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Can Arterial Disease be Reversed?

If your body can mend a bone, heal a cut, regrow muscle, and even recover from brain injury, why can’t it naturally reverse cardiovascular disease?

It can. But you haven’t heard this. Why not? Because there are two competing models of atherosclerosis. The old model describes arteries as so many mechanical tubes that have no way to protect themselves from the inevitable clogging that comes from the consumption of cholesterol and saturated fat. The other, new model sees arteries as living dynamic tissue that, in the context of a healthy diet, is capable of growth, repair, and rising to the challenge of rigorous exercise.

Atherosclerosis is not a “buildup” of fat in your arteries.

You might have heard that fatty foods causes arterial fat deposits just like kitchen grease you rinse down the drain, which, over time, builds up to clog the pipe. When you have a clogged pipe you simply bust through the clog with a plumbing snake or Draino. It would make sense to treat your body this way were your arteries anything like the plumbing under your sink.

But your arteries are nothing like the plumbing under your sink, and using the term “blocked arteries” can be very misleading. Why is that? Because once you’ve got this misleading image of clogged plumbing in your mind, the router-router treatment (surgery, whether angioplasty or stenting) can seem like a valuable intervention to a prevent heart attacks or strokes. In reality, atherosclerosis is not simply a buildup of debris that can be scooped out. Atherosclerosis is the result of scar tissue formation within the wall of an artery. And so attempting to remove plaque, by way of surgical intervention risks damaging the weakened underlying tissue.

Before a patient undergoes angioplasty or stent placement, he is warned of potential complications of the procedure. Those complications include heart attack, stroke, and death. When will those complications occur? When the surgeon manipulates a damaged artery so that the integrity of the repair is compromised. In extreme cases, the risk of surgery is less than the risk of death from atherosclerosis. But in my opinion those cases are few and far between because most people with atherosclerosis can get better results without resorting to interventions that create permanent anatomical changes to the structure of your arteries.

Even Blockages Like This Can Be Stablized and Reversed With an Anti-Inflammatory Diet

Your Body Can Heal Arterial Damage No Matter Your Age

Your body can recover from arterial damage by making two distinct types of accommodations.

First, it may bypass the damaged and narrowed artery by expanding existing collateral arteries supplying the same tissue, kind of like widening a highway to accommodate increased traffic into the city center. We see evidence of this occurring all the time when we do angiograms. Smoking or unhealthy eating makes it harder for your body to do this.

The second process is one in which the body actually heals the damaged section of artery. You’ve seen something very similar if you’ve ever gotten a deep cut in your skin down to the fat. First, a messy scab forms and, over time, typically 6 months or so, the skin around the injury grows inward to close the gap. Smoking and bad diet disrupt these processes as well.

Atherosclerotic plaque forms not from cholesterol build up but from arterial damage.

Sometimes I wish there were scientific validity to the cholesterol building up inside the pipe model; it’s so much easier to explain to people. In reality, however, the body is more complicated.

Plaques form inside arteries in locations where the artery was, at some point in the past, acutely damaged by deposits of highly irritating pro-inflammatory fats that splatter on the insides of your arteries. These splattered fats annoy the arterial lining cells that they’ve landed on. To remove these caustic chemicals, the defiled cells release a cascade of inflammatory signals that communicate their need for help. Specialized cells then arrive to remove the offending fats and get the inflammation in your arteries under control.

Time is of the essence here and the process is very delicately balanced because, if repairs are not made before a micro-hemorrhage tears the collagen supporting your artery, a deadly blood clot may form. (Pages 192-198 of Deep Nutrition gives a play-by-play pictorial of this process.)

It Matters If Your Plaques Are Stable or Unstable

You’ve probably heard of stable and unstable plaque in the context of discussions of atherosclerosis.

When the body is allowed to repair damaged arterial walls uninterrupted, it can produce a stable plaque, constructed of a robust coat of protein surrounding an ever-shrinking fatty core. This serves as a long-term fix until such time that the body can replace the patch with healthy arterial tissue.

In the context of a bad diet and/or smoking, this process is continually disrupted forcing the body to make due with suboptimal solutions. And so it cobbles together a tenuously thin protein coat surrounding the fatty core of the plaque. Much like an emergency repair made to a breached hull of a ship in high seas, this coating is a temporary fix only, and unlikely to last very long.

Stable plaques are not a threat to your health. But here’s the problem: Using the the tools currently available for diagnosing atherosclerosis in clinical practice, angiograms and carotid ultrasounds, there’s no way to tell if a plaque is stable or unstable. Therefore, since the cardiologists who I trust don’t recommend stenting a stable plaque, I’m not enamored with the idea of stenting on the basis of an angiogram alone.

The modern American diet is wrecking your heart.

The combination of excessive carb and vegetable oil intake creates the perfect chemical assault on your arteries. The time to take heart health seriously is now, before you are feeling any symptoms. To find how exactly how, read chapters Eight and Nine in Deep Nutrition. (Now available at a discount price on Amazon.com)

The five things you need to know about atherosclerosis:

  • Your body can reverse even advanced disease naturally
  • You are never to old to strengthen your heart and circulatory system
  • Smoking is bad. But in the context of a bad diet smoking is 100x worse
  • The time to think about cardiovascular health is before you feel any symptoms
  • Your arteries are living dynamic tissue that can respond favorably to the right signals

But what if, God forbid, you do wind up in the ER clutching you chest in pain? What do you need to know to have an intelligent informed discussion with your treating physicians? If you would like to learn the five essential survival tools for when you do arrive to the ER with chest symptoms concerning for a heart attack, send me an email me and tell me so, and I just might make that the subject of my next post.

14 Comments

  1. Dave says:

    Enjoyed the book. Thanks for this post.

    How is one to know that one is making progress in improving one’s cardiovascular health? I’ve been working at it for two years since having an MI and having two lesions stented. Is it just a matter of faith or is there some objective assessment?

    1. Dr. Cate Catey says:

      How to know:
      1. The best test of cardiovascular health by far is exercise tolerance. The ability to go up to 10 METS on a Bruce protocol gives you a CV health score of 100%: it is the most reliable predictor of not dying from a heart attack. Want to do a Bruce Protocol at home on your treadmill? If you’ve been medically cleared to exercise, check out Wikipedia’s Bruce Protocol and follow the submaximal table till you’ve completed stage 3.
      2. Another functional test: ED. If you had that before, it should get better–and if your testosterone levels are normal the improvements will be more robust.
      3. Get your lipids tested off meds. If your HDL is over 50 (men) or 60 (women) and your triglycerides are under 150, that’s good. LDL should also be less than 3x HDL.

      These three are the mosts reliable and cheapest objective tests that anyone can do. There are a plethora of others: Calcium scores, ultrasound measurements, more expensive lipid tests. But none of these are as well studied as those I mentioned, so while they may be fun to do if you have extra cash burning a hole in your pocket, I don’t think they’re in any way essential.

  2. Dave says:

    Thanks Cate. No ED. At last test, I don’t take meds, HDL 3.2, LDL 3.1 (Friedewald) and Trig of 0.8 (all mmol/L) so I guess that’s all good. Will check out the Bruce protocol. Cleared for heavy exercise 18mo ago and going strong

  3. Mary says:

    Hi Dr. Cate,

    Not sure how to e-mail you, but wanted to leave a comment to say…Yes! I would like to learn the five essential survival tools for what to do when you arrive to the ER with chest symptoms concerning for a heart attack.

    Thank you,

    Mary

  4. Christine B. says:

    Yes, I would like to see your comments re: But what if, God forbid, you do wind up in the ER clutching you chest in pain? What do you need to know to have an intelligent informed discussion with your treating physicians? If you would like to learn the five essential survival tools for when you do arrive to the ER with chest symptoms concerning for a heart attack, send me an email me and tell me so, and I just might make that the subject of my next post. Thank you!

  5. Murray Crow says:

    Hi, again, Cate -
    Does the reversal process also apply to claudacation? I am 80 years old and very active, low Blood Pressure, Total cholesterol under 150 (good ratios). In spite of doing regular exercise (weight training & light cardio), I have had frequent cramping in legs and hands for the last ten years. Also ED. It’s only recently, however, that I have started switching from a low fat vegan diet to a Atkins style low carb program. I have cut out coffee, all wheat products, and added sugar. My daily complex carb intake is still probably over 100 grams, but I am working on reducing that. Protein every meal and tons of steamed veges. I am hoping this helps!
    Murray Crow

  6. Dr. Cate Dr. Cate says:

    Mary
    Claudication, or “bad circulation” in the legs will also reverse and exercise is key, so your training routine is going to be essential.

  7. Murray Crow says:

    Thanks again, that’s encouraging and motivating.
    Murray

  8. jim leary says:

    great article. would like to know the 5 essential survival tools in the event i would end up in an emergency room.
    thanks.

  9. tim says:

    Hello Dr Cate,
    do you think the diet you recommend would also help reverse Vasculitis? Most of the stuff I’ve found on the web describes how it is best treated with a low fat diet.

  10. Dr. Cate Dr. Cate says:

    Tim
    Yes it will help vasculitis. Vasculitis is an inflammatory condition that may involve antibodies. The extent to which you can improve, and how fast, will depend in part on whether you have antibodies. If you do not, there will be faster improvement. Low fat diets tend to be high carb and are pro-inflammatory.

  11. David Patten says:

    Well folks I would like to email Dr. Cate however there doesnt seem to be a link for that purpose. if you are adding those concerned to a list for that purpose I would be pleased to be added to the list.
    Thank you Dr. for such timely information and God Bless.
    Sincerely,
    David

  12. john says:

    Dr. Cate, I enjoyed the article very much. Would appreciate any updated science on atherosclerosis reversal. I have stopped eating any grains, sugar or dairy (except for the odd piece of goat cheese) and converted to the Paleo diet consisting of organic grass fed beef, buffalo, free range chicken and eggs, vegetables, nuts, seeds, berries and some fruit. (Still have a glass of red wine each night). My weight has gone down 23 lbs. in 6 weeks from 213lbs to 190 lbs. and I feel amazing.

    1. Dr. Cate Dr. Cate says:

      Good for you. To reverse a disease, you have to understand it’s cause and unfortunately the standard view of fat clogging an artery is sorely out of date. We discuss the true cause of atherosclerosis in detail in Chapter 8 of Deep Nutrition, which will give you a very clear understanding of its reversal as well.




Dr. Cate welcomes your comments and questions. In an effort to make the blog a useful resource for readers, questions must be pertinent to the topic of the page. Please search the site carefully for a post on a related topic to make sure your concern has the best chance of being addressed. For personal medical questions, please schedule a phone consultation.



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