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Expert Pearls

Coronary Artery Disease - combination therapy - 46916

Combination Therapy - Niaspan® 500-1500 mg/d at dinner-time; EPA + DHA mean dose of 1440 mg/d in a divided dose with breakfast and dinner; vitamin D 3590 IU/d (25-hydroxy vitamin D of 50-60 nag/ml) in gel cap form; and the American Heart Association Step II diet with 30% of calories from fat, ≤7% from saturated fat either stopped or reversed calcium scores. The goal was to get LDL < 60, HDL > 60 and triglycerides < 60 with the above approach. There was marked improvement in this program with the addition of vitamin D. [Am J Ther, 2008 Dec 15; [Epub ahead of print]. 46916 (3/2009)] Summary Interview PubMed

Coronary Artery/Heart Disease (see also cardiovascular disease) - Altitude

Altitude - living at higher altitude is protective - hypothesis is more ultraviolet light exposure is protective. [Quart J Med, 1996;89:579-589. 26440 (1997)] Summary Interview

Coronary Artery/Heart Disease (see also cardiovascular disease) - Anger

Anger (high scores on The Anger Expression Scale) was significantly associated with coronary calcification regardless of the risk factors. [Yonsei Med J, October 2003;44(5):793-799. 41363 (2004)] Summary Interview

Coronary Artery/Heart Disease (see also cardiovascular disease) - Angioplasty restenosis/“hostility’

Angioplasty restenosis prevention by “hostility’ reduction with an educational component; biofeedback training in techniques (non-pharmacological) learned in several hours, consistent with their lifestyle, giving them the ability to control hemodynamic/blood pressure, sympathetic nervous system/adrenaline hyper-reactivity; and behavioral strategies customized to each patient's traditional cardiac risk-factors (i.e. smoking reduction/cessation, weight loss and easy ways to increase compliance with lipid-lowering diets, etc.). [Mayo Clinic Proceedings, May 1997;172:487. 27376A; Mayo Clinic Proceedings, August 1996;71(8): 729-734; (Editorial, August 1996;71(8):817-819). 27375 (1997)] Summary Interview

Coronary Artery/Heart Disease (see also cardiovascular disease) - Caffeine

Caffeine intake daily may increase deaths from coronary heart disease 9 to 14; 17 to 24 percent in deaths from stroke. [The Lancet, 1997;349:279-281. 27049 (1997)] Summary Interview

Coronary Artery/Heart Disease (see also cardiovascular disease) - Coenzyme Q10

Coenzyme Q10 100 mg t.i.d. with meals improved endothelial function and extracellular SOD. [Eur Heart J, 2007 Jul 19; [Epub ahead of print]. 45545 (9/2007)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet

Diet - refined carbohydrate (high glycemic index) associated with coronary atherosclerotic progression in postmenopausal females. [Am J Clin Nutr, 2004;80:1175-1184. 42311 (12/2004)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet - 2

Diet - higher in saturated fat intake was associated with less progression of coronary atherosclerosis in postmenopausal females. [Am J Clin Nutr, 2004;80:1175-1184. 42311 (12/2004)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet - 3

Diet - Reduce trans fat and saturated fat intake and replace with cis-unhydrogenated unsaturated fatty acids from natural liquid vegetable oils; reduce the consumption of refined carbohydrates and replace with whole grain products; increase consumption of vegetables and fruits; and balance caloric intake and physical activity to maintain optimal body weight. [NEJ M, Nov 20, 1997;1491-1499. 28614 (1998)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet - 4

Diet - eat whole-grain or high fiber carbohydrates instead of refined or high glycemic index carbohydrates. [Am J Clin Nutr, 2004;80:1175-1184. 42311 (12/2004)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet - 5

Diet - replace saturated fat with monounsaturated fats, alpha-linolenic acid and omega-3 fatty acids; reduce trans fatty acids; and eat low glycemic unrefined carbohydrate versus refined carbohydrate. [Soc Exp Biol Med, 2000;187-190. 37997 (2001)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Diet - 6

Diet - whole grain (42 grams/day) had a 18% reduced risk of coronary heart disease compared to men with the lowest intake of whole grains (3.5 grams/day). [Am J Clin Nutr, 2004;80:1492-1499. 42441 (01/2005)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Eicosapentaenoic acid

Eicosapentaenoic acid (EPA) 2.4 gm/d + Docosahexaenoic Acid (DHA) 1.6 gm/d. [Am J Clin Nutr, 2000;72:389-394. 35828 (2000)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Eicosapentaenoic acid (EPA) and Docosahexaenoic Acid (DHA)

Eicosapentaenoic acid (EPA) and Docosahexaenoic Acid (DHA) at 500-1000 mg/d are cardioprotective. [Prev Med, 2004;39:212-220. 42377 (01/2005)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Fish

Fish - primary prevention 8-9 oz per week of oily fish; secondary prevention 3-4 oz per day of fish oil. [Prev Med, 2004;39:212-220. 42377 (01/2005)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Magnesium orotate

Magnesium orotate 1,000 mg (65.6 mg of elemental magnesium) t.i.d.. [Cardiovascular Drugs and Surgery, 1998;12:153-156. 31201 (1999)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Mediterranean diet

Mediterranean diet is cardioprotective. [J Am Coll Cardiol, November 1, 1996; 28(5):1103-8. 26778 (1997)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Mediterranean diet - 2

Mediterranean diet is a non strict vegetarian diet rich in cereals, bread and rice (whole grains preferred); rich in fresh fruits, vegetables and legumes; poor in meat, delicatessen and fat rich dairy products (whole milk, butter and cream were not allowed); edible fats are olive oil, canola oil and a canola oil- derived margarine; a low-fat diet with a conservative protein intake; consumption of fish is encouraged and light wine drinking was allowed. [Arch Intern Med, June 8, 1998;8:1181-1187. 30567 (1998)]

Coronary Artery/Heart Disease (see also cardiovascular disease) - N-acetylcysteine

N-acetylcysteine (NAC) I.V. at 50 mg/kg bolus 1 hour pre-operatively (CABG and/or valve surgery) and then at 50 mg/kg/d for the next 48 hours reduced atrial fibrillation. [Eur Heart J, 2008; 29(5): 625-31. 46319 (08/2008)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Omega-3 Index

Omega-3 Index (high omega-3 levels) >8% of total RBC fatty acids as EPA+DHA are associated with a 90% reduction in risk for sudden cardiac death compared to levels <4%. (Omega-3 Index Test online at www.omegametrix.com or by phone at (866) 677-4900). [Prev Med, 2004;39:212-220. 42377 (01/2005)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Vitamin C

Vitamin C 500-1000 mg/d reduces restenosis after coronary angioplasty. [Am J Cardiol, 1996;1284-1286. 26275 (1997)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Vitamin E

Vitamin E 100 to 440 I.U./d. [JAMA, June 21, 1995;273(23):1849-1854. 22666 (1995)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Vitamin E - 2

Vitamin E 100 to 400 I.U./d. [Heart, 1996;76:355-357. 26010 (1996)] Summary

Coronary Artery/Heart Disease (see also cardiovascular disease) - Vitamin K2

Vitamin K2 (menaquinone) intake from the diet (found in meat, cheese and milk) was inversely related to coronary calcification while vitamin K1 (phylloquinone) dietary intake (found in green vegetables) showed no relationship with coronary calcification. [Atherosclerosis, 2008 July 19; [Epub ahead of print]. 46640 (10/2008)] Summary

Coronary Artery/Heart Disease - Pomegranate

Pomegranate juice 50 ml/d or pomegranate polyphenol extract 5 mL/d in a single dose with a meal. [J Agric Food Chem, 2008; 56(18): 8704-13. 46918 (3/2009)] Summary Interview PubMed

Coronary Artery/Heart Disease - vegan, vegetarian - 50195

Vegan and vegetarian diets had a 32% lower risk of ischemic heart disease than meat eaters probably from a

lower mean LDL cholesterol and a diet lower in saturated fats and higher in polyunsaturated fats and dietary fiber.

[Am J Clin Nutr, 2013 Mar;97(3):597-603. 50195 (3/2013)] Interview PubMed
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