4 Undeniable Signs of Heart Disease You Need to Address - Dr. Michael Ruscio, DNM, DC

4 Undeniable Signs of Heart Disease You Need to Address

Keep your heart healthy by paying attention to what your body is telling you 

Heart disease is one of the most common causes of death worldwide, but it’s not inevitable. 90% of the risks can be prevented. Wondering how? This video identifies the four signs of heart disease you shouldn’t ignore and how to address them for optimal heart health. 

In This Episode

Intro… 00:08
Cholesterol (with a caveat)… 02:47
Blood pressure… 05:35
Inflammation… 06:47
Blood sugar… 10:26

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Welcome to Dr. Ruscio radio, providing practical and science-based solutions to feeling your best. To stay up to date on the latest topics, as well as all of our prior episodes, make sure to subscribe in your podcast player. For weekly updates, visit DrRuscio.com. That’s DRRUSCIO.com. The following discussion is for educational purposes only and is not intended to diagnose or treat any disease. Please do not apply any of this information without first speaking with your doctor. Now let’s head to the show.

Dr Ruscio:

Hi, everyone. This is Dr. Michael Ruscio. I just want to make a quick preface that the audio that you’re about to listen to is actually the audio compendium to a video, which has appeared both on our YouTube channel and on our Instagram page for your convenience. We want to always release the audio version of a video here on the podcast. However, it’ll be evident in some videos, more so than others, that the visual aids may be heavily referenced and leaned on. In some cases, having a depiction of a concept can be very helpful in portraying and making comprehendible that concept. So in any case, if you are listening to this and you want the visual aids, please see our YouTube and/or Instagram page so you can have access to those. Okay. And here we go to the audio for today’s video.

Dr Ruscio:

Four important signs of heart disease. And you might be asking yourself, chest pain, arm tingling, shortness of breath? No. Sudden death is actually the most common indicator that heart disease is present. This is why it’s known as the silent killer. So we want to make sure that we look at preventative biomarkers or findings that can help you prevent the most common cause of death in the US and one of the most common causes of death worldwide. It is important to also indicate and to mention that 90% of the risk factors for heart disease are modifiable. So there’s a lot you can do. This is Dr. Michael Ruscio and let’s expand.

Cholesterol (with a caveat)

Dr Ruscio:

There’s a myth here we should dispel out of the gate, which is that cholesterol is the only thing that matters. And maybe even the bad cholesterol. This is part of the equation, but there’s much more to it than that. And this is why we want to understand these four signs or indicators that you may be at increased risk for cardiovascular disease.

Dr Ruscio:

Now, yes. Sign number one, high cholesterol. In brief, what is cholesterol? A fat soluble compound that is necessary for sex hormone production, vitamin D production, cell membrane function, and also bile, a digestive secretion production. It’s also important to mention that it’s not all dietary. Only about 25% of the cholesterol in your blood is from your diet, and the rest of this is produced by cells of your body. In fact, every cell of your body can make cholesterol. So if you’ve been frustrated by trying to modify your diet to control your cholesterol, understand that your diet isn’t the only input that leads to the output of your cholesterol levels.

Dr Ruscio:

An important thing to understand here about cholesterol is this riverboat bloodstream analogy. So if you think of your bloodstream as a river, blood is mostly water. Cholesterol is mostly fat, essentially. And as you know, water and oils don’t mix. So the cholesterol has to be put inside of these boats, these carrier boats, and the cholesterol are the passengers, essentially. Now the more boats, the higher the chance of a crash and these crashes cause inflammation, damage, and plaque to build up over time. A normal cholesterol panel will not measure the number of boats. You may have heard of this thing known as particle count, right? This is the number of boats, and this is a much better predictor of who does and does not get heart disease. And again, fortunately, we can measure this via a marker known as ApoB. So this is knowing the number of boats and knowing this knowing ApoB is actually more predictive than is LDL or sometimes labeled as “bad cholesterol.”

Dr Ruscio:

Now what’s the evidence supporting that? Well in the Journal of the American Medical Association Cardiology Edition 2022, 400,000 healthy individuals without heart disease and 40,000 with prior heart disease were followed up prospectively in time for 11 years. And they found that only this ApoB, the number of boats and not the LDL, was associated with heart attack. Also in JAMA cardiology, Alan Snydman, who is one of the leading lipidologists in the world was quoted saying, “ApoB should be the primary marker to assess cardiovascular risk.”

Dr Ruscio:

Have you had your APO B particle count measured? Let me know in the comments.

Blood pressure

Dr Ruscio:

Okay, sign number two: blood pressure. Probably nothing new here. 75% of people will develop hypertension by 65. Now, if we compare this to hunter-gatherers (free living humans), only 4-5% of hunter-gatherers actually have hypertention. And the higher the blood pressure, the more erosion or damage. And even reducing blood pressure by only five millimeters each year, or five points on the reading, leads to a 53% reduced risk of heart disease over one’s lifetime.

Dr Ruscio:

And interestingly, there was just a meta-analysis published, as a quick aside, finding that hibiscus can lower blood pressure by about 15 points on average. Important to mention, this is a meta-analysis. So it’s not a cherry pick of one favorable study made with a questionable design. This is a meta-analysis of a number of clinical trials, which will factor out for placebo, given the placebo-controlled nature. And they found a 15% reduction, so something to consider. But definitely blood pressure is an important marker.


Dr Ruscio:

Now there’s also inflammation. And this is one that hasn’t seemingly so permeated so much into the conventional paradigm. And this might be because many of the anti-inflammatory drugs, it’s hard to justify giving them preventatively. But if we think about the river boat analogy, the more inflammation you have, the more likely one of these boats is going to cause irritation, damage and plaque.

Dr Ruscio:

And one study found that those who had higher levels of CRP (c-reactive protein), that there was a 90% increased risk of developing heart disease at an 18 year follow-up. So inflammation is another independent risk factor. And thankfully this is where natural medicine, dietary and lifestyle changes are huge in their ability to reduce inflammation. But again, doesn’t seem to have really permeated into conventional cardiology because prednisone or some sort of biologic really cannot be justified given the cost, given the side effects in a preventative long term nature. Although there is some interventional data that has shown that anti-inflammatory drugs do reduce heart attack. Now, if we can achieve that same endpoint with natural means, even better.

Dr Ruscio:

And the, the couple factors I think are most salient regarding what drives inflammation would be an inflammatory diet, either poor quality processed foods, foods that are high glycemic load or index, also overeating. Sleep is another one. This is why there’s a correlation between sleep apnea and also night shift workers and increased risk of heart disease. So the rhythm and the timing, but also the quality. So all of these are important to keep in mind, sleep is a absolute fundamental pillar of health.

Dr Ruscio:

Suboptimal gut health is another very important and often overlooked marker. And this is probably why there’s some emergent evidence showing that gut therapies like probiotics can reduce at least some of the biomarkers associated with heart disease. And remember that the largest density of immune cells in your entire body is right here in your small intestine. So if you have poor gut health, that’s going to be a main trigger of inflammation. And we know that inflammation and heart disease correlate as evidenced by this recent systematic review that gave a nice narrative on this issue. And to build on that, certain gut pathogens or residents like H pylori have been found to increase risk also.

Blood sugar

Dr Ruscio:

So there’s definitely this gut connection, and it’s likely via gut to inflammation to cardiovascular health. And to know if you have inflammation isn’t always as simple as it sounds. C-reactive protein or erythrocyte sedimentation rate (ESR), these markers can help, but you will see patients who clearly have signs of inflammation. They may even say, “doc, I feel inflamed. I have swelling. I have joint pain. I have rashes.” Yet, these markers come back as negative. And this may be because some of these markers are what’s known as post-hepatic (after the liver) and the inflammation may be more so occurring pre-hepatic. So you can look at your symptoms and how do you feel? Do you have this intuitive sense that you’re inflamed? Things like joint pain. And you can also look at some of these biomarkers. So we want to kind of have this partially patient-centered and also lab-centered evaluation for inflammation.

Dr Ruscio:

And then the fourth sign is blood sugar. And 38% of the population has prediabetes, so elevations of blood sugar, and 15% have frank diabetes. And the high blood sugar can cause inflammation can lead to immune system over activation or imbalances. High blood sugar can also impair the dilation of your blood vessels and can damage either mitochondria or other related pathways to energy production. And remember that the heart is a very energy intensive muscle, and hence the time between blood sugar and things like blood pressure fatigue and just cardiovascular disease in general.

Dr Ruscio:

So remember the four signs here are, yes, cholesterol, but the particle count should be included, inflammation, blood pressure, and blood sugar. And if you’re looking to prevent heart disease, make sure you’re investigating these four factors. And if you need help or guidance, our clinic does have some very talented clinicians who take a very deep look into lipidology and we’re happy to help if you’re in need. Also, if this video has been helpful, please like it.

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