Symptoms & Risk Factors



Before we discuss the tests, let us look briefly at the question of who should be tested. Many different symptoms can signal the possible presence of heart disease.



You should consider testing if you have any of the following symptoms:



•Pain with exertion and excitement

•Swelling in ankles

•Dizzy spells

•Chest pain or pressure

•Slow healing of cuts and sores

•Numbness or weakness in arms or legs

•Leg cramps

•Shortness of breath

•Irregular heart beats



The above symptoms could signal some form of cardiovascular disease, CVD, for short. Any of the symptoms, however, might also be caused by other conditions, so there is no way to know without testing.



Although the symptoms above can signal the presence of CVD, their absence does not confirm cardiovascular health. As I noted above, CVD does tend to be asymptomatic in its early stages (in fact, this is the case more than 50% of the time!). Therefore, even if you have no symptoms of CVD, it is wise to be tested if you have any of the risk factors for it.



Some risk factors are beyond your control and some are the result of lifestyle choices or controllable conditions. CVD risk factors that you can change include the following:



A history of smoking: Smokers are twice as likely to have heart attacks than non-smokers. Even people exposed to secondhand smoke increase their risk of heart attack.



Sedentary lifestyle: Regular aerobic exercise is necessary for a healthy heart, so a lack of such exercise could spell trouble.



Overweight/obesity: excess weight strains the heart and causes imbalances in blood lipids and blood pressure.



High-fat diet: Excess dietary fat can make one overweight and increase free-radicals, both of which lead to CVD.



High-blood pressure: High blood pressure strains the heart and can cause strokes.



High blood cholesterol: Cholesterol in the blood vessels can cause blockages, leading to heart attack or stroke.



CVD RISK FACTORS THAT YOU CAN’T CHANGE INCLUDE THE FOLLOWING:



Heredity: If you have relatives with CVD or diabetes, the likelihood of your having it increases.



Age: If you are over 65, your risk of CVD is greater than that of a younger person.



Ethnicity: African-Americans have a greater risk of high blood pressure and CVD than other ethnic groups, although all ethnicities are susceptible to CVD.



Note, however, that even with these risk factors, you can modify your risk with lifestyle changes!



Basic Terminology of Heart Disease



Cardiovascular: The prefix cardio comes from the Greek word “kardia”, meaning “heart,” while vascular is derived from the Latin word “vasculum,” or “vessel.” Stedman’s Medical Dictionary, 25th Edition defines cardiovascular as “relating to the heart and the blood vessels or the circulation.”



Coronary: Coronary comes from the Latin word “coronaries,” meaning “crown.” It refers to the blood vessels in and encircling the heart.



Carotid Arteries: These are the two major arteries in the neck, which supply blood to the head – most importantly, to the brain. Any obstruction of these arteries can cause stroke.



Coronary Heart Disease: This is an overall term for a number of syndromes, all of which are caused by a poor blood supply to the cardiac muscle (this is the second layer of the heart, also called the myocardium). A patient suffering from coronary heart disease is at serious risk of heart attack, stroke, and sudden death.



 • Hypertensive Heart Disease: A condition in which the blood pressure’s regulation is off-kilter, making the arterial pressure higher than normal. Excessive salt intake, stress, and kidney disease are factors that can be involved in hypertensive heart disease. People with this ailment may eventually experience enlargement of the heart followed by congestive heart failure.



Arteriosclerosis: This term refers to abnormal hardening of the walls of the arteries. One of the major forms of arteriosclerosis is atherosclerosis, in which fatty deposits can affect the coronary arteries and limit the blood flow to the heart. If one of the arteries is completely blocked, it can cause a heart attack (death of a part of the heart). If the disease affects the cerebral vessels, it can impede the blood flow to the brain and cause stroke, unconsciousness, and paralysis.



Angina: This is the term for heart pain upon exertion or excitement. It is caused by a shortage of oxygen and blood flow to the heart.



If you are concerned about cardiovascular disease, there’s no longer any reason to wonder or guess about your risk. It is simple to assess the state of your arteries so that you can decide whether preventative or remedial measures are in order. The genetic testing mentioned below is available through our clinic.



This exciting new genetic test can predict potential cardiovascular problems even before they appear – and accurately predict your response to various remedial measures (such as diet modification or statin drugs)! This test is called the CardioGenomic Profile™.



Before we discuss the test itself, let’s make a quick review of Genetics 101. As you know, your physical characteristics are determined by your DNA, which you inherited from your parents via your chromosomes (one from each parent). More than 99% of your genetic material is exactly like that of every other human being; however, there are certain points along the human genome where individual differences commonly occur. These sections of DNA are called Single Nucleotide Polymorphisms, or SNPs (often pronounced “snips”). Your SNPs are slight variations from the genetic norm that could make you susceptible to certain diseases, toxic reactions, and other physiological conditions and responses. Everyone has SNPs; some are quite common and others are quite rare.



The CardioGenomic Profile™ maps the group of genes that influence processes essential to cardiovascular health. A genetic weakness in these areas would predispose you to such things as cholesterol imbalance, hypertension, blood clotting problems, inflammation, stroke, heart attack, and high blood pressure.



The profile reveals important causal relationships between your unique genetic make-up, your diet, and other lifestyle factors. If it shows that you are genetically prone to certain cardiovascular problems, it can be followed up periodically with functional assessments (such as blood tests to measure your blood lipid levels) in order to ensure that your nutritional and exercise programs are working to protect you from CVD.



The test can reveal whether you have alleles (specific combinations of genes) that would cause HRT to adversely impact your blood pressure. It can tell us whether you are a “poor methylator” – someone who has trouble converting the heart-threatening amino acid homocysteine into methionine, a helpful essential amino acid. It can tell us how well your serum cholesterol levels will respond to such supplements as niacin, red rice yeast extract, and policosanol. It can even tell us whether your high blood pressure is best addressed with a low sodium diet, weight loss, diuretics, exercise, amino acids, or other types of interventions.



For example, the APO section of the profile reveals how your body responds to dietary fats and cholesterol, and whether exercise, supplements, diet, or drugs are the best approach to reducing your risk of atherosclerosis, heart attack, and stroke. Your APO alleles fall into one of the following three categories:



APO E2 Allele: This allele suggests the least impact of diet on serum cholesterol levels.

APO E3 Allele: This allele suggests the greatest benefit from exercise, and less response from niacin.

APO E4 Allele: this allele suggests the most problems with blood lipids and the greatest risk of heart disease. It indicates the greatest need for reducing dietary fats and cholesterol. It is also associated with a higher risk of Alzheimer’s disease, which can be modified with nutritional measures.



The CardioGenomic Profile™ also maps the various genes that determine your potential for disorders affecting blood pressure and blood clotting. In addition, it shows your capacity to perform a crucial metabolic function called methylation.



Methylation is a process by which the body metabolizes various substances by adding molecules called methyl groups to them. This process is crucial for detoxification, but for cardiovascular health it is also critical because it allows you to metabolize folic acid, or folate. You may also have a SNP on the gene that governs folate metabolism. In that case, your body cannot produce the enzymes necessary to break down the folic acid in your food into the different “versions” of folate needed by your cells. If you have a “double whammy” on this gene, or two SNPs, you will not be able to metabolize folic acid even if you are taking it in supplement form. Your body will be starved for folate, and your homocysteine will rise, causing an inflammatory form of CVD. Basically, impaired folate metabolism creates elevated homocysteine levels, which cause increased risk of CVD.



Fortunately, for those of us who have this SNP there is now a breakthrough supplement called Folapro® manufactured by Metagenics. Folapro® contains a special form of folic acid called L-5 methyltetrahydrofolate. This form of folate in a sense “bypasses” those faulty links in metabolism. That is, it is already broken down into the chemical forms of folate that your body needs, so it is fully available and useful to the cells that require it. With your cells no longer deficient in folate, your homocysteine levels return to normal, which protects your heart. Folapro® is a minor miracle for those who have the SNPs leading to folate deficiency!



Safe, Natural Supplements



Based on the results of your tests, we might recommend certain supplements to protect your heart and arrest damage to your cardiovascular system. Besides the folate supplement discussed above, some of the most commonly suggested supplements include:



Hawthorne: helps reduce cholesterol levels and diminish existing plaque in the arteries, improve blood and oxygen supply to the heart, and lower blood pressure.

Butcher’s Broom: improves vein health and has vasoconstricter (narrowing of blood vessels) and anti-inflammatory effects.

Gugul Resin: lowers cholesterol and triglyceride (a type of blood fat linked to coronary artery disease) levels and improves cardiovascular health.

• Essential Fatty Acids: reduce plaque formation and blood clots, and help the body to regulate blood pressure, heart rate, vascular dilation, lipid metabolism, and blood clotting.

• CoQ10: an important and powerful antioxidant thought to reduce serum levels of lipoprotein(a), a harmful form of cholesterol.

• Niacin: reduces blood lipids.

• Policosanol: lowers cholesterol and may reduce blood clotting and plaque formation.

• Red Rice Yeast Extract: lowers LDL (“bad” cholesterol) and triglycerides, as well as raises HDL (“good” cholesterol).



These are just a few of the supplements that could help you if your tests revealed an existing, or potential, cardiovascular problem. Of course, a heart healthy diet and stress reduction are the foundation for any such program.



Don’t Forget To Exercise!



With this state-of-the-art test, your fight against heart disease is easier than ever before. But don’t forget that the old measures are still the best: diet and lifestyle modifications remain the safest and most effective means of preventing and reversing CVD. The changes in attitude and lifestyle we so frequently recommend in these newsletters are especially applicable to cardiovascular health – especially exercise and quitting smoking!



Indeed, adequate aerobic exercise and maintaining a healthy weight are crucial to a well functioning heart. Excess weight taxes the heart greatly, whereas weight reduction takes a burden off this hard-working muscle. In addition, even a modest amount of weight loss can lower cholesterol levels. Aerobic exercise strengthens the heart muscle just as it does the other muscles in the body, increases one’s circulatory capacity, and assists the blood-flow in the body. It can even lower blood pressure.



CVD is a common and potentially life-threatening condition about which most Americans feel some concern. With this breakthrough test, however, there is no need to wonder or worry any more. You can easily and accurately assess your unique cardiovascular risks, and take steps to halt any problems before symptoms appear or progress. A nutrition and exercise program will put you and your heart back on track, perhaps avoiding the need for debilitating surgeries or harmful pharmaceuticals. So get tested! We are looking forward to seeing you!