What Is It?
Cardiovascular disease (CVD) refers to a class of diseases associated with damage to the arteries. CVD is the number one cause of death in the United States. The most common cardiovascular diseases and conditions will be mentioned here. They include:
Atherosclerosis (see in bold below):
• Coronary artery disease
• Carotid artery disease
• Cerebrovascular disease
• Renal artery disease
• Peripheral artery disease
Non-atherosclerosis (much less prevalent in our society):
• Rheumatic heart disease
• Congenital heart disease
Description of common conditions that occur as a result of cardiovascular disease (see in bold/italics below):
• Heart attack
• Acute thrombosis
• Cardiac arrest
• Arterial stenosis
• Heart failure
• Blood clots
• Hypertension (high blood pressure)
• Heart arrhythmia
The terms cardiovascular disease, or heart disease, most commonly refer to atherosclerosis. Atherosclerosis is the buildup of plaque in the arteries, commonly called “hardening of the arteries”. This begins as a process known as endothelial dysfunction in which excess fatty material, cholesterol and minerals, such as calcium, accumulate, attract immune cells forming a fatty, calcified, plaque in the inner layer of the artery. Over time, the thickness of the artery increases as the plaque builds up, eventually blocking the blood flow through the artery and making it less flexible.
Inflammation underlies this process. As certain dietary lipids from fatty foods are absorbed from the intestinal tract, they are often accompanied by bacterial toxins called lipopolysaccharides (LPS). The LPS enter circulation and promote an inflammatory response that can cause the inner artery layer (endothelial lining) to become leaky, which allows oxidized fat (low-density lipoprotein or LDL) to be deposited in the arterial wall. As this process occurs, an inflammatory immune response is activated against the oxidized LDL, which begins the buildup of fatty material and cholesterol. In addition, other materials containing calcium enter the artery wall, contributing to the buildup of plaque over time. Most any increase in free radical activity in the blood could promote this process.
Some plaques are considered unstable, meaning they are more prone to rupturing. This rupturing triggers the blood to clot at the site of plaque rupture, which can further block the artery and may lead to a heart attack. This is known as an acute thrombosis.
Abnormal blood clotting
Cardiac arrest is when the heart stops beating. There are numerous reasons this may occur, one being heart attack as described above, which involves a blocked supply of blood and oxygen to the heart. The difference between a heart attack and cardiac arrest is that, with a heart attack, the heart does not necessarily stop beating.
Atherosclerosis leads to coronary artery disease (also known as coronary artery disease), a narrowing of the blood vessels. When the arteries are narrowed (arterial stenosis), this means that not enough blood can reach the heart. As a result, angina (chest pains) may be experienced, which can progress to heart attack. Heart attack is the death of heart muscle due to insufficient blood flow. If enough of the heart is recovered quickly, a person can survive a heart attack, but there is usually scarring of the heart tissue involved. Over time, coronary heart disease can weaken the heart so that it cannot pump enough blood to the rest of the body. This is known as heart failure.
When there is narrowing in a carotid artery, which leads to the brain, it is known as carotid artery disease or stenosis. When the artery narrows by 80 to 90 percent, there can be decreased blood flow to the brain. In addition, the narrowing plaque in the artery can send clots to the brain and cause a stroke.
Cerebrovascular disease (disease of the arteries of the brain) is another cause of stroke. It usually occurs when there is a blockage causing disruption of blood supply to the brain. This decreased blood flow causes brain cells to die. The stroke may be the result of a blood clot (most common, described above), plaque buildup, or sometimes a ruptured aneurysm (weakened area in the wall of an artery), often due to hypertension (high blood pressure). Conversely, atherosclerotic processes can be the cause of hypertension.
Renal artery disease is usually due to atherosclerosis of the arteries that supply the kidneys. Like other atherosclerotic conditions, as the arteries narrow, the kidneys will not function as well. As a result, the kidneys release the hormone rennin which increases blood pressure.
Peripheral artery disease refers to atherosclerosis that occurs in arteries that are not in the heart. Most commonly affected are the arteries of the abdomen, pelvis and legs. With this disease, there is a decreased blood flow to the involved areas. Peripheral artery disease can also contribute to a decreased blood flow to the heart. In addition, with narrowed arteries in the legs, there can be increased vascular resistance to blood flow that can also lead to heart failure.
The following heart diseases are not the result of atherosclerosis (non-atherosclerosis), and are not the topic of the rest of the chapter, but will be mentioned here since they are part of the class of cardiovascular diseases.
Rheumatic heart disease begins as rheumatic fever, often during childhood after a Strep infection. In rheumatic heart disease, the heart valves are damaged due to an inflammatory autoimmune attack. This is not common anymore in the United States, but in developing countries, it still remains a prevalent health risk.
Congenital heart disease is a defect in the structure of the heart or blood vessels that occurs before birth. These defects can disrupt the normal flow of blood through the heart. Those with complex heart defects often need surgery soon after birth, and some must be monitored throughout their lifetime.
Heart arrhythmia is a disorder of the pumping rhythm of the heart. Heart arrhythmias can be mild to serious. Some people live with an arrhythmia, and never need treatment. Others may need medication and/or a pacemaker to monitor and regulate heartbeat. Heart arrhythmia is the result of a malfunctioning electrical conduction that overrides the natural pacemaker that exists in the heart. When misfires occur, the heart beats irregularly. This can be dangerous, and can even lead to heart disease, stroke or cardiac arrest. Heart arrhythmias can be due to decreased blood flow to the electrical system, but can also be caused by mineral imbalances (commonly low magnesium), and metal toxicities such as lead and mercury.
What Causes it?
Some important factors that lead to the development of atherosclerosis include:
• Silent Inflammation (vs. Acute Inflammation)
• SAD unhealthy diet
• Physical inactivity
• Tobacco use
• Alcohol use
• Non-alcoholic fatty liver disease (NAFLD)
• High blood pressure
• Abnormal blood lipids
• Metabolic syndrome (which is a combination of high blood pressure, abnormal blood lipids, and high blood sugar)
• Periodontal (gum) disease
• Leaky gut
• Family history or genetics
• Abnormal blood clotting
In recent years, it has been determined that underlying the process of atherosclerosis is silent inflammation. Silent inflammation is neither seen nor felt until an health event occurs. From the very moment that LDL begins to accumulate at the arterial surface, inflammatory cells and molecules are in action as described above. This silent inflammation stimulates the proliferation of plaques, as well as assists in the rupture of plaques, the cause of further complications such as heart attack and stroke.
To better understand inflammation, consider this. If you cut your finger your body’s healing process begins immediately.You know you’re injured. It hurts. You may have obvious swelling and redness. That’s acute inflammation. This type of inflammation is a necessary process in the body, helping to defend us against invading pathogens, toxins and unwanted invaders. If we had no inflammation we would be without a strong defense.
With silent inflammation some of these things are occurring, but you don’t necessarily feel pain from the process at all. It continues beneath your awareness, like a smoldering flame. Be quite sure that your body is doing its best to deal with the situation. Sadly, normal metabolic processes become distorted and when inflammation persists, when it doesn’t properly resolve, when it lays low, yet active – we have cause for worry.
While silent inflammation can occur in anyone, one major risk factor is obesity, especially central obesity (abdominal fat). People who are obese, and even those who are not obese but have an accumulation of abdominal fat, are more likely to develop cardiovascular disease. Once the fat develops around the abdominal area, that fat becomes it’s own organ. That acquired organ actually produces toxins and hormones and other substances that trigger gut inflammation, which results in what we call leaky gut, where toxic substances are able to enter the bloodstream, circulate throughout the body, thus fueling any one of the cardiovascular conditions listed above.
The Standard American Diet (SAD) is a major source of systemic inflammation and the development of abdominal fat. The SAD diet, largely devoid of healthy nutrients and omega-3 fats, yet abundant in unhealthy fats (saturated and trans) and refined carbohydrates, plays a large role in the development of CVD. Excessive fats and sugars lead to the development of fatty plaques and inflammation that are the hallmarks of the disease. Trans fats, in particular, have been shown to play a role in the development of CVD. Additionally, excess sugar intake increases blood triglyceride levels. Fructose, usually in the form of high fructose corn syrup (HFCS), which is present in much of the processed food that is consumed in the U.S., has been shown to increase triglyceride and LDL (bad) cholesterol levels in the blood. HFCS has also been shown to contain mercury. These increases lead to CVD. Interestingly, fat tissue itself can be considered an organ due to its production of a variety of hormones and inflammatory molecules. These molecules create chronic silent inflammation and metabolic dysfunction which lead to the development of CVD, usually by way of insulin resistance. Insulin resistance leads to both high blood sugar and high insulin levels, creating a vicious cycle of yet more inflammation and fat storage. This is a major reason why diabetics have such a high incidence of vascular disease.
Physical inactivity is a risk factor for the development of cardiovascular disease. In fact, lack of exercise has been shown to cause endothelial dysfunction, and, in study after study, regular exercise has been shown to protect against heart disease and its complications. This goes hand in hand with proper diet.
Cigarette smoking and second-hand smoke exposure increase the risk for developing CVD. One way in which this occurs is by causing endothelial dysfunction. Smoking has been deemed the “leading preventable cause of disease and deaths in the United States” by the Surgeon General. Smoking increases blood pressure and blood clotting, and decreases HDL (good) cholesterol and exercise ability. Women who smoke and use oral contraceptives are at an even greater risk. Smoking also increases insulin resistance, which leads to diabetes and ultimately heart disease.
Though alcohol in small quantities (mostly red wine) has been shown to actually be protective of CVD, heavier drinking and drinking outside of mealtimes is associated with risk for CVD development.
Liver fat, a condition known as non-alcoholic fatty liver disease (NAFLD), can lead to the development of CVD by way of atherosclerosis. NALFD is also a precursor for type 2 diabetes, and often occurs in conjunction with abdominal fat, though not necessarily. Because there are no obvious symptoms of NAFLD, this can be another hidden cause of CVD.
High blood pressure, abnormal blood lipids (high triglycerides, high LDL cholesterol and low HDL cholesterol), and the metabolic syndrome (which includes high blood pressure, abnormal blood lipids, abdominal fat and insulin resistance) all lead to the development of CVD. The metabolic syndrome also leads to the development of diabetes, which itself leads to CVD. This web of diseases and conditions, one on top of the other, all lead down the same path to heart disease.
Recently, researchers have discovered a link between the bacteria in the mouth and heart disease. Specifically, periodontal (gum) disease, which is caused by an overgrowth of bad bacteria in the mouth, has been associated with CVD. This link is thought to be due to inflammation, as can be measured in the blood. The same markers of inflammation associated with heart disease are also found in those with periodontal disease, even in the absence of other risk factors such as high cholesterol and triglycerides.
One interesting study looked at intestinal function in people with chronic heart failure. This study found that intestinal permeability, or leaky gut, in addition to bacterial overgrowth, contributed to the inflammation that is found in chronic heart failure. This state of leaky gut allows bacterial toxins to enter into the bloodstream, where they trigger an inflammatory response that circulates in the bloodstream. This is a great example of the gut-heart connection. Indeed, the health of the whole body begins in the gut.
Another study found that people who ate a high-fat meal had higher levels of bacterial toxins (lipopolysaccharides, or LPS) in their blood than did people who ate a low-fat meal. Increased amounts of LPS in the bloodstream contribute to the development of atherosclerosis. LPS is produced by potentially pathogenic bacteria (gram-negative) and enters the bloodstream primarily by way of a leaky gut. This is an important gut-heart connection that is being studied further.
Numerous studies also point to the role that environmental toxins play in the development of CVD. Most notable is the effect of air pollution, which may hasten the development of atherosclerosis, and worsen the vascular diseases that result from it. High traffic exposure is also implicated in CVD development.
Bisphenol A (BPA) is another toxin that has recently been associated with heart disease. In an animal study, BPA exposure increased the risk of heart arrhythmia. In humans, BPA has been associated with angina, heart attack and coronary heart disease. Another toxin to consider in CVD is the heavy metal lead. High levels of lead in bone was found to increase the risk of death from CVD in men. Though environmental levels of lead are lower now than in the past, lead is stored in the bone where it remains for many years. So previous exposure to lead may still take its toll on health a number of years later.
Another gut-heart connection involves the exposure of infants to everyday germs. Researchers have found that exposure to a small amount of infectious microbes in infancy may actually help to prime the immune system. This provides proper regulation of inflammation throughout life, ultimately resulting in less inflammation-related diseases, such as cardiovascular disease, in later life. This is known as the hygiene hypothesis, which asserts that children today are being raised in super clean environments, which may result in an under-challenged immune system which does not learn to fight off infection and allergy properly.
Stress also plays a role in the development of heart disease. There are a few ways in which this can happen. One way that stress leads to heart disease is by causing the body to deposit more fat in the abdomen. Abdominal fat is a risk factor for heart disease. Other ways that stress can lead to heart disease is by increasing other risk factors such as blood pressure or cholesterol levels. Some studies have linked stress to increased blot clots, which lead to heart disease as well.
As with most any disease, family history and genetics plays a role as well. Children of parents with CVD are at greater risk for developing the disease. If a parent or sibling experiences an atherosclerotic event, a person has a two-fold increase in risk for developing CVD. Family history is always taken into consideration when evaluating a person’s risk for CVD.
Abnormal blood clotting can develop in the arterial circulation (arterial thrombosis) or venous circulation (venous thrombosis). Arterial thrombi usually develop in arteries diseased by the process of atherosclerosis. The factors that lead to venous thrombosis are less well understood, but inactivity and small injuries to the veins may play a role.
What Are the Signs and Symptoms?
- angina, or chest pain – described as pressure, heaviness, aching, burning, fullness or pain in the chest
- shortness of breath
- heart palpitations (the feeling of the heart skipping a beat)
- faster heartbeat
It is interesting to note that, in women, the classic symptoms of heart disease are different. Chest pain is not as prevalent a symptom in women as it is in men.
Common symptoms of heart disease in women:
- an indigestion-like pain
- nausea or vomiting
- unexplained weakness or fatigue
- discomfort or pain between the shoulder blades
- recurring chest discomfort
- a sense of impending doom
It is also important to list the symptoms of a heart attack, heart failure and stroke here, since artery disease can lead to these conditions.
Symptoms of heart attack include:
- general discomfort
- pressure or pain in the chest ,arm or below the breastbone
- discomfort radiating to the back, jaw, throat or arm
- indigestion or choking
- shortness of breath
- rapid or irregular heartbeats
Symptoms of heart failure include:
- shortness of breath, especially when lying down
- cough that produces white mucus
- rapid weight gain (two to three pounds in one day)
- swelling in ankles, legs and abdomen
- fatigue and weakness
- rapid or irregular heartbeats
- chest pain
Symptoms of stroke usually appear suddenly and include:
- weakness or paralysis of the face, arm or leg
- typically on one side of the body
- trouble seeing, such as with blurred or double vision or loss of vision
- confusion or trouble understanding
- slurred speech
- trouble walking
- loss of coordination
- severe headache
In women, stroke symptoms may look different. In particular, altered mental status, as in confusion, disorientation, or loss of consciousness may be more prevalent than in men. It is possible that stroke symptoms begin gradually, and slowly worsen over time. Some strokes are mild and more difficult to detect.
Symptoms of peripheral artery disease may be mild or not present. Symptoms that are present include:
- painful cramping in the hip, thigh or calf after moving (also known as claudication)
- abdominal pain with eating (known as intestinal angina)
- significant weight loss due to avoidance of eating
- leg numbness or weakness
- coldness in one leg or foot
- sores that don’t heal on legs or feet
- change in leg color
- hair loss on feet or legs, or changes in toenails
- sexual dysfunction
- pain in the buttocks while walking
Brenda's Better Way
In the management of heart conditions, it is clear that the most important components are diet, weight, stress and gut health. Also essential is the reduction of toxins which enter the body and the bloodstream through appropriate cleansing protocols that can help to lower the body’s toxic burden.
Healthy digestion, achieved with the consumption of a high-fiber diet, omega-3 oils, probiotics and digestive enzymes, will also help to support the body’s elimination of these toxins. Another important way to prevent a heart attack from progressing to a cardiac arrest is to regularly take fish oil high in EPA and DHA. This has been shown, in many studies, to prevent cardiac arrest and death due to heart attack.
With the aging of the baby boomer generation, we are seeing an increase in toxicity that occurs when toxins stored in the bones are released like lead and mercury. Bone is a long-term storage house for toxins that accumulate over a lifetime. When bone breaks down as we age, especially in people with osteoporosis, this release of toxins enters the bloodstream, and can trigger high blood pressure and heart arrhythmia.
Chelation therapy has been valuable in treating CVD for removal of toxic minerals, mainly lead, mercury, cadmium, arsenic and aluminum, all of which affect arterial wall function. Traditionally, this is done intravenously by doctors trained in chelation therapy using EDTA. However, it is now possible to use both oral DMSA or DMPS and rectal EDTA suppositories with good results for less money.
The cardiovascular-gut connection can often be seen in people with low gastric acid production as occurs with certain forms of gastritis, impairing B vitamin absorption. B vitamins are critical in cardiovascular health. For example, folate along with a specific enzyme makes SAMe (S-adenosyl methionine) in the body, which repairs DNA and is helpful in preventing many illnesses or disorders, including cardiovascular disease. Low SAMe leads to increased homocysteine levels, which is a well-known marker for CVD which we’ve discussed. As much as 20 percent of the world’s population may have this problem.
It’s a great idea to make sure your homocysteine levels are tested as they can be fairly easily treated with high levels of B vitamins, including B6, B12, B2, folate, trimethylglycine, and 5-methyl folate because of the prevalent mutation that doesn’t allow them to process non-methylated forms of B vitamins, specifically folate., thus reducing the risk of CVD.
Follow the recommendations below on your path for optimal heart health.
• In addition to standard blood analysis, request from your doctor the NMR LipoProfile.
• Heavy metal hair analysis, organic acid testing and many other types of tests for various toxins are available these days to help you and your doctor understand chronic inflammatory issues.
• A diet high in fruits and vegetables, and low in saturated and trans fats is protective against cardiovascular disease. In fact, the Standard American Diet (SAD) has been shown to increase heart attack risk.
• Follow the Skinny Gut Diet Eating Plan for a heart-healthy diet.
• Limit salt intake, because high salt intake is associated with higher stroke incidence.
• Limit sugar and simple carbohydrate (white flour, white rice, white pasta, etc.) intake, which increases many risk factors for cardiovascular disease.
• Foods containing soy may help lower cholesterol due to their content of plant sterols.
• Coffee may be too much of a stimulant for some people, especially type A personalities who are at higher risk for cardiovascular disease. Also, unfiltered coffee can lead to higher cholesterol levels.
• Olive oil is a great replacement for the saturated fats in the diet.
• Chia seed is high in fiber and omega-3 fatty acids, both beneficial for the heart.
• Smoking and second-hand smoke exposure increase cardiovascular disease risk. If you do smoke, quit. If you are exposed to second-hand smoke, reduce that exposure.
• Moderate exercise is protective against cardiovascular disease.
• If you are overweight, lose weight to reduce your heart disease risk.
Complementary Mind/Body Therapies
• Colon hydrotherapy is helpful for people who are constipated or want to detoxify the colon.
• Stress can be a major component of this disease, so find ways to reduce it with therapies such as meditation, yoga, deep breathing, massage, biofeedback, or music therapy.
• Acupuncture is helpful for people with CVD.