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heart attack

HEART PROBLEMS? ARE YOU TAKING THIS SUPPLEMENT?

February 29, 2012 by James Bogash

There are a few situations that produce a knee-jerk reaction when it comes to supplements matched to conditions.  Milk thistle and liver issues.  Vitamin D and bone health.  Magnesium and fish oils for diabetes.  But what about heart disease?

Of course, lifestyle changes are the best way to deal with or avoid any chronic disease in the long run.  Sometimes, poor lifestyle choices have been going on for too long and have damaged physiology enough that lifestyle changes alone will not be enough to turn health around.  This happens very commonly with the adrenal glands, where years of stress have depleted the adrenals ability to recover without nutritional support.

Regular readers of Dr. Bogash’s Rantings know that I hold the mitochondria in reverance.  The little “powerhouse of the cell.”  The little organelle within the cell that helps to generate energy for a cell.  And this “energy currency” is adenosine triphosphate, or ATP.  There are some billion or so reactions that occur in our body EVERY SECOND, and each one of these requires a molecule of ATP to get the job done.  Some tissues, like fat, use very little energy.  Others, like the heart, our muscles and our brain, use much more.  

Imagine that.  As you sit here reading this, your brain is requiring mass amounts of energy just to process the information.  Your pumping heart is in the same situation, requiring constant energy to beat for a lifetime. 

So what does this mean?  It means that each cell of the nervous system and the heart requires thousands of mitochondria just to generate the energy needed for a brain or heart cell just to perform it’s basic functions.  And each of these mitochondria are little factories churning out ATP for the brain and cardiac cells to use at an enormous rate.  Evidence has been present for several decades now that the protection and nutritional support of the mitochondria needs to be an integral part of avoiding, reducing the severity of many chronic diseases.

One nutrient that is essential for porduction of ATP is Coenzyme Q10, or Co10.   The other term is ubiquinone, meaning that it is ubiquitous – it is present in all of our cells.  Its presence is absolutely essential for our cells to make energy as well as protecting against free radicals. So taking it from the supplement standpoint can help protect the brain and the heart as they start to produce more and more ATP and the subsequent free radicals.  Coenzyme Q10 can help quench those free radicals.

This particular study took CoQ10’s benefits one step further, looking at 150 mg CoQ10’s ability to lower markers of oxidative stress in patients with >50% blockage in one of the major coronary arteries.  Researchers found that this approach lowered levels of MDA in these patients.  While this does not correlate directly with protecting the patient from further cardiac damage, it certainly adds more weight to the evidence of CoQ10 protecting the heart.

From a dosage standpoint, in general more is better.  However, coenzyme Q10 is an expensive supplement. Generally, 100 to 400 per day fits into most to people’s budgets.  Clinical studies have used doses of up to 1,200 to 2,000 per day, which is about $200 to $300 a month.  A little prohibitive for most people.

Filed Under: Heart Disease Tagged With: antioxidant, coenzyme Q10, CoQ10, heart attack, heart disease, mitochondria

CONCEPT OF ATHEROSCLEROSIS AND PLAQUING IN THE ARTERIES OF THE HEART – (5-11-09)

February 2, 2012 by James Bogash

Noninvasive diagnosis of ruptured peripheral atherosclerotic lesions and myocardial infarction by antibody profiling

Many patients have their routine stress test and come away with a sense of relief that nothing was found. Unfortunately, these patients can be just as likely to drop dead of a heart attack leaving the center because of the concept of unstable plagues. We are all aware of the concept of atherosclerosis and plaquing in the arteries of the heart. However, what many are not aware of is the idea that a plaque in a big artery taking up 25% of the opening can break free, travel to a smaller vessel and take up 100% of that opening, leading to a heart attack.

So the important concept is not just the presence of a plaque, but how STABLE that plaque is. There are lifestyle factors that play a role in the stability of a plaque (higher intakes of omega 3 fatty acids, less inflammation, etc…) but it is still difficult to asses. Certain ultrasound procedures can determine the stability of a plaque, but are somewhat invasive.

This article looks at a fantastic approach with bloodwork to help asses a patient’s likelihood of having an unstable plaque. Keep your eyes on this approach in the future–it’ll be highly, highly valuable.

Read entire article here

Filed Under: Inflammation Tagged With: atherosclerosis, heart attack, myocardial infarction, plaquing

7 FACTORS FOR HEART DISEASE–ARE YOU IN THE 1%?

January 11, 2012 by James Bogash

By now we can all accept that heart disease is almost entirely lifestyle in origin.  I’m sure there are a few events per year that were entirely mediated by genetics, but, in general, if you have heart disease, it’s because of the choices you have made.  And likely continue to make.

Everyone out there who is looking forward to their first heart attack please raise your hands.  Great…now everyone who has had a heart attack and wants a second, you can raise your hands now.  Lastly, those of you who just can’t wait to have your sternum cracked open with a spreader, your circulatory system put on a bypass around the heart and veins stripped from your leg to re-plumb your heart, go ahead and send both hands up.

Looking around, there is not a single hand in the air.  Imagine that–not a single person has a desire to experience a cardiac event.  Go figure.  NOW let’s ask the important question…

Who is willing to make changes to their lifestyle to avoid the aforementioned events?

Not so many hands, I’m guessing.

Why is that?  It really is that clear cut.  Does society think that medicines will save us from these outcomes?  If so, think again.  You could not be further from the truth.  Medicine is very, very bad at preventing events.  Sure, we run around telling everyone “our numbers are under control,” but this house of cards soon falls after the first heart attack.

Look at this particular study here.  Researchers looked at 7 cardio-protective behaviors:

  1.  Ideal healthy diet
  2. Physical activity
  3. Ideal body mass index
  4. Non-smoking
  5. Ideal blood pressure
  6. Low total cholesterol
  7. Low fasting blood glucose

That’s it.  7 simple factors.  I could easily add another 10 and tighten up what they consider “healthy diet.”   But, overall, pretty basic guidelines.  So, how many people (out of 14,500, aged 20 and above) had all seven of the factors present?

Are you sitting down?

Less than 1%.  That is flat out sickening and extremely disappointing.  There is a massive disconnect in this society between what WILL happen and what we think will NOT happen to us.

Are you in the 1%?  If not, what will happen to those you leave behind?

Filed Under: Cholesterol, Heart Disease, Hypertension, Stroke Tagged With: cholesterol, heart attack, heart disease, stroke

ARE EVERYDAY HEADACHES DANGEROUS?

November 10, 2011 by James Bogash

Last update December 19, 2014

Are everyday headaches dangerous?
Naeblys/Dollar Photo Club

I’ve been a strong opponent of the way we treat migraines in this healthcare system.  In general, we keep trying different medications until the doctor finds a medication that reduces or stops the headaches.  Then we all jump up and down and pat each other on the back and call the process a success.  If this is the approach your doctor has taken, then there ARE times when an everyday headache can be dangerous to your long term health.

Why?  Because a migraine headache is unquestionably a cerebral (brain) manifestation of a systemic problem.  If all we do is medicate the headache, we just signed an early death certificate for the patient because we have not fixed the problem.  All we have done is control the symptoms.  The “problem” was not a deficiency of Topimax or Depakote or Lyrica.  Giving these drugs may control the symptoms, but in now way fix the problem that caused the headache in the first place.

So what is the problem?

A great place to look is at the blood vessels.  Our vasculature that brings blood to every cell of our body.  With this blood comes important nutrients, vitamins and minerals for a brain cell to function at its best.

When there is a problem with our blood vessels, our brain cells can’t get the nutrients it needs to make ATP.  In case you don’t remember back to high school biology, ATP is the “energy currency” of our cells.  It is what every cell needs to do anything and everything.  The more ATP available, the healthier the cell.  The less ATP available, the sicker the cell becomes.

In cells that require very high levels of energy, such as our muscles, our heart and our brain, this process is absolutely critical.  If the brain does can not get the nutrients it needs to make enough ATP, a migraine or a seizure may be the result.

Ok.  “So what exactly is the problem with poor vascular health”, you ask.  With few exceptions, no one has a heart attack before they have a problem with the blood vessels leading to the heart.  No one has a stroke without first having a problem with the blood vessels in the brain.  Dementia begins with poor blood supply to the brain.

If you don’t fix the vascular problem that is contributing to the migraine, you are allowing unchecking damage to your blood vessels to occur.  With enough time, this will lead to a heart attack, a stroke or the slow process of dementia and loss of your cognitive function.

Medications will NOT fix this.  In fact, in several cases they will make the process worse.

This is strongly confirmed by this current study linking migraine with aura and cardiovascular disease.  Strangely, the risk of stroke was massive (380% increased risk) in women with NO established risk factors for heart disease.  However, in those women who DID have risk factors for heart disease and experienced migraines with aura, the risk of having a heart attack was increased 334%.

In other words, you can’t win either way.  Having migraines with aura will either lead to a heart attack or a stroke.  The ONLY way to save yourself is to make the changes needed to improve your vascular health.

Sadly,  despite all this research, I have yet to EVER have a patient come in with migraines that were given any type of lifestyle advice by any other provider (specialists included).  So yes–Everyday headaches can be dangerous.  Even deadly.

 

Filed Under: Heart Disease, Migraine, Stroke Tagged With: everyday headache, heart attack, migraine, migraine with aura, stroke, vascular health

TAKING THIS COMMON PAIN MED JUST ONCE CAN KILL YOU

June 2, 2011 by James Bogash

The data coming out of non-steroidal anti-inflammatory drugs (like ibuprofen) and the risk of heart attacks is downright scary.  All of this was precipitated by the lawsuit against Merck because of their suppression of data that the blockbuster drug Vioxx was causing heart attacks.  This prompted researchers to look at other NSAIDs and the data is very consistent.

In addition to bleeding ulcers, dementia, liver damage, kidney damage, joint damage and impotence, this class of drugs is absolutely, positively NOT to be used in anyone with heart disease.  This would include the >50% of the population that is prediabetic.

But this is, of course, only for people who use these drugs for months and years at a stretch, right?  According to this study, DAY ONE was soon enough to cause a heart attack or death in patients who had pre-existing heart disease.  Day one.  The particular NSAIDs that was the worst was diclonfenac, a drug that I see given to patients for simple musculoskeletal problems far too often.

Bottom line is that there are no safe drugs for pain, either prescription or over the counter.  Being somewhat biased towards chiropractic care, I would have to strongly suggest that a visit a chiropractor in Mesa is warranted even before you pop that ibuprofen or Tylenol.

http://circ.ahajournals.org/cgi/content/abstract/123/20/2226

Filed Under: Chiropractic Care, NSAIDs Dangerous Tagged With: heart attack, NSAIDs dangerous

ALL HEART ATTACKS PATIENTS NEED THIS VITAMIN

May 24, 2011 by James Bogash

Ok.  Ok.  I know you get it.  Vitamin D is important and almost everyone is deficient.  But I’m STILL not seeing this in the patients we’re seeing in the office.  A recent new patient has been diagnosed with osteopenia (“pre” osteoporosis), had low levels of D on bloodwork, has a strong family history of osteoporosis and her doctor told her she should be on 2,000 IU / day.  That’s what we START patients on if they don’t have all these issues.  The cost and safety of bumping a patient with these factors up to 4,000 IU / day is minimal.

Another potential new patient stopped in to ask some questions.  She’s had MS for over a decade.  Her recommendations from her neurologist and PCP are to take 2,000 / day, again in the presence of low levels in her bloodstream.  And there were no recommendations for her 2 teenage boys to start on vitamin D as well (vitamin D seems to play a large role in the onset, but not treatment, of Vitamin D).

This particular study again points out just how darn deficient we are as a society.  In patients who experienced a heart attack, 96% (yes…just 4% short of 100%) had insufficient levels of vitamin D.  And keep in mind that this was <30 ng/ml, while experts recommend >60 ng/ml as optimal.

Many physicians would argue that the links between heart disease and low vitamin D are not definitively proven yet.  But those same physicians will give out statins in a candy dish up by the checkout counter with even less data supporting their effectiveness.  Given the safety and low cost of vitamin D supplementation, it should be malpractice to not at least have the discussion with our patients.

http://www.sciencedirect.com/science/article/pii/S0002914911003924

Filed Under: Heart Disease, Vitamin D, Vitamins Tagged With: heart attack, myocardial infarction, Vitamin D, vitamins

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