Measuring Cardiovascular Risk

Cardiovascular Risk Factors.

The 1980’s were great, but we can’t stay there forever. Knowledge, science, and research move forward every year, as does empirical evidence. This is certainly the case when it comes to our knowledge of dietary factors and heart disease risk. You see in the 1980’s, the understanding of heart disease risk was really just beginning and much of the information spewed then was a knee jerk reaction to new found discoveries which had yet to be really understood.

Today, tons of work has been done to try to control cholesterol and LDL levels. However, we are discovering that there is more to the equation than just these two villainized components. Some experts say that total cholesterol and even LDL make no difference in heart disease risk. We know that our bodies use cholesterol to try to patch damage to the lining of our blood vessels. In my opinion, not enough attention has been paid to how to prevent the damage to blood vessels in the first place. Fortunately, other people thought the same thing before me and we do know there are certain markers of damage to watch for. Three of the main ones are C-reactive protein, homocysteine, and fibrinogen.

C-reactive protein is produced in our liver and is known to rise with inflammation. Inflammation in the arteries is associated with increased risk of heart disease, heart attack (MI), and stroke. A physicians health study with 18,000 subjects showed that increased CRP meant a 3X higher risk of heart attack. What affects CRP levels in the blood? Diet seems to be the largest risk factor. As expected, processed and artificial foods raise CRP. Other bad habits are stress, toxins, and lack of exercise. No surprise there, we know those factors are bad for the heart. The only news here is that these effects can be, to a certain degree, measured in terms of overall inflammation.

Another factor to watch for is homocysteine. Homocysteine is a metabolite of the breakdown of amino acid methionine. So we naturally produce homocysteine. Its just that it seems we produce more when we are unhealthy. Newer epidemiological data suggests that levels over 6.3 micromoles/L are linked with higher risk of heart attack (Life Extension magazine, 1999). The Linus Pauling Institute says that Higher homocysteine levels are a risk factor for coronary heart disease, heart attack, stroke, atherosclerosis and thromboemolism (“The vascular toxicity of homocysteine and how to control it”, Linus Pauling Institute). So how can we reduce homocysteine levels?

First, homocysteine can be converted to safe by-products with an enzyme called CBS (cystathionine beta synthase) ( Linus Pauling Institute). But this enzyme needs vitamin B6 to work. ( Remember, b vitamins are enzyme catalysts). This may be a reason why people who are b vitamin deficient have higher rates of CV disease. So B6 and the other b- vitamins are a good idea. I recommend using B6 food sources such as lean meat, mushrooms, yams, broccoli, turnip greens and sunflower seeds. Another way to lower homocysteine is through foods that have betaine. Betaine, also known as TMG, has the ability to re convert homocysteine to methionine. Beets are perhaps the best known source of betaine. Interestingly (at least to me), traditional Chinese medicine has always said that beets strengthen the heart. Once again, traditional empirical evidence supports modern nutrition science, or vice versa. Regardless of how you choose to see it, beets help the heart, so put some in your juicers at home.

The next factor to watch for heart health is fibrinogen. This is a plasma protein produced in the liver and is involved in clot formation. It is then a naturally produced and needed protein, but risk arises when it is higher than needed. Several epidemiological studies show that fibrinogen is a major independent risk factor (Vascular Medicine, 1997; 2(2): 115-25). Some foods to help modulate the effects of higher fibrinogen are omega 3 fatty acids and garlic (both blood thinners you’ll notice). In my opinion garlic is underestimated, as it has many positive mechanisms. A trial was done that examined the effects of garlic on plaque development on carotid and femoral arteries in subjects for 4 years. Increases in plaque volume was significantly slowed by garlic, and in some cases was reversed. (Koscielny, J. et al. Atherosclerosis 1999; 144(1): 237-249.

There are more risk factors for heart disease, such as magnesium and free testosterone, but being aware of emerging evidence is helpful in lowering your overall risk. You don’t have to use 1980’s information to assess your heart health.

Homocysteine, C reactive protein and fibrinogen lab work is available through Tampa Bay Acu Health and Spine.