Heart Disease: Beyond Cholesterol

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Atherosclerotic cardiovascular disease (ASCVD) is the biggest killer in North America.

Despite quitting smoking campaigns, public education on heart disease, and targeted medical therapies, ASCVD continues to rise.

For well over 30 years, drugs in the class of ‘statins’ have been prescribed in increasing amounts to lower the risk of heart disease. If your LDL-C is elevated, your doctor prescribes you a drug to lower your cholesterol. This is a billion-dollar industry.

Since 2020, Heart disease has increased by 29%. It kills more women than breast cancer, and more men than prostate cancer, and by far is the most important disease shortening lifespan in the modern world.

What are we missing?

  1. Heart-healthy foods are not healthy.

Numerous studies show that processed foods increase chronic disease. Regardless of the labels and advertising, cereal and margarine are not healthy. 

Eat real food in the form it occurs in nature.

Focus on high-quality protein and vegetables primarily and good fats which include butter, olive oil, coconut oil, nuts, and seeds.

Other risk factors of high priority that will lower your risk for atherosclerotic cardiovascular disease (ASCVD) are

  • Nonsmoking status
  • Avoid prolonged sitting: move often.
  • Build up your cardiovascular fitness with regular exercise (both aerobic exercise and muscle mass)
  1. Toxins.

Many studies have emerged linking environmental pollutants and heavy metals to increased risk of heart disease.

Endocrine-disrupting chemicals (EDCs): be aware of where these are found.

Use the Environmental Working Group website (www.ewg.org ) as a resource to check the ingredients in your home care, body care, food, and beyond.

We recommend daily attention to toxic burdens. This means lowering your exposure as much as possible and increasing the body’s elimination of toxins that you continue to be exposed to, and those that have built up in your body.

Lead (a heavy metal that has no safe or acceptable range in the human body) and mercury are 2 common heavy metals implicated in increasing your heart disease risk.

For decades, ‘alternative’ doctors have performed chelation on patients to lower the risk of heart disease, 

Lowering toxic heavy metals is a complex process requiring medical supervision. Testing blood levels is ineffective to detect a body’s burden of lead and mercury.

  1. Lipid particle size:

If cholesterol levels are the only thing implicated in heart disease then statin drug therapy would be an effective tool and we should see a reduction in heart disease.

Each component of your cholesterol panel is important. There is no ‘good cholesterol’ and ‘bad cholesterol’.

HDL-C levels can be elevated and still cause heart disease.

It is especially important in women, particularly older women, who can have high levels of HDL-C which are dysfunctional. This is still atherogenic (causing plaque formation). The only way to test this is to have a Lipid Particle Analysis.

Similarly, LDL-C can appear in the normal range and still increase atherogenesis (the formation of cholesterol plaques in your blood vessels). When there is an increase in the dense, small particles of HDL-C and LDL-C, your risk is elevated.

Consider cholesterol panel particles as large and fluffy or small and dense. Whether it is LDL-C or HDL-C, small dense particles can penetrate the endothelium (lining) of your blood vessels which leads to increased plaque formation and atherosclerotic cardiovascular disease (ASCVD). 

Another important test for understanding your cholesterol is looking at lipoproteins. This panel can be added to your Lipid Particle Analysis to understand your risk further.

Understanding cholesterol and heart disease risk is complex. Other tests to further understand the depth of your risk 

Other tests: in addition to your lipid particle analysis, to fully understand your risk include

– Coronary Artery Calcium Score (CAC): this test tells you about the calcification of plaque that is forming in your blood vessels. This is later-stage disease.

– CT angiogram: A test that is useful to view the arteries and diameter. Between this test and the CAC, a patient can fully understand the extent of the disease and decide on further preventative measures.

Oxidized LDL: When LDL-C is oxidised, it is inflammatory and implicated in the formation of plaque in your coronary blood vessels/ ASCVD. 

ADMA is a chemical found in your blood that can indicate lowered nitric oxide in your heart vessel endothelium. Nitric oxide is an essential molecule for endothelial health.

MPO (myeloperoxidase) is a molecule that can indicate vulnerable plaque at risk of rupturing.

Lp-PLA2 activity may help identify active cholesterol buildup inside our blood vessel walls.

These latter 3 tests can assist further in identifying an elevated risk for ASCVD regardless of your cholesterol levels.



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