Introduction 

Atherosclerosis is a general term given to several diseases which cause a hardening and thickening of the walls of the arterial system. Hence the phrase, hardening of the arteries. Atherosclerosis begins when monocytes (white blood cells) enter the walls of the arteries in certain areas and are transformed into cells which attract and accumulate fatty deposits. These places eventually become thickened and hard and are known as atherosclerosis plaque or atheroma's. All types of arteries are susceptible; peripheral, coronary,

cerebro-vascular etc. The deposits consist mostly of cholesterol and are located predominantly in areas of the cardiovascular system that are prone to blood turbulence, such as the branches and segues.

Reduced blood flow and thrombosis become likely as atherosclerosis progresses. The long term implications are grave, and include heart disease and stroke. Atherosclerosis and its consequences result in it being responsible for more deaths than all other causes combined. In its earlier stages, the progression of atherosclerosis can be stopped and even reversed with the proper lifestyle changes and using natural treatment such as acupuncture and herbal medicine.

There is continued research into the mechanism behind the build-up of plaque. Recent atherosclerosis research has connected it to a type of inflammation response. This new understanding sheds light on why it is that elevated cholesterol levels are not necessarily the main indicator of heart disease from atherosclerosis. Not all people with high cholesterol end up with atherosclerosis, and not all people with atherosclerosis have high cholesterol.

Low grade infection now seems to underlie what was previously thought of as a simple build-up of plaque.

Certain risk factors influence the release of chemicals involved in the inflammatory process. These contribute not only to the formation of atherosclerotic plaque but to the formation of blood clots. Atherosclerosis is believed to involve substances involved in the inflammatory response and cells that are characteristic of inflammation.

Research also indicates an infection may contribute to or even cause atherosclerosis. Chlamydia has been shown to have a significant association to plaque.

Treating Atherosclerosis:

Reduction of risk factors

Smoking:

Smoking is dangerous no matter what angle one views it from. In the light of atherosclerosis, it is well known that cigarette smoking significantly decreases the amount of HDL cholesterol in the blood. HDL is the good stuff which helps get rid of LDL, the bad stuff that causes atherosclerosis. And, if that isn't enough, smoking also adds to the concentration of LDL in the blood. Furthermore, carbon monoxide levels tend to be higher in the blood of smokers which is very damaging to the arterial walls. Smoking also has a vasoconstrictive effect on the peripheral arteries which leads to reduced oxygen transport to the tissue, a situation that has another Pandora's box of consequences. Finally, smoking causes a tendency for the blood to clot, making thrombosis more likely.

This is very high on the list of bad habits that the patient needs to address. However, because it is an addiction, smoking may not be the best thing to start with. Developing other good habits and seeing positive benefits may eventually inspire the smoker to quit.

Weight loss and exercise:

Starting the atherosclerosis patient out on a modest regime of walking and practicing Tai Chi or Yoga would be a good start to better health. Like anything, it is just another habit, and we are definitely creatures of habit, for better or for worse. If the patient can become disciplined enough to do even 15 minutes of exercise per day, he will be well on his way to reaping its numerous benefits. Exercise has many positive effects on the human body, one being a healthy cardiovascular system.

Since a sedentary lifestyle and obesity often go hand in hand, an exercise regime is the first step toward lowering a patient's weight. Diet is the next obstacle and will be addressed later. High LDL levels are a by-product of obesity, so the patient must take an active role in weight management.

Weight loss and exercise also aid in lowering blood pressure. Hypertension is directly linked to atherosclerosis and therefore must be kept at normal levels.

Stress reduction:

Stress is implicated in the process of many diseases and atherosclerosis is no exception. It has been clinically proven that a reduction of day to day stress lowers both LDL levels and high blood pressure.

Stress, which comes in many forms, is often one of the reasons why we engage in destructive behaviour. There is social stress, competitive stress, stress from abuse or just plain old survival stress. These stresses lead to the build-up of uncomfortable physiological and psychological sensations. Stress release is often found in the quick fix of instant gratification such as smoking, drinking alcohol, over-eating, orgasm, obsessive-compulsive or violent behavior patterns, (even acupuncture treatments) to name a few. They all serve to temporarily release the build-up of tension in our bodies. Unfortunately, the ease of suffering is only temporary, and the stresses that we do not properly deal with continue to cause trouble. After a quick release, the uncomfortable sensations associated with stress gradually build up again.

From a TCM perspective, that is what Liver Qi depression is all about. Our Qi must move freely. Stress causes it to become constrained or blocked, leading to a host of uncomfortable feelings and syndromes. When a physical or emotional release is undergone, the symptoms are temporarily relieved. But the blockage still exists.

A physical manifestation of all of this is high blood pressure and high cholesterol levels, partly due to the functional impairment of energy circulation, and partly due to the participation in these "de-stressing" habits which contribute at a physiological level. Stress is a vicious circle, and any patient who has a lot of it ought to seek out the source and deal with it. Once this has been done, bad habits become much easier to break because they do not satisfy in the same way any more. This is where psychotherapy, spiritual practice and wholesome fellowship with other human beings can be highly beneficial. A three week vacation at a holistic health retreat could be a large part of the answer ... depending on the cash flow situation.

Diet

This is a big one. There are many foods that contribute to atherosclerosis, and many foods that can reverse its course. The choice of healthy eating is always up to the patient, but it must be stressed that this is of prime importance in dealing with their condition. To begin with, dietary changes and the taking of dietary supplements should be the first offensive.

Since hyperlipidemia is generally associated with atherosclerosis, we know that fats are implicated in this disease. Any dietary modification should pay close attention to the consumption of foods high in LDL cholesterol. And because raising the level of HDL is one of the best ways to decrease LDL levels in the body, its intake should be increased via a more frequent consumption of deep water ocean fish and supplements of omega-3 fatty acids. New information also confirms that these oils also reduce inflammation, which as stated earlier in this article is a major cause of atherosclerosis. I tell my patients and friends that if there is one thing they should supplement above all other things, it is omega-3 oils! (Vitamin E should always be taken with fish oils to protect the cells.) Dark green vegetables (especially peas & lentils) as well as oatmeal contain soluble fibre which works to reduce LDL in the blood. Pectin is much the same and is found mostly in apples. Lecithin has the ability to bind fat to water molecules and is a good way for the cholesterol to leave the system. Also important is Vitamin C and Beta Carotene which are believed to significantly reduce the chance of heart attack, stroke or cardiovascular death.

Specific foods that are known to help with lowered cholesterol and hypertension are celery, eggplant (prevents absorption of fat in the blood), shiitaki mushrooms, corn, peas and legumes, lentils, beans, onions, garlic and yams. However, all green and cruciferous vegetables are good.

Constipation is an issue with atherosclerosis. Regular bowel movements are important to prevent toxic build-up in the colon which may lead to high cholesterol levels. Also, these toxins can prevent the liver from performing its task of lowering cholesterol. Periodic cleanses can be helpful.

Finally, a sufficient intake of water (distilled, with trace minerals added) is highly effective in maintaining a healthy cardiovascular system and its liberal consumption should be encouraged.

Acupuncture

Effects of diet and risk factor reduction can be monitored by cholesterol levels and the regular assessment of blood pressure. If diet modification is not enough to improve the patients condition, the addition of Chinese herbal therapy (TCM) and/or acupuncture can be introduced. But it should be remembered that in most cases, atherosclerosis is a disease of life-style and not something that can be fixed independent of behavior modification. It should be noted that there is a certain genetic predisposition for the development of atherosclerosis in some individuals while males have a higher incidence than pre-menopausal women. So in some cases, more vigorous forms of therapy might be also be indicated.

Western treatment consists of statin drug therapy. These drugs have been shown to have side effects. The most common side effect is muscle pain and weakness, a condition called rhabdomyolysis, most likely due to the depletion of Co-Q10, a nutrient that supports muscle function. Nerve problems are also a common side effect from statin use. Drugs such as Lipitor (atorvastatin), Zocor (simvastatin), Mevacor (lovastatin) and Pravachol (pravastatin) tend to be heavily promoted, despite their dangers and despite the recent evidence that inflammation, not cholesterol, is playing a key role in the development of atherosclerosis. The medical profession and drug companies are making a lot of money off these drugs and it is interesting that they are being pushed even harder now with the latest research showing that they may not be the best choice in treatment.

One alternative to statins is acupuncture and TCM herbal medicine. Acupuncture has been shown to help lower cholesterol level and combined with TCM herbal medicine, heart health can be maintained without drugs. Wholesome lifestyle choices and natural medicine is the best way to have a healthy heart.

by Dan Schalm R.Ac, R.TCMP