What it is and why it occurs

Heart disease is the number one killer in United States and is a huge subject for several reasons.  One of these reasons is that there are different schools of thought relating to the reasons why heart disease occurs and more importantly what the proper methods of dealing with it are.

For decades, the American Medical Association insisted that high cholesterol foods were the primary culprit in the development of heart disease. This has been proven to be not necessarily the case. The simple fact is 50% of all fatal heart attacks occur in people who’ve had no previous history of high cholesterol and whose cholesterol was normal at the time of death.

This is not to say that diet does not play a role in the overall health of an individual including cardiovascular health. It has been established that the better the diet and the higher the fruit, legume and vegetable content, the less risk for cardiovascular disease. Nevertheless even vegetarians die from heart attacks although at a much reduced rate.

Heart disease occurs when there is a blockage or narrowing in any of the major arteries feeding blood to the heart muscle itself. This results in weakening of the heart and death of heart tissue. When enough of the heart tissue has been damaged, a heart attack can take place creating even further damage due to lack of blood supply to the rest of the heart muscle.

Heart disease affects both men and women but until the age of 50, men have a much greater risk than women.  After the age of menopause though, a woman’s risk of developing heart disease triples. 1

1.       Nelson GJ. Dietary fat, trans fatty acids, and risk of coronary heart disease. Nutr Rev 1998;250–2.

Why does blockage occur?

This is the $64,000 question. Several theories are prevalent in the medical community and all of which carry weight scientifically.

High blood insulin has the capability of scarring or acting almost as an acid on the inside of blood vessels. This damage to the intima, the inner layer on the inside of all blood vessels, stimulates a repair mechanism whereby circulating blood cholesterol is laid down almost like a bandage on the damaged areas in the blood vessels. Over a period of time this rough area in the affected blood vessels collect more cholesterol effectively narrowing the passage through which blood circulates with an end result of atherosclerosis.

Considering that type II diabetes or syndrome X is increasing in prevalence by double digits every year, this theory very well could be a major reason why heart disease is the number one killer in North America.  In syndrome X, insulin resistance is a normal side effect which in turn forces the body to increase the amount of insulin found in the blood, resulting in high levels of insulin in the blood which in turn can cause damage to the interior layer of the blood vessels. 

High homocysteine levels have been reported to be associated with heart disease but not necessarily to cause heart disease directly. Homocysteine is a normal constituent found in the blood stream; under normal circumstances it is changed into other amino acids for use elsewhere in the body. In order for this change to occur specific B vitamins, folic acid, B 6 and B 12 and enzymes need to be present. High homocysteine levels can cause LDL cholesterol to oxidize therefore forcing this form of cholesterol to fall out of solution, creating the potential for a blockage in the bloodstream, atherosclerosis. In addition it makes the blood stickier than it should be thereby reducing circulation and increasing the potential for stroke and heart attack. Lack of these vital B vitamins in the diet is one possible reason for creation of higher homocysteine levels, however a poorly functioning thyroid, kidney disease or psoriasis and some medicines can also contribute to this issue.

Just as high homocysteine increases the rate of oxidation of cholesterol, a lack of antioxidants in the blood can also create this same problem. Overall high blood cholesterol levels are also associated with heart disease however the ratio between LDL and HDL cholesterol is vital in determining whether you have an increased risk for developing heart disease. Low levels of HDL and high levels of LDL cholesterol are commonly found in patients with heart disease.

High triglyceride levels are also dangerous. 3

The liver creates cholesterol and is used for the formation of various hormones including sex hormones such as testosterone.

1. Cunnane SC, Hamadeh MJ, Liede AC, et al. Nutritional attributes of traditional flaxseed in healthy young adults. Am J Clin Nutr 1994;61:62–8.

A sedentary lifestyle contributes dramatically to an increase in overall cholesterol levels. Regular exercise, at least two hours a week will reduce your chances of developing heart disease. Change in diet and stopping smoking are also vital. 2

1. Sebregts EH, Falger PR, Bar FW. Risk factor modification through nonpharmacological interventions in patients with coronary heart disease. J Psychosom Res 2000;48:425–41 [review].