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Health Services Specific Health Conditions Cardiovascular Disease
| Cardiovascular Disease |
Definitions of Cardiovascular Disease Risk FactorsTotal cholesterolCholesterol 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 cholesterolLow 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 risk for 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 cholesterolHigh 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. TriglyceridesAnother 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 RatioFrom 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 produced in 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. HomocysteineAnother 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 insulinInsulin is a hormone secreted by the pancreas in response to glucose levels in the blood. Insulin's main action is 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 PressurePressure 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 glucoseThe 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 health problems by many national health organizations, including:
Lifestyle-related, chronic health problems:
FirstLine Therapy® (FLT) is a therapeutic lifestyle changes (TLC) program that is clinically effective, yet easy to implement. FLT provides time-saving tools that make it easy for you to integrate recommendations for diet and exercise with medical foods and other lifestyle changes, in a format that patients can understand and follow. 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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well-being.
CardioauxinTM is a very efficacious lipid-lowering, heart risk reduction formula. This formula contains 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
Severe Risk Reduction
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods 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 is a medical food formulated to provide specialized, multi-mechanistic 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.
Concentrated and Stabilized Purity-Certified, Omega-3 Fatty Acids
Cardioauxin is a very efficacious lipid-lowering, heart risk reduction formula.
Taken orally, red yeast extract is used to reduce and maintain desirable cholesterol and lipoprotein levels in hyperlipidemic individuals. Clinical NoteIf 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
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 digitalis glycosides 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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
Stabilized, highly absorbable coenzyme Q10 with natural vitamin E and beta-carotene.
Mag Glycinate is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process that is designed to enhance absorption and intestinal tolerance of magnesium.
Nutritional support for healthy circulation and cardiac function.
Severe
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods 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.
Nutritional Support for the Management of Conditions Associated with Metabolic Syndrome and Cardiovascular Disease
High Concentrate EPA-DHA Liquid provides at least 2,800 mg per serving of EPA, DHA, and other purity-certified, omega-3 essential fatty acids in triglyceride form.
Stabilized, highly absorbable coenzyme Q10 with natural vitamin E and beta-carotene.
Nutritional support for healthy circulation and cardiac function.
If potassium deficient (due to prescription diuretic use), add:
Features magnesium and potassium in the form of true mineral aspartates to enhance absorption.
Dietary Suggestions
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
Causes of High Homocysteine
Risk Factors For High Homocysteine
Suggested Nutritional Supplementation
Vessel Care is a comprehensive homocysteine formula that supplies optimal levels of folic acid, B12, B6, trimethylglycine (betaine) and choline, nutrients known to support healthy homocysteine metabolism.
Wellness Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
CardioauxinTM is a very efficacious lipid-lowering, heart risk reduction formula. This formula contains 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 is a broad spectrum b-complex specifically designed to support healthy homocysteine metabolism
Dietary Suggestions
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 that NUTRITIONAL 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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
Vasotensin provides active peptides from bonito fish to help prevent the formation of angiotensin II, a potent vasoconstrictor, through their interaction with angiotensin converting enzyme (ACE). This activity supports healthy vascular function for optimal blood flow and healthy blood pressure levels.
Stabilized, Highly Absorbable Coenzyme Q10 with Natural Vitamin E 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 is comprehensive folate nutrition in the active forms. 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
SuperGarlic 6000 is a super-concentrated garlic supplement that is guaranteed to supply 6,000 mcg of allicin-garlic's most important active ingredient-per tablet. 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 is a classic, comprehensive herbal stress management formula targeting individuals who are "stressed and wired".
Dietary Suggestions
What YOU Can Do To Bring Your Blood Pressure Down
Regular Chiropractic Adjustments
cardiovascular system.
Give Your Body the Right Kinds of Food
pressure.
Cut Down on Salt
cooking and not add any salt at the table.
crackers, and canned foods high in sodium.
Quit Smoking
Get More Exercise
twice as active on weekends.
Increase Your Leanness if Overweight
program.
Control Your Caffeine Intake
caffeine which can elevate blood pressure.
Increase Consumption of Calcium, Garlic, Magnesium, Potassium-Rich Foods
Increase Omega- Fatty Acids
Remember
You cannot tell how high it is by how you feel. The only way of telling is in the doctor's office with a blood pressure cuff.
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, available exclusively from Metagenics, is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process that is designed to enhance absorption and intestinal tolerance of magnesium. Magnesium appears to play an important role in the pathogenesis of mitral valve prolapse.
reduce to a maintenance dosage. 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
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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
E-Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma- tocopherol; this ratio more closely resembles the tocopherol profile found naturally in vitamin E-rich plants.
EPA-DHA 720 provides 720 mg of omega-3 essential fatty acids from cold water fish per softgel- eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)-to help deliver greater support in fewer softgels. 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
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods 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° is a medical food formulated to provide specialized, multi-mechanistic 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.
High Concentrate EPA-DHA Liquid provides at least 2,800 mg per serving of EPA, DHA, and other purity-certified, omega-3 essential fatty acids in triglyceride form.
Cardiogenics Intensive Care is a comprehensive heart muscle support formula that features extracts of hawthorn and arjuna with a history of traditional use supporting the heart, possibly by helping to maintain blood vessel dilation and healthy blood pressure already within the normal range. Complementing these herbs is a blend of amino acids and minerals-including magnesium, potassium, and calcium-that play important roles in heart muscle function.
Mag Glycinate is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process 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
Heart disease and stroke are the most common cardiovascular diseases. They are the first and third leading causes of death for both men and women in the United States, accounting for nearly 40% of all annual deaths. More than 910,000 Americans die of cardiovascular diseases each year, which is 1 death every 35 seconds. Although these largely preventable conditions are more common among people aged 65 or older, the number of sudden deaths from heart disease among people aged 15-34 has increased. 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 SymptomsAtherosclerosis 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 tissues of 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:
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:
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:
Many researchers believe that atherosclerosis is caused by damage to the innermost layer of the artery known as the endothelium. High blood pressure, elevated LDL ("bad") cholesterol, an abnormal accumulation of homocysteine (an amino acid produced by the human body), tobacco smoke, diabetes, hormonal changes following menopause, and infection are all thought to contribute to endothelial damage. Once the endothelium is damaged, it becomes easier for fats, cholesterol, cellular waste products, calcium, and other substances to become deposited in the artery wall. This buildup thickens the endothelium significantly. As a result, the diameter of the artery shrinks, blood flow decreases, and oxygen supply is dramatically reduced. Blood clots may also form on top of the plaque 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
DiagnosisA healthcare practitioner can determine your risk for heart disease by conducting a variety of tests. Blood tests detect 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:
vegetables
Treatment ApproachAtherosclerosis 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 SupplementsHealthy 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 lead to 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:
acids). Food sources of omega-3 fatty acids include fatty fish (such as salmon), flaxseed and flaxseed oil, soybean oil, canola oil, and nuts.
of regular physical activity (30 to 60 minutes within target heart range most days per week) 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 CholesterolThe 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), intake of 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 PressureThe 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 DietThe 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 suffered a 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
and laboratory studies demonstrate that this herb has antioxidant properties that help protect against the formation of plaques and may help control high cholesterol and high blood pressure.
cholesterol levels, prevent blood clots, and destroy plaque.
prevent atherosclerosis, particularly coronary artery disease.
Suggested Nutritional Supplementation
Moderate
Wellness Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
E-Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma- tocopherol; this ratio more closely resembles the tocopherol profile found naturally in vitamin E-rich plants.
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
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods 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° is a medical food formulated to provide specialized, multi-mechanistic 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.
High Concentrate EPA-DHA Liquid provides at least 2,800 mg per serving of EPA, DHA, and other purity-certified, omega-3 essential fatty acids in triglyceride form.
Cardiogenics Intensive Care is a comprehensive heart muscle support formula that features extracts of hawthorn and arjuna with a history of traditional use supporting the heart, possibly by helping to maintain blood vessel dilation and healthy blood pressure already within the normal range. Complementing these herbs is a blend of amino acids and minerals-including magnesium, potassium, and calcium-that play important roles in heart muscle function.
Mag Glycinate is a revolutionary, fully reacted amino acid chelate produced by a unique, patented process 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
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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
Omega-3 fatty acids (EPA-DHA) have been shown to have beneficial effects in experimental studies of cardiac arrhythmia.
CoQ-10 ST features 30 mg of a stabilized, all natural encapsulation of coenzyme Q10 (CoQ10) 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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
Dietary Suggestions
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 Essentials Cardiovascular Support is a combination of essential vitamins and minerals, omega-3 fatty acids, antioxidants, and phytonutrients to promote healthy cardiovascular function and overall well- being.
Studies indicate coenzyme Q10 has lead to remarkable clinical improvement in patients with cardiomyopathy.
E Complex-1:1 is a unique, natural vitamin E supplement that features a 1:1 ratio of alpha- to gamma- tocopherol; this ratio more closely resembles the tocopherol profile found naturally in vitamin E-rich plants.
An experimental study indicated an L-carnitine deficiency may cause cardiomyopathy.
Severe
FLT uses a low-glycemic-index dietary regimen and exercise program while incorporating medical foods 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° is a medical food formulated to provide specialized, multi-mechanistic 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.
Dietary Suggestions
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| Last Updated on Thursday, 26 May 2011 20:51 |