Atherosclerosis

Introduction

Atherosclerosis in a nutshell is a ‘biological plumbing problem’ in arteries that feed blood to the various organs where ‘crud’ builds up causing blood flow restriction and the arteries harden over time and some cases the artery or vein can become completely blocked.

Specifically it is the arterial network that nourishes the heart called the Coronary arteries that can cause life threatening situations. 

So an informed person decides to visit his local physician for an annual checkup and after the examination he asks :

“ What causes blocked arteries “  and the physician replies in an educated manner

“ Atherosclerosis is caused by high blood pressure”  the man looks perplexed, the physician in a serious voice asks “ Why do you look doubtful ? ”…

”sorry doc..what else ?” and the physician replies

“ High cholesterol and/or high triglycerides in the blood “.  the man looks even more bewildered…

”sorry Doc can you explain how high blood pressure and high cholesterol can cause blocked arteries ?”  and the physician replies:

“There are literally hundreds of studies that prove this to be the case and that’s why we prescribe these cholesterol lowering drugs and these blood pressure tablets to keep you alive and healthy..you don’t want to have a heart attack do you ??”.

“ I was always under the impression that it was inflammation that causes atherosclerosis” said the person sounding just as educated as the physician, and the causes you have just stated are just symptomatic consequences?”  so the physician at this point becomes enraged saying

“ Look, I don’t have time to chit chat with you, is there anything else ?” and the person with ‘his tail between his legs’ says:

“ No that’s all” and leaves

Clearly, physicians time is valuable so under normal circumstances he would have time to talk to you, but he is too busy saving lives, which is probably why he became angry because he was in a hurry to see the next patient..and save their life to.  The question is who is right ?..lets us explore this.


The Heart (Biomechanical dual speed pump)

It is well documented that Atherosclerotic Arteries feeding the heart have the potential to starve the heart of blood and cause a ‘heart attack’ as well as  atherosclerotic arteries feeding the brain have the potential to trigger a ‘stroke’.

Atherosclerotic peripheral vascular conditions can cause blood starvation to the extremities ( legs, arms etc) and atherosclerotic arteries to the kidneys cause high blood pressure and kidney failure.  

The number one killer of our modern society is Coronary heart disease (CHD) which shows itself as Angina Pectoris a condition that is caused by the narrowing of the coronary artery ( right and left coronary artery locations shown in diagram below ) or Heart Attack ((Myocardial infarction) when the coronary artery is completely blocked.

The Heart is a ‘biomechanical’ dual speed pump’.  

The right side of the heart is a pulmonary circuit pump.

The heart receives oxygen poor blood from the Systemic Circulation ( from arteries/veins/capillaries etc) of the body via the Superior and Inferior Vena Cava ( the 2 big pipe receiving chambers upper and lower shown in the diagram) which then makes its way to the left and right pulmonary arteries carrying blood ( O2 poor CO2 rich) to the lungs.

The lungs oxygenate the blood and off loads the carbon dioxide from it, and then the oxygen rich blood ( O2 rich CO2 poor) drains from the lungs and returned through the 4 pulmonary veins.

This is the slower less powerful (low pressure) side of the heart pump called the Pulmonary Circuit for gas exchange and blood oxygenation.

The faster more powerful side (discharging chambers) of the heart pump is the Systemic circuit supplying oxygen rich blood and nutrients to the entire body out of the Aorta and into the systemic circulation via arteries and veins.

Essentially, the heart has 4 chambers and 2 ventricles, the right ventricle is the pulmonary circuit pump, and the left ventricle is the systemic circuit pump.  Four valves within the heart maintain a one way directional blood flow.

The Myocardium

The heart muscle is a 3 layered structure consisting of thick bundles of cardiac muscle cells called the Myocardium sandwiched between an outer layer called the Epicardium and part of the Pericardium ( the sack that protects and lubricates the heart allowing the heart to beat easily in a relatively frictionless environment) and the inner layer called the Endocardium that line the heart chambers.  

The Myocardium is the intriguing, even remarkable section of the heart muscle with its thick bundles of muscle cells twisted and whorled (convoluted structure) into a ringlike arrangement as shown in the diagram below.

When these bundles contract they move longitudinally ( from apex to base ) and radially ( side to side movement) in a twisting motion squeezing out the maximum amount of blood for every heartbeat.  

These movements mimic the ringing out of water from a wet cloth.

The heart when looked at from a frontal view appears twisted because it follows the contours of the myocardium cell bundles.

I refer to this section as remarkable because unlike skeletal muscle that requires nerve impulse stimulus, the heart muscle contracts spontaneously and independently even if all nerve inputs were severed.

Furthermore, different muscle cells in the heart beat with different rhythms, the Atrial cells (within the Atrium) beat about 60 times/minute while ventricular cells ( within the ventricles) beat more slowly at around 20-40 times/minute.

Heart Muscle Coordination

This mass of tightly woven cellular bundles are designed to contract the heart muscle proper coordinated by 2 systems that regulate heart activity.    

The first system is the Autonomic Nervous System (ANS)  and the second is the Intrinsic Conduction System (ICS).  

The ANS regulates the speed of the heart beat using the Sympathetic branch as an ‘accelerator pedal’ in response to a ‘fight or flight or exercise request, while the Parasympathetic branch slows everything down after exercise or a neutralised threat acting as the ‘brake pedal’.

The ICS is built into the heart tissue, and the actual tissue that the ICS is built from cannot be found in any other tissue in the body, constructed of a material which is a cross between muscle and nerve tissue.  

As the name suggests it is an electrical conduction system that causes the heart to contract.

As shown in the diagram below, an initial ‘pacemaking’ impulse signal that originates from the Sinoatrial node (SA) travels from the right atrium to the atrioventricular node along the atrioventricular bundle (His) stimulating a heart contraction of approximately 75 beats/minute .first to the right and left atriums and then the right and left ventricles and through the purkinje fibers, and heart muscle cells, located in the myocardium allowing blood to be pumped around the body.

This impulse signal travels right to left and also perpendicular into the surrounding muscle and cardiac (heart) cells as shown by the dark blue arrows.

Electrical Conduction

The diagram above shows a ‘blown up’ depiction ( inside the circle to the right ) of the Sinoatrial node SA and its fibers as blue colored square negatively charged cells ( approx 90 mv on the outside membrane of the cell, and 60 mv inside ).  

The surrounding dark red square which are negatively charged cells represent the surrounding muscle tissue.

When the impulse signal is initiated it is a unidirectional depolarization signal  (meaning that the negatively charged cells become more positive) that propagates to every cell in the SA and the surrounding muscle cells (Myocytes) throughout the heart causing contraction.

This signal propagation process displays a functional Syncytium meaning that this latticework of tightly bound cells allows the spread of one initial impulse signal across all the cells within the network; a truly ingenious design using non impulsed movement to generate energy to drive an organ. 

The ICS and ANS work together

The ICS and the ANS work in conjunction with each other, where the induced sympathetic/parasympathetic nerve signals are noradrenaline/acetylcholine respectively.  

These signals bind to the membrane of the Sinoatrial Node (SA) membrane increasing the flow of NA+ (Sodium) and K+ (Potassium) ions into the SA cells increasing the heart rate/and allowing more K+ ions to exit the cell making the membrane more negative and thus slowing the SA down and decreasing the heart rate, regulated by the parasympathetic branch of the ANS.

This is why the SA is referred to as a ‘Pacemaker’( Martin Flack a British medical student discovered the SA in the heart of a mole in 1907).

Again we witness these Sodium/potassium pumps that decorate every cell and the need for a high dietary intake of Potassium ( Recommended Dietary Intake = 4700mg.day) to drive the millions of pumps that exist on every cell.

The Coronary Arteries

Although the heart chambers are bathed with a continual flow of blood this does not nourish the heart muscle itself including the all important Myocardium, but it is the Coronary Arteries that are responsible for this function, supplying the heart muscle proper with a blood supply.

These crucial arteries branch from the base of the aorta and encircle the heart within an atrioventricular groove.  

If the main arteries become partially blocked then the pump itself runs in-efficiently, but if the coronary arteries become partially blocked then this is more serious causing Angina Pectoris or a Heart Attack ( Myocardial infarction) when the coronary artery is completely blocked as mentioned earlier.


Understanding Atherosclerosis

Destruction of the culprit and containment

So now you know how the heart functions, let us discuss what atherosclerosis is.  Simply, Atherosclerosis is the buildup of crud ( officially called an atherosclerotic plaque) in an artery either blocking or partially blocking blood flow.

An Atherosclerotic condition is initially and continually triggered by INFLAMMATIONIT IS NOT…I REPEAT, NOT CAUSED BY HIGH CHOLESTEROL OR HIGH BLOOD PRESSURE OR CONSUMING HEALTHY FATS. 

Cholesterol can be problematic if it becomes oxidised and not scooped up by HDL particles to be recycled, but this process is interfered with if chronic inflammation exists.

As the inflicted artery becomes more blocked, the heart needs to pump harder to deliver the same amount of blood around the body, and as a consequence the blood pressure increases.

So high blood pressure is a consequence, not a cause.  Similiarly, cholesterol like blood pressure is also a variable in the body depending on daily requirements, so, if the damaged artery, once repaired, is still being damaged then more cholesterol will be delivered in VDL/LDL packets, so high cholesterol is a consequence, not a cause.

Also it must be appreciated that ATHEROSCLEROTIC PLAQUES OCCUR WITHIN THE INNER LINING OF THE ARTERY, NOT INSIDE THE ARTERY ITSELF.  

The Inflammation process

When our bodies become injured like a wound or a cut, the body’s response is to immediately trigger an inflammatory response to alert and recruit the necessary emergency response teams to the site of injury.

In its infinite intelligence, the body elicits the aid of the immune system to take care of the cause of injury by destroying the invader and/or ‘mopping up’ upon arrival on the scene.

What actually happens is that the liver synthesises a protein called C-reactive protein that floats around in the bloodstream in an inactive state, however, when this protein encounters dead cell debris it binds to a special phospholipid located in the cell membrane.

This action activates the Innate Immune system’s ‘Complement system’ ( in reality the C-reactive proteins are actually part of this Complement system ) via C1 Complex that then recruit phagocytic cells which consume microbes and damaged cells and attack the cell membranes of pathogens that might infect the damaged tissue.

Doctors can measure C-reactive protein counts in the blood plasma as an indicator of internal inflammation.

During this time, blood platelets that contain thrombin receptors on their surfaces bind serum thrombin, converting fibrinogen into Fibrin that ‘walls off’ the injury site preventing it from spreading.

Once the preliminaries are complete, (destruction of the culprit and containment), the repair process can get underway.

In the case of a wound, the ‘walling off’ process also ends as a clotting of the blood to seal the wound and stop the flow of blood, so it is actually a repair process

Fibroblastic repair

The example just described is a typical wound on the outside surface of the body, but what happens if the damage is internal where the Endothelium, a thin layer of cells that line all of the blood and lymphatic vessels throughout the entire bodies circulatory system is compromised?.  

This can occur during an inflammatory condition, causing cell destruction, that requires repair.

This repair process involves the growth of granulation tissue (new connective tissue) that is installed by special cells called Fibroblasts whose purpose is to establish and maintain the structural integrity of connective tissue and creating the extracellular matrix ( e.g the endothelial lining and basement membrane lining blood vessels ).

The granulation tissue is mainly collagen and cholesterol.  

The natural cordial relationship of Inflammation and Repair becomes adversarial

This natural partnership of inflammation and repair works like ‘clockwork’ in a healthy body but what happens if the inflammation does not cease after repair, then the partnership becomes adversarial and over time it is a constant flip-flop between inflammation and repair. 

It becomes a constant battle between inflammation and repair and it’s up to the host to decide the victor.  

Now you can appreciate why atherosclerotic plaques are formed, because the damage site becomes a battleground between inflammation and repair, and in turn the plaque begins to accumulate over extended periods ( years ).

This plaque over time is like an ulcerated erosion of the arterial wall covered over by a mixture of cellular debris (necrotic tissue), calcium, fibrin, foam cells (fat laden macrophages that consume debris of damaged tissue, microbes, toxins and chemically damaged fats resulting in a fat macrophage that has had a ‘blow-out’ meal ).  

This crumbly fatty plaque deposit of dead immune cells ( Sacrificed trying to heal incessant damage ), toxins, oxidised cholesterol  (which should have been removed by HDL transports from the liver ) and other chemically changed lipids, potentially break off into the bloodstream blocking a smaller blood capillary downstream.

The reason why part of the plaque ( which is basically weakened collagen) breaks off is, because atherosclerotic plaques stimulate collagen enzymes ( collagenase) which begin to dissolve the fibrous collagen cap covering the plaque, again in an attempt to clear the debris, not knowing that the damage/repair process is still raging.

Cholesterol marked for death

There is a plethora of information, and I have even written about it in previous articles, about the cholesterol clogged artery myth which plenty of people still believe, but I do not want to go into any detail here.

Suffice to say, that in any event in life, anybody or anything found at the scene of a crime is instantly a person of interest, or a suspect, so any atherosclerotic plaque examined in a dead body will contain cholesterol so ignorance is bliss and cholesterol is accused of being complicit in the crime ( death in this case).  

This plaque will inevitably contain dead cells and what are dead cell membranes made of ?..Cholesterol. 

Equally, what is required to repair the Endothelial damage ?. new tissue cells, and what are the membranes of new tissue cells made of ?,..Cholesterol...simple isn’t it ?.

But these biological facts do not sell chemicals to prevent cholesterol being a part of the body’s processes.

Antioxidants are an essential part of the inflammatory response

Furthermore, during an inflammatory response many free radicals are created..how?..the immune cells use free radicals as ordinance to kill infectious agent and toxins, and like any free radical they need to be neutralised by antioxidants.  

So antioxidants are also an essential part of the inflammatory process and guess what the body uses as an antioxidant in this case?…Cholesterol.

Like all antioxidants, they become oxidised themselves (converted to a free radical) which themselves have to be converted back to into an antioxidant.

To rescue the damaged cholesterol the liver sends an HDL ( high density lipoprotein ) to scoop up the damaged cholesterol and return it to the liver to be recycled.

However, if the liver is weak or malfunctioning this may not happen and the greedy phagocytic ( macrophage ) foam cell will consume the damaged cholesterol which will end up on the atherosclerotic ‘dung heap’.

In addition, poisonous processed food containing chemically damaged lipids ( such as oils) which the body cannot use, also ends up on the meal table of the foam cell.

Other essential antioxidants

The major antioxidant that the heart, liver and kidneys use for oxygen utilization and energy production, along with every cell in the body, specifically used in the ATP transport chain, which we have discussed in previous articles, is Coenzyme Q10.

This crucial substance supports optimal pump performance, maintains healthy vessels walls and maintains a healthy oxidative state for cholesterol.

Our own body synthesises it through the mevalonate pathway..yes the same pathway that synthesises cholesterol which gets suppressed if you accept the statin drugs from your local physician.

However, it is contained in dietary foods such as liver, beef, sardines, mackerel, spinach, brocolli, and cauliflower.

Polyphenols (Anti-Antiatherosclerotic)

A number of studies have shown Polyphenols to have some protective effect on the incidence of coronary heart disease, since, it to, is an inflammatory condition with links to LDL oxidation that polyphenols inhibit.

Quercetin (Flavanol) in onions are potent inhibitors toward the progression of atherosclerotic plaques and inhibiting the expression of Metalloproteinase 1, an enzyme involved in the breakdown of extracellular structures causing arthritis and metastasis.

In some studies, polyphenol substances have inhibited platelet aggregation providing a anti-thrombotic effect.

Catechin in black tea increase the dilation of arteries and hence lowers blood pressure, while red wine (Resveratrol a Stilbenoid or polyphenol subclass) ) counters endothelial dysfunction.

Hesperitin (Flavanones ) and the Flavonol Rutin increase the strength of blood vessel walls potentially lowering blood pressure.

Another study involved a mix of Oregano, Rosemary, Garlic, Ginger and Black Pepper was found to improve vascular function.

I have recreated the following chart on Polyphenols that was first published in the article series ’90 Essential Nutrients’ Part 9:

THE CAUSE OF  INFLAMMATION

Whatever nasty metabolite or free radical produced internally, or toxic substance, pathogen or any other uninvited guest that we ingest, will all ultimately end up in the bloodstream.

Since, not one of these substances are passive and will go quietly, but will start to attack anything within its vicinity and that is the endothelium as it passes through the bloodstream.

As described above the C-Reactive protein patrols of the complement immune system call for ‘backup’.:

“the bastards have damaged part of the endothelium..summon the clean-up and repair crews immediately”.

The endothelium is not just the inner lining of a blood vessel, it is so much more; some regard it as an organ in itself, controlling blood coagulation, including the creation and dissolution of blood clots, controls muscle tone of the arterial walls, produces hormones to establish local cellular communications, controls electrolyte balance in the tissues, regulates blood pressure, blood sugar, and blood movement and plays a role in immune system activation.  

‘So the Endothelium is a pipe with a whole lot of intelligence and function’.

Substances and materials that damage the endothelium

A myriad of substances can cause damage to the endothelium creating endothelial dysfunction compromising one or more of its functions.

Since our skin absorbs what is placed on it, any pharmaceutical patch or cream is poisonous to the body potentially causing epithelial dysfunction.

Pharmaceutical drugs enter the bloodstream before intestinal absorption where the liver destroys most of it.  I always remember Dr B saying ‘If man made it don’t eat it’, which also applies ‘if man made it don’t put it on your skin’, so the use of fluoride toothpaste, chemically produced shampoo, bubble baths, shower gels, makeup, perfumes, deodorants, skin lotion, sunscreens and sun tan lotion which are all toxic and can damage the epithelium.

Synthetic cleaning products for the house are all toxic to the body, laundry and dishwasher pellets or powder is also toxic and can be absorbed into the skin or inhaled into the lungs.  

Outside of the home, industrial complexes handling toxic chemicals, pesticides, fungicides etc sprayed on crops are also a dangerous source of toxicity.

Municipal drinking water is unsafe and toxic either containing chlorine or fluoride or both are toxic to the body.

Processed food, fast food contain many toxic chemicals and have no nutritional value anyway so they should be avoided like the plague.

This ‘food’ simply pollutes our bodies not feed or nourish it.  

Maintaining gut health is crucial since pathogenic microbes are commonly found in atherosclerotic plaques including herpes Zoster and helicobacter pylori that originate from any infected site.

Furthermore, hundreds of toxic compounds are produced by an unhealthy gut flora where the commensal or pathogenic flora overgrow and take over lead position against the beneficial gut flora.  

Once these pathogens get into the bloodstream they will begin to attack the endothelium.

This is why you need to take the 90 essential nutrients that help the body defend and repair itself, particularly the area of discussion, the endothelium.

Nutrient deficiency causes many chronic diseases including atherosclerosis because your allowing the body to heal itself with a deficient tool set.

Excess homocysteine appears in the bloodstream due to deficiency in Vitamins B6,B12 and Folic acid, and it will damage the endothelium.

Another example is excessive amount of Lipoprotein A due to a Vitamin C deficiency which will also damage the endothelium.

Furthermore, you have all heard of scurvy, a Vitamin C deficiency condition that causes bleeding gums ( Gingivitis), Anaemia, and skin haemorrhage, varicose veins which are all related to weak blood vessels and endothelial dysfunction.  

Another Vitamin, E is a healing vitamin ( mushrooms and raw wheat germ is a rich source) which also assists in tissue healing.   

Lack of sun exposure will also cause injury to the epithelium because of the deficiency of Vitamin D, a Vitamin that all body tissue and organs cannot survive undamaged, without it.

So basically, everything you know to be ‘antibody’ that  includes a sedentary lifestyle, lack of exercise, excessive stress, and unquenched free radicals ( lack of antioxidants ).

Arteries are composed of Collagen which is a protein that can be destroyed by excessive amounts of hormones like cortisol, so Adrenal stress can also cause endothelial dysfunction.

In addition an impaired liver function that prevents the production of enough growth hormone as well as the lack of returned oxidised cholesterol as explained above can also be a contributing factor toward atherosclerosis.

So let us rewind that discussion from the introduction :

“ What causes blocked arteries “  and the physician replies in an educated manner

“ Atherosclerosis is caused by high blood pressure”  the man looks perplexed.the physician in a serious voice asks “ Why do you look doubtful ? ”…

”sorry doc..what else ?” and the physician replies

“ High cholesterol and/or high triglycerides in the blood “. the man looks even more bewildered…

”sorry Doc can you explain how high blood pressure and high cholesterol can cause blocked arteries ?”  and the physician replies:

“There are literally hundreds of studies that prove this to be the case and that’s why we prescribe these cholesterol lowering drugs and these blood pressure tablets to keep you alive and healthy..you don’t want to have a heart attack do you ??”.

“ My humblest apologies ( you have to precede with this statement because most physicians are very proud people who resent being told they are wrong) but it’s my belief ( you have to say this and not to infer that it is a fact known by most people except your doctor which will definitely ‘piss’ him off ( excuse my slang) ), that  inflammation causes atherosclerosis. Inflammatory causes can come from toxic chemicals such as household products, pesticide laden fruits and vegetables, chemically laden processed and fast food, a dysbiotic gut, excessive free unquenched free radical production, without adequate antioxidant activity, impaired adrenals and/or liver, poisonous municipal drinking water, sedentary lifestyle, lack of exercise all contribute to endothelial dysfunction.”.  “Furthermore, we need cholesterol not only as an antioxidant but as the bodies natural healing material, to heal the endothelial damage in concert with collagen which can also be destroyed by adrenal stress and excessive production of cortisol “

At this point, the physician will either tell you to ‘go forth and multiply’ or he will say “I am impressed, tell me more…but I DOUBT IT”.

Conclusions

So you have a choice, avoid atherosclerosis altogether, help the body repair it if you have it, or just let it progress into an out-of-control inflammatory response that can lead to a heart attack.

Your dietary choices are everything to avoid this condition, and if you have it or suspect you have it stop what you are doing and change your diet and your toxic, nutrient deficient lifestyle and live in comfort, devoid of fear that your body is going to fail you.

Eat health giving animal fats (butter and cheese from grass fed healthy beasts), and plenty of life sustaining, cleansing vegetables and fruit, whole or in juiced or blended form..and if you crave the odd doughnut or a piece of pizza eat it once a month if you really need it, I think the body can handle it in an already HEALTHY INDIVIDUAL..


References/Acknowledgments :

  1. Essentials of human anatomy & physiology Elaine Marieb Book 2000
  2. Put your heart in your mouth Dr Natasha Campbell Mcbride Book 2014
  3. Cardiac muscle, Sinoatrial node, electrical conduction of the heart, C-Reactive protein, Granulation tissue, Fibrin Wikipedia
  4. Depolarization Khan Academy
  5. The new body type guide Eric Berg DC Book 2017

Author : Eric Malouin