Great Smokies Medical Center of Asheville

Archive for the ‘0804’ Category

Our Founding Vision

Sunday, September 11th, 2005

The 25th anniversary of GSMC’s founding was celebrated at a dinner for GSMC staff on July 16. In a heart-based letter, GSMC’s founder, Dr. John Laird, first credited those who guided him in manifesting his founding vision in 1979: to offer high quality, loving healthcare that brings true healing to the body, the heart, and the spirit. He then honored Pat Gallimore, our current office manager and his first employee in 1979, for her many contributions. We thank our patients, staff and all others who have contributed to GSMC’s longevity, and look forward to carrying GSMC’s founding vision into the next 25 years.

Heartfelt

Sunday, September 11th, 2005

“I love you with all my heart.” ” She broke my heart.” Such common expressions underscore the connections between interpersonal relationships and emotions with the heart. Positive emotions result in a warm, open heart and circulation, while negative emotions result in a cold, closed heart and circulation.

You don’t need to be stuck with negative feelings, as merely expressing yourself in matters of the heart has proven to be helpful. Twenty minutes of writing down feelings of hurt, grief, sadness and anger (regardless of how long you’ve had them) daily for three days in a row has been shown to shift the experience of these feelings. Be open and honest. This exercise is between you and your heart. Since you are not likely to be forthcoming if you fear someone else may read your innermost feelings, it is important to burn the paper on which your hurts are written. As your old hurts dissipate into thin air, thank them for their lessons and allow them to flow freely from your heart.

The Cholesterol Hypothesis of Heart Disease and Statin Drugs

Sunday, September 11th, 2005

The guys in white coats are in your television set, and they’re advertising cholesterol-lowering drugs (statins) 24/7. They know if they throw enough spaghetti on the wall, some of it will stick.

Americans spend $12.6 billion/year on statins, proving the cholesterol hypothesis has stuck. The theory that cholesterol causes heart disease is called the cholesterol hypothesis. Its general acceptance as fact has resulted in cholesterol, a critically important molecule in health, being wrongly singled out, tried, and convicted of causing heart disease. This popular hypothesis falls short of explaining why people with low cholesterol have heart attacks, why people with high cholesterol can be free of heart disease, and why cultures such as the Inuit, who have fat-rich diets, have low heart disease incidence.

What has cholesterol done for you lately? For starters, feeling good is a symptom of adequate cholesterol levels. Cholesterol is required for the body to make reproductive hormones and the body’s anti-stress hormone, cortisol. Eighty percent of the cholesterol in the blood is made by a healthy liver that makes, every single day, as much cholesterol as is in six to eight chicken egg yolks. Cholesterol is part of the protective coating, the myelin sheath, that insulates nerves. Cholesterol “waterproofs” the protective cell membrane in each of the body’s cells. Cancer rates increase when cholesterol levels decrease. Cholesterol is required for the body to make Vitamin D. Stroke risk increases as cholesterol levels drop. High cholesterol levels in older people are related to longevity.

The cholesterol-lowering drugs of concern are statin drugs: Lipitor, Zocor, Pravachol, Lescol, Mevacor, and the new kid on the block, Crestor. (The 80 mg dose of Crestor was removed from the market shortly after it was introduced because of reports of kidney failure.)

The adverse side effects of statin drugs are well known and include rhabdomyolysis, muscle deterioration that can be detected by a routine blood test. Less well-known are partially reversible muscle disorders that cannot be detected by blood tests. If the affected muscles are involved in breathing, shortness of breath may result. If the affected muscle happens to be the heart, heart failure may result. Statin drugs inhibit the production of Co-enzyme Q10, an enzyme that drives energy production in every cell, notably in the liver and heart. Many animal studies show an increase in the incidence of cancer with exposure to statin drugs. In fact, some researchers consider statin drugs to be carcinogenic. Peripheral neuropathy results in pain and lack of sensation in the feet and legs. This, as well as depression, irritability, and memory and cognitive problems are known side effects.

Many physicians and researchers question not only the safety of taking cholesterol lowering drugs, but they also challenge the validity of the hypothesis that cholesterol causes heart disease.

Well-established causes of heart disease include poor nutrition, a sedentary lifestyle, low copper, excess iron, poor antioxidant status, low HDL cholesterol, infection, inflammation, smoking, and various toxins (notably mercury).

In a drug-based healthcare system, what were once thought to be scientific “facts” are routinely replaced by new, updated “facts of convenience.” For years, the acceptable level of LDL cholesterol was less than 130 mg/dl. The bar was recently lowered again, so statin treatment is now recommended to attain LDL levels at 70 to 100 mg/dl, resulting in 36 million Americans being targeted as potential users of statins. Six of nine physician panelists serving on the National Cholesterol Education Program (NCEP) that made the latest recommendations have been exposed as having received funding from drug companies that manufacture and market statin drugs.

If circulating LDL cholesterol were inherently dangerous, all arteries would have equal exposure to it and would be equally diseased. But LDL only penetrates the lining of an artery (epithelium) where the lining is damaged. As a result, vascular blockage occurs in already compromised sections of arteries. When is “bad” LDL cholesterol good? LDL cholesterol has several important functions, including a starring role in the synthesis of cortisol, estrogen, testosterone, and progesterone. Elevated LDL levels are nature’s defense against viral infections. Once viruses are bound to LDL, the ability of the virus to release cytokines (chemicals that cause inflammation, pain, and clotting) is impaired.

Oxidized LDL, not LDL, is associated with arterial damage. Addressing causes of oxidation (excess iron, smoking, poor quality diets, etc.) and glycosolation (diets high in sugar) are two natural approaches that address underlying causes of damage to arteries.

Responsible recommendations for prescription drug use are made on a one-to-one basis between a physician and patient, not to 36 million people.

People taking statin drugs need at least 50 mg of CoQ10 daily and are advised to report to their physicians any of the aforementioned side effects. Lifestyle modifications that can address known risk factors for heart disease include minimizing sugar intake, exercising, stopping smoking, and taking antioxidant supplements.

Angioplasty with Stent Placement vs. Exercise Training

Sunday, September 11th, 2005

Research results reported in the March 2004 issue of Circulation may be the best news for heart patients since, well, the bicycle was invented.

The benefits of stent angioplasty as rescue intervention in acute coronary problems is well established. But its benefits are less clear in a patient with stable exercise-induced angina.

Cardiologists in Leipzig, Germany, studied 101 men with exercised-induced angina who had received routine coronary angiography. Participants were randomly divided into two groups: those who received 12 months of exercise training (20 minutes of bicycle ergometry daily and one 60-minute session of group aerobic exercise training per week) and those who had stent angioplasty.

The study rated clinical symptoms (the ability to exercise without angina), the level of oxygenation of the heart muscle, the necessity of further interventions (coronary artery bypass surgery and angioplasty), as well as adverse clinical outcomes (death from cardiac cause or stroke, and increasing angina resulting in hospitalization).

After one year, men in the exercise-training group had an 88 percent event-free survival rate compared with 70 percent in the stent angioplasty group.

The exercise-training group had a 16 percent greater maximal oxygen uptake than the angioplasty group. This study did not use drug-coated stents. Statistical adjustment for drug-coated stents puts their event-free survival rate at 72 percent.

The study results make sense when considering three facts. First, the heart is a muscle, albeit a very specialized one, and it can be conditioned by exercise. Second, the blockage of a coronary artery is not just a simple mechanical problem, but is the result of a complex series of events including inflammation, clotting, and immune responses. Third, stenting addresses one short segment of the coronary blood vessels, while exercise impacts the function of all the blood vessels.

Note that this study was performed in men with stable angina. Stable angina is pain of cardiac origin that occurs with exertion or intense emotion at a predictable level, decreases with rest, and does not progress to a heart attack. Crescendo or unstable angina is sudden or increasing pain of cardiac origin that occurs either at rest or with exertion and is associated with unstable plaque that is threatening to advance to a heart attack.

GSMC physicians recommend individualized risk assessment, a customized program of heart-friendly nutrients, and chelation therapy in addition to exercise.

People with heart disease should consult their physician for exercise recommendations.

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