Managing Heart Disease: Causes, Risks, Prevention, and Management

Heart disease is a major health issue.

Since the beginning of the twentieth century, heart disease has been the United States number one killer, a position it still holds today. It’s responsible for killing one in every four Americans (26 percent), and the disease cost over $316 billion. Once mistakenly thought to primarily affect men, half of all deaths caused by heart disease each year are among women.

Fortunately for us, research has uncovered much information about this silent killer. It’s found that most of the nearly one million deaths are preventable, and in most cases, so is heart disease itself. They key to preventing heart disease lies in knowing what causes it, knowing your risks for developing it, and then doing all you can to reduce those risks. As an added bonus, these same steps have also been shown to be highly successful for reversing heart disease, too.

The Causes of Heart Disease: It’s Not Just Bad Cholesterol

Since the early 1950s; largely due to the Framingham Heart Study, which began in 1948 and established a link between high cholesterol and heart attacks; it has been an accepted fact that elevated levels of LDL (bad) cholesterol was the primary risk factor for heart disease. This belief led to a sharp rise in the amount of statin drugs and other cholesterol-lowering medications that are prescribed in the United States each year; to the point now where statins are the top-selling class of drugs in the country.

The problem with statins is that they can be harsh on your liver, cause negative cognitive effects, and cause muscle problems such as fatigue, pain, and weakness. They may also lower your coenzyme-Q10 levels, an essential component in cell function that is integral in generating energy in your body’s organs, with it’s highest levels found in the heart, liver, and kidneys.

While keeping cholesterol levels within normal levels is still important for preventing and treating heart disease, doctors now know that doing so, alone, is not enough. According to integrative physician Kerry D. Friesen, MD, of Chattanooga, Tennessee, “In the last decade or so there has been an entire paradigm shift in our understanding of the causes of heart disease.”

Among the research spearheading physicians new understanding of the causes of heart disease are recent studies of patients considered at risk for heart disease using Electron Beam Tomography (EBT, an ultra fast CT scan). “The EBT studies examined the coronary arteries of these patients, examining them for signs of heart disease, specifically atherosclerosis,” Friesen explains. Based on the old paradigm understanding of heart disease, patients with atherosclerosis should also have had elevated LDL levels. But the EBT studies showed that LDL levels did not correlate with atherosclerosis (hardening of the arteries caused by plaque buildup in artery walls).

“The EBT studies, as well as other studies, reveal that the widely held belief that LDL causes heart disease is inaccurate,” Friesen says. “In fact, elevated LDL cholesterol is such a poor marker for heart disease that 50 percent of patients with normal LDL levels still go on to develop heart disease. A much stronger indication of heart disease can be seen with low HDL cholesterol and elevated triglyceride levels. This was noted years ago by Dr. William Castelli, who was the director of the Framingham Heart Study, but has been overlooked until recently.”

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According to Friesen, few prescription drugs are available to treat the combination of low HDL and high triglyceride levels. “The good news is that there are a variety of natural self-care approaches that are effective for reversing this critical metabolic disorder,” he says.

A More Complete Picture of Risk

In addition to elevated cholesterol and triglyceride levels, another equally important risk factor for heart disease is chronic low grade inflammation. “This type of inflammation is often caused by infectious diseases,” Friesen says. Oxidative stress, which is often associated with chronic inflammation, is another major risk factor. Other risk factors include chronic emotional stress and unresolved emotional issues (especially anger), as well as the buildup of environmental toxins in the body.

“The role that environmental toxins, such as lead, mercury, and other heavy metals play in heart disease is also overlooked by most physicians,” states Garry F. Gordon, MD, DO, medical director of the Gordon Research Institute in Payson, Arizona. “But in fact, these toxins can be responsible for or exacerbate other major risk factors associated with heart disease, especially inflammation, oxidative stress, and chronic infections. In my own clinical practice, I’ve found that, once these toxins are addressed through a properly supervised program of detoxification, the overall symptoms of patients with heart disease usually are reduced as well.”

Allergies can be another risk factor for heart disease, especially among women ages 50 and younger, according to Andrew W. Campbell, MD, a consultant to both the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH). “Common allergic symptoms are significantly associated with an increased risk of coronary heart disease,” Campbell says. “There is a three-fold in- creased risk of heart disease with wheezing, and a 40 percent increased risk with runny nose and itchy eyes compared to no allergies.” Campbell has documented these increased risks in his own clinical practice and recommends that people who suffer from allergies be screened for heart disease as a precaution.

Another risk factor that has come to light in recent years is low testosterone in men. A recent study published in the medical journal Heart found that low testosterone is common among men suffering from heart disease and, if left untreated, can significantly interfere with recovery and increase the risk of death.

Knowing and addressing risk factors is an important key for preventing heart disease, and also for helping to treat it. Some other risk factors for heart disease include:

  • A family history of heart disease
  • Poor diet
  • Poor lifestyle habits, such as smoking
  • Lack of exercise
  • Obesity
  • Hypertension (high blood pressure)
  • Diabetes

Screening Tests for Heart Disease

In addition to blood tests that monitor HDL, LDL, and triglyceride levels, Campbell, Friesen, and Gordon agree that other blood screening tests are also important for determining heart disease risk. To screen for inflammation, they use blood tests to measure levels of C-reactive protein (CRP), homocysteine, and fibrinogen. Levels of ferriten, a marker for oxidative stress, should also be screened for.

To go above and beyond, Friesen regularly screens his patients using advanced lipid profile tests instead of the standard ones, especially if they have a family history or are in the early stages of heart disease. “Advanced lipid profiles help determine the quality of a patient’s cholesterol in addition to its quantity,” he explains. “Most doctors and patients do not realize that standard lipid profile tests don’t measure cholesterol directly, only their approximate level based on a mathematical formula. The advanced lipid profile test that I use can directly measure and differentiate between five subtypes of HDL, seven subtypes of LDL, triglyceride levels, and intermediate molecules known as VLDL and ILDL, plus the dangerous hereditary molecule Lp(a), which can mimic another molecule in the body that can trigger a fatal blood clot.”

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Another test these doctors recommend is the PLAC test, which measures lipoprotein phospholipase A2 (Lp-LPA2). This test measures free radical damage and inflammation inside blood vessels, and can be used to determine levels of existing plaque in arteries. “I frequently use the PLAC test to monitor the effectiveness of my patients? treatment regimen,” Friesen says.

Other tests he recommends are the VAP or Berkley Heart Lab test (both blood tests your doctor can order). He also suggests becoming aware of your family’s health history if you’re not already, in order to have a better idea of the health risks you may have inherited from your parents.

Gordon also recommends that patients have their doctors determine how thick or thin their blood levels are. This can be done through blood viscosity testing. Thin blood is easier for your heart to pump, reducing how much arteries have to stretch to accommodate healthy blood flow, and also reducing the risk of arterial injury. “The thicker the blood is, the higher the correlation for heart disease there is,” he says, adding that elevated LDL levels, as well as obesity and smoking, are some of the risk factors that can cause blood to thicken.

Campbell adds that analyzing hair samples for levels of the stress hormone cortisol is also important. Not only is this hormone responsible for adding belly fat, but it is an accurate indicator of stress. Elevated cortisol found in hair samples have been shown to be a significant predictor of a heart attack. “We all know that stress is a risk factor in heart disease, but previously doctors had to rely on what their patients told them about stress, whereas with hair analysis we now can measure stress levels accurately and objectively.”

Preventing and Reversing Heart Disease

When it comes to heart disease, the more proactive you are the better. There is much that you can do on your own to dramatically reduce your risk for heart disease, as well as to help manage and reverse your symptoms if you already have it. And for most people, heart disease is largely the result of long-standing unhealthy habits. By following the recommendations below, you can go a long way toward preventing and reversing heart disease; both on your own and, if necessary, by working with your doctor. The
most important key is to get started now.

Campbell recommends starting with the American Heart Association’s “Life’s Simple 7,” a series of guidelines established to help people achieve healthy heart function. These include:

  • Getting at least 150 minutes of moderate exercise, or 75 minutes of intense exercise, per week (that’s just more than 20 minutes per day)
  • Having a body mass index (BMI) of less than 25
  • Not smoking! Or, having quit for at least one year
  • Keeping your total cholesterol below 200 mg/dL
  • Maintaining blood pressure below 120/80
  • Having a fasting blood sugar level below 100 mg/dL
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Meeting 4 out of 5 of the AHA’s key components for a healthy diet (4 to 7 servings of fruits and vegetables per day, unrefined whole grains, eating fish at least twice per week, eating lean meats and skinless poultry, reducing foods prepared in or containing trans-fatty acids) We all know that eating better, getting enough exercise, making good lifestyle choices (like not smoking), and reducing stress are good practices in general. If you want to take the “Life’s Simple 7” a bit further, follow these five recommendations to maximize your heart’s benefit.

Diet: Eat according to the Mediterranean Diet, which according to Friesen is scientifically documented as being helpful for preventing and reversing heart disease. “This type of diet is also rich in polyphenols, compounds that give the skin of fruits and vegetables their rich color,” Friesen says. “A growing body of research is establishing that polyphenols are not only good for your heart, but also your brain and many other health functions.” The Mediterranean diet contains an abundant supply of fruits, vegetables, and nuts, along with fish, and poultry as its primary protein foods, and a plentiful supply of olive oil. Such a diet is also rich in healthy fats, antioxidants, anti-inflammatory fatty acids, and heart-healthy spices such as garlic. It’s also low in sugar, saturated fats, and refined carbohydrates.

Nutritional and Herbal Supplementation: “Omega-3 fish oils are a very important factor for lowering cholesterol and protecting against inflammation,” Campbell says. He also recommends coenzyme Q10 (Co-Q10) and alpha lipoic acid (ALA). Friesen adds “that turmeric, which is rich in curcumin, and boswellia extract are both excellent herbs for protecting against chronic low-grade infection.”

Exercise: You should get at least 30 minutes of exercise, every day. Friesen says aerobic exercise like walking, cycling, jogging, and swimming are the best. “I also recommend T’ai chi, due to the many benefits I’ve personally received from my many years of practicing it.” If you are unused to exercising, be sure to consult with your doctor so that the two of you can work together to create an exercise program that is most appropriate to your specific needs. Yoga is another great way to get your body moving, reduce stress, and improve your mind-body connection.

Lifestyle: If you are overweight, work with your doctor, who can help you devise a program for losing excess weight. If you smoke, seek help so that you can quit. It is also important that you get a good night’s sleep for at least seven to eight hours every evening. If you’re constantly worried or stressed about something, we have a whole section below on stress-management.

Stress Management: Given how closely linked chronic stress is to heart disease, it’s important that you take time each day to “de-stress” yourself. Useful ways for doing so are meditation, deep breathing exercises, regularly engaging in hobbies and other enjoyable activities, and spending time with loved ones. Yoga is a great way to nail two birds with one stone (exercise and de-stress!), and creating an at-home spa treatment can help to relax your nerves. If stress continues to be a problem in your life, consider working with a health professional who specializes in stress relief.

By Larry Trivieri, JR

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