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  • Daniel Chong, ND

The Cause of Heart Attacks- Part 2

In part 1 of this article, I questioned whether or not the ongoing travesty that is heart attack morbidity and mortality in our world today is at least in part due to the fact that the conventional treatment approach is not fully addressing the true cause of this condition. I also brought up some questions about cardiovascular disease that are unanswerable using the theory that elevated LDL particles are in and of themselves the sole or primary cause of this condition. Finally, I discussed a way of viewing the cause of this condition that would allow for answers to these questions and thus provide a more thorough way of addressing it. Here was my last sentence:


If then, we are to be as thorough as possible in our efforts to prevent heart attacks, we should not stop at lowering cholesterol. In fact, that should be a secondary focus, with the primary focus instead being the conditions which allow for it to become a problem.


Here’s how…..


One of my mentors, Dr. Mark Houston of the Hypertension Institute in Nashville, Tennessee, always stresses the ideas of “infinite insults” when discussing the true causality behind cardiovascular disease, and thus how to more thoroughly go about preventing and treating it.

I think of this idea often when working with people in my practice, and trying to focus (as noted above) on the conditions which allow for it.


“Infinite insults” is a term Dr. Houston uses to describe in general all the various things that can harm the health and function of your endothelium, or the inside lining of your blood vessels. Your endothelium is where the rubber meets the road in terms of potential for plaque to form in your arteries or not. A healthy, resilient, and robustly functioning endothelium makes you all but impervious to this process developing, whereas endothelial DYSfunction is the prerequisite and breeding ground for it.


Certainly, excessive levels of cholesterol carrying molecules like the infamous LDL or ‘bad

cholesterol’ can fit into the category of infinite insults, but so can elevated levels of:

  • Oxidative stress

  • Inflammation

  • Blood sugar

  • Homocysteine

  • Iron

  • Insulin

  • More obscure factors such as Lp(a), TMAO, endotoxins, heavy metals, various types of bacteria, viruses, and other microorganisms

  • Many more (hence the term “infinite”)

An additional factor to consider, is the concept of “susceptibility”, as it pertains to the vascular endothelium itself. In other words, if we are evaluating for the potential for damage to occur to a structure (the endothelium in this case) the most thorough evaluation would not only include assessment of the harmful factors noted above, but also the structure itself, and how susceptible, or vulnerable it is to damage.


In this case then, what would increase the endothelium’s susceptibility to damage?


Far and away, the factor which has the most impact on this area is nutrition. In other words, superior nutritional status, which assesses and accounts for both genetic factors such as Lp(a), MTHFR, and others, as well as specific nutrients crucial to optimal production and function of blood vessels will provide the most bang for the susceptibility buck. These nutrients include:

  • Amino acids like Arginine, Lysine, and Proline

  • Macrominerals like Potassium, Calcium, and Magnesium

  • Vitamins A, B Complex, C, and E

  • Trace Minerals like Copper, Zinc, and Manganese

  • Additional phytonutrients like nitrates, and flavonoids

For various reasons, nutritional therapy should always endeavor to obtain important nutrients

through food whenever possible. In terms of those noted above, it is not surprising that the

primary sources of all them can be found in what is popularly termed a ‘whole food, plant-based diet’.


It is also of interest to note that regular intake of processed, and/or animal-based foods will directly, or indirectly provide a steady supply of the noted insulting factors above.

Realizing this, the tremendously successful results seen through the work of pioneers in this

field like Dean Ornish, MD, Caldwell Esselstyn, MD, and Nathan Pritikin, all of whom have

utilized a whole food plant-based in the prevention and reversal of thousands cardiovascular

disease cases, start to make a lot of sense.


Hopefully by now you are starting to see that if the version of “prevention” you have settled on, in order to avoid the development of plaque in your arteries and potentially the most common cause of death in the world, starts and finishes with an aspirin and a statin or other cholesterol lowering drug, you are missing out on a tremendous opportunity to further improve your chances.


Some research even suggests that focus on the factors above will improve your chances more than the aforementioned drugs ever could. Why? Well, hopefully that is obvious by now. Drugs, by their very nature, do not and cannot satisfy nutritional needs of the body, nor do they do a very good job of helping protect you from the “infinite insults” aside from a few specific cases.


For the most part, drugs “work” by trying to make up for the results of the negative effects which occur from a combination of “infinite insults” and “susceptibility”.


Therefore, it is no surprise that we still have such dismal statistics for cardiovascular disease. The primary recommended treatments do not address the causes of the problem. They address the results of those causes. This is somewhat akin to relying on a mop to keep your floor dry, when you really just need to fix a leaky faucet.


A thorough approach then, which may or may not need to include medications if applied well enough, should always include an effort to satisfy unmet needs. When you do that, you lower your susceptibility.


If in addition to that, you return to the idea of “infinite insults”, and start to try and identify and eliminate any and all such factors, moving far beyond cholesterol alone, your chances will improve further still.


Stay tuned for the third and final part of this series, when I discuss how best to go about identifying where your cardiovascular health currently sits and what, if any, degree of damage has already occurred. This will give you the best idea of how much effort you need to put into prevention vs treating a disease that is already there.


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