The following was exerpted from "How to Reverse Heart Disease with the Coronary Calcium
Score by Jeffrey Dach MD at http://jeffreydach.com/2008/03/27/cat-coronary-calcium-scoring-reversing-heart-disease-by-jeffrey-dach-md.aspx
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The Track Your Plaque Program, by William Davis MD
1) Quantify plaque with Coronary Calcium Score with CAT scan (or with Electron Beam CT). Obtain your CAT Scan serially, every 12 months to assess response to treatment and lifestyle modification (track your plaque).
2) Use Sophisticated Lipoprotein Panel (Quest-VAP , LabCorp-NMR) to uncover hidden causes of plaque progression. LDL particle size and number, Lipoprotein (a). Repeat every 6 months.
3) The Main Treatment Goal is the reduction in Coronary Artery Calcium Score, and by inference, reduction in plaque volume and reduction in cardiovascular mortality. The cardiology community still awaits the hard data on these results (CHD mortality and CHD events, treatment arm vs no treatment arm). These numbers have not been published as far as I know.
How to Measure Success in Halting or Reversing Heart Disease Plaque
According to Dr. Davis, calcium score typically increases at an astonishing rate of 30-35% per
year without treatment. Therefore, Dr. Davis considers treatment success to be reduction in this rate from 30 to perhaps only a 5-10 per cent increase in calcium score per year. An absolute reduction in calcium score on follow up scanning is the optimal outcome, which is difficult to achieve even with strict adherance to the Track Your Plaque program, in Dr Davis's experience.
Track Your Plaque Program Details - Attain the Following Targets:
a) Reduction of LDL to 60 mg/dl (LDL should be measured directly, not calculated)
b) Reduction of triglycerides to 60 mg/dl.
c) Raising HDL to 60 mg/dl.
d) Correction of hidden causes of plaque on Lipoprotein profile such as total number of small LDL particles, IDL, and Lp(a).
e) Achieving normal blood pressure (<130/80) Even a small elevation of blood pressure in diseased
arteries can cause increased mortality. Diseased arteries are fragile and plaque rupture can occur easily.
f) Achieving normal blood sugar (≤100 mg/dl). Diabetes is a high risk factor for heart disease.
g) Reduction of C-reactive protein to <1 mg/l
Dietary
Modification and Supplements to Attain Above Targets:
Niacin
a) Niacin vitamin B3 (Slo-Niacin Upsher-Smith or Niaspan Kos Pharmaceuticals preferred) 500-1500mg. per day (avoid the no-flush niacin which contains inositol).
Omega 3 Fish Oil
b) Fish oil (Omega 3 oils) 4000 mg per day (providing 1200 mg omega-3 fatty acids). (molecular distilled pharmaceutical grade).
Vitamin D
Vitamin D level restored to above 50 ng/ml (Vitamin D3 2000-5,000 u/day), Vitamin K2 also used.
Low vitamin D is associated with increasing arterial calcification and increased heart disease risk. Consumption of calcium tablets by women increases arterial calcification and heart attack risk. Read my previous article on vitamin D which can be found
here.
d) Low Glycemic Diet (avoid Fructose Corn Syrup, avoid wheat products), and eliminate wheat products like Shredded Wheat cereal, Raisin Bran, and whole wheat bagels.
e) Consume foods such as raw almonds, walnuts, pecans; olive oil and canola oil. Beneficial for lipoprotein profile.
f) Increasing protein intake, our major building block for body tissues. Added benefit of protein intake is that it doesn't increase blood sugar. This is low glycemic nutrition.
g) Wine—Red wines contain resveratrol, (don’t exceed two glasses/ day). Bioflavonoids and anti-oxidants have a strong anti-inflammatory effect.
h) Fiber - Gound flaxseed (2 tbsp/day)-Extra fiber aids in detoxifying liver and the entire body by
interrupting the enterohepatic circulation. Psyllium (metamucil). Regulates bowel movements and has favorable effect on lipoprotein profile.
Vitamin C
Vitamin C (1000–3000 mg/day), is a key player, as it is the vitamin for strong collagen formation,
strengthening the arterial wall. See Linus Pauling's patented protocol which includes Vitamin C and amino acids Proline and Lysine, the two amino acids that act as receptors for Lp(a). By consuming additional Lysine and Proline, the receptor sites on the Lp(a) and other lipoproteins are covered up and made less sticky, resulting in less deposition in the artery wall. The vitamin C is important not only for strong collagen formation, a major component of the arterial wall, but also for all other structural elements of the body, for that matter.
Humans have a genetic deficiency in Gulano-Lactone-Oxidase (GLO), the final enzyme step in the manufacture of Vitamin C, and therefore unlike all the other animals who make their own Vitamin
C, we cannot make this necessary vitamin. We share with all other primates this genetic disease, the inability to manufacture vitamin C, producing a vitamin C deficiency state in all humans.
Also see Thomas Levy's two books on Vitamin C.
j) Exercise and weight loss- improves insulin sensitivity, reduces inflammatory markers, reduces blood pressure, improves lipoprotein profile.
Magnesium
k) Magnesium supplementation is inexpensive and safe. Magnesium deficiency due to dietary
deficiency or thiazide diuretics for hypertension is common, and is associated increased heart disease risk. Magnesium reduces blood pressure, relaxes smooth muscle in arteries, and is needed for normal endothelial function.
L-Arginine
L-arginine is converted to nitric oxide, an important substance for arterial health. Research by Furchgott and other showed that nitric oxide (NO) relaxes arterial smooth muscle, dilating coronary arteries by up to 50%. However, Nitric Oxide (NO) is gone after a few seconds, so it must be replenished at a constant rate to keep the arteries relaxed and open. Lack of NO is associated with constricted arteries, damage to the arterial lining, and accelerated plaque growth. L-arginine shrinks coronary plaque, corrects "endothelial dysfunction", improves insulin sensitivity, is anti-inflammatory and shrinks plaque. Dosage: l-arginine 6000 mg twice a day, best taken on an empty stomach.
Reverse Cholesterol Transport and Essential Phospholipid - Phosphatidyl Choline (PC)
James C. Roberts MD FACC, a practicing invasive cardiologist, lectures extensively on his clinical success with Phosphatidylcholine (IV or in Liposomal Oral Format with EDTA): Reverse Cholesterol Transport and Metal Detoxification. A DVD of his lectures is available which describes considerable clinical success with oral EDTA and phosphytidylcholine.
This page contains his DVD lecture material complete with clinical case histories.
Essential Phospholipid is available under trade name Phoschol which increases Lecithin Cholesterol Acyl Transferase activity (LCAT) (Dobiasova M 1988). Activating LCAT is beneficial because LCAT is the crucial substance which transports cholesterol from the arterial plaque back to
the liver for metabolic breakdown into bile. This process reverses atherosclerotic plaque formation. Dosage: 3 softgels Phoschol a day each containing 900 mg PC.
Thyroid Function
Normalize thyroid function. Broda Barnes MD showed that low thyroid function was a significant risk factor for heart disease. This conclusion was based on autopsy data from Graz Austria and detailed in his book, Hypothyroidism the Unsuspected Illness, and his other book, Solved the Riddle of Heart Attacks. Barnes felt that the thyroid lab tests were frequently unreliable, and he used clinical judgement instead.
LipoProtein (a)
All About Reducing Lipoprotein (a)
Lipoprotein little A, also written as Lp(a) is a genetic variant lipoprotein which is associated with a high risk of heart disease, and therefore identification and reduction is essential. The problem is that the conventional Lipid panels done in your doctor's office do not include Lp(a). Only the more sophisticated lipoprotein panels such as the VAP (Atherotech) or NMR (Liposcience) panels provide Lp(a) data.
Lp(a) and Lipoproteins:
1) Lp(a) is best to measured in (nmol/l), and target below 75 nmol/l .
2) Lp(a) measured in mg/dl (weight may not be accurate), then target below 30 mg/dl .
3) Measured (not calculated) LDL target 50–60 mg/dl.
4) LDL particle number target (NMR) of 600–700 nmol/l or apoprotein B of 50–60 mg/dl. Reduce small LDL to <10% of total LDL.
Treating Lp(a) with Niacin
Use Niaspan® (Kos Pharmaceuticals) or over-the-counter Slo-Niacin® (Upsher-Smith).
Both are better tolerated than OTC plain niacin, which may cause the hot flushes. Reduce hot flushed by drinking a full glass of water with each gelcap, and some find adding an aspirin tablet to the routine helps to reduce flushing.
Lp(a) and BioIdentical Hormones
Bio-Identical hormones are beneficial for reducing heart disease. In menopausal females, estrogen preparations such as Bi-Est are used. Estrogens have been shown to reduce coronary artery calcium score.
In males over 50, bio-identical testosterone cream may lowers Lp(a) by as much as 25% (William Davis MD). Medical studies show that optimizing Testosterone levels in aging males can reduce risk of coronary artery disease by 60%.
DHEA can promote weight loss, and improve insulin sensitivity.
The supplement L-carnitine can be a useful adjunct; 2000–4000 mg per day (1000 mg twice a day) can reduce Lp(a) 7–8%, and occasionally will reduce it up to 20%.
Remember, reduction in calcium score on follow up calcium scan is the goal.
What about Statin-Cholesterol Lowering drugs?
Dr Davis admits that the total cholesterol and the LDL cholesterol numbers are of little value in predicting heart disease risk. And he says that the statin drug side effects, ie. muscle pain and weakness, are more common in actual practice than the drug advertising would suggest, making statin
drugs difficult to take for the long term.
In my opinion, statin drugs are not recommended for women as explained in my previous article on Statin Drugs for Women, which can be found
here . My other article on Statins, Lipitor and the Dracula of Medical Technology can be found
here.
What about Calcium Supplements for women to prevent osteoporosis?
Dr Davis points out that women who take calcium tablets have double the risk of heart attacks than those on placebo.
Check out my earlier Heart Disease Reversal Page here.
Credit and Thanks is given to William Davis MD at the Track Your Plaque Web Site and Blog
for the above information.
http://jeffreydach.com/2008/03/27/cat-coronary-calcium-scoring-reversing-heart-disease-by-jeffrey-dach-md.aspx
Dear Pharmacist,
