Measuring Your Risk: The main measures that indicate you have risk or have reduced risk are blood pressure, cholesterol levels, triglyceride levels, and homocysteine level. Let’s look at each one separately.
1. Your blood pressure. This is measured as, for example, 120/76 mmHg. The top figure is the systolic blood pressure, the bottom figure the diastolic blood pressure. It’s the bottom figure—your diastolic blood pressure—that’s the most important figure. If your blood pressure is above 140/90, you have a much greater risk of heart disease. In fact, roughly every 10 point increase above 76 doubles your risk of death from cardiovascular disease.
2. Your cholesterol level. This is broken down into your total cholesterol, your LDL (“bad”) cholesterol and your HDL (“good”) cholesterol. You want to have a low LDL cholesterol (ideally below 100 mg/dL), a high HDL cholesterol (ideally above 60 mg/dL), and a total cholesterol of not less than 150 mg/dL and not more than 200 mg/dL. As a rough indicator, with every 50 point increase in your total cholesterol above 200mg/dL, you double your risk of death from cardiovascular disease. With every 50 mg/dL increase in LDL, you double your risk, and with every 20 mg/dL decrease in HDL below 60 mg/dL, you double your risk.
3. Your triglyceride level. This reflects the level of fats in your blood stream and is raised by eating high fat/high sugar diets, or by excessive alcohol. Your trigylceride level should be below 89 mg/dL. As a rough indicator, every 50 mg/dL increase doubles your risk.
4. Your homocysteine level. This is measured in, for example, 6 mmol/l. You want to have a score below 6. As a rough indicator, with every 5 point increase above 6 mmol/l you double your risk of death from cardiovascular disease. There are other important measures such as your platelet adhesion index and your fibrinogen levels, which measure the stickiness of your blood; lipoprotein (a) level, which is a highly significant risk factor; and C-reactive protein level, which indicates inflammation in the arteries. Make sure that your doctor measures all of these important risk factors as well. How Good Are Heart Medications? There are several categories of heart medications, each designed to address one of the major categories I listed above. They include statin drugs, which are designed to lower LDL cholesterol; thiazides, which are diuretics designed to lower blood pressure; beta-blockers, ACE inhibitors, angiotensin II receptor antagonists, calcium channel blockers, and nitrovasodilators, all of which are designed to lower blood pressure; and blood thinning drugs, such as warfarin (coumadin) and aspirin.
If you are currently taking heart medication, simply look at the details about your drug to find out which category it falls into. Then read below to learn a bit more about what you are taking. Statin Drugs - Overall, statin medication can be expected to lower LDL cholesterol concentration by an average of 68 mg/dL if taken for several years. Research shows that statins can reduce your risk of a heart attack by about 60 percent and your risk of stroke by 17 percent.(1) However, the risk reduction in minimal in the first year of use. The downside is that statins lower LDL cholesterol by blocking an enzyme that makes mevalonate, a precursor to both cholesterol and co-enzyme Q10 (CoQ10). CoQ10 is vital to heart health, and deficiency has been associated with fatigue, muscle weakness and soreness, and heart failure. Because statin drugs block production of CoQ10, they also lead to CoQ10 deficiency, a fact that has been well established in human trials. Therefore, long-term statin use can very dangerous. Just how serious these problems are is somewhat unknown. The major trials of statin drugs excluded those with class 3 and 4 heart failure, thus avoiding the chances of seeing an increase in death from congestive heart failure from statin medication.(2)
Other symptoms associated with statins include dizziness, headache, extreme fatigue, swelling of the ankles, muscle aches, fatigue, and suppressed immunity. Additionally, statins can be dangerous if taken with high levels of long-acting (time-release) vitamin B3 (niacin). Thiazides, Beta-Blockers, and Calcium Channel Blockers - All these categories of drugs produce similar reductions in blood pressure, averaging a 5.5 point drop with standard drug doses. Unlike statins however, the reduction happens quickly. Beta-blocker drugs counter our normal stress response, which raises blood pressure. The greatest possible reduction in risk occurs from using combinations of these blood pressure-lowering drugs in low dose combination, in some cases, reducing deaths from stroke and heart disease by half.(3) On the downside, negative side effects are common—especially for beta-blockers—and include extreme fatigue, confusion, sleep disturbances, dizziness, sexual dysfunction, gastrointestinal complaints, and vivid dreams. And the higher the dose, the worse the side effects.
Much older people, pregnant women, and individuals with renal or thyroid disease should be especially cautious about taking beta-blockers, and use the lowest dose possible to get their blood pressure under control. Like statin drugs, beta-blockers also deplete CoQ10. Just be sure that you don’t stop taking your beta-blockers cold turkey, as this could precipitate angina, high blood pressure, or even a heart attack. Heparin, Warfarin (Coumadin,) and Aspirin - These drugs are often recommended if you have a blood clotting problem or have had a heart attack or stroke. Warfarin is particularly effective if you’ve had an embolic stroke, an extensive heart attack, or have mechanical heart valves. Aspirin is less effective for preventing clots and strokes, particularly in women and those over 75. The major side effect of these drugs is excessive bleeding, such as eye and brain hemorrhages, blood in the urine, and bleeding gums.
Warfarin can also cause weakness, cold sensations, itchy skin, fever, and abdominal discomfort. And aspirin has its own can of worms. It causes gastrointestinal bleeding and should be avoided if you have gut problems, a history of hemorrhagic stroke, bleeding ulcers, hemorrhoids, or bleeding into the eyes or diabetes. While anticoagulants help prevent thrombotic and embolic strokes, the risk of a stroke-induced hemorrhage is actually higher for those taking warfarin and aspirin. Finally, you should never take warfarin and aspirin at the same time. There Are Alternatives - The good news is that several vitamins, minerals, and enzymes, as well as essential fatty acids and a few spices all help to fight and protect you against heart disease.
To lower your cholesterol: Try vitamin E and tocotrienols. When choosing a vitamin E supplement, be sure to select one that has mixed tocopherols, including d-alpha tocopherol, gamma tocopherol, and tocotrienols. For women, I suggest taking 200–400 IU a day. For men, take 400–600 IU a day for a man. If you are taking a blood-thinning drug, limit your daily intake to 200 IU. Niacin (vitamin B3) also lowers cholesterol and LDL up to 25 percent, while simultaneously increasing HDL cholesterol up to 25 percent. Niacin can even reduce your levels of lipoprotein A and fibrinogen, thus significantly reducing risk of death from cardiovascular disease. To lower your LDL cholesterol, I recommend taking 1,000–2,000 mg a day.
To lower your blood pressure: Magnesium acts like a calcium channel blocker to stabilize cardiac conduction, heart muscle, and vascular membranes. In fact, it has been shown to lower blood pressure by about 10 percent,4 as well as reducing cholesterol and triglycerides,5 thus substantially reducing risk of death from cardiovascular disease. I suggest taking 300 mg a day.
To lower your homocysteine levels: Vitamins B6 and B12, folic acid, and TMG all lower homocysteine levels. One study found that giving a combination of B6, B12, and folic acid produced a 59 percent reduction in homocysteine in three weeks. Using this guideline, I have seen many patients decreased their homocysteine from above 20 to below 6 in just one month! So, if your homocysteine is raised, you need to take 100 mg of B6, 1,000 mcg of B12, 2,000 mg of folic acid, and 3,000 mg of TMG each day.
To reduce platelet aggregration: Garlic reduces blood platelet "stickiness," and promotes healthy blood pressure, cholesterol, and triglyceride levels. To enjoy its benefits, you can eat two cloves of garlic a day or simply take two garlic capsules. Ginkgo biloba inhibits of platelet aggregation, and has the added benefit of boosting your memory and antioxidant capabilities. I suggest using 20–40 mg of a standardized extract a day. Some people experience mild gastrointestinal problems or occasional, mild headache when taking ginkgo. Turmeric (curcumin is the active constituent) reduces platelets stickiness and is also a powerful antioxidant. Take 400–600 mg curcumin twice daily.
Overall heart health: CoQ10’s positive effects of heart health and documented in over 100 clinical studies. Deficiency in CoQ10 can negatively impact heart function, thus leaving the tissues more susceptible to free radical attack. I recommend taking 30–90 mg a day for prevention, and 120–240 mg a day if you have cardiovascular disease. Be sure to take CoQ10 in an oil-based capsule for better bioavailability. Omega-3 fatty acids (EPA and DHA) have similar all around heart benefits, ranging from reducing excessive blood clotting and high blood pressure to lowering triglycerides by 25–30 percent. They also offer anti-inflammatory benefits.6 I recommend that you eat fish such as anchovies, mackerel, salmon, and sardines twice a week, and also take 2,000 mg of a good fish oil capsule containing both EPA and DHA every day.
The Downsides of the Alternatives - Garlic, gingko, and fish oil should not be taken with these blood-thinning drugs; there have been some isolated reports of bleeding on gingko and long-term aspirin therapy. And as I indicated earlier, you should limit your intake of vitamin E if you are using a blood thinner. Additionally, combining garlic, ginkgo and high-dose vitamin E increases risk of bleeding problems. Some people have also experienced unpleasant side effects from high doses of niacin, including tingling or itchiness and a feeling like hot flushes. To reduce the flushing, start with a low dose of niacin (50-100 mg per day), then double the dose each week until an effective level is reached. Flushing becomes less intense after a week or two of therapy. Niacin can also cause blood sugar fluctuations, so diabetics should avoid using niacin. Finally, niacin is counterindicated with statin drugs and best taken with high dose homocysteine-lowering nutrients as niacin may otherwise slightly raise homocysteine.
Change Your Diet and Lifestyle - In addition to the risk reductions you can expect from supplementation, improving your diet can also make major reductions in you risk of dying from or ever having cardiovascular disease. For example, limiting your consumption of saturated fat, red meat, and alcohol can reduce your risk by 50 percent, while reducing your sodium intake and lower your risk by 25 percent. Conversely, increasing your intake of fresh fruits and vegetables can cut your risk of heart disease by 30 percent.7 Along the same lines, increasing your level of aerobic activity and decreasing your stress levels can both cut your risk for cardiovascular disease in half. But the big risk reduction involves cigarettes. Simply quitting smoking reduces your risk by an astounding 70 percent!
In summary, the combined strategy of changing your diet, improving your lifestyle, and taking the right supplements is likely to be far more effective than taking prescribed drugs for both preventing and reversing cardiovascular disease. If you are on medication and take these steps to reduce your risk, and thereby achieve normalization of the biochemical markers for cardiovascular disease, there should be no need to continue heart medication. However, do not, and I repeat, DO NOT, change any prescribed medication without first consulting your doctor.
These are the kind of risk reductions you can expect if you normalize high risk levels of any of these risk factors. Medical StatisticsEstimated Potential Risk Reduction High blood homocysteine70 percent High triglyceride levels70 percent High cholesterol levels60 percent High lipoprotein A50 percent High blood pressure30 percent Insulin resistance30 percent Supplement Benefits and Dosages - If you have low levels of these nutrients and optimize your intake in the prescribed dosages, these are the kind of cardiovascular death risk reductions you can expect. Nutrient DailyDosage RiskReduction Percentage Vitamin E Women: 200–400 IU Men: 400–600 IU25 percent Niacin1,000–2,000 mg70 percent Magnesium 300 mg50 percent Vitamin B6100 mg70 percent Vitamin B121,000 mcg70 percent Folic Acid2,000 mg70 percent TMG3,000 mg70 percent Garlic2 cloves or 2 capsulesN/A Ginkgo biloba 20–40 mgN/A Curcumin400–600 mgN/A CoQ10Prevention: 30–90 mg Treatment: 120–240 mg25 percent Omega-3 fatty acids2,000 mg40 percent
1. Law, M.R., et al. 2003. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326:1423.
2. Langsjoen, P.H. Statin-induced cardiomyopathy. Redflagsweekly.com. July 8, 2002.
3. Law, M.R., et al. 2003. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ 326:1423.
4. Mroczek W.J., et al. 1977. Effect of magnesium sulfate on cardiovascular hemodynamics. Angiology 28:720-724.
5. Altura, B.T. and Altura, B.M. 1995. Magnesium in cardiovascular biology. Scientific American 28-36.
6. July 1999. Briefing paper on N-3 fatty acids and health. British Nutrition Foundation.
7. 1994. Nutritional Aspects of Cardiovascular Disease. United States Department of Health.