwanted biochemical effects of drug treatment." Therefore, it is valuable to identify a nutritional program without negative side effects that would have a beneficial effect on reducing blood pressure.
Nutrients Involved
Bonito fish peptides, garlic, calcium, magnesium, potassium, coenzyme Q10, EPA/DHA oils, arginine
Hypertension - Suggested Nutritional Supplementation
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- Vasotensin - 2 tablets twice daily with food.
- CoQ10 ST-100 - 1 capsule 1-2 times daily with meals.
Studies show that CoQ10 deficiency is present in 39% of people with hypertension. CoQ10 lowers
blood pressure by lowering cholesterol levels and stabilizing the vascular membrane via its antioxidant
properties.
- ActiFolate - 6-12 tablets daily with food.
Several studies have demonstrated that high-dose folic acid acutely lowers blood pressure and
enhances coronary vasodilator function in patients with coronary artery disease. J Am Coll Cardiol 2005;
45:1580-4, Am J Clin Nutr 2005; 82:26-31
- Super Garlic 6000 - 1 tablet 3 times daily.
Many studies confirm its effectiveness in lowering both blood pressure and cholesterol. It protects
against heart disease and strokes by affecting the process of atherosclerosis at many stages. According
to Michael T. Murray, N.D., in The Healing Power of Herbs (Prima, 1995), "the mode of action of garlic
as an anti-hypertensive appears to be related to its sulfur content and lipid-lowering properties."
For the "high-stress" hypertensive individual add:
- Serenagen - 2 tablets 2-3 times daily with lukewarm water.
"stressed and wired".
Dietary Suggestions
- FirstLine Therapy® Diet
- "What YOU Can Do To Bring Your Blood Pressure Down" chart (next page)
What YOU Can Do To Bring Your Blood Pressure Down
Regular Chiropractic Adjustments
- Maintains vital nerve flow to the
- Reduces mechanical stress to the nervous system.
- Enhances all nutritional and Dietary Suggestions by allowing for optimal assimilation.
Give Your Body the Right Kinds of
Food
- Obesity often can lead to increased blood
- Give up "empty" calories like sugar, white bread, cake, cookies, pie, saturated fats (lard, shortening), hard alcohol.
- A pint of beer or about half as much wine has about as many calories as a pat of butter. So avoid beer, wine, and liquor.
Cut Down on Salt
- Try to decrease the salt you add while
- Avoid salt-loaded foods, such as chips,
- Instead of salt, try cooking with other flavorings such as lemon juice, mint, mustard, herbs, curry, etc. Use your imagination!
Quit Smoking
- Cigarette smokers not only drive up their blood pressure, but also run twice the risk of heart attack as nonsmokers.
Get More Exercise
- Walk up and down stairs rather than taking the elevator. Walk the few blocks to the store rather than hopping in the car, etc.
- Try to be physically active every day, and
Increase Your Leanness if Overweight
- Implement an effective weight loss
- Stay away from alcohol.
Control Your Caffeine Intake
- Coffee, tea, colas, and analgesics contain
Increase Consumption of Calcium, Garlic, Magnesium, Potassium-Rich Foods
- Studies show that calcium, magnesium, garlic, and potassium may be more helpful in lowering blood pressure than salt restriction.
Increase Omega- Fatty Acids
- Studies indicate that oils in fish may help lower blood pressure.
Remember
- High blood pressure is a dangerous disease. If not brought under control, it can lead to strokes and heart attacks.
- High blood pressure is a silent disease.
you feel. The only way of telling is in the doctor's office with a blood pressure cuff.
- High blood pressure is a lifelong disease. Diet, exercise, and quitting smoking can bring blood pressure under control, but it will go back up again if these measures are stopped.
Mitral Valve Prolapse
Mitral Valve: The left atrioventricular valve, the valve between the left atrium and the left ventricle of the heart;
it is composed of two cusps, anterior and posterior. Called also the bicuspid valve.
Mitral Valve Prolapse (MVP): A condition in which some portion of the mitral valve is pushed back too far during ventricular contraction. For reasons not fully understood (there is no evident disease process) there is redundant tissue on one or both leaflets of the valve. The prolapsed portion of the valve causes a clicking sound at the end of ventricular contraction. This sound is followed by a systolic murmur as blood is regurgitated back through the mitral valve and into the left atrium. The condition is, therefore, also known as the click-murmur syndrome. Echocardiography can demonstrate the mitral valve as it prolapses into the left atrium. Another name for MVP
is Barlow's syndrome, after the physician who, in 1968, first associated the phenomenon with some potentially serious complications, such as infective endocarditis, transient ischemic attack, and arrhythmia. However, in the vast majority of persons in whom MVP can be detected by auscultation there are no other symptoms and the condition is so benign as to require no treatment.
MVP is found in persons of all ages and is fairly common. The few who have problems usually experience some chest pain, dyspnea, palpitations, and fatigue. Syncope and anxiety also occur, though less commonly. Many patients become less anxious when they understand the difference between MVP and coronary heart disease. Electrocardiographic studies may show some premature ventricular contractions (PVCs) but, unlike those in coronary heart disease, the PVCs are not harmful nor do they indicate injury to the heart muscle.
Long-term effects of MVP have not been thoroughly documented owing to the relatively short time that it has been recognized as a disease entity. There are sufficient data to show that almost all persons with MVP can lead normal and full lives.
Review Article: The histopathology, somatic morphology and genetics of MVP support the leading theory that
it results from a hereditary disorder of connective tissue. Latent tetany due to chronic magnesium deficit occurs
in over 85% of cases, and MVP complicates 26% of cases of latent tetany. Magnesium deficiency hinders the mechanism by which fibroblasts degrade defective collagen, increases circulating catecholamines, predispose
to arrhythmias, thromboembolic phenomena and dysregulation of the immune and autonomic nervous system; magnesium therapy relieves MVP symptoms (Galland LD et al. Magnesium deficiency in the pathogenesis of mitral valve prolapse. Magnesium 5(3-4):165-74, 1986).
Experimental Study: 400 children with MVP aged 8-16 recieved CoQ10 0.6-3.4 mg/kg/day. CoQ10 was found
to be definitely effective for symptomatic MVP and improved stress-induced cardiac dysfunction if the approciate dose was given. No side effects were noted. When the supplement was withdrawn, symptoms returned. Rapid normalization could be usually be achieved in 1 wk. on doses of 3.0-3.4 mg/kg/day, with gradual decreases to a patient-dependant stabilization dose (Oda T. Effect of coenzyme Q10 on stress-induced cardiac dysfunction in paediatric patients with mitral valve prolapse: A study by stress echocardiography. Drugs exp Clin ��es 11(8):557-
76,1985).
Nutrients Involved
Magnesium, Coenzyme Q10
Suggested Nutritional Supplementation
- Mag Glycinate - 2 tablets 2-3 times daily with meals.
Magnesium appears to play an important role in the pathogenesis of mitral valve prolapse.
- CoQ10 200 mg - 100 mg per 50 lbs. of body weight daily initially. Once improvement occurs, gradually
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10)
manufactured to achieve exquisite quality, purity, and bioavailability.
CoQ10 was found to be effective for symptomatic MVP and improve stress-induced cardiac dysfunction.
Dietary Suggestions
- FirstLine Therapy® Diet
Stroke (Cerebrovascular Disease)
A sudden and severe attack. Rupture or blockage of a blood vessel in the brain, depriving parts of the brain of
blood supply, resulting in a loss of consciousness, paralysis, or other symptoms depending on the site and extent
of brain damage. There will be 750,000 strokes this year resulting in 250,000 deaths.
Nutrients Involved
EPA/DHA oils, vitamin E, taurine, magnesium, ginkgo biloba
Suggested Nutritional Supplementation
Moderate
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- E-Complex 1:1 - 2-4 softgels daily with meals.
- EPA/DHA 720 - 2 softgels 2-3 times daily with meals.
Studies indicate that omega-3 fatty acids (EPA-DHA) may protect against decreases in cerebral blood flow and cerebral edema in the presence of an acute carotid occlusion.
Severe
- FirstLine Therapy® Program
and nutritional supplements. New research has shown that low glycemic diets are more effective than low
fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
- UltraMeal® Plus 360° - 2 scoops twice daily
of acacia extract, reduced iso-alpha acids (RIAA), plant sterols, and heart-healthy soy protein and isoflavones.
- High Concentrate EPA-DHA LiquidTM - 1 tsp. twice daily
- Cardiogenics® Intensive Care - 1 to 2 tablets twice daily between meals
- Mag GlycinateTM - 2 tablets twice daily with meals
that is designed to enhance absorption and intestinal tolerance of magnesium.
Hans Nieper, MD noted that treatment with magnesium for 18 months improved blood vessel elasticity
(measured by capillarioscopy) in about 90% of patients to an extent close to normal.
Dietary Suggestions
- FirstLine Therapy® Diet.
- NOTE: Avoid alcoholic beverages.
In addition, more than 70 million Americans currently live with a cardiovascular disease. Coronary heart disease
is a leading cause of premature, permanent disability in the U.S. workforce. Stroke alone accounts for disability among about 1 million Americans. More than 6 million hospitalizations each year are because of cardiovascular diseases.
The economic impact of cardiovascular diseases on our nation's health care system continues to grow as the population ages. The cost of heart disease and stroke in the United States is projected to be $403 billion in 2006, including health care expenditures and lost productivity from death and disability. (http://www.cdc.gov/nccdphp/publications/aag/pdf/aag_cvh2006.pdf).
Atherosclerosis
Atherosclerosis is a slow, complex disease in which fatty substances, cholesterol, cellular waste products, calcium, and other substances build up in the inner lining of an artery. This buildup is called plaque. Atherosclerosis is derived from the Greek words athero (meaning gruel or paste) and sclerosis (meaning hardness). The effects of atherosclerosis differ depending upon which arteries in the body narrow and become clogged with plaque. For example, plaque buildup in the vessels that supply the heart with oxygen-rich blood may cause chest pain and lead to a heart attack while plaque buildup in the arteries that supply blood to the brain may result in a stroke.
According to the Centers for Disease Control, heart disease is the leading cause of illness and death in the United States and most other Western countries. Close to one million deaths per year in the United States alone are attributable to heart disease, double the number of deaths from cancer. Because atherosclerosis is highly preventable and the risk factors are well-documented, preventive measures such as lowering blood pressure and LDL ("bad") cholesterol levels, smoking cessation, losing weight, and increasing physical activity should be followed.
Signs and Symptoms
Atherosclerosis shows no symptoms until a significant percentage (40%) of a vessel becomes obstructed with plaque and a complication occurs. Symptoms vary depending upon which arteries in the body narrow and become clogged with plaque.Coronary Artery Disease (CAD)
CAD is caused by plaque buildup in the vessels that supply the heart with oxygen-rich blood. When the tissuesof the heart begin to become deprived of oxygen (ischemia), chest pain (angina) occurs. If the artery becomes completely blocked, cells in the heart begin to die and a heart attack may occur. Symptoms of CAD are usually triggered by physical exercise, sexual activity, exposure to cold weather, anger, or stress. The most common symptoms of CAD include:
- Chest pain (generally a heavy, squeezing, or crushing sensation with possible burning or stabbing pains)
- Abdominal, neck, back, jaw, or shoulder/arm pain
- Nausea and vomiting
- Unexplainable fatigue and/or extreme fatigue after physical activity
- Weakness
- Perspiration
- Shortness of breath
- Depression and/or anxiety
Cerebrovascular Disease (Stroke)
Cerebrovascular disease is caused by plaque buildup in the arteries that supply the brain with oxygen-rich blood. Cerebrovascular disease causes transient ischemic attack (a sudden loss of brain function with complete recovery within 24 hours) and stroke. Symptoms may include:
- Weakness or paralysis on one side of the body
- Garbled speech and/or inability to comprehend speech
- Loss of vision in one eye
- Paralysis of facial muscles
- Muscle weakness
- Impaired senses
- Stupor
- Poor coordination
- Involuntary, jerky movements on one side of the body
- Rapid, repetitious, involuntary eye movement
- Vertigo
Peripheral Artery Disease
Peripheral artery disease is caused by plaque buildup in the arteries that supply the extremities of the body (such
as the hands and feet) with oxygen-rich blood. Symptoms may include:
- Pain, aching, cramps, numbness or sense of fatigue in the muscles of the lower extremities
- Diminished pulses in the extremities
- Decreased muscle mass
- "Bruits" (blowing sounds that the physician hears with a stethoscope that indicates turbulence in blood flow)
- Hair loss
- Thickened nails
- Smooth, shiny skin surface
- Skin that is cold to the touch
- Gangrene
- Causes
or damaged endothelium, thereby blocking the artery, and completely cutting off blood supply.
Because many people do not have the classic risk factors of atherosclerosis (such as cigarette smoking and high blood pressure), it is possible that there may be other contributing factors or causes of atherosclerosis, such as inflammation from an infection or autoimmune disease.
Risk Factors
- Male gender
- Lowered levels of the hormone estrogen following menopause
- Older age
- High blood pressure
- High LDL ("bad") cholesterol and/or high triglycerides
- Elevated homocysteine levels
- Low HDL ("good") cholesterol
- Family history of atherosclerosis (which may be related to learned behavior rather than genetic factors)
- Cigarette smoking and regular exposure to second-hand smoke
- Diabetes mellitus
- Insulin resistance
- Obesity, particularly in the abdominal region
- Sedentary lifestyle
- Diets high in saturated fat and trans fatty acids
- Stress
- Depression
Diagnosis
A healthcare practitioner can determine your risk for heart disease by conducting a variety of tests. Blood testsdetect elevated levels of cholesterol, homocysteine, and blood clotting factors. A stress test (otherwise known as
an exercise tolerance test) monitors heart rate and blood pressure while an individual walks on a treadmill or rides
a stationary bicycle. An electrocardiogram (ECG) is used during a stress test to measure and record the electrical activity of the heart. ECGs can detect abnormal heart rhythms, scar formation in the heart muscle from a prior heart attack, and areas of decreased blood flow when the heart is strained (as with physical activity). Advanced imaging techniques used during a stress test (such as an ultrasound) can determine precise areas of decreased blood flow to the heart. Angiograms (or angiography) can reveal arterial damage and plaque buildup.
Preventive Care
Making careful lifestyle choices is an important first step in preventing atherosclerosis. Some healthy habits
include:
- Achieving and maintaining normal weight
- Controlling high blood pressure, high cholesterol, diabetes, and other disorders that may contribute to the buildup of plaque in arteries
- Avoiding cigarette smoking and second-hand smoke
- Eating a diet low in saturated and hydrogenated fats and cholesterol, and high in starches, fiber, fruits, and
- Exercising 3 hours per week or more (such as 30 minutes per day, 6 days per week)
- Reducing stress
Treatment Approach
Atherosclerosis shows no symptoms until a complication (such as chest pain or a heart attack) occurs. For this reason, lifestyle choices such as achieving and maintaining a normal weight, lowering blood pressure and cholesterol, exercising regularly, quitting smoking*, and reducing stress, are all important steps in preventing atherosclerosis. Once a complication occurs, however, surgery and other Procedures may be required to remove plaque from clogged arteries or to create a detour around a blocked artery. Healthy diets designed to lower cholesterol, blood pressure, and excess body weight are essential in the treatment of atherosclerosis. Nutrition and dietary supplements, such as vitamin E, omega-3 fatty acids, and folate (vitamin B9) may be effective when used in addition to certain medications. Herbs, such as hawthorn, have also shown promise in lowering cholesterol levels and reducing the risk of heart disease.Stop Smoking-Cigarette smoking acutely increases the heart rate and arterial blood pressure and may therefore affect the pattern of arterial blood flow. Using a non-invasive ultrasound technique, cigarette smoking was shown
to increase arterial wall stiffness and to alter the pattern of arterial blood flow. These effects may help to explain why smoking and some other factors favor the development of atherosclerosis.
Nutrition and Dietary Supplements
Healthy eating habits can help reduce high blood cholesterol, high blood pressure, and excess body weight -- three of the major risk factors for heart disease. The American Heart Association (AHA) has developed dietary guidelines that help lower fat and cholesterol intake and reduce the risk of heart disease. The main goal of these guidelines is to promote an overall healthy eating pattern, maintain an appropriate body weight, and reach desirable cholesterol and blood pressure levels. The AHA does not recommend very low-fat diets as these diets may leadto deprivation of essential fatty acids as well as an undesired reduction in HDL ("good") cholesterol levels. The AHA also advises against high-protein diets due to the lack of scientific evidence supporting their weight-loss effectiveness or any other claims of health benefits. In general, Western diets are considered to be too high in protein, particularly animal protein (which is high in fat and cholesterol). In adults, high levels of protein can cause kidney damage and bone loss.
The AHA recommends the following to prevent the development or progression of atherosclerosis:
- A variety of fruits and vegetables (5 to 9 servings/day)
- A variety of grain products, with an emphasis on whole grains (6 or more servings/day)
- At least 2 servings of fish per week
- Limit total fat intake to <30% and saturated fat to <10% of energy. Replace dietary saturated fats and trans fatty acids with monounsaturated and polyunsaturated fats (including foods rich in omega-3 fatty
soybean oil, canola oil, and nuts.
- Limit dairy products to low-fat or fat free items (2 to 4 servings/day)
- Limit sodium intake to 6 grams per day
- Limit alcohol intake to 2 drinks/day for men and 1 drink/day for women
- Maintain a healthy body weight by matching calorie intake to energy needs; this includes a moderate level
In addition to the recommendations listed above, the AHA suggests that individuals who have heart disease or are at a high risk of developing heart disease consider the more specialized diets below:
Diets for People with High Cholesterol
The National Cholesterol Education Program (NCEP) recommends saturated fat intake of no more than 7% of total calories, cholesterol limited to less than 200 mg/day, little to no trans fatty acids (such as fried foods), intakeof both plant stanols/sterols (2 grams/day) and soluble fiber (10 to 25 grams/day), weight loss, and exercise. Studies have also shown that replacing dietary animal protein with soy protein may reduce total cholesterol, LDL ("bad") cholesterol, and triglycerides (a major form of fat in the blood) without affecting HDL ("good") cholesterol levels. The AHA also recommends a diet high in unsaturated fat diet rather than a very low-fat diet for individuals with atherogenic dyslipidemia (a condition marked by high triglycerides, low HDL cholesterol, obesity, high blood pressure, and/or diabetes).
Diets for People with High Blood Pressure
The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes a diet rich in fruits, vegetables, and low-fat or non-fat dairy products to provide high intake of potassium, magnesium, and calcium sources. Sodium intake should be less than 6 g/day. Weight loss, regular physical activity, and limiting of alcohol intake are also very important factors for lowering blood pressure.Mediterranean Diet
The Mediterranean Style Diet is comprised of whole grains, fresh fruits and vegetables, fish, olive oil, and moderate, daily wine consumption. Unlike the AHA diets, the Mediterranean Style Diet is not low in all fats; it is low in saturated fat but high in monounsaturated fatty acids. In a long-term study of 423 patients who suffereda heart attack, those who followed a Mediterranean Style Diet had a 50% to 70% lower risk of recurrent heart disease compared with controls who received no special dietary counseling. The intervention diet emphasized bread, root and green vegetables, daily intake of fruit, fish and poultry, olive and canola oils, margarine high in alpha-linolenic acid (an omega-3 polyunsaturated fatty acid found in flaxseed, walnuts, and canola oil), along with discouragement of ingestion of red meat and total avoidance of butter and cream.
Supplements and Vitamins
Folic Acid, Vitamin B6, Vitamin B12, Betaine
Many studies indicate that patients with elevated levels of the amino acid homocysteine are roughly 1.7 times more likely to develop coronary artery disease and 2.5 times more likely to suffer from a stroke than those with normal levels. Homocysteine levels are strongly influenced by dietary factors, particularly vitamin B9 (folic acid), vitamin B6, vitamin B12, and betaine. These substances help break down homocysteine in the body. Some studies have even shown that healthy individuals who consume higher amounts of folic acid and vitamin B6 are less likely to develop atherosclerosis than those who consume lower amounts of these substances.
Omega-3 Fatty Acids
There is strong evidence that omega-3 fatty acids (namely EPA and DHA) found in fish oil can help prevent and treat atherosclerosis by inhibiting the development of plaques and blood clots. In one study of 223 patients with coronary artery disease, those who received fish oil supplements daily for 2 years demonstrated a significant improvement in symptoms compared to those who did not receive the supplements. A second study of heart attack survivors found that daily supplementation with omega-3 fatty acids dramatically reduced the rate of death, subsequent heart attacks, and stroke.
L-Carnitine
Studies suggest that patients who take L-carnitine supplementation soon after suffering a heart attack may be less likely to suffer a subsequent heart attack, die of heart disease, and experience chest pain and abnormal heart rhythms. In addition, people with coronary artery disease who use L-carnitine along with standard medication may be able to sustain physical activity for longer periods of time.
Antioxidants
Evidence suggests that antioxidants may play a role in the prevention of atherosclerosis. Antioxidants are believed
to prevent fatty buildup in the arteries by suppressing the oxidation of LDL ("bad") cholesterol. They may also reduce the likelihood of blood clot formation and may help relax blood vessels thereby improving blood flow.
Vitamin E
Population-based studies suggest that vitamin E supplements may help prevent the development and progression
of heart disease.
Selenium
Low blood levels of this antioxidant may worsen atherosclerosis. Cigarette smoking and alcohol ingestion are believed to contribute to selenium deficiency. It is not known, however, whether selenium supplementation has any influence on the development or progression of atherosclerosis.
Coenzyme Q10 (CoQ10)
Researchers believe that CoQ10 inhibits blood clot formation and boosts levels of antioxidants. One study found that people who received daily CoQ10 supplements within 3 days of a heart attack were significantly less likely to experience subsequent heart attacks and chest pain and were also less likely to die of the condition than those
who did not receive the supplements.
Flavonoids
Test tube, animal, and some population-based studies suggest that the flavonoids quercetin, resveratrol, and catechins (all found in high concentration in red wine) may help reduce the risk of atherosclerosis. By acting as antioxidants, there nutrients appear to protect against the damage caused by LDL cholesterol.
Vitamin D
Low levels of vitamin D may increase the risk of calcium build-up in the arteries, a significant component of
atherosclerotic plaque. Atherosclerotic plaque build up in blood vessels can lead to a heart attack or stroke.
Melatonin
Low levels of melatonin in the blood have been associated with heart disease, but it is not clear, whether melatonin levels are low in response to having heart disease or if low levels of melatonin predispose people to developing this condition. In addition, several studies in rats suggest that melatonin may protect the hearts of these animals from the damaging effects of ischemia.
Herbs
- Hawthorn (Crataegus monogyna): Used traditionally as a remedy for cardiovascular diseases. Animal
formation of plaques and may help control high cholesterol and high blood pressure.
- Garlic (Allium sativum): Clinical trials have shown that fresh garlic and garlic supplements may lower
- Green Tea (Camellia sinensis): Population studies indicate that the antioxidant properties of green tea may
- Gugulipid (Commiphora mukul): Used in Ayurvedic medicine to treat high cholesterol levels. Certain ingredients in this herbal remedy may have antioxidant properties and may therefore convey health benefits similar to hawthorn, garlic, and green tea.
- Pseudo ginseng root/notoginseng root (Panax notoginseng): Used in Traditional Chinese Medicine to treat chest pain and coronary artery disease. Laboratory studies suggest this herb may help prevent blood clots and protect against the formation of plaques.
Suggested Nutritional Supplementation
Moderate
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- E-Complex 1:1 - 2-4 softgels daily with meals.
- EPA/DHA 720 - 2 softgels 2-3 times daily with meals.
and cerebral edema in the presence of an acute carotid occlusion.
Severe
- FirstLine Therapy® Program
and nutritional supplements. New research has shown that low glycemic diets are more effective than low
fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
- UltraMeal® Plus 360° - 2 scoops twice daily
of acacia extract, reduced iso-alpha acids (RIAA), plant sterols, and heart-healthy soy protein and isoflavones.
- High Concentrate EPA-DHA LiquidTM - 1 tsp. twice daily
purity-certified, omega-3 essential fatty acids in triglyceride form.
- Cardiogenics® Intensive Care - 1 to 2 tablets twice daily between meals
- Mag GlycinateTM - 2 tablets twice daily with meals
that is designed to enhance absorption and intestinal tolerance of magnesium.
Hans Nieper, MD noted that treatment with magnesium for 18 months improved blood vessel elasticity
(measured by capillarioscopy) in about 90% of patients to an extent close to normal.
Dietary Suggestions
- FirstLine Therapy® Diet. For the maximum effectiveness of this program it is recommended that a high- fiber, high-complex carbohydrate diet such as the Vital Life Diet be implemented.
NOTE: Avoid alcoholic beverages.
Acupuncture
Acupuncture may be particularly useful for reducing risk factors for heart disease. It is considered an excellent treatment for people who wish to quit smoking and some studies indicate that it may aid in weight loss as well as cholesterol and blood pressure reduction.
Massage and Physical Therapy
Although few studies have examined the effectiveness of massage therapy on atheroslerosis, massage has a relaxing effect and it has been shown to reduce stress-related hormone levels. Lowering stress hormone levels positively influences cholesterol and blood pressure and may therefore reduce the risk of heart disease. In addition, relaxation techniques may help individuals comply with habits necessary to reduce risk of atherosclerosis, such as dieting, quitting smoking, and exercising. Also, at least one study has found that massage can lower blood pressure.
Cardiac Arrhythmia
Arrhythmia (ah-rith'me-ah): Variation from the normal rhythm, especially of the heartbeat.
Sinus arrhythmia: The physiologic cyclic variation in heart rate related to vagal impulses to the sinoatrial node;
it occurs commonly in children and in the aged.
Nutrients Involved
EPA/DHA oils, taurine, magnesium, potassium, calcium, chromium, coenzyme Q10
Suggested Nutritional Supplementation
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- EPA-DHA Extra Strength - 2 softgels 2-3 times daily with meals. Concentrated Essential Fatty Acids for Daily Maintenance
cardiac arrhythmia.
- CoQ10 ST-100 - 1 capsule 1-2 times daily with meals.
manufactured to achieve exquisite quality, purity, and bioavailability.
Experimental study suggests that CoQ10 exhibits an effective anti-arrhythmic action, not merely on organic heart disease, but also on ventricular premature beats (VPBs) supervening in diabetes mellitus.
Maintenance Supplementation
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
Dietary Suggestions
- FirstLine Therapy® Diet.
- AVOID CAFFEINE. Caffeine has been shown to have a negative effect on arrhythmia.
Cardiomyopathy/Enlarged
Cardiomyopathy (Kar"de-o-mi-op'ah-the): a general diagnostic term designating primary myocardial disease
Alcoholic cardiomyopathy: Congestive cardiomyopathy resulting in cardiac enlargement and low cardiac output occurring in chronic alcoholics; the heart disease in beriberi (thiamine deficiency) is also associated with alcoholism.
Congestive cardiomyopathy: Syndrome characterized by cardiac enlargement, especially of the left ventricle, myocardial dysfunction, and congestive heart failure.
Infiltrative cardiomyopathy: Myocardial disease resulting from deposition in the heart tissue of abnormal
substances, as may occur in amyloidosis, hemochromatosis, and other disorders.
Nutrients Involved
Vitamin E, selenium, coenzyme Q10, and carnitine
Suggested Nutritional Supplementation
Moderate
- Wellness EssentialsTM Cardiovascular Support - 2 packets daily
- CoQ10 ST-100 - 1 capsule 1-2 times daily with meals.
cardiomyopathy.
- E-Complex 1:1 - 2-4 capsules daily with meals.
- L-Carnitine w/Chromium - 2-3 tablets 2 times daily with juice on empty stomach.
Severe
- FirstLine Therapy® Program
and nutritional supplements. New research has shown that low glycemic diets are more effective than low
fat diets in treating obesity, insulin resistance, dyslipidemia, cardiovascular disease and type-2 diabetes.
- UltraMeal® Plus 360° - 2 scoops twice daily
of acacia extract, reduced iso-alpha acids (RIAA), plant sterols, and heart-healthy soy protein and isoflavones.
Dietary Suggestions
- FirstLine Therapy® Diet.
