Cardiovascular Disease: Pathways and Prevention
Pathways to Cardiovascular Disease
There are numerous factors that play into the development of cardiovascular disease. Such factors include oxidative stress, inflammation, high blood pressure, dyslipidemia (also known as high cholesterol), blood sugar/ diabetes, obesity, toxicity and autoimmunity. There are many pathways that lead to heart disease, however, heart disease always originates in the same place: the endothelial tissue that line the blood vessels. This tissue performs various functions. Healthy endothelial tissue plays a role in blood pressure through nitric oxide signaling. The endothelium releases nitric oxide, which migrates to muscles surrounding blood vessels and causes them to reax, thereby lowering blood pressure when necessary. Endothelial tissue also acts as a barrier, controlling passage of substances from the blood into the artery. Immune response and regulation also takes place in the endothelial tissue. Endothelial function also affects blood consistency. Insults to endothelial tissue results in: thickened cell walls, thereby thickening the lining of the blood vessels (i.e arteries); arterial inflammation; autoimmune dysfunction of the artery; and increased deposits of ‘plaque’ into artery walls.
Damage to the endothelial tissue is the instigator that leads to atherosclerosis.
Damage of endothelial lining of blood vessels stimulates the body to repair injured sites. The body repairs these sites with fibrin, collagen, and then cholesterol. Collagen is one of the main proteins produced by the body. It is a building block for connective tissue. Collagen is both strong and flexible, and for this reason it is very functional as connective tissue all over the body. Collagen is made of amino acids and synthesized by other nutrients including zinc, copper and Vitamin C. Your body cannot create collagen without vitamin C. If the body cannot produce sufficient collagen to repair damage to arterial walls, it substitutes with cholesterol and fat deposits for repair. These deposits accumulate, creating ‘plaque’ build up and constricting the artery; this is a major cause of high blood pressure and heart disease. Fat deposits compromise the flexibility and function of the endothelial tissue. Plaque deposits can rupture and form a clot which migrates and can cause blockage. Conventional medicine posits that high cholesterol levels in the blood clog up the arteries, but if cholesterol were the only contributing factor, why is it that the larger arteries near the heart clog up with plaque, but not the smaller capillaries? This is because the large arteries near the heart receive more wear and tear due to the high pressure of recently pumped blood being pushed out from the heart. Therefore, it is these arteries which are most in need of repair and are more prone to plaque build up when collagen production cannot meet the demands of repair. Logic follows that a helpful strategy to prevent plaque build up is ensuring adequate intake of nutrients required to create collagen, such as vitamin C, zinc and amino acids. Another key component of the equation is limiting the damage to the endothelial tissue in the first place. Some factors that damage the endothelial tissue include: oxidative stress, inflammation, obesity, high blood sugar/ diabetes.
Oxidative Stress
Oxidative stress occurs when reactive oxygen molecules (free radicals) outnumber our antioxidant defenses in the body. Free radicals are reactive and cause damage to tissues, including the endothelial tissue. Oxidative stress is increased by exposing the body to toxicity, such as pesticides and other chemicals in conventional agriculture, processed foods, rancid/ damaged vegetable oils, smoking, radiation, alcohol and pollution. Obesity contributes to oxidative stress because adipose (fat) tissue is considered an endocrine organ that promotes excessive production of free radicals. Antioxidants essentially neutralize the frenetic activity of free radicals by donating an electron. Brightly coloured foods and herbs are high in antioxidants, such as blueberries, beets, carrots, dark leafy greens, culinary herbs etc. Our body also creates antioxidants such as CoQ10, glutathione, alpha lipoic acid and melatonin. Magnesium deficiency contributes to the development of oxidative stress as this mineral plays a role as an antioxidant, participates as a cofactor of several enzymes and maintains cell membrane stability (protecting the cells from damage). Oxidative stress damages cell membranes, including endothelial tissue cells (a root cause of heart disease). Damaged tissue engages the inflammatory response.
Inflammation
The inflammatory response is a beneficial biological adaptation as a short-term solution to injury. Blood vessels contract and blood becomes thicker to prevent you from bleeding to death. The immune system sends immune cells to fight potential viruses and bacteria that could infect the injury. Cells multiply to repair the damage. Continuous damage to endothelial tissue, however, causes continuous activation of the inflammatory response, signaling the body to contract blood vessels, thicken the blood, and send immune cells. As you can imagine, chronic activation of these responses can create a chronic state of higher blood pressure. Additionally, constantly engaging the immune response in this way can be dysregulating to the immune system. Ultimately, continuous damage to endothelial tissue leads to a buildup of scar tissue (plaque) which constricts blood flow. When combined with other inflammatory responses such as increased blood pressure and thickness, this increases risk of hypertension and heart attack. Plaque build-up in the arteries changes the internal terrain of the vasculature which creates turbulence in the blood flow, creating more damage, and perpetuating the cycle of inflammation. Numerous diet and lifestyle factors affect inflammation in the body. One of the biggest inflammation-inducing dietary factors is consuming damaged and unhealthy fats. This includes: oxidized cholesterol (cholesterol that has gone rancid due to heat exposure ex: fried/ overcooked egg yolkes); overconsumption of omega 6 fats (feedlot animals have a skewed composition of omega 6 to omega 3 fats of 18:1), excess sugar and refined grains, high-temperature cooked vegetable oils (canola, sunflower, olive), trans-fats, and hydrogenated fats. Other inflammation-inducing factors include gut microbiome dysbiosis, bacterial/ fungal/ yeast overgrowth, smoking, mold exposure, and a sedentary lifestyle.
Blood Sugar
High blood sugar makes the blood stickier and thicker. Thicker blood consistency increases blood pressure. Insulin blocks the body’s ability to make nitric oxide. Nitric oxide is one of the body’s ways to lower blood pressure. High blood sugar and insulin levels therefore raise blood pressure. High blood sugar increases inflammation in the blood vessels, which is a root cause of heart disease.
Blaming cholesterol is not the whole picture
Cholesterol is an essential component for carrying out numerous functions. Cholesterol is needed for the production of adrenal and reproductive hormones including estrogen, progesterone, testosterone, aldosterone, cortisol. Cholesterol is also needed for tissue repair; synthesising vitamin D; giving shape and integrity to cell membranes; fat digestion through the creation of bile salts; conducting nerve impulses; and nutrient and waste exchange across cell membranes. The liver manufactures 75% of the cholesterol in the body. Cholesterol does not differ in types; what differs is the density of the protein that cholesterol rides around on. Low-density lipoproteins (LDL) carry cholesterol from the liver out to the body. High-density lipoproteins (HDL) carry cholesterol back to the liver for recycling or disposal. The liver disposes unwanted/ excess cholesterol by sending it out through bile for excretion through feces. If digestion is sluggish/ constipated, this impairs your body's ability to rid itself of unwanted cholesterol and other unwanted waste products/ toxins. The amount of time stool is present in the small/ large intestine increases the opportunity for wastes to be reabsorbed by the blood stream. Total cholesterol numbers disguise the risk factors, as HDLs are helpful in transporting and removing excess cholesterol. LDLs can further be divided into buoyant LDLs and dense LDLs, which differ in size and therefore, function. The buoyant LDLs (LDL I and LDL II) are bigger, fluffier particles that do not cause cardiovascular disease. The dense LDLs (LDL III, IV, RLP and VDL) are the smallest in size and pose the greatest risk as they can pierce the endothelium and cause damage. As mentioned earlier, it is the damage to the endothelium that precedes the deposition of plaque, and not simply a matter of too much cholesterol in the bloodstream clogging up the arteries. Two people with the same total cholesterol numbers can have very different risk factors for cardiovascular disease. HDLs can also be further divided into more or less helpful depending on size and density. If HDL numbers are low, this increases risk of cardiovascular disease even if total cholesterol and LDL numbers are normal.
Some ways to increase productive HDLs are exercise, eliminating trans fats, restricting refined carbs, not smoking, healthy weight, increase intake of niacin, omega 3 fats and vitamin B5. Some ways to convert small LDL (unhelpful) to large LDL (helpful) include increasing intake of niacin, omega 3 fats, plant sterols (especially sesame and rice bran oils), soluble fibre, oleic acid (avocado, olive oil, macadamia nuts, almonds) and reducing refined carbs.
Conventional Treatments for Hypertension
Statins
The use of statin drugs to lower blood cholesterol is enormously widespread. Statin drugs lower blood cholesterol by disrupting the production of a liver enzyme that is used to make cholesterol and many other key substances needed by the body. Such key substances include CoQ10. CoQ10 is an enzyme that cells require in order to produce energy. Low CoQ10 levels can damage muscles and DNA. If you are taking statin drugs, you must supplement with 100mg of CoQ10 daily. The most easily absorbed form is ubiquinol, rather than ubiquinone. Statins activate the androgen-1 gene, which plays a key role in muscle atrophy. A side effect of statins can be muscle aches and pains due to permanent damage. Statins increase risk of type II diabetes by 50%. This occurs as a direct result of the inhibition of the liver’s production of cholesterol. The blood glucose that would otherwise be dedicated to this important task is instead deposited in the bloodstream, raising blood glucose levels. Raising blood glucose levels not only increases risk of diabetes, but also inflammation throughout the body and within the blood vessels themselves. This inflammation increases risk of damaged blood vessels, plaque formation and ultimately, cardiovascular disease, the very reason the drug is administered in the first place! Statins also possibly increase the risk of alzheimers.
Diuretics
Reduce fluid volume and therefore blood pressure, by promoting elimination of water and salt through increased urination. Eliminating water and salt from the blood results in thicker and stickier blood, as well increased concentration of blood sugar, cholesterol and triglycerides, and uric acid in the blood. Increased blood sugar can lead to insulin resistance, and increased uric acid in the blood can lead to gout. The diuretic effect also depletes the body of other minerals such as potassium, magnesium, folic acid etc. Depletion of minerals can lead to other problems including: kidney failure, muscle weakness, cramps, decreased libido, impotence, light-headedness, headache, blurred vision, nausea and diarrhea. Ultimately, the root cause of the problem is not addressed.
Beta Blockers
Blocks the binding of stress hormones to receptors, reducing rate and force of heart contractions and relaxes arteries. Increase risk of developing diabetes by 30%. They also raise cholesterol and triglycerides. They also deplete the body of nutrients, and inhibit the production of CoQ10. Again, the root cause is not addressed.
Salt Restriction
Most processed foods use ‘table salt’, which is sodium chloride. Sodium chloride as a single element is fairly toxic; it includes dextrose, anti-caking agents, aluminum silicate, is treated with chemicals and is bleached to achieve white colour. The anti-caking agents (desiccants) in refined salt prevent the salt from absorbing moisture, this makes it more convenient for storage, but undermines the ability for the salt to combine with body fluids. Unrefined salts like natural sea salt, himalayan rock salt or celtic grey salt contain over 80 minerals. When ingested, these salts allow liquids to flow freely across cell membranes, including blood vessel walls and the kidneys. The kidneys are able to remove these natural saline fluids easily, which is essential for maintaining the fluid balance of the body, and therefore, blood pressure. Refined salts, however, pose a great risk as they inhibit the free crossing of liquids and minerals, leading to fluid retention, increased blood volume and increased blood pressure as well as a myriad of other problems. Refined salt is dehydrating, in that it interferes with the cells’ access to fluids, whereas unrefined salt promotes the easful movement of fluids in the body. Salt is also essential for producing stomach acid and therefore digestion. Salt restriction can lead to mineral deficiencies, pressures the kidneys to store more salt, stress the sympathetic nervous system, increases insulin and causes adrenal overload as adrenals use a lot of salt.
Conclusion
Addressing the root cause of cardiovascular disease is of the utmost importance, as conventional medications, though sometimes necessary and life-saving, do not address the root cause. Ultimately, diet and lifestyle changes are the only way to address the root cause. Cardiovascular disease is a leading cause of death nowadays, though it never was with our ancestors. What got us here in the first place? A food system that is dominated by processed foods and foods grown with agrochemicals, in combination with sedentary lifestyle and exposure to pollution and other toxins. Exposing the body to inflammatory substances at every meal is chronic stress for the body. Here are some ways to support the body’s healing work:
Increase intake of omega 3 fats: flax, hemp and chia seeds; walnuts; fish; purslane; grass fed beef. Omega 3 fats decrease inflammation in the body; are needed to build nerve cells; lowers blood pressure and triglycerides; help normalize cholesterol levels; helps with depression, axiety and brain development/ repair; and more.
Increase fibre: fibre helps remove excess cholesterol through stool. The liver removes excess cholesterol from the blood and sends it out through bile; if there is not enough fibre to bind to, cholesterol is reabsorbed into the blood.
Do not cook with vegetable oils such as sesame, olive, sunflower etc. They are easily damaged by heat and cause inflammation in the body. Cook with coconut oil, butter, ghee or animal fats from pasture-raised animals.
Ensure all animal products (daily, poultry, eggs, beef etc.) consumed are from pasture-raised animals. Feedlot animals have a skewed fat composition of omega 6 to omega 3 fats of 18:1. In addition, the hormones, antibiotics and pesticide-ridden feed used on conventional animal products are toxic and inflammatory to the body.
Incorporate fresh and brightly coloured veggies and fruits as these contain anti-oxidants that nuetralize the damage-causing free radicals.
Use sea salt, himalayan salt or celtic grey salt and avoid table salt.
Specific nutrients that help normalize cholesterol: Vitamin B3, B5, E, C, flavonoids and polyphenols.
As always, this is for educational purposes only and is not medical advice. Please consult a medical practitioner for medical advice.