Title: Atherosclerotic Heart Disease:
1Atherosclerotic Heart Disease
- A Practical Approach
- for prevention and treatment
- Kevin Logan, M.D.
- 10/20/08
2Inflammation
- The common pathophysiologic cascade that causes
- Heart Attack Stroke Cancer and
- all Degenerative Diseases
- Atherosclerosis An Inflammatory disease (NEJM
Jan 99)
3 4Causes of Inflammation and the Effects of
Oxidative Stress
- Free Radicals are caused by Radiation, Cigarette
smoke, Heavy metals including IRON. - Oxidative Stress increases endothelial
permeability, oxidizes lipids and creates a
tendency to clot
5Immunologic Sources that contribute to
Inflammation
- Infections
- Bacterial Chlamydia, pneumonia,
H.pylori - Viral CMV, HSV, Hep A
- Antibodies to these infections were more accurate
predictors of Heart Disease than Hyperlipidemia,
Diabetes, Hypertension and Obesity. -
- Clinical Cardiology June 2000
6Metabolic Factors are the most common contributor
to Atherosclerosis and Inflammation in the US
- Diabetes affects 1 of every 16 people
- 40 of America have some degree of Insulin
Resistance and predisposition to Diabetes - Insulin is an inflammatory molecule and also
raises blood pressure - Insulin can promote Atherosclerosis before it
causes frank Diabetes
7What is Insulin Resistance?
- A Dysfunction in Metabolism whereby the body is
not responding to the normal actions of Insulin
8Insulin-counterregulatory overdrive in the
metabolic syndrome A vicious cycle
- INCREASED
- INSULIN
- Increased fuel storage Increased circulating
glucose Physiologic Effects - Increased lipogenesis Carbohydrate insulin
resistance Dyslipidemia - Increased basal lipolysis Visceral obesity
- High Blood pressure
- Increased resting heart rate
- Decreased heart rate variability
- INCREASED Glucose intolerance
- COUNTER- Endothelial dysfunction
- REGULATORY
- ACTIVITY
- Increased Glucocorticoids, Catecholamines,
Glucagon, Free fatty acids
9Insulin Resistance Leads to the Metabolic
Syndrome
- Abdominal Obesity
- Hypertension
- Decreases HDL
- Increases LDL, apo B
- Elevated Insulin
- Polycystic Ovarian Syndrome (Anovulation)
- Elevated insulin levels and impaired glucose
tolerance - Low Thyroid Function
10Does Stress Play a Role?
- Type A personality at higher risk for heart
attack - Patients with Depression are also at Higher Risk
- Most Heart Attacks occur in the morning when
stress hormones are highest
11- Stress
- Cortisol Adrenaline Insulin
-
-
- Glucose
12Chronic Stress Leads to
- Insulin Resistance
- Metabolic Syndrome
- Eventual Adrenal Fatigue, Difficulty with
Menopause, Sleep Disturbances, Low Testosterone - And Dyslipidemia
13Is Cholesterol the evil molecule that Pfizer and
Merck and manufacturers of cholesterol lowering
medications might lead us to believe?
- Cholesterol is critical for every cell membrane
in our body - Cholesterol is the precursor to all steroid
hormones including cortisol, testosterone,
estrogens, progesterone, etc. - Cholesterol is THE precursor to Coenzyme Q10, the
most important antioxidant in the mitochondria - Cholesterol is an antioxidant
- Cholesterol is the precursor to formation of bile
salts which are vital for assimilation of fats
and detoxification of fat soluble toxins
14So should we try to lower our cholesterol to the
levels currently recommended?
- 60 of all Heart Attacks occur in people with
normal cholesterol - Longevity studies show low cholesterol a risk
factor for increased mortality - ENHANCE Study recently showed Zetia when lowered
cholesterol to same levels as Lipitor showed No
changes in cardiac mortality
15What types of lipids should we pay attention
to?
16Homocysteine
- Toxic to blood vessel lining, increases clot
formation, decreases nitric oxide, increases Risk
for Alzheimers, contributor to osteoporosis - Easily treatable with B6, B12 and Folate
17Lipoprotein a (Lp a)
- With High Levels it is associated with inability
to break down clots - Treat with Vitamin C, Lysine, Niacin and CoQ10
- Decreases with increased intake of Saturated
Fatty Acids
18Lipid Peroxidation
- Measure at specialized Lab
- Metamatrix (800) 221-4640
- Marker for oxidized lipids which create Free
Radical Damage and activate the immune system - Lipid Peroxides are quenched by fat soluble
antioxidants Vit A, D, E, K and CoQ10
19- What other markers
- should your Doctor
- be paying attention to?
20Cardio CRP (C Reactive Protein)
- Increase clotting
- Identifies risk of an Acute event
- (ie Heart Attack)
- If elevated investigate for causes of
inflammation infection, toxic, metabolic, immune
21Fibrinogen
- Causes platelet aggregation and increase blood
viscosity and thus clot formation - Increase with age, smoking, obesity, Diabetes and
LDL-C - Decreased with Exercise, HDL and Alcohol
22Ask your Doctor for these tests
- Lipid Panel
- Homocysteine (12 Hour Fast)
- Cardio (HS) CRP
- Fibrinogen
- Lp (a)
- Ferritin
- Fasting Glucose/Insulin
- 2 Hour post prandial Glucose and Insulin
- Free Testosterone (Men)
23- Nutrient Dense Foods,
- as Defined by Dr. Price,
- are the key to prevention of
- Insulin Resistance, Inflammation and Infections
that lead to Heart Disease
24Fat Soluble Vitamins
- Vitamin A
- Key Antioxidant to prevent Lipid Peroxidation
- Protects mucous membranes against invading
infections - Vitamin D
- Increases insulin secretion
- Vitamin E
- Intracellular Antioxidant, Increases insulin
Sensitivity - Vitamin K
- Maintains Calcium in Bony tissue thus prevention
extra osseous calcification in Blood vessels - Coenzyme Q 10
- Key Mitochondrial Antioxidant
- Critical in all energy production in the body
- Decreased by Statin Drugs
25Important Fatty Acids found in Higher
concentrations in Grass Fed Animals/Wild Caught
Fish
- EPA/DHA the Omega 3s increase insulin
sensitivity at the cell membrane - CLA
- works at the nuclear level to stimulate genes
that improve fat metabolism and increase insulin
sensitivity - CLA also has anticancer activity
- Grass Fed Animals posses 10 times as much of CLA
as grain fed animals - Phosphatidyl Choline (Lecithin) Fat burning
- Carnitine aids in Fatty Acid transport into the
mitochondria and glucose transport
26Trace Minerals found in Organ Meats, Broths and
Fruits/Vegetables grown in Healthy live soil are
critical as well
- Chromium Increases Glucose tolerance Factor
- Vanadium Increases insulin sensitivity
- Zinc Critical for Healthy immune function and
to quench oxidized cholesterol - Manganese Critical mineral for production of
Insulin - Iodine Important for thyroid Hormone
production, Increased Metabolism and Decreased
Glucose/Triglycerides
27Other Factors
- B Vitamins cofactors in cellular energy
production - Biotin A B-vitamin that decreases insulin
resistance - Lipoic Acid, N-Acetyl Cysteine and Taurine help
improve pancreatic production of insulin and
maintain healthy cells via their Antioxidant
capability
28You Are In Control of your HealthSo Be Proactive
- Eat Nutrient Dense Foods
- Exercise
- Reduce Stress
- Have Fun