Statistics show that one out of every two persons will die of complications from cardiovascular disease. This could be a stroke, or it could be a heart attack. These statistics do not include the number of people who will live in a very compromised state of health — not able to walk distances, not able to pick up the grandchildren, not participating fully in life!

Inflammation
It is natural to think that inflammation is one of the bad guys; causing redness, swelling, heat, and pain.  But in fact, it is not as bad as you would expect.  Its purpose is to facilitate the repair of damaged tissue.

However, when the biochemical events that lead to inflammation get out of control, our body continually encourages the creation of an inflammatory state and never stops it.  At this point, inflammation can cause more harm than good.

Usually we are treated for the symptoms secondary to the underlying inflammation without addressing the cause of the inflammation.  When our symptoms decrease, we are told that we are all well, when in reality the underlying cause of the problem has not changed and usually the inflammation is still present.  Most inflammatory disease states are normally detected only due to these secondary symptoms via traditional medicine.  Coronary artery disease and peripheral vascular disease are inflammatory pathologies that do not present with traditional inflammatory symptoms until late in the disease.

The state of inflammation may be initiated by infection, trauma, burns, exposure to allergens, exposure to toxic chemicals, or overuse of muscles.

After a severe injury, a decrease usually occurs in the blood levels of various substances as they move into the surrounding cells.  These substances aid the neutrophils (special white blood cells) to slow down any infection.

The injured tissue must then be repaired.  Amino acids, the building blocks of our body, bond (connect together) to form chains of protein from which are created all the various types of tissue.  Most of the amino acids used for repair are taken from our muscles which provide a ready source.  Once the repair is complete and all the waste products are carried away, the inflammatory process shuts down automatically.

Inflammation Gone Wild
When a normal inflammatory process fails to turn itself off it becomes chronic. Chronic inflammation produces excessive amounts of free radicals (ions which cause further damage to the cell walls). Normally, these substances help to kill bacteria, but in excess, they also destroy our healthy tissue, resulting in either scar tissue formation in the lungs, liver, intestines, and skin; degradation of the joints; or thrombus (clot) formation in the arteries. The resultant disease process is dependent upon what tissue is inflamed. Crohn’s disease, coronary artery and peripheral  vascular disease, hepatitis, and rheumatoid arthritis are just a few of  the many degenerative diseases that are caused by chronic inflammation.

Inflammation Stage 1
After an injury, the injured cells release hormones which perform two functions: They help to produce pain and therefore prompt us not overuse the injured area. This allows the healing to proceed without aggravation. They stimulate clot promoting agents. These agents reduce blood flow; create a patchwork of fibrinogen (fibril threads) to patch up the damaged tissue (like sewing on a patch to cover up a hole in your jeans!); stimulate platelets to stick together; and form clots around the injured tissue. All this is done to plug up the 'hole!'

Inflammation Stage 2
Stage 2 of the inflammatory process begins just after Stage 1 begins. This  stage is involved in fighting the invading microorganisms. Special white blood cells called neutrophils attach to the microorganisms using sticky substances to bind the organism to the wall of the white blood cell. When the neutrophil is ‘full’ it releases free radicals to kill the microorganisms.  Nearby neutrophils scavenge the released free radicals to prevent prolonged exposure to the cell walls of healthy tissue.

Inflammation Stage 3
Migration of another specialized white blood cell, the monocyte, marks the  beginning of Stage 3 of the inflammatory process.  Monocytes help to clean up the debris left from the neutrophils (just like the Pac Man in the arcade game).  Upon binding to this debris they release cytokines. Cytokines are a group of chemical messengers that tell the liver to synthesize special proteins used in the repair of tissue.  As the liver increases in size to prepare for increased production, cholesterol synthesis is also increased!  Cholesterol is an indicator for not only liver problems, but also chronic inflammatory states.

The cytokines also moderate lymphocyte migration to the injured area.

Lymphocytes, another specialized white blood cell, are involved in the production of antibodies which are used to help tag 'bad guys' for future destruction. Unfortunately, in chronic inflammatory states, antibodies can be made against 'good guys' -- our own body’s tissue. This leads to degenerative diseases such as rheumatoid arthritis, lupus, etc.

Environmental Risks

Fibrin Infiltration - thickening of the intimal lining of the artery due to matting of fibrin on the fatty streak which is inflamed. This begins to block the artery and diminish blood flow down stream.  Mineral Deposition - increased infiltration of cholesterol esters, triglycerides, and mineral salts which in turn form brittle calcified plaques. At this point the artery begins to lose its elasticity.

Ulceration and Thrombosis - thinning of the medial lining (contains the Muscle portion) of the artery and release of special material into the artery that tends to form ulcerated areas. This can in turn create the formation of thrombi which can eventually lead to heart attack and stroke. In this phase the inflammatory response begins to get out of control and becomes chronic.

Arteriosclerosis has multiple causes that are often interrelated:

Dietary Changes
People with peripheral vascular disease and arteriosclerosis should be on a low fat, low protein, high complex carbohydrate diet. Low fat means that 20% of your calories should be coming from fats. There should be complete elimination of salt and all refined foods. Polyunsaturated oils should be restricted to 10% of total calories. Fats prevent efficient sugar metabolism promoting tissue anoxia with as much as a 10% reduction of oxygen. Additionally, fats produce a thin film around the solid elements of the blood making them "sticky". Carbohydrates should comprise 60% of total calories. Protein (20% of total calories) may result in negative mineral balance if taken in too great a quantity. Excessive protein intake can contribute to toxic metabolic ammonia urea nitrogen and elevated uric acid levels. Some additional dos and don'ts:

Aerobic Exercise -  This exercise tends to:

increase blood clotting time
lower blood pressure
reduce uric acid
increase arterial elasticity
elevate blood oxygen carrying capacity
stimulates the development of collateral circulation (additional arteries)
burns up excess triglycerides (fats)

Fiber -  At least 2 - 4 tablespoons of coarse raw wheat or oat bran should be consumed daily.  It helps by:

decreasing bowel transit time - the time it take for foods to pass through the intestines and colon
increasing the bulk size of the stools
reducing bowel ammonia fermentation - very toxic byproduct of poor digestion.
increasing hydration of the bowels - the water added to the stool

Salt - causes water retention, which results in:  

edema
increased cardiac workload
reduced capillary blood oxygen transfer to the cells.  

Alcohol - should be avoided because it:  

promotes platelet aggregation and clotting - causes clots to form
causes erythrocyte sludging - makes the Red Blood Cells stick together
inhibits lymphocyte chemotaxis - the process by which the good White Blood Cells can get outside of the artery and into the tissue to help protect your body
loads the liver with triglycerides - fats.   

Coffee, Tea, and Cocoa -  Xanthines (found in coffee and tea); Theophylline (found in tea); Theobromine (found in cocoa) can cause the following:

stimulation to the central nervous system
increased diuretic activity  
stimulation to the heart muscle
irregular heart beat
insomnia
elevated blood sugar
over production of gastric acid
high blood pressure
elevation of triglycerides

Smoking - Adverse side effects are primarily due to the oxidative stresses produced  by the tars and preservatives and stabilizers found in the tobacco. Additionally, the carbon monoxide inhaled competes with oxygen to bind with the hemoglobin in the red blood cell thereby reducing oxygenation of the blood.

It’s not all bad.  Catching trends early can allow time to reverse the trend and lead to a healthy, balanced life and to enjoy life long activities.  We have the equipment and expertise to do vascular studies at the Center for Family Wellness.  If you would like more information about peripheral vascular disease and vascular testing please contact our office to come in and discuss your questions with Dr. Smith.

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