Beat heart disease with the help of a new blood test and the right supplements
by Allan Magaziner, D.O. and Scott Greenberg M.D.
This article originally appeared at Letsliveonline.com

The wind is blowing through your hair as you run down the beach. That new exercise and diet program is starting to pay off. After years of stress and hard work, you are finally starting to enjoy life again. And then it happens. A fleeting moment of chest pain catches you by surprise. “Could it be my heart?” you wonder. According to your last physical, everything was fine—even your cholesterol levels were normal. Did this common blood test give you an unwarranted sense of security regarding your cardiovascular health?

It’s Not Just Cholesterol
While 1 million people in the United States die each year of cardiovascular complications, such as heart attacks and strokes, roughly half of the people experiencing their first heart attack had normal cholesterol values. The converse also holds true: People who have high cholesterol may never experience cardiovascular problems. According to research, one-third of people who have heart attacks do not have any risk factors for coronary disease, such as high blood pressure, obesity or smoking. How many friends or family members do you know who were supposedly healthy and then had a sudden heart attack?

Research Points to Protein
Recently, at Harvard University School of Medicine, Cambridge, Mass., cardiologist Paul Ridker, M.D., M.P.H., discovered that high levels of the blood protein cardio-CRP, also called highly sensitive CRP or hs-CRP, may be the most significant risk factor for developing a heart attack.

Ridker found that women with the highest levels of cardio-CRP were 4.4 times more likely to experience a “cardiovascular event” defined as suffering a fatal or nonfatal heart attack, stroke or requiring bypass surgery or angioplasty. Even more striking, he found that patients with the highest levels of cardio-CRP and unfavorable cholesterol profiles were almost nine times more likely to suffer such an event. Similar 1studies performed in men have arrived at the same conclusion.

Cardio-CRP can be measured by a simple, inexpensive blood test. Ask your doctor to perform a “cardio CRP blood test” or a “high sensitivity CRP blood test.” The test should be performed fasting.

Signs of Heart Disease
If you have chest pain, how do you know your heart is responsible? Typically, discomfort from the heart, known as angina pectoris, is described as a squeezing, grabbing pressure, or like the sensation of “an elephant sitting on the chest.” This sensation can radiate up the neck or jaw and down the left arm. It may be accompanied by nausea, shortness of breath, sweating, dizziness or a skipping heartbeat.Many people don’t experience any symptoms of heart disease, which puts them at risk for a “silent” heart attack.

Women are less likely to feel the classic symptoms of cardiovascular disease; instead, they frequently notice gas, heartburn, indigestion and other symptoms, which are often misdiagnosed as gastrointestinal problems.     Tocotrienols and Vitamin E Mention vitamin E, and you will probably think about alpha tocopherol. Vitamin E also contains important compounds known as tocotrienols, naturally found in rice bran oil. Similar to red yeast rice, tocotrienols also inhibit the cholesterol forming enzyme HMG-CoA reductase. Tocotrienols are powerful antioxidants and stimulate blood vessel dilation. In a study of 50 patients, those who supplemented with tocotrienols showed a reduction in carotid artery blockage.

Numerous studies have supported the use of vitamin E for heart health. In fact, according to some research, daily use of vitamin E may be more protective than aspirin at fending off heart disease. Natural vitamin E (d-alpha tocopherol) is superior to synthetic vitamin E because it is more easily absorbed and utilized by the body than the synthetic form. According to research, synthetic vitamin E (dl-alpha tocopherol) is only 67% as active as the natural form. Look for products that contain d-alpha tocopherol. Dosage: Take 25 to 65 mg twice daily of tocotrienols and 400 to 800 IU of natural vitamin E.

Turmeric This spice (Curcuma longa), which gives Indian foods their yellow color and boosts flavor in foods, may have a salutary effect on heart health. Sometimes referred to as “nature’s arthritis fighter,” turmeric inhibits the action of COX-2 (cyclo-oxygenase-2), similar to the actions of the new prescription drugs Celebrex and Vioxx. COX-2 blockade prevents inflammation in the blood vessel wall. Dosage: Increase consumption of foods with turmeric, or take 400 to 600 mg of curcumin (the supplement form and active ingredient of turmeric) with food. Hawthorn The hawthorn plant (Crataegus oxyacantha) contains pharmacologically active substances known as flavonoids, which have antioxidant and anti-inflammatory effects. Hawthorn can help dilate blood vessels, improve flow and reduce blood pressure in people diagnosed with hypertension. Extracts of this botanical agent also strengthen the heart muscle and are useful for the treatment of congestive heart failure. In general, the leaf has a higher concentration of the active constituents than the berry.  Dosage: Take 300 to 900 mg of a standardized extract containing both berry and leaf daily.

The Inflammation-Heart Connection
Although the exact reasons for having a high amount of cardio-CRP are not entirely clear, this new test is a sensitive indicator of blood vessel inflammation. You may know that inflammation in your joints can cause arthritis, muscle aches and chronic pain, but did you know that inflammation in your arteries can contribute to a heart attack or stroke? In fact, inflammation can injure the blood vessel wall.     Arteries afflicted with inflammation are more likely to accumulate cholesterol, white blood cells and fibrin (a clotting substance). These formations, known as “vulnerable plaque,” occur beneath the blood vessel wall. Like a balloon waiting to burst, this plaque can then suddenly rupture, travel through the bloodstream and completely block a major blood vessel in the heart or brain. This results in a shortage of nutrients and oxygen, causing a heart attack or stroke.

Recent studies have confirmed that “vulnerable plaque” may contribute to as many as two-thirds of all heart attacks, while only one-third may be due to atherosclerosis (the fatty buildup in arteries). Highly sensitive cardio-CRP may be the best indirect indicator of vulnerable plaque and artery inflammation available today.

Other Risk Factors
Although cardio-CRP is one of the most powerful indicators of vascular problems, other potential risk factors shouldn’t be overlooked. In particular, it’s important to monitor your blood pressure and sugar levels and review your family history of heart attack and stroke with your health-care practitioner. You should also get a fasting cholesterol test every year. There is more to a cholesterol test than meets the eye.  A comprehensive test includes levels of high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglycerides.

As you may know, all lipids are not created equal. LDL, triglycerides and other harmful cholesterol fractions act to deposit fatty plaque on the artery wall, leading to the chronic damage and hardening of atherosclerosis. Your level of LDL should be less than 130 mg/dL, and total cholesterol and triglycerides kept less than 200 mg/dL. HDL, on the other hand, helps protect you from harmful cholesterol and will remove fatty plaque from the artery. Ideally, your level of HDL should be greater than 35 mg/dL.

Heart-Healthy Supplements
Here are our favorite heart-protective supplements:

FISH OIL: Research has shown that consuming large amounts of fatty, cold-water fish, such as salmon, haddock, cod and sardines, is instrumental in fending off heart disease. One plausible mechanism is the strong anti-inflammatory effect of the omega-3 fatty acids DHA (doco-sahexaenoic acid) and EPA (eicosapentaenoic acid) that are found in these fish. Omega-3 fatty acids inhibit a naturally occurring substance known as prostaglandin E2 (PGE2), which contributes to blood vessel inflammation and may be implicated in the formation of vulnerable plaque.  Dosage: To reduce the harmful effects of PGE2, eat two to three servings of cold-water fish every week, and take 1,000 mg of omega-3 fish-oil capsules two to three times daily with meals.

RED YEAST RICE: Of the 9 million people in this country currently taking prescription medications to help lower cholesterol, many are now seeking safer, more natural alternatives. For centuries, the Chinese have found the fermented extract of red yeast rice beneficial for heart health. Red yeast rice contains mevinolin, which inhibits the cholesterol-forming enzyme HMG-CoA reductase. The commonly prescribed class of prescription drugs known as “statins” uses this same mechanism to lower cholesterol.

Statin inhibitors, such as red yeast rice, may have a dual beneficial effect on the heart. In addition to lowering total cholesterol, LDL and triglycerides, early research shows that statin inhibitors effectively reduce blood vessel wall inflammation and stabilize vulnerable plaque. Red yeast rice should be considered by anyone with elevated cholesterol or cardio-CRP levels.  Dosage: Take 600 to 1,200 mg twice daily.

The Estrogen Controversy
Scientists have traditionally thought that estrogen helps protect against cardiovascular disease. Women experience heart attacks and strokes approximately 10 years later than men, which is thought to be the result of declining levels of circulating estrogen. Estrogen helps to raise HDL, lower LDL and total cholesterol, but may cause an increase in triglycerides. This hormone may also help dilate arteries and serve as an antioxidant. Recent research has revealed that estrogen’s effect on the heart may not be as beneficial as initially thought. Women on hormone-replacement therapy (HRT) may actually be at an increased risk for coronary artery disease in the first year of usage. Also, while older studies looking at long-term use of hormones indicated a 40 to 50% reduction in the risk of dying from heart disease, a recent randomized trial on HRT failed to show any protection from heart disease. Emerging data also suggests that HRT may actually increase the inflammatory marker C-reactive protein. As a result, scientists are still actively investigating estrogen’s effect on the heart.

Heart disease remains the leading cause of death in the United States, killing one person every 33 minutes. With the emergence of powerful blood tests to detect vessel inflammation like cardio-CRP, we can better identify those at risk for this disease and help prevent it.

Chelation Therapy and Diet
Many people today are looking for alternative options to angioplasty, surgery and drugs to treat their heart condition. Chelation therapy is a promising treatment shown to reverse heart disease and atherosclerosis. Chelation involves the intravenous infusion of vitamins, magnesium and a chelating agent known as EDTA. This mixture serves to chelate, or bind, toxic heavy metals, calcium and free radicals in blood vessel walls, which are then excreted in the urine. As a result, blood vessels become more pliable and circulation improves, which leads to the reduction or elimination of chest pain and other symptoms of vascular disease. Patients who have completed a course of chelation therapy often notice an improvement in energy and well-being, and are often able to reduce or eliminate their need for medication.

In an analysis of more than 20,000 patients receiving chelation therapy, 87% had measurable improvement in parameters such as exercise tolerance, walking distance and cardiogram results. Chelation therapy may also be more beneficial than surgery for patients with blockages in their legs known as peripheral vascular disease. Joseph Holliday, M.D., a vascular surgeon, demonstrated that those who underwent chelation therapy needed less rest, had less pain, could walk farther and did not require amputation when compared to those who had bypass surgery. Studies such as these suggest that EDTA chelation should be strongly considered for patients with all forms of cardiovascular disease.     Fortunately, you can reduce your risk of heart attack and stroke with the help of a simple blood test, healthy diet, regular exercise and heart-healthy supplements.

In general, consume a diet rich in fresh, phytonutrient-dense fruits and vegetables, quality protein and whole grains. Avoid simple sugars, refined flour and all processed foods. Also, exercise for 30 minutes five days per week. Exercise also helps boost your energy and self-esteem, control stress and help with weight control. While it seems to go without saying, it is also crucial to avoid any exposure to cigarette smoke. These guidelines—along with the key nutrients mentioned in this article—can keep you on the road to good health and optimal cardiovascular wellness.

Selected References

Braunwald, E “Shattuck Lecture: Cardiovascular medicine at the turn of the millennium: triumphs, concerns, and opportunities” New England Journal of Medicine (1997) 337: 1360-1369

Ridker, PM, Hennekens, CH, Buring, JE et al “C-reactive protein and other markers of inflammation in the prediction of cardiovascular disease in women” New England Journal of Medicine (2000) 342: 836-843

Ridker, PM, Glynn, RJ and Hennekens, CH “C-reactive protein adds to the predictive value of total and HDL cholesterol in determining risk of first myocardial infarction” Circulation (1998) 97: 2007-2011

Goldstein, JA, Demetrious, D, Grimes, CL et al “Multiple complex coronary plaques in patients with acute myocardial infarction” New England Journal of Medicine (2000) 343: 915-922

Jacobs Institute of Women’s Health Expert Panel on Menopause Counseling. “Guidelines for counseling women on the management of menopause” Jacobs Institute of Women’s Health, Washington, D.C. (June 2000) Chappel, LT and Stahl, JP

“The correlation between EDTA chelation therapy and improvement in cardiovascular function: A meta-analysis” Journal for Advancement in Medicine (1993) 6 (3): 139-160