Arterial Disease

Heart Attacks




Some Topics

  • Inflammation in Vascular Disease

    There has been a relatively sudden paradigm shift in cardiovascular medicine from fat-based theories of arterial disease toward recognition of the pervasive role of inflammation. Inflammation is a fundamental pattern of immune response. Teague et al wrote:” Cardiovascular disease (CVD) remains the leading cause of death worldwide, highlighting the need to elucidate its pathogenesis. Once considered a passive biological process, CVD is now recognized as an active, immune-driven process that may begin in childhood. Current research into the natural history of atheroma development has implicated many immune cells, including phagocytes, lymphocytes, dendritic cells, and neutrophils. Because these cells play a major role in initiating plaque development and complication, leukocytes are promising targets for acute and chronic atherosclerosis therapy. The most numerous cells in atherosclerotic plaques are macrophages, leukocytes that are central to innate immunity. In atherosclerosis, macrophage accumulation commences as bone marrow–derived, high monocytes infiltrate the lesion.

    Chronic inflammation may arise from food, infection, and autoimmune disease. I have yet to meet a cardiologist who knows that food antigens, such as cow’s milk proteins, can trigger inflammatory disease. Delayed patterns of food allergy may cause inflammation in vessel walls and trigger the clotting mechanism. Keaney et al reported that: “Background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. In unstable angina, activated leukocytes may be found in peripheral and coronary sinus blood.”

    The mechanisms of arterial disease appear to be multiple. Hollander of Boston University suggested that atherosclerosis was an autoimmune disorder with immune complexes injuring blood vessel walls. We think that circulating immune complexes contain a variety of chemicals some airborne may are in the food supply. Food proteins act as antigens and cause a wide spectrum of food allergic disease. Since proteins derived from meat, milk, eggs and wheat have the highest risk of appearing in the blood as immune complexes, these foods are reduced or eliminated in the Alpha Nutrition Program.

    We ask a simple question - If there is any possibility that chronic symptoms such as attacks of migraine, heart rhythm abnormalities, digestive disturbances, breathing difficulties or brain dysfunction are linked to food ingestion, would it not be prudent to investigate and remove food -causes using diet revision as an inexpensive, safe, effective strategy? Protein antigens, arriving in the blood through the digestive tract may trigger an immune response that inflames and damages the arterial walls. Many people with delayed pattern food allergy develop migraine, angina, heart rhythm abnormalities and may be more likely to develop blood clots and inflammation of blood vessel walls, all features of the life-threatening complex of vascular disease.

    Keaney et al reported that:” background Inflammation within vulnerable coronary plaques may cause unstable angina by promoting rupture and erosion. In unstable angina, activated leukocytes may be found in peripheral and coronary-sinus blood. “

    A non-specific indicator of inflammation is the C-reactive protein levels in the blood. Elevated levels are associated with increased risk of heart attacks and strokes. For example, Ridker et al studied 27,939 apparently healthy American women, who were followed for eight years for the occurrence of myocardial infarction, ischemic stroke, coronary revascularization, or death from cardiovascular causes. Elevated C-reactive protein levels were a better predictor of vascular events than low LDL cholesterol levels. The researchers reported that: ” 77 percent of all events occurred among women with LDL cholesterol levels below 160 mg per deciliter (4.14 mmol per liter), and 46 percent occurred among those with LDL cholesterol levels below 130 mg per deciliter (3.36 mmol per liter)… C-reactive protein and LDL cholesterol measurements tended to identify different high-risk groups, screening for both biologic markers provided better prognostic information than screening for either alone.”

    Myeloperoxidase is another serum marker of inflammation that may be Myeloperoxidase is an enzyme that generates reactive oxygen species, is released from white blood cells. In one study, plasma myeloperoxidase levels were predictive of subsequent coronary events in patients with chest pain. Myeloperoxidase levels, in contrast to troponin T, creatine kinase MB isoform, and C-reactive protein levels, identified patients at risk for cardiac events in the absence of myocardial necrosis.“

    Circulating Immune Complexes

    Immune complexes are formed when antibody binds to antigen, usually a protein. Circulating complexes (CIC), distributed in the blood, are formed in a variety of circumstances and may trigger illness by a variety of mechanisms. The pathogenic significance of complexes depends on the antibody involved, the relative concentration of antibody and antigen, the distribution of complexes and the ability of the host to clear them. CICs play a pathogenic role variety of disease states including arthritis, polymyositis, vasculitis, glomerulonephritis, hemolytic anemia, leucopenia, and thrombocytopenia. They are found in infectious diseases, autoimmune diseases, following organ transplants, and in patients with food allergy.

    Antibody excess tends to favor rapid clearing of complexes. Antigen excess favors complexes that stay longer in the circulation. Medium sized complexes tend to be more pathogenic and tend to get deposited in tissues. Tissue ICs can be identified by immunofluorescent staining of biopsy specimens. Serum IC measurements are neither easy nor reliable indicators of disease activity. Meaningful CIC measurement would have to be carried out in a physiological manner - for example tracking in real time the serum and tissue concentrations of ICs following antigen challenge. Spot samples of serum CIC concentration will not yield very useful information.

    Von Pirquet first described serum sickness, a prototype of immune complex disease. Any antigen entering the circulation in sufficient quantity can produce symptom patterns resembling serum sickness. The most direct model of food allergy involves free antigen entering the circulation and complexing with antibody to form circulating immune complexes (CICs). Immune complexes may form in the gut submucosa and may be transported by lymphatic channels to regional nodes and may continue through to the thoracic duct to enter the systemic circulation. Serum sickness evolves over a period of 7-10 days after a discrete antigen challenge. Manifestations include general malaise, fever, flushing, sweating, hives, swelling, bruising, joint and muscle pain, progressing in the worst case to inflammatory disease in target organs with protein in the urine from kidney inflammation. In animals, a large single intravenous dose of bovine milk protein will induce serum sickness with vasculitis and glomerulonephritis. Immune complexes are present from day 5 through 13.

    Inflammation can be treated by removing the causes of inflammation, treating infection and using anti-inflammatory medication such as ASA. The role of food proteins and immune complexes as agents of inflammation is rarely investigated and may turn out to be the hidden agent behind many heart attacks and strokes.

    Keaney, J. F. Jr., Vita, J. A. (2002). The Value of Inflammation for Predicting Unstable Angina. N Engl J Med 347: 55-57

    Paul M. Ridker, M.D., Nader Rifai, Ph.D., Lynda Rose, M.S., Julie E. Buring, Sc.D., and Nancy R. Cook, Sc.D. Comparison of C-Reactive Protein and Low-Density Lipoprotein Cholesterol Levels in the Prediction of First Cardiovascular Events. NEJM Volume 347:1557-1565 November 14, 2002 Number 20

    Marie-Luise Brennan, Ph.D., Marc S. Penn, M.D., Ph.D., Frederick Van Lente, Ph.D., et al Prognostic Value of Myeloperoxidase in Patients with Chest Pain NEJM Volume 349:1595-1604 October 23, 2003

  • 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.

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