Heart disease which is largely unheard of a century ago, has now become the leading cause of deaths worldwide. Drastic change in the food system in the last 60 years contributed much to most of the diseases of modern era. Insulin resistance is the common denominator in heart disease as well.
Lipid profile actually reflects the current metabolic status. Although, atherogenic dyslipidemia tells you the current metabolic status and predicts the future risk of poor metabolic health, it fails to reflect the atherosclerotic burden. The correction of dyslipidemia by reversing insulin resistance recently by following healthy food and lifestyle cannot guarantee you that you may not suffer from cardiac events.
Humans do not produce Vitamin C due to a mutation in the GULO (gulonolactone oxidase) gene that occurred 40 million years ago. Normal GULO is an enzyme that catalyses the reaction of D-glucuronolactone with oxygen to L-xylo-hex-3-gulonolactone. This then spontaneously forms Ascorbic Acid (Vitamin C). However, without the GULO enzyme, no vitamin C is produced. This has not been selected against in natural selection as we are able to consume more than enough vitamin C from our diet. It is also suggested that organisms without a functional GULO gene have a method of "recycling" the vitamin C that they obtain from their diets using red blood cells. Arteriosclerotic plaques develop as a result of long-term vitamin C deficiency. Lipoprotein (a) became a surrogate for vitamin C in our ancestors. Arteriosclerosis is an early form of the sailor’s disease, scurvy.
The atherosclerotic plague once formed almost never heals completely, although it can be stabilized. Hence it is utmost important to realize that the past events in the blood vessels predicts the future risk. It is easier to reverse insulin resistance completely with proper diet and lifestyle within few months. But it is really possible for the plaques in the arteries of the heart to disappear completely?
For example, a person who suffered from insulin resistance (accompanied by atherogenic dyslipidemia) for the past 15-20 years could have a plaque buildup in the form of the old hard stenotic plaques and soft non-stenotic plaques. Reversing insulin resistance can drastically reduce the risk of heart attacks or stroke but may not be possible to eliminate the risks completely.
Another difficulty in predicting the atherosclerotic burden is that most of the imaging techniques from stress ECG to ECHO or even angiogram to CAT, mainly identifies hard plaques and mostly the soft plaques go undetected. But doctors have now found that most heart attacks are caused by soft or vulnerable plaques. A Vulnerable plaque is an inflamed part of an artery that can burst. Hard plaques are partially healed lesions with calcium deposition in which the inflammation has settled down and hence the chances of rupture are very less. Having hard plaques are not without risks but comparatively very less compared to soft plaques in producing heart attacks.
Any significant blockage of coronary vessels (beyond a threshold) helps in the formation of collaterals from the vessels nearby. A person who is insulin sensitive has good nitric oxide (NO) production which regulates arteriogenesis along with angiogenic factors and shear stress. NO significantly impacts vasomotor tone to enhance conductance of the newly recruited collateral arteries, and this effect is augmented by exercise training prior to arterial occlusion.NO plays a central role in arteriogenic signaling events. Maintenance or improvement of NO production and signaling, such as with regular exercise, may improve endothelial cell function and thus may help preserve the arteriogenic potential of pre-existing collateral networks. In patients with CAD, a well-developed coronary collateral circulation contributes to reduction of infarct size, LV dysfunction & mortality. Hard plaques actually can contribute to most of the stenotic lesions in producing anginal pain in which the heart muscle suffer from ischemia due to the stenotic lesion perse as well as from the poor collateral circulation. Angina is not usually life threatening, but it’s a warning sign that you could be at risk of heart attack or stroke. However, your angina may turn into a heart attack if the cells in your heart do not get enough oxygen for too long and they start to die, which is often precipitated by physical exertion like moderate to heavy exercise, trekking, unacclimatised work or strenuous physical activity or even emotional stress. In these cases, the heart attack occurs without coronary artery thrombosis. Angina symptoms are usually relieved within a few minutes by rest, relaxation, and taking medications used to treat angina.
The only way in having a bullet proof heart, devoid of risk of heart attacks is “not developing any atherosclerotic lesion throughout the life”. Is it really possible? Atherosclerosis develops only when someone suffer from insulin resistance for a substantial period of time, in which the ectopic deposition of the fat in the heart incites inflammation. Inflammation of the coronaries causes deposition of cholesterol (Cholesterol carries antioxidant molecules and it acts a band aid repairing the blood vessels) results in the formation of plaques. The antioxidants in LDL - Tocopherol, Carotenes are used before there is damage to the phospholipid bilayer or Apo B100 – When these are oxidised it’s considered oxidized LDL. When viewed from this standpoint, LDL is a friend to be cultivated rather than annihilated by Statins or PCSK9 inhibitors.
Lp (a) – Not LDL - binds To Fibrin, Collagen & Endothelial Cells.
Atherosclerosis develops over a period of “decades” but most of the heart attacks happens within “minutes” due to the rupture of those plaques producing coronary artery thrombosis.
Though there is no cure for coronary heart disease or way to remove the atheroma completely that has built up in the arteries, treatments and changes to your lifestyle can help to prevent your condition and your symptoms from getting worse. Progressive plaque cap thickening and plaque shrinkage could be accomplished with micronutrient rich diet and staying insulin sensitive, with consumption of leafy greens & beets. All these factors augment the production of nitric oxide.
Unfortunately, the development of atherosclerosis starts early in life, in their teens and progresses as one gets older. It is worthwhile to remember, that one-third of the paediatric population is suffering from insulin resistance with one or more components of metabolic syndrome. Hence, primordial prevention of heart disease should be started from the childhood itself.
1.Pycnogenol-150 mg
2.Gotu Kola - 450 mg
3.Vitamin K2 - mega doses ( 2 mg for 3 months followed by 200 mcg till normalization of biomarkers)
4.Nattokinase
5.Niacin
Tocotrienols, berberine, aged garlic, magnesium, potassium and Vit D also help to clean out plaque naturally.
