Coronary Artery Disease (CAD), also known as Coronary Heart Disease  (CHD) is the cause of heart attacks, angina, and other serious heart issues.  It is often called the “silent killer” as usually the first sign of a problem is a “heart attack”.  CAD is usually a slow, progressive disease of the heart (coronary) arteries.  Over time, an unhealthy lifestyle such as smoking, excessive alcohol, high sugar diets, poor diet habits, diabetes, obesity, stress, and lack of exercise causes plaque to build up in the coronary arteries.  This process of plaque buildup is called Atherosclerosis. 

Atherosclerosis is essentially a sticky webbing of fat that lies down in the coronary arteries.  Over time, this fat catches other products such as calcium and metabolic wastes that can harden and narrow the coronary blood vessels of the heart. To add insult to injury, this process causes the coronary vessels to become inflamed, leading to further complications.

The process of “hardening” this fat and other products is called arteriosclerosis. The dual process of arteriosclerosis and atherosclerosis can lead to symptoms of angina, such as chest pain and shortness of breath.  Angina is caused by a lack of oxygen due to the heart’s arteries being too narrow. Angina usually manifests when physically active or under stress, as blood flow is reduced due to the occlusion in the coronary arteries.  Angina is a warning that there are some serious heart problems.  Angina can present as chest (tightness, squeezing, pressure), sweating, shortness of breath, nausea, and vomiting.

A heart attack is different than angina.  Where angina is a reduction of blood flow to the heart, a heart attack( called a myocardial infarction) happens when the blood flow to the heart is cut off and actual “death of heart muscle” occurs.  This happens due to a fatty plaque clot breaking off, which occludes an artery in the heart. There is essentially no oxygen to the heart muscle, and if it goes on too long, the heart may be permanently damaged.

Damaged heart muscle causes the heart to pump ineffectively, possibly causing low blood pressure, shortness of breath, kidney issues, fluid in the legs, and more.  It can also cause electrical instability in the heart, causing the heartbeat to be too fast, too slow, or skipped beats, and other abnormal issues called “arrhythmias”. Heart attacks can also cause sudden cardiac arrest, whereby the heart actually stops beating altogether.

The process of arteriosclerosis is caused by glycation, which is essentially sugar that reacts with fats and proteins in the bloodstream.  This is why high sugar diets combined with high saturated fat diets can be so dangerous.

Most often, CAD takes many years to develop.  It is a slow, insidious process that is usually undetectable when it is mild.  However, as it progresses, there are some warning signs to suggest that there could be issues.  For example, hypertension, as discussed in the last blog post, is an indicator of blood vessel and heart health.  Stiff blood vessels from arteriosclerosis and arteriosclerosis slowly result over time.  Blood pressure greater than 140/90 consistently is a “yellow flag” and needs to be managed.  Chest pain, tightness, or pressure that does not go away in several minutes (especially if brought on by exercise or stress) is another “yellow flag” that needs to be assessed by your physician.

Blood work that looks for cholesterol and triglyceride ratios is a good way to monitor what’s going on with respect to potential arteriosclerosis in your body.  While cholesterol on its own is not necessarily concerning, high cholesterol combined with high triglycerides is problematic.

Other blood markers can assess your risk of CAD, such as calcium scores, Lipo A and ApoB blood markers, CRP, and homocysteine, which look for overall inflammation and cardiac inflammation.  Diabetes is a form of inflammation and contributes not only to high sugars in the bloodstream, but also directly damages the coronary blood vessels.  Therefore, other good indicators of potential cardiac issues are blood values that look at insulin, blood sugars, and HbA1c.

Troponin is a blood marker that can tell you if you are having an active heart attack or have had a heart attack in the last few days.  This needs to be done in the Emergency Department along with an EKG.  If you think you are having angina symptoms (which don’t go away in a few minutes) or you believe you are having symptoms of an acute heart attack, call 911 or go immediately to an Emergency Department.  This is very important!

Strategies for reducing your risk of CAD

• Diet – Focus on a diet low in saturated fats, lean proteins, low carbohydrates, lots of fruits and vegetables. We like the Mediterranean diet for managing CAD.
• Exercise – Focus on cardiovascular/aerobic exercise, resistance training, and other forms of mild to moderate sustained physical activity.
• Reduce all sugars and carbohydrates, especially if you are pre-diabetic or diabetic.
• Lose the excess weight – exercise, diet, weight loss programs, including GLP and GLP-1 medications.
• Supplement for heart health – including omega-3 fatty acids, magnesium citrate, CoQ10, and NAD.
• Get regular blood work done,
• Take your blood pressure often and aim for a normal blood pressure range of < 120/80.
• Purchase a blood glucose monitor and take your blood sugar often, and aim for a range of <140mg/dl 2 hours after eating.
• Get plenty of rest and reduce stress.
• Limit alcohol and NO smoking!
• Reduce inflammation – live a clean lifestyle and detoxify from environmental pollutants.

***If you need some help with this, at FreezeWellness, we are here for you!