Stopping CHD, The REVERSAL Study - Cleveland Clinic
CBS News: Reversing Heart Disease - Statins and Lifestyle
Oprah.com / Dr. Oz talks to Dr. Esselstyn about CHD basics
CBS News: Reversing Heart Disease - Statins and Lifestyle
Oprah.com / Dr. Oz talks to Dr. Esselstyn about CHD basics
Coronary Heart Disease Reversal ...unveiling the essential
Nutritional, Medical, Surgical and Lifestyle elements
Nutritional, Medical, Surgical and Lifestyle elements
There are, at long last, some welcome news for people who have been diagnosed with coronary heart disease or have suffered a heart attack ( M.I. ). Most patients are still unaware of crucial new developments: More often than not, you do not have to sit and watch helplessly the progression of the disease. Coronary heart disease can now be reversed to some significant degree. The therapy may add many years and even decades to one's life and restore quality of life. The best techniques and methods that are the path to successful CHD reversal are usually some form of combination therapy.
Medical intervention ( angioplasty or other procedures) and the prescription of drugs such as Lipitor, Crestor, Coumadin and Altace when combined with the appropriately befitting diet or nutrition can make that all-critical difference between the progression of the disease and its actual reversal or regression. Over the past decades, in an attempt to answer the question “How to best treat and even cure heart disease?”, clinicians and researchers have succeeded in developing simple life-saving methods that finally reverse CHD or atherosclerosis.
The Lifestyle Heart Trial and new research (the Harvard Medical School) now demonstrate clearly that medication and improved (heart healthy) nutrition work independently of each other, so that the benefits of one therapy are actually ADDED on top of the benefits of the other. For example, if your medication, alone, yields a 38% improvement and your improved diet, alone, yields a 19% improvement, your total improvement will be 38 + 19 or an impressive 57%. The graph at the bottom of this page (from the H.A.T.S study) reveals the level at which the disease ceases to progress and starts reversing. The improved survival rates are truly impressive ! Similarly, in the Lifestyle Heart Trial, it was found that, overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year.
Medical intervention ( angioplasty or other procedures) and the prescription of drugs such as Lipitor, Crestor, Coumadin and Altace when combined with the appropriately befitting diet or nutrition can make that all-critical difference between the progression of the disease and its actual reversal or regression. Over the past decades, in an attempt to answer the question “How to best treat and even cure heart disease?”, clinicians and researchers have succeeded in developing simple life-saving methods that finally reverse CHD or atherosclerosis.
The Lifestyle Heart Trial and new research (the Harvard Medical School) now demonstrate clearly that medication and improved (heart healthy) nutrition work independently of each other, so that the benefits of one therapy are actually ADDED on top of the benefits of the other. For example, if your medication, alone, yields a 38% improvement and your improved diet, alone, yields a 19% improvement, your total improvement will be 38 + 19 or an impressive 57%. The graph at the bottom of this page (from the H.A.T.S study) reveals the level at which the disease ceases to progress and starts reversing. The improved survival rates are truly impressive ! Similarly, in the Lifestyle Heart Trial, it was found that, overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year.
The nutritional approaches taken by the above mentioned clinicians do bear some similar features: the intake of saturated fat is always minimal; the intake of wholegrain cereals and legumes is encouraged as well as a large intake of fruits and vegetables. It is no coincidence if the ingredients chosen to be part of the recipes given as examples on our web site (and external hM articles) are mostly wholegrain cereals, very lean sources of protein and a profusion of vegetables and fruits.
On one hand, some of the above mentioned clinicians and researchers have now seen their versions of combination therapies documented with either angiograms or P.E.T. scans, the kind of evidence one can hardly argue with ! On the other hand, the data from major medical and scientific trials conducted on the efficacy of the prescribed medication also tend to prove them right. The drugs prescribed by those cardiologists are often of the "statin" group. Statin drugs work by reducing the production of LDL-Cholesterol by the liver. In one of the studies involving just over 500 patients, it was found that in those patients treated with an aggressive daily dose of 80 mg of atorvastatin (Lipitor) the atheroma volume (plaque build-up in the arteries) had regressed from 0.625 mm to 0.591 mm on average. This is a clear indication that not only has the progression of coronary heart disease been stopped but also that it has been rolled back or reversed to some degree. Those are very good news indeed. At long last there are now “ways and means” to reverse this affliction. Describing in detail their nutritional recommendations and the medical techniques and methods would require a massive book rather than one article.
CONCLUSION : the evidence supporting combination therapy (medical treatment + the best of heart-healthy diets) in order to reverse coronary heart disease can be summarized by the following:
On one hand, some of the above mentioned clinicians and researchers have now seen their versions of combination therapies documented with either angiograms or P.E.T. scans, the kind of evidence one can hardly argue with ! On the other hand, the data from major medical and scientific trials conducted on the efficacy of the prescribed medication also tend to prove them right. The drugs prescribed by those cardiologists are often of the "statin" group. Statin drugs work by reducing the production of LDL-Cholesterol by the liver. In one of the studies involving just over 500 patients, it was found that in those patients treated with an aggressive daily dose of 80 mg of atorvastatin (Lipitor) the atheroma volume (plaque build-up in the arteries) had regressed from 0.625 mm to 0.591 mm on average. This is a clear indication that not only has the progression of coronary heart disease been stopped but also that it has been rolled back or reversed to some degree. Those are very good news indeed. At long last there are now “ways and means” to reverse this affliction. Describing in detail their nutritional recommendations and the medical techniques and methods would require a massive book rather than one article.
CONCLUSION : the evidence supporting combination therapy (medical treatment + the best of heart-healthy diets) in order to reverse coronary heart disease can be summarized by the following:
Why combining heart-healthy nutrition or diet with medical treatment may indeed be best in order to successfully treat and even reverse the evolution of coronary heart disease (CHD, also called coronary artery disease, CAD) .
2- Two Pioneers Who Tried ...the simple, uncomplicated methods they uncovered indicated the way !
1- Abstract - GOOD NEWS !
CHD / Atherosclerosis / Angina are now reversible ! More often than not.
CHD / Atherosclerosis / Angina are now reversible ! More often than not.
Although not a physician himself, one of the grand pioneers was certainly Nathan Pritikin; who was said to have cured and reversed his own heart disease in the 1950's. After having had a heart attack, Nathan Pritikin undertook to develop his own special diet. This was before the days of statin drugs and other medication. Worthy of note: his diet was extremely low-fat and high on fibre. According to The New England Journal of Medicine, in 1985 (long after his heart attack),when he passed away from causes unrelated to CHD , his arteries were found, on autopsy, to be relatively free of the disease. Stunningly, his arteries were even found to be soft and pliable. His legacy is The Pritikin Longevity Center. ( www.pritikin.com ) The Pritikin organization claims to achieve coronary heart disease reversal mainly by nutritional or dietary means. Pritikin may well have traced a sort of road-map titled "How to Reverse Heart Disease with the right diet or befitting heart-healthy nutrition".
So, what were the important characteristics of the Pritikin dietary program? It was low-fat, not necessarily vegetarian, and was based largely on the intake of whole, unprocessed grains, fruits and vegetables. Only 10% of calories were derived from fat. ( hM on Pritikin: the program may work well with strong-responders to dietary treatment, but may not be enough with weak-responders. Consequently, the taking of medication should not be stopped ).
At about the same period, a cardiologist, Dr. Herman Hellerstein, was developing an efficient CHD reversal diet. Dr. Hellerstein also reduced dietary fats drastically, especially unhealthy saturated fats. Dr. Hellerstein made sure to keep ldl-cholesterol to low levels as well.
So, what were the important characteristics of the Pritikin dietary program? It was low-fat, not necessarily vegetarian, and was based largely on the intake of whole, unprocessed grains, fruits and vegetables. Only 10% of calories were derived from fat. ( hM on Pritikin: the program may work well with strong-responders to dietary treatment, but may not be enough with weak-responders. Consequently, the taking of medication should not be stopped ).
At about the same period, a cardiologist, Dr. Herman Hellerstein, was developing an efficient CHD reversal diet. Dr. Hellerstein also reduced dietary fats drastically, especially unhealthy saturated fats. Dr. Hellerstein made sure to keep ldl-cholesterol to low levels as well.
3- The search to identify the most appropriate foods and a truly heart-friendly diet is on:
The medical and scientific community started looking into the effect of nutritional habits on the incidence and on the evolution of cardiovascular disease. In this article, heartMonitron will be paying particular attention to today's top authorities on reversal therapy. Invariably, the diets that were found to the best and most efficient have ended up putting the emphasis on "real" foods and discouraging the intake of heavily industrially processed foods or junk foods. Trans-fats and saturated fats were quickly identified as very bad fats for one's heart. Trans-fats are fatty acids that have been modified so as to reduce cost. They should be avoided. As for saturated fats, they may be found in most foods. They prompt your liver to synthesize the bad LDL-Cholesterol. Foods that have a high amount of trans or saturated and bad fats in them include hot-dogs, burgers, pizza, potato chips and fries. Beneficial foods with low saturated fats levels include legumes, soy products, whole grains, vegetables and fruits. If and when meat is consumed, it would be extra lean, such as skinless turkey and some fish.
Clinicians and researchers have now demonstrated clearly that diets based on whole and real foods are better for your heart, and that you do not have to sit and watch helplessly coronary heart disease progress. You can, instead, successfully halt its progression and even roll it back. Medical treatment and healthy nutrition do the job.
Clinicians and researchers have now demonstrated clearly that diets based on whole and real foods are better for your heart, and that you do not have to sit and watch helplessly coronary heart disease progress. You can, instead, successfully halt its progression and even roll it back. Medical treatment and healthy nutrition do the job.
4- Dr. COLIN T CAMPBELL'S findings, "The China Study" / Surveying the eating habits of large population groups that, curiously, happen to be free of heart disease. What can be learned from the findings?
Dr. Colin T. Campbell PhD, is the author of: The China Study. In this landmark study, Dr. Campbell relates geographical areas free of heart disease with their traditional diet. Dr. Campbell's findings point to populations (comprising millions of people) who experience less than five percent (only 1/20th !) the rate of cardiovascular disease experienced in the American population. The other surprise was that these populations seemed almost free from type 2 diabetes and that obesity was virtually non-existent. The bulk of their diet is made up of "whole" foods such as whole grains, lean sources of protein with plenty of fruits and vegetables. The epidemiological data provided by the China Report was gathered over decades. The study was supported by famed universities such as Oxford and Cornell and by the Chinese government. The data is considered as being some of the most reliable. It is viewed as a basis to design efficient nutritional or dietary means of treatment to achieve coronary heart disease reversal. The report became a landmark, to the extent that The New York Times has coined the study as being "The Grand Prix of Epidemiology".
"The Grand Prix of Epidemiology".
"The Grand Prix of Epidemiology".
6- Dr. DEAN ORNISH'S therapy, "The Lifestyle Heart Trial" reveals dramatic decline in patient's heart event rates (myocardial infarction and others).
Dr. DEAN ORNISH MD, (Director : The Preventive Medicine Research Institute, Professor of Medicine : The UCSF School of Medicine). He his one of the leading proponents of a daily diet that promotes nutrition principles that closely match those introduced by The China Study. Dr. Ornish is an advocate of lifestyle changes (no more than 10% of calories coming from fat, whole foods, vegetarian diet, smoking cessation, exercise and stress management). A famed published scientific study called "The Lifestyle Heart Trial" has validated the nutritional principles: "Overall, 82% of experimental-group patients had an average change towards regression. Comprehensive lifestyle changes may be able to bring about regression of even severe coronary atherosclerosis after only 1 year", The techniques and treatment methods advocated by Dr. Ornish have been cited in several publications - see: The Journal of the American Medical Association Vol 280 No 23 Dec 16 1998. The Ornish diet is however viewed as drastic and very "hard to sell". As North-Americans, we somehow mistakenly believe that balanced vegetarian meals are not real meals.
8- Dr. CALDWELL B ESSELSTYN'S program. Researcher, The Cleveland Clinic. His strict program and diet cause the actual (documented) regression or reversal of CHD.
Dr. CALDWELL B ESSELSTYN MD, Researcher : The Cleveland Clinic. Dr Esselstyn uses a strict nutritional approach to treat CAD and achieve coronary heart disease reversal. The claimed results are impressive: "Cardiac events: The 17 patients in the study had 49 cardiac events in the years leading up to the study, and had undergone aggressive treatment procedures. Several had multiple bypass operations. After beginning the eating plan, there were no more cardiac events in the group within a 12-year period." Viewing the angiograms of his follow-up volunteer patients is also very convincing. His angiograms illustrate and prove the reversibility of coronary heart disease in most instances. Angiography is a special imaging technique allowing cardiologists to view the heart and the arteries that supply it with blood. The angiograms provided by Dr. Esselstyn illustrate the improvement of blood flow in patients' coronary arteries after a period of therapy. Those angiograms (they look a bit like x-rays) are a good demonstration of actual coronary heart disease reversal. Of course, his dietary recommendations do not include the advertised combo at the fast-junk outlet. Dr. Esselstyn would rather have you eat "real food": the whole vegetable patch with plenty of unrefined wholegrain and very lean sources of protein ! Dr. Esselstyn is an advocate very low-fat diets and of plant-based nutrition (a very, very strict - no oil, no meat -, low-fat, vegetarian or vegan diet).
10 - Dr. LANCE K GOULD's Cure, Professor of Medicine/Cardiology, University of Texas Medical School. P.E.T. Scans prove the efficacy of his reversal diet.
Dr. LANCE K GOULD MD, Professor of Medicine/Cardiology, The University of Texas Medical School. As for method of treatment, Dr. Gould is a strong advocate of a very low fat diet in combination with lipid reducing and anti-cholesterol drugs. He also points out that controlling blood pressure and smoking abstinence are crucial factors in stabilizing coronary plaque. It is heartMonitron's belief that future epidemiological studies will prove this approach to be the best way to treat or reverse CHD. This prediction is not hard to make, given that positron emission tomography ( PET Scans) has already clearly illustrated the far improved perfusion of the heart. According to Dr. Gould, the combination of a very low fat diet and lipid-reducing and anti-cholesterol drugs can reduce a person's risk of a heart attack by 90% or more. This is no small achievement. For heart patients, reducing the risk by 90% often lowers it to well below that in the average population. The Pet scans of Dr Gould's follow-up patients show in colourful ways this markedly improved perfusion (improved blood flow in the arteries of the heart) after a period of five years of therapy. These scans are a graphic illustration of coronary heart disease reversal.
11 - DAVID J A JENKINS, MD, PhD, Director / Clinical Nutrition, SMH / similar techniques, same good results.
Dr. DAVID J A JENKINS, MD, PhD, Director/Clinical Nutrition, St-Michael's Hospital, The University of Toronto Medical School; he is also the director of the Risk Factor Modification Centre. The results of the study he conducted in 2003 prove the concept and validate the theories advanced by Drs. Gould, Esselstyn and Ornish for the treatment and reversal of CHD. The goal of the study conducted by his team was “...to elucidate the potential of diet to prevent and treat chronic diseases; primarily heart disease...”
12a- Dr. Michael Miller (U of Maryland): a different approach / allows "good fats" and lean animal protein
Dr. Michael Miller (University of Maryland Medical Shcool) has a different approach as to how to treat or care for CHD.. He is not as strict regarding fats. He differentiates between the good fats, like mono-unsaturated, and the very bad fats, like saturated and -trans. He allows a certain amount of the good fats in the diet. He also allows fish and some meat, lean meat ...NOT regular ground beef! Dr. Michael Miller favors a Mediterranean -style diet. Best advice for prevention.
13- The Evidence. What foods do people eat to cure or reverse heart disease ? Why is medication part of the treatment ?
The hM MedJOURNALS contain articles, news and recipes relative to Health Care and Improvement, Nutrition, the Management of Coronary Heart Disease, Type 2 Diabetes, High Cholesterol, weight loss and the Maintenance of a Healthy Weight, including Computer Assisted Diet Planning and Nutrition Analysis - hM strongly recommends using the information in the articles and healthy recipes provided on this website under the professional supervision of your doctor or registered dietitian . Whether you are seeking to improve your general health, reverse heart disease, control diabetes or your weight, always assume that getting professional advice from your MD or RD is best. NGBeditor
Links to full-text articles on the hM NewsWire are at the bottom of this page
The heartMonitron Journals - Published for Educational Purposes, only your Doctor can provide advice
Changing our diets can prevent heart disease.
In this video, Dr. Marc Katz, Cardiac Surgeon and Chief Medical Officer for the Bon Secours Heart and Vascular Institute, talks about the prevention of heart disease.
In this video, Dr. Marc Katz, Cardiac Surgeon and Chief Medical Officer for the Bon Secours Heart and Vascular Institute, talks about the prevention of heart disease.
Explore the pathways to
Coronary Heart Disease Reversal
How Can the Best of Medical Treatment, When Combined with the Best of Heart-Healthy
Diets or Nutrition, Make That Big Difference in Your Endeavour to Roll Back Coronary Heart Disease ? - Part I
Diets or Nutrition, Make That Big Difference in Your Endeavour to Roll Back Coronary Heart Disease ? - Part I
The American Medical Association Guide to Preventing and Treating Heart Disease
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For a few people, an appropriate diet, alone, may suffice to reverse CHD, atherosclerosis or angina. But for all the other people, it will just not be enough. New medications are now available to address the causes of CHD and infarction, mainly high ldl-cholesterol levels, high blood pressure and a high tendency for a person's blood to clot. The commonly prescribed medications are statin drugs, ace inhibitors and beta-blockers, as well as Coumadin or the coated ASA.
Again, for some people, medication, alone, may be enough to cause the regression or the reversal of the disease. For all the others, it may slow down or halt the progression of the disease, but may not reverse it. In a lipid intervention study conducted at Harvard, the best results were achieved when using both the nutritional and the medical approaches simultaneously. The combo-therapy, combining medical treatment with a suitable diet and lifestyle changes, has by now an excellent track record at rolling back the disease.
Again, for some people, medication, alone, may be enough to cause the regression or the reversal of the disease. For all the others, it may slow down or halt the progression of the disease, but may not reverse it. In a lipid intervention study conducted at Harvard, the best results were achieved when using both the nutritional and the medical approaches simultaneously. The combo-therapy, combining medical treatment with a suitable diet and lifestyle changes, has by now an excellent track record at rolling back the disease.
5- What About Medication Then? Do Prescription Drugs Reverse CHD, Atherosclerosis or Angina?
7- What is Angioplasty or PCTA? ...and Does that Surgical Procedure actually Reverse Heart Disease?
9- What are Stents? and Does Stenting Reverse or Cure Heart Disease?
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Contents of this Article
>> 1 - Intro: CHD now Reversible
>> 2 - The Pioneers
>> 3 - The Influence of Nutrition
>> 4 - Dr. Colin T Campbell PhD
>> 5 - What About Medication
>> 6 - Dr. DEAN ORNISH's therapy
>> 7 -Does PCTA Reverse CHD?
>> 8 - Dr. CALDWELL B ESSELSTYN
>> 11 - Dr. DAVID J A JENKINS, MD
>> 10 - Dr. LANCE K GOULD
>> 12 - Dr. Michael Miller
>> 9 - Does Stenting Reverse CHD?
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Prevent & Reverse Heart Disease Caldwell B Esselstyn MD
Heal Your Heart
Lance K Gould MD
Lance K Gould MD
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The New American Heart Association Cookbook
Healthy Heart Cookbook
American Medical Association
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A lifesaving, very valuable and useful intervention that aims at re-opening a blocked or narrowed artery. Angioplasty or PCTA (percutaneous transluminal coronary angioplasty) is a surgical procedure in which a catheter in inserted, through the skin, in an artery of either the groin or the wrist. The catheter has an inflatable tip often referred to as a balloon. The catheter is then guided through the lumen (passageway) of the artery till it reaches a desired location in a blocked or narrowed artery of the heart. The tip or balloon is then inflated so as to reopen or widen the lumen. Blood flow is thus quickly restored to the area of heart muscle supplied by that arterial segment.
Angioplasty is a lifesaver for many patients having a myocardial infarction and brings a welcome relief to patients suffering from angina caused by a narrowed artery due to severe atherosclerosis. This alleviates the symptoms for a period of time but does not remove the causes of the disease. Unless the patient takes serious corrective measures, such as smoking cessation, cholesterol-lowering medication and lifestyle changes, another heart attack is likely to occur sooner or later and angina episodes may resume. PCTA is a useful and often necessary procedure that relieves temporarily the symptoms of the disease but does not reverse it. Unchecked, atherosclerosis or CHD do have sudden death as an endpoint. After the procedure, it is of utmost importance for the patient to seriously address the causes.
Angioplasty is a lifesaver for many patients having a myocardial infarction and brings a welcome relief to patients suffering from angina caused by a narrowed artery due to severe atherosclerosis. This alleviates the symptoms for a period of time but does not remove the causes of the disease. Unless the patient takes serious corrective measures, such as smoking cessation, cholesterol-lowering medication and lifestyle changes, another heart attack is likely to occur sooner or later and angina episodes may resume. PCTA is a useful and often necessary procedure that relieves temporarily the symptoms of the disease but does not reverse it. Unchecked, atherosclerosis or CHD do have sudden death as an endpoint. After the procedure, it is of utmost importance for the patient to seriously address the causes.
Stenting is often performed as part of an angioplastic procedure. A stent is a cylindrical metal wire mesh. Stents come in different sizes. They are collapsible and expandable. They are used to prevent the arterial lumen from closing back again after angioplasty, a common and unwanted complication.
The tubular stent is first collapsed around the balloon that is at the tip of the catheter. Once the catheter has reached the desired location in the artery, the balloon is inflated and the stent is deployed. It will then act as a sort of scaffold to keep the artery open. Like angioplasty itself, stenting is a relief procedure, it relieves the symptoms but does not address the underlying causes. While very useful, stenting does not keep the disease from progressing and does not improve survival rate or longevity at all.
It is only the medical treatment you will follow after the intervention and only the dietary and lifestyle changes that you will choose to make that will halt or reverse the progression of CHD or atherosclerosis.
The tubular stent is first collapsed around the balloon that is at the tip of the catheter. Once the catheter has reached the desired location in the artery, the balloon is inflated and the stent is deployed. It will then act as a sort of scaffold to keep the artery open. Like angioplasty itself, stenting is a relief procedure, it relieves the symptoms but does not address the underlying causes. While very useful, stenting does not keep the disease from progressing and does not improve survival rate or longevity at all.
It is only the medical treatment you will follow after the intervention and only the dietary and lifestyle changes that you will choose to make that will halt or reverse the progression of CHD or atherosclerosis.
>> 13 - WHAT IS THE EVIDENCE?
Go To PART 2 >>
12b- Dr Mehmet Oz, of The Oprah Winfrey Show fame, and Dr Dean Ornish on Reversing Heart Disease
Once you have been diagnosed with coronary heart disease, it's too late for prevention. Then you have to realize that small changes will not be enough. Big changes are, indeed, required. In the video on the right, Drs. Mehmet Oz and Dr Dean Ornish explain. Note that Dr. Oz also stresses the importance of controlling hypertension.
Links to full-text articles on the hM NewsWire
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