Editor's note: According to the American Heart Association estimates for the year 2003 are that 71,300,000 Americans had one or more forms of cardiovascular disease (CVD). Of those 65,000,000 individuals suffered from high blood pressure followed by 13,200,000 with coronary heart disease, 7,200,000 with myocardial heart disease (acute heart attacks), and 5,500,000 with stroke.

In 2003 cardiovascular diseases claimed 910,614 lives (37.3 percent of all deaths or 1 of every 2.7 deaths). This figure far outdistances the combined total of cancer deaths at 554,643, accidents at 105,695, and HIV (AIDS) at 13,544 in that year.

Their figures also indicate coronary heart disease, which is caused by atherosclerosis, the narrowing of the coronary arteries due to fatty build-ups of plaque, caused 479,305 deaths in 2003. And was the single leading cause of death in that year. It was also stated that about 330,000 people a year die of a coronary attack in an emergency department or without being hospitalized. Most of these are sudden death caused by cardiac arrest.

That year it was estimated there were 13,200,000 individuals who currently had a history of heart attack, angina pectoris or both. Also that an estimated 1.2 million Americans would have a new or recurrent coronary attack.

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Pretty sobering statistics particularly if you are a male. Or to look at it from another angle, 71 million probably accounts for 50 percent of all individuals in the country over 35 years of age. And most of us with serious cardiovascular disease probably have no idea we are afflicted by this insidious threat to our health and mortality. Particularly when according to the authors of Reverse Heart Disease Now, an important new owners guide to heart health, "Cardiovascular disease kills in an instant by heart attack or stroke. Fifty percent of the time the very first symptom is cardiac arrest. Without warning, half of all the people who have the disease die without every knowing they had it.

"CVD can also silently and slowly strangle the vitality of the most important muscle in your body--the heart muscle--which pumps life-sustaining blood and nutrient through 60,000 miles of blood vessels. The lining of those blood vessels becomes inflamed and can even be destroyed. Blockages develop and the blood can't flow."

For those of you who are regular readers of totalhealth magazine you are aware that our mantra is to become co-captain of your own health care team in partnership with a physician who practices integrative nutrition-based medicine. Leading integrative cardiologists Dr. Stephen Sinatra and Dr. James Roberts, authors of Reverse Heart Disease Now draw on their collective 50 years of clinical cardiology research to inform you how to combine the benefits of modern medicine, over-the-counter vitamins and supplements, and simple lifestyle changes to have a healthy heart--whether you have acute or chronic disease or just want to prevent cardiovascular disease from developing.

Focusing on crisis prevention, Reverse Heart Disease Now provides practical information and strategies you need to stop heart disease in its tracks. For instance:

• You can combat heart disease before the first heart attack

• Your arteries can become enveloped in inflammation and plaque that lead to heart attack, stroke, and heart failure and what to do about it.

• Medications, scientifically proven supplements, and lifestyle changes can extinguish the flames of disease and purge and stabilize arteries--even for the most compromised cases

• CoQ10, along with L-carnitine and D-ribose, can powerfully recharge weak and ailing hearts.

The breakthrough integrative program found in Reverse Heart Disease Now, shows how you can become more involved in your own healing process and, more importantly, even prevent heart disease before it strikes.

The following is an excerpt from Reverse Heart Disease Now

Most doctors today prescribe drugs for specific effects such as lowering cholesterol or blood pressure. When the drugs don't work, surgeons may be called in to perform lifesaving bypasses or heart transplants. In integrative medicine, we use or recommend these approaches as well. But we have learned to do something extra, something normally ignored, absolutely simplistic, and bargain basement cheap compared to dazzling, big-ticket technology. We optimize nutritional status--with vitamins, minerals, antioxidants, and other natural substances--to help the body heal itself.

Today we realize that vast numbers of people eat poorly and do not get the proper nutrition from their diets that their bodies need to sustain good health. Moreover, a global wave of positive nutritional research has rendered the conventional medical viewpoint on supplementation utterly obsolete. Many thousands of published studies have shown that individual Nutrients at doses higher than those usually present in food have a significant preventive and therapeutic effect for serious diseases, not just nutritional deficiency states.

Sick people need this nutritional upgrade…and they benefit magnificently. It often keeps them out of the hospital. Sometimes the supplements work rapidly like magic. Patients suddenly become rejuvenated as their nutritionally starved bodies respond to healing nutrients missing for years. Other times we see a steady but remarkable return to health by patients who previously sputtered along on near-empty tanks. Now, with their tanks full, they move actively forward in life, feeling better than they have in years.

Supplement Teamwork: A Misunderstood Principle
Used alone, single nutritional supplements can often generate powerful effects in the body. We strongly believe, however, they work best in combination--as a team--rather than just one or two alone. As an example, we can best combat the oxidative damage from free radicals with a combination of antioxidants, each packing different strengths and abilities. Vitamins C, E, CoQ10, bioflavonoids, alpha-lipoic acid, beta-carotene, lycopene, and selenium are a few of the important antioxidants. Having just one working for you--like vitamin C--but none of the others is like fielding a team with one all-star and no supporting players. We want the whole team in action, not one player alone.

Nature expects us to take in hundreds of nutrients each day to support the body's constant health protection and healing operations. And that's where nutritional supplements can make a big contribution, above and beyond eating a variety of wholesome foods.

Some of the individual supplements we recommend may be part of a multiple nutrient formulation. Others are needed in larger individual quantities than what may be contained in the multiple. This principle of team nutritional medicine makes perfect sense and many studies are proving, supplement combinations have enhanced effects.

Multivitamin/Mineral with Antioxidants
First and foremost, as a foundation for any supplement program, you need a broad-spectrum "multi"--capsules or tables packed with combinations of vitamins, minerals, antioxidants, and other nutritional factors. Unfortunately, the really good formulas with potent amounts of therapeutically important substances cannot be crammed into a single pill. Usually, a daily serving involves, two, three, or more pills. Our patients take multiformulas that consist of up to eight pills twice a day.

Most medical studies on supplements involve single nutrients. Very few consider multiple vitamin formulas because they have such diverse ingredients and potencies. Two studies on multivitamins have impressed us: one in Sweden, reported in the Journal of Nutrition in 2003, and the other in the Canadian Journal of Cardiology in 1996. Both made similar conclusions: multiple vitamins substantially lower the risk of cardiovascular disease.

Supplement Fundamentals
• Nutritional supplements work better together, in combination.

• When used alone, particularly in synthetic form or at the wrong dose, you don't get the maximum effect.

• When you stop taking supplements, you lose the benefits.

• Don't be confused by negative news reports. Educate you self. Do some research. The Internet offers many authoritative and noncommercial resources on supplement research, including the Linus Pauling Institute ( and the U.S. government's National Library of Medicine (

• Vitamin A has come under scrutiny. Long-term use of vitamin A supplements--over 20 years--may increase the possibility of hip fracture. We don't recommend more than 5,000 units of pure vitamin A (retinyl palmitate) a day. We prefer natural carotenoids (such as beta-carotene), which the liver converts into vitamin A as needed. Beta-carotene supplementation cannot produce vitamin A overload.

• Patients often ask when to take supplements if they are also taking medication. Your best bet is to take them separately, an hour or two apart. Sometimes minerals will interfere with the absorption of a particular prescription medication. In some instances, absorption could be enhanced.

• Quality is king. Avoid inferior supplements and products with artificial dyes and sugar. If you have doubts, consult with a nutritionally oriented health professional who can recommend supplements for you.

Four examples of the power of individual nutritional supplements as reviewed in Reverse Heart Disease Now:

Pomegranate Juice
Pomegranates are one of the richest sources of antioxidant flavonoids--healing nutrients found in plants. Recently, Israeli researchers have shown that these compounds slow the development of atherosclerotic plaque in mice and humans and help prevent LDL oxidation. In 2004, they reported on an experiment in which ten patients with severe carotid artery disease drank approximately 8 ounces of 100 percent pomegranate juice every day for one to three years. At the end of the study period, the researchers compared pomegranate juice drinkers to a matched group of patients who did not drink the juice, and they found a number of eye-opening differences:

• A 20 percent drop in systolic blood pressure in the juice drinkers.

• A 19 percent reduction in oxidized LDL antibodies--a test for cholesterol oxidation activity--in the pomegranate juice drinkers.

• A reduction in thickness of the carotid artery walls (30 percent, as compared to a 9 percent increase in the control group).

Coenzyme Q10 (CoQ10)
More than 4000 scientific studies and 12 international conferences have distinguished CoQ10 as a healing superstar and lifesaver. It does all these things:

• Presents disease and slows down the aging process

• Helps patients with all forms of heart disease

• Reduces mild to moderate hypertension

• Generates energy, strength, and vitality, even for older people

• Fortifies the immune system against illness, including cancer

• Counteracts the adverse effects of cholesterol-lowering drugs (statins)

• Improves nervous system and brain disorders

• Protects against gum disease, a condition affecting most adults.

CoQ10 is a fat-soluble vitamin. Despite strong scientific evidence for CoQ10's benefits, most doctors either haven't heard of CoQ10 or ignore its importance. To us this represents a major tragedy, because simply putting patients on a risk-free CoQ10 supplement pays off with health, energy, and therapeutic dividends.

Vitamin C
Most people taking vitamin C for protection from colds would never guess that they are getting a big heart and artery boost to boot. Consider these benefits of vitamin C:

• Decreases the need for repeat angioplasty by 57 percent

• Reverses endothelial dysfunction

• Improves recovery after bypass surgery and cuts the risk of post-operative arterial fibrillation in half

• Improves recovery following heart attack

• Helps control blood pressure

• Keeps CRP in check

• Helps neutralize Lp9ao and vascular wall damage due to homocystine

• Promotes conversion of excess cholesterol into bile acids that aid in digestion of fats

• Gets the lead out of your system

• Do you know of any other medication that can do so much?

Other Recommendations
Most every adult should take 1,000 mg of vitamin C as part of a daily supplement regiment. We often recommend larger doses for patients, depending on their Lp(a) and CPR levels, and our estimate of their degree of arterial inflammation. For best results, split the dosages into two or three servings throughout the day. If you are forgetful, it is better to take 1,000 mg in one dose rather than forget subsequent dosages.

In Bram Stoker's classic 1897 tale Dracula, the fair heroine Lucy uses a braid of garlic to fend off the blood-sucking count. Modern science has never gotten around to proving that garlic repels vampires, but it has repeatedly confirmed what healers throughout the ages have known: garlic is indeed nature's wonder drug.

Containing a veritable pharmacopoeia, including powerful sulfur and selenium compounds, garlic has been used for the prevention and treatment of disease for thousands of years--from infections to heart conditions.

In more recent times, garlic has gained the reputation as a natural antibiotic. Researchers have developed stabilized garlic compounds for use with supplements and found they have considerable promise against antibiotic-resistant bacterial strains.

Pathogens contribute to inflammation. Thus, garlic belongs in the armory of anti-CVD supplements. Another good, natural weapon against inflammation. Garlic is great in food; however, some of the garlic's medicinal potency is lost in cooking.

Selected Research
Studies show that garlic reduces multiple cardiovascular risk factors, including blood pressure, cholesterol, homocysteine, and platelet aggregation and adhesion, while stimulating nitric oxide generation in endothelial cells and raising HDL.

Other Recommendations
For people with CVD, supplement with a minimum of 1,000 mga day. Garlic also contributes to thinner blood. If you take Coumadin, you can still eat garlic, but don't use a garlic supplement.

We see an exciting time ahead for cardiology because so many new tools and so much new information are constantly emerging. The day is coming when no one will have to die from arterial disease.

But even today we can put out the flames of arterial disease with the best that alternative and conventional medicine has to offer. We can now determine the presence of nasty constituents within the blood--such as toxic metals--that poison the arteries We can determine with new imaging technology the extent of a patient's calcification and whether hard plaque or soft plaque is building up.

We are beginning to utilize genetics to hone in on a patient's specific weaknesses and map out individualized remedies. One day soon, we will be able to genetically test babies shortly after birth and determine enzyme deficiencies that may set them up for heart disease 40 years later. The genetic age in medicine is coming.

Soon we expect to be able to monitor endothelial function and check on the status of this critical one-cell layer that lines the arterial walls of the body. In the not-too-distant future, we may even have vaccines against atherosclerosis.

We see metabolic cardiology, electro-magnetic frequency devices, and other forms of energy medicine getting noninvasively to the heart of the matter, raising adenosine triphosphate (ATP), the body's basic fuel, and rejuvenating failing hearts.

The future of cardiology isn't just about applying high-tech gadgetry and research. Arterial and cardiac health still require that patients do their share, applying the low-tech (and low-cost) healing power of diet, nutritional supplements, and lifestyle changes. These are the basics that benefit not only the cardiovascular system but also the body as a whole. We are often amazed at how, in the shadow of high-tech medicine, we consistently achieve powerful healing effects with our patients by using simple, standard nutrients like vitamin E and niacin and CoQ10 and fish oil.

The future of cardiovascular medicine and medicine in general, must integrate the principles of a holistic approach that seeks to correct underlying causes with those of conventional medicine that addresses acute problems. We must have smart medicine in which physicians consider combinations of nutrition, lifestyle, pharmacology, and surgery to prevent or treat CVD. Hopefully, this union will occur in time to help you and your family, and before our expensive disease management approach bankrupts the Medicare and Medicaid programs.

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