What is heart disease?

Coronary artery disease (CAD) is usually caused by atherosclerosis, which occurs when fatty material and plaque build up on the walls of the arteries and cause them to narrow. As the coronary arteries narrow, blood flow to the heart can be partially or completely blocked. This results in a lack of oxygen to the heart muscle, which leads to chest pain. A heart attack results when heart muscle is damaged. CAD can also result in heart failure or sudden cardiac death.

The following factors increase your risk of CAD:

• Age 50 or older
• Diabetes
• High blood pressure
• High LDL "bad" cholesterol
• Low HDL "good" cholesterol
• Menopause
• Not getting enough physical activity or exercise
• Obesity
• Smoking
• Higher levels of inflammation-related substances enzymes

However, young adults (age 24-29) with common risk factors, like smoking, obesity, and elevated cholesterol, have a 25 percent risk of having significant narrowing of the coronary arteries. Therefore, all individuals, regardless of age, should follow a healthy lifestyle, including exercise, diet, weight control, and smoking cessation to reduce their risk of heart disease.

For more information, see The American Heart Association.

What are the conventional treatments for heart disease?

When your physician diagnoses coronary artery disease, it is likely that they will suggest basic lifestyle changes. Depending on your specific symptoms and history, the physician may also suggest one or more of the following:

Medication to:

• lower blood pressure
• lower cholesterol
• reduce strain on the heart
• thin the blood to minimize clotting
• increase blood supply to the heart

Procedures or surgery:

• Angioplasty
• Stenting
• Coronary atherectomy
• Coronary artery bypass grafts

What lifestyle changes are recommended for heart disease?

The following basic lifestyle changes can improve your heart health:

• Not smoking
• Maintaining a healthy weight
• Doing at least 150 minutes of moderate intensity exercise every week
• Eating five or more fruits and vegetables daily, minimizing animal fats, getting high fiber

Another important element for cardiac patients is the active participation of their family and support systems. Major lifestyle changes in diet, exercise, stress management, and communication practices are most effectively implemented with the participation of the immediate family members.

Those same family members, especially spouses and partners, also need to make adaptations when their partner is diagnosed with serious cardiac disease. Scroll down to see a list of books that are helpful resources.

What are some integrative therapies  to consider for heart disease?

Emotional and Social Healing Practices

Coronary artery disease is one of the few areas in which we have outcomes data on the actual application of an integrated and holistic approach. The work of Dr. Dean Ornish has been ground-breaking, contributing to lifestyle recommendations that are now mainstream and conventional. These include a lifestyle regimen featuring yoga, meditation, a low-fat vegetarian diet, smoking cessation, regular exercise, and community support. This program not only stops the progression of CAD, but actually reverses it.

Dr. Ornish's research has also shown that the social support—the "heart connection"—is critical. In his book, Love and Survival, he recommends eight ways to find the love you need:

1. Becoming aware of what you say and how you say it
2. Finding a group that supports you
3. Understanding confession, redemption, and forgiveness
4. Working to be more compassionate, altruistic, and of service to others
5. Using psychotherapy
6. Touching
7. Making commitments to others
8. Meditating

Mind/Body Practices and Stress Reduction

The use of mind/body practices lowers the excitation level of the body, which has positive impacts on blood pressure, cholesterol levels, sugar metabolism (and therefore diabetes), mood state, sleeping patterns, and communication abilities. Their use is recommended by the American College of Cardiology.

Mind-body practices include meditation, guided imagery, stress reduction, and biofeedback.

The HeartMath Institute has done extensive research into the benefits, cardiac and other, of mind/body practices, and is an excellent resource for educational materials, research findings, and tools for relaxation practices.

While there are extensive resources available for learning and practicing such techniques on one's own, instruction from a teacher or practitioner is helpful, and practice with others is very supportive. Wherever you live, it is likely you can find local resources through colleges and schools, community centers, churches, and health clubs. Because these practices are things you learn to do for yourself, long-term financial impacts are minimal.

Botanicals and Supplements

Ideally, nutritional substances are optimally obtained through the food we eat. However, some supplemental substances have been found to be of some benefit for those with CAD. Typical doses for each botanical are indicated below. However, you should talk with your healthcare provider before adding botanicals to your health regimen and ask about the right dosage for you.

• Omega-3 supplements: fish oil supplements (<3 g/day), flaxseed oil (1 Tbsp daily) or up to 3 Tbsp/day finely ground flaxseed
• Soluble fiber: psyllium (10-25 g/day)
• Garlic, raw or lightly cooked to preserve the bioactive components (1-2 cloves daily)
• Recommended dietary intake of magnesium (men - 420 mg/day; women - 320 mg/day)
• Folic acid supplementation, 0.4-1mg/day (plus vitamins B_6, 25mgs, and B₁₂ 0.5mg)
• Hawthorne (600-1,800 mg/day); it must be used with caution if digoxin in also prescribed
• Carnitine (1-3 mg/day) and Coenzyme-Q10 (100-200mg/day)

How to use integrative therapies in your heart disease care

Individuals with coronary artery disease are generally on prescription medications to protect the heart. Changing or stopping that medication can be potentially life-threatening. If individuals with CAD pursue complementary therapies, such as homeopathy, Traditional Chinese Medicine, or naturopathy, it is critical that their providers consider potential drug interactions between cardiac medications and any natural products (for example, Chinese herbs).

It is also critical that individuals contact their medical provider when they experience new or worsening cardiac symptoms, such as new or changed chest pain, shortness of breath, or dizziness. While they may also use complementary therapies while awaiting an ambulance, such as homeopathic Arnica taken sublingually, they should never replace or delay appropriate and life-saving interventions.