Professional Documents
Culture Documents
2010 04 02 Reversing Heart Disease My Two Part Plan For Success
2010 04 02 Reversing Heart Disease My Two Part Plan For Success
Dr. Crandalls
es, heart disease can be reversed! Thats the definitive answer, I am glad to say. This has been repeatedly confirmed in studies.1
Its crucial, though, to understand what reversing heart disease means. This requires an understanding of heart disease itself what it is and how it begins. This is the first of a two-part series, continued in next months edition, where Ill explain in detail exactly how you can turn around your own heart health. Cholesterol is widely known as the villain of the heart disease story. This may surprise you, but your body actually needs a healthy amount of cholesterol. Its an essential nutrient that the body uses to build cells and hormones. In fact, cholesterol makes up more than half of each cell, maintaining the cell walls permeability as it protects the cells core. Cholesterol even provides the body with Vitamin D when broken down by sunlight. This natural ally of the body can become its enemy, unfortunately, as a result of the way we eat and because of our decreased activity levels. Healthy children and adults in countries where heart disease is almost unknown have total cholesterol counts of around 118 and 125. Many adults, particularly in the West, have cholesterol counts that are much higher. They can be so high, in fact, that when a doctor draws the patients blood, chills it in a test tube, and spins it using a centrifuge, the tube can have a white, fatty layer on top, like cream on top of milk. In the worst cases, the fat makes the entire test tube turn white.
Cholesterol travels through the blood in particles. These particles are much like the globules that form in a frying pan when you are trying to wash out fat after frying bacon. The smaller and denser these particles are, the more damage they can do, because a smaller size allows them to embed more easily in the artery wall. Thats why LDL cholesterol is often called the bad cholesterol, while HDL cholesterol is known as the good cholesterol. By its nature, LDL has more power to embed in the arteries than does HDL cholesterol. Ideally, both LDL cholesterol and HDL cholesterol travel as bigger particles and in less dense packets. Lets discuss density: Imagine throwing a beach ball around a room. The ball bounces around harmlessly. Even if it hits a lamp its unlikely to do much damage because it has so little density; that is, it carries very little weight for its size. Now picture a handful of BBs which are
In This Issue...
Even Mild High Blood Pressure a Killer.................. 2 Free Blood Flow Crucial to Heart Health................ 3 Case Study: All Stress Is Bad Stress........................ 4 My Targets for Turning Around a Heart Patient...... 5 Thyroid and Your Heart; Anger Can Kill................. 6 The Real Cure for Heart Disease: Change............... 7 Ask Dr. Crandall. .................................................... 8
much smaller and denser being thrown around a room. Theyll likely cause havoc, cracking the ceiling, rattling around in the air ducts, exploding light bulbs, and working themselves down into the carpet, where youll have to dig them out with your fingers. Theyll go everywhere and stay there. Arteries, meanwhile, are made up of millions of individual cells that are aligned at what cardiologists call tight junctions. This structure allows for elasticity; the artery can dilate, or stretch to get larger, and also constrict, becoming smaller. Each artery is like a balloon in this way. Being made this way lets the artery accommodate changes in blood pressure, like when your heart pumps faster during exercise, or more slowly during sleep.
father, I have to fight high blood pressure. My hypertension never showed up during my regular check-ups thats how insidious it can be. However, when I was working under pressure, a frequent part of my job as a doctor, my borderline normal blood pressure became distinctly abnormal. I had no idea about this until I found myself in the hospital with a major blockage of the main coronary artery leading to the heart. Other inflammatory conditions, such as rheumatoid arthritis, pneumonia, even common infections, can cause inflammation in the arteries. That inflammation allows particles of cholesterol to embed in the lining at areas that are inflamed, or damaged. A vicious cycle sets in: Embedding of cholesterol leads to more inflammation, and inflammation leads to more embedding of the damaging cholesterol particle. Cholesterol that embeds in the lining causes a condition which sparks chemotactic factors, which in turn play a key role in the development and progression of atherosclerosis, or hardening of the arteries. This complex process is how cholesterol forms deposits called plaque. The formation of plaque in the arteries is whats known as atherosclerosis. People react differently to the embedding of cholesterol in the arterys lining, just as they react differently to getting a splinter under the skin. Some people handle splinters easily. They experience only minor irritation as the body repairs the damage. Other people who get splinters, however, can experience significant swelling and become infected. For one person, the embedding of cholesterol in the arterys lining can be a minor thing that happens all the time with no great damage done. For another person, though, it can be the beginnings of an eventual catastrophe. It all
Dr. Crandalls Heart Health Report is a publication of Newsmax Media, Inc., and Newsmax.com. It is published monthly at a charge of $54.00 per year and is offered online and in print through Newsmax.com. Our editorial ofces are located at 560 Village Blvd., Ste. 120, West Palm Beach, FL 33409. The owner, publisher, and editor are not responsible for errors and omissions. Rights of reproduction and distribution of this newsletter are reserved. Any unauthorized reproduction or distribution of information contained herein, including storage in retrieval systems or posting on the Internet, is expressly forbidden without the consent of Newsmax Media. For permission, contact the publisher at : PO Box 20989, West Palm Beach, FL 33416. CEO Christopher Ruddy Associate Publisher Travis Davis Author Chauncey Crandall, M.D. Contributing Editor Harold Fickett Production/Art Director Elizabeth Dole To contact Dr. Crandalls Heart Health Report send e-mail to: askdrcrandall@newsmax.com. Subscription/Customer Service contact 1-800-485-4350 or customerservice@newsmax.com. Send e-mail address changes to customerservice@newsmax.com. 2010 Newsmax Media, all rights reserved. Please note that this advice is generic and not specic to any individual. You should consult with your doctor before undertaking any medical or nutritional course of action.
April 2010
depends on how the persons body reacts to these tiny, yet insistent, attacks on the artery. Reaction usually depends on the frequency of the damage, a persons general health, and other factors. Relatively new plaque deposits initiate a process thats much like the formation of a blister. Burn yourself accidently with a clothing iron or on the stove and the spot where you touched the hot surface will become red, signaling damage to the tissues. Soon, a blister will form as the body tries to repair the damage. A plaque deposit is like that blister. The artery lining has been slightly damaged by cholesterol embedding in the wall and an inflammatory condition develops. Inflammation in the arteries also can develop as a result of inflammatory conditions elsewhere in the body, such as rheumatoid arthritis, pneumonia, and various forms of infection. In this case, the inflammation itself can be the factor that attracts cholesterol to the site and results in a build-up of plaque. Deposits of plaque are also like blisters in that they have liquid centers. Plaque deposits thus are weakest around their edges, where the wall of the plaque is the thinnest. Most of the time, if left alone, they are simply reabsorbed by the body. But they can also rupture, releasing their liquid into the blood stream. The body reacts to the rupture of a plaque deposit like it reacts to a bleeding wound: It marshals its forces to repair the damage. Sometimes the rupture of a plaque deposit will result in the bodys defense mechanisms going haywire. A blood clot can form at the site and cause a heart attack, or this clot can detach and travel through the circulatory system, causing a blockage in the arteries leading to other areas of the heart or other organs. This is how a heart attack, technically called a myocardial infarction, most commonly occurs: A blood clot delivers a devastating blow to the cardiovascular system. (Blood clots also cause brain-damaging strokes.) The clot retards the flow of blood to or within the heart and heart tissue, which rapidly begins to die from lack of oxygen and nutrients. Normal blood flow must be restored as quickly as possible in order to
April 2010
minimize the damage and prevent death. Yet most plaque deposits do not initiate the catastrophic chain of events that lead to heart attacks and strokes. The body successfully copes with these blister-like structures and turns them into fibrotic and calcified deposits. Old plaque becomes as hard as mortar between bricks. In this state, old, hardened plaques cannot be removed from the arteries by any presently known method other than surgery. Usually, this is unnecessary. Unless an artery has been narrowed by more than 75 percent, blood flow remains largely unaffected.
April 2010
significantly affecting blood flow. But if the arteries narrow by 75 percent or more the person is likely to experience exertional angina they lose their breath easily and can suffer left arm, jaw, and chest pain. This is a condition that can be managed as long as the plaque build-up causing the problems is stable. Early, non-critical, or unstable plaque buildups are the ones we worry about most because these are responsible for heart attacks and strokes These newer build-ups of plaque are also the ones that can actually be removed or eliminated through lifestyle changes in diet and exercise. A relatively minor reduction in plaque deposits say 8 percent within the body can result in major health improvements. This is because eliminating the young deposits of plaque is like opening another lane on the highway. Suddenly, the traffic changes from stop-and-go into moving along again at a good rate. There are mathematical models that can explain the physics of this, but believe me, its true! If you remember nothing else from this article, remember this: A minor reversal in heart disease, the removal of young plaque deposits from the arteries, results in a major improvement in health. The treatment of heart disease involves the elimination of the several factors that together produce the condition. I treat patients a little differently according to their basic condition. Many times patients have already experienced a cardiac event. Theyve had a heart attack, an anginal episode, or theyve experienced an arterial blockage thats been treated through angioplasty, a procedure that enlarges the artery by expanding a balloon within it, or the insertion of a stent, a steel mesh tube sometimes coated with drugs that keeps the artery open. We also see patients who have known risk factors for heart disease: hypertension (high blood pressure), hypercholesterolemia (high cholesterol), hyperglycemia (high blood sugar), weight gain, insulin intolerance, or metabolic syndrome. In this circumstance, the treatment can be less aggressive but it essentially follows the same course. For those who have had cardiac events, I tell
April 2010
them that we are in a war and we are going to use every weapon we have to win the war and walk in victory. The most powerful weapon, always, is recruiting the bodys resources as our ally. As all good doctors know, the practice of medicine depends mostly on creating conditions in which the bodys own natural ability to heal itself can function most effectively. This is particularly true with heart disease because it only develops and advances when the bodys own healing capacities are overwhelmed by a persons bad habits.
1 HEALTHbeat, Dec. 29, 2009 2 Journal of Epidemiology and Community Health, Nov. 24, 2009 3 American Journal of Preventative Medicine, August 2008 4 Circulation, Jan. 5-12, 2010
April 2010
the United States presently are able to run these studies for a little-known blood test called the NMR Profile (nuclear magnetic resonance). We want the patients blood pressure under control, no higher than 120/80. We want to make sure there are no thyroid disorders. We also want to check for kidney dysfunction, since minor renal (kidney) failure often plays a role in heart disease, especially among AfricanAmericans and the elderly. We want to get the persons body weight under control, with a Body Mass Index (the percentage of a persons weight thats from fat) under 25. To meet these targets, we employ all available means. We use medication, lifestyle changes, and perhaps most importantly, education. For a patient with high cholesterol, in most instances Im going to prescribe a statin drug immediately to get the patient to the target goal. Statins have become controversial and they can have negative side effects. Once you realize, though, how high cholesterol drives heart disease, you can see how important it is to control cholesterol. Eventually, Id like to take the statin medication away, but I want to use it as long as necessary in order to shut down the heart disease engine. Statins not only lower high cholesterol but they also have other positive effects. They have antiinflammatory properties, decreasing inflammation by eliminating free radicals, atoms or molecules that can cause destructive chain reactions within a cell. And they are vasodilators, that is, they help arteries open up. Usually, when people understand the positive effects of statins they become more accepting of their use. Ill also typically prescribe fish oil for additional regulation of fat in the blood, low-dose aspirin for its anti-coagulant effect, and other medications as needed. The patient needs to exercise regularly. I ask my patients to make use of a cardiac rehab facility for supervised exercise three times per week. On his or her off days, I want the patient to walk for an hour. I also put the patient on
April 2010
my heart disease reversal diet. I will be writing continually in this newsletter about the particulars of this diet, Im sure, but for now Ill just say that this is a largely plant-based diet, with plenty of fresh fruits and vegetables, whole grains, and particularly at the beginning as little fat as possible. Thats because I want the body to go after the fat thats already stored in a patients cells and fat deposits within the arteries and everywhere else it may be located. If the patient takes fat out of his or her diet, the body will quickly begin using the persons stored up fat reserves for energy. Its the bodys version of spring cleaning!
1 Atherosclerosis Regression, Vascular Remodeling, and Plaque Stabilization, Journal of the American College of Cardiology, January 2007 7
My doctor has prescribed a statin drug for the treatment of high cholesterol. The statin certainly has brought my cholesterol count down and did so quickly. Unfortunately, since Ive been taking the statin, Ive felt consistently tired and fatigued. Should I stop taking it or should I just put up with feeling less energetic? Sandra R., Miami, Fla.
Theres a third option. Why dont you ask your doctor to try a different statin drug? There are a number on the market and they are all metabolized (put to use by your body) a little differently. Many people find that they dont have the same side effects, like fatigue, with one statin that they do with another. Your doctor probably prescribed the statin he thought would best treat your cholesterol. However, theres probably another one that will give you similar results in terms of cholesterol reduction without sapping your energy. To your heart health,
Please note: All information presented in Dr. Crandalls Heart Health Report is for informational purposes only. It is not specic medical advice for any individual. All answers to reader questions are provided for informational purposes only. All information presented in Dr. Crandalls Heart Health Report should not be construed as medical consultation or instruction. You should take no action solely on the basis of this publications contents. Readers are advised to consult a health professional about any issue regarding their health and well-being. While the information found in Dr. Crandalls Heart Health Report is believed to be sensible and accurate based on the authors best judgment, readers who fail to seek counsel from appropriate health professionals assume risk of any potential ill effects. The opinions expressed in Dr. Crandalls Heart Health Report do not necessarily reect those of Newsmax Media.
8 April 2010