Stroke Prevention

The Canadian Heart and Stroke Foundation has recently raised the alarm bell to warn that stroke is not only a significant problem for Canadians, but that many of us don’t know what to look for in order to detect a stroke, and seek crucial early treatment. You’ve likely seen their ad campaign, reminding Canadians of the signs of stroke: sudden numbness or paralysis of the face, arm, or leg, slurred speech, confusion, blurred vision, trouble walking and dizziness.



As a naturopathic physician, I feel it is also important to educate the public about what can be done to prevent strokes. Strokes are typically a symptom of underlying cardiovascular disease. The main way to prevent cardiovascular disease is to live a lifestyle that promotes cardiovascular health. It is important to understand your risk factors and take steps to reduce them. A patient that I’ve worked with over the last year illustrates that journey.



Brent was a 54-year-old man who came to see me after his brother had a debilitating stroke at 57. As a father of three teens, Brent didn’t want that fate for himself and his family. He came to me for an assessment and to get help changing the course of his health for the better. I found out that he had smoked for 30 years and his waist circumference was 44” – well above the recommended 40” for men. His LDL cholesterol was elevated, as were his triglycerides, and his blood sugar was borderline diabetic. I ran an insulin test and found this to be very high, indicating insulin resistance. His blood pressure was above normal, at 147/90. Running his own business, he carried a significant stress load, which was taking its toll on his health.

I explained to him that he had multiple risk factors for cardiovascular disease that leave him at higher risk for stroke or heart attack than the average man his age. Genetics may be one risk factor, but the study of epigenetics has proven that our lifestyle affects our gene expression. So even when there is a family history of a disease, lifestyle can determine whether an individual gets that disease. We tested him for a genetic risk for cardiovascular disease, called methylation defects. About 15% of the population has a mutation of the gene necessary for methylation, a critical chemical process in the body. Without adequate methylation, homocysteine can build up in the bloodstream, causing accelerated atherosclerosis. A specific set of nutrients can help solve this problem, which it turned out he needed.

Next, I set out to help Brent quit smoking. Through a combination of herbal medicines to reduce cravings, stress-management and behavioral modification, Brent has been cigarette-free for almost a year now. It was important that he not gain weight after quitting smoking, so I coached him on a heart-healthy weight loss nutrition plan that has resulted in a 35 pound weight loss. Exercise was new territory for Brent, but he made it a family affair by getting out mountain-biking with his teenagers. He’s even keeping up with the youngest one now! As part of a stress management plan, he’s started a “gratitude check-in” at dinner with his family, where each person shares something they are grateful for from that day. This practice has been uplifting for Brent and his family.

After a year of coaching and treatment, Brent’s blood sugar and insulin levels were back to normal. His cholesterol levels were lower, but not low enough. He had tried Statin drugs for cholesterol in the past, but suffered leg pain as a result. I recommended natural medicines that further lowered his cholesterol while also being easier for his body to tolerate. I also recommended fish oil, Coenzyme Q10 and other natural medicines to prevent damage to his cardiovascular system from inflammation, oxidative stress and mitochondrial issues.
Brent looks and feels like a new man. His children will likely have their Dad around for many years to come. Stroke awareness is important, but prevention is critical. We can all benefit from living a stroke prevention lifestyle.

Know your Cardiovascular Risk Factors

Likely, someone you know has become ill or died from heart disease. It is the number one cause of death for both men and women. After menopause, women’s risk of heart disease equals that of men, but more women die from their first heart attack or stroke than do men. The great tragedy of cardiovascular disease is that it is a silent disease that can hit people in the prime of their life, robbing them of quality of life, or causing early death. While heredity does play a part the predisposition to heart disease, biology is far from destiny. There is overwhelming evidence that you can control whether or not you develop heart disease and whether it progresses. It is never too late to make a difference. Knowledge is power. The more you understand about the risk factors for cardiovascular disease, the more you can take action to stop it in its tracks. There is ample scientific evidence showing that diet, exercise, supplements, relaxation and chelation therapy can all help prevent and treat heart disease. Conventional medicine has made strides to help those in acute crisis with heart attacks, but drugs and surgery are not the only answer for optimizing your health.

Taking stock of your risk factors may let you know how aggressive you need to be in your prevention program. Ask about your family history and the lifestyles of those family members who had heart attacks or strokes. Take a good hard look at your lifestyle; do you smoke, eat high fat food, carry extra weight or live with high stress? If so, then it is time to get real about the choices you are making and decide that living is your priority. It is very helpful to enlist the support of a naturopathic physician or another professional who can coach you through these hard life changes. I find that making real, lasting change requires a lot more than will power. It takes looking at what drives the old patterns and addictive behaviors. Don’t be afraid to ask for help; your life may depend on it.

Your naturopathic doctor can be an important ally in your heart disease prevention program. I recommend having a thorough physical examination at least yearly to assess blood pressure and other signs of heart disease. I also recommend that my patients have a thorough set of blood work done yearly to monitor their health. Diabetes is a serious risk factor for cardiovascular problems so blood sugar levels should be watched carefully in anyone with a family history or risk factors for diabetes. High cholesterol is a well known risk factor for cardiovascular disease. The “bad” cholesterol (LDL) can serve as the raw material to clog the arteries. It damages the arteries, setting up a cascade of events that contribute to plaque build up known as atherosclerosis. Good cholesterol (HDL) actually binds to the bad cholesterol and transports it to the liver where it can be destroyed . Therefore, the proportion of good and bad cholesterol tells us more that just how much total cholesterol you have. The goal in lifestyle coaching is to increase the HDL and decrease the LDL, thus lowering the ratio. Foods that ave been shown to influence these two types of cholesterol are as follows:

Foods that improve cholesterol ratio
Foods that worsen cholesterol ratio
Beans
Saturated fats – meat, dairy and peanuts
Soy products
Trans fatty acids*
Oatmeal
Hydrogenated vegetable oil*
Garlic, onions
Vegetable oil shortening*
Salmon (omega 3 fatty acids)
Partially hydrogenated oils*
Olive oil (monounsaturated oil)
High sugar diets
Almonds (monounsaturated oil)
Ultra low fat diets* found in most packaged foods, fespecially crackers, cookies, fbaked foods, and margarine.
Avocados (monounsaturated oil)
Citrus, peppers, broccoli (vitamin C)
Green or black tea
Apples, carrots (fiber called pectin)

If you have high levels of bad cholesterol, it is important to understand that cholesterol is a fat that can go rancid, just like unrefrigerated butter does. Rancid, or oxidized LDL cholesterol is highly destructive to the artery walls. You can prevent your LDL cholesterol from becoming oxidized by having a diet high in antioxidant nutrients. That is one of the reasons why eating lots of fruits and vegetables, and taking a daily antioxidant supplement makes so much sense. Lowering your intake of omega-6 type oils is also important as they become incorporated into LDL cholesterol particles were they are readily oxidized and become destructive. Omega-6 oils are corn oil, safflower oil, and soy oil. Finally, I help my patients to lower their cholesterol without drugs by using safe, natural medicines. I constantly see the total cholesterol and the cholesterol ratio reduce by 25% after three months on natural medicine – without side effects!

Another well studied risk factor for cardiovascular disease is homocysteine. Scientists have shown a link between high levels of this amino acid and early development of cardiovascular disease, deep vein thrombosis and stroke. Interestingly, it has also been shown to be a risk factor for dementia and Alzheimer’s disease. People with family history of these diseases should ask their medical or naturopathic physician about testing for this important risk factor. The goal is to have homocysteine levels under 6. Elevated levels can be easily treated by supplementing several B vitamins and cardiologists are now routinely recommending patients take folic acid, and vitamins B5, B6 and B12.



The final piece of lab work that will help you understand if you are on the way to a cardiovascular event like heart attack or stroke, is called C-Reactive Protein. This factor in the blood has been well studied and is an indicator of the level of inflammation in the blood vessels. It is inflammation in the blood vessels that causes plaques to rupture, creating a log jam where platelets congregate and make clots that cause heart attacks and strokes. The predictive value of C Reactive Protein (CRP) as a risk factor for cardiovascular events has led some researchers to support the use of CRP as a main cardiovascular risk assessment tool. If the CRP result is over 1.3, steps should be taken to lower it.



If upon taking stock of your risk factors you determine that you need to get to work to change your fate, I encourage you to enlist the support of a health care coach like a naturopathic physician to get on the road to health. If you have heart disease, I often recommend a consultation with my colleague, Dr. Christoph Kind who performs chelation therapy. This intravenous therapy has an excellent track record of safety and efficacy in helping those with established heart disease. You can stop heart disease, and like my husband and I, take charge of your destiny with a holistic approach to health.



Hypertension: Blood pressure over 135/85 increase the risk of cardiovascular disease. Natural medicines along with a low sodium diet and exercise, can lower blood pressure.