If you are like me and many other doctors, you have seen the profession put lots of attention on helping expose the opioid epidemic and offer non-drug therapy for chronic pain. What do you think as a profession we could set our sights on next as far as prevention and reversal of disease? So many choices: osteoarthritis, osteoporosis, headaches, balance, posture, etc.
I’m going to suggest that the medical community needs our help with preventing coronary artery / heart disease, including hypertension. Cardiovascular disease is the leading killer of women and men in Western civilization.
Stats: Someone in this country is dying of cardiovascular disease every 34 seconds. Every three minutes and 14 seconds, someone suffers a stroke.1 We have work to do!
Standard medicine uses drugs, stents, and bypass operations, none of which has anything whatsoever to do with the cause of the illness. I think we can turn our attention to early detection and get more aggressive about treating patients at risk for cardiovascular disease.
The AHA Is Trying, But...
Since the late 1940s, the American Heart Association (AHA) has supported almost $6 billion worth of cardiovascular- and stroke-related research. After the NIH, the AHA is the largest supporter of cardiovascular and cerebrovascular research in the country.1 (Imagine what we could have done with a billion dollars worth of that since 1940.)
We are as much stakeholders interested in the health of the country as the AMA.
I’m going to give the American Heart Association this: We have seen marked improvements from 1950 to 2021. That said, we’re starting to see a reversal in the progress that the AHA made across the landscape, whether we look at heart failure or coronary artery disease. Things are getting worse.
Keep in mind, the progress that’s been made has largely been made from two perspectives, one of which was the public health implementation of the surgeon general report in the early 1960s around the dangers of smoking. A large focus of the American Heart Association has been on tobacco control since the 1960s. But with the vaping epidemic and a switch from vaping to combustible cigarettes, there’s been a reversal, particularly among young people. As a profession, we can be a voice of change.
The second big public health implementation is around blood pressure control. But since about 2020 in the pandemic, blood pressure control in this country has gotten considerably worse.
In other words, medical doctors and the public need our help.
Tucker’s Talking Points
Patients needs to understand that the reason they have heart disease is because they have sufficiently trashed, injured, and compromised the endothelial capacity to make nitric oxide, or may be short on nitric oxide. They need to know they’ve lost their protection, and that it wasn’t done by their genes or by stress alone. Their food and lifestyle choices are the culprits.
Hydration: I talk about how I front-load my water in the morning. I strive for 90 ounces within 90 minutes of being awake. Then I continue drinking what I have always consumed throughout the day. I typically stop drinking water around 7 p.m., which translates into less nighttime urination.
Diet: Eat dark-green, leafy veggies multiple times a day because they help turn the body into a nitric oxide factory. Garlic activates nitric oxide synthase and helps maximize nitric oxide absorption. Citrus fruits are high in vitamin C, which enhances nitric oxide bioavailability.
Pomegranate contains antioxidants that protect and preserve nitric oxide. When in season, watermelon is OK because it’s rich in citrulline, an amino acid that converts to nitric oxide. Nuts and seeds are high in arginine, which is involved in nitric oxide production.
It helps to dab vegetables with balsamic or rice vinegar. Why? The acetic acid in those vinegars can restore the nitric oxide synthase enzyme contained within the endothelial cells. I suggest eating vegetables with breakfast, again as a mid-morning snack, with lunch, as a mid-afternoon snack and then going big at dinnertime. When patients need an evening snack, I suggest pumpkin (good for prostate health) or sunflower seeds.
(Green, leafy vegetables also help restore the capacity of bone marrow to once again make the endothelial progenitor cell, which will replace our senescent, injured, worn-out endothelial cells.)
Eating green, leafy vegetables increases nitric oxide in the body through a simple process. Here’s how:2
- Green leafy vegetables contain high levels of nitrates. Chew them well.
- When you chew these vegetables, the nitrates mix with anaerobic bacteria that reside in the crypts and grooves of your tongue.
- These bacteria reduce/convert the nitrates you’ve been chewing to a nitrite.
- When you swallow the nitrates and nitrites, they travel to your stomach and become part of the gastric acid, which further reduces the nitrate to more nitric oxide, which can enter your nitric oxide pools.
- In your blood vessels, the nitrites are further converted into nitric oxide. The nitric oxide helps relax and dilate your blood vessels, improving blood flow and reducing blood pressure.
Editor’s Note: in part 2 of this article, Dr. Tucker shares more talking points for helping patients maximize their cardiovascular health.
References
- “More Than Half of U.S. Adults Don’t Know Heart Disease Is Leading Cause of Death, Despite 100-Year Reign.” American Heart Association, Jan. 24, 2024.
- Olas B. The cardioprotective role of nitrate-rich vegetables. Foods, 2024 Feb 24;13(5):691.
