Topic:	Reversal of Coronary Artery Disease
Date:	February 2000
By:	Dr. David Martin, FACN, CNS Genesis Center www.genesiscenter.com

It has been well documented that Americans can reduce their risk of coronary artery disease, heart attacks, strokes and cancer with vitamin supplementation.

Now several studies show that coronary artery disease (CAD) and the associated plaque can be reversed with the proper use of vitamin supplementation.

The following is a personal plan that will help you to identify and quantify your risk of CAD and develop a proactive action plan:

Risk - Men over 45 and women over 50 should evaluate their risk. Although coronary plaque begins in childhood it generally progresses slowly. As with most diseases it progresses 65% before symptoms appear. With coronary artery disease, many times the first symptom is death.

Genetics (family history), hypertension, dyslipidemia, hyperhomocysteinemia, nutritional deficiencies and some life style choices contribute to the acceleration of CAD.

Risk Assessment - the following are listed in a logical cost-effective approach:

1. Learn to take your own blood pressure at home. If your pressure is greater than 140/85 check it in the morning, afternoon and nighttime then once every 2 weeks. Record your pressures and take your record with you to your next doctor's visit. If you are on antihypertensive medication ask about the benefits of a high potassium diet and supplementation of calcium, magnesium and zinc.

2. If available, have a brachial artery elasticity test, this test is non-invasive and should cost approximately 20 to 50 dollars. This is only a preliminary test to show the possibility of arteriosclerosis (hardening of the arteries).

3. The single most important test you can have is an Ultrafast CT Coronary Artery Scan, also called EBCT (electron beam computerized tomography). This is a non-invasive CT scan, that looks at your coronary arteries and measures the plaque, in 7.5 minutes and it is extremely accurate (1-2% variation). This is the single best test and can serve as your base line for risk. It is also an effective way to measure progression or regression. The scan provides an accurate picture of the problem and in which arteries are involved. The cost is around 600 dollars and unfortunately there are less than 60 of these machines in the US. Some insurance companies will pay for the test. There would be more machines but at 2.4 million dollars each, not everyone can have one in their office.

Note: the 600 dollars provides more information than a $2,500 thallium stress test which is about 40% reliable or a 12,000 dollar cardiac catheterization to measure flow.

If your Ultrafast scan shows no plaque do anything, change nothing, no more testing is necessary, except to repeat the Ultrafast Scan every 2-5 years.

If your Ultrafast Scan shows a significant amount of plaque (CAC; coronary artery calcium) it is time to become proactive. If your CAC score is extremely high, call a cardiologist now. This is a very predictive test and a high score would indicate that you should consider regression therapy as soon as possible. Excessively high scores indicate that you are in a high-risk category for having an ischemic heart attack or stroke. What we can't predict is when!

4. If you are at risk as determined by an Ultrafast CT Coronary artery scan, the following blood tests should be completed:

a. Spectracell Laboratory: Serum homocysteine, Spectrox oxidative potential. These tests assess your risk of hyperhomocysteinemia and/or oxidation of LDL. Optional tests would include their cardiovascular panel that evaluates intracellular vitamin status by a method called lymphocyte proliferation.

b. A Lipid Profile. Optionally you could add in the subsets of LDL and HDL.

c. Metabolic Profile: SMA-27 with a Total T4, CBC with a differential.

5. If the tests in number 4 don't explain your Coronary Artery Disease. It would be helpful to be tested for hypercoagulation problems, C-reactive Protein or antibodies to chlamydial, cytomegalovirus, P. gingivitis and other infections by a specially trained Cardiologist.

REGRESSION THERAPY

The good news is that in most cases it is possible for a rapid regression of CAD. Outcome studies using Ultrafast Scans have demonstrated the following regression rates:

The vitamin therapy regime is based on laboratory studies and dosage adjusted by changes in laboratory data and repeat Ultrafast CT scans.

The following are general guidelines:

1. Take an effective amount of balanced vitamin/mineral supplementation. We recommend the following:

High Potency Vitamins & Antioxidants - it is essential to avoid other supplements containing additional vitamin C and beta-carotene as these have a pro-oxidant effect and can worsen CAD. The therapeutic goal is to keep your Spectrox antioxidant potential greater than the 75th percentile. High doses of antioxidants also negate the potential benefit of antioxidants in reducing your risk of cancer.

High Potency Minerals - calcium and magnesium are essential for regulation of blood pressure and normal cardiac muscle function. The phosphorus and boron are in physiological proportions to maintain bone health.

High Potency Trace Elements - of which selenium, zinc, chromium and others are essential for several metabolic pathways in the cardiovascular system.

Omega-3 oil - 300 mg a day helps inhibit thromboxane A2 and decrease the risk of platelets "sticking" together.

2. If your 12-hour fasting serum homocysteine is greater than 8.5 Umol/L it would be beneficial to take Cardiovascular HCY to maintain the level less than 8.5. Levels above 9.5 result in damage to the intima (lining) of the coronary and cerebral arteries and exponentially increase your risk for progression of CAD and Stroke. Cardiovascular HCY also contains 81 mg aspirin to inhibit the inflammatory response of C-reactive protein.

Treatment of hyperhomocysteinemia is a dose related response and if your levels are greater than 11 Umol/L please refer to the dosing schedule located in the website. Difficult cases may require a methionine stress test to determine required dosages.

3. Other supplements e.g. Fiber should contain 65% soluble fiber and 35% insoluble. Coenzyme Q-10, Carnitine etc. need to be evaluated on a case by case basis. Drug therapy with Statin drugs and beta-blockers tend to deplete cardiac CoQ10. Our website provides dosing guidelines for CoQ10.

Finally, and very difficult for most people is the modification of life style choices -- food and exercise. CAD is not a problem caused by what you do eat, but what you don't eat. It is helpful if you can modify your food intake to do all the healthy things we know about, including the 5 to 7 servings of fruits and vegetables a day and include 3 to 4 glasses of low fat milk. Skip today and its 10 to 14 servings tomorrow! Optional - add in the French Paradox.

Exercise is essential to increasing active metabolic mass … bottom-line … is when you go to the Hollywood Fitness Center, resist the use of the valet service.

Best of Health,

Dr. David Martin