Arterial Disease

Heart Attacks




Some Topics

  • Blood Circulation to the Brain

    The brain is a unique organ in the body. The blood circulation in the brain is more complex, more regulated, and less understood than the circulation in any other tissue. The large arteries carrying blood to the brain are the internal carotids and the vertebral arteries. The condition of these arteries determines how much blood flow is available to the brain. The smaller cerebral (pial) arteries respond to changing demands from blood supply from cerebral tissues. This auto regulation tries to maintain stable cerebral blood flow even with unstable cerebral perfusion pressure.

    Brain circulation responds in complex ways to a large number of stimuli. Failure of autoregulation may be one of the most common sources of brain dysfunction especially in people with high blood pressure on medications.

    Brain activity regulates brain circulation by controlling cardiac output and blood pressure. Emotions, especially anger, are strong events that act on the cardiovascular system; heart rate increases and blood pressure rises, often dramatically. Cognitive tasks increase blood flow and metabolic rate in the regions of the brain that process the task. Changes in localized blood flow are the basis of functional imaging studies that reveal the modules in the brain that are active during task processing.

    Blood-brain barrier

    Cerebral microvessels have a unique feature, the blood-brain barrier, which protects sensitive brain cells from disturbing elements circulating in the blood. Endothelial cells line blood vessel. Their behavior regulates permeability. In the brain, tight intercellular junctions limit endothelial permeability. A variety of chemical signals to and from endothelia cells control blood vessel transactions with glial cells and neurons. Cerebral vessels have nerves supplies -sympathetic, parasympathetic, and sensory nerve fibers. Gaseous transmitters such as nitric oxide (NO) dilate small blood vessels and participate in the regulation of blood flow

    Syncope (fainting) is an expression of reduced cerebral blood flow. Prolonged standing, emotional arousal, blood pressure drugs, cardiac arrhythmias, and autonomic nervous system failure are common causes of syncope. Blood tends to pool in the legs with prolonged standing. Muscle activity is required to pump venous blood uphill back to the heart. With reduced venous return, cardiac output drops and humans faint. A common symptom, the feeling of lightheadedness is an expression of reduced blood flow to the brain. Since cerebral arterial disease increases with age, decreasing symptoms of limited blood flow become more common such as lightheadedness, fainting, personality changes and deteriorating cognitive ability.

    Some of the disturbances will be regional with selectively compromised functions. Other disturbances will be global. The use of medications to reduce blood pressure may have adverse effects because lowering blood pressure can decrease cerebral perfusion in patients with chronic vascular brain pathology; they may develop focal hypoxia and even ischemia in poorly perfused regions of their brain.

    Stroke is the leading cause of disability in the U.S. and Canada

    Stroke is the leading cause of permanent disability in the U.S. and Canada, second leading cause of dementia and the third leading cause of adult death. Stroke is the third leading cause of death and a major source of disability in the US where 700,000 people have a stroke and 158,000 die from stroke. From 1993 to 2003, the stroke death rate fell 18.5%, but the actual number of stroke deaths declined only 0.7%, according to 2006 statistics.

    The main event of a heart attack is the occlusion by a sudden blood clot of one or more blood vessels supplying the heart muscle. A similar occlusion of blood vessels supplying the brain will result in the death of brain tissue or cerebral infarction. Another cause of stroke is hemorrhage from a ruptured blood vessel. Yet another stroke mechanism is the occlusion of a brain artery by a clot that traveled to the brain from another body location, usually the heart; embolism is most likely to occur in people with atrial fibrillation and mechanical heart valves.

    Neurologists say doctors and the public should give stroke victims the same urgent treatment given to heart attack victims. The clot-dissolving drug TPA (tissue plasminogen activator), when used in the first three hours after a stroke, can restore blood flow in the brains of some patients. Some hospitals have better tools for dealing with strokes, but require the stroke patient to seek treatment quickly. The message in the media is to act fast on the warning signs of a stroke - now described as "brain attacks" to encourage the same sense of urgency attributed to heart attacks. Symptoms include weakness or numbness, especially on one side of the body; blurred vision, usually in one eye; slurred speech; dizziness; and explosive headache.

    The hope for dramatic rescue of stroke victims with TPA is somewhat tarnished by the impractical requirement of getting the right treatment right away. One major problem is that some strokes are caused by bleeding into the brain and TPA would make this worse. Before getting TPA, patients must be checked to ensure they are not bleeding in the brain. If you were planning to have a stroke, you have to set up an ideal circumstance in order to be rescued. You would have to recognize that you were having a stroke almost immediately; you would have to get to a well-equipped hospital promptly. The emergency room would have to be set up to make the diagnosis promptly, get a high quality CAT scan done and interpreted by an expert and then you would have to satisfy several criteria for treatment - the first is that the CAT scan shows that there is no bleeding associated with the stroke symptoms.

    Preventing Strokes

    We share the conviction with a growing number of experts in the field that simple, safe home remedies especially diet revision and exercise can substantially reduce this destructive disease and save untold suffering and billions of health-care dollars. Smoking must stop. Diabetes, high blood pressure, and high blood cholesterol must be controlled to prevent stroke and, again, diet revision with weight loss and increased daily exercise can work wonders. Drugs are only required if risk factors are not controlled by changes in diet and lifestyle.

    Well-known risk factors are

    • high blood pressure
    • smoking
    • high alcohol intake
    • diabetes
    • excess body fat
    • physical inactivity.

    Stroke Prevention

    • Diet Revision -- Alpha Nutrition Program
    • Exercise and Weight Loss
    • Reduce blood pressure

    In the US Nurses study, a 14-year follow up involving 71,768 women aged 38 to 63 years identified stoke incidence with two dietary patterns:

    1. A "prudent" diet characterized by higher intakes of fruits, vegetables, legumes, fish, and whole grains that protected against stroke.
    Follow the Alpha Nutrition Program.

    2 "Western" diet characterized by higher intakes of red and processed meats, refined grains, sweets, and desserts that increased stroke risk.

    Bazzano et found an inverse relationship between dietary intake of folate and subsequent risk of stroke and CVD. They suggested that: “increasing dietary intake of folate from food sources may be an important approach to the prevention of CVD in the US population.“ This study included 9764 US men and women aged 25 to 74 years who participated in the National Health and Nutrition Examination Survey I USA. Over an average of 19 years of follow-up, 926 incident stroke events and 3758 incident CVD events were documented.

    Here are some key insights from epidemiological studies on the effect of drinking alcoholic beverages: A small intake of alcoholic beverages may protect against stroke, but five drinks a day or more triples the stroke risk. (A drink is a 1.5-ounce shot of liquor, 12-ounces of beer or four ounces of wine.) Those who consumed less than one drink per month had a 62 percent lower risk of stroke than non-drinkers did, while those who consumed up to two drinks a day had a 45 percent lower risk. Smokers have double the risk of stroke than non-smokers, while former smokers were at 50-percent increased risk. Your risk of stroke almost doubles if you have a parent who has had a stroke. People who consume fruits and veggies at least three times a week have a lower risk of stroke. Increased meat consumption doubles the risk.

    Exercise is good for the brain.

    A physically active life tends to be more productive with better mental health. The risk of stroke may be reduced by up to 40% with regular exercise alone. Regular exercise may delay the onset of dementia. Larson stated” “We learned that a modest amount of exercise would reduce a person's risk of dementia by about 40%." His group followed 1,750 adults, 65 years or older. At 2-year intervals, participants reported their patterns of exercise, including walking, hiking, aerobics, calisthenics, swimming, water aerobics, weight training, and stretching: 158 developed dementia including 107 participants who were diagnosed as having Alzheimer Disease (AD). The rate of dementia was 13.0 per 1,000 person years for participants who exercised at least 3 times per week vs 19.7 per 1,000 person years for participants who exercised fewer than 3 times per week.

    The Alpha Nutrition Program can be recommended, along with Alpha DMX, exercise and relaxation as a rational strategy of preventing and managing cerebrovascular disease.

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  • Topics from the book Heart & Arterial Disease The author is Stephen Gislason MD 2018 Edition: 190 Pages

    Major diseases originate from eating too much of the wrong food and damage is done to many organs simultaneously. The evidence does suggest that some interventions are beneficial in terms of preventing heart attacks and strokes and that disease progression can be halted by important changes in diet and increased exercise. The occurrence of a heart attack or stroke confirms that atherosclerosis is advanced, damage has been done and that the rules of intervention have changed. We suggest that a prudent person suffering early vascular dysfunction symptoms would be wise to pursue vigorous, thorough diet revision at the earliest opportunity.

    Order and Download Heart and Artery eBook

    ECG MD

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