Cardiovascular disease (CVD)

Alpine Physicians Health Center

Successful preventive treatment of CVD requires that:
· Plaque buildup in arteries is slowed, halted or reversed
· Blood pressure is controlled
· Heart rhythm abnormalities are corrected
· Visceral fat deposits are reduced

Prevention is much better than reacting to cardiac emergencies that require heroic treatments such as balloon angioplasty, stent placement, or coronary artery bypass graft. If heroic measures are required, then benefit can still be gained by following a program of prevention and tracking plaque growth; plaque growth can be slowed, stopped or reversed.

Treatment
Lifestyle, nutritional and other treatments can take place while you are being treated with pharmaceutical drugs or while you are recovering from heart or vascular surgery. The treatments can be effective enough that discontinuation of certain drugs may be possible. A similar treatment is used to prevent heart disease.
· Diet & weight loss – this is the single most important preventive measure; diet is a critical component of CVD treatment as well.
· Lifestyle modification – stop smoking programs are imperative.
· Exercise – contrary to some people’s belief systems, our bodies are more healthy when we exercise them in a manner that benefits the heart, arteries, and muscles.
· Specific nutrient replacement such as vitamins, minerals, and amino acids.
· IV Nutrient Therapy – as many people age their ability to absorb nutrients decreases, this is especially true of the minerals. Minerals such as magnesium and potassium are very important in keeping the heart beat regular.
- IV Phosphatidylcholine (PTC) - PTC improves the activity of HDL cholesterol. HDL helps shuttle cholesterol from arterial plaques back to the liver for recycling. PTC can be thought of as an HDL analog, that is, it has some of the same actions as HDL and helps lower plaque burden.
· Removal of toxic metals that interfere with nitric oxide production, thus lowering blood pressure and improving artery elasticity. This is accomplished mainly with IV Chelation therapy.
· Environmental – some environmental toxins damage the lining of the arteries. An example of this is chlorine and its breakdown products in drinking water.

Diagnostic Tests for CVD
Specific blood tests help identify people at higher risk for cardiovascular disease.
· Fibrinogen. High fibrinogen often results from inflammatory processes in the body. High levels increase the risk of abnormal blood clot formation.
· Homocysteine. Either high values or even upper half of normal makes the blood more viscous. Higher viscosity blood is harder to pump (the heart is the pump in this case, contributing to heart failure) and it clots easier. Homocysteine levels need to be less than 10 micro-mol/L
· Lipid panel. This test measures the fats (lipids) in your blood.
· Low-density lipoprotein (LDL) cholesterol. This is often called "bad" cholesterol. High levels may contribute to the accumulation of fatty deposits (plaques) in your arteries (atherosclerosis), which reduces blood flow. These plaques sometimes rupture and lead to heart attacks or strokes. LDL is not directly correlated with CVD; LDL-P (see below) is a much more definitive test.
· High-density lipoprotein (HDL) cholesterol. This is often called "good" cholesterol because it helps decrease LDL cholesterol deposits, keeping arteries open and your blood flowing more freely. HDL needs to be greater than 60 mg/dL
· Total cholesterol. This is a sum of the blood's cholesterol content. High levels can put you at increased risk of CVD.
· Triglycerides. Triglycerides are fat (similar to vegetable oil) in the blood. High triglyceride levels usually mean you eat more calories than you burn, especially carbohydrates. Increased levels increase your risk of heart disease. Triglyceride levels should be less than 150 mg/dL
· Lipoprotein (a) or Lp(a). This is a type of LDL cholesterol and the level is mainly determined by your genes; Lp(a) can be reduced through nutrition. Research has indicated that high levels of Lp(a) may be a sign of increased risk of CVD. High levels of Lp(a) encourages blood clot formation and reduces blood clot breakdown. Desirable levels are less than 14 mg/dL
· Apolipoprotein B (APOB) is the primary apolipoprotein of low-density lipoproteins. Through a mechanism that is not fully understood, high levels of APOB can lead to plaques that cause vascular disease (atherosclerosis), leading to heart disease. There is considerable evidence that levels of APOB are a better indicator of heart disease risk than total cholesterol or LDL. The APOB goal for patients with a history of heart disease is less than 60 mg/dL
· LDL-P: The measurement of LDL particle number (LDL-P) is a more accurate method of quantifying cardiovascular risk than traditional measurement of LDL cholesterol. NMR technology is the preferred method of measurement. The LDL particle number needs to be less than 700 nm/L in high risk people.

High levels of most of these blood tests (high = more risk, exception HDL) can be modified through nutritional and biochemical medicine offered at Alpine Physicians.

Cardiac calcium scoring uses a special X-ray test called computed tomography (CT) to check for the buildup of calcium in plaque on the walls of the arteries of the heart (coronary arteries). This test is used to check for heart disease in an early stage and to determine how severe it is. Cardiac calcium scoring is also called coronary artery calcium scoring. This is the best test to evaluate your current individual risk for heart attack.
Cardiac calcium scoring is used to track plaque increase as well as decrease. The effectiveness of treatment is evaluated by tracking coronary calcium score stabilization or decreases. Special types of scanners specifically developed for cardiac scanning must be used – regular CT scanners are NOT acceptable and expose you to too much radiation, and they are too slow to accurately image the beating heart.

This page last modified on Wednesday, October 06, 2010

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