How To Prevent - Even Reverse, Coronary Heart Disease
According to scientist and doctor, Matthias Rath, who worked closely with nobel prize winning scientist Linus Pauling, the cause of coronary heart disease is not a mystery. It is quite simply caused by an insufficient supply of biological fuel i.e. chronic nutritional deficiency. These deficiencies within the vascular wall cells, which are the most mechanically stressed arteries, cause lesions and cracks to appear.
The body attempts to repair them by using cholesterol, lipoproteins, calcium, fibrin and cellular wastes. These are transported in the bloodstream and are used to cement the artery. Eventually these repair processes become insufficient, causing smooth muscle cells from the outermost cell layer of the artery to migrate to the interior and clump together to form a ‘tumour’. This stabilises the artery further.
If the problem of nutritional deficiencies is not addressed, it becomes a chronic problem with continual cracks and repair that goes on for decades. Over time the repair process overcompensates causing atherosclerotic deposits to build and narrow the artery. If the plaque gets disrupted, exposing its contents to the bloodstream, a chain of events leads to a clot, obstructing the flow of blood.
An Early Form Of Scurvy?
How do we know nutrition has anything to do with this? There are a number of pointers both in terms of scientific research and clinical practice.
Rath’s main focus is on vitamin C. In his book ‘Why Animal Don’t Get Heart Attacks...But People Do’ he points out animals don’t develop atherosclerotic lesions of any significance. The reason, he believes, is because, with a few exceptions, they produce their own vitamin C. This stabilises the artery wall. With insufficient vitamin C, a scurvy-like condition comes about. Humans have a body reservoir of vitamin C 10-100 times lower than animals.
To prove low vitamin C levels on its own can cause atherosclerosis, he conducted an experiment with guinea pigs. These don’t produce their own vitamin C. He divided them into 2 groups. Both were kept on the same diet but one group received the equivalent of the Recommended Daily Amount for humans of 60 milligrams, while the other group received the equivalent of 5000mg. After only 5 weeks the 60mg group showed clear signs of diseased arteries while the arteries of the high ascorbate group remained healthy.
There have of course been a number of studies showing benefits of individual nutrients like vitamin C, vitamin E, beta carotene, B vitamins, magnesium, coQ10, fish oils etc. which lower cardiovascular disease risk.
Heart Disease Is Reversible
Perhaps the two most interesting studies were carried out by Dean Ornish and Rath himself. In the Ornish study, “Intensive Lifestyle Changes for Reversal of Coronary Heart Disease“, Journal of the American Medical Association 16/12/98, patients were put into 2 groups. The first were put on a low fat, wholefood, vegetarian diet including exercise, stress management and psychosocial support. The second had ‘usual’ care.
After 5 years the latter group had an average of 3 cardiac events per patient and saw and increase in artery narrowing by 2.3% representing a 27.7% worsening of their condition. The first group had only 1¼ cardiac events per patient and saw a decrease in narrowing by 1.75%, representing a relative improvement of 7.9%. This study clearly shows heart disease is reversible.
The Rath study was published in the Journal of Applied Nutrition 1996. “Nutritional Supplement Program Halts Progression of Early Coronary Atherosclerosis.” (The paper was sent to JAMA but they turned it down). 55 patients were scanned using an Ultrafast CT which measures calcium deposits in the artery walls. This was carried out over a year so the growth of the disease could be measured. Then they were given a broad spectrum supplement containing around 30 nutrients to take for a year. Scans were taken at 6 and 12 months.
After the first 6 months, growth was slowed a little. But after 12 months there was a considerable drop in the growth of atherosclerotic plaques. Before nutritional intervention the average growth was 44% a year. One year after intervention, growth had essentially stopped. In some patients, deposits reversed and disappeared. Again demonstrating heart disease is reversible.
The nutritional supplement Rath designed for this study had 4 objectives. Stabilise the artery wall. Decrease muscle tumours. Neutralise stickiness of fat molecules. Provide antioxidant protection.
Stabilise artery walls: collagen, elastin and other connective tissues give stability to artery walls. Vitamin C and 2 amino acids are needed in optimal amounts for their production. Exactly how much will vary for each person but 600mg a day can be considered a minimum requirement for vitamin C. Collagen has a particular need for the essential amino acid lysine and the non-essential amino acid proline. About a quarter of this vital structural component consists of these 2 amino acids. A person weighing 70kg has around ½kg of lysine stored in their body. Rath recommends at least 100mg a day of each as a supplement.
Decrease muscle cell tumours: muscle cells in the arteries form faulty collagen molecules in nutritional deficiency states. Optimal supplies of nutrients especially vitamin C and vitamin E inhibits this process. (minimum vitamin E requirement 130IU).
Neutralise stickiness: the most dangerous fat transport molecules are not LDL cholesterol but a variant called lipoprotein (a). Sticky protein molecules attach to LDL’s and accumulate inside artery walls. One aim of nutritional therapy is to neutralise this stickiness and prevent the attachment. The 2 primary nutrients for achieving this are again lysine and proline. By forming a protective layer around lipoprotein (a), further deposition of fatty molecules in the arteries is prevented. Those already deposited can be released, reversing the disease process. Blood levels of lipoprotein (a) can be decreased with high doses of B3 (nicotinic acid) and vitamin C.
Antioxidant protection: free radicals damage lipoproteins in the bloodstream, as well as tissue in the artery walls. A large number of nutrients and food factors have antioxidant activity and are an important part of any supplement programme.
While virtually everyone has heard of cholesterol, few have heard of this important risk factor. This by-product of methionine metabolism needs folic acid, B12, B6, and choline to regenerate it back to methionine, rendering it non-toxic. People with high levels have a risk 3.4 times greater than those with low levels. Homocysteine levels in heart disease patients are on average 31% higher than in those without active heart disease.
It is clear from both the Rath and Ornish studies that obstructive plaque is reversible. However, around 70% of heart attacks are caused by arteries that are only obstructed by about a third or so. The question is why? A growing number of researchers now believe coronary artery disease is an inflammatory process which makes plaque susceptible to rupture, choking off the blood supply to the heart.
Most plaques grow slowly characterised by small fissures that are healed and repaired again and again. Mature plaques may fill ¾ of blood vessels and cause angina. But they are fairly stable and pose little risk of a major rupture. A clot forming here may be more to do with the blood itself than the vessel wall. Inflammation is not noticeably at work.
By contrast, unstable, vulnerable plaques are younger, soft, fatty, and covered with a thinner fibrous cap. The artery may only narrow by 30% causing no symptoms and may not be spotted on an angiogram. If these rupture they will cause a heart attack. The body tends to respond to vulnerable plaque like an infection. Inflammation is at work here.
Researchers believe macrophages - immune cells - which enter the artery to clear away deposits, get overwhelmed and die off, adding to the plaque. When they do, they release chemicals that are both toxic to the fibrous cap and increase the tendency for blood to clot.
Tests for inflammation and infection could give a much clearer indication of heart problems than cholesterol testing, where 80% of people with severe atherosclerosis have normal cholesterol levels and most people with high blood cholesterol do not die of heart disease.
Markers for Inflammation
There are several inflammatory markers. Fibrinogen can induce coronary thrombosis through platelet aggregation, excess coagulation and blood thickening. Those with high levels are more than twice as likely to die of a heart attack. It can be reduced by DHEA, vitamin C, vitamin K, vitamin A, beta carotene, fish oils and nettle leaf extract. Platelet aggregation inhibitors, which lowers the risk that fibrinogen will cause a clot, are green tea, ginkgo, garlic and vitamin E.
C-reactive protein increases the risk of fibrous cap rupture and abnormal clotting. Those with high levels have nearly a threefold risk. Some of the same nutrients that lower fibrinogen are likely to be effective especially fish oils, GLA, and vitamin K. MSM at extremely high doses may be effective.
Another important new treatment for inflammation is systemic enzyme therapy. These enzymes help control inflammatory processes by lowering elevated C-reactive proteins and mitigating high levels of fibrinogen. They provide the benefits of anti-inflammatory medication without risks and side effects associated with the long-term use of aspirin and non steroid anti-inflammatory drugs.
Systemic enzymes also boost the immune system and fight bacterial and viral infections. Infectious agents such as chlamydia, cytomegalovirus and herpes, have been implicated in heart disease.
Systemic Enzymes are available as a supplement called Wobenzyme. (For further information on Systemic Enzymes see my article "Therapeutic Properties of Systemic Oral Enzymes - effective treatment for sports injuries, arthritis, heart disease and cancer" in Positive Health Magazine Issue 71 December, 2001)
Dr. Garry Gordon, one of the fathers of chelation therapy, believes new research justifies concentrating on the health of the blood rather than the arteries, something he has been doing for decades in any case.
By manipulating the molecular environment of the bloodstream using a nutritional formula based on the life’s work of Dr. Lester Morrison, he has been able to improve blood flow in his heart disease patients. 95% of those previously recommended for surgery were able to avoid it altogether. The formula consists of 9 tablets containing over 60 ingredients. He calls it Beyond Chelation (not sold in UK).
“Those of my patients taking the comprehensive 9 pill packets of Beyond Chelation combined with 3 to 5 Wobenzym N [Protenzyme] twice daily are conveniently addressing all of the newly recognized molecular mechanisms of heart disease - from controlling homocysteine and elevated cholesterol or triglycerides, to lowering C-reactive protein, which is clearly becoming one of the MOST significant tests in cardiology!”
While we may still be unclear as to the underlying cause of coronary heart disease, effective treatment is available. As well as dietary manipulation, exercise, and stress management, nutritional supplementation can support the immune system, chelate, detoxify, combat inflammation, infection, oxidation, excess lipids and excess homocysteine. With such powerful tools, who needs drugs and surgery?
This article was first published in Enzyme Digest No. 58 Autumn 2002
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