What is Arteriosclerosis?
Arteriosclerosis in simple terms, is the hardening of the arteries. Arteries are blood vessels that carry oxygen and nutrients from your heart to the rest of your body. Healthy arteries are flexible and elastic. Over time, too much pressure in your arteries can make the walls thick and stiff which can restrict blood flow to your organs and tissues. This process is called arteriosclerosis.
Diseases of the cardiovascular system cause approximately two thirds of all deaths in our western culture. Much evidence in the past decade has implicated lifestyle as the major contributing factor to the disease process.
What are the risk factors for Arteriosclerosis?
The following risk factors have been shown to potentiate the disease process:
- Cigarette smoking
- Excessive intake of refined salt, saturated fats and refined processed food (sweets, tea, coffee)
- Essential fatty acid deficiency
- Lack of exercise
- Emotional stress
- Drinking soft waters
- Vitamin and mineral deficiency (Vitamin C, E, B6 and Folate)
- Low fibre diets
Add to the list the biochemical risk factors below and you have a disease whose outcome can be manipulated significantly.
- High cholesterol and triglycerides
- Low HDL levels
- Low blood oxygen tension
- Decreased level of plasma copper
- Excessive zinc intake
- Heavy metal poisoning e.g. cadmium
- High blood sugars/diabetes/glycolated LDL/hyperinsulinism
- Elevated lipoprotein/plasminogen activator inhibitor-1/homocysteine
- Infections i.e. cytomegalovirus
- Pesticide residues in fatty tissues
- Increased blood viscosity and fibrinogen levels
- High blood pressure
How blood vessels change as we age...
Until puberty, the blood vessels of boys and girls look alike, but from puberty to the age of 45 years, women have strikingly less atherosclerosis than men because of the protective effects of endogenous oestrogen. It indirectly reduces resistance to blood flow and speeds up the breakdown of LDL's and increases production of HDL's - reducing the risk of atherosclerosis.
Although the insidious process of atherosclerosis begins in childhood, its consequences are rarely apparent until middle age, when it can cause angina and high blood pressure, and may precipitate an MI (heart attack) or CVA (stroke). When arteries are narrowed by atherosclerosis their walls thicken and intrude into the vessel lumen, making it easy to close the vessel completely. A roaming blood clot or arterial spasms can do it. Although all blood vessels are susceptible to this serious condition, the coronary and carotid arteries, arteries of the lower extremities, and the aortic and iliac vessels are most often affected.
According to the response to injury hypothesis, the initial event is damage to the tunica intima (the innermost layer of the blood vessel that has direct contact with the blood - contains the endothelial lining) caused by blood-borne chemicals, viruses, or physical factors such as a blow or hypertension. Injured endothelial cells release chemotactic agents and growth factors, and begin to transport and modify greater amounts of lipids picked up from the blood, particularly LDL's, the type that deliver cholesterol to tissue cells via the bloodstream.
When the seized LDL becomes oxidised, it not only damages neighbouring cells but also acts as a chemotactic agent to attract monocytes to the area. Monocytes cling to altered endothelial cells and then migrate beneath the tunica intima where they become macrophages (cells that engulf and dispose of dead cells - central actors in the immune system). The macrophages normally help protect the body by ingesting invading micro-organisms and toxic substances including oxidised proteins and lipids. But as they gorge themselves on the oxidised LDL's, they become transformed into lipid laden foam cells and lose their scavenging ability. Soon the macrophages are joined by smooth muscle cells migrating from the tunica media (the middle layer of the blood vessel - contains smooth muscle cells and elastin). These also take up lipids and become foam cells. The accumulating foam cells initiate the fatty streak stage. The smooth muscle cells also deposit collagen and elastin fibres, thickening the intima and producing fibrous lesions with a core of dead and dying foam cells called fibrous or atherosclerotic plaques. When these fatty mounds of muscle and fibrous tissue begin to protrude into the vessel lumen, the person has full-blown atherosclerosis.
Under normal conditions, endothelial cells release nitric oxide (NO) and prostacyclin - chemicals that promote vasodilation and inhibit platelet aggregation. Atherosclerosis, or even the very early presence of oxidised LDL's, can impair release of these vasodilators and anti-aggregating factors. Indeed, this may well be one cause of the increased thrombus formation in those with atherosclerosis.
Lipoprotein A, a special LDL seen only in some people, appears to be most involved in delivering cholesterol to sites where tissue repair is occurring - damaged endothelium for one. Although it is presumed to assist in wound healing, it "backfires" when it is present in excess. Lipoprotein A binds to subendothelial tissues more avidly than other LDL's. Because it is similar to a common growth factor, it is thought to promote mitosis of the cells in the vessel wall. Because it resembles plasminogen, it can "stand in" for it at sites where clots have formed. However, it lacks plasminogen's clot-dissolving ability, so by competing successfully with that clot buster, it may prevent disposal of unneeded or undesirable clots.
Narrowing of the arteries forces blood pressure that is already high to become even higher. As the arteries become less pliable and less permeable, cell starvation (ischemia) results due to insufficient circulation in the cells. Without the pressure-smoothing effect of the elastic arteries, the walls of the arteries throughout the body experience higher pressures. Battered by higher pressures, the arteries eventually weaken and may balloon out or even burst. Hypertension and atherosclerosis are often linked. Hypertension ravages blood vessels, causing small tears in the endothelium that accelerate the progress of atherosclerosis. As the blood vessels become increasingly blocked, blood flow to the tissues becomes inadequate, and vascular complications begin to appear in vessels of the brain, heart, kidneys and retinas of the eyes. The higher the blood pressure, the greater the risk for serious cardiovascular problems. As a rule, elevated diastolic pressures are more significant medically, because they always indicate progressive occlusion and/or hardening of the arterial tree.
Arteriosclerosis is the end stage of the disease...
As enlarging plaques hinder diffusion of nutrients from the blood to the deeper tissues of the artery wall, smooth muscle cells in the tunica media die, and the elastic fibres deteriorate. These elements are replaced by non-elastic scar tissue, and calcium salts are deposited in the lesions, now called complicated plaques.
Arteriosclerosis obliterans occurs when the lower limbs are affected. In the early stages the major arteries that carry blood to the legs and the feet become narrowed by fatty deposits. Early signs are aching muscles, fatigue, and cramp-like pains in the ankles and legs. Depending on which arteries are blocked, the pain may also be in the hips and thighs.
Leg pain brought on by walking that is promptly relieved by sitting is called intermittent claudication. Additional symptoms include numbness, weakness, and a heavy feeling in the legs. These symptoms occur when the arteries are clogged with cholesterol plaque. Pain is experienced if the amount of oxygenated blood is insufficient to meet the needs of the exercising leg muscles.
An angiogram can ascertain the degree of atherosclerosis...
With an angiogram test, a radiopaque dye is injected into an artery, an x-ray is then taken of the arteries of interest. The dye allows visualisation of arteries narrowed by arteriosclerosis or blocked by clots. Unfortunately, this dye is damaging to the endothelial lining of the blood vessels - this test should only be done if absolutely necessary. More recently, ultrasounds have been used to establish carotid artery occlusion - a much less invasive test.
Detoxification is an important step...
As environmental toxins and endogenous stimulators of inflammation (free radicals, allergies, infections) are able to induce damage to the arterial wall, thereby promoting atheroma build-up. Implementation of a detoxification program would also include the restoration of gut flora, correcting digestion, repairing gut permeability and improving liver detoxification of xenobiotics.
The Insulin Zone System is a good plan of eating to adopt as it has demonstrated the ability to balance blood sugar, insulin and lipid levels. Hyperglycaemia and insulin resistance can lead to free radical production, inflammation and protein glycation - all of which can potentially damage the intima of the arteries.
Reducing blood lipids, endothelial damage and thrombosis is paramount to prevent atherosclerotic induced complications. EPA and Garlic reduce platelet aggregation, lower cholesterol and triglycerides, lower blood pressure, whilst also reducing atherosclerosis progression and risk of heart attack. Vitamin E has demonstrated risk reducing and antioxidant effects, while Vitamins B6, B12 and Folic acid catabolise the atherogenic amino acid homocysteine. The powerful ability of Red Rice to reduce blood lipids may be combined with guggulipids and chromium to reduce atherogenic risk.
Reducing oxidation and inflammation is important to protect the LDL's. Silybum, Grape seed, Rosemary and Green tea contain some of the most effective antioxidant phyto-chemicals known. Mixed carotenoids and tocopherols, along with the phytonutrient complex, allows a much broader range of antioxidant activity to be achieved. Copper, Zinc and Manganese are necessary for the production of superoxide dismutase, and Selenium is necessary for Glutathione activation. Supplement with antioxidant nutrients such as d-alpha tocopheryl acid succinate (a form of Vitamin E), Vitamin C, Coenzyme Q10, Beta carotene, Quercetin, Chromium chelate or picolinate, Lipoic acid, Folic acid, Vitamin B12, B6, A, and Selenium.
There are many plants that provide herbal support for peripheral circulation...
Ginkgo has anti-platelet, antioxidant and anti-inflammatory properties for the maintenance of micro- and peripheral circulation
Rosemary can be used to stimulate the circulatory system but should be used with caution in those with high blood pressure.
Hawthorn and Lime blossom are both useful herbs for arterial disease.
Garlic supplementation significantly decreased both total cholesterol and LDL cholesterol - according to The American Journal of Clinical Nutrition Vol 65 pages 445-450.
Nutritional support for the cardiovascular system is also important...
Lysine is essential for Carnitine production, which boosts energy production. Promoting Carnitine production has been shown to help angina and beneficially modulate cholesterol levels. Lysine also reduces atherosclerosis, through its ability to inhibit the binding of lipoprotein A to vascular endothelium.
Taurine facilitates the metabolism of Calcium, Magnesium, Potassium and Selenium - lowering blood pressure through the suppression of Renin-angiotensin feedback.
Selenium activates Glutathione - protecting cellular structures during ischaemic hypoxia.
Vitamins B6, B12 and Folic acid protect against the accumulation of homocysteine, acknowledged as a major risk factor in the development of heart disease.
Magnesium diglycinate reduces vasospasm and promotes normal heart rhythm, whilst also diminishing triglyceride levels and regulating glucose/insulin control. Magnesium also inhibits lipid precipitation and calcification of blood vessels.
Magnesium, Chromium, Selenium and Carnitine are fundamental for vascular health.
Coenzyme Q10 and DMG (Dimethylglycine) improve tissue oxygenation, reducing ischaemia induced cell death. Germanium improves cellular oxygenation and lowers cholesterol. Vitamin B3 dilates the small arteries (arterioles), reducing the blood pressure within them. Acidophilus fibre has been shown to lower blood cholesterol. Lecithin is also indicated for hardening of the arteries (phosphatidylcholine is the strongest lipotropic factor present - reducing fat content of the blood).
Treatment with omega-3 polyunsaturated fatty acids significantly decreased the rate of death, non-fatal myocardial infarction, and stroke - according to The Lancet Vol 354 August 7th, 1999. According to the JAMA 2001 (285:304-312), the risk of cardiovascular disease is significantly reduced by eating deep sea oily fish. Eating fish 1-3 times per month resulted in a 7% reduction in risk. Eating fish once a week reduced the risk by 22%. 2-4 times a week reduces risk by 27% and more than 5 times per week reduces risk by 52%. Supplementation with the Essential Fatty Acids GLA/EPA may decrease blood cholesterol and triglyceride levels, decrease thrombic tendency of platelets, normalise biochemical abnormalities in obesity and mature onset diabetes, and improve the physiological function of the heart.
Nutrients such as Silicon, Pyridoxine, Lipoic acid, Quercetin, and Coumarin may help. Rutin inhibits rouleaux formation, stabilises red blood cell membranes and reduces endothelial cell sloughing in the bloodstream. Vitamin C decreases LDL's, increases HDL's, and indirectly converts cholesterol into bile acid, catabolises triglycerides, strengthens/influences arterial wall integrity, and increases fibrolytic activity - decreasing platelet adhesive index. Tocopherols, Beta carotene and Essential Fatty Acids play an important role in the regression of the atheromatous lesions. Lysine and Proline bind Lipoprotein A reducing its damaging effects. Bromelain, Lysine, Vitamin C and Proline supplementation reduce and reverse plaque formation.
Hormone risk factors...
Hormonal risk factors are a legitimate aspect to consider when looking at wholistic treatment of atherosclerosis. Both testosterone and oestrogen exert beneficial actions on many cardiovascular risk factors. Testosterone increases HDL cholesterol, reduces triglycerides, improves endothelial function (and thus NO production), whilst improving insulin and glucose metabolism. Oestrogen reduces oxidised LDL's, fibrinogen, and renin, and increases NO (and therefore vasodilation). Maca, Tribulus, Ashwaganda and Shatavari are all herbs that may be of assistance to treat hormonal imbalances. To determine the right treatment for you, please see your qualified Natural Health Practitioner.
Chelation therapy has been used effectively to treat arteriosclerosis for more than 40 years in the United States. This safe, nonsurgical remedy has also had beneficial results when used to treat cardiovascular disease, gangrene and other circulatory problems, myocardial infarction, metal toxicities, as well as many other ailments. Oral chelating agents include Alfalfa, Fibre, Rutin, Selenium, Calcium and Magnesium chelate with Potassium, Chromium, Kyolic Garlic, Pectin, Potassium, Coenzyme Q10, Copper chelate, Iron, Kelp and Zinc. Intravenous chelation may only be performed by a physician.
Homoeopathic remedies may be of assistance in conjunction with nutritional and herbal support. Baryta carb is indicated if you suffer from high blood pressure and palpitations. Phosphorous is for treating fainting spells, salt cravings, and nervousness. Glonoinum is for tight congested headache and pounding arteries. Vanadium is for fainting, dizziness, liver problems, feeling that the heart is being compressed.
Lavender essential oil helps to regulate the heart and may prevent a heart attack. Regular massage with Juniper and Lemon essential oils can help to break down fatty deposits in the body.
Nutritional and Herbal support for Arterioschlerosis include...
Fish oil - Salmon oil is one of the best sources of omega 3 fatty acids. The 0mega 3 fatty acids, mainly found in certain seafood's, have been clearly shown to offer some protection against heart disease. They help reduce abnormal blood clotting, high cholesterol and blood pressure - all factors which contribute to this condition.
Garlicin - Garlic helps support circulation by lowering serum cholesterol and helping maintain circulatory efficiency. Garlicin HC also includes Vitamin E which has been shown to help prevent the oxidation of cholesterol. Garlicin HC offers all the benefits of Garlic combined with the benefits of Hawthorn Berry extract, Cayenne, Rutin and Vitamin E.
Heartcare - Is a standardised (5:1) leaf and flower extract of Hawthorn. Produced by Schwabe and Co of Germany backed with 50 years of research, and subject to 80 scientific clinical studies. Hawthorn possesses cardiotonic, coronary vasodilator, and hypotensive properties. Hawthorn extracts are commonly used in Europe to treat heart problems, high blood pressure, and cardiovascular problems. Studies have confirmed Hawthorn's ability to improve the efficiency of the heart by improving blood flow to and from the heart. Hawthorn improves the contraction of heart muscle, slows progression of heart disease, enhances circulation to the extremities, prevents constriction of the blood vessels, and is a potent antioxidant.
Some important points on Atherosclerosis/Arteriosclerosis...
- Reduce total dietary fat intake to 20-30% of total calories. Increase intake of fish oils or polyunsaturated oils such as linseed, cod liver, sunflower or wheat germ oil (GLA/EFA supplement). Do not use hydrogenated vegetable oils especially margarines. Cook with pure olive oil.
- Avoid all tea, coffee, cocoa, excessive sugar, white flour or fructose intake. Do not consume table salt. Use Celtic sea salt instead, and limit consumption to no more than 3 grams per day. Reduce or cease smoking. Smokers should use the following supplements:- Beta carotene, d-alpha tocopheryl acid succinate (a form of Vitamin E) and Vitamin C.
- Drink at least 2 litres of fluid a day. If town water is soft, drink mineral water or supplement with a multi-mineral tablet. Chlorinated water should be filtered through charcoal filter prior to drinking. If you drink steam-distilled water, supplement with a multi-mineral tablet.
- Reduce alcohol intake, increase aerobic exercise to 40 mins 3 times per week, and reduce weight if need be. Eliminate deep fried foods. Apple cider vinegar, 1 teaspoon in a small amount of water, taken before meals will assist digestion and may dissolve calcium deposits.
- Eat more garlic, onions, eggplant, alfalfa, yoghurt and ginger. Ginger in particular has a good anti-platelet action. Eat more cherries, blueberries and raspberries - these fruits contain high amounts of anthocyanidins. Lecithin granules should be taken - 1-3 teaspoons per day. Increase the consumption of dietary fibre by eating raw fruits, vegetables, and wholegrain cereals. Increase the consumption of the following foods: carrots, grapes, garlic, salmon, broccoli, nuts, cantaloupe, lima beans, and soy beans. Each of these foods reduce the risk of cardiovascular disease.
- Get a cholesterol assessment, particularly LDL/HDL ratio, every 6 months and check your blood sugar regularly.
- Charcoal has been shown to reduce cholesterol in the blood, by binding with cholesterol (and toxins and waste) in the intestine, thereby reducing the risk of atherosclerosis. Activated charcoal can bind with and inactivate some therapeutic drugs and supplemental nutrients, and should be taken at least one hour before or after drugs or supplements are taken.