In spite of the fact that deaths from coronary heart disease (CHD) have dropped since 1964, it still claims more lives every year than any other dis-ease or group of dis-eases. Almost 1,500,000 heart attacks occur each year. Most of them (about 2/3s) occur in men. About 1/3 of all heart attacks are fatal; probably because the majority of them occur suddenly and treatment is delayed.

On page 86 of The Surgeon General's Report, it says that 'CHD ranks first as the reason for Social Security disability (Social Security Administration 1982), third after arthritis and hypertension for limitation of activity (Collins 1986), and third after mental illness and all forms of cancer for total hospital bed days (NCHS 1987). According to information from the National Heart, Lung, and Blood Institute (NHLBI), morbidity (results of illness-my note) and mortality (number of deaths-my note) from CHD cost the United States an estimated $49 billion a year in 1985 in direct health care expenditures and lost productivity.' In the same paragraph it says that only an increase may be expected '...in the future because of the aging of the population.'

HD includes many health problems which result from insufficient blood flow. This is almost always because of narrowing of arteries by atherosclerosis. Atherosclerosis may begin as early as age 10 and then progress slowly for many years before symptoms are noticed. These symptoms range from simple pain (angina) to heart attacks, to strokes, and, a relatively final one, sudden death.

The problem of CHD is very similar to the number one problem in our country today, the national debt. Both are preventable. Both are the result of uncontrolled appetites, excessive indulgence, lack of forbearance, and unwillingness to restrict consumption. Pardon the political aside, but I found it irresistible.

There are 3 major risk factors for CHD. They include high blood cholesterol, high blood pressure, and cigarette smoking. All are controllable or, more important, preventable. If you have difficulty giving up smoking, try some of the natural health care products which are guaranteed to help you quit, or your money back. Or, try hypnosis. Nothing works, however, if you have not committed yourself to the idea of never smoking again.

The other two risk factors have a significant dietary influence. This provides you with the major controlling weapon, prevention. See the food suggestions that follow for specific foods that help lower the risks for CHD. For high blood pressure, in particular, you will want to decrease your sugar intake. Another extremely important factor in high blood pressure is stress. Reduce the stress in your life as much as you can. Take time for yourself to do the things you find most enjoyable and relaxing. Remember that regular exercise is the best stress-reducing activity.

As for high cholesterol, we all know that there is a 'good' and a 'bad' cholesterol. The good guys are called high density lipoprotein (HDL). The bad guys are low density lipoprotein (LDL). Sorry, but I cannot help myself. The comparison to the national debt problem again. If we remove the low density representatives (LDRs) and senators (LDSs) who voted for increasing taxes without decreasing spending, we can help prevent further national debt and actually begin reducing it to safer levels. The same applies to cholesterol. We have to greatly reduce the LDLs and increase the HDLs to prevent CHD. This is accomplished through dietary controls.

On page 122 of The Surgeon General's Report, it says 'For individuals whose high total and LDL cholesterol levels warrant treatment, THE FIRST LINE OF INTERVENTION IS DIET THERAPY (emphasis added). The recently released National Cholesterol Education Program guidelines on the treatment of high blood cholesterol in adults recommend that INTENSIVE DIETARY TREATMENT SHOULD GENERALLY BE CARRIED OUT FOR AT LEAST 6 MONTHS (emphasis added). As indicated in this Report, only after that period of time, and if the cholesterol level remains significantly high, should the addition of drugs to the dietary regimen be considered. Even then, continuation of diet therapy can reduce the need for drugs and thus their risk of side effects and cost.'

Since CHD is such a common dis-ease, we prefer to see our patients with much lower levels of total blood cholesterol, preferably between 150 and 200. Requesting copies of the June and July issues of 'Perpetua' will provide you with my articles on weight loss, fats, and diet. These will supply you with an excellent starting point for creating your own CHD-prevention program. If nothing else, make sure to frequently include the recommendations which follow.

Nutritional supplements seem to be very helpful in preventing and/or reducing the risks for CHD. These include vitamins A (as beta carotene), C, E, and B-complex. Also, extra amounts of vitamins B3, B5 (pantothenic acid), and B6 are often recommended. Likewise suggested in this category are folic acid (folate) and phosphatidyl choline. Minerals which are often included are calcium, copper, magnesium, molybdenum, selenium, and zinc. A couple of helpful amino acids are carnitine and taurine. The omega-3 and omega-6 fatty acids are often supplemented, but I prefer that patients simply eat more of the fish listed below that contain those fatty acids. Digestive enzymes are extremely beneficial as is Co-enzyme Q10. Ask a qualified natural health care physician or certified clinical nutritionist (CCN) for recommendations on specific doses for any or all of the above nutrients.

Specific foods (from Jean Carper's The Food Pharmacy), which are helpful in reducing the risks for cardiovascular disease, are:

• Two or three whole apples a day can lower blood cholesterol and slightly raise heart-protective HDLs. That amount can also reduce blood pressure. Generally, the higher your blood cholesterol, the greater the benefit.
• Foods made with barley products--such as flour, grits, flakes, or the grain itself--three times a day has lowered blood cholesterol by about fifteen percent.
• A cup of cooked dried beans every day (less if you eat other cholesterol-depressing foods) should send your bad LDL cholesterol down...and lower blood pressure....
• Two teaspoons of jalapeno pepper or half a raw garlic clove a day can increase the blood-clot-dissolving mechanism that protects against heart attacks and stroke. Only a couple of raw garlic cloves daily can keep blood cholesterol down in heart patients.
• A mere ounce of fish a day--only one or two fish dishes a week--may cut your risk of heart disease in half. Some of the best fish include mackerel, salmon, bluefish, tuna, sturgeon, sablefish, herring, anchovy, sardines and lake trout.
• The pectin contained in a couple of grapefruit a day may lower blood cholesterol by up to nineteen percent and improve the critical HDL-cholesterol ratio.
• About one-half cup of dry oat bran (a large bowl full cooked) or a cup of dry oatmeal (a couple of bowls full cooked) a day can put a dramatic dent in your blood cholesterol.
• Only one tablespoon of olive oil (My Note: extra virgin olive oil is best) has wiped out the cholesterol-raising effects of two eggs. Four or five tablespoons of olive oil daily dramatically improve the blood profiles of heart attack patients. And two thirds of a tablespoon daily lowered blood pressure in men.
• Only half a raw onion a day can boost your good HDL blood cholesterol by an average thirty percent. A tablespoon of cooked onions reverses the blood's clotting tendency after eating a high fat meal.