Heart disease and evolution: why heart disease?
By Dr. Lon Jones, D.O.

Once when I was with a group of patients with heart disease I asked them what they thought the risk factors were for their disease. The great majority answered that they inherited it. Genes played a more dominant role than smoking, high blood pressure, or elevated cholesterol.

I was a little puzzled by this and by the fatalistic attitude that seemed to go with it. After all, they seemed to be saying, if it's in our genes there's not much we can do about it. Yet this group had already done a lot: no one smoked, they were watching the other known risk factors and taking appropriate medication to reduce the ones they could. They seemed to know that even genetic problems can be modified by behavior.  And they can.

People with phenylketonuria lack the ability to metabolize phenylalanine, a basic protein that is in lots of foods. It's in Nutrasweet, which is why there is the warning label on this product. If these people eat phenylalanine it causes mental retardation. If they don't they can lead normal lives. Type 2 diabetes, like phenylketonuria, is a genetic disease. The problem here is too much glucose. These people too can lead normal lives if they limit the glucose in their diets. In our culture where sweet carbohydrates are a dietary mainstay and no warnings are attached that is harder to do.

When something is genetic it is always important to ask why the symptoms are there lest we treat or block something that is useful, like we did with blood letting. (If you haven't read about this important concept go back to Featured Articles and read the one on symptoms.) In the case of heart disease there are some interesting ideas.

Long ago when mankind lost the ability to make vitamin C they got more than enough with all of the berries and fruits that they ate. But then came an ice age and all of the berries and fruits froze; and people started getting scurvy. This vitamin deficiency disease causes weakness in the blood vessels so that they leak. People with scurvy die from internal bleeding. According to Matthias Rath atherosclerosis, the laying down of plaque on blood vessel walls that is a primary factor in heart disease, patched these leaky vessels and more people with this ability lived through this time when vitamin C was scarce. And that is why we inherited this tendency that we know as atherosclerotic heart disease.

One of the facts that makes this idea appealing is that vitamin C does prevent some heart disease. Epidemiological studies done in the '60's and '70's in California showed less heart disease in people taking supplemental vitamin C and the recently reported nursing study with over a million person years showed a 27% reduction in heart disease in women who took supplemental vitamin C. This supplement apparently reduces the need for patching blood vessels with atherosclerosis.

Tip for the day. Take supplemental vitamin C a couple of times a day.