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From the Townsend Letter for Doctors & Patients
August/September 2004


Letter from the Publisher
by Jonathan Collin, MD

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On a class reunion trip this summer I was saddened to learn that a classmate's brother died following a heart attack. A 52 year-old man is not unusual as a victim of premature death from coronary artery disease. Sedentary lifestyles, overly rich diets, highly stressful careers and family lives, daily exposure to chemicals and toxic elements, periodic bouts of upper respiratory and gastrointestinal infections, and cardiovascular risk factors undoubtedly play a major role in acute death from myocardial infarct. Despite a growing public consciousness of high cholesterol and hypertension, too many middle-aged individuals only realize their risk of mortality after being surprised with "bad numbers" after a routine medical exam. Clearly the coronary artery disease did not develop overnight – atherosclerosis has been progressively clogging the arteries since teenage years. Unfortunately teenagers and young adults are not receptive to preventing cardiovascular risk.

In a move that has perplexed patients, the Board of Cardiology has established remarkably lower numbers in 2003 for defining normal blood pressure. Whereas 140/90 had been considered the benchmark for high blood pressure in years past, now a reading of 110/70 is held as the optimal blood pressure for adults of all ages. A blood pressure of 130/80 is considered to be high blood pressure and a reading of 140/90 is considered a very elevated blood pressure reading. For many adults, these new standards are difficult to achieve without the use of medication and probably multiple medications. It is not unusual for elderly adults to have readings that are now considered dangerously elevated. One cardiologist stipulates that patients with such blood pressure elevations require the use of a beta blocker, ACE inhibitor, and/or diuretic at minimum, to achieve normal blood pressure readings. With family practitioners and cardiologists administering more intensive medication regimens to hypertensive patients, there will be more frequent incidence of adverse effects. Still it will be very difficult to justify avoidance of such medications, if one were unable to achieve the newly defined normal blood pressure reading with herbals and vitamins/minerals alone. A reasonable period of time would be justified to attempt lifestyle and herbal programs for hypertension control. At the end of the day, when a patient fails to control hypertension with natural means, medication is justified and should not be withheld. One must remember that the purpose of alternative medicine is to accomplish a goal that simply cannot be met by conventional medicine approaches. One needs to be circumspect in deciding that alternative medicine works superiorly to conventional medicine for control of hypertension.

Another bone of contention has been the control of cholesterol. In this publication and elsewhere the cholesterol-controlling drugs have been derided as unnecessary, risk-producing, and fraught with adverse effects. This reasoning is reasonable except for one minor observation: ongoing studies with "statin" drugs have established preliminary evidence that statins do reduce inflammation in the cardiovascular process and may show low-grade reversal to the atherosclerotic plaque process. More work needs to be done to confirm that "statins" reverse atherosclerosis but the early evidence is highly suggestive that high and moderate risk cardiovascular patients would benefit from the use of "statin" drugs. It is now incumbent for physicians in natural medicine who oppose "statin" drug use to develop provable protocols which lower LDL cholesterol, reduce C-Reactive protein, and reverse atherosclerotic plaque. This is a major challenge and there may be valid natural protocols. We know that Vitamin C, niacin, red rice yeast extract, policosanol, citrus pectin, guggulipid herbal, and other herbals play a role in lowering cholesterol. However, many patients complain about the administration of such natural product protocols. There is difficulty in tolerating high dose niacin. While red rice yeast extract and policosanol seem to lower cholesterol, expense is an important concern. There is difficulty in achieving compliance when too many supplement pills are required each day.

This issue of the Townsend Letter explores alternatives in the prevention and treatment of coronary artery disease and angina. Undoubtedly, the alternatives play a vital role in cardiovascular risk prevention, in improving lifestyle, lowering stress, and enabling individuals to experience higher quality of life. We need to consider both conventional and alternative approaches in use – the drug agents to control hypertension and/or cholesterol as well as the herbal and vitamin/mineral factors which naturally support cardiovascular health.


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