Heart Disease
At one time, nothing could be done about heart disease. As someone
clutched their heart and gasped, we could do nothing but look on in
pain. As we learned more about the heart, we developed drugs and learned
how to cut open the body and partially repair the heart. Today, the
death rate for all heart-related diseases is 45 percent of what it was
in 1963. Many claim that drugs and surgery are the reasons for this.
But, if this is so, why is "progress" slowing down? According to the
Harvard Health Letter (January 1998), there appears to be a slight
rise in the incidences of stroke and kidney disease, and a leveling of
the death rate from heart disease among U.S. adults. In other words,
perhaps the well-established paradigm--drugs and surgery-is not the best
answer. Perhaps it is time to review our past and see what we can learn.
Perhaps it is time to change the paradigm.
History
The history of the heart and its diseases, like all medical history, is
a history of ideas: an initial idea, reinforcement of the idea,
challenges to the idea, rebukes to the challenges, and, perhaps, a new
idea.
One of the first ideas was put forth by Erasi-stratus of
Alexandria, who dissected animals and humans (probably Egyptian mummies)
2,300 years ago. He discovered the veins, arteries, and nerves, and
postulated that the heart is nothing more than their junction and that
the arteries contain not blood, but air, spirit, or soul (called
pneuma). This entered the body through the nose, throat, and lungs-in
other words, through breathing. He believed the veins do contain blood,
and his rational for why blood comes from open arteries is that the
blood from veins rushes in as the pneuma floats out.
Parts of
this idea were reconfirmed, but many more were challenged and disproved.
The great physician of the Roman Empire, Galen, confirmed that veins
contain blood, but did away with the idea of pneuma. He saw that the
heart is more than a "circulation junction" and that blood flows
throughout the body, but believed it ebbs and flows with the heartbeat.
Galen was such a great influence upon the medical world that his ideas
became "medicine". They were codified, made rigid, and acknowledged as
the "limit" to medical information.
The Renaissance saw the first
revolt against the dogmatic rules that Galen’s ideas had become. The
Swiss physician Paracelsus rejected much of Galen’s thought and spoke
forcefully against the tendency to accept Galen’s ideas as truth:
"Who does not know that doctors make terrible mistakes, greatly to the
harm of their patients? Who does not know that this is because they
cling too anxiously to the teachings of Hippocrates, Galen …"
For
daring to challenge the status quo, he was condemned to a nomadic
existence, travelling from town to town.
Andreas Vesalius, born in
1514, continued the challenge to the medical status quo. He compiled the
complete anatomy of the human body and, in doing so, discovered and
exposed more than 200 errors by Galen. In undermining much of this
traditional medical authority, he became controversial at best, and a
pariah at worst. He was attacked by many of the pro-Galen forces and
retired from academic pursuits embittered and disillusioned.
William Harvey, known as the grandfather of cardiology, drove a stake
into the heart of the old school of cardiology. He understood that the
heart and blood are elements within a closed system, described correctly
how blood flows through the heart, and saw that the heart is the engine
that pumps blood. He saw that the heart, lungs, and blood vessels are
interdependent and that what we call heart disease may actually
originate somewhere other than the heart, especially in the arterial
systems.
A common thread that runs throughout this brief history
(and, as we shall see, continues today) is that ideas become a rigid
status quo (often through no fault of the ideas’ originators) and that
when they are challenged, the challenger is repudiated, discredited, and
often driven out. It is reported that even Harvey, after publishing his
ideas, suffered an immediate decline in number of patients because of
his "strange theories."
"Strange theories" …
The
notion that new ideas are "strange theories" continues in modern times.
In the ’60s and ’70s, Nathan Pritkin was persecuted as a quack and
incompetent rebel when he concluded that most heart disease is
reversible through a combination of diet, exercise, and stress
management. The medical profession was relentless in its criticism,
accusing him of giving patients false hope and defrauding them by
selling them his program of lifestyle changes to prevent heart disease.
The 1960s saw another alternative opinion shot down by the medical
community. Kilmer S. McCully, M.D., then a professor of pathology at
Harvard University Medical School, went against the "killer cholesterol"
tide when his studies pointed to an amino acid, homocysteine, as a major
cause of heart disease.
McCully had come across research that
noted that some mentally retarded children were dying of heart disease
before reaching puberty, and the reason was due to high blood levels of
homocysteine. In 1969, after studying this issue, McCully proposed that
many Americans suffer from cardiovascular disease due to high
homocysteine levels, not cholesterol. More radically, he proposed that
all one has to do is take B-complex vitamins to solve this
problem.
For the next few years, McCully struggled against the
cholesterol tide and, in 1978, had to leave Harvard. In his book, The
Homocysteine Revolution, he notes that he was told he had "failed to
prove his theory."
… Become mainstream
Pritkin and
McCully, like Vesalius and Harvey before them, were proven correct. In
the late '80s, Surgeon General C. Everett Koop took the bold step of
reversing decades of medical thought when he declared that 75 percent of
the deaths in America are caused by lifestyle decisions on diet,
smoking, and consumption of alcohol. Today, the National Heart
Association publishes a list of dietary recommendations that echo
Pritkin’s earlier conclusions.
McCully was also vindicated.
Articles on homo-cysteine began reappearing and, in 1995, studies in the
Journal of the American Medical Association reported that
homocysteine is a major risk factor in CVD. Today, homocysteine is
considered an independent risk factor-it is not influenced by other
factors, such as smoking, cholesterol, and physical activity. It is also
acknowledged that ade-quate amounts of vitamins B12 and B6 and folic
acid can reduce high homocysteine levels and lower the risk of CVD.
Today, there is more and more emphasis on lifestyle as the key to
cardiovascular health. Virtually all heart organizations acknowledge
that diet and exercise are keys in preventing heart disease and
recommend a diet that is low in total fat, saturated fat, and
cholesterol and rich in fruits, vegetables, and fiber.
The
paradigm changes
The paradigm underlying these new ideas is
that we are responsible for our health. If bad lifestyle decisions are
responsible for 75 percent of the deaths in America; if most heart
disease is reversible through a combination of diet, exercise, and
stress management; if nutrition combats high homocysteine and
cholesterol levels, it means that we have it in our power to control our
health destiny. We do not have to wait until the crisis and then rush to
the doctor or hospital; we can take steps to lower our risk of, and
prevent, CVD.
Cardiovascular diseases (CVD)--which encompass
events such as heart attack, stroke, angina pectoris, atherosclerosis
and arteriosclerosis, and high blood pressure--are the No. 1 killer in
North America. In the United States, somebody dies from heart disease
every 33 seconds, and from a heart attack every minute. In Canada, in
1992, CVD accounted for 38 percent off all deaths.
McCully’s theory
One drawback to the "cholesterol as king" theory of cardiovascular
disease (CVD) is that many people with no risk factors suffer from heart
problems.
Indeed, an article in the June 26, 1996,
issue of the Journal of the American Medical Association notes that the
traditional CVD risk factors (age, genetics, gender, smoking, blood
pressure, cholesterol, sedentary lifestyle, diabetes, weight, stress)
only explain about 50 percent of all CVD. The amino acid homocysteine
may be the reason.
Homocysteine is formed when the
body breaks down protein, especially the protein found in meat. Meat
protein contains the essential amino acid methionine, and when
methionine is digested, it produces homocysteine. According to McCully’s
theory, if homocysteine levels increase, the result is the buildup of
plaque, which, of course, may lead to atherosclerosis, heart attacks,
strokes, and death.
Homocysteine builds up if we
eat too much meat or do not get sufficient amounts of vitamins B6 and
B12 and folic acid. These three vitamins are integral in the process of
recycling and excreting homocysteine. If we do not have sufficient
amounts of these vitamins, homocysteine levels rise.
Reducing
the risk
Practicing AIM's Healthy Cell Concept is the first stepracticing AIM's
Healthy Cell Concept is the first step. This concept states that five
elements--cell food, cell exercise, cell environment, cell protection,
and a healthy mental attitude--are all it takes to regain and maintain
your health. You will find that living the Healthy Cell Concept
encompasses the following ways to reduce your risk.
Paying attention to all risk factors
may help in combating the "unchangeable" risk factors of age, sex, and
heredity. For example, one of the reasons men are more at risk for CVD
than women may be because, on average and historically, they have smoked
more and dealt more with job-related stress. The trend is now changing.
Incidences of CVD in women are rising, and more women than men are now
dying from CVD: In 1995, about 455,000 males and 505,000 females died
from CVD. This may be because women are smoking more and are being
subjected to more stress after entering the job market. Paying
attention to all risk factors
may help in combating the "unchangeable" risk factors of age, sex, and
heredity. For example, one of the reasons men are more at risk for CVD
than women may be because, on average and historically, they have smoked
more and dealt more with job-related stress. The trend is now changing.
Incidences of CVD in women are rising, and more women than men are now
dying from CVD: In 1995, about 455,000 males and 505,000 females died
from CVD. This may be because women are smoking more and are being
subjected to more stress after entering the job market. Paying attention
to all risk factors
may help in combating the "unchangeable" risk factors of age, sex, and
heredity. For example, one of the reasons men are more at risk for CVD
than women may be because, on average and historically, they have smoked
more and dealt more with job-related stress. The trend is now changing.
Incidences of CVD in women are rising, and more women than men are now
dying from CVD: In 1995, about 455,000 males and 505,000 females died
from CVD. This may be because women are smoking more and are being
subjected to more stress after entering the job market.
Stopping
smoking limits your risk of cancer, emphysema, heart attack, and
stroke (not to mention you won’t smell like an ashtray).
Lowering your weight can raise your "good"
cholesterol level and lower your "bad" cholesterol level. It also helps
prevent diabetes and strengthens the heart.
Exercising has the same benefits as losing weight and, hey, helps
you lose weight!
Changing your diet
is one of the biggest things you can do. Avoid foods high in
cholesterol, saturated fat, trans-fatty acids, and all fat-doing so will
reduce cholesterol levels, reduce risk of cancers, and help you lose
weight. Eat more fruits, vegetables, and fiber. This again helps
maintain healthy cholesterol levels, and substances found in fruits and
vegetables known as phytochemicals work to prevent cancers. Fiber lowers
cholesterol and is linked to lower incidences of some cancers and heart
disease. It can also help you lose weight. Decreasing your sodium intake
and increasing your potassium intake can help you maintain a healthy
blood pressure.
Using supplements (and foods) high in antioxidants may help prevent
CVD. Folic acid and B vitamins combat a high homocysteine level. Garlic
and ginkgo both aid circulation in general, and garlic has been shown to
reduce cholesterol levels and blood pressure. Coenzyme Q10 helps in the
manufacturing of energy, improves quality of life for those who have
suffered heart problems, and may help lower high blood pressure. Fish
oil reduces triglyceride (a type of fat) levels and may help reduce the
incidence of coronary heart disease. Tocotrienols reduce cholesterol
levels and may help prevent breast cancer. Vitamin E may reduce risk for
CVD. Using supplements (and foods) high in antioxidants may help
prevent CVD. Folic acid and B vitamins combat a high homocysteine level.
Garlic and ginkgo both aid circulation in general, and garlic has been
shown to reduce cholesterol levels and blood pressure. Coenzyme Q10
helps in the manufacturing of energy, improves quality of life for those
who have suffered heart problems, and may help lower high blood
pressure. Fish oil reduces triglyceride (a type of fat) levels and may
help reduce the incidence of coronary heart disease. Tocotrienols reduce
cholesterol levels and may help prevent breast cancer. Vitamin E may
reduce risk for CVD. Using supplements (and foods) high in
antioxidants may help prevent CVD. Folic acid and B vitamins combat a
high homocysteine level. Garlic and ginkgo both aid circulation in
general, and garlic has been shown to reduce cholesterol levels and
blood pressure. Coenzyme Q10 helps in the manufacturing of energy,
improves quality of life for those who have suffered heart problems, and
may help lower high blood pressure. Fish oil reduces triglyceride (a
type of fat) levels and may help reduce the incidence of coronary heart
disease. Tocotrienols reduce cholesterol levels and may help prevent
breast cancer. Vitamin E may reduce risk for CVD.
Practice stress reduction exercises. Doing so can result in lower
blood pressure, less incidence of CVD, and a stronger immune system.
