You are Only As Old

as Your Arteries!By

David A Steenblock, DO26381 Crown Valley Parkway

Mission Viejo, CA 92691800-300-1063

www.stemcell.md

In tribute to Sir William Osler, M.D.,

First Director of Medicine, Johns Hopkins Hospital

“A man is only as old as his arteries.”

Arteriosclerosis“Hardening of the Arteries”

Is the leading cause of death Creates ischemic conditions for the

heart, brain, legs, kidneys and other organs, resulting in disease and degeneration.

Athero from the Greek word “gruel”

(cholesterol/fat deposits) Sclerosis from Greek for “hardness”

(collagen calcification, usually 70% of plaque)

Major Risk Factors for Arteriosclerosis

Hypertension (high blood pressure)

Smoking Serum total cholesterol Diabetes Obesity Sedentary Lifestyle Menopause in women “sticky platelets” Dietary deficiencies

The Artery

Red Blood cells (erythrocytes) transport

oxygen to the cells and carry carbon dioxide (cellular

waste) back to the lungs to be exhaled.

Arteries are large blood vessels that carry oxygenated blood from the heart to the brain,

limbs and organs.

Veins are large blood vessels that carry de-oxygenated blood back to the heart.

Capillaries are microscopic blood vessels having only one layer of

endothelial cells as a wall so that oxygen and nutrients can move into

the cells and carbon dioxide can move into capillaries and be carried

away.

The Artery Wall should expand and contract with

the heartbeat.Adventitia – outer wall (connective tissue)

Media – elastic middle layer (smooth muscle cells)Intima – endothelial layer (inflammation creates intimal thickening)Lumen – opening where blood flows

Endothelial Cells(cells of the blood vessel

walls) Form a barrier to prevent harmful

substances from entering the arterial wall.

Sense the blood pressure and flow rate and release nitric oxide to relax the vessel walls to allow more blood to flow through.

Sense vascular injury and stimulates growth factors to migrate to the area of injury.

Signal blood cells to stick to the endothelial cells (platelet aggregation/clotting) to prevent the loss of blood.

Endothelial Cell Lining

Major Causes of Endothelial Injury

Shear stress Hypertension

-Sympathetic neurotransmitters- Stress induced hormones

Diabetes (glycosylated proteins, insulin resistance)

Chemical toxins (pesticides, etc) Heavy metals (mercury, lead, cadmium) Tobacco Cholesterol, especially oxidized LDL and

VLDL Free Radicals – unpaired electrons

Endothelial Injury (continued)

Infectious agents- Chlamydia pneumoniae- Helicobater pylori (analogy to

peptic ulcer lesions)- Herpesvirus

- Cytomegalovirus Inflammation/Allergies Homocysteine Low dietary calcium -

Hyperparathyroidism

How Arteriosclerotic Plaque is formed

Injury to the endothelial cells stimulates white blood cells to stick to the blood vessel wall

The injury damages the endothelial cells allowing free radicals, lipids, calcium and cholesterol to penetrate into the inner muscular (middle) layer

The free radicals oxidize LDL and VLDL cholesterol, creating a chain reaction of cellular damage.

Macrophages invade the area to digest the rancid lipids, becoming “foam cells.”

Foam Cells- “Fatty Streaks”

Foam Cells

Form “fatty streaks” Earliest lesion in

arterioslcerosis Mostly lipid engulfed

macrophages with occasional lipid filled smooth muscle cells

Seen very early – age 3 and above

Plaque development (continued)

The collagen calcifies and becomes hard and brittle, like bone – reducing the elasticity of the blood vessel wall.

This combination of foam cells, calcification, and lipids is called “atherosclerotic plaque.”

If the plaque material ruptures, platelets accumulate and create blood clots on the inner surface of the blood vessel wall.

Artery with advanced lesions and plaque

An Aneurysm of the Abdominal Aorta

As the arteries become clogged- blood, oxygen and nutrients are unable to reach the heart, brain,

kidneys and other organs.

A heart attack or stroke is the result of these blockages!

Arteriosclerosis and Systemic Disease

Ischemia – lack of blood flow

Hypoxia – lack of oxygen

Most diseases can be attributed directly or indirectly to ischemia, a lack of

blood flow to the cell.

Reducing the risk factors for cardiovascular disease reduces other atherosclerotic disease

outcomes as well.

Ischemia and the HeartSince oxygen is the fuel needed for

muscles to contract, a reduction in blood flow and oxygen to the heart interferes with its contractions. A heart muscle starved of oxygen produces pain (angina) and is less able to pump blood efficiently to the body, especially during exercise (shortness of breath, dizziness, headache, pain in the leg muscles).

Arteriosclerosis and Heart Disease

Left Ventricular Dysfunction Arrythmia (irregularities such as

PVC’s, atrial fibrillation, skips, flutters, etc)

Angina (chest and/or left arm pain, etc)

Shortness of breath Blockage of the left main coronary

artery is the worst and often kills.

(American Journal of Medicine, 1996, 101 (Suppl 4A): 17S-24S).

Arteriosclerosis and the Brain

1) Causes transient ischemic attacks2) Causes the majority of all strokes3) Stroke is the third leading cause of

death in USA4) Lack of oxygen is a cause of memory

loss, loss of clear thinking, brain fog, poor mental functioning, confusion, forgetfulness and difficulty concentrating (cognitive dysfunction).

5) Causes vascular dementia while most cases of Alzheimer’s are partially due to oxygen deficiency.

6) Lack of oxygen occurs at night in a very great number of people who don’t realize they have the problem. All of the problems listed under number 4 can occur. Insist that your doctor order a Nocturnal oximetry test! It is free and could save your life!!!!!!!!

Alzheimer’s Disease

Chronic cerebrovascular ischemia

(chronic lack of oxygen to the brain) produces an increased

risk for the development of Alzheimer’s Disease,

with observed deficits in spatial memory (CA1 and posterior parietal cortex), visually guided movements (superior colliculus and secondary visual cortex), motor coordination (red nucleus), and escape behavior (central gray).

(Neurobiology of Aging 21: 225-233, 2000)

Alzheimer’s Disease(continued)

Vascular risk factors linked to cerebrovascular disease and stroke in the elderly significantly increase the risk of developing Alzheimer’s Disease. These include atherosclerosis, atrial fibrillation, coronary artery disease, hypertension, and diabetes mellitus. The authors report that 60-90% of AD autopsy cases exhibit cerebrovascular pathology.

(Neurobiology of Aging, 21: 321-330, 2000)

Ischemia and Parkinsons’ Disease

A transient reduction in cerebral blood flow in rats produces long-lasting degeneration and dysfunction in the dopamine system and eventually the partial loss of striatal D1RmRNA.

(Brain Research, 851, 235-246, 1999)

Ischemia andMacular Degeneration

Macular degeneration is the leading cause of irreversible visual loss in the United States. The authors used Doppler Imaging to show reduced blood flow in the central retinal artery.

(American Journal of Ophthalmology, 128: 75-80, 1999)

Macular degeneration

Improved greatly with hyperbaric oxygen, external counterpulsation, periodic acceleration therapy, chelation therapy, night time oxygen, eradication of chronic sinusitis, bone marrow and or fat stem cells. All of these work by increasing the oxygen to the macula!

Ischemia and Sexual Performance

Atherosclerosis is a risk factor for erectile dysfunction (ED). Future therapeutic targets to treat or prevent ED may include the reduction of the atherosclerotic plaque size and progression. Stem cells now are being used successfully to treat erectile dysfunction!

Ischemia andArthritis

Jonsson and coworkers found an increased prevalence of atherosclerosis in patients with medium term rheumatoid arthritis.

(J Rheumatol, 28(12): 2597-602, 2001)

Kidney Failure

Homma and coworkers showed marked atherosclerosis associated with end-stage renal disease.

(American Journal of Nephrology, 21(5): 415-9, 2001).

Renal Arteries andCoronary Arteries

Shen and coworkers found a prevalence of renal artery stenosis in patients with coronary artery disease.

(Zhonghua Nei Ke Za Hi, 40(8): 521-4, 2001 – Chinese)

Our Program includes: Bone Marrow and Fat Stem Cell

Therapies Hyperbaric Oxygen Therapy Pulsed Electromagnetic Therapy External Counterpulsation High Altitude Cardiovascular Training Periodic Acceleration Therapy Chelation Therapy Biofeedback/Neuro-biofeedback Nutritional and Hormonal Therapies Stimulation of Endogenous Stem Cells

Hyperbaric Oxygen

Mobilizes stem cells from your bones

Benefits

The combination of breathing oxygen through the mask and the chamber pressure causes two to three times the oxygen to be delivered to the blood vessel walls and organ tissues compared to breathing oxygen by the mask alone.

Benefits (continued)

The results include: More oxygen to injured tissue Releases Stem Cells from

bones New blood vessel formation Improved infection control Renewal of injured cells and

organs Elimination of toxic

substances

Benefits (continued)

Kudchodkar studied the effect of hyperbaric oxygen treatment on atherosclerotic lesions in the rabbit aorta. HBO treatment dramatically reduced the development of arterial lesions and reversed its progression and substantially reduced the accumulation of lipid oxidation products in the plasma, liver and aortic tissues.

(Arterioscler Thromb Vasc Biol, 2000, 20(6): 1637-43)

Benefits (continued)

Neubauer in 1983 showed that Hyperbaric oxygen therapy could significantly reverse generalized small-vessel stenosis in the brain. The patient presented with symptoms of gross mental confusion, memory loss, irrational speech and occasional violence. The initial series of HBO treatments resulted in a well-functioning patient.

(Minerva Med, 1983, 74(35): 2051-5)

Hyperbaric Oxygen is effective for the

following: Decompression Sickness Air embolism Poisoning Treatment of infections Non-healing wounds in Plastic and

reconstructive surgery Traumatic injuries Non-union of fractures Severe blood loss, sickle cell crises

HBO Therapies (continued)

Peripheral vascular disease: Shock, myocardial ischemia, aid to cardiac surgery, ischemic gangrene, ischemic leg pain

Neurological disorders: Stroke, multiple sclerosis, migraine, cerebral edema, multi-infarct dementia, spinal cord injury, brain abscess, peripheral neuropathy, coma

Ophthalmology: Macular Degeneration, retinal artery occlusion

Gastro-intestinal: ulcers, hepatitis, paralytic ileus

HBO Therapies (continued)

Diabetes Otorhinolaryngology: Sudden

deafness, acute acoustic trauma, Meniere’s disease, malignant otitis externa (chronic infection)

Asphyxiation: drowning, smoke inhalation

Aid to rehabilitation: Spastic hemiplegia of stroke, paraplegia, chronic myocardial insufficiency, peripheral vascular disease.

Pulsed Electromagnetic Therapy Promotes cell to

cell communication

Increases blood flow to injured cells

Stimulates the growth of neurons

Stimulates endogenous stem cell production

Speeds wound healing

Electromagnetic therapy promotes DNA

alignment

External Counterpulsation

The ECP is an exciting technology that is a safe, non-invasive method of improving circulation to the heart, brain, kidneys and other organs, and its benefits can be maintained 4-7 years after the therapeutic program.

ECP (continued)

ECP increases blood flow 22-26% to the carotid arteries to the brain, 20-42% to the coronary arteries to the heart, increases the heart’s output (stroke volume) by 12% and increases blood flow to areas in the heart not getting enough oxygen. The ECP is FDA approved for Coronary Artery Disease and is effective in the treatment of ischemic conditions, including glaucoma, angina, coronary artery disease, stroke and brain injury.

(American Journal of Cardiology, 84: 950-952, 1999)

ECP (continued)

Until recently, the predominant treatment for ischemic heart disease was open heart bypass surgery. This treatment is costly, invasive, and associated with complications that include blood clots, infection and a 4% mortality rate. In addition the health benefits of this surgical procedure are often temporary.

ECP (continued)

The ECP is an outstanding alternative for the person who cannot or will not have a bypass and the device produces numerous benefits to the ischemic heart, brain, kidneys and entire system. The equipment is safe, effective, and generally well tolerated, with few side effects or discomfort to the patient.

The Benefits of ECP include:

Increases venous blood flow returning to the heart

Increases the resting phase of the heart beat, which promotes greater oxygenation to the heart

Increased cardiac output to brain and other organs without increasing the heart rate.

Reduces peripheral resistance, thereby reducing the heart’s workload.

Promotes the development of collateral blood vessels

ECP (continued) Reduces the frequency and intensity of

angina symptoms (chest pain) Reduces ventricular fibrillation (rapid,

convulsive movements of the heart muscles)

Improves myocardial lactate removal (reduces fatigue)

Increases exercise tolerance Reduces the risk of heart attack Reduces the need for anti-anginal

medication Improves the person’s sense of well-

being and overall quality of life. (American Journal of Cardiology, 1995, 75: 840-

841)

ECP (continued)

In 1995, Lawson published a three year follow-up of 10 patients treated treated for chronic angina with ECP. Eight continued to demonstrate improved myocardial circulation. Lawson concluded that long term improvement in myocardial perfusion and exercise tolerance can occur several years after ECP therapy, probably due to its promotion of collateral circulation.

(American Journal of Cardiology, 1995, 75: 840-41)

ECP (continued)In 1997, Fricchione studied the

psychological aspects of external counterpulsation and found that the treatment significantly improved depression scores. Patients often report feeling depressed after invasive procedures. Since depression is associated with poor outcome in those with cardiac disease, external counterpulsation offers clinical advantages beyond its circulatory benefits.

(Cardiovascular Reviews and Reports, 1997, 18: 37-41)

ECP (continued)

Soran and associates found that patients who responded favorably to therapy with ECP showed a significant increase in circulating vascular endothelial growth factor (VEGF) which promotes endothelial cell migration and collateral blood vessel growth. VEGF stimulates stem cells to grow.

(Clinical Cardiology, 1999, 22: 173-178)

High Altitude Endurance Training

High mountain air is deficient in oxygen and causes the body to become oxygen starved similar to what happens with running a mile or two. This temporary decrease in oxygen stimulates the cells of the body to work harder and more efficiently in the utilization of oxygen. Stem cells are released from the bone marrow as a result of this therapy!

High Altitude Training(continued)

Cells have small energy producing factories contained within them called “mitochondria.” Mitochondria tend to shrink in size, become damaged and inefficient in their processing of food into energy as we become older and more diseased. This loss of energy is the cause of fatigue, loss of strength, loss of heart function, brain function, etc. associated with aging.

High Altitude Training(continued)

Intermittent mountain air stimulates the growth, proliferation and repair of these aging, sluggish mitochondria. The body becomes more energized and a great number of diseases and conditions are alleviated. The body “adapts” to short periods of less oxygen by becoming stronger.

High Altitude Training(continued)

The following conditions have been successfully treated with intermittent mountain air:

Ischemic heart disease Hypertension Chronic fatigue syndrome Chronic bronchitis Asthma Ulcerative diseases of the stomach and

duodenum Diseases of Locomotion Gynecological conditions

High Altitude Training(continued)

Intermittant mountain air has been shown to normalize arterial pressure, improve cardiac function, sensory coordination, and mental performance (Novikov, 1998)

Since intermittent hypoxia increases antioxidants and stem cell production as adaptive mechanisms, these effects explain, in part, the mechanism of clinical benefits of the treatment in degenerative diseases and the aging process.

High Altitude Training(continued)

Intermittent mountain air works synergistically with hyperbaric oxygen therapy to:

Increase growth factors such as VEGF

Increase the production of new stem cells

Increase red blood cell production Improve immune function Improve endurance Increase resistance to toxins,

viruses, and radiation

High Altitude Training(continued)

Promote new blood vessel growth Reduce blood pressure and heart

rate Increase vital lung capacity Protect the brain from physical

and emotional stress (oxidative stress)

Promote serotonin and dopamine levels for psychological well-being

Promote ability to sleep through the night

Increase antioxidant production

Chelation Therapy

EDTA (Ethylenediaminetetraacetic acid) is added to foods to help prevent oxidative degradation by binding to the free transition and heavy metal ions. The average intake of EDTA from our foods is 15-50 mg a day.

Oral EDTA is approved by the FDA for the treatment of asymptomatic lead toxicity.

Chelation Therapy(continued)

EDTA is a synthetic amino acid that chelates ( Greek for “to claw” or grab) with metals and carries them safely out of the body. In binding with ionic metal catalysts, EDTA reduces the production of oxygen free radical molecules and prevents a subsequent destructive chain reaction with other molecules.

Chelation Therapy(continued)

EDTA chelation is endorsed for the treatment of atherosclerotic vascular disease by the American College for Advancement in Medicine (ACAM), comprising of over 1,000 licensed physicians. It’s proponents claim that EDTA consistently improves blood flow and relieves symptoms associated with atherosclerosis in over 80% of the patients treated.

Chelation Therapy(continued)

The benefits of EDTA chelation are proposed to include:

Binds with calcium ions in arterial walls and plaque. A decrease of calcium, the arterial wall becomes more compliant, less rigid and more elastic. This results in greater expansion of the blood vessels and more blood delivery to the body’s organs.

Chelation Therapy(continued)

Binds with heavy metals such as lead, mercury, cadmium, aluminum, uranium, etc. These metals block enzyme activity and their removal helps restore enzyme functions within the arterial walls.

Binds with iron and copper ions, transition metals that promote free radical reactions. This includes reducing lipid peroxidation and oxidized cholesterol.

Chelation Therapy(continued)

EDTA has an “anti-sticky” effect on blood platelets. Lipid peroxides and free radicals inhibit the synthesis of prostacyclin that helps balance the blood clotting effects of thromboxane. The restoration of normal levels of prostacyclin reduces the risk of blood clots forming and blocking the arteries.

Chelation Therapy(continued)

Claimed and reported results include: Improved circulation Reduction of liver produced cholesterol Lowered insulin requirements in

diabetics Reduced blood pressure Normalization of cardiac arrhythmias Relief from leg muscle cramps Lessened varicose vein pigmentation Hair loss stopped and reversed Alzheimer symptoms ameliorated or

reversed Memory and concentration improved (Cranton, E.M. J Adv Med, 1989, 2: 1-416)

Nutritional Therapies

Elevated total cholesterol, homocysteine, and free radical reactions (lipid peroxidation) play a role in several major disorders including hypertension, coronary heart disease, stroke, diabetes, Alzheimer’s Disease, and arthritis.

Nutritional Therapies(continued)

Oxidative stress and Alzheimer’s Disease:

Because lipid peroxidation precedes amyloid plaque formation in mice, this suggests that brain oxidative damage contributes to AD pathogenesis before A beta accumulation in the AD brain.

(Journal of Neuroscience, 2001, 21(12): 4183-7)

Nutritional Therapies(continued)

Dietary Guidelines: The DASH diet, rich in fruits,

vegetables, and low fat dairy foods and low in saturated fat, total fat, and cholesterol significantly and quickly lowers blood pressure, total cholesterol and homocysteine levels. The diet also includes whole grain, poultry, fish, and nuts.

(New England Journal of Medicine, 1997, 336: 1117-18)

Nutritional Therapies(continued)

Free Radical Reactions:An unpaired electron can break apart the

weak bonds of other electrons and create a chain reaction of broken bonds from one molecule to another. This oxidation reaction can cause mutations in the DNA and rancidity and toxicity in lipids.

Antioxidants such as beta carotene, vit. C, bioflavonoids, vit. E, selenium, and glutathione stop this chain reaction.

Nutritional Therapies(continued)

Foods high in antioxidants (ORAC – oxygen radical absorbance capacity)

Prunes 5770Raisins 2830Blueberries 2400 Blackberries 2036 Strawberries 1540Raspberries 1220Plums 949 Oranges 750

Red Grapes 739

Cherries 670

Kale 1770

Spinach 1260

Brussels Sprouts 1260

Alfalfa Sprouts 930

Broccoli Florets 890

Red Bell Peppers 840

Beets 710

Onions 450

Nutritional Therapies(continued)

Homocysteine is produced during the incomplete conversion of amino acids to other proteins. Homocysteine is very irritating to artery linings – causing endothelial injury, the oxidation of cholesterol, and the subsequent build up of blood clots and plaque. The low intake of folic acid, vitamin B6 and vitamin B12 can cause homocysteine accumulation.

Nutritional Therapies(continued)

Cholesterol: HDL (high density lipoprotein)

carries LDL and VLDL away from the arteries. An HDL of 60 or higher is protective. Lower than 35 is a major risk factor for heart disease.

LDL (low density lipoprotein) – carries cholesterol to cells. Is easily oxidized by free radicals. An LDL of less than 100 is desirable. The higher the LDL is over 100, the greater the risk of blood vessel disease.

Nutritional Therapies(continued)

Total Cholesterol – less than 170 mg/dL. Levels higher than 170 increase the risk of artery damage and the development of atherosclerosis, heart disease, and stroke.

Triglycerides: Levels over 200 mg/dL are usually

an indication of too much sugar and fat intake.

High triglycerides injure the inner lining of the arteries.

Nutritional Therapies(continued)

Foods that fight Cholesterol include: Salmon, sardines, mackerel, tuna Beans, lentils, chickpeas soybeans Oat bran, barley, wheat germ, rice bran Garlic, raw onion Apples Almonds and walnuts Olive oil, canola oil, grape seed oil Brussels sprouts, parsnips, turnips, okra,

artichokes Oranges, apricots, mangos, grapefruit Ginger

Nutritional Therapies(continued)

Sugar intake will increase the blood cholesterol by up to 25% and increase the triglycerides. If you have high triglycerides you may well have undiagnosed diabetes.

Thrombosis: The higher the fibrinogen levels are

above 32 mg%, the greater the risk of a stroke or heart attack.

Nutritional Therapies(continued)

Foods that reduce platelet aggregation and blood viscosity include:

Water – 8-10 glasses daily Olive oil as the main dietary fat pineapple – proteases reduce

fibrinogen Gingko biloba, green tea, fish oil Vitamin E Aloe vera, ginger, wheat germ oil

Lifestyle Changes

Lifestyle changes are also important in reducing arteriosclerosis risk factors:

Reduce stress Reduce or eliminate coffee,

smoking, and alcohol Maintain an exercise program of

at least 30 minutes a day of walking, bicycling, swimming, etc.

Exercise

Exercise causes a greater flow of oxygen and nutrients through the system and more waste to be carried away from the cells. It also stimulates the development of collateral blood vessels for greater oxygen supply to the heart and organs.

How well would you do on a Treadmill Exercise Test?

Exercise(continued)

The test starts by walking on the treadmill at a low speed and elevation. Every 3 minutes, the speed and elevation are increased. The test continues until exhaustion, when you can no longer increase the amount of oxygen to the body.

Exercise(continued)

Age 20-29 30-39 40-49 50-59 60-69 70-79

Men 13 12 11 10 9 7

Women 11 10 9 8 7 5

The average man between the age of 20 and 80 years loses 50% of his exercise ability – from 13 minutes to 7 minutes, due to reduce oxygen delivery from atherosclerosis.

www.stemcell.md

For more information

David A Steenblock, BS, MS, DO26381 Crown Valley ParkwaySuite 130Mission Viejo, CA800-300-1063www.stemcell.md