Tuesday, March 8, 2011

is heart disease reversable?

Is heart disease reversible?

Now there is a question that will elicit strong opinions in the medical community especially among cardiologists whose specialty is to care for people with heart disease.
The textbook definition of heart disease or more specifically coronary artery atherosclerosis describes it as a progressive disease be treated but not cured.
Some authors have described a steady progression of the disease, however more careful analysis reveals that while coronary atherosclerosis starts when we are young its progression is a not steadily progressive but goes through active and quiescent phases.

Most cardiologists and other Physicians will insist that heart disease cannot be reversed. Some will focus totally on cholesterol levels and insist that taking a cholesterol lowering drug is all that is needed and won’t discuss it further.
Surely the goal of treating coronary disease would be to reduce and eliminate the plaque and indeed a huge amount of money has been spent attempting to demonstrate that cholesterol lowering drugs would cause the plaques to shrink.
Pfizer who makes the cholesterol lowering drug lipitor spent over one billion dollars developing and testing a drug that would raise the levels of the so called “good cholesterol”, HDL only to find that not only did they not reduce the amount of plaque but the patients had significant side effects and the drug was withdrawn from further research, in fact this and other events has led Pfizer to completely abandon further development of any heart related drugs.
A large multi center trial called REVERSAL, REVERSing Atherosclerosis with Aggressive Lipid lowering (the drug marketing department loves these acronyms) showed that while one dosage of one particular medication did seem to stop the growth of the plaque the other medication did not, so there was no reversal in spite of the considerable amount of media coverage and marketing that followed promoting the medication (Lipitor) which supposedly had a better result.
All of this data has been discouraging in stopping the largest single cause of death in the developed world.
On the other hand one can find easily on the Internet advertisements for a variety of books and products claiming to reverse heart disease.
Dr. Dean of Ornish has made a career of claiming that following his very strict no fat diet. The joke about the Ornish diet because if it is so strict is that “it won’t make you live longer it just seems like it”. My older brother many years ago went to in Ornish seminar in came back with a very simple interpretation of the diet, he said” if you put something in your mouth and it tastes good spit it out” Other authors have also insisted that eliminating all fat will stop and reverse heart disease. A large group of people believe that chelation therapy works however there has never been any data demonstrating its effectiveness at reducing plaque.

If all this seems discouraging do not give up hope there are a small group of us who believe and have some evidence that heart disease actually can be reversed to some extent.

We must remember that fundamentally coronary artery disease is not a cholesterol problem and the focus on cholesterol will not lead us to a solution. The fundamental cause of coronary artery disease is inflammation.
The idea that inflammation is the cause of coronary disease begin to emerge in the medical literature in the mid nineties. Interestingly enough the renewed attention on the cause of coronary disease came about because of the problem of re-stenosis after an angioplasty or a stent.

This research caused a fundamental reevaluation of our whole idea of coronary disease, once described is a bland lipid storage disorder. The new research by many scientists has now fully described the role of inflammation from the inception of the plaque when it is called a fatty streak, to its growth and eventual rupture with disastrous consequences such as heart attack or stroke.

We will discuss inflammation more fully in week four and help you understand this very complicated subject.
But for now let’s just talk about inflammation in its simplest forms, we have all experienced acute inflammation for example if we experience a cut or abrasion on our skin we will see that classic signs of inflammation that have been described for centuries.
Warmth (calor)
Pain (dolor)
Redness (rubor)
Swelling (tumor)

We now know if that this is exactly what’s going on inside of our coronary arteries and the rest of our arteries for that matter. We can’t see it we can’t feel it but we know that this is what is going on.
I have seen it thousands of times in the operating room and came to the conclusion that inflammation was involved even though the experimental work was just beginning. I certainly will not take credit because I did not have the skills or the facility to accomplish the work that ultimately proved the clinical observation.

Lets it go back to your skin abrasion and remember that over a short period of time the signs of inflammation including the swelling and redness go away, the body is built to heal itself. However if you continue to injure that same spot every day it will never heal.

Dr. Peter Libby from Harvard University has a written eloquently both in the medical literature and in such publications as Nature and Scientific American explaining the change in our fundamental knowledge of heart disease and explaining the mechanisms by which inflammation causes the plaque to form grow and eventually rupture. Although he is certainly brilliant and very influential I am always disappointed to see that his only solution for inflammation is to prescribe a statin medication.


The answer is yes, but not if we continue the same approach of trying to find a spot in the inflammatory pathway to block the inflammatory response.
But this is the typical approach; we don’t really ask what the fundamental cause is? We only ask how can we produce a drug that blocks the inflammatory process and make monstrous amounts of money using this medication.

Inflammation is the normal response our body makes to injury.

So to reverse heart disease a two pronged approach that; 1) avoids injury, to do this we must understand what it is that injures our arteries on a daily basis so that we can avoid the injury. 2) Understand the inflammatory process and the natural, normal things that modulate the responses so that we can maximize this affect without any side effects as are common with most medications.

It seems to me and to some others that if we stopped the injury that was causing the inflammation we would stop the growth of the plaque and facilitate healing.

I do not have any hard data but I do have several observations of patients who had dramatic reduction in the amount of plaque in their arteries by following a program to reduce inflammation.
(We may want to insert a couple of testimonials here from the inflammation awareness site)
One in particular is a man in his early fifties who was treated by a cardiologist friend of mine for chest pains, he underwent a cardiac catheterization demonstrating 60 to 70 percent narrowing in all three coronary arteries, and he was prescribed the usual statin medications but was not satisfied and sought my advice. My advice to him was to begin taking an omega three supplement, vitamin D and to restrict the amount of sugar and simple carbohydrates in his diet; he was also instructed to begin walking 30 minutes daily. At his six month follow-up his cardiologist scheduled another cardiac catheterization and warned am to be ready to have several stents placed in the arteries. Much to the cardiologist surprise the narrowing were now reduced to 40%.
I know anecdotes are not data and do not prove anything, but the observation has objective measurement of reduction in plaque which has been impossible with our current medications to reduce cholesterol.
The approach here was to have this gentleman stop injuries to his arteries by consuming a diet which he was genetically adapted to eat, avoiding those things that we know cause inflammation in the arteries. This diet and the exercise he began to do caused his weight dropped almost 20 pounds significantly reducing the inflammatory cytokines produced by that fat. We then took a look at those things lacking in his diet that are known to modulate the inflammatory response namely omega 3 fatty acids from fish oil and adequate amounts of vitamin D both of which are well documented to modulate the inflammatory spots in blood vessels.

Dr. William Davis has collected data using CT scans of the heart to obtain what is called a calcium score. Calcium in the coronary arteries proves that there is plaque there.
Dr. Davis published a paper which I was privileged to review before its publication showing that in 63 patients using a program to reduce inflammation a significant number had a reduction in calcium score. He actually had trouble getting it published in some journals because this was the first time such a thing had been reported.

Clinical observations and a small number of patients demonstrating reversal of coronary disease can never get the attention that a huge randomized trial, but we will continue to make the observations and publicize the fact that coronary artery disease is reversible by controlling inflammation.

The fundamentals of reversing heart disease then are;
Reducing the number of injuries to our blood vessels
Naturally modulating the inflammatory response.

inflammed by medical marketing


The Jupiter study made numerous headlines in November of 2008; most saying that taking a statin drug (Crestor) could lower their risk of a heart attack by 50%.

I know marketers do what marketers do but the facts are far different than the headlines.
The study was of 17,802 people with normal cholesterol levels but with elevated CRP, a blood test indication inflammation. Half were given a placebo and half were given Crestor 20 mg daily, after two years there were 157 cardiac events in the placebo group (1.8%) and 83 events in the treated group (0.9%), a real and actual reduction of 0.9% or less than ½ percent per year.
That would mean that 180 people would have to be treated for two years at a cost of $3.95 per day to prevent one cardiac event.
Since both LDL cholesterol and CRP went down no one can say that it was not the lowering of inflammation that was responsible for the small benefit.
When your Doctor started you on cholesterol lowering medications they did not tell you that there was only a 1 in 180 chance that you would benefit from the drug.
Marketing has trumped medicine, unduly influencing your Doctor, the FDA and NCEP (National Cholesterol Education Program) ignoring better solutions.
Since the last few years has produced massive amounts of evidence that inflammation is the root cause on Heart disease as well as many other chronic diseases let’s focus on ways to eliminate and correct the inflammation that is reducing the quality and quantity of our lives.

Weight Control
Overloaded fat cells produce chemicals that directly cause inflammation in our arteries. As little as 10% reduction in weight can correct the problem.

Baby aspirin
The original anti inflammatory has been proven to be more effective than drugs to prevent heart attack.

Avoid Soybean and corn oil

These oils, which are in every prepared food, and which we have been told to consume instead of animal oils, contain Omega 6 fatty acids which in excess amounts cause inflammation and heart disease.

Take a fish oil supplement

Omega 3 from fish oil is nature’s most effective anti inflammatory. Demonstrated in large studies to drastically reduce heart attack and death. Most of us do not eat enough fatty fish and need to supplement.

Be physically active

Recent studies have shown that the active muscle cell produces anti inflammatory compounds and releases them into the blood stream.

More statin nonsense

All diabetics over 40 should be on statins, says an expert
Stockholm, Sweden - All people over the age of 40 with diabetes—type 1 or type 2—should be taking statins to reduce their risk of stroke or coronary events, one expert stressed to diabetes doctors at the European Association for the Study of Diabetes (EASD) 2010 Meeting last week. Dr John Betteridge (University College London, UK) outlined the evidence base for statins in diabetes and stressed their safety, as long as they are appropriately used and drug interactions are avoided.
Betteridge has received honoraria for lectures and attendance at advisory boards and some research funding from AstraZeneca, Bristol-Myers Squibb, Kowa, Merck Sharp & Dohme and Pfizer. This man clearly is a spokesman for the pharmaceutical industry. To say or infer that what he says is unbiased is terribly naïve yet this man is the expert at medical meetings, a man who dictates medical practice to other doctors, a man regarded by other doctors as particularly knowledgeable in the use of medicines and the treatment of illness. This is a man whose words are purchased by the highest bidder. Truth has no role when he speaks only allegiance to the mantra of his owners.
This is the man who can look at these facts:
1) Of the 137,000 people admitted to 500 U.S. hospitals with evidence of heart attack, 75 percent had LDL cholesterol levels below the recommended level of 130 and 50 percent had LDL cholesterol levels below 100.
2) 50 percent of heart attacks occurred in people with normal cholesterol levels.
And say with conviction that cholesterol elevation is the cause of elevated cardiovascular risk.
This is the man who can look at the ENHANCE study comparing Vytorin (a combination of Zocor and Zetia) and Zocor alone, which showed that even though the combination drug Vytorin lowered the LDL cholesterol 40 percent more than Zocor alone there was no difference in the progression of the atherosclerotic plaque and still say “lower cholesterol is better”, the marketing mantra of the statin maker, his masters.
This is the man who with respect to statin drug side effects can say to his fellow doctors, "you have to reassure your patients that the side effects are most unlikely due to the drug, and you have to look for other causes and counsel them that this is a very important drug for them to take."
Not one word about the ten of thousands of cognitive reactions to statins, manifested by various forms of amnesia, confusion, increased forgetfulness, disorientation and a dementia closely resembling that of Alzheimers. Nor about the adverse reaction of statins in the form of emotional and behavioral reactions such as aggression, sensitivity, paranoia, hostility, depression, suicidal ideation, homicidal ideation, combativeness and a road rage type reaction. Both the statin side effect repository at the San Diego College, directed by Dr. Beatrice Golomb and Dr. Graveline’s at www.spacedoc.net have found that cognitive and emotional reactions appear in patients reports just as often as reports of various neuromuscular problems. Most authorities now agree that myopathy incidence is now much closer to 15 percent than the less that 2 percent figure stated by the drug companies at the time statins first were marketed. Dr. Golomb has recently reported that of those cases reporting myopathy, 68 percent will prove to be permanent. Neuropathy already is considered permanent and particularly unresponsive to treatment of all kinds. Dr. Wolfe’s study following Baycol withdrawal reported that rhabdomyolysis incidence now runs at several hundred rhabdomyolysis hospitalization each year with a 10 percent death rate amounting to some 30deaths annually despite the withdrawal of Baycol from the market.
In view of this information about these well-known adverse reactions from statin drug use, how can Dr John Betteridge sleep at night knowing how widely divergent his words are from the truth? If this in formation is insufficient for you to question this man’s integrity concerning the relevance of cholesterol let me add the results of the JUPITER study that he has ignored so completely. Dr. Ridker took thousands of people of both sexes and over a wide range of ages with cholesterol levels of 130 or lower and no evidence of cardiovascular disease – healthy by all standards. He then gave all of these volunteers a test for inflammation known as the (hs)CRP test. Those testing positive for inflammation by this single test he then divided into two groups. To one group he gave a placebo, to the other he gave a moderate dose of a statin. Then Ridker observed these two groups for heart attacks and strokes (hard evidence of cardiovascular disease) as time passed. By 18 months of observation the placebo group showed so many cases of heart attacks and strokes that to proceed would be to violate medical ethics. This is the study that established for all to see the irrelevance of cholesterol either as a marker for CV risk or as a factor in the disease process – 35 years of brainwashing revealed by this one study. And our expert never mentioned it at the 2010 meeting in Stockholm a few months ago.
By Dwight Lundell MD

Thursday, February 12, 2009

Utter Madness! 75% Of All Heart Attack Victims Have Normal Cholesterol!

Yet again, more evidence mounts that cholesterol is not the cause of heart disease. If we but accept all this proof, it becomes clear taking cholesterol-lowering medication is a colossal waste of time, money and human suffering from side effects produced by statin medications.

The latest evidence is a new study in the American Heart Journal published in January, 2009. This new study tested the cholesterol of heart attack patients admitted to 500 hospitals. The disturbing new findings reveal:

· 75% of those patients had LDL-cholesterol levels below the current guidelines of the National Cholesterol Education Program (NCEP) of 130 milligrams.
· 50% had LDL-cholesterol levels below 100 milligrams.
· 17% had LDL-cholesterol levels below 70 milligrams, which is the new, more stringent guidelines.

How Much Lower Must We Go Before Admitting There Is No
Correlation Between Lowering Cholesterol And Heart Attack Risk?

One would think the overwhelming evidence that lowering cholesterol levels fails to prevent heart disease would be sufficient for a new focus. One would also think a scientist would be willing to re-examine a theory when the evidence against that theory is decidedly inaccurate.

Instead, the response from the American Heart Association sponsored researchers is to lower acceptable cholesterol levels even more resulting in countless people beginning statin medications unnecessarily.

This demonstrates once again the powerful success marketers of cholesterol-lowering medications have achieved. Their influence upon Physicians, government agencies and professional bodies leaves no one daring to question the cholesterol theory without fearing ridicule and risking professional suicide.

I am left with the utmost sadness their influence leaves intelligent and caring Physicians no longer giving needed thought to what really causes heart disease or how to prevent it. Instead, they have become convinced that cholesterol-lowering drugs are the answer despite overwhelming evidence to the contrary.

Let’s use this study to our best advantage by stimulating an open-mindedness with questions and dialog about the cholesterol theory. Let’s get to the real cause and get serious about preventing unnecessary disease and death. Let’s re-examine the validity of the old science and examine the overwhelming evidence in today’s science. The latter provides the answer.

Monday, December 22, 2008

Omega-3 Fatty Acids Lower Risk for Type 1 Diabetes
Omega-3 fatty acids when consumed regularly by the children at risk of developing type 1 diabetes are revealed by a preliminary research to help lower that risk. This was published in the Journal of the American Medical Association.With type 1 diabetes, the beta cells in the pancreatic islets are destroyed. No one knows why this happens although the hypothesis has been that this is caused by both heredity and environment. Nutritional factors are also thought of as related to type 1 diabetes so Dr. Jill Norris wanted to see if the regular consumption of Omega-3 Fatty Acids were a factor in the destruction of the beta cells that produce insulin.From 1994-2006, Dr. Norris and her team studied 1770 children who were at high risk for developing type 1 diabetes. They followed this case up for more than six years on the average with the subjects taking polyunsaturated fatty acids since when the children were one year old. They found out that the regular consumption of the Omega-3 Fatty Acids lowered the risk by 55%.The following are some of the findings related to Omega-3 Fatty Acids:The tendency of the diabetics to have low HDL and high triglyceride levels makes it essential to consume omega-3 fatty acids found in fish oil. Since they are considered essential to maintain health and are not manufactured by the body, they must be consumed through foods such as tuna, salmon, and halibut, lake trout, mackerel and sardines at least twice a week.Another essential fatty acid is the omega-6 but the trouble is there has to be the correct balance between these two. An imbalance could contribute to the development of disease while a proper balance will do the opposite, that is, maintain and improve health. The usual American diet in order to be healthy should contain approximately two to four times more omega-6 fatty acids than the omega-3 but the trouble is that is not the case in what we usually eat. What we have instead is a usual diet with 14 to 25 times more of the omega-6 than the omega-3 fatty acids.
This post is from freediabesesalert.blogspot.com.
The blog contains excellent material on Diabetes, but missees the real point. Type 1 Diabestes is caused by the the destruction of the islet cell of the pancreas by an auto immune disorder. Those children who took more Omega-3 either from food or supplements have lower measured antibodies against the islet cells. Omega-3 is an anti-inflammatory and immunomodulating agent.
Do not forget to take some today and give some to your loved ones.

Thursday, November 27, 2008

Doctor Lundell’s Arizona Ironman report

I began this ironman with great trepidation; my first Ironman, having only considered triathlon two years ago, not being able to run or swim at that time, not feeling at peak fitness for cycling, only my second 2.4 mile swim, being undertrained for running because of a tibial stress fracture in the spring and multiple hamstring and foot issues.
That being said my few successes in life have been achieved more with determination than talent, so I was determined to finish with the goal of 16 hours 59 minutes.

Knowing that I am a slow swimmer in spite of Ann Wilson’s great instructions, I started near the back. The swim was comfortable and I thought I was doing OK until I saw Jeff and Shawn who were volunteers on the swim course. They said 1:23 had already passed and the Mill Ave Bridge was still in front of me, disappointed but still determined. I was out of the swim at 1:42:50. Happy to be done and feeling good, but with 2065 people in front of me.

The bike leg went well. I followed Bill Wilson’s instructions and took it easy, got in all the calories and electrolytes per the plan, and finished the bike segment in 5:48:02 having passed 847 faster swimmers.

The run was starting out poorly, running too fast then getting tired and walking. On the first Mill Ave Bridge crossing, to my humiliation Sharon caught me walking. Sharon is my sweetheart and training partner. When you run with Sharon there is no run-walk strategy it is all run. She encouraged me, so it was back to running and only walking at the aid stations. At the end of the first lap she told me that the internet spies said I was first in age group by 40 min coming off the bike, now the pressure was on. I kept a steady, but slow pace on the second loop. Sharon and her friend Jacque were at multiple locations on the course to encourage me; they may have covered more miles than I did. Sharon reported that I had lost time to my pursuer so my determination really kicked in. The last lap was my fastest segment, my legs felt OK so I picked up the pace. I saw Preston out on the course and his encouragement was vital in keeping me going for the last segment. What a beautiful sight that left turn arrow is at the bottom of the park to be followed by a more beautiful sight, the finish!
I am amazed that I finished, amazed that I was less than 13 hours and amazed to be first in age group, truly humbled to qualify for Kona.
I am extremely thankful for all support and encouragement from friends especially the TriScottsdale friends. To have children and grandchildren at the finish to celebrate was very special. I have much to be thankful for.
Special thanks to Ann and Bill from Camelback Coaching, Nate and the other pros at Endurance Rehab, Karyn Hendrickson at One Stop Fitness for getting this old carcass across the finish line.
Very special thanks to Sharon Johnston for her love, encouragement and all the great time we have spent training, she is the real Ironman.

Thursday, October 23, 2008

Another reason to stay healthy
The number of serious drug reactions and deaths reported to the government shot up in the first three months of this year to set a new record, a health industry watchdog group said Wednesday.
The Food and Drug Administration received nearly 21,000 reports of serious drug reactions, including more than 4,800 deaths, said an analysis of federal data by the Institute for Safe Medication Practices, known as ISMP.
Two drugs accounted for a large share of the latest reports. One was heparin, the tainted blood thinner from China that caused an international safety scandal. The other was Chantix, a new kind of anti-smoking drug from Pfizer.
Clearinghouse for informationThe watchdog group that prepared the analysis has served hospitals and pharmacists for years as a clearinghouse for information on medication errors. Known as ISMP, the organization is now trying to reach consumers with regular reports on drug safety trends.
“We believe that one of the most important tools to promote is to monitor trends on a regular basis,” said Thomas J. Moore, a senior scientist with ISMP. “Knowing which drugs are causing injuries and how many people are being hurt is the raw material we need to fashion sound measures to promote patient safety.”
The FDA defines serious drug reactions as ones that cause hospitalization, require medical intervention, or place a life in jeopardy. The agency’s monitoring system relies on voluntary reports from doctors and is only believed to capture a fraction of overall problems.
The 20,745 cases reported from January through March was 38 percent higher than the average for the previous four calendar quarters, and the highest for any quarter, the report said.
The number of deaths, 4,824, was a nearly threefold increase from the last calendar quarter of 2007. The FDA said heparin was largely to blame.
Previous ISMP research has shown that reports of serious drug safety problems had increased markedly since the late 1990s.
The FDA case reports provide a signal of possible problems with a drug, but a cause-and-effect connection can only be established through painstaking investigation. If the FDA were a police agency, the reports would indicate “probable cause,” but not necessarily “guilt beyond a reasonable doubt.”
‘Significant drug safety problem’The ISMP study found that heparin accounted for 779 reports of serious problems, including 102 deaths. The FDA, using data that covers a longer time period, has reported 238 deaths possibly linked to heparin.
Heparin “illustrates an example of a significant drug safety problem that was promptly and effectively resolved by the drug manufacturers and the FDA once the issue was detected and understood,” the report said.
Most physicians believe the problem of drug reaction is severely under reported be cause of the amount of paperwork the doctor must do to make a report.