Heart disease is the leading cause of death for both men and women in the United States. It claims approximately one million lives each year.

And despite a booming cholesterol-lowering statin drug industry, rates of heart disease keep increasing. In fact, experts predict it will be the number one cause of death worldwide by 2020.

This is because conventional medicine focuses mostly on cholesterol as the major risk for heart disease. Therefore, statins are far too frequently prescribed to reduce cholesterol levels. And statins do effectively lower cholesterol. But that’s it.

Statins relieve a symptom (high cholesterol), but they don’t address the underlying risk factors that can lead to heart disease.

The truth is diet and lifestyle play a critical role in the development of cardiovascular disease even when a genetic predisposition exists. Therefore, we must address these factors to end the heart disease epidemic.

How Heart Disease Begins

We now know heart disease begins with damage to a single cell lining of the arteries, known as the endothelium, that pump blood to the heart. When the integrity of the endothelium is compromised, fat cells, oxidized LDL cholesterol, immune cells, cellular debris, and calcium begin to build-up within the coronary arteries.

This “sticky” substance is often referred to as plaque. If the plaque grows large enough, it starts to restrict blood flow to the heart. Another complication occurs when the plaque ruptures. The body instantly forms a blood clot (thrombosis), which further blocks the flow of blood and prevents the heart from efficiently and effectively receiving critical nutrients as well as oxygen. This often leads to a heart attack or in some cases sudden death

In some cases, a heart attack is the first sign of heart disease. And sometimes individuals have no symptoms before a heart attack occurs. Others may experience the following symptoms:

  • Abnormal heart beat
  • Shortness of breath
  • Fluid in lungs
  • Dizziness
  • Angina (chest pain)
  • Swollen feet and ankles
  • Fatigue
  • Anxiety

Leading Cause of Heart Disease

We also now know that inflammation and oxidative stress are the leading causes of endothelium damage, which leads to the development of heart disease.

In fact, LDL-cholesterol (the “bad” cholesterol) is not all bad. It is only dangerous once it becomes oxidized. The process of oxidation makes it sticky and more likely to adhere to the arterial wall.

To make matters worse, once plaque begins to accumulate in the arteries, it causes further inflammation, oxidative stress, and other conditions such as high blood pressure and vascular autoimmunity.

Comprehensive List of Risk Factors

Inflammation and oxidative stress most often result from a nutrient deficient diet high in trans-fatty acids and refined grains and sugars. Other factors that cause and/or worsen inflammation and oxidative stress include:

  • Lack of exercise
  • Poor sleep
  • Obesity and visceral fat
  • Diabetes
  • High insulin levels
  • High blood sugar
  • Insulin resistance
  • High triglycerides and/or cholesterol
  • Elevated homocysteine levels
  • High blood pressure
  • Chronic stress
  • Heavy metal exposure
  • Environmental toxins
  • Smoking
  • Alcohol abuse
  • Chronic infections
  • Autoimmune diseases
  • Inflammatory diseases

Genetic Risk Factors

While inflammation and oxidative stress are at the top of the list, it is important to note there are also genetic factors involved in the progression of heart disease. Genetic predispositions associated with heart disease include:

  • Family history of early heart disease
  • Male-pattern baldness
  • Diagonal earlobe crease and hairy earlobes
  • Short stature (men < 5’5” | women < 5’)
  • Tall (men > 6’ | women > 5’8”)

However, it’s extremely important to understand that various individual factors can and do influence your genetics. This is known as epigenetics, which means you have the power to defy your DNA. And a healthy diet and lifestyle can prevent the expression of your “disease” genes.

Additional Risk Factors to Consider

Other unique risk factors include:

  • Defective heart muscle and/or function
  • Age (55 in men | 60 in women)
  • Gender (males are at higher risk until a woman hits menopause)
  • Osteoporosis at menopause
  • High levels of estradiol (form of estrogen) in men
  • Hormonal deficiencies
  • Kidney disease

Why Conventional Treatment Isn’t Working

As you can see, there are many risk factors associated with heart disease. Not just cholesterol or high blood pressure. And this is why administering medications to lower cholesterol and/or blood pressure will not reduce your risk of developing heart disease.

In fact, research has even shown cholesterol-lowering statin drugs can actually accelerate the progression of heart disease. While there are several ways in which this happens, two specific mechanisms include the depletion of CoQ10 and the inhibition of vitamin K2 synthesis. And these are two nutrients essential to optimal heart health.

The Functional Medicine Approach to Preventing Heart Disease

Heart disease is 100% preventable. However, it requires identifying and addressing all sources of inflammation and oxidative stress (the underlying causes).

Dietary support should rely heavily on anti-inflammatory and antioxidant foods. Therefore, I always recommend a nutrient-dense whole food diet rich in a rainbow of fruits and vegetables, high-quality proteins and fats, nuts, seeds, herbs, and spices. In addition, targeted nutrient support may be necessary.

Stress management, restful sleep, and exercise are also critical lifestyle factors to arterial and heart health.

My goal as a functional medicine doctor is to help you identify your individual risk factors as well as create a personalized diet and lifestyle plan to prevent heart disease as well as achieve vibrant health.


Bowden, J., Sinatra, S. T., & Rawlings, D. (2015). The great cholesterol myth: why lowering your cholesterol won’t prevent heart disease – and the statin-free plan that will. Beverly, MA: Fair Winds Press.

Houston, M. (2012). What Your Doctor May Not Tell You About Heart Disease. New York, NY: Grand Central Life & Style.

Hyman, M. (2012). The Blood Sugar Solution. New York, NY: Little, Brown and Company.

Rath, M. (2003). Why Animals Don’t Get Heart Disease…But People Do! Fremont, CA: MR Publishing, Inc.

Okuyama, H., Langsjoen, P. H., Hamazaki, T., Ogushi, Y., Hama, R., Kobayashi, T., & Uchino, H. (2015). Statins stimulate atherosclerosis and heart failure: pharmacological mechanisms. Expert Review of Clinical Pharmacology,8(2), 189-199. doi:10.1586/17512433.2015.1011125

Petursson, H., Sigurdsson, J. A., Bengtsson, C., Nilsen, T. I. L., & Getz, L. (2012). Is the use of cholesterol in mortality risk algorithms in clinical guidelines valid? Ten years prospective data from the Norwegian HUNT 2 study. Journal of Evaluation in Clinical Practice18(1), 159–168. Doi:10.1111/j.1365-2753.2011.01767.x

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