What is cardiovascular disease?
Cardiovascular disease (CVD) is the general term for blood vessel disease of the heart or body. CVD is the most common disease process in Western society and the financially well-off sections of developing countries. Blood vessel disease, called atherosclerosis, is the build up of atheroma or plaques along arterial walls, which leads to narrowing or complete blockage of the artery. Significant narrowing reduces the amount of arterial blood to an organ or body region, causing tissue hypoxia, reduced cell metabolism, and organ dysfunction.
In Australia, CVD is a very common and serious disease with about 3.5 million people reporting having the condition in 2007-08. Even though diagnosis, prevention, and treatment methods have improved considerably of late, CVD remains the cause of more deaths than any other disease – about 50,000 in 2008. CVD cost the health budget about $5.9 billion in 2004-05, making it Australia’s most expensive disease.
In Australia, people in lower socioeconomic groups, Aboriginal and Torres Strait Islander people, and people living in remote locations, are more likely to be affected by CVD compared with the rest of the population.
There are four main types of CVD, which cause ischaemia or a lack of blood flow.
- Ischaemic heart disease of coronary artery disease can cause a myocardial infarction or heart attack.
- Cerebrovascular disease (of the brain) can cause a stroke or cerebral infarct.
- Peripheral artery disease of the arms and legs can cause claudication (calf pain with walking), distal tissue atrophy, and in severe cases gangrene.
- Renovascular disease affects blood flow to the kidneys and can cause renal failure.
If a blood clot forms over the atheroma, this can break off and block smaller vessels downstream. Doctors call this problem arterial thrombosis. Depending on the artery affected than can cause a heart attack, a stroke, or gangrene of a limb, foot or hand.
Conventional medical treatments doctors use to treat stroke
When a person has a debilitating stroke it can change his or her life forever. Australian hospitals now have specialist Stroke Care Units that can provide thrombolysis treatment with a drug such as alpetase, to dissolve brain clots, if the patient arrives within three hours of the stroke starting. List of Australian hospitals with stroke care units. Because these drugs have dangerous side effects, strict guidelines are in place to determine the appropriate circumstances for use. MORE>
The most appropriate treatment will depend on the type of stroke and the cause. Anticoagulant drugs, which thin the blood, may be prescribed to prevent new blood clots forming and to prevent a second stroke. Examples of blood thinning medications are aspirin, aspirin plus dipyridamole (Asasantin), clopidogrel (Plavix) and warfarin (Coumadin or Marevan).
Thrombolysis is usually successful in 75% of cases, but the treatment is not able to dissolve the blood clot in up to 25% of patients. Although blood flow is restored as a result of the treatment, 12% of patients subsequently redevelop the clot or blockage in the blood vessel, during the weeks or months following treatment.
If the cause of stroke is a narrowed or blocked carotid artery in the neck, a vascular surgeon may need to surgically remove the atheromatous plaque that caused the arterial embolus or ischaemia. This operation is called a carotid endarterectomy.
Nutritional medicine treatment after a stroke
The immediate and medium-term treatment goals are to salvage brain function and restore the patency of vessels.
Once brain tissue dies it can’t be salvaged. However, some brain tissue adjacent to the problem area might be salvageable using high dose antioxidants such as vitamins C and vitamin E and glutathione, plus other nutrients such as magnesium, taurine, adenosine and acetylcarnitine.
These nutrients can limit the size of the area that dies, and restore brain function, when administered intravenously after an ischaemic stroke.
Short-term treatment by nutritional medicine focuses on reducing platelet aggregation and stabilising the wall of the artery, after an ischaemic stroke.
In the medium- and long-term, anti-platelet medication, such as aspirin and clopidrogel, is beneficial, with several studies reporting that these agents reduce the risk of further stroke by about 30-40%.
However, there is doubt about whether or not this form of therapy alters long-term survival, with contemporary evidence suggesting no long-term advantage accrues. An increased risk of haemorrhagic stroke and gastric haemorrhage in patients on long-term therapy has been documented.
Stabilisation and partial restoration of areterial flow may be achieved by utilising the platelet anti-aggregation effect of vitamin E and omega-3-fatty acids, with additional vitamin C and flavonoid compounds such as quercetin. Two phytonutrient extracts that may also aid recovery are gingko biloba and coleus forskolii, which can reduce platelet aggregation, improve cerebral circulation, and reduce blood pressure.
The advantage of a nutrient-based therapy is that, while reducing platelet aggregation, it also promotes normalisation of vascular endothelial function and enhances tissue antioxidant capacity, with a much reduced risk of causing accidental haemorrhage.
The goals of nutritional medicine treatment of stroke are to restore brain function, reduce platelet aggregation, and stabilise the arterial wall to prevent further stroke events.