Transcript Heart Heatlh - Green Healing Wellness

Heart Health and
Naturopathic Medicine
©Dr. Kevin Passero 2005
Dr. Kevin Passero, N.D.
203 Ridgely Ave
443-433-5540
Review of Major Risk Factors
Elevated Cholesterol
High Blood Pressure
Smoking
Diabetes
Inactivity
The Blood Vessel
4 Layers
the endothelium
the Intima
the Media
the Adventitia
Cycle of Damage
Chronic endothelial injury
– Hyperlipidemia
– Hypertension
– Smoking
– Homocysteine
– Toxins
– Viruses
– Immune reactions
Cycle of Damage
Endothelial dysfunction
– Increased permeability
– Platelet adhesion
– Monocyte adhesion and emigration
– LDL emigration
Causes of Endothelial Injury
Hemodynamic disturbance
– High blood pressure
Homocysteine
Cigarette Smoke
Hyperlipidema
Cycle of Damage
Further Damage
– Smooth muscle migration
– Foam cell production
– Collagen proliferation
– Feeds the cycle
Cholesterol
HDL “the good one”
– Carries fat from the periphery back to the liver
for excretion through the bile
LDL “the bad one”
– Carries fat from the liver to the periphery for
deposition and storage
Other forms of Lipids
Apolipoprotein B (ApoB)
– These proteins transport VLDL (the precursor
to LDL) throughout the blood stream.
– ApoB contributes to peripheral uptake of LDL
by receptor recognition.
– Recent research has shown that levels of
APOB can be more important in determining
cardiovascular risk factors than just HDL and
LDL.
Apolipoprotein B
Levels of ApoB can be directly tested or
measured through Lipoprotein Lp(a)
levels.
Cholesterol
Precursor to many hormones in the body
80% produced by the body
20% from the diet
Cholesterol Lowering
Exercise
One of the most important factors in
changing the ratio of HDL to LDL levels.
Both cardiovascular and weight training
programs are important to achieve
adequate results
Diet
Avoid saturated and trans/hydrogenated
fats
– Increase oxidation and potentiate endothelial
damage
– Very rigid structures that do not act
appropriately when incorporated into cellular
structure
Foods that contain hydrogenated
oils
• Virtually all refined and processed foods•
Margarine• Cakes• Cookies• Candies•
Doughnuts• Bread• Canned soups•
Crackers• Processed cheese• Canned
foods• Cereals• Snack foods• Salad oils•
Grocery store oils
Diet
Avoid animal products high in fat
– Red meat
– Processed meats (hot dogs)
– High fat dairy products
Fats
The Omega 3 vs Omega 6
– Reduce arrythmias
– Reduce MI risk
– Slow growth of plaques
– Reduce liproprotein and triglyceride levels
– Enhance endothelial function
– Induce slight drop in BP
– Lower CV risk by reducing inflammation
Fiber
Enhances cholesterol excretion by
absorption
Enhanced absorption in the GI equals
greater excretion via the feces.
Sources of Fiber
Psyllium Husk
Fruits and Vegetables
Flax seed
Supplements
Guggul Gum
– Clinical trials have demonstrated a 10%-25%
reduction in cholesterol using 75 mg of
guggulipid per day.[i]
–
[i]Gavagan, T MD, MPH. Cardiovascular Disease. Primary Care;
Clinics in Office Practice- 2002 June;29 (2)
Supplements
Niacin
– Numerous trials have shown IHN to be virtually free of the side effects
associated with conventional niacin therapy, and extensive research has
proven it’s efficacy in treating hyperlipidemia.[i] Effective doses of IHN
for treatment of hypercholesterolemia range from 500 mg- 1g TID.
–
[i] Head, K. Inositol Hexaniacinate: A Safer Alternative to Niacin. Alt
Med Review- 1996 Sep;1 (3):176-84
Supplements
Fish Oil
– Shown to lower LDL levels and raise HDL
levels
– Have strong anti-inflammatory properties
– Can have mild effects on blood vessels
Supplements
Red yeast rice
– Works via the same mechanism as traditional
statin therapy.
Drugs
Main class is the statins
– Lipator, Lescol, Mevacor, Pravachol, Zocor
– These act by inhibiting the HMG-CoA
reductase enzyme, a rate limiting enzyme in
the production of cholesterol in the liver
– HMG-CoA reductase also vital enzyme in the
production of CoQ10 (ubiquitone)
Statins
Often very effective at lowering cholesterol
without dietary changes but easily deplete
CoQ10 levels
Results in muscle cramps, aches and
fatigue.
Very important to supplement with CoQ10
when taking statins
The Rest of the Story
Inflammation
Toxicity
Carbohydrates
Homocysteine
Inflammation
Chronic inflammation can contribute
significantly to heart disease and CAD
Measuring C-reactive protein can serve as
an important marker for identifying
cardiovascular risk factors.
Reduce Inflammation
Eating a diet limited in trans fats,
hydrogenated fats, sugar, dairy products,
red meat, coffee and alcohol will help
reduce systemic inflammation
Omega 3 fatty acids (EPA) is one of the
strongest anti-inflammatory substances in
our bodies.
Toxicity
Cholesterol can often serve as buffer for
the bodies level of toxicity. Production can
increase as a defense mechanism
Toxicity can also disturb negative feedback
pathways in the liver
Carbohydrates
Stimulate a quick rise in blood sugar which
often results in rapid and extensive insulin
response
Insulin is the bodies hormone that signals
the storage of fat
Homocysteine
Naturally occurring byproduct of the
bodies metabolism
Can significantly increase inflammation,
platelet aggregation, and plaque formation
Very easy to reduce levels by eating foods
rich in folate and by supplementing folate,
B6 and B12
Overview
Important Dietary Considerations
– High Fiber Foods
– Fruits, vegetables, flax seeds, pysillium powder
Overview
Avoid high inflammatory foods
– Trans fats, hydrogenated fats, sugar, red meat
(unless grass fed), coffee, dairy products,
refined carbohydrates and highly processed
foods
Overview
Eat foods rich in folic acid and vitamins
– Dark leafy greens, like collards, spinach, kale,
beet greens
Overview
Include plenty of high quality fats from wild
fish like salmon, game meats and grass
fed beef
Overview
If diet and exercise are not enough, add
appropriate supplements
Overview
Get the proper tests along with the regular
ones for HDL/LDL and triglycerides
– Homocysteine levels
– C-reactive protein
– LpA
ALWAYS WORK IN CONJUNCTION
WITH A QUALIFIED HEALTH CARE
PROVIDER WHO CAN SAFELY
MONITOR AND DIRECT YOUR CARE.