The gravity of cardiovascular health cannot be understated with both fitness clientele and our general population. If lifestyle factors are not addressed, the development of plaque in the arteries increases the risk of heart events. There are two schools of thought regarding the potential for arterial plaque, or artherosclerosis, can be reversed: the first believes it can only be stalled out, and the other contends that plaque formation can indeed be reversed.
Share these two opposing camps with your clients that are high risk for or diagnosed with any form of heart disease so they may discuss with the care provider, noting that fatty streaks in the arteries can start as early as age 10; by the age of 35 coronary artery disease develops due to atherosclerosis1.
There is a dirth of articles that can be accessed via PubMed under the topic of atherosclerosis. Key authors that provide highlights from their research are cited below for convenience of comparison. In effect, you will be able to decide whether the only way to prevent plaque progression, once formed, is with statin drugs; or, whether the plaque formation can be reversed by using
Camp 1: Plaque Progression Can Be Halted, Not Reversed
Dr. Howard Weintraub, a cardiologist at NYC Langone Medical Center notes that atherosclerosis is evident in individuals with hypertension, diabetes, and high cholesterol. This collection of conditions is consistent with what is known as Syndrome-X (obesity, hypertension, and high LDL).
His studies purport that the most one can do is prevent plaque progression, i.e. stop plaque from growing. He notes dietary changes can be used to prevent atherosclerosis from getting worse. He also posits that plaque reversal cannot occur. His position includes statin drugs to lower LDL which he believes will prevent plaque from growing. His protocol also includes exercise and diet to reduce hypertension and high cholesterol.
Adding to Dr. Weintraub’s information that was reviewed by Dr. Payal Kohl, MD, FACC is Rena Goldman’s2 information on dietary changes needed to prevent atherosclerosis to include:
- decrease sugar intake
- eat more fiber
- eat healthy fats
- eat leaner cuts of meat
- avoid trans fats
- limit saturated fats
- limit sodium intake
- limit alcohol intake
While all excellent practices to improve overall health, the suggested lifestyle changes are not believed to reverse plaque already formed in the arteries. Rather these lifestyle changes are used to prevent progression of plaque growth. In effect, Dr. Weintraub asserts that arterial plaque requires the use of statin drugs in addition to these changes to halt progression.
Camp 2: Plaque Can Be Reversed
Dr. Michael Greger, MD believes that the body moves forward in the spectrum toward health when provided the opportunity, i.e. the body has an innate direction to heal itself given the correct conditions.
The following resources can be studied in developing one’s own decision of plaque reversal.
(1) Hibiscus Tea vs. Plant-Based diets for Hypertension. (Additional resources by Dr. Michael Greger)
(2) The Cardiovascular Cure. John P. Cooke, MD, PhD.
(3) No More Heart Disease. Dr. Louis J. Ignarro.
(4) The Arginine Solution. Robert Fried, PhD, Woodson C. Merrell, MD.
The aforementioned books and NutritionFacts are summed up by Dr. Jay Wilkins, ND in his YouTube presentation: Nitric Oxide Your Body’s Best Medicine. In his presentation, he concludes that plaque can be reversed.
One pivotal study was done by Dr. Louis J. Ignarro, MD and Dr. Cooke, MD (Head of Cardiovascular research at Stanford) which demonstrated plaque reversal in control rabbits fed a high cholesterol diet with the addition of arginine and citrulline, the amino acids necessary for nitric oxide formation.
To prevent cardiovascular disease exercise plays a part in reversal of arterial damage which primarily becomes causative based on our lifestyle and what we eat. Habits such as smoking, eating processed foods, and sugars will cause fatty streaks in the arterial wall and damage.
The amino acids L-Arginine and citrulline are precursors to nitric oxide that relax the artery and reverse arterial plaque. The following supplements have also been professed to affect LDL cholesterol, promote HDL, and/or relax the artery:
- Nettle cleans cholesterol stagnation. Nettle molecules knock down plaques from the walls of blood vessels, like tiles from walls during repairs. But cholesterol still remains in the blood vessels; it can not move on its own. That is why the second stage is needed.
- Nettle is complimented by Hawthorn extract molecules. Hawthorn – a plant of the rose family – captures the “broken” cholesterol molecules caused by nettles and together they turn cholesterol into useful lipoproteins. These newly formed proteins remove cholesterol from the blood vessels. At this point, fat is burned and energy is released – you feel a surge of strength, health improves.
- Vitamin B1, Thiamine finds blood clots and dissolves them. The remaining calcium is swept away from the walls of blood vessels and no longer threatens to injure veins, arteries and capillaries. The risk of a heart attack drops to zero. Thiamine was shown to have a statistical significant reduction in thrombosis. [Critical Care. 25. Article number:223 (2021). Khalid Al Sulaiman, et.al.].
- Vitamin B2 has a calming effect on the walls of blood vessels. Those that were compressed without normal blood flow return safely and smoothly to normal. Headaches disappear, the tinnitus subsides, the lungs and bronchial tubes work perfectly. Riboflavin is beneficial for adults with methylenetetrahydrofolate (MTHFR) gene mutations.
- Niacin, Vitamin B3: niacin raises HDL, which helps remove the LDL from the arteries. HDL will remove extra cholesterol and plaque buildup in your arteries sending the arterial debris to the liver where the liver expels it from the body.
- Magnesium prevents muscle spasms in heart blood vessels. Further magnesium prevents calcium buildup in the cholesterol plaque in the arteries. Recall the stiffening of the arteries with plaque will occur as calcium is deposited in the arteries, rather than bones.
- Healthydirections.com is the website for Dr. Stephen Sinatra. Dr. Sinatra supports heart health with the use of Coenzyme Q10 (Ubiquinol), D-Ribose, and L-Arginine.
Medical professionals, specifically cardiologists, have noted that fat streaks occur in one’s arteries as early as the age 10. Further by the age of 35 cardiologists conclude that atherosclerosis will develop based on our lifestyle and diet. Because of these facts, it is important to have a complete physical before engaging in any exercise program.
A physical may not uncover heritable conditions such as Hypertrophic Cardiomyopathy, coronary artery structure abnormalities; and/or Long QT heart rhythm disorder (usually uncovered by an EKG). Any heritable abnormality to the heart will prevent the individual from engaging in competitive sports.
In the absence of heritable heart abnormalities, there is a propensity for our lifestyle to lead to atherosclerosis. The etiology of the cause of atherosclerosis was presented. The areas of the artery that are involved in atherosclerotic plaque are the intima/ lumina and tunica/media. Two viewpoints were presented.
The first that plaque formation cannot be reversed and the best way to prevent plaque progression is by the use of statin drugs, diet and exercise. The second position is that plaque can be reversed given the correct conditions of supplements, lifestyle change, and nutrition.
The research references have been presented for both positions regarding plaque/atherosclerosis. From these technical take-aways and resources, it is hoped that you now can perform an informed decision regarding your heart health.
Finally, Syndrome-X can be ameliorated by the advice laid out in The Diabetes Code by Dr. Jason Fung. Excess sugar is stored as fat and fat cells promote an inflammatory response. High sugar foods make your liver synthesize bad (LDL) cholesterol and will lower your good (HDL) cholesterol. HDL acts like a vacuum cleaner sweeping up LDL.
- American Journal of Clinical Nutrition, Vol. 72, Issue 5, Nov. 2000, PP 1307-1315
- Healthline, Oct. 27, 2021