C Reactive Protein and other Blood Test Markers of Cardiovascular Diseases and Cardiovascular Risk

Paul Reller, L.Ac.

Cardiovascular risk refers to the many factors that increase your risk of having a stroke, heart attack, congestive heart failure, sudden cardiac death or other life threatening problem with the heart and blood vessel integrity. Family history, diabetes, obesity and aging are the most important risk factors, but atherosclerotic plaques have been a big focus in modern medicine. More detailed research has found that this accumulation of plaque on the artery walls has more to do with inflammation and scarring than it has to do with simple levels of total cholesterol in the blood. While cholesterols are part of the accumulation in plaque, inflammatory and clotting chemicals are a more important part of the mechanism of plaque buildup, as is the accumulation of calcium. Advanced glycation endproducts (AGEs) are also now known to be integral to the formation of atherosclerotic plaques. These unhealthy sugar protein complexes are primarily a result of the modern diet and commercial foods, but are also formed in our bodies due to modern physiological stresses and environmental toxins.

Since about 1985, modern medicine has focused on decreasing cardiovascular risk primarily by lowering cholesterol and blood pressure. While these factors were important in the early understanding of cardiovascular risk, our knowledge of this subject now far exceeds these early findings. The problem is that the pharmaceutical industry has devoted so much money to products to decrease cholesterol and blood pressure, and these products are now the biggest money makers in the the industry, that profit has once again defeated logic in the field of scientific advances on the subject of actually decreasing cardiovascular risk. Cholesterol is just one of the materials that accumulate in atherosclerotic plaque, and mild hypertension will not cause a stroke or heart attack unless the arteries themselves are unhealthy. The sensible modern patient and physician will focus on healthy arteries and reduction of the mechanisms that cause atherosclerotic plaque as the most important health concerns.

To demonstrate how effective these biomarkers of cardiovascular risk are, a February 8, 2011 article the Journal of the American Medical Association (JAMA) reported that a long-term study at Mount Sinai Cardiovascular Institute in New York found that elevated levels of cardiac enzymes creatine kinase or troponin, measured in the first 24 hours after coronary artery bypass surgery, was a clear indicator of early, intermediate, and long-term risk of cardiovascular death. This data was collected from about 19,000 patients in 7 randomized studies, with follow-up varying from 3 to 5 years, and clearly identifies risk factors other than high cholesterol that determine the most significant underlying health problems. To better understand the implications of these findings, read further in this article so see how Complementary and Integrative Medicine can improve the underlying health problems that are most important in cardiovascular disease.

Since 2003, a number of scientific discoveries have elucidated the subject of cardiovascular risk. Just when the majority of Americans became comfortable with the notion that high cholesterol, sustained high blood pressure, aging and weight gain were the only things to worry about, studies showed that there were more accurate test indicators for risk. The trouble now for patients is to understand just what these markers mean to their own individual health and what to do about it.

“For many Americans, the healthy choice for decreasing cardiovascular risk has been to try safe conservative methods first, and then, if necessary, resort to long term use of drugs.”

Many patients are deciding to try to do the things to regain a healthy metabolism and then try going off of these statins and beta-adrenergic inhibitors, etc. that are now so routinely prescribed. The risks and side effects of long term use of drugs are alarming to many, often times even to the prescribing medical doctors in recent years. The search for a better understanding of the real mechanisms of cardiovascular risk has come up with such interesting findings as C-reactive protein (CRP). Along with this indicator, or marker protein, are other important markers, such as protein BNP (brain natriuretic peptide), and high homocysteine, which have been found to perhaps be better indicators of cardiovascular risk than cholesterol counts. Advanced glycation endproducts, such as A1C, are also becoming important markers of atherosclerotic risk and cardiovascular disease. How to respond to these findings when they occur, with healthy choices of diet, lifestyle, nutrient supplements, herbs and Complementary Medicine, is now a new and confusing subject for many individuals, as well as physicians. The array of new information is dizzying, even for those professionals that deal with this subject every day at work. Choosing the knowledgeable medical specialists and integrating care with a knowledgeable Complementary Medicine physician, such as a Licensed Acupuncturist, is the ticket for success.

The list of markers for cardiovascular inflammation include not only C-reactive protein (CRP) and advanced glycation endproducts (A1C), but interleukin (IL-6), fibrinogen (LMWF factor VII), fibrinolytic factors (PAI) endothelial platelet activators (P-selectin, von Willebrand factor), and antibody to oxidized low density lipoprotein. All of these inflammatory markers are potential indicators of excess cardiovascular inflammatory and atherosclerotic risk. The days of believing that simple control of blood pressure and total cholesterol will insure prevention of stroke and heart attack are over. A complete and holistic regimen to restore the whole health picture and decrease chronic inflammation and oxidative stress is necessary. The way to achieve this is not with a magic pill, but with a sensible holistic health regimen, utilizing Complementary Medicine and professional holistic health care.

This article will help to explain how a holistic approach to your health, and a number of key nutrients, may address the subject of cardiovascular risk. The nutrients studied include Vitamins B2, B6, B12, folic acid, Vitamins E, C, Taurine, CoQ10, SAMe, and essential fatty acids EPA and DHA, as well as AGE reducing P5P, B1 thiamine, L-Carnosine, N-acetyl cysteine, and ALA (alpha lipoic acid). A separate article on this website deals with the subject of advanced glycation endproducts (AGEs) and the maintenance of healthy AGE receptors (RAGE). Which of these nutrient supplements to incorporate into treatment protocol, when and for how long, are questions best left to the Complementary Medicine physician, such as a Licensed Acupuncturist, who is also able to integrate herbal medicine and acupuncture to synergistically achieve better effects. Much research supports a wide variety of herbs to achieve a variety of goals in cardiovascular protection. Understanding is the first step to a healthy protocol and better quality of life and disease prevention. This article is one small contribution to this understanding.

Patient Knowledge is the Key to a Pro-Active Approach, and CRP and BNP Must be Understood for the Patient to Make the Right Choices

CRP, or C-reactive protein is a protein produced in the liver in response to inflammation or injury, and is an indicator of what we might call ‘blood heat’, which indicates inflammatory responses that are associated with the atherosclerotic changes and chronic injury and scarring of the arterial walls. CRP itself is not a negative health problem, but points to a developing problem that should be taken care of. CRP is also called hs-CRP, or highly sensitive C-reactive protein, because it is a sensitive indicator of possible arterial inflammation in response to unhealthy arterial walls.

Many factors may be involved in irritations of the arterial walls. Arterial plaques accumulate at these inflamed or scarred areas to try to repair this damage and to make the arterial wall thick so that it won't burst and cause a stroke or heart attack. Unfortunately, this process often isn't helped by our lifestyle and diet, and instead of a healthy repair, we acquire a thickening that can lead to a thrombus, or circulating blood clot, or narrowing, called stenosis. When this thrombus is large and breaks off into our circulation it can stop critical blood flow, in the brain (stroke or TIA), heart (heart attack) or lung (pulmonary embolism). Even a person that is trying to be healthy may not have a totally healthy immune inflammatory response. Reducing cholesterol may not have the protective result that we need. What we need to do is to correct the repair mechanism of our tissues, which is the inflammatory system, and to stop whatever we are doing that is causing the irritation of the blood vessel walls.

High C-reactive protein (CRP) levels indicate that we should take a more comprehensive look at our healthy choices, and perhaps seek some professional help in Complementary Medicine to understand and achieve our goals. Clearing irritants from the blood and improving our inflammatory regulation is the key to this process. While cigarette smoke is a known source of blood irritants linked to cardiovascular inflammation, many chemicals in our environment and food may get into the blood to cause vessel scarring as well. Our liver tries to detoxify the blood before they circulate and cause damage. Unfortunately, if our gastrointestinal health is a problem, these toxins may enter the bloodstream instead of going, via the portal system, straight to the liver. This called Leaky Gut Syndrome, and often happens if the stomach and small intestine function is not completely healthy, such as with acid regurgitation etc. Addressing issues of gastrointestinal dysfunction and liver health, improving the glutathione metabolism, gastric hypofunction, and celiac disease, for instance, may play an important role in cardiovascular health maintenance.

Allergies may also be a problem. If too many allergens from food or air circulate in our blood, allergic reactions may result in inflammatory scarring. While allergic medications may quiet symptoms, they will not adequately prevent this allergic mechanism. Excessive microbes, such as bacteria or fungi, or yeast and viruses, may get into our circulation too often to also cause inflammatory reactions. Systemic infections such as candidiasis are carried in our blood vessels and can have a negative effect on cardiovascular health and maintenance. Hypersensitivity reactions and chronic inflammation then occur, which puts much stress on our cardiovascular maintenance as well.

If the liver is not functioning optimally, the ability to clear toxins, microbes, allergens etc. from the blood may not be strong enough to protect us. Liver function is stressed by too much work or insufficient nutrients. Excess use of medications that must be processed by the liver, excess alcohol consumption, nervous stress, chronic muscle tissue inflammation, hormonal deficiencies, etc. are reasons that the liver is working too hard. Since the liver is mainly responsible for converting fats and proteins to sugars and vice versa, metabolic syndromes may be causing too much work for the liver. Nutrients such as essential fatty acids, antioxidants, bioflavonoids etc. may be deficient, hindering the liver processes. The word essential means that we must get these nutrients in our diet. Our liver and other tissues can't manufacture enough of them. Since essential fatty acids are key components in the making of inflammatory regulating chemicals, this is an important subject.

Essential Fatty Acids and Other Nutrients Key to Inflammatory Healing of Arterial Walls, Reduction of Atherosclerotic Plaques, and a Healthy Heart

Studies in Europe have shown that the increased intake of healthy essential fatty acids both prevented cardiovascular disease and resulted in much longer survivability for patients after a heart attack. Since beneficial essential fatty acids are highly associated with inflammatory regulation, this is a key ingredient to take when high CRP levels are noted. High levels of inflammatory leukotrienes, platelet activating factor and reactive oxidants in blood leukocytes of patients with high cholesterol suggest that these inflammatory mechanisms explain why atherosclerotic plaque forms more easily in patients with high cholesterol. On the other hand, a 2006 Angioplasty study by the National Heart Lung and Blood Institute found that angioplasty 3-28 days after a heart attack did not benefit the patients and instead had a risk of harm.

Fatty acids are the components of fat that define their melting points, texture and flavor. Saturated fats have a higher melting point, keep solid easier, and don't oxidize or go rancid as quickly. The food industry uses these fats to lengthen shelf-life of commercial foods, and has created trans-fats, or converted unsaturated fats, to act like saturated fats in this regard. Trans fat is neither an essential fatty acid, nor is it at all healthy. It is now used in most commercial products. Examples of trans fat include margarine, shortening, partially hydrogenated vegetable oils, and stearic acid in animal fat, such as lard.

Saturated fat comes mainly from red meat and dairy but also from some commercial fats, such as coconut, palm and cottonseed oils. Saturated fats are linked to atherosclerosis and heart disease in a number of studies. The World Health Organization has determined that there is convincing evidence of certain saturated fatty acids increasing risk or probability of cardiovascular disease. These are palmitic, myristic and lauric acids, found predominantly in beef, dark chocolate, salmon, butter, eggs, processed coconut, palm and soy oils.

The bottom line is that fresh whole food is necessary to get beneficial essential fatty acids from the diet and whole grains, beans, legumes, nut and seed oils, fish and vegetables are the principal sources.

Everyone has heard of omega-3 and omega-6 fatty acids by now, but who really has a basic understanding of this subject? Here are a few key points. The modern American diet has changed and with it a drastic increase in cardiovascular deaths have occured, linked to a decrease in consumption of healthy essential fatty acids. Various essential fatty acids are needed to produce hormone-like substances in our bodies called prostaglandins (PG) that play an important role in regulation of cellular processes of all kinds, but especially in regulating inflammatory processes. Two types of essential fatty acid are often deficient in our bodies in relation to arachidonic acid: linolenic and linoleic acids, which produce PGE3 and PGE1. Omega-3 and Omega-6 fatty acids are names for linolenic and linoleic acids respectively, as well as other fatty acids, such as EPA and DHA (omega 3). Arachidonic acid, also an omega-6, produces PGE2, and is primarily derived from red or fatty meats. Linolenic and linoleic acids (omega 3 and 6) are primarily obtained from whole grains, nuts, seeds, fish and vegetables.

“Omega-3 essential fatty acids are proven to both produce the needed inflammatory mediators but also to help reduce the effects of harmful fat and cholesterol accumulations. Besides a diet rich in fresh whole grains, beans, legumes, nuts, seeds, fish and vegetables, a supplement of Omega-3 may be recommended. The most concentrated supplement, which also contains a natural preservative to prevent oxidation and rancidity, is krill oil, very high in EPA and DHA, which the body may not be able to synthesize sufficiently in certain circumstances.”

Other nutrients that reduce the cholesterol and fat accumulations in the arteries are lecithin (found in most legumes, and soy), niacin, choline and Vitamins E and C. Studies have shown that simple increases in Vitamins E and C resulted in about 30% reduction of CRP levels, the same results seen with studies of Crestor (Free Radical Medicine and Biology Oct. 10, 2008; American Journal Clinical Nutrition 86:1392:2007). Whole grain and vegetable fiber helps to reduce blood lipids, and bitter grains, such as rye, quinoa, amranth and oats (steel cut) are most helpful in cleansing arteries. Paul Pritchford, the author of Healing with Whole Foods is a reliable source of this type of information. L-arginine and B6 are also proven helpful to reduce risk of atherosclerosis and heart disease. L-arginine is the substrate for nitric oxide production, which plays a significant role in vasoreactivity, along with niacin. Enothelium, or artery lining dysfunctions are thought to be a reason for L-arginine deficiency or inhibition. Vitamin B6 helps with the utilization of L-arginine. Aged garlic and pomegranate extract have also been studied and positive findings of reduced atherosclerotic plaque associated.

Cholesterol is produced in the body and is a plentiful and useful hormone. Of course, animal bodies have a lot of cholesterol in them, and so meat is a big dietary source, but this cholesterol from dead animals may not be as useful as the cholesterols your own body produces. When cholesterol molecules begin to break down, the body must eliminate them in the bile. Cholesterol is a steroid hormone and circulates attached to proteins of various densities. Of course, we know that these good complexes are high density, and that excess low density lipoproteins (LDL), when excessive, are associated with atherosclerotic plaque. HDL and LDL do not signify good and bad cholesterol. The same cholesterol is complexed in both of these lipoproteins. Good cholesterol may be that which is produced by a healthy liver, or the adrenals, skin, intestine, testes and aorta, rather than eaten. Yes, even our main arteries produce cholesterol, and this may have a relationship to atherosclerotic plaque (read further). High meat cholesterol intake suppresses the synthesis of healthy cholesterol in the liver, but not the other tissues. Healthy cholesterols may reduce the risk of atherosclerosis as well as increase the possiblity of healthier steroid hormones, which are made from cholesterol. Our main source of Vitamin D is derived from a cholesterol metabolite in our skin, activated by short exposure to sunlight. We see that consuming less meat may have a number of healthy implications, along with encouraging a healthier cholesterol metabolism, as long as the vegetarian portion of your diet contains healthy essential fatty acids.

The oils and foods highest in Omega-3 and healthy Omega-6 essential fatty acids are: toasted walnut and hazelnut oils, pumpkin seed oil, flax oil, fresh fish oil, fermented soy products, dark leafy greens, fresh nuts, seeds, legumes, vegetables, spirulina, salmon, sardine, tuna, lake trout, anchovy, and butterfish. While olive oil is a healthy oil, it is not a high source of these essential fatty acids, and other oils should be added to the diet. Always use oils that are unrefined and preferrably as fresh as possible and stored correctly. Oxidized oils may have the beneficial essential fatty oils broken down and harmful metabolites occuring. The best sources of supplemental essential fatty acids EPA and DHA are found in krill oil and spirulina.

Coenzyme Q10

This nutrient, often deficient in patients switching to a vegan diet, but also in the population at large, is found to be a commonly depleted nutrient for patients with cardiovascular problems. CoQ10 is also commonly depleted with use of medications such as hyptertension beta-blockers, cholesterol lowering statins, cholesterol lowering fibric acid derivatives, and tricyclic antidepressants. For this reason, key subsets of patients at risk should seriously consider periodic supplementation. CoQ10 is a ubiquitous antioxidant found in most cells in our body, and deficiency has been linked to cardiovascular disease. European studies have demonstrated the proven benefits of CoQ10 in prevention of stroke recurrence and this supplement has become standard protocol for many medical doctors in Europe and Japan.

High Homocysteine levels

Excess Homocysteine as an independent risk factor for cerebrovascular disease, coronary artery disease, peripheral vascular disease, carotid atherosclerosis and aortic atheroma has been documented since the 1960s. High homocysteine induces oxidative stress and modification of methylation processes linked to atherosclerosis and cardiovascular risk. Patients with low folate levels are shown to have consistently high homocysteine levels, and some population studies have found the over 70% of target populations are deficient in folates, or folic acid. The combination of Vitamin B6, B2 and folic acid has been shown to reduce homocysteine levels, while B complex has not shown to be effective. Taurine has also been shown to be effective in reducing excess homocysteine levels. Vitamin B12, which is difficult to absorb for many patients due to lack of intrinsic factor in the stomach lining, is also proven helpful to reduce high homocysteine levels and is a supplement often taken with folic acid. To insure B12 absorption, take a quality sublingual product at a high dose, by crushing the tablets between two spoons and letting it absorb into the bloodstream directly through the membranes under the tongue. B12 injections are also effective.

As with all markers for cardiovscular risk, we must ask ourselves why excess homocysteine is linked. Studies have shown that high homocysteine levels may cause cardiovascular damage by creating accumulation of S-adenosyl-L-homcysteine, which inhibits an enzyme that mediates methylation metabolism of various catecholamines (epinephrine for example) and catechol estrogens, which act as neurotransmitters and neurohormonal regulators of the autonomic nervous system. When the cardiovascular tissues fail to break down and clear these catecholamines and catechol estrogens, overstimulation of the sympathetic nervous system creates excess oxidative products, or free radicals, in the blood vessel walls. This oxidative damage leads to atherosclerotic plaque, and nervous overstimulation leads to excess stress on the cardiovascular system and high blood pressure.

This metabolic scenario is very revealing. We find that patients with high levels of nervous stress, nutritional deficiencies, and oxidative stress incur damage to the blood vessel walls that leads to atherosclerosis, high blood pressure, and increased risk of strokes and heart attacks. High homocysteine levels have also been implicated in increased risk for Parkinson's and Alzheimer's neurodegenerative disease, and estrogen-induced breast cancers, making this metabolic disturbance more alarming than our levels of low density lipoproteins. Studies have also connected high homocysteine levels to metabolic syndrome, which is commonly called diabetes.

While the subject of high homocysteine levels has been the subject of much debate because of the complexity of the metabolic mechanism and indirect nature of the problem to cardiovascular damage, what we know is very revealing to a healthy approach with Complementary Medicine. Studies have shown that women are more likely to have a high homocysteine level linked to cardiovascular pathology, and that emotional problems with repressed anger and hostility are often found in study patients with high homocysteine levels. This is explained by the metabolic mechanism mentioned above, with failure to clear catechol estrogen accumulation, which may be more pronounced in women. Metabolic disturbance also stimulates increased emotional problems. In the texts of Traditional Chinese Medicine, ancient medical doctors wrote that repressed emotions are a significant cause of internal disease, and that there was a pattern of types of emotional disturbance linked to the various organ systems. Repressed anger and hostility was linked to the liver system.

Homocysteine is a product of normal breakdown of the amino acid methionine in the liver system. Excess methionine may occur with poor liver function, either with dysfunction in breaking down proteins or transforming amino acids, or with processing of fats, since methionine is also a lipotropic compound that helps the liver process fats (lipids). A diet of excess fat and protein could also lead to excess methionine and thus excess homocysteine levels. The most important factor in high homocysteine metabolism may be the lack of folic acid, though. Homocysteine and methionine freely transform one into the other as needed in our metabolism, but homocysteine is transformed back into methionine only when there is sufficient methylated folate, or betaine derived from choline. Since high homocysteine levels may indirectly inhibit methylation, a vicious metabolic cycle may arise, contributing to deficiency in folate conversion of homocysteine back into methionine. Women with cardiovascular risk may have a deficiency of folic acid, choline, and perhaps even acquire a deficiency of methionine in this scenario, and neurohormonal imbalances would also contribute. Poor diet and stress of the liver function would also contribute. We see in this presentation the explanation why so many patients find success with reducing blood pressure and lipoprotein levels when they improve their diets and reduce stress, along with taking some of these nutritional supplements for awhile.

Studies in the last 15 years have also shown that there may be a synergistic association of high homocysteine levels and resistance to activate protein C in the onset of thrombotic disease, or atherosclerosis. Studies indicate that elevated homocysteine may affect both the vascular wall structure and the blood coagulation system.

SAMe and the potential benefits to aid cardiovascular health

S-adenosyl methionine, or SAMe, is a popular, but somewhat expensive supplement. SAMe is an essential methionine in our metabolism, contributing methyl groups to a wide range of processes, including formation of DNA, protein metabolism and phospholipid metabolism. Formation of SAMe in the body may be hindered when there exists a problem with methionine metabolism, or when the enzymes that regulate this transformation are adversely affected by hormonal imbalances or nutritional deficencies. Also, with increased liver stress, and excess methionine in the diet, from a meat or protein oriented diet, conversion of methionine to SAMe can be deficent. Taking of SAMe supplement rarely produces immediate dramatic effects, and so it is not a popular supplement, but in this subset of patients, could greatly benefit metabolism, help clear nutritional abnormalities, and reduce cardiovascular risk.

Adrenal stress and abnormal cortisol metabolism as prime causes of the metabolic disturbances leading to high homocysteine levels

Study of hormonal disorders associated with high homocysteine levels includes study of adrenal disorders such as Cushing's Syndrome, which is also associated with increased cardiovascular risk. A study to determine relationships found that patient's with Cushing's Syndrome, involving excess cortisl levels, often resulting in inexplicable weight gain, hypertension, osteoporosis, decreased liver metabolism, agitation and mental disturbance, and sometimes amenorrhea, all had high homocysteine levels and low taurine levels. Insulin and glucose levels were also higher in patients with active disease, and serum B12 defciiencies were deficient. The researchers concluded that these metabolic abnormalities were likely directly or indirectly caused by abnormal cortisol levels, and were completely normalized when cortisol levels and diurnal rhythm were also normalized. The study is presented below in additional information.

Such studies as these demonstrate the multifactorial and holistic nature of cardiovascular risk. A number of factors lead to increased adrenal stress syndrome, and abnormality of diurnal cortisol levels. While Cushing's Syndrome is often an extreme presentation of this problem, caused by tumor, or by the taking of synthetic steroid medications, many patients are presenting with subclinical adrenal stress syndromes in practice today. Neurohormonal imbalances are becoming frequently diagnosed and treated. Patients often find this combination of symptoms slowly worsening, and are frustrated by a lack of diagnosis that would explain all of the problems mentioned above. Treatment of this adrenal stress and metabolic disorder with a holistic approach often gives amazing results, and decreases the risk of cardiovascular disease very much.

Information Resources

1. An overview of recent long-term clinical studies on cholesterol-lowering is presented at Our Bodies Ourselves, a health resource center in Boston: http://www.ourbodiesourselves.org/book/menoexcerpt.asp?id=65
2. A 2002 study by the University of South Carolina reveals the mechanism of cardiovascular damage from high homocysteine levels: http://www.ncbi.nlm.nih.gov/pubmed/12371153/
3. A study published by the NIH PubMed shows that taurine is effective in lowering homocysteine levels, which might be effective to reduce atherosclerosis: http://www.ncbi.nlm.nih.gov/pubmed/19239173?ordinalpos=42&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DefaultReportPanel.Pubmed_RVDocSum
4. An overview of high homocysteine scientific data is presented at the health website of the University of Michigan Health System: http://health.med.umich.edu/healthcontent.cfm?xyzpdqabc=0&id=6&action=detail&AEProductID=HW_CAM&AEArticleID=hn-1029002
5. An article in the American Journal of Nutrition reveals many aspects of the homocysteine metabolism in relation to liver function: http://jn.nutrition.org/cgi/content/full/136/6/1701S
6. An article in the American Journal of Medical Sciences from 1998 links excess homocysteine levels to arteriosclerotic disease and stroke, Vitamin B6, B12, and folate deficiency, resistance to activate protein C, and blood coagulation disorders: http://www.amjmedsci.com/pt/re/ajms/abstract.00000441-199808000-00008.htm;jsessionid=J3HbsxYvRmQLv1HJsy1nj5KhM7fnMrj7jQPFKSpdG8222L0wklmV!751744069!181195628!8091!-1
7. A 2005 study showing a relationship between adrenal stress and high cortisol and cardiovascular disease with all of the common metabolic markers such as high homocysteine levels is presented here by researchers at the Federico II University in Naples, Italy, and published in the Journal of Clinical Endocrinology and Metabolism: http://jcem.endojournals.org/cgi/content/full/90/12/6616

The information on this website is not intended to be used as a specific medical advice or cure. Please consult with the practitioner or an appropriate physician, such as a licensed acupuncturist, naturopath, or medical doctor, to discuss the proper application of the information contained on this website.