Cardiovascular disease is the leading health problem in the western world and is considered the largest “epidemic” on earth.
It is the number one cause of death in the United States, claiming more than 1 million lives annually. An estimated 50 million Americans have heart and blood vessel disease, although many have no symptoms.
Cardiovascular disease is a general term encompassing heart attack, stroke, and other disorders of the blood-vessel system and heart. In congestive heart failure (CHF), the heart has a reduced ability to pump blood effectively, often due to a previous myocardial infarction (heart attack). This usually causes symptoms of shortness of breath, weakness, and fluid retention in the legs and feet. If the coronary arteries that carry oxygen and nutrients to the heart muscle become obstructed, the blood flow is cut off completely, and a myocardial infarction can occur. Other types of cardiovascular disease include heart failure, arrhythmias, and valvular disease. Arrhythmias are disturbances in the normal rhythm of the heartbeat. Of the different kinds of arrhythmias, some can be quite dangerous and life-threatening, and others pose no particular danger. Valvular disease is a term for disorders that impair the functioning of one or more heart valves. Mitral valve prolapse is a condition in which the mitral valve, which controls blood flow from the left atrium to the left ventricle, protrudes too far into the left atrium while it is pumping. Fortunately, in many cases this causes no problems.
The cornerstone of management for CHF is conventional drug treatment with diuretics, ACE inhibitors, digitalis glycosides, and beta-blockers, based on large-scale trials focusing on such endpoints as mortality.
Some conditions that put a patient at risk for CHF include angina pectoris, cardiomyopathy, previous heart attack(s), arrhythmia, coronary artery disease, smoking, physical inactivity, obesity, and diabetes (blood sugar levels should be kept in check). Other factors include age, genetic background, and gender (men typically experience CHF earlier than women).
It is critically important to treat hypertension and high cholesterol (hyperlipidemia), but a balance should be maintained between the use of pharmaceutical drugs, dietary supplements, and nutrition. A significant amount of cardiac disease results from damage to the arteries (arthro and arteriosclerosis), and recent evidence indicates that high homocysteine levels (greater than 14 mcm/liter) increase the risk of cardiac disease.
Probably the best way to decrease the risk of heart disease is by understanding the function of the cardiovascular system. There are over 60,000 miles of blood vessels careening throughout the body. The heart beats 100,000 times a day, performing more work than all the other organs. According to Dr. Matthias Rath, MD, a leading physician in the study of cardiovascular diseases, blood vessel instability and lesions in blood vessel walls are the primary causes of cardiovascular disease. Vitamin C is the “cement” of the blood vessel walls that stabilizes them. We need to supplement with adequate amounts of vitamin C because the body does not manufacture it. Dr. Rath further notes that deposits and spasms of the blood vessels are the cause of high blood pressure. Dietary supplements of magnesium and vitamin C relax blood vessels and normalize high blood pressure. Supplementing with the natural amino acid arginine can protect against the development of coronary artery disease by increasing blood flow.
Oxidation is an aging process, and just like elements in the environment oxidize or rust an automobile, the heart can also oxidize (it doesn’t rust only because it’s not made of metal). Biological rusting (oxidation) damages the cardiovascular system and accelerates aging. Vitamin C, beta carotene, vitamin E, and selenium are the most important antioxidants that reverse oxidation. Regular exercise and physical activity are preconditions for cardiac health.
These short-lived, unstable electrons in the environment have been implicated in the pathogenesis of many degenerative diseases, especially cardiovascular disease. They also damage DNA, lipid membranes, and the immune system. Common examples of free-radicals include cigarette smoke, pesticides, air pollutants, carcinogens, chemicals, radiation, many drugs, stress, and smog.
Famed cardiologist Dr. Stephen Sinatra promotes what he calls the “four horsemen” of nutraceuticals for supporting healthy hearts and normal glucose levels. They include co-enzyme Q10, acetyl-L-carnitine, fish oil, magnesium, and sometimes a fifth, D-ribose. These supplements all contribute to decreasing “inflammation,” which many cardiologists agree is the main contributor to heart disease, stroke, and heart attack. High cholesterol and high homocysteine levels are adequate indicators of heart disease, but appear to be secondary to inflammation.
C-Reactive Protein (CRP)
Inflammation is an important factor in the buildup of artherosclerotic plaque. The best way to measure the degree of inflammation in the body is determining the C-Reactive protein (CRP) level in the blood. Most studies show that the higher the CRP levels, the higher the risk of developing a heart attack. If CRP is lower than 1.0 mg/L, a person has a low risk of developing cardiovascular disease. Between 1-3 mg/L means an average risk, and higher than 3.0 mg/L, a person is considered a high risk.
Although one particular diet does not fit all patients, general consensus is that people with a history of heart disease should eat a low saturated fat diet, high in plant-based fibers. Many nutritionists and natural physicians believe that the traditional Mediterranean diet (with attention on olive oil and red wine) may provide maximal effectiveness against heart disease. Olive oil contains heart protective mono-unsaturated fatty acids, and several antioxidant agents that prevent circulating LDL cholesterol from damaging arteries. The protective effect of red wine is the result of flavonoids, which protects against oxidative (free-radical) damage.
Drinking plenty of water is logical, and try to omit caffeinated foods and “acidic” beverages (cola and soft drinks) that also increase oxidation. Limit salt, sugar, and cholesterol-rich foods (meat, dairy, shellfish, egg yokes). The Dean Ornish Diet is also highly recommended.
Other dietary recommendations include:
8 Dietary Considerations
- Reduce your intake of saturated fats from commercially grown red meat and trans-fatty acids found in hydrogenated fats like shortening, margarine, and commercially processed foods.
- Increase your intake of omega-3 oils by eating flaxseed oil, walnuts, and cold-water fish. There is considerable evidence that people who consume a diet high in omega-3 oils have a significantly reduced risk of developing heart disease and strokes.
- Reduce or eliminate alcohol and caffeine (it raises blood pressure).
- Reduce or eliminate excess salt
- Decrease your intake of refined carbohydrates (sugar and white flour) which has been shown to be a significant factor in developing atherosclerosis. Refined carbohydrates also increase cholesterol, stress the liver, and deplete the body’s vitamin pool.
- Increasing fiber intake (oat bran, psyllium, apple pectin) has been shown to be protective against hardening of the arteries. Dietary fiber, particularly the fiber found in legumes, oat bran, apple pectin, fruits and vegetables, is effective in lowering cholesterol levels. Wild blueberries were shown to strengthen blood vessels against oxidative stress that may lead to heart disease.
- Consume fewer animal products that are high in fat and cholesterol and treated with hormones, steroids, and antibiotics.
- Limit your intake of all dairy products. Today’s dairy foods are laced with hormones and steroids (buy organic) and will decrease magnesium absorption.
- CO-ENZYME Q10
CoQ-10 improves energy production in the heart muscle by transporting oxygen into the muscle cells of the heart; it has reduced the number of hospitalizations of CHF patients by 38%. CoQ-10 acts as an antioxidant, stabilizing membrane activity and preventing the depletion of metabolites necessary for the resynthesis of ATP. Take CoQ-10 especially if you’re on a statin drug (i.e. Lipitor, Zocor, Vytorin, Pravacol) for cholesterol. It is well reported that statin drugs cause myopathies (muscle disease), rhabdomyolysis (muscle damage), and renal failure. CoQ10 protects against stain toxicity. Dosage: 60-500 mg daily.
- A HIGH POTENCY MULTI-VITAMIN with MINERALS & ANTIOXIDANTS
A high potency multi-vitamin provides a strong foundation for optimum health, especially one with a sufficient level of antioxidants. A deficiency of any nutrient can mean the difference between health and disease. If possible, get a formula with extra antioxidants including lycopene, beta carotene, lutein, quercetin, and green tea. Dosage: As directed on package.
- OMEGA-3 FATTY ACIDS (FISH OIL, FLAX SEED)
Omega–3 fatty acids help maintain cell membranes and reduce the risk of heart disease and sudden cardiac death. In addition to their cardiac benefits, omega-3-fatty acids have shown promise in lowering blood pressure, improving autoimmune diseases, reducing symptoms of depression, and preventing cancer. These quality fatty acids also keep blood vessels healthy and flexible and work as anti-inflammatory agents, lowering cholesterol. In another study, omega-3 fatty acids showed a powerful effect in the reduction of atrial fibrillation and tachycardia in patients, without significant adverse reactions. Dosage: Flaxseed or fish (EPA, DHA), 1,000-4,000 mg daily.
Magnesium is the key mineral for the proper functioning of the heart muscle. Nearly 59% of cardiac patients are deficient in magnesium. Magnesium calms the heart and can be used with a calcium channel-blocking agent, for it acts to allow calcium into the heart muscle cells. Magnesium deficiency is associated with abnormal heart rhythms (arrhythmias) and increased high blood pressure. Dosage: 400-800 mg daily.
- SUPER GREEN DRINKS
Green drinks are a concentrated powdered drink that provides powerful enzymes, phytochemicals, and herbs like barley, wheat grass, spirulina, chlorella, and vegetable greens. These compounds are powerful antioxidants and help improve circulation and boost immunity. They have shown protection from stroke and heart disease. Dosage: See package.
- VITAMIN C W/BIOFLAVONOIDS
Vitamin C fights oxidation of “bad” LDL cholesterol and supports blood vessel flexibility. It protects the artery walls from damage, accelerates healing of wounds in the coronary arteries, and hinders clotting. Vitamin C may not only have beneficial effects with respect to acute coronary events like a heart attack or a stroke because it prevents platelet aggregation and vasoconstriction, but it also has a more long-lasting effect on the inhibition of atherosclerotic lesion formation itself. Research by the National Public Health Institute on 293,000 subjects concluded that a person without CHD who takes over 700 mg of vitamin C daily has a 25% lower risk of having a CHD-related event than those who did not supplement. If a patient has already had angioplasty, vitamin C will heal the wounds caused by the procedure. Vitamin C acts in synergy with vitamin E to reduce free-radical destruction that “ages” the heart. Dosage: 1,000-3,000 mg daily.
Acetyl L-carnitine is a substance which has well-known effects on heart muscle tissue. It improves the integrity of an aged heart, ensures efficient phosphate transport for energy, and has an antioxidant effect protecting the heart muscle from free-radical damage. Acetyl-L-carnitine also has anti-arrhythmic effects, lowers triglycerides and LDL cholesterol, and raises HDL. L-carnitine has shown moderate improvement in exercise tolerance and has reduced indices in patients with stable angina, myocardial infarction, peripheral vascular disease, and cardiomyapathy. Dosage: 500 mg 1-4 times a day. L- ARGININE improves the flow of nitric oxide and may improve symptoms of atherosclerosis.
- VITAMIN E
A natural blood thinner, vitamin E can treat blood clots as a result of arrhythmia or valve abnormality. Vitamin E strengthens artery walls, improves muscle function, improves blood flow, fights oxidation of LDL cholesterol, and improves oxygen supply to the heart. Although recent news reports mention a negative affect of vitamin E, especially in people already taking blood thinners or aspirin therapy, don’t buy into the negative hype, Vitamin E is still one of the most effective supplements in the primary prevention of heart disease and cancer. Women taking 600 IU every other day for over 10 years had a 24% reduction in the risk of cardiovascular disease. Dosage: 200-800 IU daily. Decrease to 200 IU daily, or less, if on anticoagulant drugs (Coumadin/warfarin).
- VITAMIN D
German scientists suggest that a lack of vitamin D may play a significant role in the increasingly common disease of CHF. In a recent study, women over the age of 65 who took an average of 400 IU of vitamin D daily had nearly one-third less of a risk of dying from heart disease than women who did not take the supplement. Dosage: 400-1,200 IU daily.
A natural diuretic that can flush out excessive retained fluids, B-complex vitamins also reduce stress on the heart. Take extra thiamine (B1) in connection with arrhythmia, shortness of breath, and peripheral edema. Niacin (B3) increases micro-circulation throughout the body. Extra vitamin B12 and vitamin B6 are essential to lower homocysteine levels. Dosage: 50-100 mg 2-3 times daily.
- FOLIC ACID
Folic acid may lower the risk of cardiovascular disease through its effect on homocysteine. It possibly increases nitric acid, which dilates blood vessels, and may lower colon cancer risk. Deficiencies of folic acid are linked to Parkinson’s and depression. Dosage: 400-2,000 mcg daily.
- HAWTHORN EXTRACT
Hawthorn extract is comprised of about 18% oligomeric procyanidins, and remains one of the most popular botanical medicines for heart conditions in Europe. Hawthorn has an historic use that improves parameters associated with cardiac insufficiency, increases coronary blood flow, and reduces vascular fragility. It also slightly increases the strength of the heart’s contraction, while decreasing blood pressure. Those who supplement with hawthorn show an improvement in circulation and tolerance to exercise. Hawthorn increases the effects of digitalis (Lanoxin) medications. Dosage of pure extract: 160-900 mg a day in divided doses.
Ribose is a needed carbohydrate (sugar) that helps the body quickly replace depleted energy levels. D-Ribose is a compound used by the body to rebuild energy levels during and following stressors in the body (on both the adrenal glands and the thyroid gland). Supplementing with D-Ribose can give the muscles the ATP they need to function optimally. Clinical studies have shown benefits in the treatment of heart disease, congestive heart failure, and fibromyalgia, as well as rapid athletic recovery, dramatic increases in muscle growth, and increased energy levels and anaerobic thresholds. Dosage: As directed on package.
Taurine is an amino acid required by the central nervous system as a calming neurotransmitter. Since it is the most concentrated amino acid in the heart muscle it has been used effectively in increasing the integrity of heart function. Taurine can aid in the digestion of fat-soluble vitamins and control elevated serum cholesterol. Dosage: 1,000-1,500 mg twice a day on an empty stomach.
Policosanol appears to be a safe and effective supplement that can be used to lower several cardiovascular disease risk factors, including angina, decreased triglycerides and LDL, increased HDL, and abnormal rest stress EKG patterns. The link between cardiovascular health and hypercholesterolemia is well established. Policosanol may actually exert a number of other protective effects against heart disease. Dosage: 5-20 mg daily.
Arginine is an amino acid that can protect against the development of coronary artery disease by increasing blood flow and thus reducing the need for coronary bypass surgery. It also aids in sexual function by increasing the amount of nitric oxide, the same molecule so vitally important for proper cardiac function. Arginine may improve angina symptoms and enhance exercise performance by decreasing artery wall tension. Dosages: 1,000-10,000 mg a day for men; 1,000-6,000 mg a day for women. Take on an empty stomach.
- PROANTHOCYANIDINS (OPCs) (Grape seed extract and Pycnogenol)
These potent antioxidants fight inflammation, reduce LDL oxidation (especially when combined with chromium), and strengthen capillary walls. They also appear to improve the heart’s ability to recover from trauma by reducing platelet aggregation. OPCs in red wine appear to be of benefit and provide the answer to the “French Paradox” of why the French eat fatty foods but have a low rate of LDL cholesterol. Dosage: 50-100 mg 1-2 times daily.
Selenium is an important mineral that protects against oxidative damage. Dosage: 100-300 mcg daily.
- POTASSIUM CHLORIDE
Potassium chloride is imperative for good heart rhythm and decreased hypertension. Dosage: As prescribed by a physician, or a qualified health care practitioner.
Chromium improves utilization of glucose (which positively contributes to increased energy to the heart muscle) and may help reduce low-density lipoprotein (LDL) cholesterol. Chromium picolinate supplementation also shortens QTc interval duration in patients with type-2 diabetes, helping decrease cardiac arrhythmia. Dosage: 200-1,000 mcg a day.
This amino acid helps to restore the artery wall structure and, at the same time, decreases the risk of fat deposit formation. Dosage: As directed.
Garlic improves the elasticity of blood vessel walls. Dosage: Dietary sources are best, but with supplementation 300-1,200 mg daily.
- GINKGO BILOBA
This herb has been shown to ease leg pain caused by narrowed arteries in the legs. Ginkgo dilates blood vessels, reduces blood pressure, and destroys free radicals because of its antioxidant effect. Dosage: 60-180 mg daily.
Copper is an essential trace element that has a profound influence on cardiac myopathy and heart metabolism. Copper deficiency has been linked to low glutathione in heart and liver disease. Dosage: 2-6 mg daily. Caution: Do not use in individuals with symptoms of copper toxicity.
- TERMINALIA ARJUNA
Researched in Australia, terminalia arjuna has demonstrated substantial benefits in the treatment of refractory congestive heart failure linked to cardiomyopathy. Dosage: 500 mg 3 times a day.
Guggul appears to lower LDL cholesterol while raising “good” HDL cholesterol. Dosage: As directed on package.
A great deal of research has been done on this Chinese herb for its immune-stimulating properties, as well as its effects on heart function. Studies done mostly in China have evaluated the efficacy of supplementing astragalus in the treatment of coronary heart disease and may improve the quality of life of the cardiac patient. Dosage: As directed on package or instructed by a qualified practitioner.
- CHELATION THERAPY
Chelation therapy removes plaque from the arteries by injecting a synthetic amino acid called EDTA (ethyldiamine tetra acetic acid) into the bloodstream. This takes place slowly, over a number of hours. The process reduces mineral content, which can cause heart disease, from the blood. This in turn is eliminated through the kidneys. EDTA causes calcium to be pulled from arterial plaque, restoring the balance of blood. Dosage: As directed by a qualified practitioner.
After a Heart Attack
After a brush with death, it is time to make some tough decisions. You should not repeat the dietary mistakes of the past, and make lifestyle changes that will increase your chance s of having a long life with many quality years. Here are some steps I would recommend to follow to make your “second chance” the last one you’ll need for a long time.
- Eat more complex carbohydrates. If you have been a “meat and potato” man for a long time, it is time to change to a more “flexatarian” diet. Flexatarians are vegetarians who cheat once in awhile. A reasonable diet seems to be the Mediterranean diet filled with fresh vegetables, whole grains, less fruits, olive oil, a little red wine, and fish and chicken two or three times a week.
- Take antioxidants. Vitamin E, C, grape seed, selenium, CoQ10, zinc, alpha-lipoic acid, beta carotene, and other antioxidants are known to quench harmful free radicals which oxidize cholesterol and damage arteries. CoQ10 is of particular importance.
- Take magnesium. Magnesium is nature’s “calcium channel blocker” and is a key electrolyte — one of the minerals that regulate heart rhythm. Low levels of magnesium increases the risk of heart arrhythmias, high blood pressure, and erratic heart beats.
- Be more physically active. You don’t have to be a competing athlete, but exercise builds muscle and reduces fat at any age. We known that exercise strengthens the heart over time, and researchers have found that it modifies the behavior of genes in health-promoting ways.
- Relax, practice stress management, and learn to unwind. Stress management is one of the biggest factors in decreasing your risk of another heart attack. Stressors boost the levels of the hormone cortisol and insulin, which wreck havoc with the pancreas (increasing blood sugar), causing weight gain by making you hungry and more unable to convert carbohydrates into energy. Try practicing yoga, massage, meditation, prayer, touch healing, walking in nature, or a hot bath with soft music.
- Drink more tea. Green tea and ordinary black tea are loaded with powerful antioxidants called flavonoids. Japanese men who drink 2 or more cups of tea daily have almost half the risk of suffering a heart attack than their American counterparts. Stop drinking soft drinks, alcohol and artificial sweeteners.
- Take B vitamins. B vitamins are known to lower homocysteine levels, which when elevated can damage blood cell walls and set a stage for cholesterol deposits. B vitamins not only lower homocysteine, they increase energy and the immune system.
- Take fish oil capsules and eat fish from safe waters. Cold water fish are excellent sources of protein and have virtually no saturated fat. They are heart healthy and will help lower triglycerides, cholesterol and reduce blood pressure. Some experts today believe that taking fish oil supplements may be safer than consuming large amounts of fish.
- Decrease inflammation. Remember what Dr. Steve Sinatra says about heart disease — it is mainly due to inflammation. He recommends that all his cardiac patients supplement with omega 3 fish oil, Co-enzyme Q10, magnesium, L-carnitine, vitamin C, and D-ribose to decrease inflammation in the body. Have your physician check your C-reactive protein level to determine the amount of inflammation is in your body.
Appleton, J. Arginine: Clinical Potential of a Semi-essential Amino Acid. Alternative Medicine Review, December 2002. 7(6): 512-517.
ARL Laboriatories hair Analysis research. Phoenix, AZ. www.arltma.com
Balch, JF, Balch PA. Prescription for Nutritional Healing- 3rd edition. Penguin Putman Inc. New York, NY. 2000.
Bioenergy Ribose. www.bioenergy.com
Blumberg, J. Unraveling the Conflicting Studies on Vitamin E and Heart Disease. . Linus Pauling Institute Newsletter, Spring/ Summer 2002. P. 9.
Blumenthal, M. The ABC Clinical Guide to Herbs, Austin, TX. American Botanical Council. 2003.
Braverman, ER. Eat Your Heart Out: Cardiovascular Nutrition. Natural Pharmacy. Feb 2000. 4(2):13-15.
Cardio Nutrients. Energy Times, Feb. 2003. 13(2): 35-40.
Challem, J. Latest Vitamin E Study Shows Heart Benefits for Women. Natural Pharmacy, October 9(5): 5.
Challem, J. After a Heart Attack. Alive #282, April 2006. Pp. 76-79.
Chase, C. Small Trial Shows Hawthorn Leaf and Flower is Effective in Early-Stage CHF. HerbalGram #56. 2002. P. 23.
Dean, W. CoQ10 Plays Many Roles As Anti-Aging Nutrient. Vitamin Research News, July 2004. 18(6): Pp. 1, 4-7.
Frei, B. Questions and Answers with Dr. Balz Frei. Linus Pauling Institute Newsletter, Spring/Summer 2002. P. 5.
Furlong, JH. Acetyl-L-Carnitine: Metabolism and Applications in Clinical Practice. Alternative Medicine Review. July 1996. 1(2): 85-93.
Gaby, AR, Wright, JV. Lectures Notes from Natural Medicine Conference, Seattle, WA. 1996
Jacobs, BP., Bowers WS. Ginkgo biloba: A living fossil. The American Journal of Medicine. 2000.Vol. 108: Pp. 341-342.
Janikula, M. Policosanol: A New Treatment for Cardiovascular Disease, Alternative Medicine Review, June 2002. 7(3): 203-215.
Editorial staff. The 4 Cornerstones to Heart Health. Alive Magazine #127. November 2000. P. 54.
High Vitamin C Intake Reduces Heart Attack Risk. Natural Pharmacy, April, 2005. 9(2): 4.
L-Carnitine- Monograph. Alternative Medicine Review, March 2005. 10(1): 42-47.
Liebman, M. Policosanol. Natural Pharmacy, May/June 2003. 7(3): 1, 20.
Low Vitamin D Linked to Heart Disease. Alive #251. September 2003. BBC-News item. P. 18.
Maher, TJ. L-Arginine. Nutrition Science News. Feb 2000. 5(2): 1-7.
Miller, AJ. Botanical Influence on Cardiac Disease. Alternative Medicine Review, Dec 1998. 3(6): 422-431.
Mills, S, Bone, T. Principles and Practice of Phytotherapy. Churchill Livingstone, Sydney. 2000.
Murray, MT. Heart Health in a Heartbeat. Alive #280, February, 2006. Pp. 52-56.
Nath, R. Copper Deficiency and Heart Disease. Alternative Medicine Review, June 3(3): 249.
Oligoric Proanthocyanidins (OPCs) monograph, Alternative Medicine Review, Nov. 2003, 8(4): 442-447.
Rath, M. Why Animals Don’t Get Heart Attacks..But People Do! MR Publishing Co, Fremont, CA. 2003.
Rosick, ER. Arginine Fights Coronary Artery Disease. Life Enhancement, Aug 2000. Pp. 9-13.
Sinatra, ST. Nutritional Supplements for the Cardiac Patient. Int’l Journal of Integrative Medicine. Jan/Feb. 2001. 3(1): 31-41.
Vitamin D Gets A+ for Heart and More. Whole Foods (Research News), July 2002, 25(8): 10.
Zeolia, MM. Benefits of Fish Oils Extend to Prevention of Sudden Death. APhA Drug Info Line, June, 2004. 5(6): 8