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  While the bad prostaglandins can make your blood more likely to get sticky, clump together, and cause a stroke or heart attack, good pros-taglandins lower blood pressure, inhibit blood aggregation and the production of cholesterol, and reduce inflammation reactions. Hmmmm. Sounds like “good” prostaglandins provide the same heart benefits that aspirin does—and they do. Much of heart disease has to do with the fact that bad prostaglandins are outweighing good prostaglandins.

  Later in this chapter you’ll find natural alternatives to aspirin that can reduce bad prostaglandins and increase good prostaglandins.

  Natural Alternatives for Treating Heart Disease

  In this section, you’ll find general suggestions for preventing and treating heart disease, angina, and irregular heartbeat, and in the sections on high cholesterol and high blood pressure later in the chapter, you’ll find specific suggestions for treating the underlying causes of these conditions.

  Your number one, most important step in preventing and treating heart disease is to follow the Six Core Principles for Optimal Health. That is your foundation for all-around optimal health. Every single step in the plan is vitally important to a healthy heart.

  Here are some further steps for taking care of your heart.

  Use Alcohol in Moderation

  Moderation is the ideal attitude to have when it comes to drinking alcohol. Studies show that a low alcohol intake, particularly of red wine, protects against heart disease when included as part of a healthy diet. However, even just a bit too much alcohol can bump up blood pressure and help create nutritional deficiencies that increase your risk of heart disease. This is even more true for women than for men.

  Make Garlic a Staple of Your Diet

  Garlic is the herb of legend and myth. It is mentioned in the Bible, in Homer’s Odyssey, and in ancient Chinese texts, and it has been found in the tombs of ancient Egyptians. Now we have dozens of scientific studies to back up the folklore claims for garlic’s prowess in keeping us healthy.

  While garlic may or may not work to ward off vampires, it does a great job at neutralizing three risk factors for heart disease: high blood fats, high blood pressure, and abnormal blood clotting. After raw garlic, the most effective form of garlic appears to be aged extract of organic garlic with a high allicin content, but they all have some beneficial effects.

  Keep Your Fibrinogen Low

  You may not have heard a lot about fibrinogen as a risk for heart disease, but it is a key factor. Fibrinogen is a protein substance found in blood that plays an important role in blood clotting. As with so many substances in the body, having enough fibrinogen is essential to good health, but too much can cause disease.

  In nearly every study done on heart disease, high levels of fibrinogen in the blood were found to be directly related to coronary artery disease, probably by interfering with blood flow. Excess fibrinogen is also related to atrial fibrillation (rapid heartbeat), strokes, intermittent claudication (pain in the legs when walking), and high blood pressure. Reducing fibrinogen levels may be your single best protection against having a stroke. The good news is that most of the factors that raise or lower fibrinogen are the same ones that raise or lower other risk factors for heart disease.

  What Makes Fibrinogen Levels Rise?

  • Psychological and mental stress can increase fibrinogen levels.

  • High blood sugar raises fibrinogen levels.

  • Very high LDL cholesterol levels will raise fibrinogen levels.

  • Excess natural estrogens and the synthetic estrogens found in birth control pills and conventional hormone replacement therapy (HRT) raise fibrinogen levels, which makes it ironic that the pharmaceutical industry was making claims that estrogen prevents heart disease—they are no longer allowed to make this claim. (You will read more about estrogens in Chapter 19 on HRT.)

  • Smoking has a direct effect on raising fibrinogen levels.

  • Obesity significantly raises fibrinogen levels.

  What Lowers Fibrinogen Levels?

  • Exercise is the single biggest factor in lowering fibrinogen levels.

  • A glass of wine with dinner may slightly lower fibrinogen levels.

  • Fish oil supplementation may lower fibrinogen levels.

  • Eating plenty of garlic lowers fibrinogen.

  • Olive oil lowers fibrinogen.

  • Vitamin E lowers fibrinogen.

  • Nattokinase may help lower fibrinogen.

  Nattokinase and Heart Disease

  Natto is a fermented soybean food that the Japanese have been eating for centuries. It’s a cheese-like food with a distinct odor that is definitely an acquired cultural taste, but it may be one of the keys to the low risk of heart disease among the Japanese. In Japanese culture, various foods are often used as medicines, and natto has long been a popular Asian remedy for those suffering from heart disease.

  Nattokinase is an enzyme that is extracted from natto, dried and used as a supplement. It was isolated in the early 1980s by Dr. Hiroyuki Sumi, a Japanese researcher working at the Medical School of the University of Chicago who was looking for a safer medicine that would reduce the blood clots associated with heart attacks and strokes. Subsequent test tube and rodent research has shown that nattokinase powerfully reduces blood clots by, in effect, dissolving fibrin and other substances that promote unhealthy blood clotting. The catch is that in spite of being on the market for many years, no formal, published research has been done with humans showing that nattokinase helps prevent heart attack and stroke. It’s widely used among alternative health care professionals, but it would be nice to have the clinical trials to back up the observed benefits, because it’s an inexpensive, natural, and safe supplement, unlike blood-thinning drugs such as Coumadin (warfarin).

  If you’re taking prescription blood thinners such as heparin or coumarin, talk to your doctor before taking nattokinase.

  Keep Your Homocysteine Low

  In the past few years, it has been very well scientifically documented that high levels of homocysteine, a by-product of metabolism of the amino acid methionine, is an important risk factor in heart disease and strokes associated with narrowed blood vessels. In fact, high homocysteine levels turn out to be a much more accurate marker of heart disease risk than cholesterol or blood pressure.

  Researchers currently believe that excess homocysteine damages blood vessels, so it may turn out to be a primary cause of heart disease and not just an indicator. Homocysteine is an amino acid meant to exist only temporarily in the body. In a healthy body, it’s quickly transformed into harmless substances. If you have a deficiency of certain B vitamins or a genetic predisposition that interferes with the metabolism of homocysteine, your blood levels will rise, and so will your risk of heart disease and stroke.

  Excess homocysteine directly harms the cells that line the insides of the arteries, starting (and encouraging) the process that leads to heart attacks and strokes. In fact, when it’s injected into the arteries of experimental animals, homocysteine causes the linings of those arteries to slough off. Eventually, lesions form that look very much like the clogs that form in the arteries of humans with heart disease. High homocysteine also causes the smooth muscle cells that line the artery walls to multiply, thickening them and making them less flexible. It interferes with the activity of blood components that prevent excessive blood clotting, and this sets the stage for clots that can plug up narrowed blood vessels, causing heart attacks, strokes, or thromboembolism (blood clot in the lungs). Excess homocysteine also prevents small arteries from dilating to allow more blood to flow through; it encourages the oxidation of LDL cholesterol, making this “bad” type of cholesterol even more dangerous to blood vessel health; and it generates free radicals. Antioxidants help significantly in reducing the amount of bad cholesterol in the blood, but if homocysteine levels remain high, the damage to arterial walls will continue.

  According to a study done at Tufts University School of Medicine in Boston, if your h
omocysteine levels are just 20 percent above normal, your risk of cardiovascular disease is significantly increased. If your physician wants to measure your homocysteine levels, you should know that a normal homocysteine level is about 12 micro-moles per liter (mmol/L), and cardiovascular risk increases at about 14 to 16 mmol/L.

  The case for high homocysteine as a significant risk factor for heart disease has become incontrovertible. In fact, it’s just as significant—if not more so—than cholesterol levels. One researcher states that homocysteine levels are up to 40 times better at indicating cardiovascular disease risk than cholesterol levels. (Of course, the drug companies can’t make nearly as much money selling B vitamin supplements as they can selling statins, so we don’t anticipate any major shift from the focus on cholesterol control anytime soon.)

  Here are a few examples of the latest studies on the homocysteine–heart disease link:

  • In one study, 131 subjects—each with one blocked coronary artery—were compared with about the same number of control subjects who were free of heart disease. With every 10 percent elevation in homocysteine levels came a 10 percent elevation in risk of developing severe coronary artery disease.

  • A study of postmenopausal women found that elevations in homocysteine led to a higher incidence of coronary artery disease.

  • In a study of people who developed deep vein blood clots, researchers found that subjects who developed them had much higher homocysteine levels than those who didn’t.

  • A study of 21,500 men between the ages of 35 and 64 found that those with the highest homocysteine (more than 15 mmol/L) were about three times more likely to die of heart disease.

  • In another study, 587 men with confirmed heart disease had their homocysteine levels measured and were then followed for 4.6 years. Sixty-four of them died. Of those 64, 3.8 percent had homocysteine levels below 9 mmol/L; 8.6 percent had levels between 9 and 14.9; and 25 percent had levels of 15 or greater.

  • In a study published in the New England Journal of Medicine, researchers evaluated the effects of homocysteine-lowering folic acid, B12, and B6 on artery narrowing in men who had required angioplasty to open up at least one clogged heart vessel. The men who took the supplements had lower homocysteine levels after six months, and their arteries were only half as likely to renarrow following their angioplasties.

  One much-feared disease that is thought to be related to high homocysteine levels is Alzheimer’s disease. This makes sense, because it’s likely that the brain deterioration seen with this disease has something to do with the deterioration of blood vessels that feed brain tissues. In a study from Tufts University, researchers measured homocysteine levels in 1,092 subjects over a span of about a decade. Their average age was 76, and none of them had dementia. Eight years later, 111 of them had developed dementia, 83 of them from Alzheimer’s disease. (In a few cases, dementia was caused by stroke or other vascular diseases that harm brain tissue.) When the researchers looked back at the homocysteine measurements they had taken, they found that those with homocysteine levels above 14 mmol/L were twice as likely to have developed Alzheimer’s several years later than those with average levels. Those who had elevated levels come back from both tests were at the most risk. Milder elevations in homocysteine also caused risk to rise, but not as much. They concluded that if homocysteine were removed from the risk equation for Alzheimer’s, 15 percent of cases would be prevented. As baby boomers age, this percentage would add up to tens of thousands of people.

  Some drugs can cause high homocysteine levels, particularly those that interfere with folic acid, such as methotrexate, an immunosuppressive drug given to cancer, rheumatoid arthritis, and psoriasis patients; the anticonvulsant drugs phenytoin (Dilantin) and carbamazepine (Tegretol, Epitol); and the bile acid sequestrants for lowering cholesterol levels, cholestipol (Colestid) and cholestyramine (Questran). It’s ironic that these cholesterol-lowering drugs, given to reduce heart disease, may actually cause it by raising homocysteine levels!

  Other research has shown that homocysteine levels rise when daily folic acid intake is 200 mcg (micrograms) per day or less. This is a typical example of how inadequate the Recommended Daily Allowance (RDA) amounts are, because the current RDA for folate is 200 mcg.

  Fortunately for nearly everyone, homocysteine can be easily and inexpensively lowered by taking some B vitamins. If you’re taking a daily multivitamin that includes 400 mcg of folic acid, 50 mg of vitamin B6, and 1,000 mcg of vitamin B12, you should be covered. If your homocysteine levels are high, you should be getting an additional 200 mg daily of vitamin B6 (pyridoxine) and 1 to 4 mg of folic acid daily until your homocysteine levels are back to normal.

  Since a deficiency of vitamin B12 can also indirectly raise homocysteine levels, and since a high intake of folic acid can mask a vitamin B12 deficiency, make sure your intake of vitamin B12 is at least 1,000 mcg per day. Vitamin B12 is best taken sublingually (under the tongue) or as a nasal gel or spray. Low thyroid levels and excess alcohol can also raise homocysteine levels.

  If your doctor asks you to get blood tests for heart disease, be sure to ask him or her to include homocysteine.

  Keep Your C-Reactive Protein Low, Too

  Inflammation is a necessary part of the immune system’s response to infection or injury. It leads to the development of redness, heat, and swelling, and if it’s properly controlled by the body, it breaks down damaged tissues and makes way for new, healthy tissue. In a body where prostaglandins are chronically out of balance, inflammation can easily run amok, harming healthy tissues.

  Measuring the levels of a substance called C-reactive protein accurately indicates the amount of inflammatory activity going on deep within the body. Several studies involving tens of thousands of people have strongly linked high levels of C-reactive protein—a natural part of the inflammatory response—with increased risk of dying of a heart attack. This connection makes good sense, because the formation of plaques in arteries involves inflammation, and high levels of inflammation have been found to make plaques prone to rupture or pinch off clots that can then clog arteries. It also makes sense because obesity, smoking, high blood pressure, and chronic periodontal disease all increase both cardiac risk and C-reactive protein levels. Some experts believe that the effects of statins, aspirin, and other nonsteroidal anti-inflammatory drugs (NSAIDs) on heart disease risk have more to do with their effects on inflammation than with their effects on cholesterol or blood clotting. The synthetic estrogens used in conventional HRT also increase C-reactive protein, which may explain why they don’t help prevent heart disease. An article about C-reactive protein in the New England Journal of Medicine concluded, “. . . C-reactive protein level is a stronger predictor of cardiovascular events than the LDL cholesterol level.”

  Like other so-called cardiac “risk factors,” high C-reactive protein is more an indicator of heart disease than a cause. To keep inflammation and C-reactive protein under control, balance your prostaglandins, shed excess pounds, and control high blood pressure (for more on how to do this, keep reading). Vitamin E and fish oil supplements can help lower C-reactive protein.

  Get Plenty of Magnesium

  Arnold is a fairly healthy guy in his mid-sixties who wound up in a hospital emergency room in the middle of the night, frightened and in pain, wondering if he was having a heart attack. It turned out he was suffering from a type of angina that causes spasms of the heart muscle. After giving him some drugs and monitoring him for a few hours, the doctors sent him home that night, telling him to make an appointment with his physician.

  A few weeks later, Arnold’s angina pain was returning, and his physician wanted to put him on a drug called a beta-blocker. Now Arnold takes pretty good care of himself (he does have a weakness for good ice cream), hates going to the physician, and really dislikes taking drugs. Finally he got the name of a physician using alternative health care approaches, who gave him some intravenous magnesium and prescribed a daily magnesium supplement. Not on
ly did Arnold’s angina pain totally disappear after the intravenous magnesium, but his energy level was higher than it had been in years. This was a happy guy!

  The essential mineral that’s the biggest key to prevention and treatment of heart disease is magnesium. Several recent studies have shown that if people who come into an emergency room with a heart attack are given intravenous magnesium right away, their chances of survival go way up, and if they continue to receive it, their survival rate continues to improve. It has been shown to help with angina and to improve the symptoms of congestive heart failure (CHF).

  Magnesium works on several levels to keep the heart in good working order:

  • Prevents muscle spasms. According to several Japanese studies published in the American Journal of Cardiology, the oxygen deficiency and spasms caused by magnesium deficiency narrows the coronary arteries, leading to angina. A great deal of angina pain could be relieved simply by bringing magnesium levels up to normal.

  • Keeps blood flowing smoothly. Magnesium helps keep the blood from getting “sticky,” a condition that can contribute to having a stroke.

  • Keeps cholesterol under control. Another Japanese study found that patients with low HDL (“good”) cholesterol had low magnesium levels and when they took magnesium supplements their HDL levels increased. In addition, animal studies have shown that when magnesium is deficient, the amount of oxidized LDL cholesterol increases, with a corresponding increase in arterial damage.