Table Of ContentNUTRITION Nutritional and
Sinatra
•
Houston
Integrative Strategies
Nutritional and Integrative Strategies in
Cardiovascular Medicine in Cardiovascular
Despite 40 years of aggressive pharmaceutical and surgical interventions, coronary artery disease
Medicine
(CAD) remains the number one killer of women and men in Western civilization. When it comes to
N
CAD, prevention is easier than cure, and if CAD does present itself, a combination of conventional
u
and alternative methodologies can truly make a difference in people’s lives. Nutritional and
t
r
Integrative Strategies in Cardiovascular Medicine provides scientific and clinical insight i i
n t
i
from leaders in the field of cardiovascular medicine who explore an integrative approach to treating o
C
and curing cardiovascular diseases through conventional and non-allopathic methodologies. n
a a
r l
Nutritional interventions with both appropriate noninflammatory diets and targeted nutraceutical d
a
supports are simple and basic strategies to prevent as well as help manage CAD and congestive io n
heart failure (CHF). This evidence-based book describes how to integrate nutrition, supplements, v d
a
lifestyle changes, and medications for improved outcomes in hypertension, dyslipidemia, diabetes, I
s n
c
coronary heart disease, congestive heart failure, and much more. Topics include t
u e
l g
a
• Nutrigenomics, proteomics, and metabolomics in heart disease r
r a
M t
• The risks and side effects of statin drugs i Edited by
v
e e
• The value of omega-3s and other fats d Stephen T. Sinatra
S
i
c t
• Naturopathic approaches i r
n a
Mark C. Houston
e t
e
• Gender-specific medicine
g
i
e
• Nutrient-drug interactions in cardiovascular medicine
s
Nutritional medicine and understanding nutrigenomics for the prevention and treatment of
cardiovascular disease will become the recommended practice of medicine in the very near future.
This book is designed to help established health professionals as well as students preparing for
degrees in healthcare.
K16586
6000 Broken Sound Parkway, NW
Suite 300, Boca Raton, FL 33487
711 Third Avenue
New York, NY 10017
an informa business
2 Park Square, Milton Park
www.crcpress.com Abingdon, Oxon OX14 4RN, UK w w w . c r c p r e s s . c o m
Nutritional and
Integrative Strategies
in Cardiovascular
Medicine
Nutritional and
Integrative Strategies
in Cardiovascular
Medicine
Edited by
Stephen T. Sinatra
University of Connecticut School of Medicine
Farmington, Connecticut, USA
Mark C. Houston
Vanderbilt University School of Medicine
Nashville, Tennessee, USA
Boca Raton London New York
CRC Press is an imprint of the
Taylor & Francis Group, an informa business
CRC Press
Taylor & Francis Group
6000 Broken Sound Parkway NW, Suite 300
Boca Raton, FL 33487-2742
© 2015 by Taylor & Francis Group, LLC
CRC Press is an imprint of Taylor & Francis Group, an Informa business
No claim to original U.S. Government works
Version Date: 20150211
International Standard Book Number-13: 978-1-4665-7227-0 (eBook - PDF)
This book contains information obtained from authentic and highly regarded sources. Reasonable efforts have been
made to publish reliable data and information, but the author and publisher cannot assume responsibility for the valid-
ity of all materials or the consequences of their use. The authors and publishers have attempted to trace the copyright
holders of all material reproduced in this publication and apologize to copyright holders if permission to publish in this
form has not been obtained. If any copyright material has not been acknowledged please write and let us know so we may
rectify in any future reprint.
Except as permitted under U.S. Copyright Law, no part of this book may be reprinted, reproduced, transmitted, or uti-
lized in any form by any electronic, mechanical, or other means, now known or hereafter invented, including photocopy-
ing, microfilming, and recording, or in any information storage or retrieval system, without written permission from the
publishers.
For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://
www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923,
978-750-8400. CCC is a not-for-profit organization that provides licenses and registration for a variety of users. For
organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged.
Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for
identification and explanation without intent to infringe.
Visit the Taylor & Francis Web site at
http://www.taylorandfrancis.com
and the CRC Press Web site at
http://www.crcpress.com
Contents
Introduction .....................................................................................................................................vii
Editors ...............................................................................................................................................xi
Contributors ...................................................................................................................................xiii
Chapter 1 Myths of Cholesterol: Rethinking a Paradigm.............................................................1
Jonny Bowden and Stephen T. Sinatra
Chapter 2 Fats and Cardiovascular Disease: The Good, the Bad, and the Ugly ........................15
Beverly B. Teter
Chapter 3 Has Statin Therapy Been Oversold? A Call for a Reevaluation of the Standards
for Treatment ..............................................................................................................31
Stephen T. Sinatra and Jonny Bowden
Chapter 4 Lipid Subfraction Testing ...........................................................................................43
Richard Delany
Chapter 5 The Role of Nutrition and Nutritional Supplements in the Treatment of
Dyslipidemia ..............................................................................................................75
Mark Houston
Chapter 6 Healing the Heart with Whole Foods and Food Bioactives .....................................103
Deanna Minich and Benjamin Brown
Chapter 7 Potential of Diet and Dietary Supplementation to Ameliorate the Chronic
Clinical Perturbations of Metabolic Syndrome .......................................................147
Harry G. Preuss and Dallas Clouatre
Chapter 8 Naturopathic Medicine and the Prevention and Treatment of Cardiovascular
Disease .....................................................................................................................179
Drew Sinatra
Chapter 9 Nutrition and Nutraceutical Supplements for the Treatment of Hypertension .........205
Mark Houston
Chapter 10 The Role of Dentistry in Cardiovascular Health and General Well-Being ..............247
Mark A. Breiner
v
vi Contents
Chapter 11 Lyme Disease and the Heart ....................................................................................263
William Lee Cowden
Chapter 12 Metabolic Cardiology: The Missing Link in the Treatment and
Management of Heart Failure ..................................................................................283
Stephen T. Sinatra
Chapter 13 Be the Willow: Stress, Resiliency, and Diseases of the Heart .................................305
Mimi Guarneri and Ryan Bradley
Chapter 14 Women and Heart Disease: Special Considerations ................................................325
Stephen T. Sinatra
Chapter 15 Hormones and Their Effects on the Cardiovascular System ...................................337
Pamela Smith
Chapter 16 Consequences of Cardiovascular Drug-Induced Nutrient Depletion .......................369
James B. LaValle
Introduction
Stephen T. Sinatra
It gives me great pleasure to offer Nutritional and Integrative Strategies in Cardiovascular Medicine
as an in-depth communication offering vital information in the diagnosis and management of ath-
erosclerotic cardiovascular disease. Despite 40 years of aggressive pharmaceutical and surgical
interventions,1 coronary artery disease (CAD) remains the number one killer of women and men in
Western c ivilization. Although urgent use of percutaneous coronary artery intervention (PCI) can
be lifesaving in acute myocardial infarction, the elective use of these procedures offers minimal
protection from future cardiovascular events or even longevity.2 Clearly, when it comes to CAD,
“prevention is easier than cure” and if CAD does present itself, a combination of conventional and
alternative methodologies can truly make a difference in people’s lives. Nutritional interventions
with both appropriate noninflammatory diets and targeted nutraceutical supports are simple and
basic strategies to prevent as well as help manage CAD.
In an ideal world, we would eat all the nutrients necessary to sustain and protect our health. In
reality, however, most of us do not eat a nutritious diet full of fruits and vegetables, healthy fats, and
lean protein. Instead, we too frequently eat on the basis of convenience and price, and that means
more processed foods that are high in calories and low in nutrients.
Even if we do manage to eat healthy foods most of the time, our diets probably do not contain
therapeutic amounts of antioxidants, vitamins, and minerals necessary to help prevent cancer, car-
diovascular disease, and other degenerative diseases, and which contribute to premature aging.
Behind these conditions is inflammation. And what drives inflammation are out-of-control free
radicals, molecular fragments produced by natural metabolism, foods, transfats, sugar, environmen-
tal toxins, and radiation, to mention a few. As our bodies contain limited amounts of enzymes that
neutralize free radicals, we need to look for antioxidants from outside sources.
Today, we realize that vast numbers of people eat poorly and do not get proper nutrition from
their diets that their bodies need to sustain good health. Moreover, a global wave of revealing
nutritional research has rendered the conventional viewpoint on supplementation utterly obsolete.
Hundreds of published studies have shown that individual nutrients at doses higher than those usu-
ally present in food have a significant preventive and therapeutic effect on one’s health.
Targeted nutraceuticals are not a substitute for good nutrition, but they provide the kind of sup-
port that can help prevent inflammatory damage and boost energy production in the body. Knowing
which nutrients are best for you individually, as well as in what amounts, can help you nurture your-
self appropriately. For example, supplementing with nutrients designed to facilitate and stimulate
energy substrate production is the basis of metabolic cardiology.
The combination of targeted supplements and a healthy diet has been the cornerstone of the
nutritional strategy that I applied for decades to help my patients with heart disease and many other
maladies. I used this approach therapeutically as well as preventively to heal and create optimum
health. Most doctors today prescribe drugs for specific effects, such as lowering cholesterol, blood
pressure, and blood sugar.
When pharmaceutical drugs do not work in restoring blood flow, surgeons may be called in to
perform lifesaving bypasses or heart transplants. In integrative medicine, we use or recommend
these methods as well. But we have learned to do something extra, something normally ignored,
absolutely simplistic, and bargain-basement cheap compared to dazzling, big-ticket technol-
ogy. We optimize your nutritional status with vitamins, minerals, antioxidants, and other natural
substances—by doing that we optimize your healing and health. In the fight against disease, we
vii
viii Introduction
do not fight the enemy with limited weapons. We use many. We use what works best, whether the
weapons are conventional, natural, or complementary.
Before 1990, vitamins and minerals were seen by most physicians as substances in food that
prevented nutritional deficiency states such as scurvy, beriberi, rickets, and pellagra. Mainstream
medicine viewed supplementation as unnecessary because, supposedly, “we get all the nutrition we
need from our diet.” For decades, only a small minority of nutritionally oriented physicians recom-
mended supplements for serious diseases and not just for serious deficiency states.
The wealth of research has greatly influenced the way I perceive healing. A comprehensive tar-
geted nutritional supplement program in combination with a noninflammatory diet is a major part
of a preventive and therapeutic intervention. The supplements address specific cardiovascular short-
comings and simultaneously strengthen overall physiology to thwart off infection, inflammation,
and plaque while attenuating oxidative lipid issues and blood pressure problems.
Sick people need this nutritional upgrade. They benefit magnificently. It often keeps them out
of the hospital. Sometimes supplements work rapidly like magic. Patients suddenly become rejuve-
nated as their nutritionally starved bodies respond to healing nutrients that were missing for years.
Other times, we see a steady but remarkable return to health by patients who previously sputtered
along on near-empty tanks. Now, with their tanks full, they move actively forward in life, feeling
better than they have felt in years.
In this book, a list of talented authors offers discussions and therapeutic options highlighting
their expertise in cardiovascular disease. An in-depth evaluation of fats and lipids as well as alterna-
tive and integrative options are offered in the management of lipid disorders and high blood pres-
sure. Other than cigarette smoking, hypertension remains the second most significant risk factor in
both men and women. The management of hypertension with diet and targeted nutritional supports
is thoroughly presented by several authors. Detoxification, Lyme disease (a serious microbe threat
to the heart), and the enormous importance of dental considerations are presented to the reader.
The discussion on metabolic syndrome is extremely timely given the fact that this inflammatory
metabolic problem is affecting millions of our youth. A naturopathic approach to cardiovascular
disease highlighting the value of detoxification is introduced in the care and the management of
cardiovascular patients. Hormonal bioidentical interventions and the special concerns of heart dis-
ease in women are highlighted with a gender-specific focus. The impact of emotional stress on the
heart and the poorly understood association regarding pharmaceutical drugs’ influence on nutrient
depletion are also presented.
Multiple authors have their own way of telling their stories while offering valuable informa-
tion. Some of the chapters are conversational, others are like reading a scientific journal, and
still others reflect personal observations in the care of their patients. Multiple styles of writing
offer the reader creative ways of assimilating the information. Although you may find some
duplication of the content, the reader is offered multiple choices in the search for treatments and
solutions.
This textbook was designed to help health professionals utilize natural healing foods, as well as
nutritional supports and other valuable interventions in the battle against cardiovascular disease.
This book was written for doctors who want to know about the most leading and cutting-edge
integrative advances that will benefit their patients. In the final analysis, we physicians and health
professionals want to reduce the suffering of our patients while extending quality of life at the
same time. The contents of Nutritional and Integrative Strategies in Cardiovascular Medicine are
a testimony to the integrative care of the patient.
I want to thank all the authors for their hard work and contribution to the subject matter and
especially Dr. Mark Houston for assisting me with the editing process. I would also like to thank
the American College of Nutrition for their willingness to review this book and place their seal of
approval on its contents.
