HEART DISEASE AND VULNERABLE PLAQUE -- Heart disease remains the major cause of death in the United States and other industrialized countries. Often, the first event leading to death from heart disease is the breaking off of a section of plaque from artery walls.

Then, either directly or through subsequent clot formation, this plaque leads to a blockage in the supply of blood to the heart muscle. This sequence may be the cause of death of about half the people in the U.S. The initiating material is becoming known in the research community as "vulnerable plaque."

Sudden cardiac deaths are more frequent in the morning hours. Among the many physical and mental triggers intensified in the morning hours are heart rate, blood pressure, blood viscosity, clotting ability, changing levels of hormones, levels of catecholamines and so on. Study of circadian rhythm-associating this sequence with time of day-is providing clues to mechanism and possible protection.

Many current hypotheses seek to explain why and how vulnerable plaque may break off. Possible causes include oxidative stress factors, free radical formation, destruction of nitric oxide and others. Some investigators think plaque rich with oxidized LDL (low density lipoprotein) materials may be more likely to break off than hardened or calcified plaque.

Others are concerned about reduction in mechanical strength of plaque substrates where collagen levels are reduced or where underlying collagen is exposed in areas of plaque erosion. So far, however, and apart from an awareness of a role played by "cholesterol" in its different forms, health and nutritional strategies to deal with vulnerable plaque are still very much in their infancy.

ANTIOXIDANTS BATTLE HIGH FAT MEALS - Researchers have measured how much damage just one high fat meal can cause. They've shown how, for at least six hours afterwards, arteries are unable to expand to properly handle the blood flow needed during physical or emotional stress. Scientists believe this may be one reason why people who already have "clogged" arteries so often suffer heart attacks soon after eating a high-fat meal.

Scientists have suspected that a sudden high dose of fat triggers oxidation. This results in the release of certain chemicals in the body that damage the inner layer of cells that line the heart and blood vessels. They hypothesized that introducing antioxidants may counteract the process.

Antioxidants Before the Feast
To test their theory, scientists at the University of Maryland first measured the arteries in volunteers' arms, then invited them to eat a high-fat meal, including hash browns, eggs, cheese and sausage, which contained 50 grams of fat. But before they ate, they also took two popular antioxidants; 800 units of vitamin E and 1,000 mg of vitamin C. After the meal, technicians again measured the volunteers' arteries. This time, they found no damage to the arteries. The vitamins supported cardiovascular integrity.

Hints of Lasting Benefits
"The exciting thing to us is we could see an immediate, beneficial, profound physiological effect," said Dr. Gary Plotnick, coauthor of the study. The researchers measured artery response for up to six hours after the meal and found the vitamins provided a lasting benefit.

"We were surprised by the magnitude of the results," said dr. Robert Vogel. "There's been a great debate about the use of antioxidant vitamins and we were surprised to see how powerful just one dose of antioxidant vitamins were on this important process."

STROKE AWARENESS -- If you think you or someone near you is having a stroke, which is characterized by weakness or numbness on one side of the body, a sudden slurring or loss of speech, and dimness or loss of vision in one eye, call an ambulance immediately.

Strokes result from blocked blood flow to part of the brain, and often the symptoms are either ignored or seeking medical help is delayed. A new clot-busting drug called TPA can restore the flow and an experimental drug, citicoline, appears to revive dying brain cells, but only if administered promptly. Please don't ignore the above symptoms, call a medical professional immediately.

ASPIRIN NEWS -- It has been known for over 10 years that aspirin can reduce heart attack risk in men by 44 percent. In recent studies, it has been found that even small doses (1-6 tablets per week) reduced a woman's risk of heart attack by 30 percent. Other studies have shown a decreased risk of colon cancer as well as cancer of the esophagus. Despite aspirin's proven benefits, its effects on the stomach lining can be dangerous. Consult a doctor before deciding to take aspirin regularly.

HAVE THE FISH -- One study found people who ate 5.5 gm of omega-3 fatty acids (fishoil) each month reduced their risk of cardiac arrest by 50%.

BLOOD DONOR -- Men who donate blood three times a year reduce their risk of heart attack by more than 50% and their risk of cancer by 40%. Giving blood removes excess iron from a man's body, resulting in these benefits.

OLDER AMERICANS NEED MORE B-VITAMINS -- Up to 30% of people over age 50 have lost the ability to absorb adequate vitamin B12 from meat or dairy products, the report found. People need only 2.4 micrograms a day-the amount in a mere three ounces of beef-but the institute recommended that older Americans eat fortified cereal or grains or take a daily vitamin supplement to absorb enough.
People are flocking to folic acid and vitamin B6 supplements because of reports that they might protect against heart disease or cancer. That research "is promising," the experts said, but not conclusive-so they did not recommend large increases.

Georgia State University Nutrition Dept.
CNN Health Story Page - April 7, 1998

FORTIFIED GRAINS STILL LOW IN FOLIC ACID -- A new government requirement for adding folic acid to food is set too low to reduce the risk of heart disease, researchers report. The Food and Drug Administration this year began requiring fortification of enriched flour and pasta to boost each person's intake by about 100 micrograms a day. The FDA hopes to prevent the birth defect known as spina bifida. Folic acid is needed in the first weeks of pregnancy for spinal development.

Because folic acid also lowers plasma levels of homocysteine-a by product of food metabolism that injures blood vessels. Doctors hoped the policy also would lower the risk of heart disease. The new study suggests that it won't. Manuel Malinow of the Oregon Health Sciences University, Portland, and his colleagues studied folic acid and homocysteine levels for 15 weeks in 75 men and women with heart disease.
People who ate cereal with 127 micrograms daily-an amount that approximates the level achieved by the FDA's new policy-raised their folic acid level by 31% but lowered their homocysteine levels only 3.7%, which is not enough to prevent vessel damage.

Cereals with 499 and 665 micrograms reduced homocysteine by 11 % and 14%, the researchers report in the New England Journal of Medicine.
In an accompanying editorial, Godfrey Oakley of the Centers for Disease Control and Prevention says the government's minimum standard may also be too low to prevent birth defects. "This new data should provide a rationale for increasing the levels of fortification," he writes.

USA Today Health -April 8, 1998

FOR YOUR HEART: PURPLE GRAPE JUICE -- John Folts, director of the Coronary Thrombosis Research Laboratory at the University of Wisconsin Medical School, says studies of flavonoids-substances that cause dark colors in some beers, red wines and purple grape juice-suggest those beverages may keep heart-damaging blood clots from forming. While aspirin alone is known to be "very good at turning platelets down," making them less sticky so they do not form clots, its effects are negated when adrenaline kicks in while exercising or under stress.

"With flavonoids," Folts explains: "the adrenaline has no effect, so the flavonoids keep on working."
Folts noted that flavonoids are found "in dark beer but not light beer; in tea but not in coffee; in purple grape juice but not in lighter grape juices that people give to babies; in red wines but not in white wines."

The study, presented to doctors attending an American College of Cardiology meeting in Atlanta, was funded by the Oscar Rennenbohm Foundation, the Nutricia Research Foundation and Welch Foods Inc., one of the leading producers of grape juice.

The health-supporting OPC in red wine are proven natural "flavonoids" that sustain the circulatory system.

FOLIC ACID LOWERS RISK OF HEART ATTACK - Previous studies have shown that men who have high homocysteine levels in their blood have a significantly higher risk of heart attack than men who have healthful levels do.

A new study confirms that this is also true for women.

Homocysteine elevations can be genetic, or a result of getting too little folic acid in the diet.

Editor's Note: The average one-a-day vitamin/mineral pill supplies 0.4 mg of folic acid - an amount that's been shown to reduce high homocysteine levels.

Good food sources of folic acid include green leafy vegetables, beans, lentils, soybeans, and wheat germ, but the vitamin is vulnerable to heat (i.e., cooking).

People who drink alcohol or take oral contraceptives should be especially careful to get enough folic acid: these substances interfere with the absorption of this vitamin.

Also note: Having enough folic acid in your blood in the first few weeks of pregnancy can help prevent birth defects (e.g., spina bifida).

Sources: Circulation, Vol. 96, No. 2 ; The Vitamin Book by Harold Silverman, Pharm D.

HIGH BLOOD PRESSURE - High blood pressure is a risk factor for congestive heart failure, myocardial infarction (heart attack), diabetes, valvular heart disease, and cardiomyopathies (diseases of the heart muscle).

Editor's Note: Work with your primary care provider to keep your blood pressure under 140/90. For the new DASH high blood pressure diet, visit http://dash.bwh.harvard.edu

Source: Journal of the American Medical Association, Vol. 275, No. 20

Reminder…
Risk Factors for High Blood Pressure*

    *Overweight (often, losing just 10 pounds can help)
    *Alcohol consumption
    *High-sodium (salt) diet (10% to 15% of Americans are sensitive to salt)
    *Family history of hypertension
    *Smoking
    *Too little calcium (e.g., nonfat dairy) and potassium (e.g., fruits and vegetables) in the diet
    *Medications (some prescription and nonprescription drugs either raise blood pressure, or interfere with the effectiveness of blood pressure-lowering drugs)

*A "normal" blood pressure is 120/80 or lower. If your upper (systolic) pressure is consistently 140 or higher, and/or your lower (diastolic) pressure is 90 or higher, you have high blood pressure ("hypertension").

Source: The Hope Heart Institute, Seattle

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*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure or prevent any disease.