Coronary Heart Disease

The heart is a large muscle that contracts, on average, 72 times a minute in the adult bathing the organs and tissues with adequate blood supply. So, in a day’s time your heart beats over 103,000 times. In a month you have this muscle is contracting over 3 million times. There is an extremely high fuel (blood) cost to maintain the muscle’s nutritional status enabling the heart to provide circulation sufficient to keep all body organs and tissues perfused. Oxygen and nutrients need to be delivered to the tissues and byproducts of metabolism and carbon dioxide needs to be removed.

Over time the other components of the blood (sugar, cholesterol, and various chemicals in the blood stream) can cause damage to the lining of the arteries that serve the heart with blood. With the lining damaged (endothelium) cholesterol is easily deposited in the arterial wall. These coronary arteries can become obstructed and when flow is diminished beyond a certain point, the muscle does not get the oxygen and glucose it needs and parts of it start to die (heart attack).

Coronary Artery Disease (CAD) results in significant injury and loss of life in our country making it the largest single cause of death. The encouraging news is, that over time, science has been able to identify those “aggravating” factors or risk factors for obstruction of the coronary arteries that hastens this obstructive process prematurely.

High blood lipids (fats), elevated blood sugar, increased weight, increased blood pressure, and lack of exercise are a few of the risk factors that can be measured, then compared to “optimal” levels and adjusted by life style changes and or medications to slow the obstructive process and lengthen life.

Blood lipids generally are measured as LDL (bad cholesterol), HDL (good cholesterol) and Triglycerides (gasoline in the blood stream). Excess of LDL is deposited in the lining of the coronary artery until it causes a lesion that ruptures and starts a large blood clot that obstructs flow to a certain region of the heart served by that artery. Lowering the LDL goes a long way in having excess LDL removed from the body in alternative methods. Diet, exercise and medications can lower LDL levels.

HDL is the good cholesterol that is increased with exercise and serves as a garbage (LDL) collector to remove the bad cholesterol. Low HDL levels are a risk factor in that LDL removal is diminished. Exercise and medications can alter HDL levels favorably.

Triglycerides are energy rich molecules that aggravate the lining of the artery as well as change the size of the LDL (making it smaller and getting into the lining of the vessels easier) and decreasing the size of the good cholesterol (HDL) whereby decreasing its ability to remove bad cholesterol. As the blood sugar increases, so do the triglycerides.

An increased amount of residual glucose (blood sugar) in the blood stream is like running salt water through an iron pipe and expecting it not to rust prematurely. Moving the digested and self-manufactured sugar (Liver) from the blood stream to the tissues provides energy for the tissues to continue metabolism and reduces its presence in the blood vessels. This reduces the risk of damage to the lining of the blood vessel, helping keep the protection to the blood vessels inner workings safe.

Increased weight (central adiposity) plays a large roll in prohibiting blood sugar form leaving the blood stream by blocking insulin before it can get to the blood and move sugar from the blood stream to the body tissues for use as energy. So, if your body feels it needs 10 units of insulin to adequately transport the sugar out of your blood stream and it only gets 5 units (as 5 are blocked by central adiposity), then the result is increased residual sugar in the blood stream. Increased weight also places an extra burden on the work of the heart to perfuse the extra tissues.

Increased blood pressure (hypertension) impacts the blood vessel, which is of sorts a set of tissues that can expand and contract to regulate the pressure in the vascular system. Constant increased pressure decreases the ability to change size as well as “packs” unwanted lipids in the vessel walls.

So, to decrease the natural obstructive mechanisms in the arteries that provide circulation to the heart muscle we must first protect the lining of the vessel (endothelium) and decrease those particles most likely to cause lesions in the arterial wall. Increasing HDL,decreasing LDL, decreasing Triglycerides and blood sugar as well as blood pressure will go a long way in slowing the obstructive process of the vessels accountable for delivering significant oxygen and nutrients to a muscle that must pump blood throughout the entire body.

Compromising one of the major vessels that feeds the heart will lead to damage or death of that segment of the heart whereby compromising blood flow to the body. (Congestive Heart Failure)

W. Lane Edwards, Jr. 1-28-22

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