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 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.)
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:
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.
Dr. Cate on blogtalkradio
Dave (1 year ago)
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?
Catey (1 year ago)
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.
Dave (1 year ago)
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
Mary (1 year ago)
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
Christine B. (1 year ago)
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!
Murray Crow (1 year ago)
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
Dr. Cate (1 year ago)
Mary
Claudication, or “bad circulation” in the legs will also reverse and exercise is key, so your training routine is going to be essential.
Murray Crow (1 year ago)
Thanks again, that’s encouraging and motivating.
Murray
jim leary (1 year ago)
great article. would like to know the 5 essential survival tools in the event i would end up in an emergency room.
thanks.
tim (1 year ago)
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.
Dr. Cate (1 year ago)
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.
David Patten (1 year ago)
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
john (1 year ago)
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.
Dr. Cate (1 year ago)
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.
Nicoleta (10 months ago)
Hello Dr. Cate,
I liked the article though I would have liked to see more advice on how to treat damaged arteries naturally.
My mother has just been diagnosed with cerebral aneurysm. I don’t believe it has ruptured but the possibility of operating it is there. There is one more test to be done to see the aneurysm better. My mother has never drunk and smoke in her life. I can say that diet wise, she has never eaten junk, but she might have eaten a bit too many fats and maybe sugar. She also had a heart attack when she was only 48. Also, she is a bit on the overweight side without being obese though.
Do you recommend any specific natural foods or teas that she could use to help strengthening her arteries and also clean them. I have read about green tea, garlic etc. and I know that physical exercise is recommended. But do you have any other suggestions?
Is there a way to avoid surgery. I understand that if the aneurysm is big, they will have to operate no matter what and they only leave it if it is small. I don’t think my mother’s is small.
Thanks so much,
Nicoleta
Marsha Waggoner (10 months ago)
I wish I had encountered this information BEFORE I had my heart attack. Although I was a long-time smoker, I had eaten a fairly healthy diet for many years. I was an Adele Davis fan decades ago when my kids were growing up, still have all her books, and her sound recommendations no doubt protected the kids as well as me from more serious harm. But the heart attack was a surprise.
Along with the warnings about the dangers of the stent placement, I was also told that I would die without it. Not knowing any better, I accepted that as true. Now my stent and I are knee-deep in vegan, fat-free, raw-food, “heart-healthy” diet books. It’s very confusing, because I also have fibromyalgia, and everything I’ve read indicates that a low-carb anti-inflammatory diet with some healthy fat is the best way to fight that, and I’ve had good success controlling symptoms that way for several years. Now I’m eating fat-free, and my pain is back, my rosacea is returning with a vengeance, and I feel worn out and hungry all the time. I’d almost rather have another heart attack! (Okay, not really.)
I’m in the middle of _Deep Nutrition_ and I just want to say thank you. I’m really looking forward to adding some things back into my diet that I’ve missed very much — things like butter and cheese and soup made with real bones. All this time I’ve been thinking about my grandmother, who cooked with lard and made chicken soup with chicken feet and served liver at least once a week, and lived to be 91, and I’ve been wondering about the wisdom of a diet without any meat or fat. (God, I want a cheese and spinach omelet cooked in butter!)
My oldest son turned 40 today and was just complaining about joint pain and what a drag it is getting older. I’ll be giving him a copy of _Deep Nutrition_ for his birthday.
Any additional information you can offer on healing arterial disease would be most appreciated.
Gratefully,
Marsha
Robert Wright (9 months ago)
like to learn the five essential survival tools for when you do arrive to the ER with chest symptoms concerning for a heart attack, Please send them to me.
craig wolfe (7 months ago)
Hi…it was wonderful meeting you the other day! Sure I would like the e-mail on what to do if you are in the ER clutching your chest….thank you!
…c
Gerald Sobel (7 months ago)
I had weird chest pains coming and going around my chest, center of chest, side of chest, sometimes down to my fingers, so my girl friend, an RN, insisted I go to the Wadsworth VA Hospital and get checked out. The ECG tests at the hospital were negative as well as consecutive blood tests, and while I was at the hospital overnight, my blood pressure went from 141 over 93, the highest I’ve ever seen on admission, with a extraordinarily low heart rate of 55, which I saw drop down to 51 after several hours of rest approaching dozing off. This all stabilized back to 127 over 76, with a heart rate of high sixties when I got off the gurney the next day. I still did have those weird wandering chest pains on the way out of the ER, tho. In the middle of the night that night, I had a brief experience of feeling a stabbing pain in middle of my chest, lasting just a second, which then zapped to the ends of one finger at the ends of both arms. Weird, but I was thankful it only lasted an instant. The next day I had a stress test and was essentially good. My pre-test BP was 117 over 63. The PA took me up to 100%, holding me at 155 BPM for five minutes, with only the comment that one trace looked like there could be a slight partial blockage. I was tired and winded but OK. Three days later, after warming up with 20 laps in a collegiate length pool, I did some 50 yd. sprints. The second or third one, I felt chest pains and a pain in the jaw which lasted less than a minute after I stopped, a slight back pain, and felt a bit dizzy. I did a few more easy laps then got out of the pool. Now I’m back to wandering, stinging chest pains, which are not severe but a bit annoying. I suppose I’m in for more tests now.
J H (5 months ago)
Very very interesting but cannot find the link to e.mail Dr Cate !!
Peter K (5 months ago)
Hi very interesting article and comments from others. I came across this article while searching for answers. I recently had a mild heart attack although to me it’s been anything but mild…I was in the ER clutching my chest. Well not really as my symptoms were more a tightness and dizzy spells anyway after settling my body down with some meds an angiogram was done and the found 30% blockage of the LAD and a 90% blockage in one of the branches after the first septal. I was of course awake for this and spoke with both the doctor performing the procedure and my attending cardiologist and both seemed rather non concerned about the 90% and both unanimously agreed to just leave it..this has me completely baffled why not fix it and what’s my future look like? So I guess what I’m asking Dr Cate is for those five essentials and perhaps you can shed some possible light as to why they would leave the blockage and what my future may hold…I should mention I’m a non smoker not over weight and had always exercised. I have however come to learn that my markers were there and just ignored or missed by my GP….oh well what’s done is done time to focus on the future..
paul Jaimungal (4 months ago)
Hi my total cholesterol is 3.53 , HDL 1.28, Ldl 1.7, Triglycerides 1.17 Yet i had a heart attack.
I am 5 ft 6.5 inch 154 lb. I did smoke at the time. I am male and 66 years old.
Richard (3 weeks ago)
Hi, in October i suffered from “mild keytosis” and at that time they found my tropone levels elevated. .14 and the following morning .29 they gave me both plavix and lopressor thus I didn’t have any say in the matter at the time ( I was unconscious when I arrived in the er) following morning I refused both of those drugs ( potential side effects make them too risky).
I have been taking Hawthorn capsules ( 600 – 800mg daily I make my own capsules) q10, fish oil capsules and have reduced consumption of all forms of meat. but I also suffer from chest pains almost on a daily basis ( an angiogram showed I have 70 – 90% blockages in 4 of my arteries stents were ruled out in my case.). what other herbs and or supplements can I take to naturally revers the blockages…. my BP has gone from 130/70 to an average of 160/90 with highs of 225/111 i am either intolerant or allergic to statens, ace inhibitors, channel blockers and beta blockers. have been told by cardiologists that “they can’t do anything for me.”
Running scared in Ontario Canada