If you think about high cholesterol, and the possibility of blocked arteries caused heart attacks, that most of us that the block is not only a big piece of fat in the arteries. Well, that part of history, but not all. This is a complex inflammatory process begins with atherosclerotic plaques that can then lead to a heart attack, when a plaque breaks loose.

Blood is traveling at high speed and pressure when you leave your heart, after all, whobe pumped hard enough to get all the way through the body. Your blood is full of red cells, white cells, and many other components. Sometimes the power of these components is true of the arterial wall is sufficient to cause an injury or wound on the wall of the arteries.

As with all wounds, immune and inflammatory components will immediately start the scene as for the repair. Are sticky, and tend to attract different audiences, such as LDL-cholesterol molecules. IfThe wound does not heal fast enough, can begin to form a sticky plaque on the artery wall. If you have a healthy, physically active people with a good supply of antioxidants and immune system are to increase the nutrients in the diet, the panel can be cleaned and erased the initial injury. But if your LDL is too high and your diet is poor, the atherosclerotic plaques can continue to grow and grow. Finally, you can take a large part of the artery should be in the bloodflow.

This blockage in the arteries is not simply because it is very difficult for the heart to pump blood. When the atherosclerotic plaque breaks away from the wall of the arteries, there is a flood of inflammatory components, trying to repair the original injury. Such a component is pro-thrombotic, that is, it promotes blood clotting. Still able to develop bleeding immediately add to the potential of the arteries blocking clumps of cholesterol, which have just brokenfree. The researchers found that the majority of fatal coronary events may be one or more of these plates cause breakage.

You can prevent this from happening. Is diagnosed if your blood cholesterol is high, or if you have been associated with atherosclerosis, that's what you do to improve your health:

1. Increase intake of soluble fiber every day. This means, 2-3 apples, or oats, or serve vegetables.

2. Get exercise every day, enough to blow up and sweaty.This will reduce the amount of LDL cholesterol in your body. Consult its important to consult your doctor and a qualified fitness instructor, prior to the safest and most effective fitness program for you.

3. Taking a supplement of antioxidants a. The most effective are superoxide dismutase, although a mixture of various antioxidants such as vitamin C may have a broader impact.

4. Take a supplement Omega 3 (fish oil). The minimum dose therapeutic 3G (three capsules) with aat least 300 mg of EPA and DHA 200 mg in a capsule.

There are so many things you can do to improve the health of arteries. For best results, with approved clinical doctors consulted to determine the most effective strategies to improve health for you.

Ah, the smells of football.  Blood ground into a jersey.  Mud caked onto cleats.  The sweat at the bottom of the pile.  For most of us, though, we don’t really smell these particular odors.  So let me start again for the average fantasy fan…….

Ah, the smells of football.  Buffalo chicken wings.  Creamy coleslaw.  French fries.  Nachos.  Bacon cheeseburger.  Oh, yeah, we know these smells quite well!  However, the better you know these smells, the better you might know what LDL stands for.  And, I can tell you, it does not stand for Left Defensive Lineman. 

LDL is the “bad cholesterol” or “low density lipoprotein” for you science types out there.  I think of cholesterol as kind of like a car-wax type of substance.  Except that it is found in your bloodstream and in all your body’s cells.  Just the right amount of cholesterol is a good thing – your body uses it for a number of important functions – but too much and you and your family may be dealing with your coronary heart disease, heart attack, or stroke. 

High cholesterol puts you at risk for atherosclerosis which is a fancy name for crud in your arteries.  It is like a thick plaque that builds up on your teeth, except a dentist just can’t scrape it away because the plaque is in your artery walls.  When blood can’t flow freely, all sorts of bad things happen.  Our heart and our brain like a regular supply of blood, so when the freeways are jammed, the resulting traffic jam can be deadly. 

Like I said, LDL is the bad guys.  HDL, or high density lipoprotein, is the good guys.  HDL seems to slow down or repair some of the damage that the LDL does.  You want to be lower in LDL and higher in HDL.   When you get a blood test to check your cholesterol, and you totally should, they count your LDL, HDL and triglycerides and Lp(a) which is LDL’s no good cousin. 

Your body creates the cholesterol you need but you also get it through foods.  The American Heart Association has a really cool food guide that will give you advice on what to eat and what not to eat for all sorts of different foods:  Mexican, American, Thai, Vietnamese, Chinese, fast food, steakhouses, etc.  

The daily recommended cholesterol limit is less than 300 milligrams for people with normal LDL levels.  The nutrition facts label of food, learn more about those here, is a good place to look.  Even if it lists cholesterol content as low or none, see if it has saturated fats and/or trans fats.  Does it have hydrogenated fats and oils on the list of ingredients?  All these things lead to higher cholesterol. 

So what do you do about it?  You play Fantasy Healthball with us and change your lifestyle!  Don’t smoke, eat less fatty foods, keep your weight down, exercise, talk to your doctor in-depth about if medications are necessary.  Replace some of those football smells I mentioned earlier with some new ones – veggie burger, grilled fish or chicken breast, taco salad (skip the shell), steamed or stir fried veggies, low sodium soups and more.   Ah, the smells of football!  Smells good!  — Jim Ballard

Coronary circulation is the circulation of blood in the blood vessels of the heart muscle. Although blood fills the chambers of the heart, the muscle tissue of the heart (the myocardium) is so thick that it requires coronary blood vessels to deliver blood deep into it. The vessels that deliver oxygen-rich blood to the myocardium are known as coronary arteries. The vessels that remove the deoxygenated blood from the heart muscle are known as coronary veins.

The coronary arteries that run on the surface of the heart are called epicardial coronary arteries. These arteries, when healthy, are capable of autoregulation to maintain coronary blood flow at levels appropriate to the needs of the heart muscle. These relatively narrow vessels are commonly affected by atherosclerosis and can become blocked, causing angina or a heart attack. (See also: circulatory system.) The coronary arteries that run deep within the myocardium are referred to as subendocardial.

I guess you are wondering what’s up with the definition for coronary circulation?  Well, I have some posts here titled “finding God” and “Know who you serve“.   I even posted a commentary by Matthew Henry on John 16:7-15. So what does all this have to do with coronary circulation you might ask… Well, if you think about how all that God does in our lives start within the heart and how true faith starts there and moves outwardly.  The openness and strength of these arteries help maintain the health of the heart.  To be drawn by God the heart needs to be open. For there to be life the blood has to flow freely.  The harder it is for the blood to flow and the more resistance the circulation has, the greater the negative effects on the heart.  If we are resisting God or hardering our hearts against the flow of the Holy Spirit; as God draws us and teaches us in other to give us the Christ?  How does it effects our lives and the fullness of our lives?  The effects can be negative for an eternity of damnation.  We will never experience of the fullness of God’s righteousness or all the God has for His elect; the children of the living God.  As long as our selfish hearts put our selfish desires ahead of God’s will; we will continue to go through whatever it is God is doing to soften our hearts.  As long as we desire to be rebels against God, as long as we revel in sin and desire sin, glorify sin in song and dance, as long as we dance around our idols and worship them we will suffer greatly.  Brokenness is not what I use to think it was.  To me brokenness is the process of God killing the idols, the lust, the pride and the devils in our hearts as we fight to hold onto our sinful flesh’s will.  At time I feel that we are the pagan god mammon; but we can’t serve two masters.  We will love one and hate the other.  Whether you know it or not you are a slave to something; Christ or Satan; Jesus or your flesh; sin or the Holy Spirit.  Some of us are dying cause we have chosen to cute off circulation to Christ; as we picked sin over righteousness.  Right now you say that you are just having fun and you have time to serve God when you are old….   You should really rethink that statement and understand what it is that you are really saying to God and about God’s will…..   I refuse to put words into your head because you need to think about it on your own with your own heart and examine the relationship with God that you have.

L-arginine is an amino acid that has numerous functions in the body. It helps the body get rid of ammonia (a waste product), is used to make compounds in the body such creatine, L-glutamate, and L-proline, and can be converted to glucose and glycogen if needed.

L-arginine is used to make the nitric oxide, a compound in the body that relaxes blood vessels. Preliminary studies have found that L-arginine may help with conditions that improve when blood vessels are relaxed (called vasodilation), such as atherosclerosis, erectile dysfunction, and intermittent claudication.

L-arginine is also involved in protein formation. In larger amounts, L-arginine stimulates the release of hormones growth hormone and prolactin.

Why Do People Use L-Arginine?

• Heart disease

In the body, L-arginine is used to make nitric oxide, which reduces blood vessel stiffness, increases blood flow, and improves blood vessel function.

However, L-arginine should not be used following a heart attack. An study sponsored by the National Institutes of Health examining the use of L-arginine after a heart attack was terminated early after six patients died, a disproportionate number. There were no deaths in the patients who did not receive L-arginine.

The study researchers speculate that L-arginine may aggravate the effects of cardiac shock. The results were published in the Journal of the American Medical Association.

• Erectile Dysfunction

L-arginine has been used for erectile dysfunction. Like the drug sildenafil citrate (Viagra), L-arginine is thought to enhance the action of nitric oxide, which relaxes muscles surrounding blood vessels supplying the penis. As a result, blood vessels in the penis dilate, increasing blood flow, which helps maintain an erection. The difference in how they work is that Viagra blocks an enzyme called PDE5 which destroys nitric oxide and L-arginine is used to make nitric oxide.

In one study, 50 men with erectile dysfunction took either 5 grams of L-arginine per day or a placebo. After six weeks, more men in the L-arginine group had an improvement compared to those taking the placebo.

Unlike Viagra, L-arginine must be taken daily.

• Wound healing

L-arginine’s possible activity in wound repair may be due to its role in the formation of L-proline, an important amino acid that is essential for the synthesis of collagen.

• Other Conditions

L-arginine is also used for high blood pressure, migraines, sexual dysfunction in women, intermittent claudication, and interstitial cystitis.

Sources of L-Arginine

L-arginine is conditionally essential, which means that the body normally has enough. It’s produced in the kidney and to a lesser extent, in the liver.

Food sources of L-arginine include plant and animal proteins, such as dairy products, meat, poultry, fish, and nuts. The ratio of L-arginine to lysine is also important – soy and other plant proteins have more L-arginine than animal sources of protein.

Severe burns, infections, and injuries can deplete the body’s supply of arginine. Under these conditions, L-arginine becomes essential and it is necessary to ensure proper intake to meet the increased demands.

L-arginine is also essential for children with rare genetic disorders that impair the formation of L-arginine.

I was excited to see an article, “A Look at the Low-Carbohydrate Diet,” in the December 3, 2009, New England Journal of Medicine.  I was quickly disappointed.

Expecting a scholarly review of low-carb eating in humans, I found an exposition of a diet study in mice.  And not just your garden-variety mice.  These were a lab strain deficient in apolipoprotein E, which makes them particularly susceptible to atherosclerosis when fed a “Western” high-fat, moderate-protein, moderate-carbohydrate diet instead of standard lab chow.

Click on the HeartWire reference below for a discussion of the original mouse research.  I wrote a short post about it in August, 2009.

The article author, Dr. Steven R. Smith, states the usual concern that high-fat (especially saturated fat), high-protein, low-carb diets may cause cardiovascular disease such as atherosclerosis (hardening of the arteries).  He doesn’t mention the scientific evidence showing little or no role of total and saturated fat in cardiovascular disease.

I give credit to him for mentioning that high-fat low-carb diets area associated with improvement in several cardiovascular risk factors such as HDL cholesterol and blood pressure.  He thought they also improve ( lower) LDL cholesterol levels—not something I’ve been impressed with.  He didn’t mention the lowering of triglycerides so often seen. 

Dr. Smith explains that, compared with controls, mice eating the Western high-fat low-carb diet demonstrated progression of atherosclerosis, perhaps mediated by elevated nonesterified fatty acids and low numbers of endothelial progenitor cells.  These are not yet considered classic cardiovascular risk factors in humans.

To quote Dr. Smith, his main point is that . . .

The work of Foo et al suggests that the [high-fat low-carb] diet might increase the risk of cardiovascular disease through mechanisms that have nothing to do with these “usual suspects” [e.g., LDL and HDL cholesterol, blood pressure, C-reactive protein] and so provides a note of caution against reliance on the traditional cardiovascular risk factors as a gauge of safety.

He rightfully calls for investigation of these issues in humans, but . . .

In the meantime, the ageless advice applies to the consumer of the [high-fat low-carb] diet and other fad diets: caveat emptor.

Take Home Points

I agree that human studies are needed.

As the evidence in favor of the safety and efficacy of high-fat low-carb diets increases, the reigning medical establishment is looking for new ways to discredit them.  This attempt is pathetic.

Unfortunately, the typical physician reading NEJM will skim this article and conclude, “Yeah, I was right—the Atkins diet causes heart disease.  Low-fat high-carb is still the best.” 

If you have beloved pet mice that are deficient in apolipoprotein E, don’t feed them a high-fat low-carb diet.

Steve Parker, M.D.

References:

Smith, Steven R.  A Look at the Low-Carbohydrate Diet.  New England Journal of Medicine, 361 (2009): 2,286-2,288.  [This may cost you $10 USD.]

Foo, S.Y., et al.  Vascular effects of a low-carbohydrate high-protein diet.  Proceedings of the National Academy of Sciences of the United States of America, 106 (2009): 15418-15423.   doi: 10.1073/pnas.0970995106  [This may cost you $10 USD.]

Busko, Marlene.  Atherosclerosis heightened in mice fed low-carb, high-protein diet.  HeartWire, August 26, 2009.  [Free]

Angioplasty in India

An Overview

The heart muscle depends on a regular and optimum supply of oxygen to function properly. In turn, it pumps blood throughout the body. The oxygen supply to the heart is completed with the help of a system of coronary arteries.The blood flowing through the coronary arteries carries oxygen to the heart muscles. Sometimes deposits of substances like cholesterol,excess muscle cells, collagen and sometimes the accumulation of proteins on the inner walls of the arteries cause narrowing and hardening of these blood vessels.This process in medical term is known as “atherosclerosis”.
Blockage of an artery in this way starves the heart of oxygen. If the blockage is mild only pain results. If severe, the part of the heart that is starved of oxygen actually dies—this is what we call a heart attack .An angioplasty is a medical procedure used to open a blocked coronary artery and improves blood flow to the heart.
Sometimes after a heart attack, surgeons attempt to open up a clogged artery through a technique called ‘Balloon Angioplasty.’In balloon angioplasty, a long tube (catheter) with a balloon at one end is inserted through the groin and is guided to the clogged artery in the heart. At the site the balloon is inflated. The inflated balloon crushes the plaque (deposit) on the artery wall. The balloon is then deflated and withdrawn.
Besides balloon angioplasty there is another technique called laser angioplasty in which a laser beam is used to cut through the plaque.
After the procedure, your doctor may insert a device called a stent to keep the artery open for a longer period of time. In most cases, this procedure is safe and effective. If complications occur, they can include nausea, minor infections, and temporary pain.

What Is Angioplasty?

Balloon angioplasty (also known as just angioplasty) is a procedure that allows your doctor to open blocked coronary arteries, which are the arteries that provide oxygen and nutrients to your heart muscle. In this procedure a balloon catheter (thin tube) is inserted into a blocked artery to remove the blockage. The blockage may be present in an artery in the arm, leg, or in the heart.

The catheter is inserted into a blood vessel either at the elbow or groin. It is pushed through the inside of the blood vessel so that the tip of the catheter is at the point of the blockage in the artery. The narrowed artery is stretched by inflating a balloon at the tip of the catheter allowing blood to flow normally through the artery again. The doctor then removes the catheter and balloon.

Often, an expandable device, called a stent, is inserted into your blocked artery after the procedure. Stents can help the artery remain open for a longer period of time. Your doctor’s choice to perform an angioplasty or insert a stent is based on the type and location of your blockage.In addition to being effective, this procedure is safe and well tolerated in most cases.

The Question that must be striking in our mind is why To Select India for such Treatments ?

India offers World Class Medical Facilities, comparable with any of the western countries. India has state of the art Hospitals and the best qualified doctors. With the best infrastructure, the best possible Medical facilities, accompanied with the most competitive prices, you can get the treatment done in India at the lowest charges. People from different walks of life cut across the entire span of the globe come to India to have their treatments done with peace of mind. India’s excellent education system is not only churning out computer programmers and engineers, but an estimated 20,000 to 30,000 doctors and nurses each and every year. The list of India Best Hospitals includes Apollo, Fortis, Max Healthcare, Escorts, AIIMs, Wockhardt, etc. A few top Medical tourism providers are ThaiMediHealth.com, India4health.com. With time more and more visitors will flock to this part of the globe for their treatment and relaxation needs.

Indraprastha Apollo Hospitals New Delhi is part of the Apollo Hospitals Group and is a multi-specialty tertiary care Institute with over 50 medical and surgical disciplines. With over 7000 beds in 38 hospitals, a string of nursing and hospital management colleges, and dual lifelines of pharmacies and diagnostic clinics providing a safety net across Asia, Apollo Hospitals is a healthcare powerhouse you can trust with your life.

Narayana Hospitals Bangalore is one the best hospitals in India, in the field of Cardiology, Pediatric care, Neurology, Gastroentrology, Nephrology & Urology and Transplants. The rich come here for the world’s best heart care. The poor come here for the world’s kindest care, for no one here is turned away for lack of funds.

Fortis Healthcare Limited (FHL) is an enterprise from the promoters of Ranbaxy, India’s largest pharmaceutical company and a global giant. With the first flagship venture of the Group, Fortis Hospital at Mohali in 2001, today the Fortis network has grown to ten hospitals with a bed capacity of around 1600 beds establishing itself as one of India’s leading advanced tertiary care Healthcare Group.

This is one of the important point that cannot be ignored is that you get the best treatment in most reasonable charges. Moreover India is rich in natural beauty and it’s wide heritage. Here you can have your treatment done as well as relax and have complete mental peace. Medical Tourism in India is being offered by ThaiMediHealth.com , India4health.com, Medical tourism singapore,IndiaHeals, they arranges for travel, medical treatment, hospitalization, stay in India. Various hospitals and health care providers have recognized our reliability in this area across India. Ten years ago, medical tourism was hardly large enough to be noticed but nowadays Medical Tourism is fast becoming a worldwide, multibillion-dollar industry, whereby people from world over visit India for their medical and relaxation needs.

For more help with medical queries visit : http://www.india4health.com/asiahealth/Enquiry.html to Send your medical query for free or http://www.india4health.com/Fortis.html link of the Fortis Hospital India or to get more informations on Angioplasty go through http://www.thaimedihealth.com/Angioplasty.html

Atherosclerosis   remains the number one cause for all vascular disease of human beings. It probably  kills more  patients than all other causes put together .

Modern medicine has never conquered the disease. How  the vascular system ages and why some develop premature atherosclerosis remains largely speculative. While it is true , we have identified some major risk factor for development and progression of the atherosclerosis  , patients with out any of those risk factors do develop severe atherosclerosis !So researchers sought to look for some other risk factors . There lies the difficulty  and irony .

We always tend to the research with the affected population .When we know millions of people with the so called risk factors live comfortably , there lies an opportunity  to  analyse why they are protected against the onslaught of atherosclerosis .It is always convenient to blame it or bless it on the genetic predisposition .But we need to look beyond that .Of course  . every genetic expression has to  manifest phenotypically .

While the search for all those hidden secrets has to continue , we should also realize in pursuit of breakthrough we some times waste our energy in false targets  for too many decades !

The reality as on today is ,  there is no reliable  &  undisputed drug available to arrest atherosclerosis  (Some would love to call statin so . . . )

While  our basic science colleagues struggle  in molecular  factories and biological models in pursuit of answer against  atherosclerosis , our elite  cardiac physicians   carry on with the cosmetic touches over this   progressive disease  in  sophisticated cath labs.

Let us hope  man prevails over nature . . .

A cartoon , Just for laughs . . .

MODERN MEETS ANCIENT CT scans of some Egyptian mummies, like the one being done on this priest, reveal signs of atherosclerosis.

The Book of Exodus in the King James translation of the Bible describes a pharaoh who “hardened his heart” against the exodus of the Jews from ancient Egypt. But if a research letter published last week in The Journal of the American Medical Association is correct, the pharaoh may have been suffering from hardened arteries.

The new report recounts how a team of cardiologists used CT scanning on mummies in the Egyptian National Museum of Antiquities in Cairo to identify atherosclerosis — a buildup of cholesterol, inflammation and scar tissue in the walls of the arteries, a problem that can lead to heart attack and stroke.

The cardiologists were able to identify the disease in some mummies because atherosclerotic tissue often develops calcification, which is visible as bright spots on a CT image. The finding that some mummies had hardened arteries raises questions about the common wisdom that factors in modern life, including stress, high-fat diets, smoking and sedentary routines, play an essential role in the development of cardiovascular disease, the researchers said.

“It tells us that we have to look beyond lifestyles and diet for the cause and progression of this disease,” said Dr. Randall C. Thompson, a cardiologist at St. Luke’s Mid America Heart Institute in Kansas City, Mo., and part of the team of cardiovascular imaging specialists who traveled to Cairo last year. “To a certain extent, getting the disease is part of the human condition.”

Last February, the team of cardiologists — one Egyptian and four American — conducted whole-body scans of 20 of the museum’s mummies that were well preserved and thus likely to have identifiable arteries. The study also included two mummies that had been scanned by other researchers.

Sixteen of the people mummified had been members of a pharaoh’s court, among them two priests, a king’s minister and his wife, and a nursemaid to a queen. They lived between 1981 B.C. and A.D. 334, the cardiologists said.

Among the 16 mummies that had identifiable cardiovascular tissue, there were 5 confirmed and 4 probable cases of atherosclerosis.

The researchers found calcification in the leg arteries and the aorta of some mummies, which means that these ancient Egyptians had risk factors for problems like strokes and heart attacks — though not necessarily that they had developed heart disease before they died. As with modern humans, arterial calcification was more prevalent among the mummies who lived longer. The study’s small sample and the subjects’ high socioeconomic status may mean the findings do not extend to more ordinary ancient Egyptians, said Dr. Adel H. Allam, the Egyptian cardiologist on the team.

“They were rich people, and the habit of diet and physical activity could be a little bit different than other Egyptians who lived at that time,” said Dr. Allam, an assistant professor of cardiology at the Al Azhar Medical School in Cairo.

The group hit upon the idea of examining mummies for arterial disease in 2007, when another cardiologist, Dr. Gregory S. Thomas, was visiting Dr. Allam in Cairo and happened upon a mummified pharaoh named Menephtah in the museum. A plaque by Menephtah’s case explained that the pharaoh, who died about 1200 B.C., had been afflicted with atherosclerosis.

Dr. Thomas, a clinical professor of medicine and cardiology at the medical school of the University of California, Irvine, did not believe it.

“For one thing, how would they know?” Dr. Thomas said in a phone interview last week from Cairo. “For another thing, what would people be doing with atherosclerosis 3,000 years ago, without tobacco, with an all-natural diet and, presumably, with much more walking?”

Egypt’s Supreme Council of Antiquities gave permission for the team to scan a group of mummies, provided that none were royalty. The team used a CT scanning system, housed in a trailer at the back of the museum, that had been donated by the medical device maker Siemens and had been used by a different team in 2005 to scan Tutankhamen. Siemens, the National Bank of Egypt and St. Luke’s Mid America Heart Institute were sponsors of the study.

The oldest mummy in whom the group found hardened arteries was Lady Rai, a nursemaid to a famous queen, who died in about 1530 B.C. when she was between 30 and 40 years old. Dr. Thompson said the calcification in her aorta looked similar to that in images of his own patients with atherosclerosis in Kansas City.

“She went in a relic,” Dr. Thompson said of the mummified Lady Rai. “She came out a patient.”

Modern habits have long been linked to cardiovascular disease in the public mind — in part, said Dr. Roger S. Blumenthal, director of the Ciccarone Center for the Prevention of Heart Disease at Johns Hopkins, because of correlations like the one between smoking and heart disease.

Heart disease increased in the 20th century as more people took up smoking. Then it declined after the surgeon general’s famous warning in 1964, said Dr. Blumenthal, who is not affiliated with the mummy researchers.

But Dr. Thomas says he now views arterial buildup as being more like wrinkles — a human condition whose progression may be inhibited by behavior like avoiding cigarettes and too much sunlight, but which is ultimately inevitable. If that is the case, he said, preventive lifestyle changes become even more important.

“You have to think about it differently if everyone is going to get it,” Dr. Thomas said. “I don’t want to say it is something we can prevent, but it is something we can delay.”

Natasha Singer, New York Times

__________

Full article and photo: http://www.nytimes.com/2009/11/24/health/24heart.html

Ischemic Stroke: sudden loss of function resulting from disruption of the blood supply to a part of the brain. Neurons die when they can no longer maintain aerobic respiration.

• Event usually the result of long-standing cerebrovascular disease
• early Tx results in fewer symptoms and less functional loss

5 different types

1. large thrombosis – 20%
2. small penetrating artery thrombosis – 25%
3. cardiogenic embolic stroke – 20%
4. cryptogenic 30%
5. Other – 5%

Large artery thrombosis strokes: due to atherosclerotic plaques in the large blood vessels of the brain. Thrombus formation and occlusion at the site af the atherosclerosis result in ischemia and infarction.

Small Penetrating artery thrombotic strokes: affect one or more vessels and are the most common type of ischemic stroke.

Aka lacunar strokes because of the cavity that is created once the infarcted brain tissue disintegrates.

Cardiogenic embolic strokes: are associated with cardiac dysrhythmias, usually atrial fibrillation. Emboli originate from the heart and circulate to the cerebral vasculature, most commonly the left middle cerebral artery, resulting in a stroke. Embolic strokes may be prevented by the use of anticoagulation therapy in patients with atrial fibrillation.

The 2 remaining categories of ischemic strokes are cryptogenic with no known cause and others causes such as cocaine, coagulopathies, migraine and spontaneous dissection of the carotid or vertebral arteries.

Pathophysiology:

Martin, Glenn and Porth, Carol, Mattson. 2009. Pathophysiology Concepts of Altered Health States. 8th ed. Lippincott Williams and Wilkins. Philadelphia

FREE eBook (adobe file, Introduction and first two chapters: Way of Thinking and Way of Food, should take you a long way). Email me (rgheft@netzero.com) if you are interested.

The best physician is you. Physician heal thyself. Education first.

HeartWire on November 23, 2009, reported the discovery of atherosclerosis (hardening-of-the-arteries) in Egyptian mummies 3000 years old. 

So it appears that atherosclerosis in not just a disease of modern civilization, as suggested by some.

Steve Parker, M.D.

Herba tekanan darah tinggi adalah bahan alami yang boleh mengurangkan tekanan darah. Walaupun herba-herba ini tidak disyorkan kepada mereka yang mengalami tekanan darah yang terlalu tinggi, herba boleh membantu ramai orang. Jika tekanan darah anda hanya sedikit tinggi, maka anda boleh mempertimbangkan manfaat dan kebaikan herba tekanan darah tinggi.

Antioxidant dalam herba dan makanan adalah alat penting mengawal jantung dan kesehatan. Ini ialah karena antioksiden membantu menghalang oksigen daam badan daripada merosakkan (mengoksidakan) molekul kolesterol dalam saluran darah. Ini sangat penting kerana kolesterol yang telah dioksidakan boleh menyebabkan plag dan penyumbatan, menyebabkan lebih sukar darah mengalir ke jantung.

Salah satu kuasa penawar alami kunyit ialah kandungan tinggi antioksiden, antaranya ialah vitamin C dan E, dan juga karotenoid (carotenoids). Ia juga mengandungi antioksidan yang berkesan seperti curcumin dan kompaun curcuminoids. Oleh sebab curcumin ialah antioksiden yang mujarab, ia membantu menghalang kolesterol menyempitkan arteri, dinamakan atherosclerosis, antara penyebab utama serangan jantung.

Kunyit mengurangkan paras kolesterol darah dengan menstimulasikan pengeluaran ‘bile’. Ia juga menghalang pembentukan ketulan darah yang boleh menyebabkan serangan jantung. Kunyit juga membantu jantung dengan cara menghalang platelete , iaitu sel-struktur kecil dalam darah, daripada melekat antara satu sama lain menyebabkan darah berketul (blood clots).

Cara pengambilan:

1. Suplemen curcumin boleh dibeli di farmasi
2. Gunakan kunyit dalam masakan harian
3. Ambil kunyit sebesar ibu jari. Kupaskan kulitnya dan dicuci hingga bersih. kemudian diparutkan dan diperah hingga mengeluarkan airnya. Campurkan air perahan kunyit itu dengan 1 sendok madu dan 1 sendok teh lada hitam. Minumlah ramuan ini dua kali sehari yaitu pagi dan petang. InsyaAllah ia dapat mengurangkan tekanan darah tinggi

“Selamat Mencoba”

The metabolic syndrome & smoking-related diseases

Diagnosis and treatment of most disease is simple. The body builds up and breaks down largely according to food, nutrients, to which there are only two: building and cleansing. Too much or too little building or cleansing, in the extreme, tends to cause disease via too much or too little blood, structure and function. The correct balance via simple diet and common herbs restores health.

Protein and fat, highly concentrated in red meat, chicken, turkey, fish, eggs, hard cheese,etc. and to a lesser extent beans, nuts and seeds build, fuel, thicken, heat, hold, etc.

TOO MUCH PROTEIN AND FAT, especially animal tends to slow, thicken and heat the blood (high cholesterol, tumors, cancer), liver (congestion), arteries (plaque, atherosclerosis, arteriosclerosis, high blood pressure), skin (acne, warts, psoriasis), head (restlessness, insomnia), kidneys (stones), stomach (ulcer), body odor (putrid, offensive), large intestines (dry stools, constipation, tumors), etc.

TOO LITTLE PROTEIN AND FAT tends to thin, weaken, slow digestion (abdominal bloating), blood (thin, anemic), face, skin, nails, hair (pale, thin, cracked), bones (osteoporosis), immune system (weak immunity, catches colds, easily, autoimmune illnesses), ovaries, uterus (infertility, miscarriage, short-term pregnancy), testes (impotence, premature ejaculation), etc.

Water, minerals, sugar, vitamins, enzymes (fruit, vegetables, grains) reduce, cleanse, cool, moisten and sink.  TOO MUCH water sugar, minerals (salads, tropical fruits, juices, smoothies, sugar, ice cream) reduce, cleanse, cool and moisten digestion (abdominal bloating, gas), stools (loose, diarrhea), body odor (sour, sweet, musty), respiration (mucous, phlegm, coughing, snoring, hacking, sleep apnea), reproduction (vaginal discharges, leukorrhea, yeast infections), breasts (cysts, lumps (movable), thighs, legs (edema, cellulite), etc. Too little causes dryness (constipation, coughing).

Too little building and too much cleansing tends to cause cold, damp, under built diseases. Too much building tends to cause overbuilt, thick diseases.

TREATMENT of dietary diease is very simple. Eat a balanced diet(foods, herbs) that is tilted in the opposite direction.

Eat more building (red meat, chicken, turkey, eggs hard cheese) and less cleansing foods (salads, tropical fruits, juices, smoothies, cold drinks, sugar), herbs (bitter) , etc. if your condition is COLD, UNDER BUILT.

Eat more cleansing (fruits, vegetables) and less building (animal, fried foods) food, herbs, etc. if your condition is hot, overbuilt The middle diet, meal plan: 1/3 building, 1/3 grain, 1/3 vegetables (3- 5, cooked, raw), fruit (1), spices, tea and or soup) is a balanced diet, in the opinion of th author.

These are general treatment plans.

Most disease is caused by poor diet (too building or too cleansing).

There are only two dietary symptoms, diseases, extremes, despite the variety.

While most people, including doctors see a nonsensical, unrelated list of symptoms, diseases (high cholesterol, tumors, cancer, liver congestion, cirrhosis, atherosclerosis, arteriosclerosis, high blood pressure, warts, psoriasis, restlessness, insomnia, kidney stones, stomach ulcer, body odor (putrid, offensive), dry stools, constipation, abdominal bloating, thin blood, anemia, pallor, thin, cracked skin, nails, and hair, osteoporosis, weak immunity, catches colds, easily, autoimmune illnesses, infertility, miscarriage, short-term pregnancy, impotence, premature ejaculation, gas, loose stools, diarrhea, body odor, mucous, phlegm, coughing, snoring, hacking, sleep apnea, vaginal discharges, leukorrhea, yeast infections, cysts, lumps (movable), edema, cellulite, constipation, coughing, etc.), I see only only: overbuilt and under built.

1. Overbuilt diseases, symptoms: High cholesterol, tumors, cancer, liver congestion, cirrhosis, atherosclerosis, arteriosclerosis, high blood pressure, warts, psoriasis, restlessness, insomnia, kidney stones, stomach ulcer, body odor (putrid, offensive), dry stools, constipation

2. Under built symptoms, diseases: abdominal bloating, thin blood, anemia, pallor, thin, cracked skin, nails, and hair, osteoporosis, weak immunity, catches colds, easily, autoimmune illnesses, infertility, miscarriage, short-term pregnancy, impotence, premature ejaculation, gas, loose stools, diarrhea, body odor, mucous, phlegm, coughing, snoring, hacking, sleep apnea, vaginal discharges, leukorrhea, yeast infections, cysts, lumps (movable), edema, cellulite, constipation, coughing, etc.

I also only see two causes, cures, treatment plans. Learn biology, diet and nutrition unless you want someone else (doctors, insurance companies) taking care of your health and FINANCES  For more info, buy, read the book if not totally confident with doctors, drugs, surgery, insurance and nursing homes. Available Amazon: http://www.amazon.com/Hot-Cold-Health-Richard-Heft/dp/0974791709

We know diabetes, smoking, hyperlidemia, hypertension are major risk factors for progressive vascular disease. They damage the vascular endothelium either directly or indirectly ,   by aggravating the atheroscelortic process .  Diabetes apart from affecting the medium sized arteries , also affect the microvasculature.  Smoking  has a direct effect on endothelial function .It depletes vascular nitric oxide. High levels of circulating lipids injures the sub endothelial structures and invades the media by entering macrophages .So , all these 4 risk factors either operate independently or interact with each other and result in progressive vascular    disease.

While we  believe  , these risk factors do not have any bias in attacking the human vascular  tree, in the real world it is observed they have their own  behavior pattern and  have unique predilection and a deadly alliance .

For example , in  chronic smokers TAO is the commonest manifestation , thrombo angitis is far too less common to occur in the coronary arteries.

Similarly  hypertension  per se  rarely results in an acute coronary syndrome while it is  the  single  important  cause for cerebro vascular  disease. Diabetes especially in women has very strong predilection for CAD , while diabetic per se is a lesser risk for stroke. Hyperlipedimia may be the one which has fairly even risk throughout the vasculature. Similarly there is  a difference in renal and   carotid arterial involvement with reference to  the conventional  risk factors .

Why this apparent difference ?

We are unlikely  to get an answer to this question in the near future .  Left to the youngsters  . . . of tomorrow !

* Note of  clarification

The source for the above chart is collected from various studies and also a huge observational data from our hospital. There could be some geographical variation , a given individual may respond differently to these risk factor depending upon his genetic predisposition and susceptibility . So the above data can be applied to general population and not to a individual.

This blog is dedicated to helping out patients with heart disease.  My name is Sharon and I am a Physician Assistant specializing in cardiology.  I wrote the book What To Do When You Have Heart Disease which will be available on amazon.com in early 2010.  In writing the book, my goal was to help heart disease patients through recovery and to learn as much about keeping their heart healthy as possible.  While the book includes most of the basics, I realize that it cannot possibly answer all of the questions that may come up along the way.  This blog is my way of continuing to give you all the help and support you need.  I welcome any of your comments and questions about heart disease!

Hot and Cold Health and Disease is not for everyone, especially those who are firm believers in doctors, drugs, surgery, radiation, insurance and nursing homes. If you need more convincing, read the 15 case histories listed below. Education, simple diet and common herbs can prevent and or cure most disease not your doctors, naturopaths, chiropractors,  acupuncturists, drugs, herbs, etc. The best doctor you will ever have is you. I, Hot and Cold Health and Disease can give you the education, the rest is up to you.  

Is a one-time fee of $6.95  (ebook) or $16.95 (paperback)  too much money, too big of a risk?

The downside is extrememly limited, the upside, unlimited.

Hot and Cold Health and Disease (new name, available on Amazon, old title, cover is pictured. http://www.amazon.com/Hot-Cold-Health-Richard-Heft/dp/0974791709 

TABLE OF CONTENTS

SECTION I PHILOSOPHY AND DIET

Chapter 1 The Way of Thinking Chapter 2 Energetics of Food Chapter 3 Digestion, Spices and Chinese Herbs Chapter 4 Cooking Class

SECTION II BIOLOGY, EAST AND WEST

Chapter 5 Three Treasures Chapter 6 Blood and Body Fluids Chapter 7 Spleen Chapter 8 Stomach Small Intestine Chapter 9 Large Intestine and Urinary Bladder Chapter 10 Heart Chapter 11 Liver & Gall Bladder Chapter 12 Lungs Chapter 13 Kidneys Chapter 14 Disease and Diagnosis

SECTION III DISEASES A- Z

Chap 15 A Diseases AIDS 141 Alzheimer s 143 Anal fissure 143 Anemia 144 Anger 145 Aging 146 Anxiety 147 Arthritis 148 Asthma 152 ADD 154 Auto-immune 154 Chap 16 B Diseases Blood 157 Blood Pressure 158 Body Odor 159 Bones 161 Breast lumps 162 Bronchitis 164 Chap 17  C DiseasesCandidiasis 167 Canker Sores 169 Cellulite 171 Cholesterol 173 Chronic Fatigue 175 Circulation 176 Cirrhosis 178 Cold hands, feet 178 Cold (lungs) Constipation 180 Coughing 182 Crohn s 182 Chap 18 D DiseasesDepression 185 Detoxification 188 Diabetes 191 Diarrhea 193 Diuretics 195 Dizziness 195 Dysmenorrhea 196 Chap 19 E-F DiseasesEar Infections 197 Eczema 197 Edema 200 Endometriosis 202 Eyes 202 Fear 204 Fever 204 Fibrocystic Breasts 204 Fibroids 205 Fibromyalgia 205 Forgetfulness 207 Frigidity 208 Chap 20 G-H DiseasesGall Stones 209 GERD, GIRD 210 Gout 212 Hair Loss 213 Hearing Loss 215 Hepatitis 218 Herpes 220 Hot Flashes 220 Hysteria 221 Chap 21 I-J Diseases Infertility 223 Inflammation 223 Insomnia 224 Irritable Bowel 226 Itching 227 Jaundice 227 Chap 22 K-O Diseases Kidney Stones 229 Miscarriage 230 Mucous 231 M. Sclerosis 231 Nails 233 Nausea 235 Numbness 236 Obesity 237 Osteoporosis 238 Chap 23 P-R Diseases Pediatric 241 Perspiration 244 Plantar F. 244 Pregnancy 248 PMS 250 Prostate 251 Psoriasis 252 Rashes 252 Restless Leg 252 Chap 24 S-Z Diseases Sex 255 Shaking, tremors 257 Sinusitis 258 Skin Diseases 259 Sleep Apnea 261 Snoring 262 Sweaty hands 263 Teeth 264 Tumors 266 Urinary T. I. 267 Varicose Veins 269 Weight loss 270 Yeast infection 274 Chap 25 Case Histories 275

SECTION IV DAILY PRACTICES

 Chapter 26 The Way of Breathing, Chap 27 Exercise, Chap 28 Meditation 303, Chap 29 Spiritual Practices 307 Appendix 313 Bibliography 315 About the Author 317

Cardiovascular diseases

Diets high in saturated fat have been correlated with an increased incidence of atherosclerosis and coronary heart disease.

Combined cholesterol and saturated fat feeding has shown an increase in cholesterol levels of African green monkeys^[7], while one study with baboons showed the opposite effect on LDL cholesterol. PMID 7625361 (PubMed)
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An increase in cholesterol levels has been observed in humans with an increase in saturated fat intake, such as a study of 22 hypercholesterolemic men.^[8][9][10] Some studies have suggested that diets high in saturated fat increase the risk of heart disease and stroke. Epidemiological studies have found that those whose diets are high in saturated fats, including lauric, myristic, palmitic, and stearic acid, had a higher prevalence of coronary heart disease.^{[11][12][13][14]} Additionally, controlled experimental studies have found that people consuming high saturated fat diets experience negative cholesterol profile changes.^{[15][16][17][18]}

In 1999, volunteers were randomly assigned to either Mediterranean (which replaces saturated fat with mono and polyunsaturated fat) or a control diet showed that subjects assigned to a Mediterranean diet exhibited a significantly decreased likelihood of suffering a second heart attack, cardiac death, heart failure or stroke.^[19][20]

An evaluation of data from Harvard Nurses’ Health Study found that “diets lower in carbohydrate and higher in protein and fat are not associated with increased risk of coronary heart disease in women. When vegetable sources of fat and protein are chosen, these diets may moderately reduce the risk of coronary heart disease.” ^[21]

Meta-studies conducted by scientists in 1997^[22] and 2003^[23] found high corelation between excessive amounts of saturated fats and coronary heart disease. Mayo Clinic highlighted oils that are high in saturated fats include coconut, palm oil and palm kernel oil. Those of lower amounts of saturated fats, and higher levels of unsaturated (preferably monounsaturated) fats like olive oil, peanut oil, canola oil, avocados, safflower, corn, sunflower, soy and cottonseed oils are generally healthier.^[24] The National Heart, Lung and Blood Institute,^[25] and other health authorities like World Heart Federation^[26] have urged saturated fats be replaced with polyunsaturated and monounsaturated fats. The health body list olive and canola oils as sources of monosaturated oils while soybean and sunflower oils are rich with polyunsaturated fat. A 2005 research in Costa Rica suggests consumption of non-hydrogenated unsaturated oils like soybean and sunflower over palm oil.^[27]

The Cochrane Collaboration published a meta-analyses of fat modification trials finding no significant effect on total mortality, but with significant reductions in the rate of cardiovascular events that was statistically significant in the high risk group.^[28]

Fatty acid specificity

Epidemiological studies of heart disease have implicated the four major saturated fatty acids to varying degrees. The World Health Organization has determined that there is “convincing” evidence that myristic and palmitic acid intake increases the probability, “possible” risk from lauric acid, and no increased risk at all from stearic acid consumption.^[29]

In 2005, Dutch scientists at Department of Human Biology, Maastricht University compared the effects of stearic acid with oleic and linoleic acids. Forty five subjects (27 women and 18 men) consumed, in random order, three experimental diets, each for five weeks. The results suggest stearic acid is not highly thrombogenic compared with oleic and linoleic acids.^[30]

Cancer

Breast cancer

There is one theorized association between saturated fatty acids intake and increased breast cancer risk.

Prostate cancer

Myristic and palmitic saturated fatty acids are associated with prostate cancer.

Small intestine cancer

A prospective study of data from the NIH-AARP Diet and Health Study correlated saturated fat intake with cancer of the small intestine” ^[31]

Dietary recommendations

A 2004 statement released by the Centers for Disease Control (CDC) determined that “Americans need to continue working to reduce saturated fat intake…” ^[32] Additionally, reviews by the American Heart Association led the Association to recommend reducing saturated fat intake to less than 7% of total calories according to its 2006 recommendations.^[33][34] This concurs with similar conclusions made by the World Health Organization (WHO) and the US Department of Health and Human Services, both of which determined that reduction in saturated fat consumption would positively affect health and reduce the prevalence of heart disease.^[35][36][37]

The World Health Organization (WHO) has concluded that saturated fats negatively affect cholesterol profiles, predisposing individuals to heart disease, and recommends avoiding saturated fats in order to reduce the risk of a cardiovascular disease.^[38][39]

Dr German and Dr Dillard of University of California and Nestle Research Center in Switzerland, in their 2004 review, pointed out that “no lower safe limit of specific saturated fatty acid intakes has been identified”. No randomized clinical trials of low-fat diets or low-saturated fat diets of sufficient duration have been carried out. The influence of varying saturated fatty acid intakes against a background of different individual lifestyles and genetic backgrounds should be the focus in future studies.^[40]

Contrary Research

The relevance of particular information in (or previously in) this article or section is disputed. The information may have been removed or included by an editor as a result. Please see discussion on the talk page considering whether its inclusion is warranted.(March 2008)

One confounding issue in studies may be the formation of exogenous (outside the body) advanced glycation endproducts (AGEs) and oxidation products generated during cooking, which it appears some of the studies have not controlled for. It has been suggested that, “given the prominence of this type of food in the human diet, the deleterious effects of high-(saturated)fat foods may be in part due to the high content in glycotoxins, above and beyond those due to oxidized fatty acid derivatives.” The glycotoxins, as he called them, are more commonly called AGEs^[41]

• A 3-year study conducted of 235 postmenopausal women with established coronary artery disease, many also having metabolic syndrome concluded that “in postmenopausal women with relatively low total fat intake, a greater saturated fat intake is associated with less progression of coronary atherosclerosis.” Nevertheless, the authors deemed that “the findings do not establish causality.” ^[42][43]

• A study of 297 Portuguese males with acute myocardial infarction (MI), found that “total fat intake, lauric acid, palmitic acid [two common saturated fats] and oleic acid [a monoinsaturated fat] were inversely associated with acute MI” and concluded that “low intake of total fat and lauric acid from dairy products was related to acute MI”. The authors suggest that “recommendations on fatty acid intake should aim for both an upper and lower limit”^[44].

• Fulani of northern Nigeria get around 25% of energy from saturated fat, yet their lipid profile is indicative of a low risk of cardiovascular disease. This finding is likely due to their high activity level and their low total energy intake.^[45]

• A 2004 article in The American Journal of Clinical Nutrition raised the possibility that the supposed causal relationship between saturated fats and heart disease may actually be a statistical bias. The authors take the example of the “Finnish mental hospital study” in which saturated fat intakes were monitored more closely than were total fat intakes, therefore ignoring the possibility that simply a larger fat intake may lead to a higher risk of coronary diseases. It also suggests that other parameters were overlooked, such as carbohydrates intakes.^[46

We all know that some foods are good for and some not so much. But what about fat? For what seems like forever, fat has been stigmatized for it’s damaging effects on the human body, but recent studies has revealed that certain fats can actually help slow the aging process! To clear up some of the confusion, here’s some quick knowledge on good fats and bad fats.

Some fats, including trans and saturated fats eccelerate the aging process and increase the risk of heart disease, memory loss and cancer. Food’s such as red meat, fatty dairy products and anything made with hyrogenated vegetable oil expedite the effects of aging on the body and mind. Studies have also revealed that by avoiding these “bad fats,” can actually add some zest to your sex life! It has been found that when men consume high-fat meals, their blood-testosterone levels can plummit by 50%. Another excellent benefit of limiting your intake of saturated and trans fats is that you are greatly reducing your risk of clogged arteries, which can lead to a number of diseases including atherosclerosis.

Healthy fats on the other hand include the monounsaturated fats in extra-virgin olive oil and the fats found in most fish. The omega-3 fat in fish called DHA helps reduce aging the brain, heart and eyes. The American Heart Association reccomends daily servings of these fats to prevent heart disease. I know some of us may not be the “seafood” type and that’s fine – Omega-3 fat is also found in walnuts and flaxseed, as well as vegetarian sources such as marine algae.

Balanced nutrition is huge part of healthy aging, but exercise, stress reduction and your hormones also play a vital role in your overall heallth. Hormones naturally decline as we age. We can lead healthy lives on the outside and still be a hormonal mess on the inside. The best way to determine if you have a hormonal imbalance is to get your hormone levels tested by a physician who specializes in hormone therapy. Many physicians are using bioidentical hormones to correct underlying hormonal issues. Bioidentical hormones are moleculary identical to the hormones that our bodies produce naturally.

WEDNESDAY, Oct. 21 (HealthDay News) — High blood levels of C-reactive protein (CRP) may increase a person’s risk for heart attack and death, but not for stroke, a new study has found.

The study included 2,240 people in New York City who were 40 or older and stroke-free. At the start of the study, the participants’ blood was checked for levels of CRP (a marker for inflammation) and their heart attack and stroke risk factors were evaluated by researchers.

During an average follow-up of eight years, there were 198 strokes, 156 heart-related events and 586 deaths. People with CRP levels greater than 3 milligrams per liter of blood were 70 percent more likely to have a heart attack and 55 percent more likely to die than those with CRP levels of 1 milligram per liter or less, the researchers reported in the Oct. 20 print issue of Neurology.

After they took other risk factors into account, the study authors concluded that CRP levels didn’t influence stroke risk.

“The role of this protein in predicting risk of stroke has been controversial, although prior studies have found it to be a marker for predicting risk of heart disease,” study author Dr. Mitchell Elkind, of Columbia University Medical Center in New York City, said in a news release from the American Academy of Neurology. “However, in our large, multiethnic population, CRP levels did not play a role in predicting stroke, though they may still help determine whether someone is at risk of heart attack or early death.”

CRP levels are influenced by factors such as physical activity, smoking, alcohol consumption and diabetes.

“It appears that by living a healthy lifestyle, one may be able to lower these protein levels, thus lowering the risk of cardiac events and possibly early death,” Elkind said.

“It may be that the failure of CRP to predict stroke in our study, unlike in some other populations, reflects the fact that our population is older and has more of these risk factors. While CRP may be predictive in generally young healthy people, it may be less useful among older, sicker people. More research needs to be done on why the protein wasn’t able to predict stroke in the same manner as heart disease,” he said.

More information

The American Association for Clinical Chemistry has more about C-reactive protein.