Easing Angina and Heart Attack Recovery

  • 21 Aug 2011
  • Reading time 10 mins
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If you’ve had a heart attack or suffer from angina, don’t underestimate the combined effect of a total nutritional strategy.

If you know you have significant arterial blockages or have had a heart attack, possibly leaving your heart muscle somewhat compromised, do not underestimate the combined effect of a total nutritional strategy, ideally personalised by a nutritional therapist depending on your test results. These steps are also worth taking if you are facing bypass surgery.

This may include:
• A low GL diet, with plant sterols, soluble fibres and antioxidant nutrients
• High potency niacin for lowering cholesterol and lipoprotein(a) and raising HDL
• Extra antioxidants, including CoQ10, alpha-lipoic acid, vitamin C, vitamin E and glutathione or NAC
• Extra lysine, especially if your lipoprotein(a) level is raised
• Extra omega 3's both from eating fish and supplements
• Extra magnesium and potassium, and strict sodium avoidance, both eating more fruit and veg and supplementing 300mg of magnesium, which relaxes arteries

These form the basis of the diet and supplementary recommendations, together with building up exercise and learning techniques such as HeartMath for reducing your stress level. These kinds of actions have been shown to reduce angina, relax arteries, lower triglycerides and LDLs and reduce risk of a heart attack. However, there are a few other strategies that you might like to consider. Boost your nitric oxide level Your body produces a highly versatile nutrient, nitric oxide (NO), that does many of the things you need to recover after a heart attack and improve the health of your arteries. It expands blood vessels, it stops platelets in the blood clumping together forming clots and it helps to break down arterial plaque and, acting as an antioxidant, it helps to protect blood fats from damage. While a number of drugs, notably Viagra and ACE inhibitors, aim to boost NO, according to Louis Ignarro, who won a Nobel Prize for his research into NO, you can increase your body’s ability to make NO by taking a combination of certain supplements, as well as exercising.

He recommends: L-arginine, which is an amino acid found in all protein foods. From arginine the body makes NO. He recommends supplementing 2,000 to 3,000 milligrams (mg) taken twice daily – for a total of 4,000 to 6,000 mg. L-citrulline. Supplemental arginine doesn’t enter cells readily unless it is combined with L-citrulline, another amino acid. Melons and cucumbers are rich sources of L-citrulline, but they don’t provide high enough levels to significantly increase nitric oxide levels. He recommends 400 to 600 mg daily. Daily multivitamin including vitamin E. Vitamin E helps reduce the assault of cell-damaging free radicals on the endothelial lining and may promote higher levels of nitric oxide. The amount of vitamin E that is in most multi-vitamin/mineral supplements is about 50 international units(IU), which is an effective dose. Vitamin C.

Like vitamin E, vitamin C will reduce oxidation in the blood vessels and may cause an increase in nitric oxide. He recommends supplementing at least 500mg. Some supplements contain all these nutrients as naturally NO boosters. Exercise, which also helps boost your own natural levels of NO, needs to be part of your heart friendly action plan. CoQ10 plus carnitine – The dynamic duo If you’ve had a heart attack, especially if there is some residual damage, CoQ10 can really help recovery if taken in combination with the amino acid L-carnitine. Like CoQ10, carnitine is a semi-essential nutrient. This means that your body can make it, but it doesn’t make enough for optimal health – especially if you’re getting on in years.

Carnitine is made from two amino acids: L-lysine and L-methionine. However, it’s better to get a direct supply, especially for heart muscle function. More than half of your heart’s energy comes from fat, and since it’s working hard every second, it needs a steady supply. Carnitine is the delivery boy that brings in fatty acids to process for energy. It also takes away the toxic by-products, including damaged fats. Carnitine helps your heart liberate the energy it needs efficiently. Without enough, your heart would struggle to function properly, causing heart and blood pressure irregularities. Toxic waste would also accumulate, leading to reduced blood flow (ischemia), particularly in the legs.

A number of studies confirm its usefulness particularly if there’s stress on the heart, for example after a heart attack or heart failure, or if you suffer from angina. In a study of 47 patients with chronic stable angina given 2 grams a day of L-carnitine or placebo for three months, those receiving L-carnitine recovered more quickly and showed sufficient improvement to be able to start exercising [1]. In another study of people with coronary artery disease given both L-carnitine and the antioxidant alpha-lipoic acid for eight weeks their blood pressure decreased and the diameter of the brachial artery increased, indicating better circulation [2]. Very high doses (9 grams a day for six days intravenously, followed by 6 grams a day orally) also help recovery after bypass surgery.

A trial on 537 patients showed that propionyl-L-carnitine improves exercise capacity in patients with heart failure and keeps the heart healthy [3]. Carnitine choices There are actually three different kinds of carnitine, all with slight advantages for different processes in the body.

They are:
• L-carnitine
• acetyl-L-carnitine (ALC)
• propionyl-L-carnitine (PLC)

All three work in terms of improving heart muscle function. Probably the best if you had to pick one is PLC. It specifically helps heart and peripheral muscle function. It works so well that it’s in and out of your heart very quickly, showing the advantage of a continuous supply. L-carnitine and ALC are probably better for brain function. For example, I’d recommend ALC for people with age-related memory decline or Alzheimer’s, or to maximize recovery from a stroke. ALC also targets the eye ......

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