Complementary Alternative Cardiovascular Medicine

Recommendations

Info

80 Alternative Cardiovascular Medicine addition, a cross-sectional study reported an inverse association between linoleic acid intake and CHD prevalence (25). The epidemiologic studies showing a beneficial effect of omega-6 PUFA are supportive of earlier clinical trials conducted to assess the effects of diets high in PUFA but low in SFA and cholesterol on the risk of coronary morbidity and mortality. Several major primary and secondary prevention trials (26–29) were conducted to assess the effects of diets that provided 35– 39% of calories from total fat, 13–21% of calories from PUFA, and approx 9% of calories from SFA and were low in cholesterol. The studies were the first to show that a high-PUFA diet decreased serum cholesterol levels markedly (13–16%), which was associated with a concurrent decrease in CVD events. Although initially these findings sparked much interest in the use of a high-PUFA diet to decrease CVD risk, enthusiasm diminished because of limited data from long-term studies and the scarcity of data from population groups who followed this diet habitually. Questions were also raised about the role of PUFA in oxidation reactions, risk of cancer, and some evidence that high intakes of PUFA can inhibit formation of long-chain omega-3 PUFA from ALA (1). Because of the lack of population data about the safety of high-PUFA diets, interest was sparked in assessing the role of MUFA in a blood cholesterol-lowering diet (i.e., low in SFA and cholesterol) as a substitute for SFA calories. Based on a significant database of experimental studies with diets that can be consumed habitually, although PUFA do have a greater total and LDL cholesterol-lowering effect vs MUFA, the differences are small. Thus, for practical purposes, MUFA or PUFA elicit blood cholesterol-lowering effects that are quite similar when incorporated in a diet that meets current recommendations (30). There are emerging CVD risk factors that play a role in atherogenesis and inflammation. One area of great interest relates to the regulatory effects that fatty acids have on expression of genes involved in leukocyte adhesion molecule synthesis. Omega-3 fatty acids inhibit endothelial activation, and omega-6 fatty acids have a less potent inhibitory effect, albeit more so than MUFA (31). In summary, PUFAs have cardioprotective effects that are mediated by multiple mechanisms that extend beyond the risk reduction conferred by decreases in total and LDL cholesterol. Omega-3 Fatty Acids The primary plant-derived omega-3 fatty acid is ALA and the marinederived omega-3 fatty acids are EPA, C20:5n-3 and DHA C22:6n-3. There is an impressive database from epidemiologic studies and randomized controlled clinical trials that omega-3 fatty acids have
Chapter 6 / Oils, Fats, and CVD 81 cardioprotective effects. These effects have been demonstrated for EPA and DHA, as well as ALA. Numerous epidemiologic studies have shown that fish consumption beneficially affects several coronary endpoints and, notably, sudden death. In the US Physicians’ Health Study, men who consumed fish at least once weekly had a relative risk of sudden death of 0.48 (p = 0.04) vs men who consumed fish less than once per month (32). More recently, the Physicians’ Health Study reported an inverse relationship between blood levels of long-chain omega-3 fatty acids and risk of sudden death in men without a CVD history (33). The relative risk of sudden death was significantly lower in men with levels in the third quartile (RR = 0.28) and the fourth quartile (RR = 0.19), compared with men whose blood levels were in the first quartile. The Nurses’ Health Study reported an inverse association between fish intake and omega-3 fatty acids and CHD death (34). Compared with women who rarely ate fish (
Page 1 and 2:
Complementary and Alternative Cardi
Page 3 and 4:
CONTEMPORARY CARDIOLOGY CHRISTOPHER
Page 5 and 6:
© 2004 Humana Press Inc. 999 River
Page 7 and 8:
vi Preface physician or other healt
Page 9 and 10:
viii Contents 10 Massage Therapy an
Page 11 and 12:
x Contributors ERIN L. OLIVO, PhD
Page 13 and 14:
Chapter 1 / CAM and CVD 1 1 Complem
Page 15 and 16:
Chapter 1 / CAM and CVD 3 patients
Page 17 and 18:
Chapter 1 / CAM and CVD 5 The crite
Page 19 and 20:
Chapter 1 / CAM and CVD 7 disease c
Page 21:
Chapter 1 / CAM and CVD 9 analyses,
Page 24 and 25:
12 Alternative Cardiovascular Medic
Page 26 and 27:
Page 28 and 29:
Page 30 and 31:
Page 32 and 33:
Page 34 and 35:
Page 36 and 37:
Page 39 and 40:
Chapter 3 / Botanical Medicine and
Page 41 and 42: Chapter 3 / Botanical Medicine and
Page 61 and 62: Chapter 4 / Herb and Dietary Supple
Page 71 and 72: Chapter 5 / Vitamin Therapy and CVD
Page 83: Chapter 5 / Vitamin Therapy and CVD
Page 86 and 87: 74 Alternative Cardiovascular Medic
Page 100 and 101: Table 2 Type and Quantity of Dietar
Page 102 and 103: Table 2 (Continued) Type and Quanti
Page 112 and 113: 100 Alternative Cardiovascular Medi
Page 142 and 143:
130 Alternative Cardiovascular Medi
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Page 165 and 166:
Chapter 10 / Massage Therapy and CV
Page 167 and 168:
Page 169 and 170:
Page 171 and 172:
Page 173 and 174:
Page 175 and 176:
Page 177 and 178:
Page 179 and 180:
Chapter 11 / Acupuncture and CVD 16
Page 181 and 182:
Page 183 and 184:
Page 185 and 186:
Page 187 and 188:
Page 189 and 190:
Page 191 and 192:
Page 193 and 194:
Page 195 and 196:
Page 197 and 198:
Page 199:
Page 202 and 203:
Page 204 and 205:
Page 206 and 207:
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Page 248 and 249:
Page 251 and 252:
Chapter 15 / Aromatherapy and CVD 2
Page 253 and 254:
Page 255 and 256:
Page 257 and 258:
Page 259 and 260:
Page 261 and 262:
Page 263 and 264:
Page 265 and 266:
Page 267 and 268:
Chapter 16 / A Guide for Physicians
Page 269 and 270:
Page 271 and 272:
Page 273 and 274:
Page 275 and 276:
Page 277 and 278:
Page 279 and 280:
Page 281 and 282:
Page 283 and 284:
Page 285 and 286:
Page 287 and 288:
Page 289 and 290:
Page 291 and 292:
Index 279 INDEX A N-Acetylcysteine
Page 293 and 294:
Index 281 taurine studies, 106 Conj
Page 295 and 296:
Index 283 Homeopathic medicine, see
Page 297 and 298:
Index 285 funding of studies, 148 g
Page 299:
Contemporary Cardiology COMPLEMENTA
show all

Complementary Alternative Cardiovascular Medicine

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?