Michael Ash BSc (Hons) DO ND F.DipION is presenting a functional medicine approach to patients with cardiovascular disease using nutrition and the immune system to provide evidence based strategies to assist in the care of affected patients. The CAM conference series three lecture, will be held at Cavendish Conference Centre, London on the 14th May 2010. Other speakers will help make this a very informative and strategic day.
Cardiovascular disease continues to be the number 1 cause of preventable death in the industrialised world as confirmed by a recent report undertaken in the UK. some 5000 patients followed up in the United Kingdom’s Whitehall Study, which began in the 1960s has revealed that just three cardiovascular risk factors shortened their life span by a whole decade.
High blood pressure, high cholesterol, and smoking — is associated with an almost 10-year shorter life expectancy compared with men with none of these risk factors.[1] The men also had a 3-fold higher rate of vascular mortality and a 2-fold higher rate of nonvascular mortality. These calculations were based on long-term follow-up data from the Whitehall study, which first examined 19,019 men aged 40-69 years between 1967 and 1970. At entry, 42% of the men were current smokers, 39% had high blood pressure, and 51% had high cholesterol.[1]
More extreme categorisation of these risk factors including BMI, diabetes mellitus/glucose intolerance, and employment grade was associated with a 15 year difference in life expectancy from age 50 (20.2 v 35.4 years)
Prof Peter Weissberg, MD, medical director at the British Heart Foundation, which cosponsored the study, speculated that although it involved only men,
“There is no reason why the same [findings] should not apply to women.”[2]
Copies of slides and notes will be available on the Clinical Education web site after the event
References
[1] Clarke R, Emberson J, Fletcher A, et al. Life expectancy in relation to cardiovascular risk factors: 38 year follow-up of 19 000 men in the Whitehall study. BMJ. Published online ahead of print September 17, 2009. View Paper
[2]A decade of difference – BHF urges the middle-aged to have a heart risk check. British Heart Foundation news release. September 18, 2009. Available at: http://www.bhf.org.uk/default.aspx?page=10470
2 Comments. Leave new
What about the H Factor. I get my Homocysteine measured annually. I take supplements to keep this low. This test is very important but not available on the NHS – I wonder why. The more people that are educated about this test the more pressure there will be to test H Factor levels.
Hello Wendy
Homocysteine (an amino acid) as a trigger of atherosclerosis has been experiencing a number of clinical developments since Kilmer McCully first related the condition homocystinuria with increased CVD risk. The time since his first article in American Journal of Pathology in 1969 has been beset by those who value this proposal and those who question it. It is of course very attractive to use food extracts B12, B6, Folic acid and trimethylglycine as an enzyme promoting combination to reduce plaque formation.
Homocysteine lowering, achieved after the introduction of the folate food fortification programme in North America, was accompanied by an accelerated decline of cardiovascular risk and especially of stroke. Although the initial clinical trials suggested that homocysteine-lowering treatment with folates and B vitamins induces coronary plaque regression, this finding was not confirmed by more recent clinical studies.
Despite the decline of cardiovascular risk in North America after the introduction of folate food fortification, two recently published clinical trials (the NORVIT7 and HOPE-28) failed to demonstrate any benefit from pharmacological treatment targeting Hcy levels in patients with coronary atherosclerosis, putting into question the whole concept of Hcy being a risk factor for atherosclerosis.
This does not mean that following a diet and taking relevant supplements is not beneficial, rather it means that on a global scale the mechanisms for reduction have perhaps yet to be fully extrapolated. The time however is now – we do not really want to wait another 30 years to refine this for public policy, continue taking your homocysteine lowering supplements, there is no risk and likely benefit, but do continue to check they are having the desired effect. You may need to change your dose as you age.
The NHS has its own political and internal battles regarding CVD and public health policy, just because as an organisation the test has yet to be ‘approved’ does not mean that many physicians do not consider hyperhomocysteinuria a valid marker for intervention.
Michael
Bonaa KH,Njolstad I, Ueland PM, Schirmer H, et al. Homocysteine lowering and cardiovascular events after acute myocardial infarction. N Engl J Med 2006;354:1578-1588. View Full Paper
Lonn E, Yusuf S, Arnold MJ, et al. Homocysteine lowering with folic acid and B vitamins in vascular disease. N Engl J Med 2006;354:1567-1577. View Full Paper