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Hormone Deficiency  |  Hormone Therapy's Cardiac Benefits  |  Biochemical Nutritional Testing  |  Chelation Therapy  |  Supplements for Cardic Health  |  Research on Cardic Supplements

Cardiovascular Disease

Our comprehensive approach to improving cardiovascular health includes individualized Hormonal Replacement Therapy, Biochemical Nutritional Testing and Therapy and EDTA Chelation Therapy. We also offer a non-invasive office test ( "ASI", Arterial Stiffness Index) to assess the degree or arteriosclerosis in the arterial system. We also recommend certain cardiac nutritional supplements to help maintain cardiac health and provide selected research to support these recommendations

Medical research has demonstrated a definitive cause and effect relationship between hormone deficiencies and cardiovascular disease. The identification and treatment of age-related hormone deficiencies is an essential step to restoring health to the cardiovascular system.

Medical research has also uncovered the link between certain serum risk factors and the development of cardiovascular disease.

Biochemical Nutritional Testing

Unhealthy levels of the serum risk factors Lp(a), fibrinogen, C-Reactive protein, LDL, fibrinogen, homocysteine and Apoprotein-A have been found to be contributory to the development of cardiovascular disease. These risk factors can be normalized with nutritional therapy. By identifying and treating these risk factors nutritionally one can neutralize the contribution these risk factors make toward the progression of heart disease.

In addition to slowing the progession of disease biochemically with hormonal and nutritional medicines, one can simultaenously improve the health of the entire circulatory system with intravenous EDTA chelation therapy.

This comprehensive approach of curing hormone deficiencies, neutralizing biochemical/nutritional risk factors while undergoing chelation therapy improves the health and vitality of the whole body and mind while it treats the problems of the cardiovascular system.

Hormonal deficiencies have been shown to contribute significantly to the development of heart disease. Men and women develop hormonal deficiencies, as a result of the aging process, that contribute to the development of heart disease.

Identifying these deficiencies and treating them can result in a much healthier, better functioning body and mind. Optimizing levels of Growth Hormone, Testosterone, Thyroid, DHEA and Melatonin, all of which decrease as we age, can dramatically improve the function of the heart, the circulatory system as it restores health and vitality to the whole body-mind system..

Growth Hormone Deficiency

Research has shown that treating HGH deficiency increases cardiovascular function, improves lipid profiles, reverses atherosclerosis and reduces carotid intima thickening.

In a review study*tes of the effects of HGH deficiency, the authors discuss the effects of HGH deficiency on cardiovascular function:

Rosen et al. (76) compared known cardiovascular risk factors in 104 adults with GH deficiency with healthy controls from a population study. The patients had a higher body mass index, higher plasma triglycerides (TG), and lower high density lipoprotein cholesterol (HDL-C). In addition, there was a higher incidence of hypertension in the GH-deficient subjects compared with controls.

The mechanisms responsible for the increased cardiovascular mortality remain largely unknown, but carotid artery ultrasonography has demonstrated increased intima-medial thickening and intimal plaque formation (77) and reduced arterial compliance (78) in hypopituitary adults. Johannson et al. (79) compared levels of plasminogen activator inhibitor-1, fibrinogen, blood lipids, and blood pressure in 20 adults with GH deficiency with those in healthy subjects. The patients had increased TG, plasminogen activator inhibitor-1 activity, and fibrinogen compared with controls. These changes contribute to increased artherogenic propensity and cardiovascular disease.

Two studies comparing echocardiographic findings have demonstrated reduced left ventricular mass and impaired systolic function in adults with GH deficiency compared with healthy controls. Treatment with GH for 6 months normalized these indexes, and 6 months after cessation of therapy, cardiac function had returned to baseline. Six months of GH replacement have been shown to increase left ventricular mass (18%), stroke volume (28%), and cardiac output (43%) and reduce peripheral vascular resistance (84) in GH-deficient adults. A sustained effect on cardiac performance has been reported in two open studies up to 3 yr after commencement of GH therapy.
Cuocolo et al. studied cardiac function in 14 adults with GH deficiency and 12 matched controls using radionuclide scanning. The GH-deficient patients were studied before and after GH replacement. Compared with controls, the patients had decreased left ventricular ejection fraction, decreased stroke volume index, and decreased cardiac index. GH therapy for 6 months increased these variables, reversing these deficits in cardiac function.

In summary, patients with long standing GH deficiency have reduced life expectancy, largely related to increased mortality from cardiovascular disease. GH deficiency results in smaller left ventricular size and impaired ventricular function. These changes can be reversed by GH replacement and sustained benefit is seen up to 3 yr after commencement of GH therapy.

*(Growth Hormone Deficiency in Adulthood and the Effects of Growth Hormone Replacement: A Review, The Journal of Clinical Endocrinology & Metabolism, February 1998, p. 382-395)

Testosterone

Low testosterone correlates with heart disease much more reliably than does high cholesterol. Optimizing age-related deficiencies of Testosterone improves heart disease.

Testosterone strengthens the heart muscle. There are more testosterone receptors in the heart than in any other muscle. Testosterone lowers LDL cholesterol and total cholesterol and improves cardiac risk factors. It lowers the genetically caused elevation in the biochemical risk facor Lp (a).

Most importantly, testosterone therapy improves circulation to the heart and the rest of the body. In general, low levels of testosterone are associated with coronary heart disease, and oral doses improve angina pectoris in patients with coronary heart disease.

Testosterone also functions as a blood thinner, preventing blood clots . In women, estrogen replacement has been shown to improve endothelium-dependent vasodilation of coronary arteries in women, perhaps due to its antioxidant properties. This exerts a beneficial effect on cardiovascular function.

Research has demonstrated that higher levels of testosterone conferred a protective ratio against atherosclerotic coronary artery disease (ASCAD) of greater than five-fold in men. Phillips, et al. reported an inverse correlation between free testosterone levels and both the degree of coronary artery disease and the various risk factors for myocardial infarction.

Chronically low testosterone levels, they concluded, may actually precede—and thus in part precipitate—coronary artery disease and thrombosis in men."A normal physiological level of testosterone may protect against the development of hyperlipidaemia, hyperinsulinism, hypertension, thrombophilic tendency, obesity and increased waist-hip ratio," echoed British cardiologists in the Quarterly Journal of Medicine, "The decline of testosterone with age may partly explain the greater risk of CAD with advancing years." They emphasize the importance of identifying young men with relative hypogonadism, who are at increased risk of premature CAD. These patients may only exhibit symptoms of fatigue and depression, while "the true diagnosis is unsuspected and undiagnosed."

This recommendation is supported by a cross-sectional study of South African Indian men, which revealed lower testosterone levels in younger men with pre-mature coronary artery disease. A variety of physiological mechanisms may explain the associations between testosterone imbalances and the pathogenesis of coronary disease, myocardial infarction, stroke, in addition to testosterone’s ability to modulate lipid and glucose factors.

Low testosterone is linked to higher levels of fibrinogen and plasminogen activator inhibitor, which play a crucial role in blood viscosity, plaque formation, and platelet aggregation. Experimental studies also show testosterone capable of triggering vasodilation of the arteries—a relaxant effect believed to have a beneficial impact on angina and other cardiovascular impairments. Testosterone deficiency has been called the "primary event" contributing to the development of insulin resistance, diabetes, myocardial infarction and stroke. Low testosterone levels independently predict the likelihood of developing diabetes, and restoring depleted levels has been shown to improve insulin resistance.

Thyroid

Correcting low thyroid levels can normalize cholesterol and triglyceride, lower blood pressure and decrease LDL and Lp(a). Low thyroid levels is a risk factor for premature coronary artery disease. A recent study showed that women with untreated low thyroid levels are twice as likely to have a heart attack as women with normal thyroid levels.

DHEA

Experimental evidence suggests that DHEA inhibits the process of atherosclerosis, the progressive build-up of fat sludge inside the arteries, in animals fed a cholesterol-rich diet.

The effects in humans seem less clear, but most studies on men associate low circulating levels of DHEA with an increased risk of heart disease.

This would support certain metabolic relationships observed in relation to DHEA in men: Low DHEA levels have been linked to increased body fat, obesity, and hyperinsulinemia, well-known risk factors for cardiovascular disease. Lower levels of DHEA are also linked with increased incidence of blood vessel diseases in heart patients receiving bypass grafts.

Melatonin

A decrease in melatonin causes increased night-time sympathetic activity, which in turn is linked to coronary disease. One study found that patients with coronary heart disease had nocturnal melatonin levels five times lower than in healthy controls. Investigators surmised that lower levels of melatonin may act to increase circulating epinephrine and norepinephrine.

Atherogenic uptake of LDL cholesterol is accelerated by these hormones at high concentrations. Laboratory research has shown that melatonin treatment also exerts the beneficial effect of increasing the HDL/LDL ratio, possibly by enhancing the body's cholesterol clearance mechanisms. In addition, melatonin appears to inhibit platelet aggregation (blood clotting), which plays a significant role in the progression of cardiovascular disease.

Identifying and treating age-related and/or genetically caused hormonal deficiencies can be a powerful natural approach to treating heart disease.

Hormonal Therapy’s Cardiac Benefits (Selected Research)

HGH……A Study from the NIH ( US National Institute of Health)

PHYSIOLOGY OF GROWTH HORMONE DECLINE IN AGING: CURRENT CONCEPTS AND LESSONS FROM THE NIA/NIH CLINICAL TRIAL AT JOHNS HOPKINS. MR. Blackman, M.F. Bellantoni, J. Busby-Whitehead, T. Stevens, K.G. O'Connor, J. Jayme, C. Christmas, T. Munzer, J. Edmond, T.J. Marcell, E. Cottrell, K. Stewart, J.D. Tobin, T.A. Roy, E. Shapiro, P. Hees, B. Hurley, F.M. Ivey, C. St. Clair, K. Pabst, J.D. Sorkin, and S.M. Harman. Johns Hopkins Medical Institutions and Intramural Research Program, NIA, NIH, Baltimore, MD 21224.

Normal aging is often accompanied by a gradual decline in various physiological functions, which in some people results in physical impairments, and may lead to disabilities, which worsen the quality of life and limit independence. Normal aging is also frequently associated with reduced circulating levels of GH, IGF-I, and sex steroids; decreased muscle mass and strength; and increased total and intra-abdominal fat. Treatment with recombinant human GH or sex steroids can improve body composition in some older persons, yet the effects of such hormonal treatment (singly or in combination) on various physiological functions remain to be defined. We hypothesized that age-related decreases in GH, IGF-1 and sex steroids separately and interactively contribute to diminished skeletal muscle mass and strength, increased total and abdominal body fat, and reduced aerobic capacity in elderly women and men; and that restitution of normal GH, IGF-I and sex steroid status by combined hormone therapy would exert additive or synergistic effects to increase muscle mass and strength, decrease total and intra-abdominal fat, and increase aerobic capacity. We have recently completed a placebo-controlled, double-masked, randomized study in 125 healthy, ambulatory, community-dwelling women (n=53) and men (n=72) ages 65-88 y (mean 72 y), with low baseline IGF-1 and sex steroid levels to determine whether 6-months of administration of GH alone, sex steroids alone (Estradermฎ + Proveraฎ = HRT in women, or testosterone enanthate = TE in men), or combined GH plus sex steroids would increase or improve skeletal muscle mass, strength, and total body protein synthesis; decrease total and abdominal fat; and improve aerobic capacity and cardiovascular function, as well as selected endocrine, metabolic, immunological, dermatological, and psychobehavioral outcomes. We also assessed mRNAs for GH, IGF-1 and androgen receptors, and IGF-I, by PCR in skeletal muscle biopsy specimens. Within one month of administration of active hormone(s), serum levels of IGF-1 (men and women), T (men) and E2 (women) increased to values seen in healthy young adults, where they remained for the rest of the study. GH and sex steroid administration each significantly increased lean body mass (LBM) by DEXA, with the increase after GH+TE > after GH or TE alone. GH and/or sex steroid augmented aerobic capacity, expressed as V02max/kg body weight. GH decreased body fat, with no preference for visceral vs subcutaneous depots. In women, no additional effect on fat was seen with HRT. In men, TE produced an added lipolytic effect. GH related fat loss was accompanied by reduced serum leptin and LDL cholesterol, no effects on HDL cholesterol, and increased triglycerides. Neither HRT nor T influenced GH-related reductions in cholesterol……... These data suggest that supplementing GH in older persons is a promising strategy to counter sarcopenia and to reduce cardiovascular risk. Concomitant sex steroid replacement may provide additional benefits, especially in men. New strategies are needed to optimize the benefit/risk ratio associated with GH and/or sex steroid supplementation in the elderly.

Testosterone

Testosterone Patches Improve Exercise Capacity in Men With Angina

TORONTO, Jun 22,2000 (Reuters Health) - Improving the quality of life and exercise performance in men with stable angina might be as simple as getting them to wear testosterone patches, Dr. Katherine M. English said here at the annual meeting of the Endocrine Society.

Dr. English, a research fellow at the Royal Hallamshire Hospital in Sheffield, England, pointed out that there have been fears that increased testosterone levels increase the risk of heart disease and prostate cancer. But studies in recent years have indicated that not only are low testosterone levels common in men with angina, but low levels may actually be a risk factor.

Testosterone levels drop as a part of the male aging process, and it may be that levels that drop below a certain point are too low, she said. In addition, studies of castrated animals show that the lowered resulting androgen levels are associated with greater atheroma formation.

To investigate, Dr. English and colleagues randomized 46 men with chronic stable angina to wear either active testosterone patches, each of which contained 2.5 mg of testosterone, or placebo patches. The men wore two patches each day for 12 weeks.

They underwent exercise testing at baseline, then again at 4 and 12 weeks into the study. They were also asked to fill out quality-of-life questionnaires. The researchers found that there was a significantly greater improvement in exercise tolerance among the men who wore the active patches, compared with those who had used placebo. They also reported superior quality-of-life scores.

The improvement seen in men wearing active patches may be caused by a vasodilatory effect of the male hormone, "which may improve the blood supply to the myocardium, thereby reducing symptoms of angina," Dr. English said.

Association between plasma total testosterone and cardiovascular risk factors in healthy adult men: The Telecom Study.

Authors:
Simon D , Charles MA
J Clin Endocrinol Metab 1997 Feb;82(2):682-5

Abstract: The associations between androgens and cardiovascular risk factors in men are controversial. A nested case-control study was used to compare the levels of cardiovascular risk factors in two groups (n = 25 each) of healthy men contrasted by their plasma total testosterone concentration, matched by age and ethnic origin.
Compared to the men with normal plasma total testosterone(mean +/- SEM, 19.8 +/- 0.7 nmol/L), the men with low plasma total testosterone(10.1 +/- 0.3 nmol/L) had a significantly higher body mass index (P < 0.01), waist/hip ratio (P < 0.001), systolic blood pressure (P < 0.05), fasting and 2-h plasma glucose (P < 0.04 and P < 0.02 respectively), serum triglycerides (P < 0.001), total cholesterol (P < 0.04), low density lipoprotein cholesterol (P < 0.01), apolipoprotein B (P < 0.01), fasting and 2-h
plasma insulin (both P < 0.0001), and lower values of serum high density lipoprotein cholesterol (P < 0.01) and apolipoprotein AI (P < 0.05)

Thyroid Problems up Heart Attack Risk in Elderly Women

NEW YORK, Feb 15 (Reuters Health) -- Older women who have a reduction in thyroid function -- but no obvious signs of the problem -- are at increased risk of heart disease and heart attacks, study findings suggest.

A reduction in thyroid function, known as hypothyroidism, is characterized by low metabolism, weight gain, dry skin, and mental and physical lethargy. There is also an increase in cholesterol and blood pressure, and consequently, the risk of heart disease.

A less severe condition known as subclinical hypothyroidism occurs in 10% of women in their 60s and 70s, and appears to increase the risk of heart disease, according to a report in the February 15th issue of Annals of Internal Medicine. In subclinical hypothyroidism, patients have signs of thyroid malfunction on blood tests, but do not experience any obvious symptoms.

"Our results show that subclinical hypothyroidism is highly prevalent among elderly women and is associated with a greater frequency" of heart disease and heart attacks, write Dr. Jacqueline C.M. Witteman and colleagues at Erasmus University Medical School in Rotterdam, the Netherlands.

In the study of more than 1,000 women with an average age of 69, the investigators found that about 124 women had subclinical hypothyroidism. These women were more likely to have a history of heart attack or a build-up of fatty plaque in the aorta, the largest artery in the body, Witteman and colleagues report. The presence of such plaques in the aorta is thought to be an indicator of heart disease, a clogging in the arteries supplying the heart with blood.

The researchers estimate that subclinical hypothyroidism was the cause of 14% of all heart attacks in the study sample, a contribution just slightly less than other major risk factors, such as high cholesterol, smoking, high blood pressure, and diabetes.

"Subsequent studies," Witteman and colleagues suggest, "may focus on the effectiveness of possible therapies for subclinical hypothyroidism in elderly women and the desirability of screening such women for this disorder."
Annals of Internal Medicine 2000;132:270-278.

Biochemical Nutritional Testing

Recent medical research has uncovered a host of predictive serum risk factors more sensitive than the traditional checking of total cholesterol, HDL and LDL. The most complete panel of biochemical serum risk factors for atherosclerosis include low HDL and unhealthy levels of LDL, Lipoprotein-A, Apo-protein A, Apo-protein B, Homocysteine, Fibrinogen and C-Reactive Protein. These risk factors can be assessed with a single blood test.

If the blood test shows the presence of dangerous amounts of any of these biochemical risk factors, they can be treated effectively with nutritional supplements and herbal extracts. By eliminating the contribution of disease producing processes, one can treat heart disease at its biochemical genesis.

The combination of treating biochemical risk factors and hormonal deficiencies is a very effective natural method to treat atherosclerosis and can be life saving.

However, unless one does the appropriate tests, one will never identify, diagnose and be able to treat the hormonal deficiencies and biochemical imbalances that are promoting heart disease.

Chelation Therapy

In addition to biochemical and hormonal treatments, chelation therapy, an intravenous therapy, has been successfully used to safely treat hundreds of thousands of Americans with arteriosclerosis. Arteriosclerosis, or hardening of the arteries, is usually not limited to the coronary arteries but is invariably a systemic condition compromising the blood flow to the brain and the legs also.

Chelation works to improve circulation to the entire body. Unfortunately, traditional bypass surgery and angioplasty only treat a few inches of the circulatory system, which is miles long.

This treatment, besides addressing only a small portion of the circulatory system, only treats it temporarily. If one does not treat the cause of the arteriosclerosis it will continue to progress and necessitate repeat surgeries.

For more information on chelation therapy , please visit Dr. Cranton’s excellent website: www.drcranton.com

Unless the progression of the disease process is reversed, the need for further bypasses and angioplasties is inevitable. In addition to exercise and improving diet , the combination of biochemical, hormonal and intravenous therapy is the most effective natural way to treat and cure heart disease at the root cause.

Identifying cardiovascular disease in the asymptomatic patient

With patients who are asymptomatic, it is valuable to determine whether there is a silent pathological process in the blood flow to the heart that is threatening to produce future heart attack. Cardiovascular and cerebral vascular and peripheral arterial diseases are slow developing silent disease processes before they progress to the stage where they cause symptoms. All too often the first symptom is a heart attack or a stroke, which causes irreversible heart and brain damage. It is very helpful to be able to identify the presence of these disease processes before they cause irreversible damage. Identifying the problem is the first step in addressing it.

The Arterial Stiffness Index Test,

A new noninvasive office test, approved by the FDA, measures the flexibility of the brachial artery. (http://www.healthandage.com/publi/0103020129/p4.htm) If this computerized Arterial Stiffness Test identifies a lack of flexibility in the artery caused by the presence of arteriosclerosis or "hardening of the arteries", the patient has the benefit of taking care of a potentially dangerous condition, before it causes damage to the heart or brain.

This hi-tech test is as easy as having ones blood pressure taken and takes less than 5 minutes to administer. Because the Arterial Stiffness Test is noninvasive, inexpensive and easy to administer, it is also a useful monitoring tool to track the success of therapies such as chelation and hormone replacement therapy which are designed to improve the lack of adequate circulation, which characterizes cerebrovascular, cardiovascular and peripheral arterial disease.

ASI references

Hirai T, Sasayama S, Kawasaki T, Yagi S. Stiffness of systemic arteries in patients with myocardial infarction. Circulation 1989;80:78-86.

Lehmann E. Pulse wave velocity as a marker of vascular disease. Lancet 1996;348:744.

Dart AM, Cameron JD. Effects of coronary risk factors on aortic and arterial properties in man. In: Boudoulas H, Toutouzas PK, Wooley CF, editors. Functional Abnormalities of
the Aorta. New York: Futura, 1996:353-64.

Ultra-fast CT scan

An ultra-fast CT-scan, a new technology which visualizes calcium deposits in the arteries supplying the heart, can assess the health of the arterial system non-invasively. The presence of significant and dangerous levels of plaque in the blood vessels supplying the heart is related to the amount of calcium visualized in the arterial system . Since coronary artery disease often does not produce any symptoms before a heart attack occurs, this is another test to assess the value of early preventative measures. If a patient has the benefit of knowing that he/she has a silent ongoing progressive disease process, it allows us to intervene before a catastrophic event occurs.

It is not safe to assume that being in shape or being able to run many miles means that you are free of heart disease. Jim Fixx, the marathon runner, was unfortunately unaware he had a significant buildup of plaque in his coronary arteries. He was able to run and win marathons, passing these extreme "stress tests" without symptoms. His first symptom of his silent heart disease was a fatal heart attack

It is much wiser to identify and treat heart disease before it starts to produce life-threatening problems. Heart disease is a progressive condition, which develops gradually over time. Autopsies of Vietnam War casualties showed the presence of heart disease in men in their late teens. The sooner a problem is addressed, the easier it is to treat and reverse.

Supplements for Cardiac Health

Lipotain (guggul and inositol hexaniacinate)
Ultra EPA-DHA (uncontaminated fish oils)
Unique E ( The best full- spectrum E available)
Methoxy-Flavone (Vit C and Bioflavanoids)
Multigenics Intensive Care (multi vitamin-mineral)
CoQ10-ST (A stable therapeutic C0 Q-10)
Cyto-redoxin (anti-oxidant mixture)
Magnesium Glycinate (Magnesium that does not upset the GI tract)
Vascutone (Hawthorn and synergistic herbs)
Super Garlic (Has a blood thinning effect and anti-oxidant effect)
Ginkgo-Roseox (improves circulation and has blood thinning effects)

Research on Cardiac Supplements

Guggul significantly lowers serum triglycerides and cholesterol as well as LDL and VLDL cholesterols (the "bad" cholesterols. At the same time, it raises levels of HDL cholesterol (the "good" cholesterol). As antioxidants, guggulsterones keep LDL cholesterol from oxidizing which protects against atherosclerosis.3

Guggul has also been shown to reduce the stickiness of platelets—another effect that lowers the risk of coronary artery disease.4 One study found guggul extract similar to the drug clofibrate for lowering cholesterol levels.5 Clinical studies in India have consistently confirmed guggul extracts improve lipid levels in humans.6

Guggulsterone, a Potent Hypolipidaemic, Prevents Oxidation of LDL

Author(s): Singh K, Chander R, Kapoor NK
Source: Phytotherapy Research. 1997; 11(4):291-294.

Abstract:

The oxidation of low-density lipoprotein (LDL) induced by Cu+2 caused marked oxidative changes in the lipid and protein constituents of this lipoprotein in vitro. Guggulsterone (present in the oleogum resin of Commiphora wightii) prevented the generation of lipid peroxides measured as thiobarbituric acid reactive substances, lipid hydroperoxides and conjugated dienes. This compound protected LDL against
depletion of lipid constituents such as cholesterol, cholesterol esters, triglycerides [triacylglycerols] and phospholipids as well as inhibiting the conversion of cholesterol into oxygenated cholesterols. Oxidized LDL containing less apoprotein B with a high protein carbonyl value was more electronegative as evidenced by the increase in relative electrophoretic mobility (REM) on agarose gel. Guggulsterone significantly protected LDL apoprotein as measured by reversal of REM after oxidation. The protective action of guggulsterone may be due to its free radical scavenging property as this compound significantly inhibited the generation of hydroxyl radicals in a non-enzymic system.

2. Nityanand S, Kapoor NK. Hypocholesterolemic effect of Commiphora mukul resin (Guggal). Indian J Exp Biol 1971;9:367–77.

3. Singh K, Chander R, Kapoor NK. Guggulsterone, a potent hypolipidaemic, prevents oxidation of low density lipoprotein. Phytother Res 1997;11:291–94.

4. Mester L, Mester M, Nityanand S. Inhibition of platelet aggregation by guggul steroids. Planta Med 1979;37:367–69.

5. Malhotra SC, Ahuja MMS, Sundarum KR. Long-term clinical studies on the hypolipidemic effect of Commiphora mukul (guggul) and clofibrate. Ind J Med Res 1977;65:390–95.

6. Nityanand S, Srivastava JS, Asthana OP. Clinical trials with gugulipid—a new hypolipidemic agent. J Assoc Phys India 1989;37:323–28.

Niacin

The B vitamin niacin, also known as nicotinic acid, has been used for many years in relatively high doses (e.g., 1 to 4.5 grams/day) as an inexpensive treatment for hyperlipidemia, a condition characterized by elevated blood levels of cholesterol and/ or triglycerides (fats).

Despite its advantages, unfortunately it produced undesirable side effects in many people, including flushing, itching, gastrointestinal upset, and at higher dosages possible liver abnormalities. The inositol hexanicotinate form of niacin does not cause the side effects associated with the simple form of niacin or nicotinic acid, and still provides the benefits.

Research

"Niacin is a useful lipid-modifying drug because it (1) decreases low-density lipoprotein (LDL) cholesterol, total cholesterol, triglycerides, and lipoprotein(s), and (2) raises high-density lipoprotein (HDL) cholesterol" as reported in the American Journal of Cardiology, December 1998.

The Journal of Cardiovascular Risk (June 1997, 4/3:165-71) concluded a report by stating, "This study of hypertriglyceridemic men has shown that long-term treatment with nicotinic acid not only corrects serum lipoprotein abnormalities, but also reduces the fibrinogen concentration in plasma and stimulates fibrinolysis."

A 1998 study reported in the Journal of Cardiology indicates niacin increased "good" HDL by almost 30% in a study of patients over a 5-year period. The study also reported that the presence of low HDL was an independent predictor of coronary artery disease.

Co Q10

Coenzyme Q10, also known as ubiquinone, is a fat-soluble vitamin-like substance. It is involved in several key steps in the production of energy within a cell, and it also functions as an antioxidant, a feature that explains its clinical advantages. It has no known toxicity or side effects.

There have now been numerous studies in various countries detailing the use of Coenzyme Q10 as a treatment in heart disease. The efficacy and safety of the treatment has been well established, including in large trials. One study, by Baggio et al., which took place in Italy, involved almost 2664 patients with heart failure.

A study by Greenberg and Frishman found that 150 mg of CoQ10 reduced the frequency of angina attacks by up to 46%, while improving the capacity for physical activity in those patients. That work was published in the Journal of Clinical Pharmacology in 1990.

A study by Sunamori et al., published in 1991, reported that pretreatment with Coenzyme Q10 minimized the myocardial injury caused by cardiac bypass surgery and improved heart function compared with patients not pretreated with CoQ10 (Cardiovascular Drugs and Therapy).

More recently, R.B. Singh, from the Heart Research Laboratory at the Medical Hospital and Research Center in Moradabad, India, told the inaugural conference of the International Coenzyme Q10 Association that, in a randomized double-blind trial of 144 patients with acute myocardial infarction, Coenzyme Q10 was seen to be associated with a significant reduction in angina pectoris, arrhythmias, and left ventricular dysfunction. Nonfatal infarction and cardiac deaths also were significantly lower in the Coenzyme Q10 group than in the control group.

Early in 1999, as part of a double-blind study, scientists in Melbourne, Australia, gave Coenzyme Q10 to elderly people about to undergo cardiac surgery in a bid to make their old hearts young again. (A double blind study is one in which neither the subjects nor the persons administering the treatment knows which treatment a subject is receiving.)

Dr. Franklin Rosenfeldt, head of cardiac surgical research at the Baker Institute, says he expects the treatment will make the hearts of people over the age of 70 perform as well as those of 30 year-olds. Rosenfeldt believes CoQ10 will improve heart function in two ways.

The antioxidant fights free radicals released at times of stress, such as during cardiac interventions (including angioplasty, thrombolysis, and surgery). It also improves the way cells convert oxygen and food to energy, strengthening the heart and making it beat
more strongly. "We are giving the patients CoQ10 for a week before surgery to build up the energy levels in their cells, and we are testing to see whether their recovery after surgery is better, whether their heart shows less damage, and whether cardiac tissue removed at the time has greater energy capacity and also can stand up to stress better," Rosenfeldt says.

It is especially important when acquiring Co Q10 to get a high quality form since it is an inherently unstable substance and requires expertise in manufacturing to keep stable.

Any patient taking a "statin" drug such as lipitor, mevacor , zocor or pravachol should consider taking supplemental Co Q10 since these drugs deplete the body of this important nutrient for the heart.

Hawthorn

The extract of hawthorn, an herb which has been used for centuries to treat heart disease, can increase blood flow to the heart muscle itself, helping to counteract one of the most common modern causes of death in industrial countries--heart attack due to lack of blood flow to the heart.

In pharmacological tests on both animals and humans, hawthorn has

Been shown to improve the contractility of the heart muscle (which can

Lead to a stronger pumping action of the heart), increase cardiac

Performance and output, lower the peripheral vascular resistance(reducing the workload of the heart), steady the heartbeat (antiarrhythmic effect), as well as increasing the heart's tolerance to oxygen deficiency, such as might happen during stress or excitement, or in diseases where the arteries are partially blocked.

In Europe, thousands of doctors prescribe hawthorn to prevent cardiovascular disease or to help alleviate symptoms of mild to moderate problems. It is considered so safe that it is sometimes prescribed concurrently with heart medications such as digitalis. Hawthorn is also considered a mildly calming herb for the nervous system--an appropriate bonus considering that stress and nervousness often accompany cardiovascular problems.

Medical Abstract

Efficacy of the Hawthorn (Crataegus) Preparation LI 132 in 78 Patients with Chronic Congestive Heart Failure Defined as NYHA Functional Class II
Author(s): Schmidt U, Kuhn U, Ploch M, Hobner WD
Source: Phytomedicine. 1994; 1:17-24.

Abstract:

Seventy-eight male and female patients between the ages of 45 and 73, who were affected by chronic heart failure defined as NYHA functional class II, were treated either with Crataegus extract or with aplacebo preparation. The extract LI 132 was administered to the patients in the form of 3 drag้es a day (verum preparation) corresponding to a daily dose of 600 mg.

Treatment was continued over a period of 8 weeks, with a wash-out phase of one week.

The confirmatory parameter used to assess the efficacy of the preparation was the patients' working capacity, which was measured using an ergometer bicycle.

Before the start of the study, an increase in the patients' working capacity of at least half an exercise step on the ergometer bicycle (12.5 watt) was determined to be clinically relevant.

Apart from the compatibility of the preparation, a score system was used to assess the severity level of the typical symptoms. From day 0 to day 56 of the trial, the median values obtained for the working capacity of the patients treated with the verum preparation were found to have increased by 28 watt, while the increase in the working capacity of the placebo patients was as little as 5 watt. The difference was statistically
significant (p < 0.001). Apart from that, a significant reduction of the systolic blood pressure, of the heart rate and of the pressure/rate product was observed for the patients treated with the verum

Vitamin E has been shown in studies to help protect against the development of atherosclerosis. ... It is important to use a full spectrum Vitamin E supplement that contains alpha, beta and gamma and delta mixed tocopherols in a natural formulation that cannot become rancid.

Vitamin E enrichment has been shown to retard LDL oxidation, inhibit the proliferation of smooth muscle cells, inhibit platelet adhesion and aggregation, inhibit the expression and function of adhesion molecules, attenuate the synthesis of leukotrienes, and potentiate the release of prostacyclin through up-regulating the expression of cytosolic phospholipase A2. Collectively, these biological functions of vitamin E may account for its protection against the development of atherosclerosis. (Journal of Nutrition, 1998 [Oct], pp. 1593-96).

Some other studies about vitamin E and cardiovascular disease have been summarized as follows:

Vitamin E acts as an important antioxidant against oxidative modification of low-density lipoprotein (LDL), which is accepted as an initial event in the pathogenesis of atherosclerosis (Free Radical Research (United Kingdom), 1998, 28/6:561-72).

There is growing evidence that supplementation with vitamin E in higher doses has a protective role in prevention of atherosclerosis (Medizinische Welt (Germany), 1998, 49/5:250-55).

Evidence indicates that antioxidant supplements, particularly vitamin E, can reduce oxidation of LDLs (American Journal of Epidemiology, 1994, 139:1180-89).

Dose-response studies in humans have reported that 400 IU/day vitamin E increased its levels in plasma two-fold and prolonged the lag time before LDL oxidation. It has been reported that oxidizability of LDL was correlated to the atherosclerotic score of coronary angiography in CHD patients. About 400 IU/day vitamin E, which increases its levels two-fold and prolongs sufficiently the lag time before LDL oxidation, might be beneficial in decreasing the individual risk of CHD (Biofactors Journal, 1998).

As mentioned earlier, the August 1996 issue of the American Journal of Clinical Nutrition showed that the use of vitamin E resulted in a 63% reduction in death from heart attack. Vitamin E has clearly established itself as a front-line preventative and treatment for coronary artery disease.

Vitamin E is an antioxidant that serves to protect LDL from oxidative damage and has been linked to prevention of heart disease in double blind research. Virtually all nutritionally oriented doctors recommend 400–800 IU (700-1400 mg) of vitamin E per day to lower the risk of atherosclerosis and heart attacks