More on the evidence showing that pharma has medical science looking in the wrong places for the causes of cardiovascular disease.

Highly recommended is reading the article on the role of pathogens and that of trans and rancid polyunsaturated fats in the development of atherosclerosis and its comorbidities—links below. 

Endothelial Dysfunction its Key Role in Cardiovascular Disease

Thus far I have shown that pharma’s hypothesis as to the cause of CVD is not merely a minor causal factor, but totally false (the cholesterol-saturated fats myth).  I have answered the question what causes CVD by showing that pathogens and the subsequent immune response (including LDL mopping up bacterial toxins) play the key role in the development of atherosclerosis.  This still leaves the question of how does the Western diet figure into the much higher rate of CVD:  how does a diet high in sugar, refined carbs, and trans and polyunsaturated fats cause CVD?  Part of the answer is found in fatty liver and insulin resistance and their consequences among which is an increase in endothelial dysfunction of the artery walls.  Endothelial dysfunction is the gateway to atheroma (plaque) formation.[1] 

The endothelial cells that line the inner walls of arteries are the gatekeepers for what enters the underlying tissues.  Thus damage to these cells promotes atherogenesis (development of atherosclerosis).  Endothelia dysfunction has 6 main causes (and one way in which it promotes the subsequent ischemic events:  1) diet and lifestyle that causes high level of blood sugar, especially the 7 times more reactive fructose, through the process of glycation,[2] which damages the endothelial cells.  2) Fructose is converted to fat in the liver, and too much fructose with little physical excursion results in a fatty liver.  A fatty liver mucks up the metabolic regulatory system to cause insulin resistance, which slows the clearance of sugars from the blood. These cause increased glycation which damages endothelial cells.  3) A diet high in trans-fats and polyunsaturated fats (polyunsaturated fats are subject to a process of rancidification in the body, in deep fryers, and on the shelf).  Their abnormal shapes adversely affect the cell walls of the endothelial cells (and all other cells) and thus their function as gatekeeper to the underlying tissue.  The compromised cell walls make the underlying tissue subjected to a greater viral and bacterial load.  Pathogens in the artery wall cause the development of atherosclerosis and their associated pathologies.  Infections   It also affects every cell in the body since these abnormal fats accumulate in cells because they can’t be metabolized.  They adversely affecting cellular functions; for a review of the evidence click on link.  4) Carbon monoxide (mostly from tobacco) and other reactive chemical in the blood bond to the endothelial cells (similar to glycation).  5) Infectious agents through their toxins circulating in the blood damage the endothelial cells (chronic infections are associated with CVD).  In summation:  these causes of damage to endothelial cells which compromise their function as the gatekeeper that selectively permits chemicals and cells to enter the underlying layers of the artery; thus so damaged the endothelial cells permit the penetration of pathogens into the tissue within the arteries.  Infectious agents in the artery walls have been clearly shown to be the major cause of plaque formation through an immune response to their presence.[3]  In conclusion, the five processes which damage the endothelial cells are atherogenic.  6) Elevated homocysteine is causally associated with endothelial dysfunction through reactive chemicals (the details of this mechanism are sketchy at best) and also by causing LDL aggregation (clumping) following LDL’s reaction with pathogens or their toxins.  Such clumps it is theorized hinder the flow of oxygen from the vasa vasorum (Uffe supra 210).  Vitamin C in large dose has been demonstrated to be protective (at).[4]  7) The damaged endothelial cells are more likely to leak the underlying young plaque and thereby cause an ischemic event that could result in myocardial fraction, stroke, or kidney damage-- depending on location of leak.  The Western diet with its fructose, refined carbs, and unnatural fats has caused the CVD, T2D, and obesity pandemics.  These conditions along with strokes, heart attacks, arthritis, macular degeneration, osteoporosis, and dementia are collectively called “the diseases of Western society/civilization”.  Tragically the food manufacturers have successfully exported this diet to Asia and the underdeveloped world—watch Globesity.    

The vasa vasorum (Latin, "the vessels of the vessels") is a network of small blood vessels that supply the walls of large blood vessels, such as elastic arteries (aorta) and large veins (vena cava).   Cells need to be within a few cell-widths of a capillary to stay alive. In the largest vessels, the vasa vasorum penetrates the outer (tunica adventitia) layer and middle (tunica media) layer almost to the inner (tunica intima) layer. In smaller vessels it penetrates only the outer layer. In the smallest vessels, the vessels' own circulation nourishes the walls directly and they have no vasa vasorum at all.  An interesting point of fact is that, in the human descending aorta, vasa vasorum cease to supply the arterial walls with oxygenated blood at the level of the renal arteries.^[4] Thus, below this point, the aorta is dependent on diffusion for its metabolic needs, and is necessarily markedly thinner. This leads to an increased likelihood of aortic aneurysm at this location, especially in the presence of atherosclerotic plaques. Other species, such as dogs, do have vasa vasorum below their renal vasculature, and aneurysms at this site are substantially less likely. Cerebral blood vessels are devoid of vasa vasorum; however, these vessels have rete vasorum, which have similar function to vasa vasorum.  Small vessels like vasa vasorum and vasa nervorum are particularly susceptible to external mechanical compression.^[7]and thus are involved in pathogenesis of peripheral vascular and nerve diseases.

Vasa nervorum are small arteries that provide blood supply to peripheral nerves. These vessels supply blood to interior parts of nerves ^[1] and their coverings. Small vessels like vasa vasorum and vasa nervorum are particularly susceptible to external mechanical compression.^[2] Vasa vasorum and a decrease in blood flow through the vasa nervorum has been implicated in the development of diabetic neuropathy.   During invasive diagnostic or therapeutic procedures, injecting a vasoconstrictor close to nerve can reduce perfusion to its supplying vessel, risking ischemic nerve injury. Occlusion of vasa nervosum at level of epineurial arterioles leads to ischemia of nerves leading to vasculitic neuropathy.^[3][4] and has been implicated as cause in few cases of facial nerve paralysis.^[

The cause of CVD from a 2006 review article on trans-fats:   “In addition incorporation of trans-isomers into membrane phospholipids may influence the physical properties of the membrane as well as the activities of the membrane-associated enzymes.  Several studies suggest that trans-fats cause endothelial dysfunction [affects wall of arteries and other tissues]… soluble vascular-cell adhesion factor…reflected by reduction in brachial artery flow-mediated vasodilation by 29 percent [raises blood pressure], as compared with intake of saturated-fats.”  The 1986 ADA review article states the same.  There is list of effects of rancid polyunsaturated fats. Polyunsaturated fats are subjected to oxidation through reactive products of metabolisms (ROS), and as rancid fats, like transfats the body lacks enzymes for their metabolism.  They too accumulate in the body and muck up various systems. “Rancidification can produce potentially toxic compounds associated with long-term harmful health effects concerning advanced aging, neurological disorders, heart disease, and cancer. A combination of water-soluble and fat-soluble antioxidants is ideal” Wiki.  “under such conditions [of commercial frying] both thermal and oxidative decomposition of the oil may take place.  Such unavoidable chemical reactions cause formation of both volatile and nonvolatile decomposition products…. Various symptoms of toxicity, including irritation of the digestive tract, organ enlargement, growth depression, and even death have been observed when highly abused (oxidized and heated) fats were fed to laboratory animals”… and the article goes on “Lipid peroxidation refers to the oxidative degradation of lipids. It is the process in which free radicals "steal" electrons from the lipids in cell membranes, resulting in cell damage.  It most often affects polyunsaturated fatty acids, because they contain multiple double bonds in between which lie methylene bridges (-CH₂-) that possess especially reactive hydrogens.  If not terminated fast enough, there will be damage to the cell membrane,…”

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Even among those primitive societies that consume a significant amount of fruit and carbs there are several differences all of which work towards remaining slim and not developing atherosclerosis:  1) lack of steady food supply.  Fruits are seasonal, and during dry season the diet is much different than during the rainy seasons.  And even during times of plenty, daily foods varied more; thus these people do not prior to farming have a steady diet high in sugars and refined carbs.  2)  Wild varieties of fruits have only a fraction of the sugar of domestic varieties.  3) Grains are not processed to remove the cereal germ and the bran, and most tubers contain a significant portion of fiber; thus they have a lower glycemic and insulin index.   4) Periodic periods of scarcity results in energy restricted diets.  5) Physical excursion for entails a lower insulin spike which drives fat storage an essential element in developing fatty liver disease.   The literature and old photos confirm that obesity was virtually unknown and medical records once contact with civilization occurred before lifestyle was changed indicate that the diseases of civilization (heart attacks, strokes, dementia, arthritis, and cancer) were very rare if recorded at all.  Infectious diseases and violence were their principle cause of death.  The daily high sugar (fructose) Western diet has no equivalent among paleo societies.       

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Cardiovascular disease (CVD) & endothelial dysfunction  --  old