A Theory of Heart Disease as Guide in Cure

Patients with heart disease having infusion chelation therapy in a clinic at Metro Manila, Philippines. Writer is at right side of photo.

The free radical theory of heart disease is basis of prevention, treatment and cure; conventional medicine has no cure for heart disease

Let us engage in theory-making in medicine. We come up with concepts and relationships among concepts based on present knowledge. It is similar to theoretical nuclear physics engaged in by Einstein who did not conduct any experiment in the laboratory. He made use of the results of experiments conducted by other scientists. He used the speed of light measured by Michelson and Morley, the transformation formulated by Antoon Lorentz and the non-Euclidian geometry of Bernard Riemann. He did mind experiments. For example, to his question "What would happen if I traveled with light?". His answer: "time would stand still and the mass of objects would contract."

What is a theory? A theory consists of concepts and relationship or relationships among concepts. This is how Einstein defined theory (Einstein, A. Ideas and Opinions. 1954). For example, “The shape and size of killed poliovirus incites immunization.” The concepts are shape, size, killed poliovirus and immunization. The relationship is incites. I have a Hub “A Theory of Salk Vaccine: How Does Shape And Size Of Killed Poliovirus Incite Immunization?” showing a method of theory-making.

To proceed in our theory-making in medicine, we start out with a hypothesis which means a scientific guess used as guide in research. When this hypothesis is proven as true, it graduates into a theory. In other words, a theory is a hypothesis proven as true. That means the concepts that constitute it are right; the relationship among concepts are verified.

Uses of a theory of heart disease

Heart disease involves arteries that wrap around the heart and supply blood and oxygen to the heart muscles. At least one artery or several arteries sustain plaque that lessen blood flow. The plaque consists of collagen, fibrin, elastin, bad cholesterol and other debris. Calcium apatite serves as cementing agent. Their combination grows into a mound that narrows the diameter of the artery.

Heart disease is different from hole in the heart, arrhythmia (irregular heart beat), heart failure (incapability of heart to pump blood into organs like liver), cardiomyopathy (deterioration of heart muscles), and rheumatic heart (narrowing of heart valve or insufficient closure of heart valve allowing back flow of blood).

A theory of heart disease explains this disease. This theory serves as a basis of effective means of preventing heart disease; and as basis of treatment and cure. Effective means it ensures certainty, not trial and error. In other words, a theory of heart disease is a guide of action that leads to prevention, to treatment (if heart disease had started), and to cure (no recurrence of heart disease out of the same cause or causes).

Don’t we have a theory of heart disease yet?

Conventional medicine has no theory of heart disease yet. Its main proponents have a definition of heart disease. They have risk factors of heart disease. Risk factors do not comprise a theory of heart disease.

“In the 17th century, practical medical knowledge began to grow. The English scientist William Harvey (1576-1657) rejected the traditional belief that the blood was made up of ‘spirits’ and ‘humors’ (body fluid) and that ‘bad’ humors cause disease. Harvey theorized that blood circulates through the heart to the lungs, through the arteries, and ultimately back to the heart via the veins” (Shader, L. MD. and J. Zonderman. Mononucleosis and Other Infectious Diseases. 1989:20).

What Harvey “theorized” is not expressed in the form of a theory. Of course, it is not a theory of heart disease.

The first to vaccinate was Edward Jenner in 1796 who used pus of cowpox against smallpox. “Jenner devised a method for combating smallpox. However, he did not understand exactly why inoculation worked” (same source as above, page 21).

We may say Jenner devised a technology based on result or based on statement of fact. The result is: “a person inoculated with a pus of cowpox does not get sick of smallpox.“ This technology is not explained; it may be called result-based technology. A prediction based on result is uncertain. It is a sort of hit-and-miss. We are after a prediction that is certain. Such a prediction is based on theory. The technology developed out of theory may be called theory-based technology. We will use this terminology again later.

Two renowned proponents of conventional medicine gave a definition of heart disease as follows:

“Coronary heart disease, also called coronary artery disease, is atherosclerosis of the coronary arteries, that is, the blood vessels that supply blood to the heart muscle itself. As we discuss later, in Chapter 13, exactly how atherosclerosis arises remains speculative, even though the disease process, including the consequences in such events as angina pectoris (chest pain), heart attack, and stroke, is a very familiar one. Since we have not yet defined the precise mechanism of atherosclerosis development, it is fortunate that we can identify factors that determine people’s risk for development of the disease” (DeBakey, M. MD and A. Gotto, Jr., MD. The New Living Heart. 1997:79).

They gave up on the formulation of a theory of heart disease, saying:

“A number of theories have been proposed to explain the development of atherosclerosis, but no single one completely and satisfactorily accounts for all the observations that have been made about this disease. To be valid, any theory about the cause and development of atherosclerosis must be consistent with what is known about its relationship to age, sex, serum cholesterol, diet, and other risk factors, and its pathological characteristics” (DeBakey, M., MD and A. Gotto, MD The Living Heart. 1977:155, authors’ italics).

Of the seven theories they discussed in this book, they adopted none. Instead they pursued risk factors.

“We do not have to know the exact mechanism for the development of a disease to be able to reduce risk for it. For example, the exact mechanism of lung cancer is not known, but the great majority of cases of lung cancer could be prevented through smoking cessation.”

“A risk factor is defined as any trait or habit, whether genetic or environmental (which includes lifestyle factors), that can be used to predict an individual’s probability of developing a particular disease....” (DeBakey, M. MD and A. Gotto, Jr., same source as above).

So, a rick factor is only a device used to predict the probability of the occurrence of a disease. A risk factor is not a cause. A risk factor is based on association not on causation.

However, a risk factor is not a certain or reliable predictor.

Risk factors are classified as uncontrollable and controllable. Uncontrollable includes: “personal history of coronary heart disease,” age, “family history of premature coronary heart disease.” Controllable risk factors include: “current cigarette smoking,” high blood pressure, “elevated LDL-cholesterol,” low HDL-cholesterol,” diabetes mellitus, obesity, “physical inactivity” (DeBakey, M. MD and A. Gotto, Jr. MD. The New Living Heart. 1997:82).

Because they are risk factors, it is expected that if high level of cholesterol and hypertension were controlled occurrence of death is lowered. That is, lower than among patients who were not given cholesterol-lowering drugs and anti-hypertension drugs. Take this direct quote:

“Background. – A randomized primary prevention trial was begun in 1974–1980 to assess the value of intensive dietetic and hygienic measures, hypolipidemic therapy with clofibrate and/or probucol, and antihypertensive therapy mainly with B-blockers and diuretics. Ten-year follow-up data now are available on the 610 control subjects.

“Findings. – Half the subjects in the intervention group received antihypertensive medication and 45% were given hypolipidemic medication. Overall mortality was 10.9% in the intervention group and 7.5% in the control group.... The rates of mortality from coronary heart disease were 5.6% in the intervention group and 2.3% in the control group.... Multiple logistic regression analysis failed to explain the excess cardiac mortality.

“Implications. – Coronary mortality increased in this study despite effective reduction of cardiovascular risk factors. The findings may relate only to this particular population, and they do not invalidate the concept of multifactorial primary prevention. They do, however, mean that ongoing research is needed on selecting methods for primary prevention of cardiovascular disease” (Strandberg THE. Salomaa VV. Naukkarinen VA. Vanhanen HT. Sama SJ. Miettinen TA Univ of Helsinski, Finland; Natl Public Health Inst. Helsinski, Finland; Jorvi Hosp. Espoo, Findland. JAMA 266:1225-1229, 1991 1-19. Long-term Mortality After 5-Year Multifactorial Primary Prevention of Cardiovascular Diseases in Middle-Aged Men, in:. 1992 Yearbook of Cardiology. 1992:18-20, emphasis supplied).

This benchmark research is important. Dr. Dean Ornish commented on it in his book "Dr. Dean Ornish's Program for Reversing Heart Disease," to wit:

" A large-scale study in Helsinki compared 612 people who were intensively treated with anti-hypertensive and cholesterol-lowering drugs to a control group of 610 people who received usual medical care with fewer drugs. Although these drugs produced a 35 percent overall reduction in risk factors (primarily blood pressure and cholesterol levels) in the drug-tested group, the participants developed twice as much heart disease after five years when compared with the control group of patients that took fewer anti-hypertensive and cholesterol-lowering drugs" (Ornish, D. MD. Dr. Dean Ornish's Program for Reversing Heart Disease.1995:51).

I suppose the research was meant, as shown by the "background," to validate the expectation that if the risk factors of hypertension and cholesterol were lowered, the death rate owing to heart disease would also go down. The research gave an opposite result. The findings were supposed to be true not only for this Helsinki group but for at least Finns, at most for people of the world.

The implications part says that there "is needed on selecting methods for primary prevention of cardiovascular disease.” The research group perhaps forgot that they were testing risk factors not just methods. Hypertension and cholesterol failed, as risk factors, to predict what was expected. Since this was a pivotal research, its results could have been enough to trigger a revision of accepted belief that these risk factors serve as predictors.

This was the effect on Dr. Ornish, MD who devised a program that does not use drugs in the treatment of heart disease. He claims that those who followed his program had their plaque reversed by 8% in four years.

Dr. Ornish saw the futility of applying angioplasty and coronary artery bypass surgery (CABG). He said CABG is not addressing the cause of heart disease. His case is a especial one because he had his internship in cardiac surgery right under Dr. DeBakey. However, Dr. Ornish failed to pin down free radicals as causes of heart disease. He only modified the risk factors adopted from Dr. DeBakey and Dr. Gotto.

To Dr. Ornish "what injures the lining of the coronary arteries (are) high blood cholesterol levels, excessive dietary cholesterol and saturated fat (independent of blood cholesterol levels), high blood pressure, nicotine."

I think Dr. Ornish serves as a transition between the risk factors school and the free radical school of medicine. Although he uses modified risk factors, Dr. Ornish advocates reversal and maintenance diets consisting mainly of vegetables allowing only yogurt and tofu as sources of calcium. He also advocates vitamins.His book does not have "free radical" in its index . He used the term "oxidized" once and "oxidation" once in his book. However, his framework is not the free radical theory of heart disease. He said diet is part of lifestyle.

I think his maintenance and reversal diets qualify in the free radical theory of heart disease. I got a copy of Dr. Ornish's book ahead that of Dr. Cranton's (Bypassing Bypass) and I have been following the reversal diet as I went into infusion chelation therapy. Dr. Cranton also has menus of free radical diet in his book. Dr. Ornish claims credit of having been a medical consultant to President Bill Clinton in the White House. Perhaps, upon his advice Bill Clinton banned smoking in the White House.

Due to the lack of theory, campaigns against smoking have been vulnerable to the attacks by the tobacco industry. There is merit in the counter argument of the tobacco industry, to wit:

“The standard gambit then, as now, was that the health research implicating smoking was based only on statistics and not on medical observations. If a real cause and effect sequence from cigarette smoking inhalation to cancer could be shown, the industry cried, rather than all these statistics, that indeed would constitute proof” (Epstein, S.S. MD. The Politics of Cancer.1978:167).

Fortunately, if Dr. Epstein tried to demonstrate in 1978 that smoking caused cancer and heart disease he could have succeeded even if he used risk factors as his premises. The reason is that cigarette smoke contains free radicals and X-rays that cause cancer and heart disease. The caveat is that his presentation would have been wrong if he reasoned that tar caused heart disease and cancer. At that time he believed that tar and other agents like benzene caused these diseases. That is why he could not explain the fact that uranium miners who did not smoke and did not inhale second hand smoke contracted cancer and heart disease. The reason being that uranium decayed into polonium 210 and lead 210 which are radioactive. When these decayed into the stable lead 206 they emitted X-rays and generated free radicals. (I have a Hub “How Free Radicals and X-rays In Cigarette Smoke, Not Tar, Caused Cancer and Heart Disease?”). Tobacco plant accumulates polonium and lead from the soil and fertilizer used to raise it.

Available data and reasoning have established that risk factors are not reliable predictors. Only a theory of heart disease is a reliable predictor.

What then is a hypothesis of heart disease that can graduate into a theory of heart disease? Let’ take a look into this one:

“Free radicals injure the inner wall of the artery that results in a benign tumor called atheroma. The body repairs this atheroma with cholesterol, collagen, elastin and other debris. Calcium apatite joins in later that serves as cementing agent. Their combination grows into a plaque that partially or completely blocks at least one artery. Blood flow to the heart decreases, likewise oxygen for heart muscles decreases that result in angina or heart attack.”

The concepts are: free radical, inner wall of artery, benign tumor, atheroma, body, cholesterol, collagen, elastin, debris, calcium apatite, cementing agent, combination, plaque, blood flow, oxygen, heart muscles, angina, heart attack.

The relationships are injure, result, attempts to repair, joins in, later, grows, partially block, completely block decrease.

We will call this a free radical hypothesis of heart disease. When proven, it will turn into free radical theory of heart disease. Rare events that may occur on the heart, like spasm, knife stab and extreme exertion are excluded. Extreme exertion can constrict heart muscles to the extent that they hurt themselves. Spasm caused by lack of magnesium to sustain the calcium/magnesium pump in the heart is a rare occurrence. Free radicals are so pervasive in the human body

The form of this hypothesis satisfies Occam’s razor, devised by Occam to indicate screening out of thousands of fertilized eggs into a few surviving nymphs. A hypothesis or theory should be such as it contains the minimum vocabulary (Russell, B. Human Knowledge: Its Scope and Limits. 1947). It must be short. Each term is not derived from another term; each term can be expanded. If there are two formulations that say the same thing and are short, the criterion for choosing one formulation is aesthetics, according to Russell. The hypothesis above is in a popularized formulation so it is not the shortest possible that could express the same thing. An example of a short one is E = mc2. E (energy) is not derived from another term, so is m (mass) and c (speed of light). But they can be expanded. Each concept is not fictitious; relationships (equivalent, multiply) are verifiable; squared is mathematically derived indicating the collision of two photons, or energies in the form of light. Such collision results in chain reaction of fission, the basis of the atomic bomb.

Similar free radical hypothesis of heart disease are also forwarded by Dr. Cranton and by Dr. Sharma in his book ("Freedom from Disease," pages 82-87). These are not presented as hypothesis but these contain elements that can go into a hypothesis. These are presented as happentance with accompanying explanations. Dr. Cranton's, for being the shorter one, is quoted here:

"...The initial event in arterial disease is damage to the arterial lining, resulting from blood flow stress, routine wear and tear, or free radical damage. To understand the basic concepts underlying the development of atherosclerosis, visualize these cells within the arterial walls abnormally multiplying until they form a benign tumor, a growth akin to the cellular proliferation seen in cancer. These arterial wall cells mutate in response to free radical damage to the genes contained in the nucleus, identical to the way in which atomic radiation causes mutations. An occasional cell losses its ability to control cell division and multiplication,. resulting in uncontrolled, tumor-like growth.

"The tumor (atheroma) thus formed is nonmalignant and will not metastasize or spread to other parts of the body. But it is nonetheless an unwelcome, space-occupying mass on the inside of the artery, which accumulate collagen, elastin, and other connective tissue constituents.

"When the growth exceeds its blood supply of oxygen and nutrients, it begins to break down in the center, becoming decayed or necrotic, and gradually gathers deposits of cholesterol and calcium. As it grows into what we call plaque, it becomes progressively firmer and more rigid. Calcification is actually a late occurrence in plaque formation - not the initial event" (Cranton, E., MD. Bypassing Bypass. Updated 2nd edition, 1995:72-73).

Definition of concepts

Free radical. It is an atom or a molecule or a fragment of a molecule that has at least one unpaired electron. For example atomic oxygen; it has eight electrons: two electrons in the first orbital nearest the nucleus and four in the second orbital (path of electron around the nucleus). The last two electrons do not pair up, they repel each other, which is unique in oxygen. In molecular oxygen (two atoms of oxygen joined by a covalent bond), two unpaired electrons spin around the whole molecule in parallel directions. In singlet oxygen (two atoms of oxygen joined by covalent bonds), one unpaired electron had been excited by energy and its spin is reversed. The two unpaired electrons spin in opposite directions. Each unpaired electron is unstable and seeks another electron to stabilize. In so doing it grabs that electron and inflicts injury in the molecule of a tissue resulting in mutation that shows as tumor or cancer. A molecular oxygen when it grabs another electron is left with one unpaired electron that is now a superoxide. Superoxide is a master free radical.

Siblings of superoxide

Some sources of superoxide are: (1) cyclooxygenase, (2) adenine dinucleotide dehydrogenase, an enzyme in the mitochondria, (3) xanthine oxidase, (4) nitric oxide synthase, and (5) cytotochrome P450 monooxygenase (Spieker, L. E. , A. J. Flammer and T. F. Luscher “The Vascular Endothelium in Hypertension.” The Vascular Endothelium II.2006.249-283).

Superoxide (O2-) reacts with nitric oxide (NO) resulting in peroxynitrite (ONOO-) with one free unpaired electron.

Peroxynitrite catches NO three times faster than superoxide does, reducing the supply of NO.
O2- oxidizes (destroys) L-arginine, the precursor of NO resulting in reduced supply of NO.

Catalyzed by SOD, superoxides react with each other producing hydrogen peroxide.

Superoxides reacting with each other in the presence of iron results in hydroxyl radical (Sharma, H., MD. Freedom From Disease. 1993). This is the most destructive free radical.

Superoxide oxidizes low-density lipoprotein of fats into lipid peroxide, a reactive oxygen species (ROS), that grabs a molecular oxygen with its two unpaired electrons intact resulting in another ROS.

When it takes away an electron from hydrogen peroxide, O2- results in hydroxyl radical.

Superoxides reacting with each other in the presence of copper result in alkoxy radical.

O2- when it exceeds the threshold of SOD results in singlet oxygen (Cranton, E., MD and A. Brecher. Bypassing Bypass. 1984:200).

Ultra violet rays energizing water in the skin results in hydroxyl radical (Brown et al. Chemistry the Central Science. 2nd ed.).

Sources or causes of free radicals and ROS outside the body are: (1) ozone, from the atmosphere, (2) ultraviolet rays that energize molecular oxygen, the one that we breathe, into singlet oxygen. Radioactive materials from tobacco, lead 210 and polonium 210, decompose into lead 206 emitting X-rays and generating free radicals.

We can see the proliferation of oxidant free radicals, reactive oxygen species (ROS) and signal free radicals. An example of the latter is nitric oxide produced by the endothelium nitric oxide synthase (eNOS/NO), an enzyme. eNOS/NO is a messenger that triggers the artery to dilate and allow more blood flow. Oxidant free radicals and ROS are the destructive type if they are not neutralized or balanced out. There is no escape from them. What is essential is balance between free radicals and ROS, on the one hand, and antioxidants and chelators, on the other.

“Free radicals can be caught in the act of creating cancer by using electron spin resonance (ESR) spectrometers" [Sharma, H., MD. Freedom from Disease (How to control free radicals, a major cause of aging and disease) 1993:90].

Inner wall of artery. This is also called endothelium that consists of one layer of cell. The cell membrane consists of fats that can easily be attacked and injured by free radicals and ROS. Its low-density lipoprotein is turned into LDL-ox which is a free radical itself. LDL-ox is a streak of cholesterol, the first sign of atherosclerosis (Sharma, H. Freedom from Disease.1993). Of course, there are those cholesterol from diet floating in the blood. A normal endothelium releases nitric oxide (NO), a gas free radical, that if catalyzed by endothelium nitric oxide synthase (eNOS). NO serves as a message that dilates the artery to allow more blood flow. Injured endothelium do not release NO, instead they leak iron and copper (Cranton, E., MD Bypassing Bypass. Updated 2nd ed. 1995).

Atheroma. it is a benign tumor that the body tries to repair. In the process it gathers collagen, elastin, and other debris. Calcium apatite joins in later that serves as the cementing agent. Their combination grows as a mound that calcifies and later on turn into a plaque.

Body. Means body of a person. Its reaction is to repair itself when injured along the concept of homeostasis or self integrity.

Cholesterol. It consists of alcohol and fats. It contains low-density lipoprotein or LDL which is attacked by free radicals and ROS. It turns into LDL-ox which is itself a free radical that starts a chain reaction of LDL-ox free radicals.

Collagen. A type of protein that supports tendon, arterial wall and skin.

Elastin. Elastic tissue that is also found in the wall of the artery.

Debris. The macrophage, a component of the immune system, engulfs LDL-ox then clings to the endothelium like a foam. This foamy material adds to the mound growing on the atheroma

Calcium apatite. It is also called calcium phosphate. It serves as a cementing agent of the collagen, elastin, and debris gathered upon the atheroma. It comes in later than other components in the development of plaque.

Cementing agent the same as calcium apatite

Combination. pool of collagen, elastin, bad cholesterol, debris and calcium apatite

Plaque. Also called block or occlusion. It is comprised of the mound that had grown on the atheroma. It narrows the diameter of artery and lessens blood flow and supply of oxygen to heart muscles.

Blood flow. It provides nutrients and oxygen for the heart and takes away by-products like carbon dioxide.

Oxygen. It takes on varied forms like atomic (O2-), ozone (O3), molecular oxygen (O22-), singlet oxygen (1/2O2), and superoxide (O2-). It engages in reaction and reduction. An unstable electron that grabs another electron from a molecule of a tissue inflicts damage or injury. It ramifies into reactive oxygen species.

When molecular oxygen is lacking, energy production cannot proceed or the amount of energy produced cannot sustain life. When it is lacking xanthine dehydrogenase turns into xanthine oxidase. This enzyme produces free radicals every time it recycles a purine base of DNA (Sharma, H., MD Freedom from Disease. 1993).

Heart muscles. They are non-renewable or are not subject to apoptosis that is programmed cell death. If they were renewable the injury like atheroma would be thrown away, as it were, when new heart muscles come in. In apoptosis, the nucleus of cell shrinks; dead cells are apoptosed by healthy neighboring cells. They can be healed with endothelium progenitor stem cells that originate from the bone morrow and roaming in the blood. They dilate from the signal delivered by nitric oxide produced by eNOS. They need nutrients and oxygen provided through the blood.

Angina. Also called chest pain that is a symptom of lack of oxygen for heart muscles. Classified as silent, stable and unstable.

Heart attack. Failure of the heart to pump blood owing to death of heart muscles that are starved for oxygen. Victims can recover or may die.

Definition of relationships

Verification on concepts and relationships involves several expertise and sophisticated tools like spin traps to subject free radicals under the electron resonance spin spectroscopy.

Several approaches using spin traps for free radicals are employed, as follows:
(1) use of model systems (in vitro)
(2) trapping is done on the humans and samples are studied in the test tube
(3) direct trapping in the humans and direct measurements are taken under physiological conditions
(4) “indirect assays based on reactions of free radicals with nitroxides or other paramagnetic labels” (Swartz, H. M. et al. “Free Radicals and Medicine." Biomedicine EPR-Part A: Free Radicals, Metals, Medicine, and Physiology. 2005:25-74).

For research on nitric oxide, the trapping agent dithiocarbamate has been approved for use on humans. Other trapping agents are being evaluated.

Injure. Free radicals and ROS grab electrons from molecules of tissues resulting in malfunction. For example, an injured voltage-gate channel allows the entry of too much calcium that poisons the cell. Calcium also carries along calmoldulin that triggers constriction and spasm. A molecule of low-density lipoprotein is injured when it is oxidized then turn into a free radical itself. It engulfs a molecular oxygen with its two unpaired electrons in tact then turn into LDL-ox that continues a chain reaction in free radical and ROS production.

Result. Become, turn into, as when two atoms of oxygen joined together by a covalent bond result in molecular oxygen. A cell whose DNA had been mutated by free radicals becomes a tumor.

Attempts at repair. This has a tinge of anthropomorphism, a human interpretation. We assume that the body wants integrity, to normalize what had been disorganized. (This assumption is similar to that in physics, that nothing is destroyed only converted into another form. That is why we have the law of conservation of matter.) A patch of collagen, elastin, cholesterol, and dead macrophage that had engorged LDL-ox is laid on the atheroma. The patch grows as a mound and obstructs partially or completely an artery. We say this is an attempt at repair that had gone awry. The patch lessens blood flow that starves heart muscles for oxygen, another serious problem not intended by the body.

Joins in. Combines with; lays over.

Later. Calcium apatite joins and contributes to the mound on the atheroma after an interval from the creation of a lesion on the endothelium.

Grows. More collagen, elastin, debris and calcium apatite pile on the atheroma in time. Cholesterol contributes a lot to the mound.

Partially block. The plaque that had grown still allows passage of blood in the artery. A blockage of 50% of the diameter of artery might still allow a normal volume of blood to the heart. When blockage had grown a little thicker up to 75% of the diameter, angina occurs. A 1% increase in the diameter of an artery results in four-fold increase in blood flow (Cranton, E. MD. Bypassing Bypass. Updated 2nd edition. 1995).

Completely block. No blood flow occurs through the artery. This is a guarantee to a heart attack. Sometimes, the artery grows collateral circulation that consists of small branches that bypass the blocked part of the artery. Collateral circulation forestalls heart attack.

Decrease. Lessen; reduce. A plaque that partially blocks an artery lessens the amount of blood flowing to the heart that may result in angina or heart attack.

Test of hypothesis

How do we test this free radical hypothesis of heart disease? We apply the method used by Einstein in the general hypothesis of relativity. From his general hypothesis of relativity, Einstein made predictions. One of them is: “light bends when it passes the vicinity of a large mass like the sun.” This was verified by Sir Arthur Eddington in 1929. Another statement of fact is: “the universe is expanding.” This was discovered by astronomer Edwin Hubble (Levy. D. Cosmology 101. 2003). These provided proofs for Einstein’s general hypothesis of relativity. Therefore, this hypothesis graduated into the general theory of relativity. Every time a manned spacecraft went out to space and came back to earth Einstein’s general theory of relativity is further verified. This theory accounts for gravity as a curvature of space-time. The trajectory of a spacecraft landing on earth is 6.2 degrees as specified by Einstein’s theory. If the Newton’s theory were applied which would specify that the trajectory is right angle to the equatorial plane, the spacecraft would bounce back to space and become marooned there.

What we illustrated with this example is that Einstein’s method of theory-making is right. However, we do not mean to say that we should not test the free radical hypothesis of heart disease by means of experimentation. We should do that also. For the present, I am arguing that with Einstein’s theory-making method and with the available data, we can prove this free radical hypothesis of heart disease. Let's proceed.

Some 400,000 patients with heart disease had been administered with infusion chelation therapy and got well. That is, without fatality (Cranton, E., MD. Bypassing Bypass. Updated 2nd edition.1995:120). The basis of chelation therapy is the free radical hypothesis of heart disease. Based on 400,000 cases of patients with heart disease administered with chelation therapy and who got well we infer a statement of fact as follows: “A patient with heart disease who is administered with chelation therapy gets well.” This statement of fact is true. The hypothesis that is formulated based on them, is true. Therefore, the free radical hypothesis of heart disease graduates into a free radical theory of heart disease.

Let others scrutinize the above chain of arguments. Einstein argued with a chain of reasoning that included Riemann's non-Euclidean geometry and made predictions that other scientists like Eddington and Hubble verified.


Some people do not believe or will not believe in the posited free radical theory of heart disease. However, lack of belief in it does not make it false. Belief is not a test of truth. Take the case of the general theory of relativity. Some 100 German scientists signed a manifesto (instigated by Hitler) denouncing this theory as a Jewish nonsense (Einstein, the proponent of the theory, was a Jew). Einstein countered that one fact only can vanish all the disbelief of these 100 scientists. I think that fact is: the speed of light is constant. The test of theory is truth not belief. The theory of truth being used here is correspondence theory of truth. We will not pursue the discussion of this theory. Suffice it to say that it is contrary to Thomas Kuhn's theory of truth that, in a capsule: a statement of fact is true if several people believe in it. In the past, several people believed that the sun revolved around the earth. We now know that the earth revolves around the sun. (Galileo saw this through his telescope; he told it to the Pope who forced him to recant and by means of the Inquisition imprisoned Galileo for life).

A theory explains

A Huber says that, following advice of Dr. Paul Pauling, a two-time Nobel Prize winner, he reversed the blockage of his heart arteries by taking vitamin C. The free radical theory of heart disease can explain this fact of reversal of blockage. Vitamin C is an antioxidant and a chelator (Walker, M. M.P.D. The Miracle Healing Power of Chelation Therapy. 1986). Vitamin C is a weak chelator, according to Dr. Walker, but a chelator nevertheless. Vitamin C reduces the population of free radicals and ROS and chelates plaque.

Points of intervention for prevention, treatment and cure

A theory is true for past events, for the present and predicts with a high degree of certainty future events. The free radical theory of heart disease serves as a guide in the formulation of interventions.

Free radicals

Neutralize them with supplement antioxidants (vitamin A, C, E, melatonin, coenzyme Q10) and chelation therapy; enhance production of built-in enzyme antioxidants like superoxide dismutase, catalase, glutathione peroxides, glutathione reductase, glutathione synthase; chelate catalysts like iron and copper; neutralize reactive oxygen species. Glutathione consists of glutamate, cysteine, cystine and cofactors B-2, selenium, zinc and lipoic acid that the body makes. Carbohydrates (glucose) provide glutamate, garlic and onion supply cystine and cysteine; nuts like cashew give selenium; vegetables like amaranthus supply zinc. Carotene converted into vitamin A absorbs heat that otherwise excites molecular oxygen and turns it into singlet oxygen. Carotene is the only antidote of singlet oxygen.


Support healing of injured inner wall or endothelium. This can be done with oral chelators and/or infusion chelation therapy, The endothelium progenitor cells, stem-cell-like cells originated from the bone morrow and roaming in the blood are involved in the healing.


Cholesterol can be managed by diet and cholesterol-lowering drugs; the oxidation (lipid peroxidation) of low-density lipoprotein can be minimized by neutralizing free radicals and by chelating iron and copper. The liver produces 75% of the cholesterol that the body needs. Only 25% can be manipulated by diet. Unsaturated fats should be avoided because they readily add to bad cholesterol.

Calcium apatite

It is also called calcium phosphate which is involved in hardening or calcification of artery. Early deposits can be seen even in the fetus. Calcium apatite can be chelated by oral chelators or infusion chelation therapy consisting principally of EDTA (ethylene-diamine-tetra-acetate). How does chelation work?

"During the short time that EDTA is circulating in the body (it has a half life of only one hour), it temporarily lowers blood calcium. The resulting drop in serum calcium provides a stimulus in the parathyroid gland to step up production of parathormone. This hormone, in turn, signals osteoblasts in bone to increase their production of normal bone calcification, drawing on other calcium sources in the body, some presumably, from pathological sources" (Cranton, E. MD. Bypassing Bypass. Updated 2nd edition. 1995:80).

One of those pathological sources is the plaque.


Interventions include counter against free radicals and reactive oxygen species, prevention of injury on the endothelium resulting in atheroma, prevention of the oxidation of fatty acids, halt in the growth of plaque, and reversal of plaque by chelation therapy. For more information on this technique, access the internet with the search entry cv chelation therapy cranton frackelton.

Because plaque can be reversed by chelation therapy, angioplasty and coronary artery graft surgery (CABG) are not necessary. CABG may be resorted to as an emergency measure when a heart attack occurred. When a person had survived a first heart attack a subsequent heart attack can be prevented by chelation therapy. A heart attack can be prevented or forestalled by heeding a warning like angina.


The intervention is designed to prevent the growth of plaque; to reduce the size of plaque once it had started; and to allow the production of the signals for the dilation of artery. A normal artery releases nitric oxide (NO) that is a messenger that signals the artery to dilate. An injured artery does not produce NO, therefore free radicals should be countered. NO is depleted by peroxynitrite which is a product of superoxide reacting with NO. Therefore, production of superoxide should be controlled with antioxidants and enhancement of the production of superoxide dismutase that neutralizes superoxide. Lessened blood flow can be remedied with nitroglycerin that produces nitric oxide. The plaque can be reversed with oral chelation therapy when it occupies at most 50% of the diameter of the an artery (Walker, M. M.P.D. The Miracle Healing Power of Chelation Therapy. 1986). The plaque of whatever size can be reversed with infusion chelation therapy (Cranton, E., MD Bypassing Bypass. Updated 2nd edition. 1995).

Intervention for blood flow is preventive when free radicals are countered such that they do not inflict an injury on the inner wall of artery; it is treatment when the size of the plaque is reduced to less than 50% of the diameter of the artery, production of NO is enhanced. It is curative when the plaque is reduced into insignificant amount, significant amount of NO is produced and the free radicals are balanced by antioxidants. These interventions had been done successfully.

The blood contains white blood cells, red blood cells and platelets. White blood cells are part of the immune system. The red blood cells have hemoglobin that carry oxygen for energy production. Increase in the population of hemoglobin is inducible by exertion, including exercise. A training for a bout of boxing increases the number of hemoglobin so does acclimatization for mountain climbing. So exercise contributes to the health of the heart. Exercise has the same effect on the population of mitochondria, the energy factory. Platelets are involved in clotting which can be prevented by inhibitors of the enzyme cyclooxygenase.This enzyme takes on arachidonic acid and produces prostaglandins with superoxide as by-product (Sears, B., Ph.D. The Zone. 1995:113). Prostaglandin consists of prostacyclin and thromboxane A2 that promotes aggregation of platelets, thus clotting. Clot contributes to heart attack. Production of thromboxane A2 can be prevented with aspirin. Prostacyclin promotes dilation of arteries. What is needed is a balance between prostacyclin and thromboxane.


The interventions are designed to ensure supply of oxygen, and to normalize supply of oxygen when the artery is occluded. Interventions for blood flow are also interventions for oxygen because the blood is the carrier of oxygen.

Heart muscles

Interventions are designed to ensure health of muscles, prevent injury, and enhance healing of injured ones. Exercise enhances health of heart muscles.

Free radicals are countered; blood flow and oxygen supply are normalized.

Injured cells allow the entry of too much calcium that carries along calmodulin. This is a protein that triggers constriction of muscles and promotes spasm. Entry of calcium can be slowed down with calcium channel blocker like angiosem, zandil, or dilzem. Adequate supply of magnesium, sodium and potassium should be ensured as these are involved in the calcium/magnesium and sodium/potassium pumps. Without these pumps there is no life.

"To live, the cell must pump" (McElroy, W. Cellular Physiology and Biochemistry. 1961).

Unlike in diffusion, cell pumps are driven by energy, the ATP produced by metabolism of glucose in the mitochondria. Cell pumps belong in action potential that involves the flow of ions against the gradient, from the less concentrated to the more concentrated. For example, the sodium.potassium pump. At rest, the cell has 4 ions of sodium outside the cell membrane and 3 ions of potassium inside the cell. The potassium ions move across the membrane toward the outside and sodium moves in carrying along glucose. Usually the supply of calcium and magnesium is not a problem. But sometimes sodium and potassium become inadequate because sodium in not stored. Sodium is also an electrolyte that is needed in the electrical conduction in the cell. So sodium and potassium must be supplied.


This is a signal that oxygen in heart muscles are lacking. Interventions are designed to prevent free radicals from inflicting injury, prevent the growth of plaque, reduce size of plaque, normalize blood flow and supply of oxygen. Work load, or stress or deep emotions should be avoided to prevent constriction of muscles that clamp on capillaries and prevent blood flow.

Heart attack

Interventions are designed to ensure supply of oxygen to heart muscles such as to prevent their death. Interventions are a convergence of interventions for free radicals. atheroma, cholesterol, calcium apatite, plaque, blood flow, oxygen and heart muscles.

With the free radical theory of heart disease what happens to the risk factors? Only “cholesterol” is included as a concept in the free radical theory of heart disease.

The free radical theory takes care of the risk factors as a matter of course. For example:

Age - it is considered as a disease in free radicals theories of disease; it is not considered as natural that nothing can be done about it. Control of free radicals also prolongs life. Long life can be attained (Willix, R. MD. 3 Minutes A Day Toward a Life Span of 120 Years).

Obesity - it can be dealt with through diet and exercise and drugs and hormones if appropriate. Obesity has nothing to do with heart disease except when the person is so fat that the heart is overburdened in supplying blood to the organs.

Hypertension - free radicals are the primary causes of hypertension; they cause hardening of arteries and capillaries and start the occlusions in the carotid artery or in the femoral artery. Counters against heart disease also remedy hypertension. No such thing as essential hypertension whose cause is unknown; it is unknown to conventional medicine because it does not recognize free radicals as causes of hypertension.

Diabetes - it is ultimately caused by free radicals by inflicting damage on the alpha cells of the Islets Langerhans. Free radicals also damage the insulin receptors of cells resulting in insulin resistance. So remedies for heart disease also take care of diabetes types 1 and 2.

Smoking - antioxidants neutralize free radicals generated by smoke. Quit smoking. So far there is no research result that shows how to mop up the X-rays emitted by decaying polonium 210 and lead 210, radioactive materials with half life of 138.4 days and 22 years, respectively. What is known is that X-rays accumulate in the body, that is why exposure to the X-ray machine is metered. The amount of X-rays generated by polonium and lead 210 in a smoker has not been monitored because (1) some scientists and the tobacco industry hid these facts from the public 50 years ago, and that (2) conventional medicine does not seem to mind the X-rays from cigarette smoke because that would also show the generation of free radicals. It would force conventional medicine to recognize free radicals as causes of disease.

(I have Hubs "Why Conventional Medicine Is Antagonistic to Chelation Therapy," and "How Free Radicals And X-rays From Cigarette Smoke, Not Tar, Cause Cancer And Heart Disease").

Cholesterol - antioxidants neutralize free radicals that oxidize fatty acids. Only cholesterol survives among risk factors as a concept in the free radical hypothesis of heart disease.

Lack of exercise - exercise is good regimen for normal and sick persons if suited to health status.This risk factor is covered as a matter of course.

Risk factors belong in epidemiology; they still serve as rough predictors but not as causes. For example, Snow's hypothesis that drinking water in London in 1849 caused cholera; It is not the water that caused cholera but the bacteria in it (Friis R.H. and Seller, T.A. The History and Scope of Epidemiology. 1996). To cite a case in epidemiology like "Nearly one in two Americans die of cardiovascular disease - one every 34 seconds" is no longer enough. Practically all risk factors serve as bases of result-based technologies of prevention and treatment. They do not deal with cure. They fall where they may; logic should not be strained to save them.

The free radical theory of heart disease deals in molecular biology. Heart disease is analyzed down to the electron level. For now there is no need to go deeper, into quarks or neutrino.

How important is a theory of heart disease?

We can appreciate the importance of a theory from its absence. Overall, its absence contributes a lot to the status of heart disease as the number one killer in the world. (I have a Hub, "Why Is Heart Disease The Number One Killer In The World?")

We can illustrate the importance of a theory with physical theory of Newton which applies to all parts of the universe that travels slow (about 10,000 km/sec) compared with the speed of light. Let’s consider things on earth. Our weight of, say, 35 kilos, is accounted for by Newton’s theory. That a stone thrown upward will come down is explained by Newton’s theory. In the construction of buildings, especially very tall ones, Newton’s theory is applied. The materials and methods of construction in the ground floor of a 20-storey building must be such that they can carry the weight of materials of nine floors above. Otherwise, the ground floor will be crushed. The weight and flight of spacecraft is designed according to Newton’s theory. The use of Newton’s theory is so pervasive that it is taken for granted.

In spacecraft design there are only a few cases where Einstein’s theory of relativity is applied. For example, the clock inside the cabin of a spacecraft traveling at 18,000 km/sec must be adjusted. The clock in the spacecraft is slower than the clock on earth by 38 millionth of a second that translates into 10 kilometers in splashdown area of the earth. A manned spacecraft must not reenter the earth at right angles to the plane of the equator otherwise it will bounce back to space and our man will be marooned in space. Its angle of reentry must be 6.2 degrees according to the general theory of relativity.

Let’s take a look into the application of a result-based protocol versus a theory-based protocol.

In conventional medicine heart attack is dealt with by restoring blood flow to the heart. This is result-based. In free radical theory of heart disease blood flow is restored and reperfusion injury is taken care of likewise. This is theory-based. Reperfusion injury is inflicted by superoxide when the blood rushes to the heart muscles. During heart attack oxygen is absent in heart muscles; superoxide dismutase (SOD) are likewise absent because oxygen is the signal for the production of SOD, the scavenger of superoxide, When blood flow is restored no SOD is around to mop up the superoxide that damage DNA and cell membranes.

“When doctors use new drugs such as streptokinase to dissolve the blood clot that is preventing blood from reaching the heart muscles, the sudden flood of oxygen returning to the cells causes an explosion of oxy radicals and ROS (Sharma, H. MD. Freedom from Disease. 1993:31).

This injury is remedied by, among others, hyperbaric oxygen therapy that administers 100% oxygen (Cranton, E. MD. Updated 2nd edition. 1995:164). Glutathione peroxidase supplement comes in handy because it contains lipoic acid that is known to dismantle hydrogen peroxide, a reactive oxygen species, into safe water.

The free radical theory of heart disease serves as a guide in medical research. (You may read my Hub "How to test a free radical hypothesis of rheumatic heart"). It provides confidence that research endeavors are fruitful that result in highly reliable findings. It ensures that interventions for prevention, treatment and cure of heart disease are effective and efficient.

Hubs on chelation therapy by conradofontanilla:

















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Comments 7 comments

bmcoll3278 profile image

bmcoll3278 4 years ago from Longmont, Colorado

I tried to find more on infusion chelation therapy and had little luck understanding. Can you tell a little about what kind of vitamins would be best to help. You commented on my hub that I should watch out for free radicals in the blood. But i need to know more about how to combat them.

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conradofontanilla 4 years ago from Philippines Author


Please access the internet with cv chelation therapy cranton frackelton and find an updated article of Dr. Cranton and Dr. Frackelton on chelation therapy. Antioxidant vitamins are vitamin A, C, and E. You can include melatonin (precursors are serotonin and tryptophan) and coenzyme Q10. Melatonin can be bought over the counter in the U.S. of course also coQ10. Chelation therapy and these vitamins combat free radicals. There is now oral chelation therapy in the U,S. try the internet http://www.cardiorenew-international.com.

bmcoll3278 profile image

bmcoll3278 4 years ago from Longmont, Colorado

Thank you so much.

gregadmas 4 years ago

nice and informative hub..voted

conradofontanilla profile image

conradofontanilla 4 years ago from Philippines Author

gregadmas, thanks.

There are several ramifications of the lack of theory of heart disease. One is that drug companies will formulate the protocol that doctors will follow in their practice. That way the medical profession will become slave to the drug companies to the detriment of the potential and actual victims of heart disease. All the more now that the HMOs have conjoined with the drug companies. The patients will become all the more helpless.

proton66 profile image

proton66 4 years ago from Southern California

I agree that free radials are highly destructive and the rate produced is very high, so much so that most people don't care to know or are oblivious. So, would it not make sense to increase or boost the enzymes (SOD & CAT) that can combat free radials by a ratio of a 1000000:1?

conradofontanilla profile image

conradofontanilla 4 years ago from Philippines Author

Yes, built-in enzyme antioxidants like superoxide dismutase, catalase, and glutathione peroxidase can be recycled and boosted. Glutathione can be boosted with nutrition since it is made up of glutamate, cyteine, and cystine and cofactors B2, lipoic acid, zinc, and selenium.

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