More Severe Heart Disease Found in Patients With Low Vitamin D

Have you had your vitamin D levels tested? I certainly hope you have because lower levels of vitamin D predict extent of coronary artery disease. Your goal should be a 25 OHD level of 30ng/mL or higher.

Vitamin D deficiency is an independent risk factor for heart disease with lower levels of vitamin D being associated with a higher presence and severity of coronary artery disease, according to research to be presented at the American College of Cardiology's 63rd Annual Scientific Session.

A growing body of research shows that vitamin D may be beneficial in preventing heart disease. Several recent studies also support the idea that low levels of vitamin D are linked to an increased risk of heart disease. Since most of us wear sunscreen and many of us are spending most of our time indoors, supplements may be your only means of maintaining adequate vitamin D levels.

In the largest study of its kind to evaluate the relationship between vitamin D levels and coronary artery disease, vitamin D deficiency (<20ng/mL) was observed in 70.4 percent of patients undergoing coronary angiography – an imaging test used to see how blood flows through the arteries in the heart. Vitamin D deficiency was associated with higher prevalence of coronary artery disease, with a 32 percent higher occurrence in patients with the lowest vitamin D levels and a near 20 percent higher frequency of severe disease affecting multiple vessels. A progressive increase in heart disease was found according to the severity of vitamin D deficiency. Patients with values lower than 10 mg/dl had a near two-fold increased rate of coronary atherosclerosis as compared with those showing normal levels.

Researchers evaluated vitamin D levels in 1,484 patients. Vitamin D deficiency was defined as levels lower than 20ng/mL, and severe vitamin D deficiency was defined as levels under 10ng/mL. Patients were considered to have coronary artery disease if they had a diameter reduction of greater than 50 percent in at least one coronary artery. The extent and severity of heart disease were measured by quantitative coronary angiography – a procedure that determines the degree of blockage in arteries.

"Present results suggest vitamin D deficiency to be the cause rather than the consequence of atherosclerosis," said Monica Verdoia, M.D., specializing cardiologist at the Department of Cardiology, Ospedale Maggiore della Carità, Eastern Piedmont University in Novara, Italy, and investigator on the study on behalf of the Novara Atherosclerosis study group by Prof. Giuseppe De Luca.

Researchers estimate that more than half of U.S. adults are vitamin D deficient, with the highest rates among African Americans and Hispanics. Vitamin D is being studied for its possible connection to several diseases and health problems, including diabetes, high blood pressure, multiple sclerosis, autoimmune conditions, bone disorders and some types of cancer.

Vitamin D supplements are inexpensive. Look for vitamin D3 as it is most effective at raising circulating vitamin D levels.

The research was presented at The American College of Cardiology’s annual scientific sessions.

Women: Walk away your risk of stroke.

Women who walk at least three hours every week are less likely to suffer a stroke than women who walk less or not at all, according to new research from Spain.

Women who walked briskly for 210 minutes or more per week had a lower stroke risk than inactive women but also lower than those who cycled and did other higher-intensity workouts for a shorter amount of time.

The results for women who were regular walkers translated to a 43 percent reduction in stroke risk compared to the inactive group.

Each year in the U.S., about 795,000 people suffer a stroke, according to the American Heart Association. Put another way, one American has a stroke every 40 seconds and dies from one every four minutes.

Despite a recent dip in strokes attributed to better blood pressure control and anti-smoking campaigns, the World Health Organization (WHO) predicts that stroke cases will increase as the global population continues to grow older.

Guidelines set by the WHO and U.S. Centers for Disease Control and Prevention recommend at least 150 minutes - or two-and-a-half hours - of moderate exercise such as brisk walking each week.

Source: Physical Activity and Risk of Cerebrovascular Disease in the European Prospective Investigation Into Cancer and Nutrition-Spain Study

http://stroke.ahajournals.org/content/44/1/111

Taking statins? Also take Coenzyme Q10 and Vitamin D

An experimental study involving statin-treated mice found that coenzyme Q10 could reverse atorvastatin-related mitochondrial dysfunction. atorvastatin-treated mice developed muscular mitochondrial dysfunction due to ubiquinone deficiency and a decrease in exercise endurance. The findings of this study in mice suggest that coenzyme Q10 supplementation may benefit those taking statin drugs by reversing some of the adverse effects induced by these medications. But coenzyme Q10 is not the only supplement that may be beneficial for those taking statins to control cholesterol. Vitamin D in a separate study was found to reverse the muscle pain and weakness associated with statin use, even when patients continued taking the statins.

Coenzyme Q10 reverses mitochondrial dysfunction in atorvastatin-treated mice and increases exercise endurance," Muraki A, Miyashita K, et al, J Appl Physiol, 2012

Ahmed W, Khan N, Glueck CJ, Pandey S, Wang P, Goldenberg N, et al. Low serum 25(OH) vitamin D levels (<32 ng/mL) are associated with reversible myositis-myalgia in statin-treated patients. Transl Res 2009;153:11-16

Is there a minimum dose for EPA and DHA for heart health?

June 1, 2011: We know that taking fish oils protects the heart. But is there a minimum dose for general heart protection? It appears that there is…A new meta-analysis on the doses of EPA and DHA required for optimal cardioprotection was published in the British Journal of Nutrition (BJN), demonstrating that 250mg of intake per day is an absolute minimum requirement to reduce the risk of some coronary heart diseases.  The meta-analysis revealed that by increasing intakes of EPA and DHA over 250mg, the risk of sudden cardiac death in a healthy population was reduced a further 35% and the risk of non-fatal coronary events a further 16%. Please note that this is the minimum and for those who have known heart issues the American Heart Association suggests four times that amount.

See the abstract here

Protecting against a second heart attack...

Have you or has a loved one had a heart attack? Would you like to know some tried and true steps for slashing the chance of a second one? Here are some steps…and there is a book on the subject. See the link at the bottom of this post.

For starters, if you are under the care of a doctor, fill your prescriptions and take your medications! Studies show that patients who fail to fill any of their prescriptions have an 80 % greater chance of dying in the year following their heart attack, compared to people who faithfully take their meds. Patients who pick and choose,  filling only some of their prescriptions have a 40 % increase in risk of death in the year following their heart attack. This is huge and easy to remedy. Take your meds…

Know about and avoid the plaque-building, heart stopping foods. Stop eating, or cut way back on foods from the western pattern diet—red meat, cream and cheese, and trans fats from margarines, spreads, chips and snack foods. Fried foods are particularly dangerous. Refined sugars are culprits too. These are the “heart attack on a plate” foods that explain the comparatively high rates of heart disease in western cultures. These foods hasten plaque buildup, increase inflammation, make you gain weight which burdens the heart and thus raise your risk of another heart attack. 



Instead, build a diet of foods that heal the arteries, reduce inflammation and strengthen your heart. The most well studied and scientifically endorsed diet for cardiovascular disease prevention and treatment is the Mediterranean Diet. In this diet, extra virgin olive oil is the primary source of fat. Fresh dark green leafy vegetables such as spinach, kale and collard greens, and vegetables of all types figure prominently. You’ll enjoy fresh fruits such as figs, apples and pears. Instead of refined “white flour” breads and cereals, you’ll have heart healthy and slimming whole grains such as oatmeal. You’ll eat the cholesterol lowering legumes such as lentils. In addition, your primary protein will be Omega 3 rich fish such as salmon, mackerel and sardines. Snacks might be walnuts or macadamia nuts, and you will enjoy a relaxing glass of antioxidant rich red wine with meals. And as the name of this blog hints… a daily treat of rich and decadent deep, dark chocolate has been proven to help treat and reverse heart disease.

Walk. Every step counts. A daily exercise regimen  is integral to reversing heart disease. Walking is one of the simplest, safest and least expensive heart-health-promoting strategies. Walking longer distances frequently has been proven to be the best exercise prescription for heart patients. Exercise improves your tendency to gain weight, raises protective HDL cholesterol, normalizes blood pressure levels, helps to open and clear clogged blood vessels, and boosts mood.

Take these heart smart supplements. Not all supplements are created equally when it comes to treating and reversing plaque build-up. A few stand out among the crowd and should be in every heart attack survivor’s medicine chest:

Niacin, the B vitamin available over the counter or as a prescription drug, has been proven to possess the greatest capacity to increase your blood level of “good” cholesterol, HDL—compared to other drugs.

With over thirty years of research supporting its safety and effectiveness, you and your doctor should discuss adding this vitamin as a second agent on top of your statin to boost your fight against plaque. Please note that a normal effect of Niacin is the “ Niacin Flush” which demonstrates the vitamin’s efficacy as a vasodilator. The flush makes your face, neck, chest and arms turn bright red and itch..it isn’t harmful, but you should know that it might happen. Drinking a glass of cold water or taking an aspirin with your niacin can reduce the severity of the flush, and it usually passes in about 30 minutes. There is a no-flush version of niacin called Enduracin which you can find via the internet.

           

Omega 3’s from the Sea. Did you know that taking the right Omega 3s actually slashes your risk of a first or second heart attack?
Lovaza is the Omega 3 prescription fish oil supplement, recommended by many doctors today, and guaranteed by the Food and Drug Administration to be free of contaminants and impurities. One Lovaza capsule provides approximately 900 milligrams of mixed EPA and DHA omega-3 fatty acids.

But! You don’t have to involve your insurance in order to afford Lovaza, however. There are high quality, Omega 3 supplements sold in natural food stores and online, that supply the American Heart Association’s suggested amount of 1000 mg of EPA and DHA combined in two capsules or in a teaspoon full of liquid, and they cost far less than the prescription form does. Not to mention reducing the burden of the cost of health care, for all of us…just be sure the product label states that it has been tested by an FDA registered lab and found to be fresh, fully potent and free of detrimental levels of major contaminants such as mercury lead and PCB’s.

The American Heart Association says all heart patients should be taking 1000 to 4000 mg of EPA and DHA daily—under their doctor’s supervision. Note: the higher dose is for patients who need to reduce their triglyceride levels.

           

Vitamin D.  Inadequate dietary intake of this essential nutrient results in vitamin D deficiency, and studies are accumulating suggesting that a low vitamin D status negatively affects cardiovascular health. In fact major studies show that being deficient can double your risk of heart attack! I suggest that at your next check-up ask your doctor to test your vitamin D level and to consider taking a daily supplement of vitamin D, to boost your level, if it is indeed low. Scroll down for a separate post on new reasons to take higher doses of vitamin D.

CoEnzyme Q-10. Some of the medications that heart patients take deplete this important heart strengthening nutrient. Some researchers suggest that the depletion of COQ10 could account for some side effects associated with statin drugs such as muscle pain and elevated liver enzymes which suggest liver damage. I suggest 100 mg daily.

Some of the points above were adapted from an article promoting the book you see here...

it's on Amazon.com
http://www.amazon.com/Prevent-Second-Heart-Attack-Reverse/dp/030746525X/ref=sr_1_1?ie=UTF8&qid=1299525150&sr=8-1

The Sunshine Vitamin and Heart Risk..The Framingham and Physicians Health Studies

       A Heart Attack is no walk on the beach...then again more frequent walks on the beach...may lead to less risk of heart attacks! 


       The connection...sunlight..which leads to having better levels of vitamin D. OK feeling utterly peaceful doesn't hurt either...

       Worried about sunlight and skin cancer? Then put on the sunscreen and take a vitamin D supplement. And get your vitamin D level tested at your next check-up. You want a level not less than 30 ng/ml and up to 100ng/ml is still safe. In Canada or New Zealand the normal level starts at 80 nmol/L. Adults will likely need 4000 ius vitamin D3 daily to maintain levels of 30ng/ml. 

Framingham Study Links Low Vitamin D to Heart Risk

Vitamin D deficiency—more traditionally associated with bone and muscle weakness—may also increase the risk of cardiovascular disease (CVD).

Low 25-hydroxyvitamin D levels have been linked to CVD risk factors: hypertension, obesity and diabetes, as well as major cardiovascular events such as stroke and congestive heart failure.

The prestigious Framingham Heart Study found that people with Vitamin D levels below 15ng/ml were twice as likely as those with higher levels ( 30 ng/ml or better) to have Heart Attack, Stroke or Cardiovascular event...and it was likely that the event would occur in the next five years 

  American College of Cardiology (2008, December 2)

The Physicians Health Study Links Low Vitamin D Levels to Doubling The Risk Of Heart Attack

Men with a vitamin D deficiency (< 15 ng/ml) had twice the risk for heart attack compared with those having 30 ng/ml or higher.

         Low levels of vitamin D appear to be associated with higher risk of myocardial infarction (heart attack) in men, according to a new report. Studies have shown that the rates of cardiovascular disease-related deaths are increased at higher latitudes and during the winter months and are lower at high altitudes, according to background information in the article. "This pattern is consistent with an adverse effect of hypovitaminosis D [vitamin D deficiency], which is more prevalent at higher latitudes, during the winter and at lower altitudes. Vitamin D has been shown to affect the body in ways that may influence the risk of heart attack or heart disease.

         Edward Giovannucci, M.D., Sc.D., of Harvard School of Public Health and Brigham and Women's Hospital, Boston, and colleagues reviewed medical records and blood samples of 454 men (age 40 to 75) who had non-fatal heart attack or fatal heart disease from the date of blood collection (between January 1993 and December 1995) until January 2004. They then compared the data from these men with records and blood samples of 900 living men who did not have a history of cardiovascular disease. The men's diet and lifestyle factors, recorded by self-administered questionnaires were also noted.

         

         Men with a vitamin D deficiency (having 15 nanograms per milliliter of blood or less) had an increased risk for heart attack compared with those with a sufficient amount (having 30 nanograms per milliliter of blood or more) of vitamin D. "After additional adjustment for family history of myocardial infarction, body mass index, alcohol consumption, physical activity, history of diabetes mellitus and hypertension, ethnicity, region, marine omega 3 intake, low- and high-density lipoprotein cholesterol levels and triglyceride levels, this relationship remained significant," the authors write. Men with intermediate levels of vitamin D had a higher risk of heart attack than those with sufficient vitamin D levels.

         

        "Vitamin D deficiency has been related to an increasing number of conditions and to total mortality. These results further support an important role for vitamin D in myocardial infarction risk," the authors conclude. "Thus, the present findings add further support that the current dietary requirements of vitamin D need to be increased to have an effect on circulating 25(OH)D [vitamin D] levels substantially large enough for potential health benefits."

            Edward Giovannucci; Yan Liu; Bruce W. Hollis; Eric B. Rimm. 25-Hydroxyvitamin D and Risk of Myocardial Infarction in Men: A Prospective Study. Arch Intern Med., 2008;168(11):1174-1180 

Take your Fish Oils..Your Heart Will Thank You

This is information that has the power to save lives. The EPA and DHA benefits from the heart cannot be overstated....taking at least 1000 mg combined EPA and DHA everyday is something I have recommended since I first learned of their heart benefits. I lost my dad to sudden cardiac death...and that happens to more than half a million families every year in the US alone. I would like to see those numbers drop, every one of those people leaves behind a family who will never be the same. This issue is the reason I became a nutrition educator.


Fish is an excellent source of protein and, unlike fatty meat products, it’s not high in saturated fat. Quite the opposite..fish provide the lifesaving long chain unsaturated fats that most people aren't getting. Yes, fish is a rich source of the most important omega-3 fatty acids EPA and DHA. Omega-3 fatty acids benefit the heart of healthy people, and those at high risk of, think family history...or who already  have cardiovascular disease. 


Research has shown that omega-3 fatty acids decrease risk of arrhythmias (abnormal heartbeats), which can lead to sudden death. An Italian study ( GISSI) showed that in men who had already had a heart attack fish oil supplements (840 mg EPA/DHA daily) reduced sudden cardiac death rates by 45%. Omega-3 fatty acids also decrease triglyceride levels, slow growth rate of atherosclerotic plaque, protect against inflammation and lower blood pressure (slightly).


What you need to know...


The American Heart Association recommends eating fish (particularly fatty fish) at least two times (two servings) a week. Each serving is 3.5 ounce cooked, or about ¾ cup of flaked fish. Fatty fish like salmon, mackerel, herring, lake trout, sardines and albacore tuna are high in omega-3 fatty acids. 


The American Heart Association recommends that anyone who has heart disease get 1000 mg combined EPA and DHA (the Omega 3's in fish oils or fish) daily.


The American Heart Association recommends that anyone who needs to lower their triglycerides get 2000-4000 mg combined EPA and DHA daily.


Source: AHA Scientific Statement 

Fish Consumption, Fish Oil, Omega-3 Fatty Acids, and Cardiovascular Disease

http://circ.ahajournals.org/cgi/content/full/106/21/2747#TBL1


GISSI Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico. Lancet.1999; 354: 447–455