Cardiovascular disease is the number one cause of death in the world. In Australia, CVD affects 1 in 6 people and kills one person every 12 minutes! [1] The majority of cardiovascular diseases are considered preventable and may occur due to lifestyle factors and diet choices – and there are plenty of natural therapies that help to support cardiovascular health!

What is Cardiovascular Disease (CVD)?

CVD includes any disease of the heart and blood vessels. Many of these conditions occur as a result of atherosclerosis and high blood pressure (more on these in a moment).

There is a collection of conditions that fall under the umbrella of cardiovascular disease(s). CVDs include:

• Coronary heart disease: Disease affecting the muscles of the heart, often resulting in a heart attack.
• Ischemic stroke: The most common type of stroke that occurs when a blood vessel to the brain is blocked.
• Peripheral arterial disease: Disease affecting blood vessels supplying to the arms and legs.
• Rheumatic heart disease:  Damage to the heart from rheumatic fever due to infection of Streptococcal bacteria.
• Congenital heart failure: Malformations to the heart at birth.
• Pulmonary embolism: Blockage of arteries of the lungs. [1] [2]

Atherosclerosis Explained

Arteries are the blood vessels that carry oxygen-rich blood away from the heart, delivering it to tissues all over the body. Atherosclerosis is the most common way that arteries lose their elasticity and become thickened, and it is particularly dangerous because it can cause coronary heart disease, stroke and peripheral artery disease [3].

Here's what's going on

Because oxygenated blood is essential for cells all over the body, arteries are designed to quickly get blood to where it's needed.

The walls of arteries are usually elastic so that they can stretch to accommodate more blood when the heart pumps harder or faster. For example, the heart pumps more during exercise to push extra blood through the arteries to deliver oxygen and nutrients to the muscles that are moving.

In atherosclerosis, plaque builds up on the inside of arteries. This occurs as a result of injury or inflammation to the arterial walls, and plaque eventually builds up there. This build-up shrinks the space available for blood to flow through the arteries and it hardens the blood vessels so they can no longer stretch to accommodate more blood [3].

Plaques grow in two stages

• Stable Plaques: This type of plaque is unlikely to rupture. Stable plaques can get smaller, remain the same size, or grow very gradually over decades. They generally remain undetected until they grow so large that they “occlude” (fill up) the artery and cause a blockage, which then causes symptoms of atherosclerosis.
   
• Unstable Plaques: Unstable atherosclerosis plaques are dangerous because they are prone to become dislodged. Pieces of the plaque can break off and be carried with the blood until they become lodged in smaller vessels where they block blood flow and can cause coronary heart disease (and heart attack), stroke and peripheral artery disease.

Symptoms of Atherosclerosis

Early atherosclerosis is very hard to detect as it rarely causes symptoms. Symptoms may occur once the artery is occluded by more than 70% and blood flow can't keep up with tissue demand for oxygen. These symptoms include:

• Localised pain
• Chest pain (angina) when exercising
• Leg cramps when walking
• Kidney failure and/or dangerously high blood pressure
• Heart attack if arteries to heart are suddenly blocked
• Stroke if arteries to brain to are blocked
• Gangrene to toes, feet or legs if arteries to legs are blocked  [3]

High Blood Pressure & Cardiovascular Disease

Blood pressure is determined by how hard the heart is required to contract in order to push blood through the vascular system. High blood pressure rarely exhibits symptoms, so get yours checked often – most pharmacies will do it for free.

• High blood pressure is a risk factor for atherosclerosis because the turbulence of the blood can cause injury to the artery wall. It's particularly risky when arterial plaque has already accumulated as fast moving blood cells can rip open unstable plaques and cause stroke or thrombosis.
• High blood pressure can cause haemorrhagic stroke. This is where a weakened blood vessel within the brain bursts and causes a stroke [4].
• Blockages in the arteries can cause an increase in blood pressure as the heart has to pump harder to push blood through semi-occluded arteries [3].

Because atherosclerosis can lead to high blood pressure and visa versa, they have the same risk factors. These include:

• Smoking or chewing tobacco damages the walls of arteries.
• High levels of cholesterol in the blood adhere easily to injured artery walls.
• High blood pressure damage the walls of arteries and dislodge unstable plaques.
• Diabetes causes large sugar molecules to remain in the blood where they damage arterial walls.
• Obesity
• Sedentary lifestyle or lack of exercise
• Daily diet low in fruits and vegetables
• Diet high in processed meats
• Family history of atherosclerosis or heart disease
• Advancing age   [3][4]

Coronary Heart Disease & Heart Attack

The heart's blood supply is called “coronary circulation”. The heart is the body's most important organ and the majority of physiological process are geared towards keeping it pumping. Contractions of the heart ensure that blood is delivered to tissues all over the body,  but what about the blood that supplies the heart muscles? For the heart to contract hard enough and fast enough to push blood through the whole body, its muscles require lots of oxygen and nutrients. When the heart's blood supply is reduced, it can't pump properly – this results in a heart attack [2].

Atherosclerosis is a major cause of coronary heart disease and heart attacks. Plaque builds up within the heart's arteries and can gradually block more and more blood flow. Unstable plaques from other areas of the body can break off and travel to the small vessels within the heart's circulation, causing blockages and heart attack.

What Does a Heart Attack Feel Like?

Know the symptoms of a heart attack and get help quickly

• Shortness of breath or difficulty breathing *
• Feeling sick or vomiting *
• Light-headed or faint
• Becoming pale
• Sweating (often a “cold sweat”)
• Pain or discomfort in:
  • The centre of the chest
  • One or both arms
  • The left shoulder
  • Elbows
  • Jaw *
  • Back *

* = Women are more likely to have these symptoms. [2]

 Natural Therapies for Cardiovascular Health

The Mediterranean Diet is a diet protocol based on the foods traditionally eaten in the Mediterranean where cardiovascular disease was basically unheard of for hundreds of years. 

Its basis is fresh vegetables and fruits, whole grains, fish and low in processed foods  – it's a diet that is rich in antioxidants, healthy fats and plenty of fibre.

Very heart-friendly!

Try the Mediterranean Diet – Or Go Vegan

oing one step further, vegetarians have been found to have the lowest rates of heart disease and a lower risk of death from CVD than non-vegetarians (including people on the Mediterranean diet) [8]. The effects are even more pronounced on a totally vegan diet. Plant-based diets that exclude all animal products including fish, dairy, eggs and honey have been shown to lower risk of cardiovascular disease and complications, and are protective against risk factors for CVD including obesity, diabetes and hypertension [5] [6].

Magnesium

Magnesium is known as the relaxation mineral for muscles (the heart is a muscle, right?), and it helps blood vessels to chill out, too. Magnesium is a “vasodilator” – it encourages blood vessels to stretch normally, and reduces any tightness and contractility that could be contributing to high blood pressure. A large mega-analysis showed that hypertensive patients experienced a reduction in long-term blood pressure when taking magnesium supplements daily [10].

Vitamin C

Vitamin C is often for colds and flus but overlooked for serious conditions like cardiovascular disease. This amazing nutrient has a number of potent actions that can help to protect blood vessels and heart muscles against disease [7].

• As a potent antioxidant, vitamin C can protect arterial walls from damage that can lead to atherosclerosis, and can prevent oxidation of LDL cholesterol [7].
• High dose supplementation can help to keep your lipid levels healthy by boosting the excretion of excess cholesterol and metabolism of triglycerides [8].
• Vitamin C also helps to keep blood pressure under control by supporting relaxation of arteries, and supporting the adrenal glands to keep stress hormones as a moderate level [9].

Foods rich in vitamin C include kiwi fruit, red capsicum, broccoli and strawberries. Supplementation is considered very safe in doses of 500mg – 2,000mg per day for adults.

Garlic

Garlic has been used for hundreds of years in traditional medicine for its heart-health benefits and is the most heavily researched herbal therapy. 

A 2016 meta-analysis concluded that the current research agrees that garlic has a role in protecting the cardiovascular system. It has potent antioxidant actions and its rich sulphur content can encourage vasodilation and thin the blood to reduce high blood pressure in people with hypertension [11]. Evidence shows that garlic supplement have the potential to protect against CVD risk by reducing total cholesterol levels, lowering blood pressure, and preventing atherosclerosis [12].

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References:

[1] Heart Foundation (2017) Heart Disease in Australia. https://www.heartfoundation.org.au/about-us/what-we-do/heart-disease-in-australia

[2] Merck Manual (2017) Cardiovascular Disorders. http://www.merckmanuals.com/professional/cardiovascular-disorders

[3] Merck Manual (2017) Atherosclerosis. http://www.merckmanuals.com/professional/cardiovascular-disorders/arteriosclerosis/atherosclerosis

[4] Merck Manual (2016) Overview of Hypertension. http://www.merckmanuals.com/professional/cardiovascular-disorders/hypertension/overview-of-hypertension

[5] Tuso, P. J., et al. (2013) Nutritional Update for Physicians: Plant-Based Diets. Perm J., 17:2, 61 – 86. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3662288/

[6] Le, L. T. & Sabate, J. (2014) Beyond Meatless, the Health Effects of Vegan Diets: Findings from the Adventist Cohorts. Nutrients, 6:6, 2131 – 2147. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4073139/

[7] Knekt, P., et al. (2004) Antioxidant vitamins and coronary heart disease risk: a pooled analysis of 9 cohorts. Am J Clin Nutr., 80:6, 1508 – 1520. https://www.ncbi.nlm.nih.gov/pubmed/15585762

[8] McRae, M. P. (2008) Vitamin C supplementation lowers serum low-density lipoprotein cholesterol and triglycerides: a meta-analysis of 13 randomized controlled trials. J Chiropr Med., 7:2, 48 – 58. https://www.ncbi.nlm.nih.gov/pubmed/19674720

[9] Mak, S. (2002) Vitamin C prevents hyperoxia-mediated vasoconstriction and impairment of endothelium-dependent vasodilation. Am J Physiol Heart Circ Physiol., 282:6, H2414 – 2421. https://www.ncbi.nlm.nih.gov/pubmed/12003853

[10] Rosanoff, A. & Plesset, M. R. (2013) Oral magnesium supplements decrease high blood pressure (SBP > 155 mmHg) in hypertensive subjects on anti-hypertensive medications: a targeted meta-analysis. Magnesium Research, 26:3, 93 – 99.  http://www.jle.com/download/mrh-298491-oral_magnesium_supplements_decrease_high_blood_pressure_sbp_155mmhg_in_hypertensive_subjects_on_anti_hypertensive_medications_a_targe--WfZii38AAQEAAHwl2MsAAAAJ-a.pdf

[11] Stabler, S. N., et al. (2012) Garlic for the prevention of cardiovascular morbidity and mortality in hypertensive patients. Chocrane Database of Systematic Reviews, 2012:8. http://onlinelibrary.wiley.com/doi/10.1002/14651858.CD007653.pub2/full

[12] Varshney, R. & Budoff, M. J. (2016) Garlic and Heart Disease. Journal of Nutrition, 148:2, 416S – 421S. http://jn.nutrition.org/content/146/2/416S.long