HEART ATTACK

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HEART ATTACK STROKE How To Decrease Your Risk
by Lowering Your Cholesterol Blood Pressure
Naturally.

• /

• Presented by Michael Armentano, ND

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Reflection

• Cardiovascular disease, including heart disease
  and stroke, is the leading cause of death among
  women, accounting for more than 500,000 deaths
  per year, or about one death per minute.

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Atherosclerosis is the Underlying Cause of
Cardiovascular Disease
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Atherosclerosis

• Atherosclerosis is responsible for 43 of U.S.
  deaths
• Atherosclerosis is responsible for nearly all
  heart attacks 80 of strokes

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The Good News!

• In most cases, cardiovascular disease, including
  atherosclerosis is preventable!
• The cause is poor diet lifestyle choices.
• This means that this is a disease that you should
  be able to control

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Atherosclerosis Pathophysiology

• A minor injury occurs to a blood vessel wall
• This invites the binding of LDL cholesterol to
  the blood vessel wall (plaque formation)
• As part of the healing process, smooth muscle
  cells migrate in to the forming plaque
• Cholesterol continues to accumulate, further
  narrowing the lumen
• When the plaque occludes the lumen by about 90,
  symptoms are noticed

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Complications of Atherosclerosis

• Angina (occlusion in coronary arteries)
• Intermittent claudication (occlusion in arteries
  of the legs)
• Heart attack (blockage in coronary arteries)
• Stroke (blockage in cerebral arteries)
• Blockage of an artery can result from 100
  occlusion or embolus

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Risk Factors of Atherosclerosis

• Elevated serum cholesterol levels
• High blood pressure
• Smoking
• Diabetes
• Lack of physical exercise
• Low levels of Antioxidants
• Low levels of essential fatty acids
• Poor magnesium potassium status
• Elevated serum homocystiene
• Type A personality
• Diet high in saturated trans-fatty acids,
  refined carbohydrates, low in fiber
• Excess coffee consumption

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What do the risk factor mean?

• High cholesterol high blood pressure Risk of
  atherosclerosis increases risk by 300
• High cholesterol smoking increases risk by 350
• High blood pressure smoking increases risk by
  350
• High cholesterol high blood pressure smoking
  increases risk by 720

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Prevention of Atherosclerosis

• An ounce of prevention is worth a pound ton of
  cure!

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Prevention foods to avoid

• Excessive intake of saturated fats dietary
  cholesterol (AHA recommends fat)
• Refined carbohydrates
• Fried foods
• Trans and hydrogenated fats used to extend shelf
  life of foods
• Fatty cuts of red meat (eat lean cuts sparingly)
• Poultry skin,

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Prevention what to eat

• 2/3 of volume of food eaten should be colorful
  non starchy vegetables
• Carbohydrates eaten should be complex
• Raw organic nuts are a good source of essential
  fatty acids nutrients
• Plenty of fish (3 or more times per week)
• Buffalo, skinless poultry, and eggs in moderation
• Oats
• Drink green tea instead of coffee
• Stanol ester margarine (brand name is Benecol)

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Prevention Lifestyle tips

• 30 minutes of aerobic exercise daily
• If you are a smoker....QUIT!
• Decrease stress meditate, breathe, yoga, etc.
• If you drink alcohol, drink red wine in
  moderation

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Conventional Treatment of Atherosclerosis

• Angioplasty
• Bypass surgery
• Growth factors to grow new collateral blood
  vessels
• Antiplatelet agents (eg aspirin)
• Cholesterol lowering agents

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Adverse effects of statin drugs

• More common reactions abdominal cramping,
  constipation, diarrhea, gas, heartburn
• Less common reactions headache, dizziness,
  insomnia, weakness, runny nose, blurred vision,
  bronchitis, nausea, altered taste, hepatitis,
  pancreatitis, impotence, rash, itching,
  rhabdomyolysis (life threatening disease of
  muscle tissue), joint muscle aches

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Goals of Naturopathic Treatment

• Treat the person, not just the condition
• Correct the underlying root cause
• Use the treatment protocol which will cause the
  least amount of harm while being effective
• Teach the patient how to prevent recurrence

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Natural Treatment of Atherosclerosis

• Follow prevention guidelines
• Treatment is best followed by a Naturopathic
  physician as individualized treatment plans are
  most effective and adverse effects are possible
  with natural therapies.
• Ornish Diet (luminal narrowing
• Water drink half your body weight (in pounds) in
  ounces

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4 well studied supplements

• Studies have shown Niacin, Gugulipid, garlic and
  pantethine to significantly
• reduce total cholesterol
• reduce LDL cholesterol
• reduce Triglycerides
• increase HDL

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Comparison of Niacin, Garlic, Gugulipids
Pantethine
Changes in Serum Lipids Niacin Garlic Gugu Pa
ntethine Total chol(-) 18 10 24 19 LDL
(-) 23 15 30 21 HDL() 32 31 16 23 Triglycerides
(-) 26 13 23 32
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Comparision of Effectiveness of Lovastatin
Niacin after 6 months

• LDL reduction
• lovastatin 32
• niacin 23
• HDL increase
• lovastatin 7
• niacin 33
• LP(a) (Lipoprotein a) reduction
• lovastatin 0
• niacin 35

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Is fiber effective in lowering total cholesterol?
Daily Dose Reduction Oat bran (50-100g) 20
Psyllium (10-20g) 10-20 Veggie fiber
(27g) 10 Guar gum (9-15g) 10 Pectin (6-10g)
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A promising Study with Multiple natural
interventions

• Most studies look at one intervention only.
• Vegan diet which was high in soluble fiber, soy
  protein, plant sterols almonds had the
  following results in 4 weeks
• LDL decreased by35
• LDL/HDL ratio decreased by 30

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Other Useful Supplements

• Vitamin C
• Vitamin E
• Fish oil or Cod liver oil
• Fresh ground flax seed
• Chromium
• Magnesium
• Copper
• Milk thistle
• Alfalfa seeds
• Artichoke leaf extract
• Bilberry

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Other Useful Supplements (continued)

• Turmeric
• Eggplant
• Gamma-oryzanol
• Ginger
• Ginkgo biloba
• Hawthorn berry
• Panax ginseng
• Royal jelly
• L-carnitine

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Supplements for statin drug users

• HMG co-reductase inhibitors (statin drugs)
  deplete CoQ10
• Take CoQ10 at 100 mg per day

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High blood pressure (Hypertension)
Add a graphic of the grim reaper
"The Silent Killer"
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Grades of Hypertension

• Borderline 120-160/90-94
• Mild 140-160/95-104
• Moderate 140-180/105-114
• Severe 180/115

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Prevalence

• Over 60 million Americans
• Over half of all americans over 65 years old
• 3/4 of American blacks over 65 years old
• 50 of all cases either mild or borderline

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Risk factors

• Obesity
• Lack of exercise
• High stress
• Smoking
• Excess alcohol intake
• Excess coffee consumption
• High sodium to potassium ratio
• Low fiber / high sugar intake
• High saturated and low essential fat intake
• Low calcium, magnesium and vitamin C

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Natural Treatment Protocol Borderline/Mild
Hypertension

• Reduce body weight if overweight
• Eliminate salt (on foods salty foods)
• Avoid alcohol, coffee, smoking
• 30 minutes aerobic exercise daily
• Stress reduction techniques Heart Math Institute
  technique, yoga, etc
• Supplement with
• Vitamin C 1000 mg, 3 times/day
• Vit E 400 iu/day
• Magnesium 300 mg, 3 times/day
• Fresh ground flaxseed 3 tablespoons per day
• Optional supplement Garlic equivalent to 4 g
  fresh garlic/day
• Allow 3 months of natural therapy (medications
  may be indicated if no significant improvement

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Natural Treatment Protocol Moderate Hypertension

• Utilize protocol for borderline/mild hypertension
• Coenzyme Q10 50 mg, 3 times/day
• Hawthorne berry extract 250 mg, 3 times/day

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Natural Treatment Protocol Severe Hypertension

• Drugs required to lower blood pressure.
• Use CoQ10 as depletion is probable with drug use
• Use concurrent natural therapies

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Treatment Foods

• Eat more plant foods as they are a significant
  source of vitamins minerals esp potassium,
  calcium, magnesium, vitamin C, also a good
  source of fiber essential fatty acids
• celery may lower BP by 12-14
• garlic may lower BP by 8-11 points
• green leafy veggies
• raw nuts seeds
• fish
• whole grains, beans flax seed
• Broccoli, fruits

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Treatment Heart Math technique

• Breath slowly deeply focus on your breath
• Visualize breathing throught the heart
• Bring feeling of love and/or appreciation into
  your heart

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Summary of Lifestyle changes to improve
cardiovascular health

• Decrease intake of saturated fats, trans and
  hydrogenated fats, fried foods, dietary
  cholesterol
• Decrease intake of refined carbohydrates, Carbs
  eaten should be complex
• 2/3 of volume of food eaten should be colorful
  non starchy vegetables
• Eat fish 3 or more times per week
• Eat whole oats
• Meats that are OK to eat in moderation buffalo,
  skinless poultry, lean red meats, and eggs
• Substitute butter or margarine with Benecol
• Drink green tea instead of coffee
• If you drink alcohol, drink red wine in
  moderation
• If overweight, loose weight
• 30 minutes of aerobic exercise daily
• If you are a smoker....QUIT!
• Decrease stress meditate, breathe, yoga, etc.

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THANK YOU!

• If you are interested in being treated by Dr.
  Armentano, please contact him at
• Natural Medicine Wellness Center
• 296 Sound Beach Avenue
• Old Greenwich, CT 06870
• 203-637-8464