Heart attack

What is a heart attack?

Symptoms of a heart attack

Risk factors for a heart attack

Prevention / remedies / recovery from heart attack

References

What is a heart attack?

Heart attack (myocardial infarction) is the interruption of blood supply to part of the heart, causing heart cells to die. Usually it is caused by the blockage of a coronary artery following the rupture of an atherosclerotic plaque in the wall of an artery. The resulting restriction in blood supply (ischemia) and shortage of oxygen (hypoxia) damages or destroys heart muscle tissue.

A heart attack is different from but can cause:

• Cardiac arrhythmia (abnormal heartbeat).
• Cardiac arrest (heart stops beating).
• Heart failure (pumping action of the heart is impaired).

Heart disease was the leading cause of death for both men and women worldwide for several decades, (2) and caused 16% of all deaths in 2022. (20)

A heart attack is a life-threatening medical emergency. The immediate action to take is to get urgent medical help.

Symptoms of a heart attack

Approximately one quarter of all heart attacks are silent, without chest pain or other symptoms. (1)

• Chest pain, usually increasing over several minutes, rather than instantaneous. It typically radiates to the left arm or left side of the neck, though it can also be in the lower jaw, neck, back and other areas. Typically, there is a feeling of pressure, tightness or squeezing.
• Shortness of breath.
• Nausea or vomiting.
• Palpitations. (19)
• Sweating.
• Weakness, light-headedness or loss of consciousness.
• Anxiety (often described as a sense of impending doom).
• Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue. Sleep disturbances can occur as long as a month before the heart attack.

Risk factors for a heart attack

• Heart attacks are primarily caused by atherosclerosis. (5, 6) The risk factors listed below all cause or are associated with atherosclerosis.
• Vitamin D deficiency. (22)
• Chronic inflammation is both a cause of atherosclerosis and risk factor for heart disease.
• One of the best predictors of a heart attack is the Coronary Artery Calcification Score (CACS). See hypercalcemia. The build up of calcium in the wrong places is the cause of several of the risk factors on this web page.
• Psychosocial factors such as low socioeconomic status, social isolation, lack of autonomy or feeling trapped in an unhappy life, shorter education, negative emotions and stress. This leads to chronic high stress, raised stress hormones including cortisol, raised blood glucose, elevated pyruvate, and increased levels of lactic acid (lactate). (15, 16, 17, 18)
• High blood pressure. (18)
• Calcium deposits, hypercalcemia.
• Obesity, especially having a large gut.
• Poor blood cholesterol profile. The conventional measure of total blood cholesterol, high density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides is cheap, widely used and of limited effectiveness. The level of blood triglycerides and the HDL/LDL ratio are the most significant of these conventional measures.
  Small dense LDL particles are much more susceptible to oxidation and accumulation in arterial plaques than large buoyant LDL. In the past, tests to measure these small dense LDL subtype patterns were not widely available, and were also been expensive. (3, 4) There is a correspondence between higher triglyceride levels and higher levels of smaller, denser LDL particles, so the conventional blood triglyceride level is a useful proxy for the more expensive test.
  A 2018 study suggests LDL and cholesterol in general are not important risk factors. (8)
  A major 2021 study found no correlation between a high saturated fat diet and heart disease - just the opposite. (9)
• Toxins. Primarily from diet. Certain drugs (tobacco smoking, alcohol, cocaine, methamphetamine, and certain pharmaceutical drugs). Pollution of air, water and food.
• Lack of movement and exercise. (18, 19, 21)
• Being unfit.
• A heart attack can be triggered by intense exertion (more intense than the person is used to), either physical or psychological.
• Periodontal disease and other sources of infection.
• Previous cardiovascular disease.
• Family history of heart disease.
• Age.
• Gender. Men are more at risk than women, particularly before menopause.
• Diabetes.
• Chronic kidney disease.

Prevention / remedies / recovery from heart attack

• Cayenne pepper, both as an immediate emergency treatment (tell the ambulance and doctor if you used it) and as a long term preventative.
• Reduce stress, handle chronic stress. The cost of having a serious heart attack (death, loss of functions) will always exceed the cost of re-prioritising your life in the first place. Start meditating, take an honest look at your life (Grow Youthful has a chapter on how to do this), and decide what is most important.
• Exercise. Daily, enjoyable, low stress exercise like a long walk in a park or a swim or even active housekeeping. Keep moving much of the day, try to get out into a natural environment rather than being cooped up indoors. (21)
• Vitamin D sufficiency. (22)
• Garlic.
• Vitamin B3 (niacin). Fish, beef, chicken, turkey and spirulina are the best food sources of niacin. In a more urgent situation, niacin can be purchased as a supplement, and may be useful at 500 mg per day in an extended-release form. Niacin is a powerful antioxidant which acts upon cholesterol, and in particular niacin decreases small, dense, oxidised forms of cholesterol. It provides cardiovascular protection by preventing white blood cells forming atherosclerotic accumulation. Niacin decreases triglyceride levels. It decreases vascular oxidation through its anti-inflammatory effects. Niacin decreases C-reactive protein, which is a strong predictor of heart attack, stroke and peripheral vascular disease. (10, 11, 12, 13, 14)
• Vitamin B1 (thiamine) sufficiency. The best food source of vitamin B1 is unfortified nutritional yeast. Other food sources include grass-fed meat, fish and brewer's yeast. Black tea is high in tannin, a compound that binds a variety of micronutrients, particularly vitamin B1, calcium, iron and zinc.
• Taurine.
• The diet recommended in Grow Youthful. Eliminate sugar and sweet foods. Whilst not a strict ketogenic diet, research shows that this type of diet is effective in treating heart disease. (6, 7)
• Vitamin E. Food sources of vitamin E include sunflower seeds (soaked, of course), wheat germ oil, almonds, roast peanuts, pumpkin and red pepper.
• A diet rich in natural antioxidants. Taking antioxidants in the form of pills is not likely to be effective.
• See details of remedies recommended by Grow Youthful visitors, and their experience with them.

References

1. Valensi P, Lorgis L, Cottin Y. Prevalence, incidence, predictive factors and prognosis of silent myocardial infarction: a review of the literature. Arch Cardiovasc Dis 104 (3): 178-88. PMID 21497307.

2. World Health Organization (2008). The Global Burden of Disease: 2004 Update. Geneva: World Health Organization. ISBN 92-4-156371-0.

3. Superko HR, Nejedly M, Garrett B. Small LDL and its clinical importance as a new CAD risk factor: a female case study. Progress in Cardiovascular Nursing 17 (4): 167-73. PMID 12417832.

4. Warnick GR, Knopp RH, Fitzpatrick V, Branson L. Estimating low-density lipoprotein cholesterol by the Friedewald equation is adequate for classifying patients on the basis of nationally recommended cutpoints. January 1990, Clinical Chemistry 36 (1): 15-9. PMID 2297909.

5. Natasha Campbell-McBride. Put your heart in your mouth. Medinform Publishing, 2007.

6. Paul Jaminet & Shou-Ching Jaminet. Perfect Health Diet. Four Steps to Renewed Health, Youthful Vitality, and Long Life. P YinYang Press, 2010.

7. Soudijn W, van Wijngaarden I, Ijzerman AP. Nicotinic acid receptor subtypes and their ligands. May 2007, Medicinal Research Reviews 27 (3): 417-33. PMID 17238156.

8. Rafel Ramos, Marc Comas-Cufi, Ruth Marti-Lluch, Elisabeth Ballo, Anna Ponjoan, Lia Alves-Cabratosa, Jordi Blanch, Jaume Marrugat, Roberto Elosua, Maria Grau, Marc Elosua-Bayes, Luis Garcia-Ortiz, Maria Garcia-Gil. Statins for primary prevention of cardiovascular events and mortality in old and very old adults with and without type 2 diabetes: retrospective cohort study. BMJ 2018;362:k3359. Published 5 September 2018.

9. Marinka Steur, Laura Johnson, Stephen J. Sharp, Fumiaki Imamura, Ivonne Sluijs, Timothy J. Key, Angela Wood, Rajiv Chowdhury, Marcela Guevara, Marianne U. Jakobsen et al. Dietary Fatty Acids, Macronutrient Substitutions, Food Sources and Incidence of Coronary Heart Disease: Findings From the EPIC-CVD Case-Cohort Study Across Nine European Countries. 19 November 2021. Journal of the American Heart Association. 2021;0:e019814.

10. Karacaglar E, Atar I, Altin C, Yetis B, Cakmak A, Bayraktar N, Coner A, Ozin B, Muderrisoglu H. The Effects of Niacin on Inflammation in Patients with Non-ST Elevated Acute Coronary Syndrome. Acta Cardiol Sin. 2015 Mar; 31(2):120-6. doi: 10.6515/acs20140630e. PMID: 27122858; PMCID: PMC4804877.

11. Si Y, Zhang Y, Zhao J, Guo S, Zhai L, Yao S, Sang H, Yang N, Song G, Gu J, Qin S. Niacin inhibits vascular inflammation via downregulating nuclear transcription factor-kB signaling pathway. Mediators Inflamm. 2014;2014:263786. doi: 10.1155/2014/263786. 27 May 2014. PMID: 24991087; PMCID: PMC4058495.

12. Canner PL, Berge KG, Wenger NK, Stamler J, Friedman L, Prineas RJ, Friedewald W. Fifteen year mortality in Coronary Drug Project patients: long-term benefit with niacin. J Am Coll Cardiol. 1986 Dec;8(6):1245-55. doi: 10.1016/s0735-1097(86)80293-5. PMID: 3782631.

13. Berge KG, Canner PL. Coronary drug project: experience with niacin. Coronary Drug Project Research Group. Eur J Clin Pharmacol. 1991;40 Suppl 1:S49-51. PMID: 2044644.

14. Ganji SH, Qin S, Zhang L, Kamanna VS, Kashyap ML. Niacin inhibits vascular oxidative stress, redox-sensitive genes, and monocyte adhesion to human aortic endothelial cells. Atherosclerosis. 2009 Jan;202(1):68-75. doi: 10.1016/j.atherosclerosis.2008.04.044. Epub 2008 May 9. PMID: 18550065.

15. Britta Kubera, Christian Hubold, Saskia Otte, Ann-Sophie Lindenberg, Irena Zeib, Regina Krause, Mirja Steinkamp, Johanna Klement, Sonja Entringer, Luc Pellerin, Achim Peters. Rise in Plasma Lactate Concentrations with Psychosocial Stress: A Possible Sign of Cerebral Energy Demand. Obes Facts 1 June 2012; 5 (3): 384-392.

16. Verberne AJ, Korim WS, Sabetghadam A, Llewellyn-Smith IJ. Adrenaline: insights into its metabolic roles in hypoglycaemia and diabetes. Br J Pharmacol. 2016 May;173(9):1425-37. doi: 10.1111/bph.13458. Epub 2016 Mar 8. PMID: 26896587; PMCID: PMC4831313.

17. Sibylle Soboll, Roland Scholz. Control of energy metabolism by glucagon and adrenaline in perfused rat liver. June 1986. Institut fiir Physiologische Chemie I, Universitiit DiisseldocL Moorenstr. Volume 205, number 1 FEBS 3914.

18. Calbet JA. Chronic hypoxia increases blood pressure and noradrenaline spillover in healthy humans. J Physiol. 2003 Aug 15;551(Pt 1):379-86. doi: 10.1113/jphysiol.2003.045112. Epub 2003 Jul 4. PMID: 12844510; PMCID: PMC2343162.

19. Morand J, Arnaud C, Pepin JL, Godin-Ribuot D. Chronic intermittent hypoxia promotes myocardial ischemia-related ventricular arrhythmias and sudden cardiac death. Sci Rep. 2018 Feb 14;8(1):2997. doi: 10.1038/s41598-018-21064-y. PMID: 29445096; PMCID: PMC5813022.

20. World Health Organisation 2023.

21. Howden EJ, Sarma S, Lawley JS, Opondo M, Cornwell W, Stoller D, Urey MA, Adams-Huet B, Levine BD. Reversing the Cardiac Effects of Sedentary Aging in Middle Age-A Randomized Controlled Trial: Implications For Heart Failure Prevention. Circulation. 2018 Apr 10;137(15):1549-1560. doi: 10.1161/CIRCULATIONAHA.117.030617. Epub 2018 Jan 8. PMID: 29311053; PMCID: PMC5893372.

22. Judd SE, Tangpricha V. Vitamin D deficiency and risk for cardiovascular disease. Am J Med Sci. 2009 Jul;338(1):40-4. doi: 10.1097/MAJ.0b013e3181aaee91. PMID: 19593102; PMCID: PMC2851242.