When it comes to your heart, is damage happening faster than repair?
Maybe you think that heart or other vascular (blood stream) conditions happen because of genetics, bad luck, or even your cholesterol. Yes, there could be a genetic contributor. But luck is what happens when you buy a lottery ticket. And cholesterol is a natural product created by the body for good purpose, not to give you a heart attack.
In reality those conditions happen because damage is happening faster than repair. In this post I’m going to help you understand how that matters to you personally.
If you have had a heart attack or some sort of bypass surgery or stent, there is no question. Damage has happened faster than repair. But for the rest of us, the real question is: IS damage happening faster than repair? Because if it is, you are susceptible.
What is cardiovascular disease?
This heart/vascular thing might be called atherosclerosis, heart disease, or cardiovascular disease.? In the interest of simplicity, we can go with the American Heart Association definition of atherosclerosis.
“Atherosclerosis is a condition that develops when a substance called plaque builds up in the walls of the arteries. This buildup narrows the arteries, making it harder for blood to flow through. If a blood clot forms, it can block the blood flow. This can cause a heart attack or stroke.”
So why might plaque build up in the arteries?
We are all susceptible for a very simple reason. Damage to our vascular (blood delivery) system starts the minute we are born and continues throughout our lives. So the greatest broad risk is age.
Think of this as an accumulation thing. The older you get, the more insults your vascular system has encountered and the more repair required. Eventually the grand plan provides for us to transition to an after life whether we want to or not.
Quoting from a post I wrote last year,
“The problem with your heart is this. If you live long enough, if something else doesn’t take you out first, your heart is going to quit beating. That is why age is the highest risk factor for cardiovascular disease. The question is NOT will you die from heart failure because you very likely will. The question is HOW SOON WOULD YOU LIKE THAT TO HAPPEN?”
What is the vascular system?
The vascular system is some 60,000 miles of blood vessels lined on the inside with a thin layer of endothelial cells covered with hair-like structures called glycocalyx. This lining is called the endothelium. Don’t worry. You don’t need to remember any of those words but you do need to know their job.
The endothelium’s job is to protect the vessel walls from penetration. Penetrated vessel walls bleed internally which most of us know can be deadly. Consider a garden hose. A hole in the hose means water is going to leak out.
Anytime there is damage to the endothelium your “national guard” immune system kicks into 911 operation, doing what is required to repair the damage quickly before the vessel wall is penetrated.
That repair might just be replacing a damaged part. A more dangerous repair involves a blood clot and the accumulation of a variety of blood-born elements that seal over the damage. New endothelial cells (manufactured in bone marrow) cover over the seal once the repair is done. I just made that sound much simpler than it is. You are welcome.
Damage is always going on in the vascular system and the immune system is always working to repair. You won’t notice that repair because it doesn’t hurt. The long term problem for the vascular system is when repair can’t keep up.
When it comes to damage to things constructed by humans, things like highways, parking lots, and houses, always happens faster than repair. Repair never just happens miraculously – except in the case of things divinely designed and created. The human body is the perfect miraculous example.
An egg and sperm merge and eventually build themselves into a full grown body that is perfectly capable of repairing itself. A baby arrives expecting to be fed. The growth and ongoing operation of the body expects that certain proteins, fats, vitamins, and minerals will be in the food. And how all that works is so amazing.
The human body
The complexity of your body’s operation is beyond description. Diagrams of the various pathways in every body would blow your mind so I won’t show them. But here is a really simplified process description.
- Interconnecting, overlapping pathways, interwoven with each other in an amazing pattern,
- literally manufacturing an extraordinarily long list of protein, fats, antioxidants and enzymes (as examples) from a very short list of essential nutrients in your diet,
- directing those proteins, fats, antioxidants, and enzymes to exactly where they are needed,
- and depending on essential vitamins and minerals in your diet to catalyze the chemical and electrical signaling necessary to make things happen properly. This is where nutrient deficiency particularly comes into play.
This is a mindbogglingly version of a stacked inter-exchange such as the one in Dallas. Some of you perhaps have encountered that inter-exchange first hand and have painful memories.
The Dallas inter-exchange works just fine so long as you know exactly where you are going and don’t take a wrong turn; some of the roads aren’t blocked by accidents, snow, or (God forbid) collapse; signs don’t fall down; or lights don’t fail.
A failure on the Dallas inter-exchange is usually only a major inconvenience that interferes with your plans. But the failure of your body is not just an inconvenience; it can be terminal. So a built in repair system is required. The trick is to keep it working.
Out of balance
When the expected food nutrients are missing then the body’s operation will be out of kilter. But other things besides nutrient deficiency create imbalance too. When things aren’t working quite right, inflammation is present somewhere.
Out of balance can be temporary or chronic. Temporary imbalance is an acute one time deal and actually happens all the time. Temporary generally comes in two forms.
The very operation of the body, replacement of worn out parts, performance of organic functions like breathing, digesting, heart beating, brain thinking, blood flowing etc. (everything) creates acute damage (inflammation) and then promptly fixes it. You don’t notice this process because it doesn’t hurt. Its normal.
Another temporary imbalance is when bad things outside the body get inside. The outside can be dangerous. Examples are bacteria, viruses, fungus, air pollution, and even toxins common to plants. Read more about plants here.
When bad stuff from outside gets inside acute inflammation happens and the same immune system kicks into gear. This would include broken bones or any other bodily damage, those cases when you will surely require a doctor’s intervention.
You might be a little (or a lot) sick during this process so you will notice it. But again, the immune system is just doing its job.
When acute becomes chronic
The immune system wanders around in your body, on the alert for things that don’t look right or don’t belong and works to straighten them out. When acute inflammation become chronic, there is trouble. This is when damage starts happening faster than repair.
Chronic diseases like arthritis, diabetes, fibromyalgia, kidney disease, asthma, cancer, crohn disease (its a long, long list) often present as acute, occasionally with no early symptoms, and then evolve to chronic when the root cause is not eliminated.
On occasion the immune system gets confused and attacks things that do belong. When this happens you have an autoimmune diseases with the inherent and chronic inflammation. Read more about autoimmune on this link.
What does chronic have to do with your heart?
The existence and treatment of every one of those chronic conditions listed above causes damage (inflammation) in the cardiovascular system and engages the immune system at every turn.
That 60,000 miles of arteries, veins, and capillaries is the primary transportation system in your body. Everything, everything your other systems and organs need get delivered through it. Those everythings including stuff like oxygen, nutrients, hormones, to name only a few. The beating of your heart keeps the blood moving.
Doctors work hard to diagnose and name your condition so they can “treat” it according to their guidelines. And you might want a name so you can find out about it on Google or your favorite internet search engine. But from a vascular damage perspective, its not the diagnosed disease names that are at issue.
The physiological conditions that underlie those diseases are what causes damage to your cardiovascular system and reduce immune repair capability.
So what are those physiological conditions?
High blood sugar and insulin
Most of us recognize these two as issues with diabetes. Type 1 diabetes is marked by the absence of the hormone insulin. Type 2 diabetes begins with high insulin and, unmanaged, works its way to low or no insulin. More detail about diabetes and insulin is in this post, Diabetes is an energy storage problem.
When type 2 diabetics require insulin shots that means that the pancreatic beta cells that make insulin are damaged. This was discussed in this post, How We Get Fat and Why it Matters./.
The point here is that the underlying physiologic conditions in diabetes are high blood sugar, high insulin, or both. Both do major damage to the endothelium. And given that at least 50% (so far) of Americans are pre-diabetic or diabetic this is a major source of vascular damage.
This can become more complicated. High blood sugar can also oxidize (damage) lipoprotein, those things that get measured in your cholesterol lipid panel when you make an occasional visit to the doctor.
Lipoprotein deliver cholesterol, fat, and fat based vitamins to your cells and actually play important roles in the immune system. But when they are damaged, things go in the wrong direction.
Oxidized lipoprotein just hang around in your blood for way too long. When the endothelium is damaged, these oxidized lipoprotein can then contribute to plaque build up in a very bad way.
High Blood Pressure
The structure of the arterial system in the heart and into the brain have some sharp turns, creating natural stress. High blood pressure just increases that stress, creating points of potential damage to the vessel walls. High pressure thickens and weakens the vessel wall which is obviously not a good thing.
Maintenance of blood pressure is largely managed by the chemical nitric oxide which is produced in the glycocalyx on the surface of the endothelium. The more the glycocalyx is damaged by any means (see high blood sugar and insulin above) the greater the potential for high blood pressure.
Too much body fat (described here in an earlier blog post) generates extreme inflammation which is reflected systemically in the circulatory (blood) system. This becomes, effectively, a chronic disease perpetually challenging the immune system. This article from Circulation Research explains (very technically) how this happens. https://www.ahajournals.org/doi/10.1161/01.res.0000163635.62927.34.
Smoking and other air born pollutants/contaminants
Anything breathed into the lungs that doesn’t belong will create inflammation. Cigarette smoke and other environmental pollutants arrive in the blood stream through your lungs (and sometimes your skin.) That inflammation can become chronic as in asthma or COPD. Examples? Lead, mold, mercury, coal dust etc. etc
But remember that the blood stream is the delivery system for everything. Those pollutants will eventually arrive in the blood, do damage to the glycocalyx, and challenge the immune system.
Immune suppressants (steroids and NSAIDS)
Two factors here. These drugs damage the endothelium all on their own and also reduce the immune system’s ability to repair.
Pain reflects inflammation. The immune system responds to inflammation and is required for healing the inflammation. The healing process will inevitably cause swelling, fever, and pain. Ever break a bone, accidentally spill boiling water on your skin, or suffer from arthritis?
Nobody likes pain. Steroids and NSAIDS are prescribed to reduce inflammation and pain. They are supposed to be temporary band aids. Unfortunately they accomplish that by suppressing the immune system. Read more about NSAIDS here.
There is an underlying physiologic cause of any inflammation. Suppressing the immune system does nothing to eliminate the cause. Perpetual suppressant keeps the immune system from doing its job. A perfect example is the ongoing immune suppressors required for organ transplant patients.
The immune system views the transplant as something that doesn’t belong. Organ transplant patients incur major damage to the cardiovascular system (and every other system) associated with the ongoing administration of immune suppressants. The associate pastor at my church was a double lung transplant patient, in and out of the hospital regularly until he died because of the immune suppression in the rest of his body.
Another unfortunate side effect of steroids is increases in blood sugar and insulin, thus long term use contributes to the blood sugar/insulin damage described above.
If you have ever seen a drug commercial on television you know there is a list of side effects many of which are nasty. I have seen such a commercial warning that the drug might cause the autoimmune condition that almost killed me about 20 years ago.
A drug attempts to stick its pharmaceutical hand inside a really complicated metabolic pathway and interfere with a step in the process. The intentions are good but in spite of best efforts, the interference often creates a new problem somewhere else. You take one drug and then three more to treat the side effects. And problems always cause inflammation. That’s just how it works.
So the more conditions you have, the more drugs you take to treat those conditions, the more you can be creating whole new problems for your immune system.
What can you do to avoid cardiovascular disease?
The key is minimize both damage and immune suppression. There is no one answer. Everything needs attention all the time. The good news is this. For most of us, It’s All about the Food.
- Amazing reductions in blood sugar/insulin, blood pressure, and chronic diseases can be achieved just by losing and keeping off excess fat. This can only be accomplished through diet.
- Assure that your diet is whole food based (animal and plant). Minimize and ideally eliminate commercially manufactured foods, especially those containing grain and seed (vegetable) oils. This change alone makes weight loss much easier and, for most, will avoid the inflammation/symptoms of autoimmune diseases.
- Accomplishing the two above minimizes and potentially eliminates drugs including immune suppressants.
- And, of course, don’t smoke.
Start your journey to heart health and general wellness by reading the book, It’s All about the Food. Questions? Call or email me.
Pat Smith is the author of “It’s All About the Food,” a book that guides nutritious food choices as the way to avoid illness and maintain a healthy weight. Pat is a resident of Montgomery County, AR, president of Ouachita Village, Inc. board of directors (Montgomery County Food Pantry), and president of the Mount Ida Area Chamber of Commerce board of directors. Her email address is firstname.lastname@example.org; phone number is 870-490-1836; visit her website at allaboutthefood.org