New way to prevent heart disease....

Today's post: Wednesday, 1-9-2008

On Monday night I went to a lecture on preventing heart disease looking for something new that I might use myself & share with you.

The lecturer was Randall Stafford, MD from the Stanford Prevention Research Center & Preventive Cardiology Clinic. This Stanford center has tracked the developments in preventing heart & cardiovascular disease for many years.

The news Dr Stafford delivered was extremely powerful. It expands what we can do to prevent or reverse heart disease. It increases the leverage we can bring to bear to do it. And, it also is an extremely valuable new way to measure cardiovascular risk.

Here are the three pieces of background you need to understand how very valuable this new method is:

1. It’s extremely protective to have high levels of HDL cholesterol.

According to a recent email I got from Dr Al Sears, it was reported in JAMA that people with HDL levels of 65 or over had only an eighth of the cardiovascular disease of people with less than 35.

Put in use-oriented language, that translates into,

“Raise your HDL enough & your risk of cardiovascular disease, heart attack, & stroke drops by nearly 90 % from just doing that one thing.”

Doctors have tended to underuse this information as there have been no drugs that safely raise HDL levels.

>>> Regular exercise, particularly vigorous interval training and progressive strength training; taking the vitamin niacin (300 mg a day to 1,000 mg in divided doses like 300 mg after each meal seems to be both safe & effective}; & moderate, regular drinking raise HDL levels. (Over 2 drinks a day & drinking more than one drink before driving are NOT wise, however.)

So does eating right & taking some supplements. Using only extra virgin olive oil instead of polyunsaturated oils or butter seems to help a lot. Choline, Zinc, & Chromium supplements also help. (Avoid taking over 50 mg a day of zinc.)

2. Ever wonder why almost every health expert in the country is trying to get transfats banned & virtually all of them makes a very strong personal effort NOT to eat any?

It’s pretty simple, eating that junk CAUSES cardiovascular disease. I’ve not read of any class action lawsuits on this yet. But the evidence is overwhelming.

Here’s how it works. Cardiovascular disease is caused by having high levels of oxidized LDL particles that are physically small enough to go into the molecular chinks in your artery walls. LDL that’s physically larger may sludge up things a bit; but it bounces off & doesn’t do lasting damage.

Eating transfats turns your larger and safer LDL particles into the smaller, denser, & dangerous kind that DO cause permanent damage.

But, the prevention challenge has been that the test which shows whether your LDL is the harmless (or very much less harmful) kind or the really dangerous kind costs about $600 to $800. So it’s not been used outside of small research studies for the most part.

3. High triglyceride levels are known to be a heart disease risk but have not yet gotten much attention by doctors.

Lowering LDL levels does work to prevent heart attacks. Doctors know statin drugs do that and often prescribe them. (Niacin, eating right, & taking sterol supplements are also quite effective in lowering LDL levels.) But, there are not really safe & effective drugs that lower high triglyceride levels. And the risks posed by high triglyceride levels are less well known. Understandably, doctors tend to stick to things they know well & things they know will be helpful.

You can lower your triglyceride levels by cutting way back on eating sugar; NEVER eating or drinking high fructose corn syrup; eliminating refined grain foods; by eating a lot of vegetables, & particularly by eating lots of onions. Eating wild caught fish that’s high in Omega 3’s and taking omega 3 supplements also seems to help. Regular exercise, particularly vigorous interval training and progressive strength training also helps.

Taking the supplements chromium & alpha lipoic acid may also help.

Note that these are the same factors that tend to prevent or improve type II diabetes. So doing these things also protects your heart from the effects of excessive levels of sugar and insulin.

Doing this set of things also tends to trim off excess fat which is a very nice extra benefit indeed.

Here’s the news. The physiology underlying these three measures interacts. And, the HDL and triglycerides interact in a way that apparently determines the size of your LDL particles.

We know this because:

>>> It’s been found that the ratio between HDL & triglyceride levels is a very accurate estimate of what the much more expensive test of your LDL particle size would find if it were done.

(Dr Stafford presented it as the Triglyceride level divided by the HDL level.

That would make a lower ratio desirable. So, the desirable reading is 1.0 or less where the level of HDL is high enough & the triglycerides are low enough, 75 each for example or 70 for triglycerides & 80 for HDL that there’s clearly enough HDLs to process the triglycerides & your LDL cholesterol. Decent would be about 2.0 or maybe 3.0 with something like 50 HDL & 100 to 150 triglycerides. A reading of over 3.0 is undesirable. And, a reading of 10.0 or more -- from something like 320 triglycerides & a 32 HDL level -- is so high risk it’s scary.)

This is a HUGE lever we can use to prevent heart disease.

It has a large number of really useful implications or corollaries.”

1. We can detect the bad guys, the tiny high density LDL particles, cost effectively with just two of the cheaper tests we already are using !! Just take the HDL level and the triglyceride level and divide the triglycerides by the HDL reading.. The answer will show you how many of the bad guys you have.

2. And, this one is also HUGE. If your HDL is high & your triglycerides are low you have an extremely low risk of cardiovascular & heart disease. Conversely, if your HDL is low & your triglycerides are high, you are in serious trouble even if you haven’t had a heart attack or other symptoms yet. This ratio measures both at once.

3. So, if you do the things that increase your HDL; do the things that lower your triglycerides; do the things that are known to make your LDL particles larger; & avoid the things that make them smaller, particularly by NEVER eating transfats, YOU can take control over your risk of heart disease.

Many other people beside me are recommending many of these practices in part because they have many other health benefits besides protecting your heart.

In summary, this news allows us to see in part WHY these practices protect your heart and blood vessels. AND, it gives us an extremely powerful way to measure if there is a problem and to see if our efforts are solving it once we start to use these practices & have been doing them for a few weeks.