Statins and Coronary Artery Disease

Discovered in 1967 in Japan, Satins (HMG CoA reductase inhibitors)have revolutionised the treatment of coronary artery disease by lowering the blood cholestrol. This in turn leads to a reduction of the incidence of artery blockage (artherosclerosis), angina pectoris, heart attck and stroke.

Cholestrol in our body is produced through both synthesis within the body itself (internal or endogenous) and external food sources (exogenous). Hence common sense would tell us that while strict diet control is highly recommended for those having high cholestrol prolem due to exogeous factor,it is going to be futile for problem due to the endogeous nature.

All the fatty foods and cholestrol from our food would eventually end up in the liver where they are stored. Please bear in mind that cholestrol is also being produced by this very important organ,liver. Nature has created such a wonderfully structured organ to allow it to synthesize cholestrol endogeously that is needed for the production of cell walls, vitamin D and bile salt etc.

While controlling exogenous cholestrol by adhereing to the right diet, we could also reduce and control the production of endogeous cholestrol in the liver. This is where Statins come in very useful.

In most biochemical reactions, including cholestrol synthesis, enzymes are needed to act as catalysts. In the case od cholestrol synthesis, such enzyme is known as HMG CoA reductase. If this enzyme is retarded, neuralised or inhibited, production of cholestrol by our body could be reduced.

Statins are inhibitors of HMG CoA reductase. They specifically reduce the level of LDL cholestrol. LDL is low density lipotrotein that is commonly known as the bad cholestrol as opposed to HDL (high density lipoprotein)which is the good cholestrol.
LDL cholestrol has the tendency to deposit cholestrol in the artery walls,causing inflamming and eventually blockage of the artey.

On the other hand the good HDL cholestrol help to remove the unwanted cholestrol from the artery wall.

Like all medications, Statins could produce side effects. Although the advantages outweighs disadvantages, doctors must be consulted before starting a course of Statins.

What is Angina Pectoris?

A heart attack isn't the only result of coronary artery disease. Chest pain called Angina Pectoris also can occur. Angina is a symptom of a condition called myocardial ischemia, which occurs when the heart muscle (myocardium) doesn't get as much blood (hence as much oxygen) as it needs for a given level of work. Lack of blood supply is called ischemia.

Angina pectoris can occur when blood circulation to the heart is sufficient for normal needs but inadequate when the heart's needs increase, such as during physical exertion or emotional excitement. Running to catch a bus, for example, could trigger an attack of angina while walking to a bus stop might not. Some people, such as those with a coronary artery spasm, may have angina when they're resting. Angina can be a warning sign that someone is at risk of heart attack.

Simple Diet for Arteriosclerosis, Coronary Thrombosis and Heart Attacks

Based on experience in Asian countries like Japan and Korea, it'd be prudent to try the following as possible diet to prevent coronary thrombosis, arteriosclerosis and heart attack:

1) Avoid animal fats, meat, eggs and dairy products. For cooking oil, use only unrefined vegetable oil e.g. corn oil, palm oil, sunflower oil and safflower oil. Reduce the consumption of protein as well as fats. If you can't avoid cheese, take only the soft cottage cheese.

2) Take brown rice as frequently as possible.

3) Take fresh vegetables and fruits daily. Include wheat germ oil. ( To many, taking vegetables and fruits in the same meal could lead to flatulence. If you tend to have gastric disturbances, avoid taking the two together and see the difference )

4) Iodine is good in preventing arteriosclerosis hence taking plants rich in natural iodine would be beneficial. One good example is seaweed. Other herbs with medicinal value are cress, horseradish, leeks, ginko biloba and the old faithful garlic.

5) Cut down the intake of salt as this would raise your blood pressure. Replace table saly with sea salt.

Hypertension and Arteriosclerosis

The layman's term of "hypertension" is high blood pressure which is an important causative factor in coronary artery disease and stroke. Hence we have to know what blood pressure is normal. Also, we have to understand the terms,"Systolic" and "Diastolic". The former refers to the pressure of blood being forced out of the heart when the heart beats or rather pumps while the latter refers the pressure in the blood vessels when the heart is in a resting state i.e. the time between heart beats.

The normal range for systolic blood pressure is 100 - 139 millimeters of Mercury (mm Hg)while the normal range for diastolic blood pressure is 60- 89 mm Hg.

Any thing beyond these ranges are considered high and the person concerned is said to be having hypertension.

In severe cases of hypertension, systolic pressure can be as high as 220 mm Hg, or higher and the diastolic blood pressure can rise to as high as 140 mm Hg. This often lead to a heart attack or stroke if the patient is not immediately treated and managed.

When the artery walls becomes hard and thickened we get a condition called "arteriosclerosis". Hypertention accelerates this damage which in turn would lead to
deposition of cholesterol plaque, another condition termed "atherosclerosis". This is very seriouse as it could result in a stroke or heart attack because of failure of blood supply to these organs due to the narrowing of the arteries. In many cases, the kidney is also negatively affected resulting in an unwanted buit-up of toxin in the body.

As the blood vessels continue to narrow over time due to atherosclerosis, the heart is forced to work extra hard to push and distribute the blood increasing further the blood pressure. If no intervening remedial action is taken, the heart that is now working too hard begins to enlarge ( cardiac hypertrophy ) and eventually fail
( Congestive Heart Failure ).

The incredible heart

The heart in the human body must be one of the best egineering designs in the world. Where else can you find a machine that's running 24 hour a day, 360 days a year for an average of about 60 to 70 years without ever having to stop for maintence work?

When we studt the structure and the muscles making it we cannot help but wonder at such a bewilding design. Thousands of fibres (fibrils)come into play to ensure the elasticity of the muscles of the heart. Coupled with this are a complex network of nerves and blood vessels.

Despite this almost miracle-like structure, problems still and do occur!