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Women's Heart Health - by Marilyn R. Clevenger
« on: March 12, 2007, 04:06:28 PM »
Women’s Heart Health

by Marilyn R. Clevenger, NE, NC (can.), CCHT

Coronary Heart Disease, which can lead to heart attack and ultimately to heart failure and death, is the number one killer of both men and women in the United States each year. According to National Geographic Magazine, 500,000 people die each year from this disease.  Globally 72 million die annually.  Cancer is the second largest killer in the U.S.  Most heart attacks are caused by plaque embedded within the artery wall.  Ruptures in this plaque can crack open the artery wall and trigger the formation of a blood clot, which blocks the flow of blood to the heart muscle. The lack of oxygen and nutrients that results can destroy the heart. Interestingly, heart attacks more often occur in arteries that have moderate blockage.  The kind of plaque present is more relevant, than the quantity. Softer, unstable plaques, rich in cholesterol are more likely to rupture than hard, calcified plaques. Research indicates that genetic factors may be more significant than previously thought when determining who will suffer a heart attack.  In some people a genetic defect may produce a faulty protein, which may be the root of a predisposition to Coronary Heart Disease.  (National Geographic Magazine, 2007,  p 48.)  It is also clear that diet is a significant component among those who develop Coronary Heart Disease.  People who consume diets high in cooked fats, especially fats cooked at high temperatures, such as in fried foods, are at significantly higher risk. 

Markers for Coronary Heart Disease -
Several conditions, including:  increased platelet aggregation, hyper-coagulation and excessive blood thickening, indicate an increased potential for heart attack. 
When looking for markers indicating the increased potential for Coronary Heart Disease, inflammation is one of the significant indicators. A coagulation protein, Fibrinogen, is a marker for high inflammation.  Death from heart attack has been shown to be twice as likely among persons with high levels of fibrinogen.  To protect against Fibrinogen inducing an arterial blood clot and causing an ischemic stroke the Life Extension Foundation recommends the following protocol:  Regular use of Low Dose Aspirin, Vitamin E (contraindicated with anti-coagulant medicine), Garlic, Gingko Biloba and Green tea extracts.  (Life Extension, 2003, p. 414). 
A significant risk factor for stroke is elevated Fibrinogen levels.  Supplementation effective in lowering elevated Fibrinogen levels include daily intake of:
   2000 mg. per day of Vitamin C   2400 mg. of ‘flush free’ niacin
   2800 mg. of EPA/DHA from Fish Oil   2000 mg. of Bromelain
(Bromelain is an enzyme, found in pineapple and papaya, that supports the digestion process of breaking down fats for assimilation by the body.  It is recommended for people who have difficulty digesting fats, and is especially indicated to support digestion of cooked fats.)

Another inflammatory marker for increased risk for heart attack is C-reactive protein, indicating an increase in destabilized atherosclerotic plaque and abnormal arterial clotting.  An acute heart attack can be triggered by destabilized arterial plaque.  There is some indication that death resulting from a heart attack is increased threefold among people with high levels of C-reactive protein. Included in Life Extension’s analysis was a women’s health study which indicated that C-reactive protein is the single strongest predictor of future vascular risk. Addressing elevated C-reactive protein levels with Ibuprofen, aspirin, and Vitamin E. (which is contra-indicated with anti-coagulant medicine) is recommended. (Life Extension, 2003, p. 414).
High Homocysteine levels is another correctable risk factor for heart attack.  (Life Extension, 2003, p. 416). Even though there is significant knowledge of the underlying causes of arterial disease, the conventional medical approach tends to address a limited number of factors.  Prescribing cholesterol lowering drugs and controlling hypertension are routinely practiced approaches, which bypass addressing the underlying causes of arterial disease.  In many cases health care provider plans often will not pay for tests that may indicate conditions that represent increased risks for heart attack.
Inflammatory risk factors can sometimes be corrected using supplementation such as fish oils and DHEA, which will suppress over production of dangerous cytokines.  Other approaches to support heart health include nettle leaf extract, green tea, gingko Biloba, Garlic, and vitamins A, B 6, B12, C, E, Folic Acid, and regular use of olive oil.  The Life Extension Foundation has demonstrated an effective lowering of high homocysteine levels using supplementation of 6 Grams of TMG (Trimethylglycine) daily.  Homocysteine can occur as a result of a diet high in the amino acid methionine (found in red meat and chicken) when there are insufficient vitamin co-factors (such as Folate and Vitamin B6.)  Life Extension recommends these levels of Daily intake of vitamins and supplements to maintain safe Homocysteine levels:
500 mg. of TMG (Trimethylglycine)         800 mcg. Folic Acid
   1,000 mcg. of Vitamin B12         250 mg. of Choline
   250 mg. of Inositol            30 mg. of zinc
   100 mg. of Vitamin B6

They also recommend blood tests to monitor safe homocysteine levels. A meta-analysis of 15
studies revealed that an 86% increase in the potential for stroke resulted from mild to moderate
elevations in homocysteine levels.  Stroke, which also results from Cardiovascular disease, is the 3rd leading cause of death in developed countries results in 25% death, 50% moderate to severe health impairments and long term disabilities, and only 26% recovering most or all of normal health and function. (Life Extension, 2003, p. 416)

Heart Attack Symptoms in Women -
Women’s heart attack symptoms may be the same as, or different from symptoms in men. The most familiar symptoms is a squeezing chest pain and pain through the left arm. Other symptoms may occur, particularly in women, in the absence of these more common and obvious symptoms. These include:  mild chest discomfort or dull ache, heart palpitations, nausea, vomiting, weakness, dizziness, coughing, fainting and cold perspiration, tingling in the hands, wrists, and fingers, shoulder, neck and jaw pain, indigestion, back pain, tooth pain and dry mouth. In some circumstances a heart attack may occur is no pain, which is known as a ‘silent heart attack’.  The elderly and people with Diabetes are more likely to experience a heart attack of this type.  Women more often have atypical symptoms than men. These symptoms may include:  shortness of breath, excessive sweating, intense fatigue, nausea and intuitive perception of having a heart attack, when other symptoms are not present.  When Angina Pectoris, characterized by chest pain occurs in women, they are more likely to delay treatment than men.  According to the Mayo Clinic Health Letter, Women who are Diabetic are more likely to experience both coronary artery disease and heart-related fatalities, and are more likely to experience a second heart attack than men. Women are more often misdiagnosed than men for heart attack symptoms. (Simontacchi, 2004, p.29)

Heart Disease Rates -
The rate of heart disease has been declining over the past few years, although it is declining more slowly for women, than for men. In one study the death rate for women who experienced heart attack was more than double the level for men. Historically women have been under-diagnosed, and that remains true today. (Simontacchi, 2004, p 26.)  Heart disease often led to death 50 years ago, but more recent developments in treatment, including statin drugs and procedures such as angioplasty and bypass surgery have made chronic heart disease more manageable, and have increased the potential survival rate among those who receive treatment in a timely way. (National Geographic Magazine, 2007, p.55).

Heart Attack Risk factors include
Too little “good” fats (High-Density Lipoproteins) and too much “bad” fats (Low-Density Lipoproteins) quadruples the risk.
Diabetes - in women quadruples the risk. (In men, it doubles the risk)
Hypertension - doubles the risk for women and nearly triples the risk for men.
Stress and Depression - nearly triples the risk.
Abdominal Obesity - more than doubles the risk.
Lack of Exercise - increases the risk by about 20 percent.
Smoking - can double or even triple the risk.

Conversely – A Healthy Diet DECREASES the risk by close to 30 percent!
AND, as non-invasive techniques improve, the rate for bypass surgery goes DOWN!
(National Geographic, 2007, p. 55)

A ‘Heart Friendly’ Healthy Dietary Approach
According to Julia Ross in her book “The Diet Cure” American diets tend to be high in simple carbohydrates (processed grain foods such as pasta and bread), and high carbohydrate vegetables (especially corn, potatoes) and too low in complex low carbohydrate vegetables (such as cabbage, chard, spinach, tomatoes, cucumbers, asparagus, broccoli, mushrooms, garlic). It would be especially supportive of restoring the body’s health to replace poor quality cooked fats and oils with raw (uncooked) fats such as Cold pressed organic olive oil and avocados. (Ross, 1999, p, 303-308)
After initial assessments for an individual, which would include:  Age, current weight, ideal weight, activity level, stress, health status and metabolic tendency, as well as any other relevant information specific to the individual, recommendations can be made to move towards greater health and vitality, based on ‘diet direction’. Both the types and the quality of foods should be considered, along with exposure to toxins, whether through diet, environmental exposure, or from use of medications or recreational drugs, or alcohol consumption.  (Bauman, 2005, p. 541)
A dietary approach to support a healthy heart would likely begin with a “Cleansing Diet Direction”, to support the body to cleanse both excess weight and stored toxins. 
This approach would include:  60 – 80% Carbohydrates, 10 – 20% Protein, and 10 – 20% Fats

As weight was re-established at a healthier level (based on Body type and height), as the body was experiencing the benefits of cleansing, the approach could be redirected towards a “Balancing Diet Direction” which would include:
50 – 70% Carbohydrates, 15 – 25% Protein, and 15 – 25% Fats. (Bauman, 2005, p.541)
The dietary adjustments would allow the carbohydrate emphasis to move away from highly cooked, high carbohydrate vegetables and cooked fruit, towards lightly steamed or raw low carbohydrates vegetables and raw fruit. (Ross, 1999, p. 303)


Bauman, Ed, M.Ed., Ph.D., Bauman College Nutrition Educator Handbook, Bauman College Nutrition and Culinary Arts, Penngrove, 2006.
Life Extension Disease Prevention and Treatment, 4th Edition, Cardiovascular Disease: Overview, Comprehensive Analysis, Review. Life Extension Foundation/Media, Hollywood, p.413 -528, 2003.
Kahn, Jennifer. Mending Broken Hearts. National Geographic Magazine, February, 2007: 40 - 65, National Geographic Society, Tampa, February, 2007.
Simontacchi ,Carol, C.C.N., M.S. and FitzGerald, Frances, E., A Woman’s Guide to a Healthy Heart, McGraw Hill, New York, 2004.
Ross, Julia, M.A., TheDiet Cure, Penguin, New York, 1999.

Marilyn R. Clevenger, Holistic Certified Nutrition Educator and Consultant, Certified Clinical Hypnotherapist. Live Foodist! Nutrition Education Courses: Nutrition Support for Illness, Addiction, Depression, Weight Loss, Children's Health.  See Forum Calender for Class Schedules.