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
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
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
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.
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.
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.