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WisconsinChristianNews.com
Volume 25, Issue 9
Protecting Your Heart
By Dr. David Lange, Genesis Primary Care February 2025 It is kind of hard to believe that it is Febru- ary already. This means it is back to heart month. So in a physical way, how does one protect their heart? One of the first tests
are also very low density lipoproteins (VLDL) but we don’t usually spend too much time on these. Finally there are triglycerides. These are fats in the bloodstream. They seem to come and go out of favor as to their contribution to artery blockages but they are especially important, if quite high, to causing problems with plugging of the pancreas.
Who is low risk? Young, perfect cholesterol, no di- abetes, no bad habits. As one gets older, has high blood pressure or not perfect cholesterol, this test will provide more value as a screen for heart dis- ease. The test is measuring the amount of calcium that has been deposited in the arteries around the heart. But there are some pretty big leaps of faith
gone changes over time, but I think 140/90 is still a pretty good goal to be under. As one gets older or has more health concerns, there is some room for debate as the ability to tolerate sudden changes in blood pressure is reduced and that can be just as dangerous. Watching the salt in one’s diet may be helpful in some, but is not a guaranteed improvement. Exercise is very helpful in general but especially in high blood pressure. Weight loss can also be helpful but again is not a guarantee. One last thing on blood pressure, there is no set number for too low. It is about how you tolerate the low number. If you feel well at 90/60, that is great. If you are dizzy and feel faint, then it is too low and some adjustment should be made to let it come up to a pressure that has no symp- toms with it. Since we are talking about screening, I won’t go into detail about treatment. There are natural ways to try to help lower the cholesterol and the inflam- mation that leads to heart disease. Red yeast rice is a common supplement. This contains lovas- tatin. Yes, you are reading that correctly. The very first statin is a naturally occurring chemical. Now the pharmaceutical product is many times more concentrated than the natural product and in the world of statins is the least potent of the bunch, but it is natural. Plant sterols and stanols can be helpful. These were first released as an add in to margarine, but margarine is “edible” plastic and should be avoided. These are now available in capsule form. There are other supplements with reported benefits as well and again a detailed dis- cussion is outside the scope of this article. Diet is likely beneficial as well, even if it isn’t the sole an- swer to lowering your cholesterol. Remember, more may change from an improved diet than just the cholesterol number so it is still worth explor- ing. With any change, such as diet or medication, follow up testing in 6-12 months is needed to see what happened to the cholesterol. This isn’t screening any longer, but monitoring. It is very im- portant but is technically different than screening and annual testing is appropriate. Screening with these tests is very important as heart disease remains the number one cause of life years lost. If screening tests find something amiss, then you can use that information to decide the best course of action to protect your heart and live your best life possible. GenesisPrimaryCare.com Please see the display ad on Page 20 of this issue of Wisconsin Christian News).
everyone thinks of in the area of heart disease is cholesterol. I am often asked about cholesterol test results in my practice. Every clinic does this test so it must be important. Cholesterol is an ab- solutely essential component to life. It is the base ingredient of most hormones, cell membranes and essential to the production of Vitamin D. We have been told for decades to reduce fat and choles- terol in our diet to help control our cholesterol lev- els, but this was not based on actual dietary studies. It was expert opinion. Assuming we are eating a natural diet, 90% of our cholesterol is made by us and 10% is from our diet. One will make a substantial change in their values only if the diet is high in processed foods. There is clear evidence that the blockages that develop in arteries is from cholesterol. These blockages can start as early as 2 years of age. They will grow over time, but not everyone seems to get them. This isn’t even based on your choles- terol values, but likely on some other factor that is either not yet understood or the pharmaceutical industry has not yet figured out how to manipulate. I like to think of it as having sticky or slippery cho- lesterol. There are clearly things that can make cholesterol more sticky. Inhaling burning veg- etable matter of any sort is not just bad for your lungs, but also your blood vessels. Artificial foods, also known as processed foods, are also pro-in- flammatory. Unfortunately, I don’t think anyone has figured out what makes your cholesterol more slippery. Statins reduce your cholesterol and re- duce inflammation, but that does not necessarily equal slippery. The total cholesterol is based on several indi- vidual components. The most recognized is the high density lipoprotein (HDL). This is the good kind. Think garbage truck removing garbage. The more of this the better. The only way to get more is through exercise, but that does not raise it as much as needed sometimes. The other number people focus on is the low density lipoprotein (LDL). This is the bad stuff, the garbage, that if not removed, leads to plaques in the arteries. There
This is the basic cholesterol test that measures these components. It is checked frequently, often annually, but is that really the right answer. Why exactly would this test be needed annually if it is normal? Money, of course. Many employers have promised their employees a lower premium on their heath insurance to have this, and several other tests and health parameters, measured and reported to someone. Rather than critically ana- lyze who needs these tests and adjusting the in- terval to be more based in the medical literature, it is just easier to have a spread sheet and make sure the boxes have been checked. If your cho- lesterol is normal then once every 5 years is ade- quate. Beyond the standard test is something called the NMR cholesterol. This test actually looks at the size of the HDL and LDL particles and gives a total particle count in order to better determine the potential damage the cholesterol can do. It is pretty expensive and not covered by insurance so most people do not have this done. I don’t know that it is a lot better than the standard test and I use it more to help someone decide if their alter- native to pharmaceuticals approach to lowering their cholesterol is working. Another screening test that is valuable is the coronary calcium score. Like many tests, if some- one is low risk then it is not really that valuable.
in this test, so it needs to be interpreted carefully. Calcium is deposited in artery walls because there is inflammation. The number one cause of inflam- mation is plaque buildup. The test does not look at how much blockage is present, but is suggest- ing that something may be going on if the number is high. This test is generally under 100 dollars and takes about 15 minutes. It does involve radi- ation as it is an x-ray test, but it is a minimal amount. There is no dye or IV needed so it is pretty much safe for anyone. Another strong contributor to heart disease is diabetes. While diabetes is an article unto itself, the reason that it contributes to heart disease is that it is pro-inflammatory. It creates sticky cho- lesterol. Controlling diabetes helps to reduce in- flammation. The absolute number one factor to control though is your blood pressure. I was at a conference many years ago and a well respected a Family Medicine doctor who does preventive cardiology stated it this way: “If I have high blood pressure, diabetes and high cholesterol, I want you to first treat my high blood pressure. Second, I want you to treat my high blood pressure. Then third, I want you to treat my high blood pressure. After that, you can worry about the rest as a distant fourth concern.” The definition of high blood pressure has under-
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