Last week we looked at atherosclerosis (plaque buildup) in the arteries. It appears that at the root of this process is damage or stress to the arterial lining (also known as endothelial dysfunction) from a variety of factors, which then sets off a series of events due to an overactive inflammatory response. With prevention as our first priority, here is a brief look at 8 common risk factors that may cause this initial dysfunction and set off this detrimental process.
- Oxidative Stress: This is a fancy way of saying that there are not enough antioxidants available to neutralize harmful oxidants (free radicals) in the body. Oxidative stress is one of the main drivers of inflammation and destruction of arterial lining. As mentioned last week in Part 1, oxidation occurs due to highly unstable molecules, known as “free radicals” which damage cells. Oxidative stress can be the result of regular biological processes, smoking, alcohol, emotional stress and lack of sleep, pollutants, chronic infections, poor nutrition or high blood sugar. Note that excess homocysteine also promotes oxidative stress. This amino acid is normally found in the bloodstream but is dangerous when elevated.
- Poor Diet: The following dietary factors contribute to “endothelial dysfunction” and excess inflammation in the body: alcohol, regular intake of processed/refined foods and trans fats, high sugar or low-fiber diet, chemicals, additives, and imbalanced consumption of omega 6 in relation to omega 3. Note that both omegas are necessary from the diet, however excess omega 6 can be harmful.
- Unhealthy Weight: Accumulated belly fat contributes to chronic inflammation and may initiate atherosclerosis. Even people who are overweight, but not obese are at increased risk of heart disease. Physical inactivity and sedentary lifestyle are major risk factors for heart disease. Regular exercise protects against the development of cardiovascular disease and can help improve other risk factors such as insulin resistance and obesity. Dr. Michael Murray, ND, states that “obesity is the major dietary cause of high blood pressure”.
- High Blood Sugar: Increased blood sugar and insulin resistance both trigger inflammation and are associated with increased oxidative stress. High blood sugar also contributes to the production of molecules called AGEs, which are able to modify LDL cholesterol particles so that they can be more easily oxidized. This we know, from Part 1, is a common underlying trigger for atherosclerosis. Insulin resistance also causes retention of sodium and water from the kidneys, leading to high blood pressure as well as greatly increases the risk for clot formation.
- Environmental Toxins: These may come in the form of cigarette smoke, air pollution, pesticides, herbicides, chemical additives, heavy metals or hormone disruptors (i.e. in plastics). Toxic exposure contributes to oxidative stress, causing damage to the endothelial lining and triggering silent inflammation in the body. When the body is overburdened with toxins, antioxidants are depleted.
- Poor Gut Health: We have seen that inflammation plays a role in all stages of atherosclerosis, as it is an inflammatory disease. What is important to note is that the gut is the major source of chronic, low-grade inflammation. This generally occurs in response to changes in gut bacterial balance or activity, food sensitivities, emotional stress, inadequate enzymes or stomach acid or intestinal permeability (i.e. leaky gut), which allows bacteria and undigested food to enter circulation. Therefore, there is a direct connection between the gut and the heart. The gut also plays a major role in cholesterol metabolism. Brenda Watson, CNC, states that a study has shown that the composition of gut bacteria may even affect whether statins work effectively or not!
- Emotional Stress: Stress increases inflammation in the body. This can lead to an increase in abdominal fat, high blood lipid levels, poor digestion and insulin resistance, which are other triggers for heart disease. Brenda Watson explains that the physiological response to stress increases blood pressure and heart rate, which puts pressure on arterial walls, thus damaging the lining. As we have seen, this damage can trigger an inflammatory response that sets off plaque accumulation. She also states that elevated levels of cortisol are found in people with both acute and chronic stress and that even mild “normal” stress can negatively affect the heart. Did you know that depression and anger are also related to heart disease? According to a study shared by Dr. Michael Murray, ND, greater anger and severity of depressive symptoms were significantly associated with increased inflammatory markers as well as increased cortisol, endothelial dysfunction, high blood pressure and increased platelet aggregation.
- Inflammation: Inflammation plays a role at every stage of the plaque buildup process and is considered a risk factor as it can initiate artery damage. Inflammation is necessary in the body and serves as the response to injury or infection. It can occur due to a foreign invader, malfunction or damage. It serves an important purpose and is meant to stop once the trigger is taken care of. However, when the irritation is constant, the result is chronic, low-grade inflammation. Factors that promote this “silent” inflammation include poor diet, high blood sugar and insulin resistance, obesity, environmental toxins, emotional stress, chronic infections (even gum disease), increased exposure to free radicals, poor digestion and food sensitivities, etc. Remember that the gut is an important source of inflammation.
Bonus Tip: healthy estrogen levels can play a protective role against heart disease. These levels are known to decrease after menopause. Balance is an important key to heart health!
Now that we understand that heart disease stems from a combination of risk factors, we see how important it is to target various aspects of health in our efforts to prevent heart disease. In addition to taking lifestyle measures to control these triggers (such as balancing blood sugar, eating well, managing stress, digesting properly, controlling weight, avoiding toxin exposure), tune into Part 3 next week for natural ingredient suggestions to help increase your chances of a healthy and happy heart!