Atherosclerosis information:What is atherosclerosis?

The build up of plaque inside of blood vessels resulting in the reduction of the diameter of the blood vessel with consequent reduction of blood flow and formation of blood clots if the plaque is ruptured or dislodged.  Plaque is made up of:

• fatty substances
• cholesterol
• waste products from cells
• calcium
• iron
• fibrin

Atherosclerosis is a progressive condition and in general the main cause of heart disease. In lay terms it is described as "hardening of the arteries".

What is the difference between arteriosclerosis and atherosclerosis?

Arteriosclerosis is a general term describing the thickening and hardening of arteries. Atherosclerosis is a hardening of an artery specifically due to plaque build up. Atherosclerosis is the most common form of arteriosclerosis.Often atherosclerosis is also just called arteriosclerosis.

How do you get atherosclerosis?

The main cause is thought to be the outcome of the body’s response to damage to the artery wall from cholesterol, high blood pressure and cigarette smoking.

Other causes include:

• High triglycerides. Levels above 400mg/dL have been implicated in the development of atherosclerosis
• Lack of exercise
• There  is increased risk in diabetics. Risk can be lowered by keeping the diabetes under control
• Obesity
• Heredity
• Gender. Men are more likely to have heart attacks before the age of 60 than women
• Age. Men at 45 or older and women at 55 or older are at a higher risk of suffering from atherosclerosis

How does atherosclerosis develop?

The development of atherosclerosis probably begins by damage to the endothelium(the single layer of cells that lines blood vessels).  This damage causes cholesterol and fat to penetrate into the vessel walls and deposit there.  This action also encourages cells in the damaged area to grow. Calcium salts are also deposited there. 

Factors that can cause the single layer of cells that line blood vessels to get damaged are:

• High content of blood fat and especially saturated fat
• Inflammation of the blood vessels
• High blood pressure
• High content of “bad cholesterol” in the blood serum and low content of “good cholesterol”
• Diabetes
• Smoking
• High content of the amino acid homocystein in the blood serum

 

Many of these factors are ultimately caused by a bad diet and lack of daily exercise.

 

What are the symptoms?

The symptoms vary depending on where the atherosclerosis has occurred:

• Chest pain, heart attack and sudden death if it occurs in the heart arteries
• Sudden dizziness, weakness, loss of speech if it occurs in the carotid arteries of the brain
• Cramping and fatigue in the calves of the legs when walking if it occurs in the femoral arteries of the legs
• High blood pressure which is resistant to treatment if it occurs in the arteries of the kidneys

Diagnosis

Physicians can listen to the activity of the arteries with a stethoscope or they can carry out an electrocardiogram and stress test to study the heart’s activity under normal circumstances and during exercise.

They can carry out: echocardiography, which is ultrasound to examine the heart valves and chambers; ultra-sonography, to assess arteries of the neck and thighs, radionuclide angiography and thallium scanning to study blood flow through the heart and arteries. In the latter technique radioactive material is injected into the blood stream.

How to treat atherosclerosis

Most common treatments emphasize lifestyle and dietary changes, regular exercise and a diet low in saturated fat, cholesterol and sugar, and high in fibre, fresh fruits and vegetables.

Medical intervention include balloon angioplasty and coronary artery bypass surgery.

Drug treatment is mainly to treat the contributors to the disease like high cholesterol, blood clots and high blood pressure.

Dr Lundell graduated from Arizona University Medical School and then completed his studies in cardiovascular surgery at Yale University. Over a 25 year period he practised as a cardiovascular and thoracic surgeon and during that time he has performed over 5000 heart surgeries. He has also pioneered heart surgery without the use of a bypass machine (Chapter 1).

In “The great cholesterol lie” I found the most value in the fact that Dr. Lundell doesn’t just tell you that the cause of heart disease is chronic inflammation he first explains very clearly in layman’s terms what inflammation is(chapter 3) and then explains it carefully within the context of heart disease(chapter 4). If you have struggled with scientific concepts before you don’t have to worry here. Dr Lundell paints a very clear picture of what is happening in your body and you are left in no doubt what to do next with the information you just learned.

This ebook is really a self-help manual on how to prevent and cure heart disease. Most self-help manuals just get on with the practical self-help from chapter one. Dr Lundell doesn’t have this privilege as he points out that in the case of cholesterol “concepts have become consensus”, meaning that ideas about what causes heart disease have become fact without the evidence to support them. In view of this he dedicates two chapters first explaining why the original premise that cholesterol was the cause of heart disease is wrong (chapter 2) and a second chapter (chapter 5) explaining what his 25 years of experience have taught him to be the actual cause of heart disease. Chapters 6,7,8 carry a lot of practical advice on how to combat heart disease more along the lines of a traditional self help manual.

I must admit it took me a little time to put everything I had learned about cholesterol to one side and to start thinking about heart disease in terms of inflammation. When reading the ebook I soon realised I had been conditioned like many others to accept the current view about cholesterol put out by the mass media and market and had never really sought an alternative explanation to the cause of heart disease. If you get nothing else from the reading of this ebook the take home message is that there are always two sides to every story. Yes! Even a science story. When the story is as important as this just paying attention to the other side could mean the difference between life and death.

The only thing I felt this ebook could use was a more detailed explanation of the blood marker/s of inflammation. Please let me explain. In chapter 5 Dr.Lundell explains that the body produces C-Reactive Protein (CRP) in response to inflammation and that the latter is the marker of inflammation in the blood. He goes on to emphasize that in the near future a CRP test will be used as a primary indicator of heart disease and other related diseases.

The fact that CRP can be an indicator of other related diseases as well as heart disease got me thinking about how specific CRP was as a marker of inflammation in heart disease. I fired up Google and soon discovered that CRP is in fact a non-specific marker of inflammation. That is, if you have a simple cold, ankle sprain or tooth abscess your CRP is probably high but it may not necessarily mean that your heart and brain are in danger. I felt that the author could have emphasized that CRP was a non-specific marker because for me after finding this out the question that still remains unanswered by the ebook is under what circumstances does lowering your CRP actually matter when it comes to heart disease? I can understand why Dr. Lundell has probably had to compromise on this point when faced with the limitations of having to write for a lay audience. On the positive side Dr Lundell does give a resource website (p.135) about the latest research on CRP but hopefully he will produce a follow-on ebook that will address in more detail for a lay audience what the results of a CRP test actually mean.

In this particular case with Dr Lundell’s ebook I feel 100% comfortable that based on the promises made in the sales letter, this ebook doesn’t leave any questions unanswered or promises unfilled. Furthermore, at the end of the ebook (pp.134-136) he provides an extensive list of resources for further reading and even a web address where you can ask him any questions you may have about what you have read.

Get The Great Cholesterol Lie Now!

Dr Dwight Lundell (The author of the ebook) reveals how you can heal your heart simply and naturally without cholesterol medications.

DISCLAIMER: You must consult your doctor before going on this, or any other program.

What is the definition of heart disease?

Heart disease is a general term for a range of medical conditions that affect the heart.

What are the different kinds of heart disease?

Coronary heart disease

Is a condition of the artery that supplies blood to the heart caused by the accumulation of plaque in the artery.

Cardiomyopathy

Deterioration of cardiac muscle.

Cardiovascular disease

A number of specific diseases that affect the heart and/or the blood vessels associated with the heart especially the veins and arteries leading to and from the heart.

Ischaemic disease

A disease of the heart itself that results in reduced blood supply to the body organs.

Heart failure

Can result from any structural or functional problems that prevents the heart from filling up with blood or pumping the blood around the body.

Hypertensive heart disease

Caused by high blood pressure.

Valvular heart disease

Caused by one or more defective heart valves.

Inflammatory heart disease

Caused by inflammation of the heart muscle and/or the tissue surrounding it.

How many people die of heart disease?

There are 208,000 deaths per year in the United Kingdom(UK) and 8,64480 deaths per year in the United States(US).(US and UK Statistics for 2005).

Barley Betafiber:Another Source of Beta-Glucan Soluble Fiber

The FDA is amending the health claim regulation entitled “Soluble fiber from certain foods and risk of coronary heart disease” to include barley betafiber as another source of beta-glucan soluble fiber.

The FDA has concluded that in addition to whole oat and whole grain barley products,  barley betafiber is also an appropriate source of beta-glucan fiber.

Barley betafiber is a processed product from whole grain barley flour.

Beta-glucans is a soluble fiber that has the potential to reduce LDL cholesterol.

Sources:Fed Register.2008 Feb25;73(37):9938-47.

Oatmeal that is produced from whole oat does significantly reduce total cholesterol and “bad cholesterol” and does not affect “good cholesterol” and triglyceride levels.

In 1997 the US FDA approved the first food specific health claim for foods containing whole oat and reduced risk of coronary heart disease. The decision was based after a very detailed review of the scientific evidence up to that time.

Ten years on from that decision, Andon and Anderson in the American Journal of Lifestyle Medicine(2008) have confirmed the original conclusion by the FDA that whole oat does significantly reduce total and “bad cholesterol” and has no adverse effect on “good cholesterol” or “triglycerides” by an exhaustive analysis of the contemporary scientific literature.

What Makes An Oat Whole?

A grain of oat is whole if it contains all three parts of the kernel. That is the bran , the endosperm and the germ. 

The Bran

The bran is the course outer layer of the kernel and it is often removed during processing.It is the part of the kernel that contains the most fibre.

The soluble fibre found in oat grains is beta-glucan and it is responsible for lowering cholesterol.

The exact mechanism of how beta-glucan lowers cholesterol is not known but in general it seems to bind some of the cholesterol in the digestive tractand remove it from the body naturally.

The insoluble fibre found in oat grains is what is commonly referred to as roughage. The latter helps the movement of food through the intestines but does not help with the removal of cholesterol.

Oats are unusual as compared to other grains like for example rice,maize and wheat in that they contain a significant amount of both soluble and insoluble fibre.

The bran also contains antioxidants, phytonutrients, iron, zinc,copper, magnesium and B vitamins.

The Endosperm

The endosperm is the largest part of the kernel and contains moat of the carbohydrates and proteins. It is often the only part of the kernel that remains after processing removes the bran and the germ.

The Germ

The germ is also often removed during processing and it contains B vitamins, minerals, oils, antioxidants and phytonutrients.  

                          Schematic of Oat Kernel Cross-section

How Much Whole Oat Do I Have To Eat To Reduce My Cholesterol?

Many scientific studies have provided evidence that 3 or more servings of whole oats per day are associated with reductions in risk of cardiovascular disease.

What Reduction In “bad Cholesterol” Should I Expect ?

You can expect an approximate reduction of 5 % of  “bad cholesterol” when you consume 3 or more servings of whole oats per day . Every 1% reduction in “bad cholesterol” is associated with a decreased risk for coronary heart disease of 1 to 3%. This means that a 5% reduction in “bad cholesterol” could reduce your risk of coronary heart disease in the range of about 5% to 15%. Also, how well eating oatmeal works for you depends on how high your cholesterol is to start with. At the lower cholesterol levels(under 200mg/dL), what really matters is an overall low-fat, low-cholesterol diet.

Oats into the future

Andon and Anderson in the American Journal of Lifestyle Medicine confirmed that the contemporary scientific literature agreed with the original findings of the FDA that whole oat consumption does significantly reduce total cholesterol and “bad cholesterol” and does not affect “good cholesterol” and triglyceride levels. Furthermore, they have identified emerging new science that claims whole oats consumption :

• Reduce “bad cholesterol” during weight loss
• Supply compounds that reduce plaque formation
• Reduces the risk of developing type 2 diabetes
• Reduces the risk of weight gain and obesity

This test was developed by Atherotech, a cardiodiagnostic company. It provides physicians with the direct measurement of LDL, HDL and all relevant subclasses and emerging risk factors.

This test can identify a far greater number of lipid abnormalities than the standard test.

Risks of both heart disease and diabetes can be reduced with the right preventive measures,which is why more accurate diagnosis is critical for the patient.

Overall the VAP® test identifies twice as many people at risk of cardiovascular disease than the currently available routine test.

Sources:Atherotech

Sources: Kowa Pharmaceuticals

What are triglycerides?

They are the most common type of fat in your body and a major source of energy.

When you eat excess calories the body stores them as fat regardless of what kind of food you eat. That is, carbohydrate, protein or fat.

Having high triglycerides on its own may not be an indicator of heart disease, but when high triglycerides are part of a group of symptoms called metabolic syndrome the converse may be true.

Metabolic Syndrome includes having:

• Low “good” cholesterol
• High blood pressure
• High blood sugar
• Too much fat around the waist
• High triglycerides

Having the syndrome also increases the risk of diabetes and stroke.

How are triglycerides measured?

Triglycerides are measured as part of the blood test that measures cholesterol.

Triglycerides Levels (mg/100ml)

What causes high triglycerides?

Conditions include:

• Excessive alcohol consumption
• Kidney disease
• Excessive eating
• Poorly controlled diabetes
• An underactive thyroid

Medications that might raise triglycerides include:

• Tamoxifen
• Birth control pills
• Eostrogen
• Steroids
• Diuretics
• Beta-blockers

It is worth noting that suffering from high triglycerides may also be an inherited condition.

What are the symptoms of high triglycerides?

Usually, people with high triglycerides show no symptoms of the condition although in some rare cases they may suffer inflammation of the pancreas which can lead to severe abdominal pain, nausea, loss of appetite, vomiting and fever.

When the high triglycerides are as a result of an inherited condition fatty deposits may appear under the skin.

How can you lower your high triglycerides?

If you are overweight the first plan should be to make a lifestyle change by eating fewer calories, limiting the consumption of fats, sugars and alcohol and exercising more. If this doesn’t work then there are medications like niacin and fibrates that may lower your triglycerides.

What are Statins?

Statins are a category of drugs that reduce the level of cholesterol in your blood.

How do they work?

They inhibit the enzyme in the liver that is responsible for making cholesterol

For what conditions are they used?

Statins are used for the reduction of cholesterol and for the prevention and treatment of atherosclerosis.

Atherosclerosis is a condition in which cholesterol containing plaques are formed in arteries.  These plaques block arteries and reduce blood flow to the heart resulting in heart disease.

It is important to emphasize that high levels of cholesterol are not always necessary for plaques to form.

Statins are able to slow the formation of new plaques by lowering the production of cholesterol, they can reduce the size of plaques that already exist and may also reduce the risk to the patients by stabilising plaques so that they don’t break away and block arteries.

Are there differences amongst Statins?

They differ in their ability to reduce cholesterol, in how strongly they interact with other medication that increases the blood concentration of the Statin, and in the frequency with which they cause severe muscle damage. Cerivastatin was withdrawn worldwide because it caused severe muscle damage one hundred times more often than other statins.

What are their side effects?

The most common side effects are:

• muscle pain
• weakness
• rash
• diarrhoea
• constipation
• vomiting
• nausea
• headache

The rare but most serious side effects are liver failure and Rhabdomyolysis (very serious damage to muscles).  The latter can progress to kidney failure and death.

Examples of Statins approved for use in the United States of America.

All plans to lower your cholesterol start with reforming your diet.

The latter statement seems obvious to all of us now but wasn’t so in the 1950′s when the New York City department of health was amongst the first to discover that cutting back on cholesterol fats and calories was a way to prevent heart attack.

In the 1980′s the National Institute of Health formulated a low cholesterol diet plan for healthy people with cholesterol levels in the 200 – 239(mg/100ml) range and for people with cholesterol levels greater than 240mg/100ml. In early 2001 these diets were subject to review and more emphasis was put on the requirements of people with specific medical conditions and risk factors and was coined the Therapeutic Lifestyle Changes Diet(TLC) . I have summarised the two low cholesterol diet guides in tables 1 and 2 below.

The total daily calories are indicated as 1,600, 2000 and  3,000 depending on the individual needs of the person.

Low Cholesterol Diet

For healthy people with total cholesterol levels in the 200 -239 (mg/100ml) range

                        Table 1.

Therapeutic Lifestyle Changes Diet(TLC)

For people with specific medical conditions and risk factors such as:

• High levels of LDLs and low levels of HDLs
• A previous history of cardiovascular disease or heart attack
• Type 1 diabetes
• Type 2 diabetes
• High blood pressure
• Excess weight

                     Table 2.