The aorta is the largest artery in the body. It starts at your heart and ends around your belly button, supplying blood flow to your brain, muscles, organs and even the heart itself!
Just before it ends and forks into the iliac arteries to supply your legs, the aorta can enlarge, thus forming an aneurysm.
So, what exactly is an abdominal aortic aneurysm (AAA)? First, it is important to understand that aneurysms develop when the lining of the blood vessel wall weakens, which puts the blood vessel at risk for dilation and thus rupture. A AAA occurs therefore when the aorta becomes either weakened or enlarged. Depending on the height of the person, any diameter above 30mm (3 cm) is considered “enlarged”.
One of the hallmark pathologies of an AAA is a proteolytic imbalance that results in excess endothelial destruction and weakening of the arterial wall.
What are the risk factors for AAA?
We can summarize the REAL causes of an AAA as three-fold: poor nutrition, unhealthy lifestyle and a high toxic burden.
As a result, here are the top identified risk factors for an AAA:
- Arterial hardness
- Arterial hardness is mostly due to arterial calcification, in which plaque deposits in the arteries. You want your arteries to be like rubber…soft, elastic and able to easily expand. You don’t want excess calcium deposited in the aorta as this leads to stiff and hardened arteries. Often, arterial calcification is due to a vitamin K2 deficiency (more on this below).
- Toxins are harmful substances that cause damage to whatever they come into contact with. When in circulation, toxins can destroy the endothelial lining of arteries. They also put excess stress and strain on the aortic walls, contributing to the formation and risk of aneurysm. Toxins can include those of heavy metals, environmental toxins, etc. Due to the high levels of toxins encountered in the world today, most individuals have a high toxic body burden (meaning their bodies are overwhelmed with toxins).
- Micronutrient deficiencies
- Micronutrients, including vitamins, minerals and antioxidants, serve crucial roles in arterial health. They are in essence “helper” molecules. When it comes to aortic aneurysms, one key nutrient deficiency seen is vitamin K2. Studies have indeed shown that vitamin K2 supplementation reduces the risk of aortic aneurysms. Vitamin B12 is also another nutrient for consideration. A study found that low levels of vitamin B12 correlated with larger AAA’s. Another study revealed that in patients with an AAA they had depleted serum levels of zinc as well as significantly decreased concentrations of magnesium in the aortic wall, contributing to the notion that these two minerals are vitally important when it comes to an AAA.
- Inflammation is at the root of every disease process, including an AAA. Chronic inflammation can cause inflammatory thickening of the aortic wall leading to fibrosis and a general weakening of the wall. Inflammation is a known “toxin”, and it also contributes to further arterial hardening of the arteries. It is a vicious cycle in which inflammation must be reduced to prevent or treat an AAA. Often, those with widespread inflammation, tend to be deficient in essential omega 3 fatty acids (EPA and DHA). These two fatty acids are the best at lowering cellular inflammation.
- Collagen degradation
- Collagen degradation is a known risk factor for AAA. In fact, a study has shown that the growth and risk for rupture of an AAA is associated with increased collagen turnover and loss. This is most often due to enzymatic breakdown by proteases of this important protein. However, if collagen degradation and reduction is linked with an AAA pathology, then it can also be important to look at one’s own intake of collagen and collagen-precursors such as vitamin C. Often nutrient deficiencies are also at the root of a cardiovascular issue such as this.
- High blood pressure
- Blood pressure that is high for a sustained amount of time is a risk factor for an AAA because it weakens, stresses or enlarges blood vessels. Essentially, over time, the increased pressure of blood that moves through the weakened artery can cause the wall to enlarge and form a bulge (i.e., aneurysm). When it comes to high blood pressure, you have to discover what is at the root of it. There are many root causes of hypertension that you can read about here.
- Abnormal lipids
- Abnormal cholesterol is also a risk factor for an AAA as it can contribute to plaque buildup, endothelial dysfunction and a weakening of the blood vessels over time. Research has established that dyslipidemia is linked to the risk for AAA formation likely due to inflammatory effects within the arterial wall.
The scary part of this story is that AAA’s typically do not cause symptoms and are undiagnosed until the time of rupture leading to a surgical emergency. Around 30% of people with rupture die! (2). Given the risk of rupture, the repair of AAA should be undertaken for anyone at 55 mm. BUT…let’s optimize the heart first. Read on for how we do that.
Fix the AAA
The bigger the AAA, the higher the chance of rupture. Numerous clinical studies have demonstrated that the risk of AAA rupture markedly increased and surgical repair is required when the maximum diameter reaches 50–55 mm (3, 4). Instead of an open surgical repair, intravascular stent options are becoming the standard in most hospitals.
Poor nutrition and poor lifestyle lead to inflammation, oxidative stress, protein breakdown and apoptosis (cell death)(5–8). Ultimately, this leads to breakdown of elastin, collagen, and other components of the aortic muscle and wall.
Many studies have been conducted to look at pharmaceuticals to reduce the rate of progression of AAA including angiotensin converting enzyme (ACE) inhibitor, calcium channel blocker, lipid lowering agents, anticoagulants and anti-inflammatories. None have been shown to be effective in human studies.
How to Diagnose AAA
Many countries, including the U.S and U.K. provide all adults over the age of 65 a one-off non-invasive AAA screening with the aim to reduce AAA-related mortality through early detection of this fatal condition. Ultrasound is a safe and effective tool to look at the abdominal aorta, certainly preferable to CT given the lack of ionizing radiation. Physical examination does not provide much insight and is highly dependent on doctor skill and patient body habitus. AAA is usually large by the time it is felt. A stethoscope may be used to listen for turbulence, known as a bruit, but this exam finding is not common.
Please follow these guidelines to prevent the start of an AAA or halt the progression of AAA, if already diagnosed.
- Enjoy organic, Paleo food
Follow the wisdom of our ancestors. This dietary plan provides the nutrients the body needs and excludes the “foods” our body does not need. Veggies, spices, and seafood are key to preventing the expansion of AAA. Also, good sources of protein supply lysine and proline to build collagen. Finally, citrus and avocado provide vitamin C, a nutrient needed for collagen formation. Paleo is anti-inflammatory, and inflammation increases the risk of AAA.
- Get more sunshine
The power of the sun and its solar radiation can help and make any tissue stronger including that of the heart. Sunshine increases vitamin D, lowers inflammation, and improves blood flow by charging up the Exclusion Zone (EZ), a key area in vessels that support arterial health.
- Sleep well
This is the time our body recovers. Rest-assured, the factors leading to AAA will improve by sleeping with nature. Sundown to before the sunrise is how our ancestors did it for millions of years. Get tested for sleep apnea too if that is a potential risk factor for you.
- Eliminate toxins
Detoxification is critical to preventing or treating an AAA. Make sure your home is toxin-free. Look at your household items, make sure you’re drinking clean water, and be sure that you are purifying the air that you breathe. Another important thing to do is to detox as we are all likely exposed to toxins daily. You can read more about our top ways to detox daily here.
Stress acts like a toxin in the body. Stress causes strain on the aortic wall leading to potential weakening of the aortic wall and a risk for rupture. Stress also raises other risk factors associated with AAA including but not limited to high blood pressure, inflammation, nutrient deficiencies and heart disease. Choose your favorite de-stressing method and stick with it.
- Get tested
Do not miss this step. We recommend first beginning with our advanced cardiovascular panel. This test looks at advanced lipid markers, inflammation in the arteries, hormones, immune function as it relates to the heart and more. That will be a great start. We also recommend the Genova NutrEval. This test looks at amino acids, such as lysine and proline, essential nutrients to build collagen.
- Use evidence-based supplements
- Arterosil 1 cap 2x per day (code: WOLFSON)
- Based on Arterosil’s biological activities in the body, such as repairing the inner lining of the blood vessels, it can help to rebuild and strengthen the arterial wall which is essential in AAA.
- Super C 1 tab 2x per day
- Vitamin C builds collagen, the main protein in your arteries, which strengthens the wall of your arteries. Use vitamin C to help with your body’s own production of collagen.
- Hydrolyzed collagen powder 2 scoops per day
- Including collagen in your diet daily is one of the best ways to strengthen the wall of your arteries, including your aorta, and therefore decreases the risk of aortic rupture.
- Daily Defense 2 scoops per day
- Daily Defense is a rich source of whey protein, which provides the key amino acids lysine and proline to build up collagen levels and boost antioxidant status. This product also contains adequate levels of zinc to support AAA prevention.
- Omega DHA 2 caps per day
- Omega 3 fatty acids, including EPA and DHA, are the best way to lower cellular inflammation. These fats are essential and must be obtained in the diet. Supplementation is often key for any cardiac patient.
- Super K 1 cap per day with food
- Vitamin K2 prevents and aids in reducing arterial calcification, especially that of the aorta.
- Magne 5 2 caps 1-2 x per day
- Magnesium has been found to be depleted in the aortic wall in those with AAA. It is important to build up magnesium concentrations there as either prevention or once diagnosed with AAA.
- Arterosil 1 cap 2x per day (code: WOLFSON)
If you have questions about advanced testing or which supplements are best to include in your AAA protocol, please feel free to schedule a free coaching consultation with one of the Natural Heart Doctor coaches here.