What Is Coronary Artery (Heart) Disease?
Coronary artery disease is characterized by a narrowing of the major arteries in the heart, a situation that leads to reduced blood flow and, in effect, slow starvation of cells forming the heart. The narrowing is caused by several factors, including lesions made up of cholesterol, abnormal growth of smooth muscle cells, and accumulated platelet cells. A heart attack occurs when a lesion grows large enough to completely block blood flow to the heart, or when part of a lesion breaks off and blocks an artery.
Theories describing the cause of coronary artery (heart) disease often become fashionable and then, after a number of years, unfashionable. Elevated levels of cholesterol were long seen as a major cause of heart and other cardiovascular diseases. The cholesterol theory oversimplifies the multifactorial causes of heart disease, and is being replaced by other theories, though you could not tell that by the large numbers of holesterollowering drugs prescribed.
The two best explanations involve nutritional deficiencies and inflammatory injury to artery walls, and it is likely that both processes occur simultaneously. (They are not mutually exclusive.) One theory, proposed by Kilmer McCully, M.D., in 1969, argues that lack of certain B vitamins (chiefly folic acid and vitamin B6) disrupts a fundamental biochemical process known as methylation. As a consequence, blood levels of homodiseases cysteine increase, damaging blood vessel walls. The body’s response, meant to heal the damage, actually leads to the deposition of cholesterol and other substances. The other theory, which dates back in part to clinical work by Evan Shute, M.D., in the 1940s and research by Denham Harman, M.D., in the 1950s, argues that oxidized LDL cholesterol is swallowed by white blood cells, which become lodged in the matrix of cells in artery walls. More recent clinical research by a variety of researchers, including Ishwarlal “Kenny” Jialal, M.D., of the University of Texas Southwestern Medical Center, Dallas, has clearly shown that oxidized but not normal LDL cholesterol is attacked and engulfed by white blood cells. What makes this research so intriguing is this: LDL is the medium through which fat-soluble nutrients such as vitamin E are carried in the blood. Oxidized LDL cholesterol is a sign of inadequate vitamin E intake (or, conversely, excessive intake of oxidized fats, such as in fried foods). Just as the B vitamins reduce homocysteine levels, so vitamin E reduces oxidation of LDL cholesterol.
How Common Is Coronary Artery (Heart) Disease?
An estimated 60 million Americans have coronary artery disease, and approximately 725,000 die each year from it, making it the leading cause of death in the United States. It is also the leading cause of death in Canada and England. Stroke accounts for another 116,000 annual deaths in the United States, with ischemic stroke (in effect, a “heart attack” in the brain) being the most common type.
Nutrients That Can Help
Many nutrients inhibit the inflammatory process in blood vessel walls and provide a variety of improvements in heart function. Several B vitamins lower homocysteine levels and appear to reduce the risk of heart attack.
One study, published in the November 29, 2001, New England Journal of Medicine, found that modest supplements of folic acid, vitamin B6, and vitamin B12 significantly lowered homocysteine levels and clearly reversed coronary artery disease in heart patients. Reducing homocysteine levels eliminates a major cause of blood vessel inflammation.
Vitamin E supplements lower CRP levels and, several clinical trials have found, reduce the risk of heart disease and heart attack. Vitamin E also reduces the tendency of LDL cholesterol to oxidize, which in turn keeps white blood cells from attacking LDL. In addition, vitamin E prevents the stiffening of blood vessel walls (endothelial dysfunction), which reduces blood flow and increases the risk of heart disease. Vitamin E also turns off the gene that programs the growth of excess smooth muscle cells, which also narrows blood vessels.
The omega-3 fatty acids found in fish oils and other sources, have diverse benefits to the health, stemming in part from their anti-inflammatory and cytokine-modulating properties. Research has found that the omega-3 fatty acids can reduce heart irregularities known as cardiac arrhythmias and also can lower blood pressure. In 2001 Danish researchers reported in the American Journal of Cardiology that heart patients with extensive narrowing of blood vessels had elevated levels of CRP and had low levels of omega-3 fatty acids. Supplements of omega-3 fatty acids should always be taken with vitamin E to protect them against oxidation.
Vitamin C and the B vitamin niacin (a form of B3, which causes a temporary flushing sensation) have been found to lower cholesterol levels and to lower levels of lipoprotein (a), a cholesterol fraction that increases the risk of heart disease. In addition, magnesium plays a crucial role in heart rhythm, and supplements can sometimes reduce arrhythmias.
What Else Might Help?
It is of utmost importance to follow a diet that emphasizes nutrient density, such as the Anti-Inflammation Syndrome Diet Plan, which emphasizes fish, lean meats, and large amounts of fresh vegetables. Diets high in refined carbohydrates, sugars, and partially hydrogenated vegetable oils set the stage for insulin resistance and overweight, which increase the risk of pre- and full-blown diabetes and heart disease. Such a dietary approach, combined with anti-inflammatory nutritional supplements, also should reduce the severity of phlebitis, varicose veins, and blood pressure.
Finding some means of stress reduction or stress management is important as well. Stress raises levels of cortisol, which in turn boosts insulin levels—contributing to an increased risk of both abdominal obesity and heart disease. Removing yourself from the stress, even temporarily, can have an extraordinary effect. Consider a daily walk (which also lowers glucose and insulin levels), meditation, a hobby, recreational reading, or sightseeing as stress-reducing activities.