What your doctor doesn't know about heart disease

What causes coronary heart disease or coronary atherosclerotic plaque, this thing that we track with heart scans?

Well, here are a few little-publicized facts about heart disease that you are unlikely to hear from your When's-the-next-stent? cardiologist or the What is there besides statins? primary care doctor.

(Since everybody knows that smoking is a modifiable risk for heart disease that can be readily identified, let's focus on the blood tests that reveal heart disease causes.)

What's the number one most common cause for heart disease?

Small LDL particles. The proliferation and popularity of the snack food/processed food culture, compounded with the "eat more healthy whole grain " propaganda has launched small LDL solidly to first place as the most common reason to have heart attacks, stents, and bypass. All that advice to increase your "healthy whole grain" intake? It increases heart attack risk.

What's the number one most aggressive cause for heart disease?

That's lipoprotein(a), or Lp(a). It's certainly not high cholesterol, though the drug industry loves that you think that. We could argue over whether smoking is more aggressive, but the two are pretty darned close. Combine the two--Lp(a) in a smoker--and the combination is an explosively powerful trigger for heart disease and stroke.

What's the number two cause for heart disease?

After small LDL comes low HDL cholesterol. Ask anyone who has had a heart attack: What was your cholesterol panel like? 9 out of 10 will say "My LDL cholesterol was 135 mg/dl" while knowing little or nothing about HDL, which is commonly in the 30-42 mg/dl range--sufficient to contribute to heart disease risk considerably.

Can "normal" thyroid hormone tests still contribute to heart disease?

Yes. Hypothyroidism is an exceptionally powerful risk factor for heart disease. Many people have been told that their thyroid tests are "normal," when in reality risk for heart disease may be as much as tripled from low thyroid with thyroid blood tests in the "normal" range.

Does a "balanced, healthy diet" prevent heart disease?

No, it does not. In fact, the modern notion of a "balanced, healthy diet" increases risk for heart disease. Of course, the dangers of such diets vary, depending on how you define it. If it's the diet advocated by the USDA Food Pyramid, then it is an enormously destructive diet that causes your health to careen towards both diabetes and heart disease. The American Heart Association TLC diet is little better.

Does eating fish twice a month reduce heart attack risk?

Yes, it does--but just barely. Unfortunately, large studies that show that eating fish as infrequently as twice per month reduce risk for dying from heart attack have led some authorities to suggest that's all you need to do. What they fail to understand is that the benefit is dose-dependent--the greater the intake of omega-3 fatty acids, the greater the benefit (within reason, of course). So, while the effect can be detected by eating fish twice per month, it doesn't mean that full benefits are achieved with this "dose." Full benefits are obtained by mimicking the omega-3 intake of the Japanese.

Do nutritional supplements reduce risk for heart attack?

If you are referring to vitamin D, then, yes, nutritional supplements reduce risk for heart attack . . . enormously. We need more data to validate this phenomenon, though epidemiologic observations strongly bear this out, including the Health Professionals Follow-up Study, the Framingham Heart Study and NHANES, all of which demonstrate a graded effect: the lower the vitamin D blood level, the greater the risk for heart attack.

Over the years, we've experienced more than our share of disappointments in nutritional supplements for heart disease, including vitamin E and B vitamins to reduce homocysteine. But I believe that nothing approaches the solid feel of vitamin D--no other nutritional supplement raises HDL, reduces triglycerides, reduces blood sugar, enhances insulin responses, reduces the inflammatory C-reactive protein, reduces blood pressure like vitamin D. Vitamin D is here to stay--and I'm very grateful.

And don't forget omega-3 fatty acids from fish oil, yet another supplement with unquestioned benefits for reduction of heart attack and death from heart attack.

Why didn't your doctor counsel you on the importance of these issues?

The primary reasons your doctor didn't tell you any of the above:

1) He/she has been persuaded that only drugs are of any real use in health. Nutritional supplements? Hah!

2) Neither the number one cause of heart disease in the U.S.--small LDL particles--nor the most aggressive cause for heart disease--Lp(a)--are corrected by patent-protectable, high profit pharmaceutical agents promoted to your doctor. Instead, these abnormalities can be corrected inexpensively, without prescription. That means no expensive commercials, no media spots, no write-ups in magazines.

3) Your doctor's business is to treat crisis: sore throat, broken ankle, lung tumor, heart attack. Prevent heart disease 10 or 20 years before it shows itself? Heck, no (unless the marketing pull of the drug industry is involved, of course).

It's best that you bear in mind: What your doctor doesn't know can kill you.

Comments (12) -

  • Anonymous

    3/10/2009 12:51:00 PM |

    Can you expand a little on the non-pharma management of small LDL particles and of Lp(a)?  Thanks.

  • Stevie

    3/10/2009 5:53:00 PM |

    Well I know our GP is clueless. So glad we found you Dr. Davis!

    Stevie and the cptn

  • Anonymous

    3/10/2009 9:13:00 PM |

    I agree with the evidence on Vitamin D and the heart, and with the conclusion that many nutritional supplements that seemed promising ultimately showed little or no benefit. But niacin has not been a disappointment in raising HDL or lowering mortality.  


  • pmpctek

    3/11/2009 1:41:00 AM |

    "Can you expand a little on the non-pharma management of small LDL particles and of Lp(a)? Thanks." -  Anonymous

    "The proliferation and popularity of the snack food/processed food culture, compounded with the "eat more healthy whole grain " propaganda has launched small LDL solidly to first place as the most common reason to have heart attacks, stents, and bypass." - Dr. Davis

    In other words, limit (or better yet, stop) eating corn starch, flour, sugar, sucrose, high-fructose corn syrup, maltodextrin, dextrose, or just about anything your GP calls a "healthy" grain or cereal (including barley, bulgur, durum, maize, millet, oats, rye, semolina, wheat, etc.)  Also, a diet that's generally low in carbohydrates (100 grams/d or less) will go a long way.

    Non-pharma management of Lp(a)?

    I'd love to know that one too.

  • ned50

    3/12/2009 6:04:00 AM |

    Appreciate some help please! I know I have adrenal insufficiency and suspect I have low thyroid too. All the advice seems to be that I need to fix adrenals first but I'm struggling to do this despite taking all recommended supplements (except corticosteroids which i can't take because of glaucoma). Struggling to cope with high anxiety, poor sleep etc. Any advice or personal experience?

  • Anonymous

    3/13/2009 4:07:00 AM |


    I started using Relacore about 10 days ago. I take it to help repair my adrenals and my thyroid. My body temp has gone up from 97.2 to 97.8 in that time. Still not where I want it to be, but I doubt anything would heal me overnight. I also hear good things about DHEA, but I am not going to take that at the same time I take Relacore as Relacore has DHEA in it. I am wary of too much of a good thing.

  • Trinkwasser

    3/13/2009 2:44:00 PM |

    IMO lots of Omega 3s are good so long as you don't spoil the effect by eating lots of Omega 6s and spoiling the balance all over again (as some "authorities" recommend)

  • Anonymous

    3/13/2009 9:26:00 PM |

    Or one could say "What your doctor 'knows' can kill you!"

  • Anonymous

    3/14/2009 7:21:00 PM |

    Be interesting to hear some commentary on the Chia seed ipo fish oil as it has a high Omega 3 to 6 ratio

  • Bruce

    4/1/2009 8:36:00 PM |

    If you've already had a heart attack or bypass, cardiologists are adamant about prescribing statins. The evidence is supposedly stronger for secondary prevention.

    What evidence is there that a carb-restricted diet with supplments can prevent a second MI or CVD-related death?

  • Ben Takes Natural Remedy From Heart Disease

    8/8/2010 1:29:08 AM |

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    Thank you,