The ChangingParadigm

Heart Disease

At one time, nothing could be done about heart disease. As someone clutched their heart and gasped, we could do nothing but look on in pain. As we learned more about the heart, we developed drugs and learned how to cut open the body and partially repair the heart. Today, the death rate for all heart-related diseases is 45 percent of what it was in 1963. Many claim that drugs and surgery are the reasons for this.

Bwpe177.jpg (12521 bytes)ut, if this is so, why is “progress” slow-ing down? According to the Harvard
Health Letter
(January 1998), there appears to be a slight rise in the incidences of
stroke and kidney disease, and a leveling of the death rate from heart disease among U.S.
adults. In other words, perhaps the well-established paradigm–drugs and surgery-is not
the best answer. Perhaps it is time to review our past and see what we can learn. Perhaps
it is time to change the paradigm.


The history of the heart and its diseases, like all medical history, is a history of
ideas: an initial idea, reinforcement of the idea, challenges to the idea, rebukes to the
challenges, and, perhaps, a new idea.

One of the first ideas was put forth by Erasi-stratus of Alexandria, who dissected
animals and humans (probably Egyptian mummies) 2,300 years ago. He discovered the veins,
arteries, and nerves, and postulated that the heart is nothing more than their junction
and that the arteries contain not blood, but air, spirit, or soul (called pneuma). This
entered the body through the nose, throat, and lungs-in other words, through breathing. He
believed the veins do contain blood, and his rational for why blood comes from open
arteries is that the blood from veins rushes in as the pneuma floats out.

Parts of this idea were reconfirmed, but many more were challenged and disproved. The
great physician of the Roman Empire, Galen, confirmed that veins contain blood, but did
away with the idea of pneuma. He saw that the heart is more than a “circulation
junction” and that blood flows throughout the body, but believed it ebbs and flows
with the heartbeat. Galen was such a great influence upon the medical world that his ideas
became “medicine”. They were codified, made rigid, and acknowledged as the
“limit” to medical information.

The Renaissance saw the first revolt against the dogmatic rules that Galen’s ideas
had become. The Swiss physician Paracelsus rejected much of Galen’s thought and spoke
forcefully against the tendency to accept Galen’s ideas as truth:

“Who does not know that doctors make terrible mistakes, greatly to the harm of
their patients? Who does not know that this is because they cling too anxiously to the
teachings of Hippocrates, Galen …”

For daring to challenge the status quo, he was condemned to a nomadic existence,
travelling from town to town.

Andreas Vesalius, born in 1514, continued the challenge to the medical status quo. He
compiled the complete anatomy of the human body and, in doing so, discovered and exposed
more than 200 errors by Galen. In undermining much of this traditional medical authority,
he became controversial at best, and a pariah at worst. He was attacked by many of the
pro-Galen forces and retired from academic pursuits embittered and disillusioned.

William Harvey, known as the grandfather of cardiology, drove a stake into the heart of
the old school of cardiology. He understood that the heart and blood are elements within a
closed system, described correctly how blood flows through the heart, and saw that the
heart is the engine that pumps blood. He saw that the heart, lungs, and blood vessels are
interdependent and that what we call heart disease may actually originate somewhere other
than the heart, especially in the arterial systems.

A common thread that runs throughout this brief history (and, as we shall see,
continues today) is that ideas become a rigid status quo (often through no fault of the
ideas’ originators) and that when they are challenged, the challenger is repudiated,
discredited, and often driven out. It is reported that even Harvey, after publishing his
ideas, suffered an immediate decline in number of patients because of his “strange

“Strange theories” …

The notion that new ideas are “strange theories” continues in modern times.
In the ’60s and ’70s, Nathan Pritkin was persecuted as a quack and incompetent
rebel when he concluded that most heart disease is reversible through a combination of
diet, exercise, and stress management. The medical profession was relentless in its
criticism, accusing him of giving patients false hope and defrauding them by selling them
his program of lifestyle changes to prevent heart disease.

The 1960s saw another alternative opinion shot down by the medical community. Kilmer S.
McCully, M.D., then a professor of pathology at Harvard University Medical School, went
against the “killer cholesterol” tide when his studies pointed to an amino acid,
homocysteine, as a major cause of heart disease.

McCully had come across research that noted that some mentally retarded children were
dying of heart disease before reaching puberty, and the reason was due to high blood
levels of homocysteine. In 1969, after studying this issue, McCully proposed that many
Americans suffer from cardiovascular disease due to high homocysteine levels, not
cholesterol. More radically, he proposed that all one has to do is take B-complex vitamins
to solve this

For the next few years, McCully struggled against the cholesterol tide and, in 1978,
had to leave Harvard. In his book, The Homocysteine Revolution, he notes that he
was told he had “failed to prove his theory.”

… Become mainstream

Pritkin and McCully, like Vesalius and Harvey before them, were proven correct. In the
late ’80s, Surgeon General C. Everett Koop took the
bold step of reversing decades of medical thought when he declared that 75 percent of the
deaths in America are caused by lifestyle decisions on diet, smoking, and consumption of
alcohol. Today, the National Heart Association publishes a list of dietary recommendations
that echo Pritkin’s earlier conclusions.

McCully was also vindicated. Articles on homo-cysteine began reappearing and, in 1995,
studies in the Journal of the American Medical Association reported that
homocysteine is a major risk factor in CVD. Today, homocysteine is considered an
independent risk factor-it is not influenced by other factors, such as smoking,
cholesterol, and physical activity. It is also acknowledged that ade-quate amounts of
vitamins B12 and B6 and folic acid can reduce high homocysteine levels and lower the risk
of CVD.

Today, there is more and more emphasis on lifestyle as the key to cardiovascular
health. Virtually all heart organizations acknowledge that diet and exercise are keys in
preventing heart disease and recommend a diet that is low in total fat, saturated fat, and
cholesterol and rich in fruits, vegetables, and fiber.

The paradigm changes

The paradigm underlying these new ideas is that we are responsible for our health. If
bad lifestyle decisions are responsible for 75 percent of the deaths in America; if most
heart disease is reversible through a combination of diet, exercise, and stress
management; if nutrition combats high homocysteine and cholesterol levels, it means that
we have it in our power to control our health destiny. We do not have to wait until the
crisis and then rush to the doctor or hospital; we can take steps to lower our risk of,
and prevent, CVD.

Cardiovascular diseases (CVD)–which encompass events such as heart attack, stroke,
angina pectoris, atherosclerosis and arteriosclerosis, and high blood pressure–are the
No. 1 killer in North America. In the United States, somebody dies from heart disease
every 33 seconds, and from a heart attack every minute. In Canada, in 1992, CVD accounted
for 38 percent off all deaths.

McCully’s theory

One drawback to the
“cholesterol as king” theory of cardiovascular disease (CVD) is that many people
with no risk factors suffer from heart problems.

Indeed, an article in the June 26, 1996,
issue of the Journal of the American Medical Association notes that the traditional CVD
risk factors (age, genetics, gender, smoking, blood pressure, cholesterol, sedentary
lifestyle, diabetes, weight, stress) only explain about 50 percent of all CVD. The amino
acid homocysteine may be the reason.

Homocysteine is formed when the body
breaks down protein, especially the protein found in meat. Meat protein contains the
essential amino acid methionine, and when methionine is digested, it produces
homocysteine. According to McCully’s theory, if homocysteine levels increase, the
result is the buildup of plaque, which, of course, may lead to atherosclerosis, heart
attacks, strokes, and death.

Homocysteine builds up if we eat too much
meat or do not get sufficient amounts of vitamins B6 and B12 and folic acid. These three
vitamins are integral in the process of recycling and excreting homocysteine. If we do not
have sufficient amounts of these vitamins, homocysteine levels rise.

Reducing the risk

wpe186.jpg (11695 bytes)

Practicing AIM’s Healthy Cell Concept is the first stepracticing AIM’s Healthy Cell Concept is the first step. This concept
states that five elements–cell food, cell exercise, cell environment, cell protection,
and a healthy mental attitude–are all it takes to regain and maintain your health. You
will find that living the Healthy Cell Concept encompasses the following ways to reduce
your risk.

Paying attention to all risk factors
may help in combating the “unchangeable” risk factors of age, sex, and heredity.
For example, one of the reasons men are more at risk for CVD than women may be because, on
average and historically, they have smoked more and dealt more with job-related stress.
The trend is now changing. Incidences of CVD in women are rising, and more women than men
are now dying from CVD: In 1995, about 455,000 males and 505,000 females died from CVD.
This may be because women are smoking more and are being subjected to more stress after
entering the job market.

wpe173.jpg (4100 bytes)Stopping smoking limits your
risk of cancer, emphysema, heart attack, and stroke (not to mention you won’t smell
like an ashtray).

Lowering your weight can raise
your “good” cholesterol level and lower your “bad” cholesterol level.
It also helps prevent diabetes and strengthens the heart.wpe17B.jpg (4406 bytes)



Exercising has the same
benefits as losing weight and, hey, helps you lose weight!


Changing your diet is one of the biggest things you can do. Avoid foods high
in cholesterol, saturated fat, trans-fatty acids, and all fat-doing so will reduce
cholesterol levels, reduce risk of cancers, and help you lose weight. Eat more fruits,
vegetables, and fiber. This again helps maintain healthy cholesterol levels, and
substances found in fruits and vegetables known as phytochemicals work to prevent cancers.
Fiber lowers cholesterol and is linked to lower incidences of some cancers and heart
disease. It can also help you lose weight. Decreasing your sodium intake and increasing
your potassium intake can help you maintain a healthy blood pressure.

Using supplements (and foods) high in
antioxidants may help prevent CVD. Folic acid and B vitamins combat a high homocysteine
level. Garlic and ginkgo both aid circulation in general, and garlic has been shown to
reduce cholesterol levels and blood pressure. Coenzyme Q10 helps in the manufacturing of
energy, improves quality of life for those who have suffered heart problems, and may help
lower high blood pressure. Fish oil reduces triglyceride (a type of fat) levels and may
help reduce the incidence of coronary heart disease. Tocotrienols reduce cholesterol
levels and may help prevent breast cancer. Vitamin E may reduce risk for CVD.

Practice stress reduction exercises.
Doing so can result in lower blood pressure, less incidence of CVD, and a stronger immune


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