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Heart Conditons and Drug Treatments

artery-wall-diagram.jpg

Notice the expansion of the artery diameter
atherogenesis-stages.jpg
Plaque is in Tunica media layer

Heart  Conditions and Drug Treatments  ---   6/16/14 (http://healthfully.org/rns/id2.html middle of page)

The causes for cardiovascular disease (exposing pharma’s bad science:  It isn’t cholesterol that causes atherosclerosis and cardiovascular disease (CDV), but rather damage to low-density lipoproteins (LDL) through reactive chemical (sugar or oxidation) and the subsequent immune system response to the damaged LDL.  LDL is the blood transport system for cholesterol and triglycerides in response to bodily needs.  Cholesterol is vital for all cells.  LDL is water (blood) soluble complexes, and house approximately 1,500 cholesterol molecules and 3,000 triglycerides.  When LDL that has penetrated the artery wall is damage by a reactive chemical (especially sugar), two types of white-blood cells start the process of forming plaque. This occurs in the Tunica media.   Over a lifetime the plaque accumulates and develops into cardiovascular disease (CDV).  Once developed, the most one can do is try to slow its progression and allow the body to slowly harden the plaque into a stable form and improve blood flow through revascularization.  Soft YOUNG plaque that leaks causes 85% of the strokes and heart attacks.  Thus cholesterol, triglycerides, and LDL levels are moderately associated with CDV, but they don’t cause CVD.  The liver produces more LDL filled with cholesterol and triglycerides inside it to replace the damaged LDL.  Pharma wants doctors and patients to believe that statin family of drugs because they lower cholesterol, triglycerides, and LDL that they can make a big different—that’s B.S.  Like cholesterol, hypertension is a sign of atherosclerosis, and thus of increased risk for adverse events, but hypertension is not significantly a cause of the adverse events (with one exception:  15% of all strokes result from a hemorrhage; and hypertension increases that risk). 

Outter layer is damaged by sugar or reactive chems
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Drug Treatments 

Anticoagulants:  They are widely prescribed to prevent or treat thrombosis (blood clots), which can damage the brain (stroke), heart (myocardial infarction), lung (pulmonary embolism), and other organs.  With a few exceptions, they aren’t worth the side effects.  Pharma in junk clinical trials exaggerates the risks of thrombi and the benefits of their anticoagulants; their sales mantra is “safe and effective”.  Pharma’s opinion leaders use these junk clinical trials to instruct physicians in the mandated continuing education classes. Anticoagulants are routinely given to those who undergo major surgery, hospitalized over 2 days, or have arrhythmia (irregular heart beat) because of the higher risk of thrombosis. Once out of the hospital this treatment is normally continued.  They aren’t worth the side effects.  A much, much better choice is to take a 325 mg of aspirin in the morning and another in the evening, and it has many other health benefits (see aspirin above).  At this higher dose it is a better long-term anticoagulant for preventing heart attacks and strokes (by about 50%), while the low dose (thank you pharma) becomes ineffective over time because of tolerance to its antiplatelet effect.  At this dose it also slows are stop atherogenesis.   Aspirin also lowers the risk of most cancers overs 40%, and for those with stage I, ii, or iii cancer it lowers the risk of it becoming metastatic by over 40%.  For these reasons pharma educates doctors about a grossly exaggerated risk of major bleeding, while in fact their patented anticoagulants have a much higher risk.  Long term ulcer risk at high dose is 4%.  Healthful life-style of low carbohydrate-sugar diet and strenuous exercise offers significant benefits because a poor flow of blood is the major causal factor for a thrombi forming, and it lower s blood pressure another causal factor for blood clots. 

               

Arrhythmia (irregular heartbeat):  is any of a large and heterogeneous group of conditions in which there is abnormal electrical [nerve] activity in the heart. Although many arrhythmias are not life-threatening, some can cause sudden death.  About half of sudden deaths occur during a major heart attack due to the destruction of heart muscle.  A basic problem with treating an irregular heart beat with drugs is that they are not magic bullets that just work upon the cardiac nerves and muscles.  They inhibit neurotransmitters or the neural balance of minerals; thus upset cognitive and bodily functions.  Arrhythmia is a disease of mostly seniors, especially those who have had a heart attack, and most arrhythmia drugs are on the American Geriatric Society’s avoid list.   Moreover, they don’t stop arrhythmia (just modestly reduce them short term) and long-term cause pro-arrhythmia (drug induced arrhythmia) thus increasing death.  The evidence base for these drugs is broken since pharma does the clinical trials for commercial gain.  Other treatments include physical maneuvers, electricity conversion, and electro or cryocautery are over sold.  Arrhythmia is used as a way to push anticoagulants  medication.  Their long-term usage has serious side effects.  A far better choice is 325 mg of aspirin with meals.  Doctors doing something is not the same as doing good.  For a heart health learn about diet and prevention of atherosclerosis. 

 

Hardening of the arteries (atherosclerosis, cardiovascular disease):  Cardiovascular disease results from reactive chemical damage (especially glycation from sugars) to LDL and VDL (the bad cholesterols) that stimulates an inflammatory response in macrophages (a type of white-blood cell).   They ingest the damaged LDL.  When too much they become foam cells that die to form plaque within the walls of arteries that when sufficient become the medical condition of atherosclerosis.  Leaking plaque cause over 80% of strokes and heart attacks.. Healthful life-style of low carbohydrate-sugar diet and exercise are the first line of defense.  CoQ10 should be taken daily starting in the teen years.  In addition women starting with menopause and continuing thereafter should take the natural estrogen (estradiol), and men starting between 60 and 75 should take testosterone.  There is major cardiovascular protection with estradiol; it is why cardiovascular disease and heart attacks occur following menopause. Men on Testosterone are less likely to develop metabolic syndrome (diabetes, hypertension, and atherosclerosis) and are more likely to survive a heart attack.  Estrogen and Q10 protect LDL and VDL from reactive chemical damage, and aspirin and estrogen inhibit the inflammatory process.  As for Statins:  pharma hypes its benefit and hides their side effects.  Lowering cholesterol has no significant effect upon atherogenesis.  Aspirin, however, in the anti-inflammatory dose of 325 mg with meals or greater prevents atherogenesis, cancer, Alzheimer’s disease, and numerous other conditions.  Thus pharma runs junk clinical trials and educates doctors not to recommend an effective dose of aspirin.  Aspirin, estradiol, and Q10 along with healthful lifestyle and low carb-sugar diet can stop the formation of new plaque, and in most cases over the years there will be a gradual lowering of risk for heart attack and stroke as the body heals through revascularization. 

 

Heart Attacks (MI) and treatments:  “Each year [2005] 1.5 million Americans experience a heart attack and nearly 460,000 are fatal.  Of those who die, almost half die suddenly, before they can get to a hospital” AHA.   As with most acute conditions the list of standard treatments, most are not worth the side effects.   Following the list below when the patient is depending upon the help requires making the doctor aware of who is the ultimate decider.  With MI, there are two phases acute and recovery.  What works:   Because tissue dies quickly, depending on the degree of blockage, the PCI is modestly superior to the thrombolysis (balloon angioplasty compared to clot-busting drug).  The main benefit is within 90 minutes of first symptoms.  After 3 hours neither procedure is worth the risks and side effects (as with all things medical the benefits are greatly oversold and the risks understated).  For arrhythmia there are drugs not worth taking, and physical interventions should be permitted only in the most serious of circumstance.  The drug best interventions are nitroglycerine for angina pain and improved circulation, morphine for pain and sedation, lidocaine for arrhythmia, epinephrine (adrenalin), and aspirin in high dose, up to 2.5 grams per day as blood antiplatelet effect and anti-inflammatory.  All of these things have been attacked by pharma using junk science trials and fed to doctors through pharma’s thought leaders (see).  For recovery the typical well insured patient is treated long-term for a variety of issues that cost on an average over $100,000 per year.  Nearly all of them have better alternatives.  CRITICAL CARE Effectiveness of PCI declines:  it is significantly effective in the first 1.5 hours from first symptoms in lowering the death of heart muscle.  After 3 hours it is not advisable because of considerable risks[1], though guideline state 6 hours.  Thrombolysis (clot-busting drug) has a similar window of effectiveness, though slightly less than PCI.  Synchronized electrical cardioversion can be used to manages major arrhythmia and major tachycardia (fast heart) if lidocaine and morphine are inadequate.  Implantable Cardiovascular Defibrillator (ICD) reduces risk of sudden death.  Again these treatments are given to those who don’t benefit; those with typical, rather than major arrhythmia.  AVOID:  (in order of importance):  downers (psychotropic drug), Protein Pump Inhibitor (PPI), heparin & other blood thinners, high blood pressure medication except if extreme 180 over 110, antiarrhythmics except for lidocaine, and oxygen.  Downers (psychotropic drugs) have many indications such as anti-nauseas, muscle relaxant, sedative. If drowsiness or mental confusion is a side effect, it is probably a downer (or an opiate).  Some have been approved for hypertension.  Drugged, the patient is less likely to inform the nurse of a negative turn in their condition, or resist their doctor’s advice.  PPIs for acid indigestion are addicting.  Instead of heparin or similar anticoagulant promptly take 975 mgs aspirin, followed by one every 4 hours.  Drugs for hypertension other than nitroglycerin do not lower morality Cochrane Library  and many of them are downers.  RECOVERY AVOID:  PPI is given with the anticoagulant, but PPIs are addicting because of the rebound effect, and long-term usage causes serious life-shortening, side effects such as osteoporosis & colitis.  Tums, when needed, is a better choice.  Statins are totally over sold, and are justified only by marketing science.  Counter to their marketing science, they are not cardiovascular protective through they improved the lipid profile and thus are not worth the side effects.   PPI, statin, blood pressure drugs, blood thinner, antiarrhythmics drug therapy, and downer lack quality evidence that proves their net worth and superiority to other choices; yet they are routinely administered in the hospital and nursing home, when the patient is most vulnerable.  Avoid polypharmacy because it multiplies the risk of major side effects.  All too often their side effects are treated with additional drugs.  All side effects are grossly under-reported.  Most drugs started in the hospital and nursing home will be continued long-term. While recovering, avoid both stent and bypass operation, they do not prolong significantly life, though they reduce angina pain.  The vast majority of MIs do not originate with obstructions that narrow arteries" Wiki.  Coronary heart disease is caused by   atherosclerosis, with the young, unstable plaque causing over 80% of the myocardial farctions.  This results from damage to LDL in the artery wall which elicits an immune response.  Thus high level of cholesterol and hypertension are a result of atherogenesis.  Thus the best long-term way to prevent subsequent MI is to prevent damage to LDL and lower the immune response.  This is effectively accomplished by taking 300 mg of CoQ10 and 325 mg of aspirin with each meal.  The natural estradiol 2mg lowers the risk for women of MI by 50%, and testosterone should be taken sufficient dose to raise the serum level to above 500 ng/dL.   Aspirin anti-inflammatory effect prevents at the high dose atherogenesis, while at 325 mg per day lowers risk of blood clots.  CoQ10 is the best of antioxidants.  Unfortunately the physician is not a reliable source of information, his continuing education classes are given by pharma; a pharma that does marketing studies to convince through their opinion leaders that these off-patent drugs are ineffective and dangerous. 

 

Hypertension results atherosclerosis (hard stiff arteries).  The process starts with reactive chemical damage (especially glycation from sugars) to LDL and VDL (the bad cholesterols) that stimulates an inflammatory response in macrophages (a type of white-blood cell).   They ingest the damaged LDL.  When too much they become foam cells that die to form plaque within the walls of arteries that when sufficient become the medical condition of atherosclerosis.  Leaking plaque cause over 80% of strokes and heart attacks.  The best way to prevent or reverse hypertension is to prevent damage to LDL and the inflammatory response.  Hypertension is a sign of atherosclerosis.  Thus lowering blood pressure has little effect upon the cause of strokes and heart attacks—though pharma claims, of course, otherwise.  Except for diuretics, pharma’s drugs to treat hypertension will in general cause the heart to pump with less force or the arteries muscles tissue to relax.  These drugs in combination lower cognitive function and physical strength and thus quality of life—three of them are often prescribed.  If you must take a hypertension drug use a diuretic.  During a heart attack drugs that weaken muscles increase the risk of a fatal outcome.  Moreover, the prestigious Cochrane review concluded that:  “Drugs for mild hypertension have not been proven to benefit patients.” Mild hypertension is a systolic 140-159 and diastolic 90-99.  Given that pharma runs clinical trials and owns the results, bias is the norm; thus the Cochrane conclusion is an understatement. Treating hypertension with pharma’s drug arsenal (over 100 drugs of which 3 are typically prescribed at one time) has serious side effects including drowsiness, cognitive impairment, erectile dysfunction, muscle weakness, and low libido.  Moreover, pharma’s régime of drugs when taken long-term doesn’t extend life.  For example the very popular group of calcium channel blockers cause a “higher mortality rate over extended periods of use” Wiki--see also Worst Pill, and. “Beta-blockers are not recommended as first line treatment for hypertension as compared to placebo due to their modest effect on stroke and no significant reduction in mortality or coronary heart diseaseCochrane.  Beta blockers inhibit CoQ10 (Q10). Ace inhibitors (5th highest selling class of drugs) have similar issues of side effects and likely fail to improve mortality long-term.  Clinical studies are all flawed as to under-reporting of side effects, short duration and thus lack of mortality figures—see Cochrane.  The best  approach (CoQ10, aspirin 325 mg, low carb-sugar diet, and exercise) is the only reasonable choice.  Long term prevention of further development of hardening of the arteries through aspirin 325 mg, Q10, low sugar low starch diet, and estrogen will in most cases result in a gradual lowering of blood pressure, and a significant long-term reduction in mortality.  Follow heart recommendations which treat the cause of HP, atherosclerosis, and those on diet (low carbs and sugars).  This program will permit the body through revascularization to lower blood pressure, eliminate angina, and dramatically lower risk of MI.    Revascularization is a slow process.  

 

Statins and cholesterol:  Cardiovascular disease (CVD) results from reactive chemical damage to LDL and VDL (the bad cholesterols) that stimulates an inflammatory response in macrophages that engulf the damaged LDL.  This result in the formation of foam cells (dead macrophages), which constitute most of plaque.  Macrophages are a type of white blood cell that scavenges damage cells and promote healing.  A lower level of cholesterol doesn’t prevent reactive chemicals from damaging LDL.  The main cause of damage LDL is glycation (a simple sugar attaching to LDL) and reactive chemicals produced from the metabolism of glucose and fructose.  Thus low carb low sugar diet along with regular strenuous exercise is the first line of prevention.  Carbon monoxide from incomplete combustion (especially cigarettes) is another important cause for damaged LDL.  Cholesterol and triglycerides are essential for life.  The liver produces cholesterol and triglycerides (a form of fat) for transport within LDL for blood transport to cells which have LDL receptors.  More packages of LDL are produced to replace the damage LDL, thus damage causes higher level of LDL and its contents.  Lowering cholesterol and triglycerides is a bad idea, for this doesn’t treat the cause of CVD , reactive chemicals and the immune response.  Thus statins don’t protect against coronary artery disease and its deadly consequences.  Several large earlier clinical trials have failed to find significant health benefits from statins—though of course there are later marketing studies that produce positive results.  Statins side effects (especially its negative effects upon cognitive function, sexual activity, and physical energy) make them not worth taking.  Pharma has done marketing (junk)studies to show that statins are safe and effective.  Pharma’s use of continuing education classes taught by their opinion leader to promote sales of statins, hypertension drugs, etc.    In these classes thy say little about side effects, the negative early studies as to prevention of death, storke and heart attacks, or that those with congestive heart failure and the frail die at a higher rate on statins.  The critics lack an effective forum to affect medical practice.   For prevention of CVD the best choices is a low sugar and carb diet, exercise. Strong evidence support taking  CoQ10 300 mg, which prevents oxidative damage to LDL, aspirin 325 with meals for its anti-inflammatory effect, post-menopause women should take the natural estradiol 2 mg (the only effective natural estrogen) plus 100 mg progesterone, and for elderly men topical testosterone 100 mg in a topical lotion.  These hormones and drugs lower the risk for CVD, metabolic syndrome, and the resultant much higher rates for heart attacks and strokes, and have other healthful effects.   The best source for hormones is a compounding pharmacy.  Pharma uses marketing (tobacco) science to discourage the use of these off-patent products.


[1] Cholesterol embolism is very strongly associated with invasive procedures:  20 of 22 patients in a histologically post mortem proven cases.  Cholesterol embolism issues became evident with 3 months, most within 3 weeks, at. This cause of risk is rarely mentioned, and if the adverse event occurs the physician will like attribute it to natural causes, not their invasive treatment!  Moreover, the typical “Anticoagulant therapy appeared to exert an adverse affect” at, and also at, which found warfarin a cause.      


See cholesterol myth.  For those who want to lower cholesterol, the natural way is best:

Niacin family and other natural cholesterol lowering drugs and cardiovascular disease (CVD):  Pharma recommends 1,500 to 3000 mgs of niacin (nicotinic acid) taken with meal; however insulin blocks its cholesterol lowering affect.  High dose causes the unpleasant flushing and thus low compliance.  The only long-term study (niacin usage 6 years and effects followed an additional 9 years) was of high dose niacin.  It produced a reduction in deaths from cardiovascular disease by only 11%.   However, a study based on blood work showed that 200 mgs of either niacin or its inositol formulation taken at bedtime was just as effective at lowering cholesterol, and without flushing.  In the same experiment similar results were obtained with inositol hexanicotinate, a source of niacin.  Niacin also possesses anti-inflammatory and antioxidant benefits, and thus inhibits atherogenesis.  Phenolic substances found in red wine are of value, as is nutritional yeast, red yeast extract, and omega-3 fatty acids (found in fish and fish oil supplement) all reduce risk of CVD.  For lowering cholesterol use 200 to 500 mgs at bedtime of either niacin or inositol hexanicotinate.  The reason niacin only makes a modest reduction in adverse events, and statin even less (once the bias of marketing science has been removed) is because high cholesterol is not the cause of CVD.  But rather it is reactive chemicals that damage LDL and the subsequent immune response.  This has been known for 4 decades and is widely acknowledge in journal and Wikipedia articles.  LDL, cholesterol, and triglycerides are essential for life; and saturated fats are health-wise the best source for energy.  Numerous scientists have exposed the myth about cholesterol and triglycerides that pharma spreads.  Pharma makes billions selling drugs that treat the symptoms of atherosclerosis.   Treating them this way is as effective as treating the fever accompanying the flu with a drug that lowers fever.  They make billions more treating the damage caused by a heart attack.  However, as explained in “Heart Issues”, the most important factor for CVD is the inflammatory response to damaged LDL, for which aspirin and CoQ10, and estradiol for postmenopausal women are truly protective.  Testosterone past the age of 70 lowers risk of MI, heart failure, and metabolic syndrome.  Changes in lifestyle are very effective; especially regular strenuous exercise and eating a low carb low sugar diet.  If you must lower cholesterol, then take 200-500 mg of sustained released niacin or inositol hexanicotinate at bedtime.       

 

 

How can a drug make a damage heart muscle beat the normal pattern?  It can’t!  To give a drug to fix this problem based on a surrogate outcome or improved ECC graph has been shown in the real world population of patients to cause more deaths and heart attacks than those who are not treated.   Nevertheless cardiologists routinely give arrhythmia drugs, they are following guideline. 

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