Cardiovascular Health

HEALTHY

CARDIOVASCULAR

SYSTEM

HEALTHYHEART

HEALTHYARTERIES

HEALTHYBLOOD

PRESSURE

Globally….• 17 million people die of

cardiovascular disease each year.

• In the United States, coronary heart disease is the single biggest killer and is responsible for 1 in every 5 deaths.

• In Europe, cardiovascular disease causes 4 million deaths each year.

• In Asia, the figure is on the rise.

In Singapore…..• Heart disease is the No.2 killer after

cancer.

• Approximately 2,000 people get heart attacks every year. Of these 50% die because they do not receive medical help fast enough.

• Death rate due to cardiovascular disease was 7.7% ( 1957 ) to 26.3 % ( 2001 ).

In Singapore…..

• Death due to ischaemic disease is 100/100,000 population.

• United States is 125/ 100,000, Australia 97/100,000, Japan 22/100,000 and Hong Kong 40/100,000.

According to the ‘State of Health 2001’ report….

• 27% of Singaporeans are hypertensive.

• 58% are physically inactive during their leisure time.

• 24% are overweight with 6 % being obese.

Surveys show that most women are far more

afraid of breast cancer than of cardiovascular

disease (even though 1 in 30 women’s deaths is from breast cancer while

1 in 2.4 is from CVD

2002 Heart and Stoke Statistical Update, American Heart Association

The Pathobiological Determinants of Atherosclerosis in Youth (PDAY)

Study Group: ~ 3000 persons dying of external causes

• Atherosclerosis begins in childhood

• By age 15, all subjects had atherosclerosis

McGill HC Jr, McMahan CA, Herderick EE, Zieske AW, Malcom GT, Tracy RE, Strong JP; Circulation 2002 Jun 11;105(23):2712-8. Comment in: Circulation. 2002 Jun 11;105(23):2696-8.

Zieske AW, Malcom GT, Strong JP. Natural history and risk factors of atherosclerosis in children and youth: the PDAY study. Pediatr Pathol Mol Med 2002 Mar-Apr;21(2):213-37

Strong JP, Zieske AW, Malcom GT. Lipoproteins and atherosclerosis in children: an early marriage? Nutr Metab Cardiovasc Dis 2001 Oct;11 Suppl 5:16-22

214

111.8

49.4 47.223.2

329.2

050

100150200250300350

Billions of Dollars

Estimated Direct and Indirect Costs of Cardiovascular Diseases and Stroke

United States: 2002

2002 Heart and Stroke Statistical Update, American Heart Association

As recently as five years ago, most physicians would have confidently described atherosclerosis as a straight plumbing problem.

Scientific American May, 2002 pg. 48

Atherosclerosis:

The NEW VIEW• The long held conception of how the

disease develops turns out to be wrong.

• Not a straight plumbing problem!

• Inflammation fuels the development and progression of Atherosclerosis

Peter Libby Scientific American May 2002, p 47-55.

Habitual response to events as if they were

life-threatening generates a repetitive

stress/inflammatory response that may result in

atherosclerosisBlack PH, Garbutt LD. Stress, inflamation and cardiovascular

disease. J Psychosomatic Res 2002, 52, 1-23.

How many people……

1) Hypertension ?

2) High cholesterol ?

3) Diabetes ?

CVD: How does it happen?

• Infections can inflame arteries and lead to heart attacks

• Six microbes associated with CVD risk

–Cytomegalovirus–Hepatitis A–Herpes Simplex viruses 1 and 2–Chlamydia pneumoniae–H. Pylori

• American College of Cardiology March 2000

Targeted Transfer Factor

• Managed environment• Unfertilized eggs

Egg Allergies• Prevalence of probable food allergy

– 0.61% for peanut. – 0.53% shrimp – <0.27% for wheat– 0.09% for cow's milk and egg

• Main egg allergens are found in whites

• Woods RK, Thien F, Raven J, Walters EH, Abramson M. Prevalence of food allergies in young adults and their relationship to asthma, nasal allergies, and eczema. Ann Allergy Asthma Immunol 2002 Feb;88(2):183-9

• Anet J, Back JF, Baker RS, Barnett D, Burley RW, Howden ME. Allergens in the white and yolk of hen's egg. A study of IgE binding by egg proteins. Int Arch Allergy Appl Immunol 1985;77(3):364-71

Magnesium“Magnesium deficiency has

been shown to correlate with a number of chronic cardiovascular diseases, including hypertension, diabetes mellitus, and hyperlipidemia.”

Fox C, Ramsoomair D, and Carter C. South Med J 2001; 94(12) :1195-20. Abstract.

“The American diet is low in magnesium, and with modern water systems, very little is ingested in the drinking water.”

Innerarity S. Crit Care Nurs 2000; 23(2): 1-19. Abstract.

Magnesium

• Allows blood vessels to relax not spasm

• Required for metabolic efficiency

• Deficiency leads to hypertrophy or enlargement of the heart

• Magnesium is a NATURAL calcium channel blocker (1)

(1) Stigson, L. and I. Kjellmer (1997). "Serum levels of MAGNESIUM at birth related to complications of immaturity." Acta Paediatr 86(9): 991-4.

(2) Med Text refs

Magnesium

Dietary Copper Deficiency

–high blood pressure–enhancement of

inflammation –anemia–reduced blood clotting–arteriosclerosis

Saari JT and Schuschke DA. Biofactors 1999; 10(4): 359-75.

ZincZinc requirements

of the vascular

endothelium

are increased

during inflammatory conditions

such as atherosclerosis.

Hennig B, Meerarani P, et al. Br J Nutr 1999; 81(2): 85-6.

Both men and women who took zinc supplements had higher HDL cholesterol levels than non supplementing individuals.

Neggers YH, Bindon JR, et al. Biol trace Elem Res 2001; 79(1): 1-13.

Zinc

Selenium• Selenium deficiency leads

to an increased frequency of cardiovascular diseases.

• “Selenium is well recognized as a preventive factor for cancer and cardiovascular diseases.”

Racek J, Holecek V, et al. Vnitr Lek 1999; 45(6): 373-8.

Miyazaki Y, Koyama H, et al. Nippon Koshu Eisei Zasshi 2001; 48(4): 243-57.

Hyperhomocysteinemia

• Elevated levels of homocysteine promote the development of atherosclerosis.

Zacarias-Castillo R, Hernandez-Rebollar AE, et al. Gac Med Mex 2001; 137(4): 335-45.Ubbink JB, Becker PJ, Vermaak WJ. Nutr Rev 1996; 54(7): 213-6. Clarke R, Armitage J. Semin Thromb Hemost 2000; 26(3):341-8. Auer J, Berent R, et al. Wien Med Wochenschr 2001;151(1-2):25-8.

• Approximately 10% of coronary artery disease cases are attributable to hyperhomocysteinemia.”

• Folic Acid -25% homocysteine• Vit B12 -7% homocysteine

Vitamin C• Antioxidants, such as vitamin C,

may slow atherogenesis.• An increased intake of vitamin

C is associated with a reduced risk of chronic diseases such as cancer, cardiovascular disease, and cataracts

Price KD, Price CS, et al. Atherosclerosis 2001; 158(1):1-12. Carr AC and Frei B. Am J Clin Nutr 1999; 69(6): 1086-107.

Vitamin E Supplement Benefits

• Decreased cardiac events:– U.S. Nurses’ Health Study

- 34% risk reduction– U.S. Health Professionals’ Study

- 39% risk reduction– Iowa Women’s Health Study

- 47% mortality reduction– Cambridge Heart Antioxidant Study

- 47% infarct reduction

Emmert DH, Kirchner JT. Arch Fam Med 1999; 8(6): 537-42. Abstract.

Lysine and Herpes

• “Herpes group viruses, especially cytomegalovirus and herpes simplex virus type 1, have been associated with both atherosclerosis and restenosis.” (1)

• L-Lysine monohydrochloride is used as a suppressant of recurrent herpes simplex infections. (2)

(1) Leinonen M, Saikku P. Scand Cardiovasc J 2000; 34(1): 12-20.(2) Flodin, NW. J Am Coll Nutr 1997; 16(1): 7-21.

Arginine & NO• Nitric oxide is a relaxing factor • L-Arginine is the precursor for

nitric oxide (NO). • Oral L-Arginine

supplementation can improve symptoms of cardiovascular disease.

(Note: Magnesium is also critical.)

Wu G, Meininger CJ. J Nutr 2000; 130(11): 2626-9.Boger RH, Bode-Boger SM. Annu Rev Pharmacol Toxicol 2001;41:79-99.

Resveratrol• Antioxidant,

• Promote nitric oxide production,

• Inhibit platelet aggregation,

• Increase high-density lipoprotein (HDL) cholesterol,

• Cardioprotective agent.

Bhat KPL, Kosmeder JW, 2nd. Antioxid Redox Signal 2001; 2(6): 1041-64.

Coenzyme Q10• Useful in congestive heart failure,

angina pectoris, cardiomyopathy, coronary artery disease and in the preservation of myocardium.

• Coenzyme Q10 is normally found in LDL cholesterol and it inhibits its oxidation.

• Cardiac levels of Coenzyme Q10 were decreased in heart disease.

Singh RB, Niaz MA, et al. J Assoc Physicians India 1998; 46(3): 299-306.Kucharska J, Gvozdjakova A, et al. Bratisl Lek Listy 1996; 97(6): 351-4.

Red Yeast Rice• Reduces

– total cholesterol,

– LDL cholesterol, and

– total triacylglycerol concentrations

• “Provides a new, novel, food-based approach to lowering cholesterol in the general population.”

Heber D, Yip I, et al. Am J Clin Nutr 1999; 69(2): 231-6.

Cardio Herbs• Hawthorne

–Salt Balance, Vessel Integrity

• Ginkgo Biloba–Antioxidant, stabilizer

• Garlic–Antimicrobial, Antioxidant

SUMMARY of the Problem• CVD is the #1 Killer• CVD Starts Early• CVD is NOT a Simple Plumbing

Problem• The Immune System is Critically

Involved in CVD• Infection may Initiate CVD• Metabolic Toxins and Chronic

Stress Can Trigger Chronic Inflammation

Summary of a Solution• Control Infection

• Control Inflammation

• Help the Blood Vessels Relax

• Protect the Heart and Arteries from Toxin and Oxidative Damage

• Increase the Pumping Efficiency of the Heart

Summary of Supplements• Tune the Immune System

– Targeted TF, Zn, Lysine

• Help relax the Blood Vessels– Arginine, Mg, Ginko, Hawthorne,

Butcher’s Broom

• Help support the Pumping Efficiency of the Heart– Mg, CoQ10

Summary of Supplements• Help block Oxidative Damage

– Se, Cu/Zn;

– Beta carotene, Vit C, Vit E, Resveratrol,

• Help improve Toxin Clearance– Folic Acid, Vit B6 and Vit B12

• Help maintain Cholesterol Balance– Red Rice Yeast, Garlic