LifeCare Chiropractic

The Best Chiropractic Care in Mesa, Arizona

Heart Disease, Stroke, Blood Pressure Tips

ADD THIS TO YOUR DIET TO DRASTICALLY LOWER RISK OF STROKE

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As I’ve written about in the past, the 90’s completely screwed up our concept of what constitutes healthy foods. An entire population was brainwashed with the idea that fat = fattening. Researchers at the time the USDA’s food guide pyramid was released (allocating fats and oils – use sparingly – at the top) were concerned about increased rates of most chronic diseases. Unfortunately, they were correct.

This study, among many others, continues to prove just how errant this thinking was. This particular study finds that those consuming high amounts of olive oil had a 41% lower risk of stroke. Considering that some of the most popular diets, such as Weight Watchers, promote the replacement of olive oil based dressings with “low fat” dressings. These low fat dressings replace olive oil with high fructose corn syrup. Clearly a health devastating tradeoff, and yet one that remains a popular choice among those trying to lose weight or maintain an otherwise healthy lifestyle.

Well—in case there is any question in your mind that avoiding olive oil because it is high in fat—dispel it now. Olive oil, especially as a component of a Mediterranean type diet,has numerous health benefits. It aids in the absorption of certain fat soluble nutrients like the fat soluble vitamins A, D, E, K as well as other phytonutrients like the fat soluble carotenoids. Lycopene, in particular, is high in Mediterranean diets because of the tomato intake.

Olive oil itself, particularly the cold pressed extra virgin forms, are very high in their own polyphenols that confer very high levels of protection.

A little tip when it comes to olive oil. There is no doubt that the less processed, the more virgin, the oil, the better it protects. So, these means the more expensive olive oils really are better for us. BUT…most of these polyphenols are destroyed by heat. This means that cooking with olive oil is likely to reduce the protective benefit of the expensive oils. It does still retain the benefits of the oil itself, however.

Bottom line is to keep two olive oils at the house. A more expensive one for the dips and dressings, and a less expensive oil for cooking. It’ll be a better use of your money.

http://www.neurology.org/content/early/2011/06/15/WNL.0b013e318220abeb.abstract

YOU KNOW YOUR CHOLESTEROL, BUT DO YOU KNOW THIS LEVEL?

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In today’s health environment, thanks to aggressive marketing by the pharmaceutical companies promoting the near godlike power of the statins to lower levels, most everyone knows where their cholesterol sits.  The reality is that total cholesterol, as a risk factor for heart attacks and cardiovascular mortality, is just short of worthless.  The more important value, however, is not known by most people.

Triglycerides have long been known to be a major player in heart disease risk.  The relationship between triglycerides and HDL (“good”) cholesterol is a key factor to look at in evaluating your risk.  Ideally, a ratio of 2:1 or less is desirable.  There are only a handful of patients I have seen where the triglycerides are close to or even lower than the HDL levels.

There reason these levels are so important is that they are driven by our relationship between our insulin and our cells (i.e. prediabetes).  Since prediabetes and diabetes absolutely destroy our cardiovascular system you can see why this ratio is so important.

This particular study further reinforces this, finding that non-fasting levels of triglycerides were the strongest predictor of total mortality.  While non-fasting cholesterol levels were associated with risk of heart attack, the risks of high non-fasting triglycerides were much more severe.   Levels above 443 (normal fasting values should be well under 150) increased the risk of heart attack by 420% and risk of death overall by 50%.  THIS is why you need to know your numbers.

http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2796.2010.02333.x/abstract

OBESITY AND CANCER, REVISITED…

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I know.  I know.  Eat your fruits and veggies.  Exercise.  While we all kind of agree that this MAY lower our risk of cancer, just how much seems to get glazed over.  After all, Grandpa Joe smoked and drank Jim Bean until he died in a brothel accident at 106.  So just how much of an impact does a good lifestyle have on cancer rates?

Something important to consider.  The weight of cancer prevention seems to be towards quitting smoking.  This is, of course, a no-brainer.  But, as this article mentions, 80% of the population are never or former smokers, this recommendation falls on the deaf ears of the bulk of the population who are already following this recommendation.

This particular study looked at adherence to an ideal body composition, physical activity, diet, and alcohol consumption on cancer rates, heart disease fatality rates and all-cause mortality (risk of dying from anything).  Those with the highest adherence had a 42% lower risk of all cause mortality, 48% lower risk of dying of heart related causes (58% for women!!!!) and a 30% lower risk of dying of cancer.

These are general lifestyle recommendations.  General.  As in very simple to accomplish.  I could expand on the specifics in a hundred ways to make them more effective.

The bottom line is that NOTHING, absolutely NOTHING, is a powerful as lifestyle changes in lowering your risk of dying from anything.  The strength of this message seems to continually be drowned out by “this for a cure” and “that for a cure” and prevention promotions sponsored by Coke (Basha’s Heart Smart T-shirts proudly promote Coke).

As a society we need to put our collective feet down and stop funding these organizations that promote a “cure” while shoving prevention with simple lifestyle changes to the fine print.  Only THEN will they wake up and realize that this is what their individual charters

ARE YOU TAKING THIS BLOOD PRESSURE MED?

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I remember being at a child’s birthday party and speaking with an attendee.  Turns out this person was a pharmacist teaching cardiovascular drugs to pharmacy students.  One could assume that all they are teaching to new students is evidence based and devoid of dogma.

I asked her if beta blockers were still being used given their high risk of creating diabetes (about 22%) and stroke (about 12%).  The pharmacist was unaware of any such association.  Considering that the study I was referring to was in a cardiology journal and involved looking at 95,000 patients, I was sure it was a familiar one.  I was apparently wrong.  Despite the pharmacist / instructor in cardiology drugs’ lack of knowledge in this area, there is no longer any doubt that the beta blocker class of drugs used to treat hypertension creates diabetes and stroke (heck–isn’t that what we’re trying to prevent!!??).  Think of the “ol” drugs like atenolol or propranolol.

But dont’ worry if you’re still on this class of drugs.  This article finds that giving an ACE-inhbitor (think “il” like lisinoprol or captopril) almost counteracts the negative effects of the beta blockers.  What magic!  So, the bottom line is that, if you are written a prescription for a beta blocker that will increase your risk of diabetes and stroke, make sure you get your doctor to write that second prescription to counteract the side effects of the first.

Or……..you could cut out enriched wheat flour, hydrogenated oils and exercise more….

http://www.sciencedirect.com/science/article/pii/S0002914911010277

Mesa AZ Chiropractor Gives Insight on the Effects of Asprin

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DOES ASPIRIN REALLY PROTECT OUR HEART?

Of course it does.  Right?  I mean…this has been drilled into our collective minds by Bayer and our doctors and other advertising for decades now, so it has to be true.  Wasn’t hormone replacement therapy good for us?  And dairy?  Isn’t dogma wonderful?

Unfortunately in medicine, we begin with a great concept (at least, from a “give a drug to everyone to prevent a single disease” mindset) but it may take decades before the studies catch up with the concept.  More often than not, the reality does not hold up to the promise.

Statins were all initially approved to lower risk of heart attacks.  Problem was, we didn’t actually test this.  We ASSUMED this because statins lowered cholesterol.  Turned out, years later, that they weren’t all that great at lowering heart attack rates.  Now the engine of statin use has been plugging along for so long that we’re finding it really hard to slow it down despite the evidence that they just suck at lowering first heart attack rates.

Back to aspirin.  It’s known that aspirin contributes greatly to bleeding ulcers.  To hemorrhagic stroke.  Even to pancreatic cancer (that’s a scary one we don’t hear too often!).  These negative things are glossed over when we talk about how great aspirin is.  But do they really work at protecting our hearts and brains?

Without much fanfare, in 2009 a dogma-destroying study was published that demonstrated no benefit for the average person taking aspirin on their vascular event risk.  The benefits were higher for those above 70, but below 70 the person would have to have a much greater risk of heart disease to see a benefit.  Get that?  NO BENEFIT for the average person.  This is another dogmatic concept that will die a very, very slow death.  Maybe not even in our lifetimes.  This current article looks at 90,000 patients and finds similar outcomes–while there was a small change in the risk for a non-fatal heart attack, no differences were seen in risk of death from heart disease, stroke or all cause mortality.  Overall, not much to hang our hats on.  Heck–combine aspirin with statins and salt reduction and you still can’t lower your risk more than a walk around the block!! 

Worse, all this flies in the face of REAL recommendations like the Mediterranean diet, which has consistently shown strong reductions in diabetic and heart disease risk.  Same thing with nut consumption (again–NO added oils!).  The problem with lifestyle and dietary changes is that the side effects of death are very high.  Heck, Jack LaLane only lived until 96 and worked out for 2 hours the morning before he passed.  If it didn’t work for him, what can us normal people hope for?

http://www.sciencedirect.com/science/article/pii/S0002914911010137

HOW DO I RAISE MY HDL (“GOOD”) CHOLESTEROL?

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Most importantly, you do not EVER, EVER, EVER (get the point…) do it with drugs.  Just ask the patients who were taking torcetrapib, a drug made by Pfizer that was designed to raise HDL levels and lower risk of heart attacks.  Wait–you can’t ask many of these patients because the risk of death was 60% HIGHER in patients taking the drug, which obviously was never brought to market.

In my dreaming, society will someday wake up and realize that modifying a single marker (called a surrogate endmarker suchas total cholesterol, HDL, LDL, HbA1c, blood pressure or uric acid) synthetically with a drug does very little to change the endpoint.  In other words, taking a drug to lower cholesterol makes your number look better, but the true impact on heart attacks and cardiac death is small.  Drugs to increase HDL will be no different.

Want to raise your HDL the better way?  Soy, exercise, niacin, red wine, dark chocolate and general healthy, anti-diabetic lifestyles will all do the trick.  Just don’t believe that a medication will do it for you safely.

http://jcem.endojournals.org/content/96/5/1246.abstract

HOW WELL ARE WE MANAGING HEART DISEASE RISK FACTORS?

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Let’s face it.  If you are willing to make changes, managing cardiac risk factors is a piece of cake (or rather…avoiding that piece of cake…).  Lifestyle changes are not difficult, but require commitment.  Society does not easily support healthy lifestyle and requires a shift from what you’ve been doing.  But the payoffs are massive for you and your family.

I continue to contend that lifestyle changes are the ONLY way to manage chronic diseases.  Maybe if we did not live under the false pretense that, because our “numbers” look better (cholesterol, HbA1c, blood pressure, blood glucose, etc…), we’ve dodged the bullet of early death.  I cannot stress enough that this is just not true.  We live in a society dominated by surrogate end markers.  We think that because our cholesterol has magically been lowered by the coveted, mystical statin that we’ve lowered our risk for a heart attack or stroke.  Ok–so maybe you have, but only by a SMIDGEN (which, in medical terminology, is about 1%).  This is NOT prevention, it is false hope.  Lifestyle changes, on the other hand, have true global health benefits that are unquestionable.

This particular study just reinforces how pathetic “we” are when it comes to cardiac risk factors.  We can’t even do it right using drugs!  In shooting for lower LDL levels AND optimal CRP levels (a marker of inflammation) only 12% of the patients in this large study managed to achieve the desired numbers.  You will hopefully note that they were looking at LDL levels and not total cholesterol.  Hopefully, we are finally abandoning the futility of checking total cholesterol in lieu of better markers.

The authors’ suggestions?  “Smoking cessation, weight reduction, and the greater use of more potent statins at higher doses might be able to improve these outcomes.”  We just don’t get it.  It’s almost laughable how sickeningly dependent we have become on medication to “protect” our health.  Even with a society heavily dependent on meds, we still can’t get 88% of the population to target levels.

http://www.sciencedirect.com/science/article/pii/S0002914911004632

USING CT TO LOOK AT YOUR HEART VESSELS

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Something that is not well understood by the general population (except devout readers of my rantings…) is that there is plaquing of the arteries and there is plaquing of the arteries.  None of it is good and it is a sign of poor vascular health.  But without a doubt, the soft, vulnerable plaque is far more dangerous than the hard, stable plaque.

Picture a nice, wide open blood vessel that has some plaquing in it.  The plaque takes up maybe 10% of the opening of the canal.  If it’s a stable plaque this is just fine.  Plenty of blood flow and oxygen are getting the heart.  Your treadmill stress test comes through with shining colors. 

But what if the plaque is unstable?  That mass taking up 10% of the lumen of a large blood vessel, but now it breaks free and works its way into a smaller vessel, taking up most of the canal, starving the heart muscles for oxygen and causing a heart attack.  The stress test on this plaqued artery prior to the mass breaking off?  Again passed with shining colors.

What??  Am I saying that you can drop dead of a massive heart attack leaving a perfectly healthy stress test?  Yup.  And it all boils down to the stability of a plaque.  So how do we know? 

First, this study looks at the ability of CT scan to identify the soft vs hard, stable plaques and finds that it does a pretty good job.  Not too shabby.  Next, we can easily check lipoprotein-associated phospholipase A2 (Lp-PLA2, or PLAC test for short) in the blood.  This test has some pretty strong correlation with being able to predict if any plaques are unstable and ready to rupture.

Even more importantly, what can we do to make sure any plaques were are sporting are the stable type?  Exercise, higher intake of healthy fats (raw nuts, seeds, wild caught fish, avacodos, flax, olive oil, etc..) and lowering our levels of inflammation (see earlier blog postings) all increase the stability of a plaque.

Of course, making sure they’re not there in the first place sounds more preferable to me.

http://www.sciencedirect.com/science/article/pii/S0002914911003912