Heart Disease Prevention

TheSegal

I recently lost my father to heart disease and as a result I decided to read up on everything I could on the disease to help understand it and try to prevent it from happening to me. My father was in his mid 50s and had normal blood pressure, cholesterol was in a healthy range (low LDL, High HDL, low triglycerides), wasn't overweight, stress free lifestyle, non-smoker, would have about 5-6 pints on a Saturday night and exercised 4 nights a week (3 cardio, weights sessions and 1 night swimming) but he still suffered from severe buildup of plaque in his right coronary artery, >90%, which caused a heart attack.

Our family physician said that our family is susceptible to heart disease as my grandfather died from one, my grandmother had to have a stent fitted due to severe atherosclerosis (I'm not sure which artery caused the problem). My uncles and aunties have also been tested and some of them are starting to show signs of the disease and they were no where near as fit as my father and lead unhealthy lifestyles. I'm waiting on my angiogram, doctor said it's not a high priority for me as i'm not in my 30's yet but i'd rather get tests done for piece of mind.

I'm wondering if anyone can help point me in the right direction when it comes to proper research in the area? At the moment i'm reading articles which suggest a diet rich in grains which i'm incredibly skeptical about.

I'm 26, I follow a diet free from processed carbs, plenty of protein, plenty of healthy fats from fish, nuts and other sources and i've never abstained from saturated fat either as I know the original seven country study was a very 'selective' study in the countries they picked and there is no correlation between heart disease and saturated fat intake. I exercise regularly (powerlifting along with HIIT sessions and long cycling trips) and keep my bodyfat around 12-14%, I don't smoke but unfortunately I do have a tendency to drink quite a lot at weekends (could go through half a bottle of whiskey in just over an hour).

Sorry if the format of this message isn't great, I have a lot of questions that I really want to know the answers too.

Also, anyone who reads this with a history of heart disease in their family, make sure to get yourself checked out if you're over the age of 30, even earlier if possible. Losing my father to a preventable disease was a horrible experience that I would never wish on anyone

Hannibal Smith

My dad has heart disease. He is fit healthy and has normal cholesterol. ..but normal is too high for him. He has had 2 stents put in in the last 5 years.

The irish heart foundation gave us great information. There is a recipe page on their site.

Sorry about yr dad.

El_Dangeroso

People with genetically high Lp(a) are usually those who die of a heart attack while seeming perfectly healthy. I'd go back to your doctor first. Diet is subtle and I'm not sure it would do much in the face of very high genetic predisposition to heart disease.

siochain

El_Dangeroso wrote: »

People with genetically high Lp(a) are usually those who die of a heart attack while seeming perfectly healthy. I'd go back to your doctor first. Diet is subtle and I'm not sure it would do much in the face of very high genetic predisposition to heart disease.

Yeah that was my understanding had a chat with Prof. Sugrue in the Mater a few weeks ago and he said it was questionable about the effects of lp(a) on CHD but at the same time wouldn’t back his statement up with anything.

OP having your lp(a) levels checked is definitely worth doing. A few studies claim niacin can help reduce it marginally. In your early 30’s push hard to have the tests done so you can start preventive measures early.

My father died in early early forties and I have massively raised lp(a). Over the years I’ve had ultra sounds to check heart muscle thickness , last year I have an angiogram done next year I’ll be looking to have a calcium score test done. The ultra sound did show some thickening but that can be common in people who train a lot most importantly the angio showed arteries are clean as a whistle. When I eliminate all wheat and eat primal style nutrition my total cholesterol comes in at 3.8 (1.6:2.2 – HDL:LDL). But this is what works for me and may not work for others it’s really about trial and error. Really it’s not the LDL \ lp(a) that does the damage on its own its when its combined with inflammation in the arties when the problems start.

Forest Demon

Whole food plant based diet has reversed heart disease and has shown amazing results. Some people on here dismiss it as Voodoo but watch the following debate and look into it further if it interests you. The countries with the lowest rate of heart disease eat small amounts of protein, with mainly rice (starch) and plants and vegetables and very little to no dairy. Maybe also watch the documentary called Forks over Knives.

https://www.youtube.com/watch?v=mJYlXmfb08M

http://news.cancerconnect.com/a-plant-based-diet-offers-great-benefits/

El_Dangeroso

siochain wrote: »

Yeah that was my understanding had a chat with Prof. Sugrue in the Mater a few weeks ago and he said it was questionable about the effects of lp(a) on CHD but at the same time wouldn’t back his statement up with anything.

That's very interesting, can you expand why he doubted it as a factor? Everything I've read points to it being the most potent risk factor for heart disease and stroke. (Not that high Lp(a) guarantees heart disease or anything, there are obviously more complex elements further down the line with the LDL receptor etc.)

Forest Demon wrote: »

Whole food plant based diet has reversed heart disease and has shown amazing results.

There's a reason people on this forum dismiss that notion. This myth keeps getting perpetuated on the basis of a single study where they changed loads of things about a persons lifestyle so it's unscientific to claim it was due to anything about a plant-based diet.

If you compare health-conscious vegetarians with health-conscious meat eaters there is no difference in overall health. Most studies compare health-conscious vegetarians with the McDonald's eating average Joe so obviously there is going to be a huge difference in health there.

Forest Demon

El_Dangeroso wrote: »

There's a reason people on this forum dismiss that notion. This myth keeps getting perpetuated on the basis of a single study where they changed loads of things about a persons lifestyle so it's unscientific to claim it was due to anything about a plant-based diet.

There are loads of published papers and studies regarding the positive effects of a plant based diet for cancer and heart disease. Don't get me wrong I am not 100% convinced myself as similar results have been reported with fasting and very low calorie diets but I certainly would not dismiss the possibility that a fruit, vegetable and plant based diet is the way to go to minimise the risk of heart disease.

Nonoperational

To be honest man, if you have a healthy lifestyle with ZERO smoking and low alcohol consumption, cholesterol and blood pressure at the lower end of normal, a good balanced diet and plenty of exercise keeping your weight down, then you've pretty much done everything you can. Family history is a major risk factor for heart disease unfortunately but if you make it your only risk factor then your doing everything you can.

I wouldn't over-think it, you have to live too. A perfectly healthy 26 year old following some seriously restrictive diet that is not proven to be of measured benefit is madness in my humble opinion.

El_Dangeroso

Forest Demon wrote: »

There are loads of published papers and studies regarding the positive effects of a plant based diet for cancer and heart disease. Don't get me wrong I am not 100% convinced myself as similar results have been reported with fasting and very low calorie diets but I certainly would not dismiss the possibility that a fruit, vegetable and plant based diet is the way to go to minimise the risk of heart disease.

There definitely are loads of papers, but as I said before the comparison of a generally health-conscious person to non-especially health conscious person isn't really fair. Add to that the fact that vegetarians are usually of a higher economic class, better educated and loads of other things that we know reduce the disease burden on the better off. So you can see why yes, it's good to recomnmend a whole foods diet with plenty of fresh food, but no, that doesn't preclude meat, dairy and fish.

2xj3hplqgsbkym

Op there's no real point having all the tests done and taking so much care with your diet if your going to drink half a bottle of whisky in an hour. Don't you think you should sort that out first?

TheSegal

Thanks for all of the advice so far from everyone, had no idea about reading into lp(a) levels. Spent most of my time reading the causes of atherosclerosis but could never find what caused people to be genetically prone to heart disease.

El_dangeroso, is there any specific journals that I could use to read up on research in the area? You always seem to know your stuff inside out on this forum (not saying that other people on the forum don't know their stuff, i've found this forum to be brilliant with regards proper nutrition and citations to backup arguments). I'm only familiar with engineering journals so i'm not sure which journals are reputable in medical areas, i've learned long ago that impact factor can be a bad benchmark to rely on!

Amaris Powerful Halogen wrote: »

Op there's no real point having all the tests done and taking so much care with your diet if your going to drink half a bottle of whisky in an hour. Don't you think you should sort that out first?

Don't worry, i'm sorting that out after spending time with my uncle over the last few weeks who is an alcoholic and seeing what alcohol abuse can do to someone and the family around them. I'm not going to give up drink completely, just have a few pints of stout as opposed to half a bottle of whiskey!

El_Dangeroso

The journals would all be pretty involved to be honest and probably not addressing your exact issue. I'm not even sure about the conclusions of half of them myself.

I think getting to a specialist to discuss Lp(a) even if you have to go private would be worth it for the peace of mind alone.

If you really want to splash out a heart scan (costs in the region of 500 euro) can tell you exactly how much plaque you have built up, though may be of better value to you in your 40's.

siochain

El_Dangeroso wrote: »

That's very interesting, can you expand why he doubted it as a factor? Everything I've read points to it being the most potent risk factor for heart disease and stroke. (Not that high Lp(a) guarantees heart disease or anything, there are obviously more complex elements further down the line with the LDL receptor etc.)

.

Wish I could expand on it i spent €150 for 10 mins of his time he wouldn't answer any questions and the more questions I asked the more annoyed he seemed to get and this guy is the top cardiologist in the country. At least he agreed to give me the referral letter for the angio.

Only way to get decent health care in the country is educate yourself, have health insurance and demand the various health screening tests/procedures related to your areas of concern.

Unfortunately no such thing as preventive health care.

Forest Demon

El_Dangeroso wrote: »

There definitely are loads of papers, but as I said before the comparison of a generally health-conscious person to non-especially health conscious person isn't really fair. Add to that the fact that vegetarians are usually of a higher economic class, better educated and loads of other things that we know reduce the disease burden on the better off. So you can see why yes, it's good to recommend a whole foods diet with plenty of fresh food, but no, that doesn't preclude meat, dairy and fish.

Everything you say is true but what I was referring to prevention and also treatment of already sick people and the reversal of heart disease. The following page explains it better than I can and is very close to the request of the OP.

http://www.heartattackproof.com/

Dr. Caldwell B. Esselstyn carried out a 20 year nutritional survey, the longest ever conducted on a plant based, oil free diet.

The proof is in the results. The patients in Dr. Esselstyn’s initial study came to him with advanced coronary artery disease. Despite the aggressive treatment they received, among them bypasses and angioplasties, 5 of the original group were told by their cardiologists they had less than a year to live. Within months on Dr. Esselstyn’s program, their cholesterol levels, angina symptoms, and blood flow improved dramatically. Twelve years later 17 compliant patients had no further cardiac events. Adherent patients survived beyond twenty years free of symptoms.

Drop in cholesterol levels: After 5 years on Dr. Esselstyn’s plant-based diet, the average total cholesterol levels of his research group dropped from 246 milligrams per deciliter to 137 mg/dL (Above 240 mg/dL is considered “high risk,” below 150 mg/dL is the total cholesterol level seen in cultures where heart disease is essentially nonexistent.) This is the most profound drop in cholesterol ever documented in the medical literature in a study of this type.

Cardiac events: The 17 patients in the study had 49 cardiac events in the years leading up to the study, and had undergone aggressive treatment procedures. Several had multiple bypass operations. After beginning the eating plan, there were no more cardiac events in the group within a 12-year period.

Angiogram evidence: Angiograms taken of the participants in the study show a widening of the coronary arteries, and thus a reversal of the disease.

feelgoodinc27

El_Dangeroso wrote: »

If you really want to splash out a heart scan (costs in the region of 500 euro) can tell you exactly how much plaque you have built up, though may be of better value to you in your 40's.

What sort of scan is that, like what sort of imaging is used etc?

El_Dangeroso

Forest Demon wrote: »

Everything you say is true but what I was referring to prevention and also treatment of already sick people and the reversal of heart disease. The following page explains it better than I can and is very close to the request of the OP.

http://www.heartattackproof.com/

Dr. Caldwell B. Esselstyn carried out a 20 year nutritional survey, the longest ever conducted on a plant based, oil free diet.

The proof is in the results. The patients in Dr. Esselstyn’s initial study came to him with advanced coronary artery disease. Despite the aggressive treatment they received, among them bypasses and angioplasties, 5 of the original group were told by their cardiologists they had less than a year to live. Within months on Dr. Esselstyn’s program, their cholesterol levels, angina symptoms, and blood flow improved dramatically. Twelve years later 17 compliant patients had no further cardiac events. Adherent patients survived beyond twenty years free of symptoms.

Drop in cholesterol levels: After 5 years on Dr. Esselstyn’s plant-based diet, the average total cholesterol levels of his research group dropped from 246 milligrams per deciliter to 137 mg/dL (Above 240 mg/dL is considered “high risk,” below 150 mg/dL is the total cholesterol level seen in cultures where heart disease is essentially nonexistent.) This is the most profound drop in cholesterol ever documented in the medical literature in a study of this type.

Cardiac events: The 17 patients in the study had 49 cardiac events in the years leading up to the study, and had undergone aggressive treatment procedures. Several had multiple bypass operations. After beginning the eating plan, there were no more cardiac events in the group within a 12-year period.

Angiogram evidence: Angiograms taken of the participants in the study show a widening of the coronary arteries, and thus a reversal of the disease.

Dr. Esselstyn’s diet changed loads of things, made people exercise, lose weight, eat less junk food, take relaxation classes. There is absolutely no way to deduce it was all down to not eating dairy and meat.

Nonoperational

El_Dangeroso wrote: »

The journals would all be pretty involved to be honest and probably not addressing your exact issue. I'm not even sure about the conclusions of half of them myself.

I think getting to a specialist to discuss Lp(a) even if you have to go private would be worth it for the peace of mind alone.

If you really want to splash out a heart scan (costs in the region of 500 euro) can tell you exactly how much plaque you have built up, though may be of better value to you in your 40's.

What scan?

El_Dangeroso

feelgoodinc27 wrote: »

What sort of scan is that, like what sort of imaging is used etc?

Nonoperational wrote: »

What scan?

A CT scan of the heart.

Nonoperational

You shouldn't be getting coronary CTs unless there is a clear indication.

siochain

Nonoperational wrote: »

You shouldn't be getting coronary CTs unless there is a clear indication.

Such as family history which the op has.

El_Dangeroso

Nonoperational wrote: »

You shouldn't be getting coronary CTs unless there is a clear indication.

It's not like OP can rock up to a hospital and get one, you have to be referred surely.

Nonoperational

siochain wrote: »

Such as family history which the op has.

A healthy young adult with a family history is very unlikely to be referred for a CT angiography.

El_Dangeroso wrote: »

It's not like OP can rock up to a hospital and get one, you have to be referred surely.

Yep.

El_Dangeroso

Nonoperational wrote: »

A healthy young adult with a family history is very unlikely to be referred for a CT angiography.

Probably more likely in his 40's and likely to yield more informative results. I know there are inherent risks with CT's with radiation etc, so you wouldn't want to be getting a bunch of them. But if the person is willing to go private, and they were highly concerned given their family history, why wouldn't a doctor refer in that instance? There really isn't a better test of risk of cardiac event than a CT scan is there?

Nonoperational

I'm not a cardiologist but I'd imagine that even in his 40s if he is symptom and risk factor free (family aside) that they'd be slow to do it.

Angiography is still the gold standard test for coronary artery disease, but CT is being used more and more.

There are other non-invasive tests that would be done first at any rate...