Heart Attack Makes Deadly Comeback

Do you remember how prevalent heart attacks and strokes used to be in the 1960s?

Acute cardiovascular death was so common that corporations faced management crises as key executives perished from heart attacks.

One of medicine’s great achievements has been slashing deaths from heart attack and stroke.

The slides on this page demonstrate remarkable decreases in cardiovascular deaths that have occurred in recent decades.

I use these slides in live presentations to demonstrate how technology is winning the war against degenerative aging.

Sadly, a prediction made by many experts has transformed into tragic reality.

Instead of cardiovascular deaths continuing to plummet as they have over the past 60 years, they are increasing in middle-aged Americans.

In some cases, older parents today are seeing their middle-age children perish from preventable vascular disorders.

The reasons are not surprising.

An underlying cause is an obesity and type II diabetes epidemic that is offsetting robust gains made against cardiovascular diseases in past decades.

The encouraging news is that aging individuals can garner significant protection by following proven cardiovascular risk reduction behaviors.

Those who fail to measure and correct artery-clogging factors are at high risk of heart disease and stroke.

Life Extension® readers have annual blood tests to take corrective actions before chest pain, paralysis, or death b arterial blockage manifests.

This article provides a wealth of published data about how to slash one’s risk of suffering a crippling or lethal cardiovascular event.

America’s heart attack epidemic peaked in 1968 and steadily declined as more people understood the artery-clogging role of poor dietary and lifestyle behaviors.

Cardiovascular risk plummeted in response to:^1-7

• Sharp drop in tobacco use,
• Improved emergency responses,
• Near perfection of angioplasty and stenting,
• Huge drop in LDL-related blood lipids resulting from changes in dietary patterns and advancements in pharmacology,
• Use of aspirin for secondary prevention (reduction in heart attack or stroke after having had a prior event), and
• Reduced systolic blood pressure targets.

There has also been a 20-fold increased intake of dietary supplements (like vitamin D and CoQ10).

In a remarkable accomplishment, cardiovascular disease mortality declined by around 70% over the past 60 years.^7-10

This trend of reduced cardiovascular mortality has now turned in the wrong direction.

The prime culprit is record numbers of American adults who are overweight or obese. This has translated into…

A Resurgence of Cardiovascular Disease

Instead of continuing to decline in prevalence, we are seeing progress grind to a virtual halt.

For people aged 45 to 64, cardiovascular mortality increased during the years 2011 to 2017.¹¹ This death rate increase represents a reversal of what had been sharp declines in heart attacks and ischemic strokes that occurred in previous decades.

These deadly trends correlate with rising levels of obesity, type II diabetes and blood pressure. Here are current statistics in the United States:^12-14

• Approximately 40% of adults are clinically obese.
• Over 30% are overweight.
• Approximately 10.5% of adults have diabetes, and
• More than 20% of those with diabetes don’t know they have it.
• Approximately 46% of American adults have hypertension often caused by excess body weight.

The reprint on the left side page shows maps from the Centers for Disease Control and Prevention.

They depict an outbreak of obesity and type II diabetes beginning in 1994 whose impact on cardiovascular disease incidence is now manifesting into deadly reality.

A Ticking Time Bomb

What the maps on the facing page don’t reveal is the number of undiagnosed diabetics, which is astronomical based on today’s surging obesity epidemic.

These maps also don’t consider a position that Life Extension® took in the early 1980s that the concept of "prediabetes" is highly misleading.

That is because damage to eyes (retinopathy), kidneys (nephropathy), and nerves (neuropathy) begins before the onset of full-blown diabetes.

Our position has been validated in dozens of studies showing that damage to blood vessels, nerves, kidneys, and eyes accumulates wit suboptimal glycemic control before full-blown type II diabetes is diagnosed.^15-20

To put this into numerical perspective, conventional medicine guidelines in the 1980s diagnosed type II diabetes when fasting glucose reached 140 mg/dL (on two occasions).

Life Extension® vehemently argued that any fasting glucose reading over 100 mg/dL increased one’s risk of developing diabetes, as well as silent damage to blood vessels, nerves, eyes, and kidneys.

For decades, we urged our readers to keep their fasting glucose between 70-85 mg/dL.

Obesity Surges

A startling 72% of Americans are overweight or obese.¹²

The average person’s glycemic blood markers (hemoglobin A1c, insulin and glucose) today are at frighteningly high levels.

I analogize this ticking diabetic time bomb to how lung cancer deaths did not sharply increase until 30 years after cigarette smoking became prevalent after year 1900.

We are now about 27 years into a spiraling rise of obesity prevalence. The pathologic impact is being demonstrated by increased heart disease deaths in middle-aged Americans.²²

You don’t have to be a victim, even if you are in the diabetic or overweight category.

Simple Steps Yield Huge Benefits

In response to the plague of diabetic disorders striking Americans, several studies were initiated to evaluate whether cardiovascular events could be reduced with modest risk-factor changes.

When only aggressive glycemic control is instituted in type II diabetics, there are usually negligible reductions in heart attack and stroke risk.

This is not surprising when considering that a diagnosis of diabetes often occurs with other co-morbid conditions like hypertension and elevated lipids.

Published data show that when diabetics control other risk factors, like high blood pressure and elevated LDL cholesterol, there are marked reductions in cardiovascular risk.

For example, a group of 2,018 diabetics were treated to achieve safer ranges of blood pressure, hemo-globin A1c (blood marker of long-term glucose control) and LDL cholesterol.²³

In those who achieved one or more of the three targeted ranges of:

• Blood pressure
• LDL cholesterol
• Hemoglobin A1c…

…there was an incremental lower adjusted rate of cardiovascular events. In other words, with each additional treatment goal met, cardiovascular risk decreased further.

The chart below shows the percent of risk reduction in response to targeting one risk factor (such as blood pressure),two risk factors, or all three risk factors (blood pressure, LDL, and hemoglobin A1c) vs. none:

This table shows a 60% coronary-event risk reduction when all three risk factors are controlled.

This prompted the study’s authors to note how uncommon it is for diabetics to have all three risk factors in safe ranges.

They concluded that optimization of these risk factors is:

"…associated with substantially lower risk of coronary heart disease and cardiovascular disease."

Cardiovascular disease events include stroke and heart attack.

This study indicates that many lives can be spared if basic, conventional risk factors, especially blood pressure and lipids are better controlled.

Critical Need of Comprehensive Therapy

There is a lack of consistent data on treating diabetics with intensive glycemic control alone.

While aggressive glycemic control by itself lowers risk of kidney failure, neuropathy, and retinopathy, the risk of heart attack and stroke are typically not reduced.

For example, a clinical trial of Danish type II diabetics compared intensive multi-modal therapy to conventional therapy for a mean treatment period of 7.8 years.²⁴

The intensive, omprehensive therapy group had a 57% reduction in cardiovascular disease death and a 59% reduction in cardiovascular disease events.

A much larger, five-year study of 859,617 diabetic adults in the United States showed inadequate risk factor control to be responsible for 11% to 34% of cardiovascular disease events.²⁵

The defined “risk factors” in this five-year study were blood pressure, LDL, hemoglobin A1c, and smoking.

Another study looked at similar risk factors for American type II diabetics and projected that controlling all of them would prevent35% of coronary heart disease events in men and 45% in women.²⁶ The authors concluded:

"…a significant proportion of coronary heart disease events in adults with type II diabetes could be prevented from composite control of risk factors often not at goal."²⁶

The data relating to heart attack and stroke prevention reveal that diabetics need to control more than just glucose and hemoglobin A1c levels.

What About Obese Individuals?

In a 2016 report published in JAMA, Johns Hopkins researchers followed a group of 13,730 people for about 23 years.²⁷

Body Mass Index of this large study group ranged from normal weight (BMI 18.5 to <25 kg/m²) to severely obese (equal to or more than 35 kg/m²).

After controlling for factors like age, smoking status, and physical activity, severely obese subjects had about a two-fold higher risk of coronary heart disease and ischemic stroke.

The box below reveals the surge in cardiovascular risk factors in Colorado, a state associated with healthier behavioral patterns than the southeast United States.

When the researchers of this 2016 JAMA study controlled for:

• Diabetes,
• Hypertension,
• Cholesterol/triglycerides, and
• Kidney function...

…there was no longer a difference between obese and normal weight people for risk of coronary heart disease and stroke.

While this is encouraging, the researchers discovered that severely obese individuals had a nearly four-fold increase in heart failure, even when conventional risk factors (like blood pressure, glucose, and lipids) were considered.

The researchers pointed to evidence that excess body weight increases the heart’s workload. They also pointed to the role of fat cells in the belly (abdomen) releasing inflammatory factors that further damage the heart.

None of these studies measured critical additional blood factors that contribute to coronary artery disease, ischemic stroke, and heart failure.

If these added artery-clogging factors (like C-reactive protein and apolipoprotein B) were measured in type II diabetics and/or obese individuals, there would be an opportunity for more substantial reductions in cardiovascular diseases.

Too Many Needless Deaths

The studies reported in this editorial looked at conventional cardiovascular risk factors in overweight and diabetic individuals.

Up to 62% lower rates of cardiovascular events occurred in diabetics who achieved better control over their blood pressure, lipids, and blood sugar.

But what about the 38% risk for cardiovascular events that remained, even after controlling conventional risk factors?

As a reader of this magazine, you know there are about a dozenadditional cardiovascular factors such as homocysteine, apolipoprotein B, and hormone imbalances.

These blood markers should be measured, and efforts made to reduce them to safe ranges. This will likely yield greater reductions in cardiovascular events.

Now that cardiovascular disease is making a deadly comeback, it is imperative to have comprehensive blood tests, which is what most readers of this magazine do each year when they order the popular Male or Female Panels.

Annual Lab Test Sale

The high cost of blood tests prevents many people from testing for, and then optimizing, their cardiovascular risk factors.

We at Life Extension® recognized this problem 25 years ago.

Back in those days, many of our readers were challenged to persuade their doctors to order tests like homocysteine and hemoglobin A1c.

The price of blood tests in the 1990s was far higher than today.

This motivated us to develop a program that enables readers to order low-cost tests and then visit a blood draw station in their area at their convenience.

Blood test results come back in less than a week and are promptly emailed and mailed.

If there are any questions, our Wellness Specialists are available to assist, seven days a week, at no charge.

Once a year we discount prices of all lab tests. This serves as a convenient reminder to have one’s annual assessments performed at the lowest prices.

The extensive array of blood tests included in the Male and Female Panels can be viewed on the page to your right.

The discounted price for this year’s Male or Female Blood Panels (that includes apolipoprotein B and newly added ferritin) is $224. It’s a bit higher now than in years past, but it includes more important measures that cost over $2,000 at commercial labs.

To order the Male or Female Panel today, call 1-800-208-3444 or log on to: www.LifeExtension.com/blood

You can then visit a blood draw station we refer you to in your area at your convenience.

For longer life,

William Faloon

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