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Heart Disease is the number one cause of death in the United States, more than 700,000 deaths in the year 2000 alone. However, many cases of heart disease can be prevented by eating a proper diet, exercising, reducing stress, having routine lab tests, and taking herbal and nutritional supplements.

Atherosclerosis, or hardening of the arteries, is the primary culprit of heart disease. Currently, many physicians and most lay people would describe atherosclerosis as a "plumbing" problem: fat collects on the inside of passive arteries, gradually narrowing the space through which blood can flow, eventually closing off the artery completely, leading to a heart attack or stroke. However, recent research reveals that the process is actually much more complex and that inflammation is the original problem, laying the groundwork for atherosclerosis.

Atherosclerosis begins with an insult to the artery walls. This insult could be the result of refined carbohydrates, insulin , homocysteine, chlamydea, virus, pro-oxidants, poor fats (such as rancid fats or hydrogenated fats, including margarine), or a variety of other causes. The damaged cells of the artery release chemical compounds which attract specific white blood cells called monocytes. The monocytes migrate into the middle layer of the artery, termed the intima layer, convert to macrophages, and release oxidizing chemicals meant to destroy the cause of the original insult. However, these chemicals can also damage healthy tissue, which will attract more monocytes, hence, starting and sustaining a vicious cycle. These macrophages also ingest LDL, the "bad cholesterol," trapping it in the wall of the artery. Continued insult leads to constant migration of monocytes, eventually resulting in a bulging of the intima layer into the space within the artery.

The bulge may or may not occlude the artery entirely. Recent research has shown that the majority of heart attacks are not caused by complete occlusion of the artery, but rather by the bulge bursting, producing a clot, which in turn may occlude the artery. This is a key point, because now we know that not only do we need to limit the insult to the artery, we also need to address the body's clotting mechanism to help prevent such life-threatening blood clots.

How do we assess the potential for heart disease? Diet and lifestyle risk factors are the first place to start. Studies show that a diet high in red meat, processed meat, hydrogenated oils, refined grains, sweets, and desserts as well as low in fruits and vegetables increase the risk for a heart attack by 64 percent. Smoking is a major risk factor, of course; people who smoke are at least twice as likely to suffer a heart attack than are non-smokers. Obesity, sedentary lifestyle, type A behavior (time conscious, impatient, aggressive, frequently angry, etc.), stress, diabetes, high blood pressure, and low thyroid function have also been independently linked to a higher incidence of heart disease.

Routine blood tests should be taken to determine the following levels: total cholesterol and its subfractions of HDL and LDL, triglycerides, Lipoprotein (a) (considered a higher risk factor than even LDL cholesterol), homocysteine (a strong oxidant), C-Reactive protein (a sign of inflammation), fibrinogen (a clotting indicator), and fructosamine (gives indication of mean sugar level over the last three weeks).


  • EAT A DIET HIGH IN fruits, vegetables, legumes, whole grains, fish, and poultry.
  • AVOID OR LIMIT intake of red meat, hydrogenated oils, and refined carbohydrates (sugars).
  • REDUCE stress.
  • EXERCISE REGULARLY: Take a meditation class, yoga class, or join the gym!

Fiber, especially, from oats, psyllium seeds, fruit, and beans, reduces cholesterol levels significantly. I recommend fiber in supplement form if a person doesn't get enough through their diet.

Niacin, or vitamin B3, is a great cholesterol reducer, especially LDL, and does an even better job than some pharmaceuticals. It also reduces triglycerides, lipoprotein(a), and fibrinogen levels, while simultaneously raising HDL cholesterol levels. However, some people may experience transient flushing, nausea, or an increase in liver enzyme levels from niacin. Another similar supplement that avoids these side-effects is inositol hexaniacinate. The dose of either niacin or inositol hexaniacinate is 500 mg three times a day for the first two weeks, then 1000 mg three times a day thereafter. It may take two to six months to get your cholesterol where you want it (below 200). Consider using pantethine.

Gugulipid, an extract of the mukul myrrh tree, is one of my favorite herbal medicines used to lower cholesterol. It has been shown to reduce LDL cholesterol and triglycerides about 30 percent and raise HDL about 20 percent in 12 weeks. Garlic and onions also lower LDL and raise HDL, as well as lowering fibrinogen, one of the risk factors for increased clotting.

Increasing antioxidant status in the body is another strategy to combat the risk of heart disease. Antioxidants help to neutralize pro-oxidants, such as environmental chemicals, heavy metals, oxidized LDL, and other molecules involved in the inflammation process. NAC, alpha-lipoic acid, and the vitamins C, E, and CoQ10 are all excellent antioxidants and have been shown in many studies to help prevent atherosclerosis. CoQ10 is also necessary if you are taking a statin-class of drugs, as these deplete CoQ10 stores in the body. Flavonoids are a class of compounds that can be extremely strong antioxidants. These can be found in dark red or blue berries and fruits, such as raspberries, blueberries, blackberries, cherries, etc. Grape seed extract is one of my favorite antioxidant flavonoids.

I recommend fish oil to almost everybody because its benefits are so profound. In the cardiovascular health arena, it lowers LDL, triglycerides, lipoprotein(a), fibrinogen, and homocysteine (also use vitamins B6, B12, and folic acid if you have high homocysteine levels). Fish oil also raises HDL, improves blood pressure, and decreases inflammation.

Last, but not least, I recommend nattokinase, an extract from a traditional fermented soybean food popular in Japan, to help break down fibrinogen and dissolve blood clots. As previously mentioned, blood clots can be responsible for heart attacks and strokes, and research has proven that blood-thinning therapy has decreased morbidity and mortality of some cardiovascular conditions. Nattokinase has proven to be safe at extremely high doses, however, healthcare providers may need to lower their patients dose of Coumadin, a blood-thinning drug. Dose is 1 to 2 72-mg caps 2 times a day.

Heart disease is complex and can be the result of many different factors. However, by reducing inflammation, lowering cholesterol, having adequate antioxidant levels in your body, reducing clot formation, eating a healthy diet, and getting regular exercise, you can greatly reduce your chances of suffering from heart disease.

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