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Proven Strategies To Prevent and Treat Heart Disease

Ischemic heart disease, also known as coronary heart disease, is characterized by the accumulation of plaque in the heart’s arteries, which can lead to a heart attack, heart failure, or even death. It is the second leading cause of death in Canada.

Understanding facts about cardiovascular diseases (CVD) and taking measures to reduce the risk, including adopting a healthy lifestyle and early diagnosis and treatment of medical conditions, are important steps in preventing this problem.

Some statistics

According to data from 2017-2018 from the Canadian Chronic Disease Surveillance System (CCDSS):

  • Approximately 1 in 12 (or 2.6 million) Canadian adults aged 20 and older suffer from diagnosed heart diseases.
  • Approximately 14 Canadian adults aged 20 and older with a diagnosis of heart disease die every hour.

CVD affect men and women differently.

  • Men are twice as likely to be at risk of a heart attack as women.
  • Men are usually diagnosed with heart diseases about 10 years earlier than women (between the ages of 55-64 for men compared to 65-74 for women), which is associated with the decline in estrogen levels in women after menopause.

Death rate from cardiovascular diseases

The mortality rate from CVD varies significantly among different population groups in Canada:

  • It is 2.9 times higher among adults aged 20 and older with diagnosed heart diseases compared to those without.
  • It is 4.6 times higher among adults aged 20 and older who have had a heart attack compared to those who haven’t.
  • It is 6.3 times higher among adults aged 40 and older with diagnosed heart failure compared to those without.

The good news is that from 2000-2001 to 2017-2018, the statistics on CVD have significantly improved:

  • The number of Canadian adults diagnosed with heart disease for the first time decreased from 217,600 to 162,730.
  • The mortality rate, or the number of deaths per 1,000 people with known heart diseases, decreased by 21%.

Preventive screenings for cardiovascular diseases

In cases of heart problems or suspicion of heart disease, it is important to regularly undergo a series of medical tests and examinations for timely diagnosis and assessment of heart health. These include:

  • Electrocardiogram (ECG): This test records the electrical activity of the heart and can detect rhythm abnormalities and conduction disturbances.
  • Echocardiography (heart ultrasound): Echocardiography uses ultrasound waves to create an image of the heart. It helps assess the heart’s structure, valves, sizes, and chamber function.
  • Stress test: This test evaluates how the heart responds to physical activity. It may involve light jogging on a treadmill or cycling on an exercise bike.
  • Holter monitoring: This test continuously records heart activity for 24-48 hours, helping to identify rhythm abnormalities that may not always be visible on an ECG.
  • Vascular ultrasound: Ultrasonography of blood vessels (Doppler ultrasound) can help detect the presence of clots and evaluate the condition of blood vessels.
  • Blood pressure measurement: Measuring blood pressure is important for assessing the overall condition of the cardiovascular system and monitoring hypertension.

Blood tests

  • Cardiac injury markers: Determining levels of markers such as troponins can help detect acute phases of heart muscle damage.
  • Blood sugar analysis (Fasting glucose, HbA1C): To assess blood sugar levels and identify the risk of diabetes.
  • Lipid profile (LDL, HDL, Tg): Determining cholesterol and triglyceride levels helps assess the risk of atherosclerosis and heart diseases.
  • Inflammatory markers analysis: Determining levels of inflammatory markers such as C-reactive protein (CRP) can help assess the risk of heart diseases.
  • Anemia screening: Anemia can worsen heart function.
  • Coagulation profile (INR, PTT): To assess blood clotting and identify disorders that may contribute to clot formation.
  • Fibrinogen: Fibrinogen is a protein involved in blood clot formation, measured in grams per liter of blood.
  • Platelet count: This test measures the number of platelets in the blood, which play a key role in the clotting process.
  • D-dimer: D-dimer is a product of fibrin breakdown that can appear during blood clot activation. Measuring the D-dimer level can help detect thrombosis and other conditions.
  • Homocysteine: Elevated levels of homocysteine in the blood can be caused by genetic factors and predispose to thrombosis.
  • Genetic tests: Sometimes, thrombosis can be associated with genetic abnormalities that increase the risk of clot formation. Genetic tests can help identify such abnormalities.
  • PULS Cardiac Score: This indicator quantitatively assesses endothelial damage and predicts the likelihood of acute coronary syndrome (including myocardial infarction, unstable angina, and sudden cardiac death) within 5 years. This test measures the body’s immune response to endothelial damage in coronary arteries, leading to plaque formation, progression, and the risk of plaque rupture, which can lead to a heart attack.

Lifestyle and Diet

Changes in lifestyle and diet play a significant role in the prevention and treatment CVD.

  • Healthy Eating: Proper nutrition plays a crucial role. It is recommended to consume more vegetables, fruits, low-fat dairy products, and lean meats. Limit the intake of saturated fats, trans fats, salt, and added sugars. Food rich in antioxidants can protect the heart.
  • Physical Activity: Regular physical activity strengthens the cardiovascular system. Moderate-intensity exercises like walking, swimming, or cycling for 150 minutes per week are recommended.
  • Smoking Cessation: Smoking is one of the primary risk factors for CVD. Quitting smoking can significantly reduce the risk and improve overall health.
  • Weight Management: Excess weight increases the workload on the heart. Maintaining a healthy weight through balanced nutrition and physical activity can significantly reduce the risk of CVD.
  • Stress Management: High-stress levels can raise blood pressure and affect the heart. Meditation, yoga, and relaxation techniques can help cope with stress.
  • Moderate Alcohol Consumption: If you consume alcohol, do so in moderation.
  • Blood Sugar Control: Uncontrolled diabetes can significantly increase the risk of complications in cardiovascular problems. Elevated blood sugar damages blood vessels, which, in combination with high blood pressure and high cholesterol levels, can lead to severe consequences.
  • High Blood Pressure (Hypertension) and CVD are often linked, and blood pressure management plays a crucial role in preventing and treating CVD.

What is used for the treatment and prevention of ischemic heart disease?

As you may have noticed, despite Canada’s growing population, the incidence of the most dangerous and often fatal diseases has significantly decreased over the past two decades. Many believe that the reason for this is medications that help reduce the risk. Among these groups of drugs, only statins, aspirin, and drugs to lower high blood pressure show, according to research, a connection to increased life expectancy in the presence of cardiovascular problems.

What are statins?

I would like to discuss statins. Currently, there is much debate about statins, but we actually have few medications that, at the research level, show a connection to increased life expectancy. So, before deciding on the use of statins or discontinuation of this therapy, let’s understand what statins are and to what extent they reduce the risk for different population groups.

Statins are a class of medications developed to lower cholesterol levels in the blood. They are among the most commonly used drugs to control cholesterol levels and prevent CVD. Statins work by reducing the production of cholesterol in the liver and increasing the number of receptors for LDL cholesterol (the so-called “bad” cholesterol) on the surface of liver cells. This allows the body to more effectively remove excess cholesterol from the blood.

Statins are often prescribed to patients with high cholesterol levels and to those who have risk factors for CVD such as smoking, hypertension, diabetes, and previously diagnosed CVD. These drugs help reduce the risk of heart attacks, strokes, and other cardiovascular complications.

Popular examples of statins include atorvastatin, simvastatin, rosuvastatin, pravastatin, and others.

History of Statin Development

Statins were initially discovered and synthesized as antimicrobial compounds during research on natural products. The first statin extracted from natural sources was lovastatin.

Lovastatin was synthesized by microbes called Penicillium citrinum in 1976 by a group of researchers led by Japanese scientist Akira Endo. It’s important to note that originally, lovastatin was discovered as a potential antimicrobial agent, but it was later found to have the ability to lower cholesterol levels in the body by inhibiting the enzyme HMG-CoA reductase, which is a key enzyme in the biochemical pathway for cholesterol synthesis. This discovery laid the foundation for the development of statins as medications for cholesterol reduction and the prevention of CVD.

From a chemical structure perspective, lovastatin has a chemical structure that is similar to mycotoxins produced by certain fungi and molds. Therefore, from a chemical standpoint, it can be considered a compound closely related to mycotoxins.

However, it’s important to note that lovastatin underwent synthesis and modification for use in medical purposes.

What other medications can be used for the prevention of cardiovascular diseases?

In addition to statins, there are several other classes of medications and approaches used for the treatment and prevention of CVD.


These drugs, such as gemfibrozil and fenofibrate, help lower triglyceride levels (fats in the blood) and simultaneously increase HDL cholesterol (good cholesterol) levels. They can be used as monotherapy or in combination with statins. However, when used together with statins, they increase the risk of muscle pain.

Nicotinic Acid

This medication, also known as niacin (vitamin B3), can increase HDL cholesterol levels and lower LDL cholesterol levels. However, it can cause side effects such as skin flushing and burning. When used concurrently with statins, it may lead to complications in the liver.

Cholesterol Absorption Inhibitors

Medications such as ezetimibe help reduce LDL cholesterol levels by blocking its absorption in the intestines. I want to draw your attention to the fact that this automatically leads to a problem with the absorption of all fat-soluble vitamins (vitamins A, E, K, D) and other essential substances in the body, such as omega-3 fatty acids.

Cholesterol-Lowering Resins

These medications, such as cholestyramine, bind to fats in the intestines and help excrete them from the body, which contributes to lowering cholesterol levels. Cholestyramine does not block the absorption of nutrients if taken as instructed—with plenty of water and separately from food. I also want to note that it is the best binding agent for removing mycotoxins from the body among all known mycotoxins and is used in the treatment of CIRS (chronic inflammatory response syndrome) caused by mycotoxins.

Side Effects of Statins

Various side effects can occur when taking statins, although they do not always manifest in all patients. Side effects are more likely to occur with higher doses of medications, and this applies not only to statins. Here are some of the most common side effects of statins. If you notice these issues after starting statin therapy, it is crucial to discuss them with your doctor:

  • Muscle Pain and Weakness: This side effect, sometimes called myalgia, can manifest as discomfort, pain, or weakness in the muscles. In some patients, this condition may be mild, while in others, it can be more severe. In rare cases, it can lead to serious muscle problems such as myopathy. If you experience muscle pain while taking statins, it is essential to inform your doctor. The dosage may be adjusted or the medication may be changed. There are no other methods to combat this symptom, and it is not uncommon; some data suggest it may occur in up to 30% of statin users.
  • Gastrointestinal Symptoms: Some patients may experience gastrointestinal symptoms such as nausea, vomiting, diarrhea, or abdominal pain. Remember, we mentioned that statins were originally developed as antimicrobial agents. Some of these side effects may be due to the fact that this antimicrobial agent is now being taken for an extended period, which is not usually done.
  • Elevated Liver Enzyme Levels: In some patients, statin therapy can cause a temporary increase in liver enzyme levels in the blood.
  • Side Effects on the Nervous System: Statins can cause side effects that affect the nervous system, such as dizziness, insomnia, or drowsiness.
  • Increased Risk of Diabetes: Statins are also associated with glucose metabolism and insulin sensitivity. They can both reduce and increase the risk of diabetes.
  • Dementia: Some studies suggest a potential association between long-term statin use and an increased risk of neurodegenerative diseases such as dementia.
  • Coenzyme Q10 (CoQ10) Deficiency: Statins can reduce the level of coenzyme Q10 in the body. Coenzyme Q10 plays a vital role in energy processes in the body, including mitochondrial function. Mitochondria are cell organelles involved in ATP (adenosine triphosphate) energy production. CoQ10 is necessary for the health of the heart muscle. Often, people take CoQ10 as a supplement when taking statins to compensate for the loss of this coenzyme.
  • Vascular Calcification Issues: In some cases, statins may be associated with increased vascular calcification. However, research on this topic remains inconclusive, and not all patients are affected. This is linked to the impact of statins on the conversion of vitamin K1 to K2, which is responsible for calcium deposition in bone tissue.
  • Vitamin D Deficiency: Some studies suggest that statins may reduce vitamin D levels in the body. Vitamin D plays a crucial role in the body, including bone health and the immune system. It is essential to monitor and, if necessary, supplement vitamin D levels.

Do not engage in self-treatment!

If you have been prescribed medications and something is bothering you, or if you want to discontinue taking the medication, you need to consult a doctor to help you replace the medication, adjust the dosage, or discontinue it. Many medications, including statins, should not be abruptly discontinued. There is a specific regimen that should be followed to avoid harming your health. The decision to change the dosage and switch medications should also be made only after consulting with a specialist.

Several medications interact with statins and alter their metabolism in the body, and there was no place in this article to list them all. If you are taking any medications besides statins, your doctor must be informed. All of this applies to any medications, not just statins.

In Conclusion

Prevention and treatment of CVD are essential. If lifestyle changes and diet are not effective enough in reducing the risk of CVD, the use of medication should be considered. In such situations, statins can be an important tool that can extend life. The decision to take statins should always be made in consultation with a doctor, who will conduct the necessary evaluation and consider all risk and benefit factors for the individual patient. The use of statins does not negate other recommendations but is an additional tool in the treatment protocol. Adhering to medical advice and regular monitoring of one’s health with a doctor will help achieve the best results in the prevention and treatment of CVD.