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Heart Disease: Understanding the basics and how to avoid it!

Learn how heart disease develops, and how Modern Functional Medicine can help you prevent it.

Our heart is a non-stop, powerful muscle that pumps blood to every corner of our body, replenishing our cells with much needed oxygen for their normal function. However, an optimally functioning heart depends on multiple factors, extrinsic and intrinsic.

At the Australian Centre for Functional Medicine we understand that heart disease is influenced by multiple factors, from the food you eat to the daily routine you follow and the genes you inherited. All these factors and others influence the health of your hearth and the likelihood that you will develop heart disease.

In the past decades, heart disease has become a global problem, particularly in developed countries, where they represent the number one cause of death.

Find out how heart disease forms and what the Australian Centre for Functional Medicine can do to help keep your heart healthy.

 

How the heart works

 

Our heart is the organ in charge of pumping blood, non-stop, throughout the body. The heart is made up four chambers, which work together by contracting and relaxing, receiving oxygenated blood coming from the lungs and pumping it to the rest of the body.

 

A key feature of the heart, which allows it to contract and relax constantly, is the cardiac muscle tissue, which is made up specialised cells, called cardiac muscle cells and pacemaker cells. Cardiac muscle cells are responsible for the contraction and relaxation of the heart, while pacemaker cells produce electrical impulses that regulate the pace of the heart. These pacemaker cells are autonomous, and allow for the functioning of the heart independently from our central nervous system. There are between 2-3 billion of cardiac muscle cells in the heart, which allow for constant muscle movement and pumping of blood. The heart is also made up various other cell types, including smooth muscle and endothelial cells, fibroblasts and other connective tissue cells, mast cells and immune system-related cells. Together, all these cell types allow for the optimal and constant functioning of the heart1.

When there is a heart attack, and the inflow of oxygenated blood is reduced, cells from the cardiac muscle tissue can die, and are replaced by scar tissue. Scar tissue does not have the same properties are cardiac cells, so your heart if left with a sub-optimal cellular makeup and function. After a heart attack, depending on how extensive id the cardiac ell damage, your heart may not be able to function properly again, potentially leading to an early death.

 

What is heart disease?

 

The term “heart disease” includes a wide range of different problems that affect the heart, including coronary artery disease (also known as coronary heart disease or ischemic heart disease), arrhythmias (abnormal rhythms of the heart) and genetic defects (mostly inherited genetic defects), among others.

Among all these conditions, the most common and the one that kills more people around the world is coronary heart disease, a condition that primary affects the blood vessels that connect with the heart.

Coronary heart disease is a condition where the arteries that supply oxygenated blood to the heart are blocked by plaque. Plaque is a substance made up of cholesterol, which can become attached to the inside of the arteries, making them narrower over time – a process known as atherosclerosis. As more and more of this plaque builds up inside the arteries, less blood can flow through the arteries to provide oxygen to the heart.

A heart attack occurs when the muscles of the heart stop working properly, due to a lack of sufficient oxygenated blood. Often, the main cause for the blockage of oxygenated blood comes from a fragment of plaque that has dislodged from the artery’s wall and is now blocking the way of oxygenated blood to the heart. If this condition is not treated quickly, the heart muscle cells start to die. Depending on how extensive the damage is, the heart function can be compromised, as death heart muscle cells are replaced by scar tissue, which does not function as muscle cells2-5.

When you have a heart attack you may experience symptoms like:

      • Chest pain or discomfort

        Most people experience pain, pressure, or discomfort in the centre or left side of the chest, which can last for a few minutes or can goes away and come back. It also can feel like heartburn, fullness or indigestion and the whole sensation can be mild or severe.

 

      • Upper body discomfort

        another typical symptom of an ongoing heart attack is pain or discomfort in one or both arms, or on the back, shoulders, neck, jaw, or the stomach area.

 

      • Shortness of breath

        Sometimes, people who have a heart attack only experience this symptom. Other times shortness of breath may come along with chest pain or discomfort.

 

Development of coronary heart disease

 

Among all forms of heart disease, coronary heart disease is the most common, affecting more than half million Australians every year. See our article on this worrisome issue.

Coronary heart disease is, essentially, a disease of the arteries that supply oxygen to the heart. When the arteries get blocked by excessive plaque accumulated in the inner walls, a condition known as atherosclerosis, blood cannot go through and provide the oxygen heart cells need. Also, when significant amounts of plaque have accumulated in the walls of arteries, there is an increased chance that a fragment of plaque can dislodge and completely block an artery, causing total blockage and leading to cardiac cell damage, and heart disease.

At the Australian Centre for Functional Medicine we focus on two important factors influencing coronary heart disease: diet and lifestyle. These factors can lead to the slow accumulation of plaque in the arteries leading to the heart. A recent review,  which analysed the findings of 123 studies, showed that there is a positive association between the risk of coronary heart disease, stroke and heart failure with high consumption of foods like red meat, processed meat, and sugar-sweetened beverages and eggs5. In other words, the more you consume of these foods, the more likely you will develop a heart condition. The review study also found that foods like whole grains, vegetables, fruits, nuts, and fish has the opposite effect: high consumption of these foods was associated with lower risk of heart disease.

 

Heart Disease Focus on: Cholesterol

 

Atherosclerosis is caused by the accumulation of cholesterol in the inside of the arteries that connect with the heart. However, cholesterol is not a poison we need to avoid at all cost, but an essential component of our body.

Cholesterol function – cholesterol is a molecule used by our body to maintain the integrity and optimal function of cell membranes. It is also used as a building block for the formation of important biomolecules, such as steroid hormones, bile acids, and vitamin D.

However, excessive intake of cholesterol can be a problem, mostly because our body does not need any extra cholesterol. Here is an important fact: Our body can synthesize all the blood cholesterol it needs, hence why it is recommended to reduce the intake of cholesterol-rich foods. Foods rich in cholesterol include meat, seafood, poultry, eggs, and dairy products and consuming an excess of these foods will inevitably lead to an excess of cholesterol in our body.

In Australia, about half of all adults have more than the recommended levels of cholesterol in their blood. The main factor driving this worrisome trend is the unhealthy diet followed by a large proportion of Australians. Diets rich in animal-based fats, such as meats, processed meats (ham, salami), chips, deep-fried foods, cakes and pastries, as well as dairy products are all rich in cholesterol. At the Australian Centre for Functional Medicine we focus on helping our patients escape from their western diet and find a new and healthy way of eating.

 

Heart Disease: Beyond diet


Following an unhealthy diet is an important factor in plaque formation leading to atherosclerosis and, subsequently, heart diseases. However, at the Australian Centre for Functional Medicine we are mindful that there are other factors that influence the development ofheart disease. These include:

      • Chronic inflammation

        In recent years, studies have identified low-grade chronic inflammation as an important factor influencing the development of atherosclerosis, from plaque initiation to acute plaque rupture, which precedes a heart attack6.

 

      • Oxidative stress

        Polyunsaturated fatty acids (PUFA)-containing phospholipids and cholesterol esters found in the cellular membrane and in lipoproteins found in the blood can be readily oxidized through a free radical-induced lipid peroxidation (LPO), a process that results in a complex mixture of oxidation products7. Multiple studies have shown that these oxidized lipids take part of the inflammatory responses associated with atherosclerosis, through their interaction with immune and endothelial cells8-10. See our article on this topic.

 

      • Certain diseases

        People with certain autoimmune conditions, like Sjögren’s syndrome (pSS), a chronic systemic autoimmune disease, have been shown to have an increased risk of developing coronary heart disease11. Also, some infections have been linked to an increased risk of heart disease12. See our recent article on this topic.

 

      • Metabolic syndrome 

        The term metabolic syndrome includes various health problems, including high blood pressure, high blood sugar, thyroid malfunction (hypothyroidism) excess body fat around the waist and unhealthy cholesterol levels. All these conditions increase your risk of developing heart disease or stroke13-15. Metabolic syndrome, for most cases, involves conditions that can be prevented or treated. See our article on metabolic syndrome.

 

      • Genetic mutations

        Congenital heart disease is a genetic-based condition where the heart has structural abnormalities. This condition is the most common type of birth defect, affecting around 1% of all newborn infants. Studies have shown that people who develop congenital heart disease have mutations in a wide range of genes, with one study suggesting the involvement of early 400 genes16. Beyond congenital heart disease, studies have also identified genes that are associated with an increased risk of developing heart disease. Genetic testing, in some cases, can help clinicians identify people who are at a higher risk of developing heart problems17-18.

 

      • Stress and depression

        Studies have shown that chronic stress, such as that resulting from work stress, dementia caregiving, or social isolation, can cause an increased risk of developing coronary heart disease (CHD)19-20. Other sources of stress have also been implicated with increased risk of heart disease. For example, one study found that people who have frequent outbursts of anger has a higher chance of developing an acute myocardial infarction or other heart problems21. Another study found that the incidence of myocardial infarction was 20 times higher in the 24 h after the death of a loved one22. See our article on stress and health.

 

      • Smoking

        The overall health risks of smoking are well established, and among them is an increased risk of developing different forms of heart disease23. Chemicals found in cigarettes can cause inflammation and other problems in the blood vessels leading to the heart. This can increase the chances of developing problems like atherosclerosis, coronary heart disease, stroke, peripheral arterial disease, and abdominal aortic aneurism24-28.

 

      • Lack of exercise

        Much like following a healthy diet, doing regular exercise is a good way to protect your heart. Leading a sedentary lifestyle has been shown to double your risk of developing coronary heart disease, compared to active people29-30.

 

      • Gut Microbiota

        Multiple studies have found associations between the composition of the gut microbiota and the risk of developing heart disease. Several potential mechanisms have been proposed to explain this link and involve factors like the presence of certain bacterial metabolites or how gut bacteria influence lipid metabolism, among other factors31-36.Future studies will help us gain a better understanding of this link may one day help design tailored treatments that target gut microbiota. See our article on this topic.

 

Heart disease at the Australian Centre for Functional Medicine

 

For most people, coronary heart disease is a problem that takes decades in the making. The accumulation of cholesterol plaques within your arteries is a process that progresses over years of exposure of different risk factors, like following a poor diet, smoking, or leading a sedentary lifestyle.

The first line of defence against heart disease is to test and identify the underlying causes of heart dysfunction.  The Australian Centre for Functional Medicine investigates all possible drivers of heart disease and designs a personalised treatment plan.

For most of us, our life is filled with practices that are not heart friendly. Diet, for example, is one of the most important factors that determine the health of your heart. Finding an optimal diet that meets your body’s requirements is an important first step to protect your heart.

At the Australian Centre for Functional Medicine in Perth, we do not recommend the same diet for all our patients. Instead, we perform comprehensive testing, alongside advanced health questionnaires, which help us understand your health history and identify the drivers of your heart condition.  Based on this information, we can then create a personalised roadmap for treatment, which will include individualised nutritional plans.

The Australian Centre for Functional Medicine applies a modern approach to Functional Medicine, where heart disease is not considered an isolated event, but just the tip of the iceberg. Patients who have suffered a heart condition or are at risk of developing any form of heart disease are likely also experiencing many other problems, some of which might even be asymptomatic. At the Australian Centre for Functional Medicine we seek to uncover all your health problems affecting your body and design a comprehensive treatment plan to cure you. Become a patient today!

 

References

 

  1. Tirziu D, Giordano FJ, Simons M. Cell communications in the heart. Circulation. 2010 Aug 31;122(9):928-37. Read it!
  2. Christoffels V. Muscle for a damaged heart. Nature. 2011 Jun;474(7353):585-6. Read it!
  3. Pinnell J, Turner S, Howell S. Cardiac muscle physiology. Continuing Education in Anaesthesia, Critical Care and Pain. 2007 Jun 1;7(3):85-8. Read it!
  4. Battles V. Heart attack types based on pathophysiologic mechanisms. Heart. 2018 Nov 16. Read it!
  5. Bechthold A, Boeing H, Schwedhelm C, Hoffmann G, Knüppel S, Iqbal K, De Henauw S, Michels N, Devleesschauwer B, Schlesinger S, Schwingshackl L. Food groups and risk of coronary heart disease, stroke and heart failure: a systematic review and dose-response meta-analysis of prospective studies. Critical reviews in food science and nutrition. 2019 Apr 12;59(7):1071-90. Read it!
  6. Mishra PK, Adameova A, Hill JA, Baines CP, Kang PM, Downey JM, Narula J, Takahashi M, Abbate A, Piristine HC, Kar S. Guidelines for evaluating myocardial cell death. American Journal of Physiology-Heart and Circulatory Physiology. 2019 Nov 1;317(5):H891-922. Read it!
  7. Moore KJ. Targeting inflammation in CVD: advances and challenges. Nature Reviews Cardiology. 2019 Feb;16(2):74-5. Read it!
  8. Lee S, Birukov KG, Romanoski CE, Springstead JR, Lusis AJ, Berliner JA. Role of phospholipid oxidation products in atherosclerosis. Circulation research. 2012 Aug 31;111(6):778-99. Read it!
  9. Berliner JA, Leitinger N, Tsimikas S. The role of oxidized phospholipids in atherosclerosis. Journal of lipid research. 2009 Apr 1;50(Supplement):S207-12. Read it!
  10. Subirana I, Fitó M, Diaz O, Vila J, Francés A, Delpon E, Sanchis J, Elosua R, Muñoz-Aguayo D, Dégano IR, Marrugat J. Prediction of coronary disease incidence by biomarkers of inflammation, oxidation, and metabolism. Scientific reports. 2018 Feb 16;8(1):1-7. Read it!
  11. Wu XF, Huang JY, Chiou JY, Chen HH, Wei JC, Dong LL. Increased risk of coronary heart disease among patients with primary Sjögren’s syndrome: a nationwide population-based cohort study. Scientific reports. 2018 Feb 2;8(1):1-0. Read it!
  12. Pothineni NV, Subramany S, Kuriakose K, Shirazi LF, Romeo F, Shah PK, Mehta JL. Infections, atherosclerosis, and coronary heart disease. European heart journal. 2017 Nov 14;38(43):3195-201. Read it!
  13. Gorter PM, Olijhoek JK, van der Graaf Y, Algra A, Rabelink TJ, Visseren FL, SMART Study Group. Prevalence of the metabolic syndrome in patients with coronary heart disease, cerebrovascular disease, peripheral arterial disease or abdominal aortic aneurysm. Atherosclerosis. 2004 Apr 1;173(2):361-7. Read it!
  14. Carlberg C, Ulven SM, Molnár F. Heart Disease and the Metabolic Syndrome. InNutrigenomics: How Science Works 2020 (pp. 153-172). Springer, Cham. Read it!
  15. Yang GR, Dye TD, Li D. Association between diabetes, metabolic syndrome and heart attack in US adults: a cross-sectional analysis using the Behavioral Risk Factor Surveillance System 2015. BMJ open. 2019 Sep 1;9(9):e022990. Read it!
  16. Zaidi S, Brueckner M. Genetics and genomics of congenital heart disease. Circulation research. 2017 Mar 17;120(6):923-40. Read it!
  17. Hynninen Y, Linna M, Vilkkumaa E. Value of genetic testing in the prevention of coronary heart disease events. PloS one. 2019 Jan 15;14(1):e0210010. Read it!
  18. Asatryan B, Schaller A, Seiler J, Servatius H, Noti F, Baldinger SH, Tanner H, Roten L, Dillier R, Lam A, Haeberlin A. Usefulness of genetic testing in sudden cardiac arrest survivors with or without previous clinical evidence of heart disease. The American journal of cardiology. 2019 Jun 15;123(12):2031-8. Read it!
  19. Wirtz PH, von Känel R. Psychological stress, inflammation, and coronary heart disease. Current cardiology reports. 2017 Nov 1;19(11):111. Read it!
  20. Moran KE, Ommerborn MJ, Blackshear CT, Sims M, Clark CR. Financial stress and risk of coronary heart disease in the Jackson heart study. American Journal of Preventive Medicine. 2019 Feb 1;56(2):224-31. Read it!
  21. Mostofsky E, Penner EA, Mittleman MA. Outbursts of anger as a trigger of acute cardiovascular events: a systematic review and meta-analysis. European heart journal. 2014 Jun 1;35(21):1404-10. Read it!
  22. Mostofsky E, Maclure M, Sherwood JB, Tofler GH, Muller JE, Mittleman MA. Risk of acute myocardial infarction after the death of a significant person in one’s life: the Determinants of Myocardial Infarction Onset Study. Circulation. 2012 Jan 24;125(3):491-6. Read it!
  23. Kamimura D, Cain LR, Mentz RJ, White WB, Blaha MJ, DeFilippis AP, Fox ER, Rodriguez CJ, Keith RJ, Benjamin EJ, Butler J. Cigarette smoking and incident heart failure: insights from the Jackson Heart Study. Circulation. 2018 Jun 12;137(24):2572-82. Read it!
  24. Centers for Disease Control and Prevention Office on Smoking and Health. Smoking and Cardiovascular Disease Fact Sheet. Surgeon General’s Report on Smoking and Health 50th Anniversary. Accessed August 14, 2020. Read it!
  25. Zieske AW, McMahan CA, McGill Jr HC, Homma S, Takei H, Malcom GT, Tracy RE, Strong JP, Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Smoking is associated with advanced coronary atherosclerosis in youth. Atherosclerosis. 2005 May 1;180(1):87-92. Read it!
  26. Pan B, Jin X, Jun L, Qiu S, Zheng Q, Pan M. The relationship between smoking and stroke: A meta-analysis. Medicine. 2019 Mar;98(12). Read it!
  27. Price J, Mowbray PI, Lee AJ, Rumley A, Lowe GD, Fowkes FG. Relationship between smoking and cardiovascular risk factors in the development of peripheral arterial disease and coronary artery disease; Edinburgh Artery Study: Edinburgh Artery Study. European heart journal. 1999 Mar 1;20(5):344-53. Read it!
  28. Aune D, Schlesinger S, Norat T, Riboli E. Tobacco smoking and the risk of abdominal aortic aneurysm: a systematic review and meta-analysis of prospective studies. Scientific reports. 2018 Oct 3;8(1):1-9. Read it!
  29. Berlin JA, Colditz GA. A meta-analysis of physical activity in the prevention of coronary heart disease. American journal of epidemiology. 1990 Oct 1;132(4):612-28. Read it!
  30. Francis K. Physical activity in the prevention of cardiovascular disease. Physical Therapy. 1996 May 1;76(5):456-68. Read it!
  31. Tang WW, Hazen SL. The contributory role of gut microbiota in cardiovascular disease. The Journal of clinical investigation. 2014 Oct 1;124(10):4204-11. Read it!
  32. Marques FZ, Mackay CR, Kaye DM. Beyond gut feelings: how the gut microbiota regulates blood pressure. Nature Reviews Cardiology. 2018 Jan;15(1):20. Read it!
  33. Tang WW, Kitai T, Hazen SL. Gut microbiota in cardiovascular health and disease. Circulation research. 2017 Mar 31;120(7):1183-96. Read it!
  34. Kitai T, Tang WH. Gut microbiota in cardiovascular disease and heart failure. Clinical Science. 2018 Jan 16;132(1):85-91. Read it!
  35. Yang Q, Lin SL, Kwok MK, Leung GM, Schooling CM. The roles of 27 genera of human gut microbiota in ischemic heart disease, type 2 diabetes mellitus, and their risk factors: a Mendelian randomization study. American Journal of Epidemiology. 2018 Sep 1;187(9):1916-22. Read it!
  36. Marques FZ, Mackay CR, Kaye DM. Beyond gut feelings: how the gut microbiota regulates blood pressure. Nature Reviews Cardiology. 2018 Jan;15(1):20. Read it!