Natural Strategies for the Prevention of Cardiovascular Disease (CVD)

Doctor’s Advice Ask the Expert…
Dr. Decker Weiss, N.D.

Dr. Decker Weiss is a leading expert in the integration of traditional cardiac medicine and naturopathic medicine. He received specialized training under the supervision of world famous cardiac surgeon, Dr. Edward Diethrich. He is the first naturopathic physician in the U.S. to complete conventional residencies at the Columbia Hospital System and the prestigious Arizona Heart Institute. He is also the first naturopathic physician on staff at a conventional hospital, the Arizona Heart Hospital. Dr. Weiss possesses illuminating insights and expertise that have enabled him to pioneer the application of effective natural alternatives to bypass or angioplasty. He has helped over 10,000 patients with his definitive holistic approach to cardiovascular disease management.

Did you know that one person dies of cardiovascular disease (CVD) every 33 seconds? Currently, one of every four Americans suffer some form of CVD, with almost 6 million hospitalizations each year, and more than one million deaths. In opposition to common belief, CVD is the leading cause of death in women, as well as men, and of people in their prime of life (35-64 years). Controlling potential risk factors seems to be the key to reducing the risk and halting the progression of CVD. Researchers are finding that nutritional therapies and other preventive interventions must begin at an early age since harmful conditions leading to cardiovascular diseases can start in childhood.

Q: How do I know if I ‘m at risk for CVD?
A: Some of the well-known and controllable risk factors of CVD include smoking, poor diet, physical inactivity, obesity, and stress. Elevated blood pressure, poor circulation/blood flow, elevated blood cholesterol, and diabetes represent factors that are less easily controlled, but are certainly within the realm of factors that can be modulated by various nutrients and herbs, a healthy lifestyle, and proper eating habits. If any of these risk factors apply to you, now is the time to address them. 2,3

Q: Is CVD preventable?
A: Cultural studies and clinical research show clear evidence that there are multiple lifestyle, diet, and powerful nutritional measures that you can take to decrease your risk of developing CVD. The fact is, you can do plenty to get your cardiovascular system in shape, even if you already have heart disease. What researchers are realizing is that the sooner these measures are taken, the better. 1

Q: How can I make myself and my lifestyle healthier?
A: Achieve and maintain ideal body weight, get regular aerobic exercise, do not smoke, eliminate consumption of coffee, reduce stress and anxiety, consume less saturated and hydrogenated fats by reducing animal products and refined or processed foods in your diet, maintain normal blood sugar levels, and increase your consumption of soy foods and fiber-rich plant foods. In addition, consume adequate amounts of vital and targeted vitamins, minerals, herbs, and other nutrients that have been researched for their positive effects on the cardiovascular system. 3-12

Q: What role does stress play in CVD?
A: Stress can have serious negative implications for the progression of heart disease, especially chronic stress. Its impact on blood pressure, levels of harmful substances in the bloodstream, and its influence on the secretion of stress.

Hawthorn (Crataegus oxyacantha) has a long history of traditional use throughout Europe. Its main active ingredients exert a positive effect on the heart and circulation, making it useful for persons with weakened heart function, such as early stage congestive heart failure. Hawthorn works by improving blood flow through the coronary arteries, increasing the efficiency of the heart ‘s pumping activity, and making vessels less susceptible to damage by strengthening their structure. Additionally, it lowers cholesterol and blood pressure and has antioxidant properties. Hawthorn use can result in a stronger, healthier heart and better blood flow throughout the body. When choosing herbal products you should be aware that there are wide variances in product strength and quality. Verification of herb species, parts, and manufacturing procedures are necessary to ensure excellent quality, and the active constituents confirmed by a third party laboratory. Furthermore, formulas should be targeted for specific uses. The best formulas will use time-honored methods of herb preparation such as decoction combined with standardized extracts to create effective herbal formulas.

Q: I know it’s important to keep my cholesterol down. Are there nutrients that can help me do that?
A:
Yes. However, in addition to lowering your total cholesterol, it is equally important to have a good ratio of LDL:HDL (bad:good) cholesterol. Many nutrients and herbs have been found to have a significant, positive effect on these parameters. Inositol hexanicotinate (a time-released form of niacin), the essential fatty acids EPA and DHA, and herbs like guggul resin, arjuna bark, Inula racemosa, and garlic all have clinical evidence of their ability to lower total and LDL cholesterol, while raising HDL -the “good cholesterol.” In addition, inositol hexanicotinate and CoQ10 are important nutrients for the reduction of lipoprotein(a), a cholesterol related risk factor for CVD.

Q: What is homocysteine and how does it relate to CVD? Are there nutrients that may be able to help?
A: Homocysteine is an amino acid that is an indicator of cardiovascular health. It is now suspected to play a role in the development of atherosclerosis by damaging the arteries, thereby reducing the integrity of the blood vessel walls, and by suppressing anti-clotting activity in the blood. People with premature vascular disorders have been shown to have elevated levels of circulating homocysteine. Low blood levels of folic acid, vitamins B6 and B12, choline, and trimethylglycine (TMG) can lead to the accumulation of homocysteine in the blood. Providing generous amounts of these key nutrients may help significantly reduce homocysteine levels and the risk of developing CVD. A factor that has been implicated in some cases of excessive blood levels of homocysteine is a deficiency of enzymes and coenzymes necessary for the conversion of dietary folate to the more active form used at the cellular level. By ingesting a form of folate that has already been converted, such as 5-formyl tetrahydrofolate, complicated enzyme pathways can be bypassed. This can result in higher levels of bioactive folate for improved reduction of homocysteine. The risk of CVD is omnipresent in our society and, because of its insidious nature, preventive measures need to be taken before or at the onset of clinical manifestation. Traditional clinical care is necessary and important, but is often lacking in preventive measures. By taking a close look at your lifestyle, habits, diet, and nutritional supplement intake, you and your health care practitioner can identify your risk of CVD and begin taking the measures necessary to help you avoid becoming a statistic.

References 1. Centers for Disease Control and Prevention. Cardiovascular Disease (July 14, 1999) (online). Retrieved via Microsoft Internet Explorer. http://www.cdc.gov/nccdphp/cardiov.htm. 2. Havranek EP. Primary prevention of CHD: nine ways to reduce risk. Am Fam Phys 1999;59(6):1455-63. 3. Koch HP, Lawson LD, eds. Garlic: The Science and Therapeutic Application of Allium sativum L. and Related Species. 2 nd ed. Baltimore: Williams & Wilkins; 1996. 4. Werbach MR, Murray MT. Botanical Influences on Illness: A Sourcebook of Clinical Research. Tarzana, CA: Third Line Pr; 1994. 5. Allan R, Scheidt S. Group psychotherapy for patients with coronary heart disease. Int J Group Psychother 1998;48(2):187-214. 6. Stephans NG, Parsons A, Schofield PM, et al. Randomised controlled trial of vitamin E in patients with coronary disease: Cambridge Heart Antioxidant Study. Lancet 1996;347(9004):781-6. 7. Mohr D, Bowry VW, Stocker R. Dietary supplementation with coenzyme Q10 results in increased levels of ubiquinol-10 within circulating lipoproteins and increased resistance of human low-density lipoprotein to the initiation of lipid peroxidation. Biochemica et Biophysica Acta 1992;1126:247-54. 8. Altura BM, Altura BT. Magnesium ions and contraction of vascular smooth muscles: relationship to some vascular diseases. Federation Proc 1981;40:2672-9. 9. Margolin G et al. Blood pressure lowering in elderly subjects: a double-blind crossover study of omega-3 and omega-6 fatty acids. Am J Clin Nutr 1991;53:562-72. 10. Silagy CA, Neil HA. A meta-analysis of the effect of garlic on blood pressure. J Hypertens 1994;12(4):463-8. 11. Hodis HN, Mack WJ, LaBree L, et al. Serial coronary angiographic evidence that antioxidant vitamin intake reduces progression of coronary artery atherosclerosis. JAMA 1995;273(23):1849-54. 12. Anthony MS, Clarkson TB, Williams JK. Effect of soy isoflavones on atheosclerosis: potential mechanisms. Am J Clin Nutr 1998;68 (6Suppl):1390S-1393S. 13. Watson SL, Shively CA, Kaplan JR, et al. Effects of chronic social separation on cardiovascular disease risk factors in female cynomolgus monkeys. Atherosclerosis 1998;137(2):259-66. 14. Skantze HB, Kaplan J, Pettersson K, et al. Psychosocial stress causes endothelial injury in cynomolgus monkeys via beta1-adrenoceptor activation. Atherosclerosis 1998;136(1):153-61. 15. Stone PH, Krantz DS, McMahon RP, et al. Relationship among mental stress-induced ischemia and ischemia during daily life and during exercise: the psychophysiologic investigations of myocardial ischemia (PIMI) study. J Am Coll Cardiol 1999;33(6):1476-84. 16. Baldewicz T, Goodkin K, Feaster DJ, et al. Plama pyridoxine deficiency is related to increased psychological distress in recently bereaved homosexual men. Psychosom Med 1998;60(3):297-308. 17. Friedman M, Breall WS, Goodwin ML, et al. Effect of type A behavioral counseling on frequency of episodes of silent myocardial ischemia in coronary patients. Am Heart J 1996;132(5):933-7. 18. Bown D. Encyclopedia of Herbs & Their Uses. New York: Dorling Kindersley; 1995. 19. Chan AC. Vitamin E and atherosclerosis. J Nutr 1998; 128:1593-6. 20. Devaraj S, Jialal I. The effects of alpha-tocopherol on critical cells in atherogenesis. Curr Opin Lipidol 1998;9:11-5. 21. Wolf G. gamma-Tocopherol: an efficient protector of lipids against nitric oxide-initiated peroxidative damage. Nutr Rev 1997;55(10):376-8. 22. Papas AM. Other Antioxidants. In: Antioxidant Status, Diet, Nutrition, and Health. New York: CRC Pr; 1999. 23. Bagchi D. A review of the clinical benefits of coenzyme Q10. J Adv Med 1997;10(2):139-47. 24. Kishi H, et al. Clinical application of coenzyme Q10 and the quality control of its preparations in Japan. In: Biochemical and Clinical Aspects of Coenzyme Q. Elsevier/North-Holland Biomedical Pr; 1981. 25. Mahan LK, Escott-Stump S. Krause’s Food, Nutrition, & Diet Therapy. 9th ed. Philadelphia: W.B. Saunders; 1996. 26. Altura BM, Altura BT. Magnesium ions and contraction of vascular smooth muscles: relationship to some vascular diseases. Federation Proc 1981;40:2672-9. 27. Ashmead HD. Comparative intestinal absorption and subsequent metabolism of metal amino acid chelates and inorganic metal salts. Biol Trace Elem Res 1991:306-19. 28. Margolin G, et al. Blood pressure lowering in elderly subjects: a double-blind crossover study of omega-3 and omega-6 fatty acids. Am J Clin Nutr 1991;53:562-72. 29. Busse W. Standardized Crataegus extract clinical monograph. Quar Rev Natl Med 1996(Fall):189-7. 30. Tyler VE. Herbs of Choice: The Therapeutic Use of Phytochemicals. New York: Pharmaceutical Products Pr; 1994. 31. Janssens D, Michiels C, Guillaume G, et al. Increase in circulating endothelial cells in patients with primary chronic venous insufficiency: protective effects of Ginkor Fort in a randomized double-blind, placebo-controlled clinical trial. J Cardio Pharmacol 1999;33(1):7-11. 32. Schulz V, Hansel R, Tyler V. Rational Phytotherapy: A Physicians’ Guide to Herbal Medicine. New York: Springer-Verlag; 1998. 33. Ammon HPT, Safayhi H, Mack T, et al. Mechanism of antiinflammatory actions of curcumine and boswellic acid. J Ethnopharmacol 1993;38:113-9. 34. Aptiz-Castro R, Badimon JJ, Badimon L. Effect of ajoene, the major antiplatelet compound from garlic, on platelet thrombus formation. Thromb Res 1992;68(2):145-55. 35. Khalfoun B, Thibault F, Watier H, et al. Docosahexaenoic and eicosapentaenoic acids inhibit in vitro human endothelial cell production of interleukin-6. Adv Exp Med Biol 1997;400B:589-97. 36. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid. A new hypolipedemic agent. J Assoc Physicians India 1989;37(5):323-8. 37. Ram A, Lauria P, Gupta R, et al. Hypocholesterolaemic effects of Terminalia arjuna tree bark. J Ethnopharmacol 1997;55:165-9. 38. Levy E, Thibault L, Turgeon J,et al. Beneficial effects of fish-oil supplements on lipids, lipoproteins, and lipoprotein lipase in patients with glycogen storage disease type I. Am J Clin Nutr 1993;57:922-9. 39. Head KA. Inositol Hexaniacinate: A safer alternative to niacin. Alt Med Rev 1996;1(3):176-84. 40. Ma J, Hennekens CH, Ridker PM, et al. A prospective study of fibrinogen and risk of myocardial infarction in the Physicians’ Health Study. J Am Coll Cardiol 1999;33:1347-52. 41. Singh RB, Niaz MA. Serum concentration of lipoprotein(a) decreases on treatment with hydrosoluble coenzyme Q10 in patients with coronary artery disease: discovery of a new role. Int J Cardiol 1999;68:23-9. 42. Ubbink JB, Vermaak WJH, van der Merwe A, et al. Vitamin requirements for the treatment of hyperhomocysteinemia in humans. J Nutr 1994;124:1927-33. 43. Dudman NPB, Wilcken DEL, Wang J, et al. Disordered methionine/homocysteine metabolism in premature vascular disease. Its occurrence, cofactor therapy, and enzymology. Arterioscler Thromb 1993;13(9)1253-60. 44. Shils ME, Olson JA, Shike M, eds. Modern Nutrition in Health and Disease. 8 th ed. Philadelphia: Lea & Febiger; 1994.

Causes of Death, United States * Total cardiovascular diseases Ü All cancers Unintentional injuries Chronic obstructive pulmonary disease Pneumonia and influenza Diabetes mellitus AIDS/HIV Suicide Homicide Other 0 50 100 150 Rate per 100,000 population 200 250 300 * All data are age-adjusted, 1970 total U.S. population. Ü Total cardiovascular disease death rate includes the rate of death due to ischemic heart disease (135.2 per 100,000) and the rate of death due to stroke (42.5 per 100,000). Source: National Center for Health Statistics and National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 1995. “The realization has grown worldwide that clinical care – while remaining necessary and important – is not enough,,and it is critical that we prevent cardiovascular diseases by preventing,from childhood on,development of the risk factors leading to them.” Rose Stamler, MA, Northwestern University Medical School Third International Conference on Preventive Cardiology (Preventive Medicine 1994;23:529) MET292 8/99 Copyright ©1999 Advanced Nutrition Publications, Inc.