The ENDOTHELIUM Association
All heart attacks and most strokes are caused by a sick endothelium
Why The ENDOTHELIUM Association
Because the existing public institutions that provide information about the
number one cause of death, heart disease, are not providing complete
accurate information to the public, Who has been told that arterial endothelial
ill health is the place where heart attacks, stroke, peripheral artery disease,
as well as a host of other maladies, originate. The heart is not the cause of
the problem. How do you solve a life style problem if people are not even
know the source of the problem or the reason for the problem? The
ENDOTHELIUM Association is need.
Right now we are having a heart attack epidemic. Heart attacks are the
leading cause of death, about 2000 a day. Cardiovascular illness (CVD) cost
last year, according to the American Heart Association, was about
$ 500 billion in 2009. Yet the public knows nothing about this primary cause
of heart attacks: the failure of an organ called the arterial endothelium.
The heart attack was a mystery in 1915 when doctors in New York and
Boston first started the American Heart Association (AHA). Finally, at the
1988 annual American Heart Association meeting, after 73 years, Dr. Louis
Ignarro presented his work that led to a Nobel. It was not the heart. The
heart is an innocent victim that has had its oxygen supply cut off by an artery
blockage. (This was not news.) The new research news was that the artery
lining, the endothelium, was the key. Nobody had known, until this line of
research had begun, that the arterial lining even was an organ, let alone that
it controls whether you will or will not have a heart attack. In 1998, the Nobel
was given to Drs. Furchgott, Ignarro and Murad and Furchgott for their work.
The arterial endothelium, and the way it functions, is the key to understanding
arterial health. The arterial endothelium is a one cell thick lining of the artery
walls. To provide oxygen to all the cells of the body requires about 100,000
miles of arteries in the human body. All arteries are endothelium lined. What
the Nobel winning researches found is that the endothelium is not just a lining
but a highly complex and unique servicing organ. The endothelium receives
messages from the artery walls that tell the endothelium what is needed,
usually nitric oxide (NO), which is made from an amino acid, L. arginine. The
endothelium manufactures what is needed and secretes it to the spot where
it is needed. Artery walls, with a healthy supply of NO from the endothelium,
are supple and flexible for life.
The arterial endothelium also creates a protective barrier within the arteries
and over and within organs of the body. The arterial barrierr is routinely
described as being like Teflon, a substance to which nothing sticks. Dr. John
Cooke, a Stanford professor and researcher, in his book, “The
Cardiovascular Cure” states that “it is virtually impossible to have a heart
attack if the endothelium is healthy”. In fact, throughout the world, in societies
that eat a plant based diet, about 4 billion people, arteriosclerosis and heart
attacks are unknown. Here in the US and the rest of the industrial world,
about 2 billion people, who eat a meat based diet, all have heart attacks are
universal. The key difference is the diet.
We humans are primates and primates are herbivores not carnivores. A
meat diet causes an irritation of the arterial endothelium. The constant
irritation eventually causes the endothelium to become inflamed. The arterial
endothelium, having become sick, seeks help from white cells to fight the
infection. To let the white cells into the endothelium to do its job, the
endothelium gives up its Teflon quality. The door is opened. Not only do the
white cells come in but so does everything else: cholesterol, triglycerides,
platelets, etc. The artery walls become like Velcro to which everything
sticks. A cascade of biological events lead to arteriosclerosis which, in turn,
leads to heart attacks, strokes and a host of other ills.
In the '70s Nathan Pritikin, having heard of the WWII German dietary
experiment, was the first to publicize a plant based diet. In the ‘80s, a
number of clinicians such as Dr. Esselstyn at the Cleveland Clinic and Dr.
Ornish in L.A. demonstrated that they could permanently reverse the
progress of arteriosclerosis without surgery by radically changing patients’
diets from meat based to plant based. Today, their first patients, some of
whom were on deaths door, recovered and still are on the diet and are still
living active productive lives. Angiograms of these patients have shown the
remarkable recovery of their once nearly closed arteries. Their endotheliums,
given the opportunity, had recovered their healthy functioning.
Over twenty years after Dr. Ignarro explained the endothelium’s functioning
and the role of nitric oxide to the 1988 American Heart Association annual
meeting, won a Nobel in 1998 and last year received their Distinguished
Scientist Award of the AHA, the AHA literature still tells the public, “ TAKE
CARE OF YOUR HEART”. The key role of the arterial endothelium is
ignored. Only if you look at AHA literature with great care, can you even find
mention of the endothelium. AHA literature has no detailed explanation of how
the endothelium works or how its debility occurs. Neither is there an AHA
recommendation that the endothelium be regularly tested. There is one
endothelial improvement. Over the past twenty years the AHA dietary
suggestions have slowly inched toward the dietary recommendations of Drs.
Ornish and Esselstyn, but there is still a substantial gap.
The heart is the central focus of the AHA and that is not surprising. That is
their name, The American Heart Association. Over the years, researchers
have learned a great deal about the heart and more is being learned all the
time. There are many ills of the heart beyond the heart attack. The heart, by
legend, the center of emotion, and in practice, a pump, often brings itself to
our attention. We know it is there. We feel it all the time. Would it be
reasonable to expect the AHA, which has focused upon the heart for nearly
100 years, to now take up the cause of the endothelium as its primary
For an unknown organ or illness, to become well known, an advocate is
needed. Most major organs or
disabilities have them. If there are pills for treatment, we are sure to hear
about them. For example, we have heard a great deal about our cholesterol
from Pfizer selling Lipitor. Erectile dysfunction is another prominently
advertised malady with pills readily available from Pfizer. Unfortunately, there
is no endothelium pill. Therefore, there is no institutional support. The cure for
the endothelium is dietary, leafy green vegetables.
Who really wants to change their accustom diet except, perhaps, to
something that is sweeter, saltier and greasier? What is good? Our primate
relatives were vegetarians with minor exceptions. Evolutionary biologists have
pointed out that somewhere in our development, about 2.6 million years ago;
our ancestors developed a taste for meat and fat. This made us more
versatile as to food supply and where we could survive. As a result, we like
our burgers, cheeseburgers, steaks and fries. We also like eating what we
are used to eating. The Fast Food Industry advertising backs this up.
Restaurants are relentlessly selling foods that “taste better.” Dr David
Kessler, former Commissioner of the FDA, in his new book, “The End of
Overeating…..” points out that foods that combine fat, salt and sugar
together have an addictive quality that is comparable to cocaine addiction.
No help can be expected from the meat industry, fishing industry or the dairy
There is also resistance in the medical community. Doctors are no more
eager to change their own diets than anybody else. Change is hard.
However, doctors can and do change. Now, there are very few smoking
doctors. From a dietary point of view, we are at a time comparable to the
1920s when many doctors smoked. In the future, doctors will change the
way they eat too. In fact, some have started.
Neither can we expect doctors to rush to change the way they practice
medicine. History shows that doctors are very reluctant to change what they
do. Furthermore, the current way of treating heart patients is just so
rewarding financially. Would you, as a physician (who is also a small
business-man), rather have a patient come in for a stent procedure ($10,000
to $30,000 per procedure) or tell the patient to go home and eat the
broccoli? Dr. Ornish made the point in his first book in 1990: he said it took
about the same time to do an angioplasty as it does to educate a patient
about his diet. The insurance company would pay him $7500 for the former
but only $150 for the latter. Not much help there.
Hospitals too have found their cardiac care units to be a wonderfully reliable
profit centers. Keep in mind that a large part of the over $500 billion, the total
cost of cardiovascular treatment and care, both direct and indirect, went to
hospitals! We have an epidemic going on and everyone is making money.
The most powerful driver of this epidemic is our taste and sense of smell
which is directly wired to the brain. The food industry exploits this. Money is
no object when it comes to persuading people to buy. New products are
constantly under development. Once developed and tested, the selected
products are introduced with the most persuasive packaging human ingenuity
can devise. Free samples are given out wherever a crowd will gather.
Movies and TV constantly reinforce the idea that food is for something other
than nutrition: fun, recreation, celebration, consolation, companionship and
just the experience of food in the mouth. Have some more popcorn.
How are we really going to start getting a real handle on this epidemic if
nobody has the slightest idea of the root cause – “A sick what ? “
What better way is there to address this health calamity than with an
organization that is dedicated to advocacy for and publicizing of the
ENDOTHELIUM: The ENDOTHELIUM Association?
The Endothelium Association has an immense and enormously important job
before it. Obviously the job cannot be completed in one lifetime - but we can
make a start.
First is the task of getting the information out that the Endothelium’s sickness
is the causative factor in a heart attack. The primary recipients of this
information should be the information providers such as the health authors
and editors, medical professionals, the schools at all levels, the HMOs, etc.
Seconds is to encourage endothelium testing by the medical professionals. It
needs to become a basic screening tool. Potential recipients need to request
testing. The tests are getting better and better. There is now a test machine,
the EndoPAT 2000, a simple glove that measures blood flow in the finger
tips, developed by an Israeli company and tested by the Mayo Clinic, that
yields data at the sub-clinical (before real problems have developed) level.
No doubt tests will get better as demand increases. TEA will hopefully
accelerate this process.
Third is the development of treatment protocols that patients will find easier
to sustain over the long term. How should the patient be told? Is the same
procedure used for everyone or should it be tailored? Are there a variety of
treatment options? There are many questions that need to be asked and
treatment options developed. Only time and attention will provide the
While the main focus of TEA is on the heart attack, the loss of oxygen to any
cell of the body is debilitating, wherever it occurs. Strokes are the number
three cause of death. Most strokes have an endothelial origin. Dementia is
another potential ailment. Peripheral Artery Disease (PAD) which decreases
the blood flow to the legs and thus makes walking difficult, is a wide spread
problem. It may even lead to a complete blockage, which leads to gangrene,
which necessitates amputation. Then there is the eye. The problems
occurring because of endothelium debility are diverse, often completely
unexpected, and frequently fatal.
The causative factor in the health problems is the human love of meat and the
profit derived from it. This in turn has led to unsustainable medical costs. The
animals we two billion meat eaters demand for our diet has created an
environmental nightmare that is ultimately unsustainable. It has led to an
industry energy usage nearly equaling transportation, the gases animals
create are 51% of global warming; the billions of animals cause degradation
of land and oceans; their numbers have resulted in pollution by the excrement
produced, excess antibiotics used to keep crowded animals alive until hey
reach slaughter weight, the pesticides and fertilizer required to feed them and
finally cattle use 70% of the potable water in a world very short of potable
water. It is unsustainable, a disaster in the making.
The tongue is the enemy of the endothelium and the tongue is winning. We
are eating 50 lb. more meat today than we did 50 years ago. Things are not
getting better. In fact, globally they are getting worse. Diets in China and
India are moving more and more to animal products as their income rises. So
too are heart attacks and strokes.
The Endothelium Association is being established because, if we do not
provide the knowledge that will make it possible for people to bring their
rational mind into their decision making process, who will? It needs to be
done. It should be done. Help us do it now.
There is a lot to do.