Conventional cardiologists give some attention to lifestyle factors, but they often focus more on high-tech procedures and prescription drugs. These physicians are trained mainly to suppress or eliminate symptoms rather than to treat the underlying causes of heart disease.
Example: A patient with angina (chest pain due to insufficient blood flow) might be treated by a conventional cardiologist with angioplasty to compress and/or remove blockages that restrict circulation to the heart. Angioplasty relieves symptoms temporarily, but the procedure has risks… and the blockages return in 30% to 40% of patients, usually within six months.
A naturopathic physician focuses more on the factors that cause the blockages, including ongoing plaque buildup in the arteries (atherosclerosis). A patient with angina might be given treatments to naturally lower cholesterol… increase blood flow to the heart… and decrease arterial deposits.
Elevated LDL “bad” cholesterol is one of the main cardiovascular risk factors. The use of cholesterol-lowering drugs is not always the answer.
Recent finding: It was announced in January 2008 that the drug Zetia, widely used to lower cholesterol, had failed to benefit patients in a two-year trial. The drug not only did not slow the accumulation of plaque in the arteries — it may have contributed slightly to plaque formation.
Statins, such as atorvastatin (Lipitor) and pravastatin (Pravachol), are effective, but they can cause troubling side effects, including sleep disturbances and severe muscle pain or weakness (myopathy).
Most patients can manage cholesterol with safer measures, including a high-fiber diet — aim for five to 10 grams of soluble fiber a day (oatmeal and oat bran are good sources). Also important…
Red yeast rice extract. Red yeast rice is rice that has been fermented by red yeast (Monascus purpureus). It contains chemical compounds, monacolins, that have statinlike effects. Patients who take red yeast rice extract can see drops in LDL cholesterol of about 30% and increases in HDL “good” cholesterol of about 20%. Unlike statins, red yeast rice extract is not likely to cause myopathy or other side effects.
What I recommend: Pharmaceutical-grade red yeast rice extract, which must be prescribed by a doctor. It’s of better quality than most of the supplements available in health-food stores. Patients using red yeast rice extract also should take coenzyme Q10 (CoQ10), a substance that occurs naturally in the body, and the B vitamin niacin. The active ingredients in red yeast rice extract may lower the body’s levels of CoQ10. Niacin may enhance the effect of red yeast rice extract.
Dose: 300 milligrams (mg) of red yeast rice extract… 25 mg of niacin… 5 mg of CoQ10 — all taken twice daily.
Nuts. All nuts — but particularly walnuts and almonds — have cardio-protective nutrients, including omega-3 fatty acids, vitamin E and soluble fiber. Large studies report that people who eat a handful of nuts (raw or toasted) two or more times weekly have a 30% to 40% reduction in heart disease risk factors.
Plant sterols. Found in small amounts in many plant foods, sterols decrease intestinal absorption of cholesterol. People who consume 1.6 g of sterols daily, divided over two or more meals, reduce LDL cholesterol by more than 10%. In patients taking statins, adding a plant sterol can lower LDL cholesterol by up to 15%.
What I recommend: Some brands of orange juice, yogurt, cheese, salad dressing and granola bars are rich in plant sterols — check labels. Two eight-ounce servings of plant sterol-fortified orange juice have about two grams of plant sterols. Or you can use plant sterol-fortified margarine (Benecol, Take Control) — about one tablespoon a day.
A review in Archives of Internal Medicine looked at 97 clinical trials involving omega-3 fatty acid consumption. The study found that omega-3s are more effective than statins at reducing heart disease-related mortality.
Omega-3s, found mainly in cold-water fish, are powerful anti-inflammatory agents. Chronic arterial inflammation is believed to be one of the main causes of heart disease. Omega-3s also stabilize heart rhythm and inhibit the ability of platelets to form clots.
What I recommend: Three or more weekly servings of fish. Salmon and canned sardines are good choices because they’re low in mercury. If you don’t like fish: Take a daily fish oil supplement that provides between 1,000 mg and 3,000 mg of omega-3s.
C-reactive protein (CRP) is produced by the liver. High levels of CRP are a sign of inflammation in the body, which is thought to promote the progression of atherosclerosis and stimulate the release of tissue factor, a protein that increases the risk for clots.
Everyone should get tested for CRP. A reading of less than 1.0 mg/L is desirable. Readings higher than 3 mg/L can indicate that heart attack risk is high.
What I recommend: A diet high in anti-inflammatory foods, including fish, garlic, turmeric and ginger, can reduce CRP. People should avoid eating inflammatory foods (fatty meats, butter, whole milk, fried foods and sugar). Also, don’t smoke — it increases CRP.
In excessive amounts, this naturally occurring amino acid damages the inner walls of arteries and increases the activity of clot-promoting platelets.
What I recommend: Two daily doses of vitamin B6 (60 mg) for a total of 120 mg… vitamin B12 (500 mcg) for a total of 1,000 mcg… and folic acid (1,000 mcg) for a total of 2,000 mcg.
Bonus: Folic acid enhances the bioavailability of nitric oxide, a naturally occurring blood gas that improves cardiovascular health.
A deficiency of magnesium is the second most common dietary mineral deficiency in Americans, after iron deficiency. Magnesium relaxes the smooth muscles within blood vessels. People who don’t get enough magnesium have an increased risk for high blood pressure (hypertension), one of the main causes of heart disease.
Magnesium deficiency is common in patients who take diuretics to lower blood pressure. Some diuretics flush magnesium as well as potassium from the body.
What I recommend: Most people should take a daily supplement of 400 mg of magnesium. Higher doses can help lower blood pressure in some patients but should be used only under a physician’s supervision.
