by Stephen T. Sinatra, M.D. and James C. Roberts, M.D., with Martin Zucker
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From the book Reverse Heart Disease Now by Stephen T. Sinatra, M.D. and James C. Roberts, M.D., with Martin Zucker. Copyright 2008. Reprinted by arrangement with Wiley (www.wiley.com). All rights reserved. This book summary may not be copied or distributed in any form without the permission from HealthBookSummaries.com. HealthBookSummaries.com assumes no responsibility for the use or misuse of this material. Always work with a qualified health professional before making any changes to your diet, prescription drug use, lifestyle or exercise activities. CAT 215150
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CRP is a biochemical substance indicating the presence of vascular inflammation. The presence of the highest levels of CRP in a person indicates five times the risk of developing CVD. The highest levels also indicate four times the risk of heart attack or stroke compared with those having the lowest levels of CRP. CRP levels were found to be the best predictor among twelve studied, including cholesterol. An estimated 25 percent of Americans have low to normal cholesterol, yet may unknowingly have elevated CRP, and the CRP-inflammation link sheds light on why more than 50 percent of heart attack and stroke victims have normal cholesterol levels.
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show major lesions in the coronary arteries of 20 25 percent. This clearly illustrates that millions, even those at an early stage in life, have significant coronary damage and in most cases, are unaware of it. It is yet to be determined what causes the plaque to be stable or unstable. The stable plaque could very well result from modifications in the persons life to reduce inflammation and halt the trend, such as quitting smoking, reducing stress, and dietary changes. One thing that is known is that many people live with plaque-ridden arteries and become octogenarians and beyond, as long as it is stable. Unstable plaque, as mentioned previously, is the killer. An ongoing inflammatory assault can cause the plaque to rupture. Once called coronary thrombosis, this event is now referred to aptly as plaque rupture. This can lead to three things: an acute heart attack, death from arrhythmia (the heart stopping or racing wildly due to lack of oxygen), or stroke if the rupture occurs in a carotid artery or the brain.
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3. Oxidative Stress: Free radicals inflict oxidative stress on internal tissues much like metal oxidation in the form of rust or oil oxidation in the form of rancidity. Free radicals are caused by many things, including smoking, high sugar intake, and excessive stress. 4. Poor Bioenergetics: Bioenergetics is the process in which mitochondria produce energy that also involves enzymes, protons, electrons, and electrical charges. Within the cells are between 200 5,000 mitochondria, and within those enzymes take the sugars and fatty acids we get from food and turn it into adenosine triphosphate (ATP), a needed power source for every cell in the body. If mitochondrial processes are not functioning properly, CVD can develop. 5. Bacterial Threat: Gum Disease Many times, heart disease begins in the mouth. One study of illustrates this fact poignantly: 10,000 people aged 25 74 had their starting oral health correlated to their cardiovascular health over the next fourteen years. Those with a pristine oral condition had only a 10 percent risk of CVD, gingivitis at the start indicated a 14 percent risk, periodontitis a 32 percent risk, and if all of their natural teeth were out, they had a whopping 42 percent risk. The infections present in gum disease can last for decades, in turn causing a state of chronic inflammation, which puts major stress on the immune system as well as the cardiovascular system. 6. Toxic Metals: Ninety percent of the lead in a persons body is concentrated in the bone tissue. This is one reason postmenopausal women see an increase in their blood pressure after menstruation stops, as bone mineral density falls and the lead is released. Cadmium and mercury are two other threats not usually addressed by mainstream medicine but that can cause serious threats. Mercury enters the body through not only dental fillings and vaccines, but eating fish and simply breathing. Many believe that this heavy metal overload plays an active part in CVD. 7. Emotional Stress: Stress causes the blood to clot more, and acute situational anger can cause blood clots. Chronic anger can increase blood pressure and enlarge the heart. Depression triples the disease-producing effect of smoking, and even for a non-smoker, the risk of heart disease is significantly increased. 8. Gender Factors: Specific cardiovascular protection is afforded by the estrogen produced in women and the testosterone produced in men. In aging, both of these suffer a decline in production, which is associated with inflammation. 9. Trans-Fatty Acids: Man-made partially hydrogenated fats are great for shelf life, but wreak havoc on us internally. As stated by nutrition experts at Harvard: By our most conservative estimate, replacement of partially hydrogenated fat in the U.S. diet with natural un-hydrogenated vegetable oils would prevent approximately 30,000 premature coronary deaths per year, and epidemiologic evidence suggests this number is closer to 100,000. A small serving of fast-food French fries contains a day and a half worth of our intake if going by dietary guidelines stating no more than one percent of caloric intake should be trans fat, and in 2002 a National Academy of Sciences panel stated the only safe intake of trans-fat is zero.
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10. High Blood Pressure: Hypertension causes an excess of force in blood pressing against the artery walls. Not a disease in itself, it is the underlying cause of something else; in 90 percent of cases this cause is unknown. Age, weight, diet, heredity, ethnicity, kidney infection, and stress all can cause increased blood pressure. Two proteins, angiotensin II and endothelin are released due to hypertension, and they both promote and accelerate oxidation and inflammation in the arteries, which may explain the link between hypertension and atherosclerosis. 11. Genetics: The Human Genome Project opened up new doors for cardiologists trying to figure the role of genes in with cardiovascular disease. Genetic profile blood tests can reveal more than was previously known about underlying causes of CVD in stubborn cases. 12. Radiation: X-rays may damage the endothelial cells. There are patients who have received radiation in the chest and then subsequently developed coronary disease; this is known as radiation atherosclerosis. When radiation occurs, you are essentially being burned, and burns cause the body to react with an inflammatory response, which in turn can cause plaque build-up.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.
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HDL <50 mg/dl in women, <40 mg/dl in men Blood pressure >130/85 (or in those requiring blood pressure medication) In addition to the standard five above, in New Cardiology they also test for: Insulin >17 microunits/L Hemoglobin AIC >6% total HGB Together these provide more definitive proof of the presence of metabolic syndrome and insulin resistance. Other tests that New Cardiology may employ are: Genetic Testing: There are three common alleles (gene combinations) responsible for producing apolipoprotein E (APO E), a protein with an important role in fat metabolism. Not all people have one, but specific ones found through testing can help explain why one person responds well to exercise while another may be extra susceptible to heart disease. Armed with this knowledge, a cardiologist may be more prepared in the planning of treatment for the particular patient. Imaging: Electron beam computerized topography (EBT) produces high resolution imaging measuring hardened plaque in coronary arteries. Another form of imaging that is fairly recent is a type of ultrasound that measures carotid artery intima media thickness (IMT), which also produces pictures, but of the crucial arteries leading to the brain.
Standard drugs:
Statins (Mevacor, Lipitor, Prava-chol, Zocor, Lescol, Crestor): 15 20 million Americans take for cholesterol control Statin therapy substantially reduces heart attack and mortality rates May reduce plaque
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Are best for people with a history of major cardiac event such as heart attack or bypass, those with diabetes, or those who have a high coronary calcium level May not be indicated for those who have no prior history of vascular disease, heart attacks, or have normal CRP levels Are expensive, costing around $100 per month Statins decrease blood cell adhesiveness and plaque calcification. They may also decrease the risk of bone fracture, macular degeneration, and may slow the onset of Alzheimers disease. There are side effects, such as muscle weakness, soreness, and flu-like symptoms. Liver dysfunction, kidney failure, and in extreme cases, death may occur. Statins block CoQ10 formation, needed for adequate ATP production, so statins also predispose people to heart failure. Coumadin (Warfarin): Used to prevent blood clots from forming or becoming larger. Blocks the action of Vitamin K, which is a fat-soluble vitamin the body uses naturally for blood clotting. The drugs activity in the body is checked by performing a Protime or PT/INR blood test (prothrombin time/international normalization ratio), which assesses the amount of time the blood takes to form clots. Coumadin interacts negatively with fish oil, garlic, gingko biloba, St. Johns Wort, and various other medications, and should not be taken with these. In addition, many doctors warn against eating Vitamin K-rich foods, such as spinach, kale, and asparagus, or against taking multivitamins. New Cardiology, however, tends to disagree. Vitamins are too important for health maintenance and Vitamin K is necessary for bone strength and the integrity of the arteries. Long term Coumadin use is cause for concern, being a Vitamin K antagonist, so it is therefore recommended to maintain a steady intake of Vitamin K-rich foods while on the drug. Angiotensin-Converting Enzyme Inhibitors (ACE inhibitors Capoten, Altace, Accupril, Lotensin, Prinivil): ACE is produced in the lungs and converts angiotensin I (a harmless molecule), into angiotensin II, a powerful blood vessel constrictor. Therefore ACE inhibitors are used to lower high blood pressure, relax blood vessel walls, and reduce the burden on the heart.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.
Block the formation of free radicals and preserve nitric oxide Fat-soluble, tissue-specific inhibitors such as Accupril and Altace are preferred as they work both in circulation and in the endothelium, blocking free radical activity and improving nitric oxide production. The first, such as Capoten, work only in circulation.
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ACE inhibitors, whose main downside is an annoying but nonthreatening dry cough, is recommended for those with symptomatic atherosclerosis, plaque, or history of heart attack. If the cough is an issue, an angiotensin receptor blocker (ARB) may be prescribed instead. ARBs work by blocking angiotensin IIs influence on cell biochemistry. Helpful for heart failure and kidney disease, research hasnt shown significant benefit for coronary artery disease. Beta Blockers Among the most effective and safest drugs in the cardiology arsenal Lower blood pressure, reduce angina, help prevent further ischemic damage in heart attack patients Reduces the hearts workload, thereby reducing the need for blood and oxygen, and help the heart to beat more regularly Good for stressed, hypertensive individuals May cause mental confusion in elderly patients May trigger asthma attacks, and can amplify depressive symptoms if already depressed. Other side effects include nightmares, diarrhea, and erectile dysfunction Calcium Blockers Reduces the tone of arterial walls, in an effort to improve blood flow through narrowed vessels Effective for high blood pressure but have a destabilizing effect on the heart rate variability In certain large-scale trials, were associated with a 25 percent higher rate of acute heart attacks and heart failure compared to other drugs Cause ankle swelling, so diuretics often prescribed in conjunction with Last resort drug Aspirin is a prevention therapy commonly recommended by some cardiologists due to its blood thinning effects. While seemingly harmless, it is the leading cause of gastrointestinal bleeding. Painkillers are another problem for the cardiovascular system. Acetaminophen can harm the liver, nonsteroidal anti-inflammatories (NSAIDS) like ibuprofen can cause high blood pressure and weaken the kidneys, and prescription drugs like Vioxx, Aleve, Celebrex, and Bextra have made headlines by the increased risk of heart attack they pose. This causes conflict when prescribing for patients with other problems, such as painful arthritis. In these cases, supplements such as fish oil, glucosamine, chondroitin, and willow bark can be helpful.
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Supplements:
According to the Harvard researchers, published in the Journal of the American Medical Association in 2002, most people do not consume an optimal amount of all vitamins by diet aloneit appears prudent for all adults to take vitamin supplements. Unfortunately, conflicting media reports along with the lack of researchers and health care providers understanding this need, only furthers consumers confusion. For a strong nutritional base, multi-vitamins and multi-mineral supplements are recommended. Most one-a-day formulations do not provide adequate amounts of key ingredients. Potency may be lacking as well as important antioxidants: Alone, Vitamins C and E decrease three-year carotid artery disease progression by 5 percent, but together the progression is slowed 45 percent. Post-heart attack recovery is improved and chance of death decreases by a full third with a cocktail of Vitamins C, E, A, and beta-carotene. Patients undergoing bypass surgery have added protection from arrhythmia and heart attack when taking antioxidant combinations, and they also decrease plaque build-up in the arteries of heart transplant patients. Combinations beneficial for the cardiovascular system provide B vitamins, magnesium, bioflavonoids, lycopene, lutein, and other supportive nutrients, in healing amounts. Fish Oil Contains eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), which provide Omega-3 fatty acids that the liver doesnt have to expend energy to convert, as in plant sources. Benefits the heart by decreasing Lp(a), triglycerides, blood pressure, and arterial wall inflammation, increases HDL, improves endothelial function, stabilizes and possibly reduces plaque, and makes blood less sticky, and therefore less likely to form clots. Care should be taken when supplementing fish oil while taking Coumadin. Magnesium Magnesium is a critical mineral that more than half of all Americans may be deficient in, symptoms of which include muscle cramps, premenstrual difficulties, and sudden cardiac death. Alleviates chest pain and other symptoms of angina, and improves metabolic efficiency of heart muscle cells. Stress, alcohol, and colas all deplete magnesium.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.
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Chronic deficiency may play a role in the development of diabetes. A red cell or ionized magnesium test can determine deficiency. Too much may act as a laxative, and extra magnesium should not be taken in cases of chronic kidney failure, as build-up can occur. Nattokinase and Lumbrokinase Nattokinase, extracted from the soy food natto, is believed to contribute to the low incidence of coronary heart disease in Japan. Lumbrokinase, extracted from earthworms which are commonly used in Asian medicine, was developed in both China and Japan. Both have fibrin-degrading abilities; they are natural blood clot eaters. Both works within minutes to hours after being taken orally to dissolve clots, and when taken preventatively, may prevent clots from forming in the first place. Patients taking Coumadin shouldnt take either without their doctors approval, and neither should be taken directly prior to or after surgery. L-arginine This amino acid, necessary for nitric oxide production, can be found in dairy products, meats, poultry, fish, nuts, seeds, and even chocolate. The more L-arginine that is taken in, the more nitric oxide is produced, which equals greater protection against smoking, diabetes, high blood pressure, and free radical stress. Provides an anti-oxidant effect, blocks LDL oxidation, decreases the frequency of angina and nitroglycerin need, improves the outcome following a heart attack, and reduces endothelium dysfunction. Is known as The Poor/Smart Mans Viagra for its positive effects on erectile function. Should not be taken right after a heart attack, or like other supplements, taken alone.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.
Phosphatidylcholine (PC - Essential Phospholipids) This is two fatty acids bound to the molecules of phosphorous and choline, and is part of the make-up of the cell membrane. Low PC to cholesterol ratios in platelets can cause inappropriate blood clots, but those rich in phosphatidylcholine function correctly.
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Improves cell membrane function, cholesterol profile, insulin resistance, has anticlotting activity, and lowers blood viscosity. IV treatments are quite effective, albeit quite expensive. An oral supplement is now available through doctors. Vitamin C Slows progression of atherosclerosis, as well as decreasing cardiovascular events and death by 40 60 percent; also decreases the need for angioplasty by 57 percent, and improves recovery after bypass surgery, reducing postoperative atrial fibrillation by half. Helps control blood pressure, keeps CRP in check, reverses endothelial dysfunction, and improves heart attack recovery. Helps remove lead from your system, neutralizes Lp(a) and vascular wall damage caused by homocysteine. Promotes conversion of excess cholesterol into bile acids that further aid in digesting fats. Is needed to make collagen, and enhances iron absorption. A potent antioxidant, Vitamin C offers protection from free radical damage to proteins, lipids, carbohydrates, and DNA. Mammals make Vitamin C in their liver, with the exception of bats, guinea pigs, and humans. People who take more than 700 mg per day have approximately a 30 percent lower mortality rate from CVD than those who do not ingest the vitamin. B Vitamins B-6, folic acid, and B-12 deficiency leads to homocysteine overloads, which triggers arterial disease by causing blood clots and plaque formation High intake of folic acid helps the body convert L-arginine to nitric oxide, is the best defense against neural tube defects during pregnancy, and helps lower homocysteine levels.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.
Niacin, or B-3, is the B vitamin responsible for the flushing effect, that provides vascular benefits. Contrary to popular belief, it doesnt cause liver damage. While non-flush niacin is available, the same benefits are not obtained. Improve endothelial function, and are beneficial in the treatment of stress, nervous problems, fatigue, and alcohol problems.
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The whole range of B vitamins should be supplemented. Taking one individually can cause deficiencies in others. Vitamin E Decreases by 50 percent the two-year event rate of newly diagnosed CVD patients, and the two-year heart attack rate of dialysis patients with CVD by 75 percent, also decreases disease progression in men following bypass surgery. Taken with aspirin in patients with TIA (transient ischemic attack), decreases the risk of stroke by 50 percent when compared to those taking aspirin alone. Is fat soluble, so should be taken with food. D-alpha-tocopherol is the natural form, and the synthetic form DL-alpha-tocopherol should be avoided. Garlic Considered a natural antibiotic due to its allicin content. Known as natures wonder drug, garlic contains sulfur and selenium among others, and was cited in an ancient Egyptian medical papyrus as a cure for heart disease, worms, and tumors. Reduces cardiovascular risk factors such as high blood pressure, cholesterol, and homocysteine. Pomegranate Juice According to one study, lowers systolic blood pressure by 20 percent. May be able to reduce progression of arterial plaque. Vitamin K-2 Slows down the resorption of bone cells and increases bone mineralization, which means stronger, healthier bones. Has been shown to counteract atherosclerosis. Not widely found, the highest concentrations are in natto, and fermented, curded cheese. Coenzyme Q10 (CoQ10): Fat-soluble, these molecules shuttle electrons back and forth between enzymes during the production of ATP. Even a slight deficiency can cause many disorders to develop. Helps all forms of heart disease, reduces mild to moderate hypertension, fortifies the immune system, even in cancer cases, improves nervous system
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and brain disorders, protects against gum disease, and generates strength, vitality, and energy. Is a very powerful antioxidant that protects the mitochondria in cells. Reduction by 25 percent of CoQ10 in cells can cause organs to become deficient and functionally impaired, and at 75 percent serious tissue damage and death can occur. L-carnitine Works synergistically with CoQ10 to raise ATP production. Transports fatty acids to be oxidized to make ATP, and also transports waste out of the cells mitochondria. Comes from two amino acids: lysine and methionine, which mixes with niacin, B-6, and vitamin C to create L-carnitine. Improves oxygenation utilization by the heart cells. D-Ribose A building block of ATP, it deploys energy into sick hearts, helping to restore energy reserve and diastolic function, can also lower blood glucose levels. Easily absorbed, approximately 75 percent of it gets through, and symptoms have a tendency to improve quickly with supplementation.
New Cardiology focuses on a heart healthy diet based on the Asian and Mediterranean cuisine, and stand for Pan-Asian Mediterranean diet. It is not a temporary diet, but a change in eating habits to be sustained for life. Carbohydrates should be limited to 40 percent of total daily caloric intake, and in the form of vegetables and low glycemic fruits. Organic proteins, such as free-range meats and poultry, fish, and omega-3 fortified freerange eggs compose 25 -30 percent of daily intake and the other 30 35 percent should consist of monounsaturated fats like olive oil, fish, tofu, nuts, and avocado. Anything high
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in antioxidants is welcome, as well as olive oil. More fish should be consumed than meat and dairy; and low sodium should be a focus, with an increase in garlic, soy, nuts and seeds. Exercise CoQ10, magnesium, D-ribose, and L-carnitine together energize not only heart muscle cells, but your entire body as well. Most people need more exercise, and this combination has proven helpful to those whove always felt that exercise is just too hard. The most important thing is to find something enjoyable to do, from dancing to gardening, even jumping rope; and perform it regularly. Stress Stress is a major concern with cardiovascular disease. Learning to diffuse it and control it goes miles in decreasing the health risks. Some ways to do so: Give, and receive, attention. Practice meditation whether it is done through visualization, yoga, tai chi, or any other form, meditation has proven very beneficial in reducing alcohol and tobacco use, lowering blood pressure, cholesterol, and lipid oxidation, and decreasing psychosocial stress. Faith having spiritual or religious beliefs, affiliation, and practices is associated with better health and recovery times. Magnesium ensure you are not deficient. A magnesium deficiency, along with stress, can be deadly. Attitude Mind over matter DOES matter you have to want to heal. Anger, resentment, and hostility all work to further disease progression. Support is key. Try to find the good in every situation you confront. Practice altruism it is better to give than to receive, as the Bible shows. Kind deeds that help others can actually promote longevity, while receiving has no effect, as shown by a study done at the University of Michigan.
Adding It All Up
One day, there may not be so much of a difference between alternative and conventional medicines. One therapy may not be frowned on so much just because it doesnt involve high prices, pharmaceuticals, or dangerous surgery. Cardiologists and doctors in general, may pay more attention to the prevention of disease, as well as the underlying causes; focusing intentions on those rather than just band-aiding the problems that arise when disease occurs. New Cardiology offers a glimmer of hope for the integration of nature and science, breaking down the barriers and opening the eyes of those in practice; giving us all a chance for a brighter, healthier future.
If you like this summary, youll definitely want to order the complete book Reverse Heart Disease Now: Stop Deadly Cardiovascular Plaque Before Its Too Late.