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Plaque, Blockage, Hardening: Vascular Health Explained By Natural Heart Doctor Jack Wolfson


The vascular system is responsible for moving blood throughout the body, delivering oxygen and nutrients, while removing waste and toxins. Having great vascular health is essential, especially as we get older. Monitoring lifestyle choices such as nutrition, not smoking, and controlling your blood sugar are all necessary for optimal vascular function and avoiding cardiovascular diseases. The host of the Healthy Heart Show, Doctor Jack Wolfson, is a board-certified cardiologist and founder of the Natural Heart Doctor. His mission is to prevent, treat, and reverse cardiovascular diseases naturally. In this episode, Dr. Jack and his co-host, Dr. Lauren Lattanza, talk about the number one killer worldwide and the most common type of heart disease – coronary artery disease. Tune in to this episode to learn more about this dreaded disease and how to avoid it.

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Plaque, Blockage, Hardening: Vascular Health Explained By Natural Heart Doctor Jack Wolfson

I am joined by our own Dr. Jack Wolfson, Board Certified Cardiologist. In this episode, we are discussing the number one killer worldwide and the most common type of heart disease, coronary artery disease. I wanted to lay out some statistics for you. Roughly 18.2 million adults over the age of 20 have coronary artery disease, and an estimated 20% of deaths from coronary artery disease are in ages less than 65 years old. It is too young. Dr. Jack Wolfson, what is going on with coronary artery disease?

Oftentimes, like cancer and some of these infectious diseases, they get a lot of publicity. Coronary artery disease is the number one killer worldwide. If you look back to the medical literature prior to the early 1900s, there was not much talk about coronary artery disease. It highlights the fact that coronary disease is a modern phenomenon that is happening. It touches everybody. It’s a very important topic that I love to discuss.

I agree that it doesn’t get enough credit. In 2020, it was over COVID deaths. It was nearly doubled the amount of deaths related to cardiovascular disease than COVID. It’s very significant and affects us all. We all know somebody with coronary artery disease or knew somebody.

As it pertains to people with COVID, it was one of those comorbidities. If you are someone who is labeled who has coronary artery disease, had a heart attack or had some coronary procedure, then that also was comorbidity that increased the likelihood of ICU admission or even death from COVID. Something we want to do is a tremendous revenue source for the pharmaceutical companies regarding all the different pharmaceuticals that are used. We will touch on that as well. We will give people some good natural alternative solutions to help clear out those pipes.

It is an evolving process. We have to take a step back and look at the coronary arteries. If you would, explain what the coronary arteries are.

It’s funny because we were talking about COVID and Coronavirus. Corona is Latin for the word corōna. The coronary arteries form a crown over the heart. At least, that’s how it was depicted by Greek and Roman doctors or pathologists at the time. There are three main vessels that form these coronary arteries and put a crown around the heart. There was the left anterior descending, the left circumflex, and the right coronary arteries of three major blood vessels and may give off branches as well to supply the full spectrum of the heart. Those are the three main ones there.

There’s also what is called the left main. The left main comes off the aorta on the left side, and the right coronary comes off on the right side. The left main divides into the LAD, the Left Anterior Descending on the front of the heart, and the left circumflex around the side of the heart. What’s commonly known as the widow-maker is the beginning portion of the left anterior descending. Those are the coronary arteries like any other arteries that supply blood from the heart to the body. In this scenario, these are the arteries that supply the blood to the heart itself.

It’s very important to keep that heart muscle pumping with oxygen full of nutrients. We have to feed the heart, and the heart is still responsible for feeding those arteries. This is an evolved process. It doesn’t just happen overnight. What does it mean when these arteries become diseased?

When we say they are diseased, it means that they are starting to become dysfunctional. What could that mean? That could be what most people think of as blockages in the heart. It could mean subtle changes where the blood vessels of the heart don’t work as well. That’s what’s called endothelial dysfunction. When you have that vessel that’s not working, you are not getting enough oxygen, blood supply, and nutrients to the heart muscle itself. At first, you could develop symptoms from that, and those plaques can rupture and lead to heart attacks and even death. That’s what coronary artery disease means for most people.

HHS 43 | Vascular Health
Vascular Health: I’m very against nuclear material being injected into people for the purpose of doing stress testing.

There are some other subtle diagnoses like spontaneous coronary artery dissection. It is a possibility that there’s coronary spasm and prinzmetal angina, and there’s Kawasaki syndrome. There are different things that can involve the arteries. When we are talking about coronary artery disease, we are talking about blockages that lead to a lack of blood flow.

We alluded to how common coronary artery disease is. In your patient population and the population, we see here at the Natural Heart Doctor, how common is coronary artery disease?

The statistics sometimes are misleading because you can see things like eighteen million people having coronary artery disease. If we were to go inside of everyone’s blood vessels, take a look around from the inside, have a camera, and see the vessel walls and the pipes, you find that every adult has some form of coronary artery disease, where the lining of the blood vessels is abnormal. It’s already starting to show changes that should not be present in a normal person.

If we were living 5,000 years or 50,000 years ago, what would our arteries look like over 35? It’s much more likely now, at the age of 35, that there are a lot more abnormalities than how it was so many years ago. If you look at the majority of adults, that number could be in the 90% area as far as the actual number of adults with coronary artery disease.

We mentioned this idea of endothelial dysfunction. It’s supposed to be this protective mechanism for the inside of these arteries. Maybe if you want to elaborate a little bit on the endothelium and things in our environment and modern lifestyle that hinder that endothelial function and protection.

The actual arteries themselves are made up of multiple layers. The innermost layer that touches or interfaces with the blood is called the intima. The intima, the innermost lining of that, is called the endothelium. The endothelium we talk about very often is a one-cell thick layer that goes through all the arteries. That area is so active because that controls what gets inside the blood vessel wall and what doesn’t.

We want a good, healthy endothelium. All the strategies that we talk about here in the Natural Heart Doctor promote healthy endothelium. As we talk about our overall treatment philosophy and eat well, live well, think well, as we do all those things that lead to a healthy endothelium that we test, don’t guess. We will use evidence-based supplements to help support that endothelium.

Think about the blood vessel. The intima is the first section containing the endothelium. The middle is called the media, appropriately. That’s where a lot of the smooth muscle cells are. That muscular layer allows the artery to expand and relax. What’s called the adventitia is this outer supportive area that helps to provide nutrients and the nerve supply to the coronary arteries and all the other arteries as well. Those are the main components of the coronary arteries.

It looks like an organ on its own. Elaborating on that makes us realize that it’s much more involved than just a tube carrying blood. This evolves over time. How might we expect coronary artery disease to begin?

I’m one of those people who believe that, genetically, we are built about perfectly. Why would we be genetically programmed to develop coronary artery disease, blockages of the heart, and suffering heart attacks? The answer is we are not.

If we look back to some of the autopsies that were done on some of the men who came back from the Korean War, for example, what they found is that 18 and 19-year-old boys had evidence of coronary artery disease. What we now know is that coronary artery disease can start while very young. It can start when we are babies. The disease undoubtedly starts in the womb and maybe even preconception.

What does that mean? It means that the diet and lifestyle of your mother and father are likely as well, even before conception and while you are in utero, and in those formative years, all those things lead to the development of that endothelial blood vessel dysfunction. The development of what is called a fatty streak inside the blood vessels and sows the seeds for overt coronary artery plaque and calcification.

One of our main passions that you and I both share is for the health and wellness of the children and trying to reach people as early as we can to get them to adhere to the healthiest lifestyles to make a difference so we can prevent coronary disease down the road. That’s why it’s ubiquitous in society because this violation of the principles of eat well, live well, and think well leads to disease. This is the most common manifestation of all the toxins.

It’s unfortunate but true. Even if you are born with this predisposition, it doesn’t begin with us all the time. Some of these things are out of our control. There are certain things that we can do through the lifestyle, which we will certainly talk about and get to. Are there any symptoms that we should look out for at a younger age so that we can prevent an outright sudden cardiac event?

The classic symptom of that is Levine’s sign. There was a show from my generation, which was called Sanford and Son. The actor Redd Foxx who played Fred Sanford, was always clutching his chest. He was like, “Elizabeth, I’m coming to join you.” It’s his wife. This is Levine’s sign where oftentimes it’s not a pain. It’s described as a pressure or tightness that people have without the exertion of force.

Shortness of breath could be a sign. Women could sometimes be present with those but we also have to be intuitive to some of the different complaints from women. Sometimes it’s fatigue, feeling tired, and don’t have a lot of energy. We have to take that seriously to make sure that it is not some form of a symptom of coronary artery disease.

When we talk about other symptoms that we can be concerned about, we’ve often heard that chronic pain is a sign that you likely have coronary artery disease. When you have chronic pain, that means you are chronically inflamed, most likely. When you have that chronic inflammation, it’s a major risk factor for coronary artery disease. Oftentimes, we need to pay attention to people who suffer from a lot of aches, pains, stiffness, and these different pain syndromes that people have and understand that, “We got to help you with that but also we need to check out all cardiovascular issues and make sure you are okay.”

It’s important to recognize this chronic level of inflammation as a contributing factor to atherosclerosis plaque formation and coronary artery disease as a whole. Beyond the differences in men and women, are there other genetic components that can play a role in coronary artery disease?

For anyone who follows us on Natural Heart Doctor, most people know our opinion on genetics. We offer the most advanced, cardiac-specific genetic testing in the world. It’s just not one of the first tests that I reached for. I’m one of those people who believe that, genetically, we are built about perfectly. We can run, jump, see, feel, and hear. We can love and experience emotions. We can make babies and do all the amazing stuff. Why would we be genetically programmed to develop coronary artery disease, blockages of the heart, and suffering heart attacks? The answer is we are not.

HHS 43 | Vascular Health
Vascular Health: For most people, whether they get a procedure or not, they’re going to be on drugs. That’s kind of the poster child of cardiovascular and pharmaceuticals, and it’s just such a failure.

That comes into the idea that there are genetics, our DNA, and that DNA is the blueprint for protein production for all things to happen in the body. It’s all about how our diet, lifestyle, and emotions influence our genes as the concept of epigenetics. When you plug all the right things in like the right food, lifestyle, and thoughts, if you plug that into our DNA architecture, our genetics, we are going to get amazing things.

That’s why you, I, and everybody at Natural Heart Doctor always focus on the basics first. That’s what makes us so successful. Oftentimes, people are like, “Don’t mind. My father had this. My mother had this. My uncle had this.” That’s all interesting certainly but most people live the same lifestyle as their relatives, and then you should expect the same health outcomes. When you become different from your relatives, that’s when you are going to expect different outcomes.

One thing you will agree on this too is that there are some genetic factors to take a look at. We test everybody for lipoprotein(a), which is a genetic marker that’s important to know about everybody. I’m not saying that genetics plays zero roles. I’m saying that in a healthy person, no matter what your genetics are, your risk is much lower when you adhere to the right lifestyle.

Genetics is the gun, and your environment and lifestyle pull the trigger. The hand you were dealt does not mean you will end up with whatever disease your father, grandfather or mother had. That does not lay out your fate. We are at the will of our environment and lifestyle, so we can certainly take the driver’s seat in that. Coming from a conventional standpoint, what is the testing? What are some of the approaches to identifying coronary artery disease and some of the imaging and testing that might be found from a conventional standpoint?

If you have symptoms like chest discomfort, shortness of breath or you are a woman with fatigue and stuff like that, there may be an opportunity there to do stress testing. I prefer conventional treadmill stress testing if they want to do some imaging. In addition to that, you could do a stress echocardiogram. You have an ultrasound of your heart before the treadmill, go on the treadmill, and then an ultrasound afterward. That’s what I like to do.

I’m very against nuclear material being injected into people for the purpose of doing stress testing. There were a lot of problems with that. We’ve got some good literature on those types of tests. Stress testing can be valuable for people with symptoms. Routine stress testing has no benefit whatsoever. Stress testing can help with the diagnosis but it’s going to be significant obstructive coronary disease. People will experience symptoms when there’s a blockage of 70% of the blood vessel or greater. The pipe starts to shrink down in size.

When it reaches an area where it’s 70% blocked, that’s when people can start to experience symptoms during activity. The more and more it gets blocked to 80%, 90%, 95%, or 99%, the easier it is for someone to develop symptoms with minimal activity or even at rest. When it’s 100% blocked, that’s when someone is suffering a heart attack when it becomes acutely 100% blocked. That’s where that will be. There are other tests that we can talk about as it pertains to the diagnosis of coronary artery disease.

For example, a lot of people are doing calcium scans and coronary CT scans. I’m very anti-radiation. I don’t believe that test has any value aside from being motivational to people. Proponents of the tests will claim, “If they have coronary artery disease, they can go on statin drugs, we can use aspirin or do certain procedures.” If organ, they may say, “It’s motivational.” If you tell someone, “Here’s a picture of your arteries. They are calcified. Your scan number is high,” that could be motivational.

I don’t think we should try and motivate people by radiating and finding the results. The flip side is that what if somebody has a normal coronary CT scan? Does that mean they could go about their habits of drinking, smoking, poor sleep, nutrition or physical activity? The answer to that is clearly no. The CT scan, as far as my approach, has zero roles. I’ve never ordered that particular test. It’s something I don’t believe we should be doing. Radiation causes heart disease, cancer, and dementia. It causes people to die, so it’s not something I would ever recommend.

Every adult has some form of coronary artery disease, where the lining of the blood vessels is abnormal.

In our practice, we often see patients who will establish with us because they’ve had a calcium score, and it comes back 800 or 900. Even with the stress testing at 70%, that’s very significant. It’s pretty late in the game to start considering it, which is why we always have to focus on prevention because 70% occlusion is 70%. You are 70% of the way there already to a heart attack, so we have to think about this way early on.

You can do ultrasound tasks, carotid artery ultrasound or what’s called CIMT to take a look at the neck. Even for tomography, sometimes you can see that the blood vessels are very hot. The blood vessels are on fire. There are a lot of tests we can do that is non-radiation based. Sometimes, people come to us and have already had a CT scan. We are not going to admonish you or beat you up for having a CT scan.

We are going to try and advise you not to do it again. Sometimes even conventional chest X-rays or people who have X-rays for other purposes see a lot of coronary calcification. Those lines are setting those people our way, which is great because we can talk about helping people as opposed to sticking them full of a lot of different pharmaceuticals.

You mentioned 70%, 80% or 99.9% occluded. At what point do you think someone needs a stent or bypass surgery?

Stents and bypass surgeries are for people with symptoms. We can decide how to treat symptoms. Do we treat it with stents or bypass? Do we treat it with pharmaceuticals? Do we treat it with nutritional supplements and eat well, live well, and think well? We do all those things or a combination of all those things but we should be able to give people options.

That’s what we do at Natural Heart Doctor. We give people options on how best to approach it. If someone is having symptoms, stents or bypass surgery may provide the quickest relief but we need to let people understand that for people with stable coronary artery disease. If someone has blockages or, for the last few months, they walk up a flight of stairs, get chest discomfort, and have an abnormal stress test, and the literature is very clear. Stents and bypass surgery do not prevent heart attacks.

They don’t prevent people from dying. They help with symptoms. Even that is a very short-lived phenomenon. You and I both have these in our presentations, and I love to show these to our patients here. When we show people the data and the studies, the data seems a little counter-intuitive to people when you say, “If I have a blockage of 90%, don’t we need to stent it? You are telling me that the stent won’t prevent a heart attack and from dying?” It seems counter-intuitive but the reality is it doesn’t.

It helps with symptoms in that person who has a 90% blockage. Oftentimes, what causes the heart attack is not the 70%, 80%, or 90% blockage. It is the 30% blockages that stents don’t address. With the 30% blockage, you wake up one day and become 100% blocked, and now you’ve suffered a heart attack. The stents and the bypass would not have helped that individual person.

When you put a stent into a 70% blockage, that 70% blockage is something that can be very stable. If you think of it like this rock-hard calcium deposit in the artery. It’s not something that’s going to break loose. Now you stent it, stir up the pot, and mess with the natural healing mechanisms of the body. We didn’t dive into why coronary artery disease form because it’s certainly not a cholesterol issue.

HHS 43 | Vascular Health
Vascular Health: Physical activity is another part of living. The more you go outside, the better. And then you avoid environmental toxins, chemicals, and pollutants.

Coronary artery disease is essentially scar tissue that occurs in a non-healthy person in an unhealthy blood vessel. What we do at Natural Heart Doctor is that we try and get people to have healthy blood vessels but it’s not like this evil cholesterol molecule attacking our arteries. That’s not the way the body works. Cholesterol comes in as part of the support crew to help the healing of the blood vessel that has been damaged from the violations of eat well, live well, and think well.

It is your body trying to protect and support itself as a protective mechanism. When we have these stents placed and the decrease in symptoms, that decreases patient motivation as well. You have chest pain as this reminder to eat well, live well, and think well. If you take away that reminder, then you might take away some of those principles of a healthy foundational life.

People go into the hospital, get a stent, and are discharged, and 24 hours later, they are like, “I can keep living my life.” As far as that need for stents and bypass, take note. The President in the 1950s, Dwight Eisenhower, and Lyndon Johnson in the ’60s, these people lived with angina. They lived with chest pain. They lived with the symptoms of coronary artery disease. There was no bypass. There were no angioplasties, stents, and balloons.

All there was, was that you could modify your lifestyle. That will help. Those were the early days of pharmaceuticals where people could use nitroglycerin and a couple of others to help with their symptoms. Both of those people, whether it’s Johnson, Eisenhower or millions of other people like that lived with these for years with those symptoms.

It’s not that, “I’m having symptoms. I need to go on the stent.” If you want to have a stent, that’s perfectly fine but you need to understand the risks and benefits of the stents. You need to understand the long-term pharmaceutical use associated with stents. That’s what we do at Natural Heart Doctor. Hopefully, we give people that first opinion but sometimes the second opinion on what the plan is. We have been doing very well with that for years.

We do a nice job also at what we focus on should that patient choose to have that procedure done. We get them in optimal health beforehand so they can have a better bounce back rather than going in as an unhealthy individual, for a procedure and having a struggle coming out of that. That’s a focus that we want.

We talked about the dangers of radiation. Stents are radiation-based procedures. In doing bypass surgery, you are under general anesthesia. These things have complications. If you are the healthiest version of yourself prior to these procedures, you are going to get the best outcomes. You are going to minimize long-term complications and side effects from radiation, anesthesia or whatever it may be here. If we make the healthiest version of you, you are going to get the best results.

If they are opting out of the procedure, what pharmaceuticals are commonly used in conventional medicine?

For most people, whether they get a procedure or not, they are going to be on statin drugs. That’s the poster child of cardiovascular pharmaceuticals. It’s such a failure. It’s a feasible approach. Unfortunately, the literature tells us that for primary prevention in people over 65, and you may have a higher risk of dying if you are on statin drugs. For the general population for primary and even secondary prevention where you have a stent and bypass surgery, and now you are going to take a statin, the benefits are minimal.

Preventing coronary heart disease is all about how our diet, lifestyle, and emotions influence our genes and the concept of epigenetics.

We call it this data very often from March of ’22, which in the journal of the American Medical Association, statin drugs versus placebo in 21 trials showed that stroke reduction is 0.1% a year, heart attack reduction is 0.3% chance a year, and lives saved are 0.2% per year. The benefits, according to their literature as far as I’m concerned, are minimal because our goal is not to reduce heart attacks. If someone’s heart attack risk is 5% to 4.7%, it’s how you are going to make it 0%. They fail at that. That’s not a good model. We want 0% for our people, and that’s where we go at Natural Heart Doctor.

Maybe we can use this to break into our treatment philosophy at Natural Heart Doctor if you want to open it up to eat well, live well, think well, what our philosophy is and how to treat and prevent coronary artery disease.

As we get into the, eat well, live well, think well, that’s what we do. We want people to understand our approaches to nutrition. We want people to understand our approaches to living well, that healthy lifestyle, and also the thought process. As we encompass all those different things, that’s going to be what we focus on. It’s like the common sense approach that medical doctors are not taught. When I was going through a medical school residency cardiology fellowship on the job for ten years in the biggest group in the state of Arizona as a senior partner, it was not one of those things that we ever talked about.

We never talked about nutrition. We never talked about, “What are healthy lifestyle and healthy thought processes.” It’s all in the medical literature. It’s all there for us to see, even members of the public. You can find all the information you want. It’s all there. We are cardiologists from day one. We are taught about statin drugs, the miserable failure of aspirin, and blood pressure drugs. We just need a much better approach. That’s where eat well, live well, think well came up.

In this idea of evidence-based medicine, we have to realize that it has a farther reach than just pharmaceuticals. Eat well, we have the literature that supports a paleo approach to diet, having plenty of Omega 3s in the diet as a preventative mechanism for preventing atherosclerosis and coronary artery disease. Sunshine exposure decreases the risk for plaque formation in the coronary arteries.

The literature is there. It’s all evidence-based medicine but evidence-based medicine does not have to equal pharmaceutical drugs. Let’s talk about eat well if we can dive mostly into that. I know that we stand firmly with a paleo approach to diet. Let’s talk about that as it relates specifically to coronary artery disease.

As far as the eat well philosophy, we all debate about nutrition but we never want to lose focus on the live well, think well components. If anyone likes to talk about eating well and diet, let’s talk about that first. My education in nutrition was zero but as I would meet my wife and she opened up my eyes to all things health and wellness, and I started to read about different nutritional philosophies, to me, I came up with the ancestral diet. How did our ancestors eat for so many years?

What are the foods that we eat? What are the foods that we did not eat? That’s the common sense approach. It’s only us humans that debate what to eat. A lion, tiger or camel knows what to eat. For some reason, humans argue about this. If you look at the paleontology literature and anthropology literature, you can see that we are hunter-gatherers. If you look at modern-day survival shows like Alone, Naked and Afraid, and Survivor, you can see these people are hunter-gatherers. It’s very odd, even in modern paleo people that when we live that hunter-gatherer diet, that is optimal.

What we try and do is we bring that into the 21st century. For people, we tell them to eat a lot of wild seafood, free-range, grass-fed, nose-to-tail animal products, eggs, fruits, vegetables, nuts and seeds, avocados, coconuts, and olives. We get people away from eating a lot of grain and gluten. I, Dr. Jack Wolfson, and my family never eat gluten ever. The ultimate thing is that no matter what diet you’re following, no matter what you are eating, make it organic. I’m not condoning eating ice cream but if you’re going to eat ice cream, make it organic. If you are good at chocolate, make it organic. If you are going to have a pizza, make the ingredients organic.

HHS 43 | Vascular Health
Vascular Health: Looking at all these different parameters gives a very good insight. And then, intracellular vitamins and minerals and the highest levels of glutathione lower the risk of coronary artery disease.

Let’s all agree to get the chemicals, pesticides, and synthetic fertilizers out of our diets. If I had to pick one food that was the ultimate strategy for cardiovascular and coronary artery disease, health, and wellness, it’s seafood. We know that people with the highest levels of Omega-3 from eating seafood have the lowest risk of everything. That’s our strategy.

I know we’ve talked about this before but it’s hard in this modern age to avoid some of the additives, be it pesticides, herbicides or seed oils, that are omnipresent in processed foods. If we can avoid things with labels, eat real whole organic foods. We minimize some of these easily oxidized inflammatory particles in our diet and keep them in better control.

When we know exactly what we are putting into our bodies, it minimizes some of those risk factors from the diet. You mentioned seafood. We can both agree about eating organ meats. If we talk about consuming grass-fed beef hearts, that’s supportive of our hearts. Eating nose to tail, be it seafood and organ meats as well, that’s going to be supportive of a healthy heart.

You and I have often talked about the leaky gut and leaky heart. As we eat these certain foods, there are other factors that lead to a leaky gut where things get into the body that doesn’t belong. A leaky gut leads to a leaky heart. A leaky heart starts with those leaky coronary arteries. As the endophilin of that lining of the blood vessels starts to leak, things get into the inside of the blood vessel, setting up a lot of inflammation, oxidative stress, and immune dysfunction. You, ultimately, wind up with coronary artery disease. That starts so many times in the gut, and some of these unnatural foods don’t belong in our guts. That leads to a leaky gut and leaky heart.

We must look to the past in terms of knowing that healing begins in the gut. We have to stop both processed foods. It’s by eating an ancestrally appropriate diet certainly. Let’s look at live well, living well to prevent coronary artery disease, and things like not smoking. What else can we talk about with the things that we should include?

We always debate about the different foods but is food any more important than sleep? The answer is no. Sleep is probably the most important thing we get. We know from the literature that people who sleep six hours less have a much higher risk of heart attack, stroke, and everything else. We want to make sure we get our good quality sleep. We go to sleep at sundown, wake up before sunrise, and watch the sunrise.

All those activities are beneficial but no matter what version of the story we believe in, whether it’s the biblical version or the evolutionary version, first, it was darkness, and then there was light. All plants, bacteria, and animals grew up and evolved with this circadian rhythm. In that circadian rhythm, it allowed for the importance of sleeping at night and awake during the day. That would get us into the next component of living well.

First, there was sleep, and the second was being outside outdoors in the natural light and using our skin as a solar panel to collect the light. As you alluded to as well, the power of the sun, the light, radiation, UVA, UVB, UVC, infrared, and the visible light spectrum comes right into your heart and helps clear out those arteries to keep your pipes clean. You and I can talk about this on a deep scientific level for hours and hours but in general, people just need to understand what makes common sense. Get outside and get in the sun.

Physical activity is another part of living well. The more we do that outside, the better, and then avoid environmental toxins, chemicals, and pollutants. We want to make sure that is a part of our plan inside of living well. We have a lot of this information on the website, where we break this down pretty heavily. Dental and oral health is critical. Chiropractic care, physical medicine, and self-care are critical. Those are different components of living well.

The more the arteries get blocked, the easier it is for someone to develop symptoms with minimal activity, even at rest.

As you said, we can break the whole sunshine component down on a scientific level and talk about the receptors, retina, and how this hormonal cascade occurs. What I often tell patients is that we know if we can think about it from a common sense perspective. We know that if we bring most plants inside and don’t allow them sunshine exposure, it’s not going to thrive.

We are a much more evolved system than just a house plant. We need to realize we’ve got a lot more necessity for sunlight. We got to get outside. Modern-day life is not just waking up and going from your covered car to your covered indoor environment with false light. That’s not going to set you up for a vital life.

All life is outside. Humans have been outside since the dawn of human existence. There’s only now where so many people spend their lives inside, in the artificial lights, sitting in a chair, physically inactive. When you think about blaming that on genetics, how could we possibly blame this on genetics when we are sitting at our desk, typing away at a computer all day long, and having a soda pop while snacking on potato chips and candy bars? Where does genetics come into that? That is a problem. It’s clearly our lifestyle. I’m not saying that living the way you and I teach everyone to live is necessarily easy but it’s the answer.

I would love to know the statistics of the hunter-gatherer societies and their coronary artery disease when they are living outside, moving all day, and living and sleeping by the sun’s cycle. It’s an evolved disease that our modern lifestyle has brought upon us.

There’s no evidence at all that animals in the wild, for example, and some of the closest animals to us have heart attacks and strokes. They don’t. They aren’t dying from those things. Those are from the toxic, unhealthy manmade lifestyle.

That leaves us with think well, thinking well as it relates to coronary artery disease.

Our thought process is they matter very much as well. The eat well, live well, and think well process is critical. The think well component is just as important. We know that mental health issues are a serious problem. We know that people who have anger, anxiety, stress, depression, and all of these different issues are at a much higher risk of cardiovascular disease. We want people to understand this. Find your happy. Minimize distress. Change your life. Do the things you need to do to find your happy that’s going to be your salvation.

We all grow up in different environments. There are certain traumas and stressors from a young age. Careers can be stressful but chronic psychological stress does significantly increase your risk of atherosclerosis and plaque formation in your coronary arteries and directly increases your risk of heart attack and stroke. Although we can’t always avoid stress, we have to have in place healthy ways to manage the stress and surround ourselves with a supportive environment and people we enjoy.

Our ancestors never had chronic stress. We had occasional stress. When you are under chronic stress, it doesn’t allow your body to heal. It doesn’t allow self-maintenance that goes on in the liver, heart, kidneys, muscles, and heart arteries themselves. When your body constantly thinks it is getting chased by a tiger and is always under stress, our prehistoric brain thinks it’s getting chased by a tiger, and that self-maintenance doesn’t happen.

HHS 43 | Vascular Health
Vascular Health: Don’t just do it with a shotgun approach. Discuss the risks and the benefits of these drugs, and then let the patients decide.

Your repair mechanisms that are going on to help keep inflammation down are not there. We got to get out of that constant sympathetic overdrive, that constant overly stressed mentality with anger, social isolation, depression, and all these various things. All these things that happen are something that needs to be addressed. It’s very clear that the medical doctors reach for Prozac. That was Chapter 5 of my book. One Nation Under Prozac was the name of the chapter. The answer is not with Prozac, the answer is to find out why you have these mental health and emotional issues and work to solve them.

Adding onto that is a mental standpoint on things, whether you think you can heal or whether you think you cannot, you are right. We have to put ourselves in a positive light and mindset to be able to move forward with healing. That whole healing process does not start unless you have wrapped your head around, “I can heal. I can do this.”

That’s fantastic information. Sometimes I talk about fasting as a strategy to reverse coronary artery disease. As we fast, our body starts breaking down the coronary and plaque to use for food or fuel. I want people also to visualize their coronary arteries. When you close your eyes and think about the arteries, and are eating, living, and thinking this way, even things like intermittent fasting and you visualize, that plaque is slowly dissolving.

We have evidence of that. We’ve got people who have done coronary artery scans against our wishes. We’ve seen before and afters. We are seeing tremendous results in these people when they follow our plan eat well, live well, think well, and then springboard us into the test don’t guess, and ultimately into the evidence-based supplements.

At Natural Heart Doctor, we like to use blood, urine, and different tests. An important component of that testing would be maybe our Level 2 testing. Maybe you want to explain why that would be so relevant to this disorder.

Most people get the 1970s testing when they go to the doctor. You look for cholesterol, LDL, HDL, and triglycerides. They will look at some kidney and liver enzymes and get a complete blood count to see if they are anemic. There’s a lot of information inside of those but the way that we do it with our levels of testing Levels 1 through 4, and many of our people start with that Level 2 testing, those are six tests that are a penultimate deep dive into all things health-related and certainly coronary artery disease. We look at all the different advanced lipid markers, lipoprotein(a), and all the markers of inflammation and oxidative stress.

We talk about things like uric acid and homocysteine. We are looking at hormones. We are looking at advanced thyroid and advanced metabolic like insulin levels, A1C levels, and fasting glucose. We are looking at all these different parameters that give us a very good insight and also intracellular vitamins, minerals, and glutathione. People with the highest levels of glutathione have the lowest risk of coronary artery disease. What’s your glutathione level? Don’t you want to know? Don’t you want to bring it up? It raised the level as a strategy as opposed to, “You got a coronary CT scan and coronary artery disease.” Now what?

We are going to run you through the wringer with our tests. We will do the advanced intracellular vitamins, minerals, glutathione, and Omega-3 levels that are critical to know. We talked about intracellular vitamin K2. K2 keeps calcium in the bones and out of the arteries. We then do the leaky gut testing with the Wheat Zoomer, looking for gluten wheat sensitivities and leaky gut and leaky heart. We do the Triple Toxin Test for metals and 30 different mold mycotoxins over 40 different environmental toxins.

We are trying to give you the cause of why you have these issues or help you prevent these issues. There’s a role for this testing in everybody. You and I both do it to so many people, and we changed many lives. That’s what our strategy is. In our first meetings with people, we check at the beginning. We come up with a comprehensive plan, and then we test them a few months down the road. When people follow the plan, they do spectacularly.

Coronary artery disease is scar tissue that occurs in a non-healthy person in an unhealthy blood vessel.

We see tremendous results. Knowledge is power. We gain all of this information and insight into the risk factors of the individual so that at follow-up appointments, we have an individualized treatment plan for them. Maybe you eat well but your body system is telling you that you’ve got some insulin resistance or some oxidation going on. You have mold exposure despite the fact that you built your home and swore there is no mold in it up and down. Having that black and white in front of you, sometimes when it’s circled in big red numbers, we have to identify that. We work to prioritize and personalize the treatment for that individual.

That’s why we get such fantastic results. This doesn’t have to be separate from the medical system. We can work with people who are on pharmaceuticals and under the care of another cardiologist. If you want the ultimate strategy to prevent, treat, and reverse coronary artery disease, this is what you and I are talking about.

Most mainstream can order the majority of the testing that we are talking about. Even if it is just that they are testing homocysteine levels or lipoprotein(a) levels, they can order these tests. We have specialized in-depth testing that doubles down and identify some further risk factors.

The conventional cardiologist doesn’t feel the need to do advanced lipid cholesterol analysis because they are going to put people on a maximum dose of statin drugs anyways. It doesn’t help them too much as opposed to, “We are looking at the apolipoprotein B/A ratio.” We are looking at LP(a). We are looking at some of these other factors. The more we improve all these factors, the longer and better people are going to live.

If they don’t have a pill for that corrective mechanism, they probably won’t order it. That’s unfortunate but true. Rather than pharmaceuticals, we can talk about some of the evidence-based supplements that we know are tried and true and preventing and reversing coronary artery disease.

Some of our favorites have certainly high-dose vitamin K2 supplementation based on our testing. That’s got some fantastic literature, and more and more is being produced every day. We love this other product called Arterosil. They’ve got a fantastic website, which is, where they’ve got a lot of videos explaining how their nutraceutical supplement helps the blood vessel lining, which is so critical. That product has United States patents for stabilization of plaque and even plaque reversal. That’s a great product. I love the product Heart Beet and Vessel Support as nitric oxide. Producers help to open up those pipes, so the blood flows better.

It’s pretty much anything we can look at that would help to improve lipid, inflammation, and blood sugar control. For example, our product OptiLipid, which is six different nutrients to help support not only healthy lipid levels but also lowers inflammation and oxidative stress and help improve blood sugar and insulin resistance. There are a lot of different things that we can use from an evidence-based supplements approach. It’s nice to test the person first, start them on eat well, live well, think well, put them on a supplements regimen that’s beneficial, and then see how they do after a few months.

I do want to mention our new product, which is Kick Start My Heart. We talked about those organs, and Kick Start My Heart is from an American free-range, grass-fed, grass-finished bison that are majestic animals. It’s a 4 to 1 ratio of liver to the heart. There’s nothing more nutrient-dense in the world than animal liver, and the heart does pretty well in addition. We are talking about people with heart issues, and you mentioned the concept of support. That’s where eating heart comes in. Whether or not you eat the heart, you can certainly take our Kick Start My Heart capsules.

Within that, I wanted to mention CoQ10. That’s a component within the heart tissue that’s in Kick Start My Heart. I love that because it can take the place of multi. It’s so many supplements that the Kick Start My Heart fills in those gaps that we wouldn’t gain elsewhere, especially from our plates. It’s second to none. I know the research on CoQ10, cardiovascular disease, and inflammation. I was listening to an interview with the late great Dr. Stephen Sinatra. His early work on CoQ10 was within 1 to 3 milligrams. It’s a very low dose, so we know that we’ve come a long way in that. CoQ10 has earned its name on that list of evidence-based supplements for cardiac prevention as well.

HHS 43 | Vascular Health
Vascular Health: Fasting is a strategy to try to reverse coronary artery disease. When fasting, our body starts breaking down the coronary plaque to use for food for fuel.

I would look at the Arterosil. If you haven’t learned it from us, check them out because it’s rare to find supplements with a brand name on them that has a study on that exact supplement. Arterosil is excellent at providing support, reversal, and that endothelial lining. I’ve seen in patients, and I’m sure you have as well, Dr. Wolfson, a carotid intima-media thickness scan and reversal of plaque from all of these evidence-based supplements we do, and no pharmaceuticals are onboard. It’s incredible work that we can do. How can we reduce and eliminate pharmaceuticals from these patients?

It’s working with people and patients as partners on how we can talk to people and show them the data and say, “This is the data on statin drugs. I don’t think it’s very impressive.” If you would agree, we can typically stop statin drugs immediately without any weaning process or people on aspirin, which is the same thing on the blood thinners. It’s how the evidence discussion about what we do with all these different pharmaceuticals.

Oftentimes, we can reduce or eliminate all the pharmaceuticals for these people. We don’t do it with a shotgun approach. We discuss the risks and benefits of these drugs, and then let the patients decide. We are working in a partnership as opposed to the traditional medical doctors where, “It’s my way or the highway. Here are the pharmaceuticals. Don’t ask any questions.” People deserve better from healthcare practitioners, and we offer that.

A lot of patients come to us, and we hear there are a lot of fear tactics involved, especially as it relates to coronary arteries. It’s as serious as a heart attack, as they say. They use a lot of fear tactics to instill that, “This is the only approach. If you don’t do this, this is your fate.” We work on that cost-benefit analysis and the risk-benefit analysis with every patient. We meet them where they are at and explain what evidence there is. That’s an important approach to our treatment here.

If this sounds like you or somebody that you know and love, who wants to identify your risk factors, prevent any cardiac illness in your life, and get to your 100-year heart, I would highly encourage you to look into becoming a patient with us, scheduling a free twenty-minute health coach call here at Natural Heart Doctor. Go to You can find us on our private Facebook group, Natural Heart Doctor, and on Instagram, @Natural_Heart_Doctor. Any additions on how patients can work with us?

Don’t forget TikTok too. I appreciate having you, Dr. Lauren, at Natural Heart Doctor. What an asset you are to all the patients, potential patients, and all the people in the world as we get this information out there. Your level of intelligence and knowledge regarding heart health and, among so many other things, you are very skilled when it comes to overall general health. The fact that you are able to address this from a preventative and a causative standpoint puts you light years ahead of the other cardiologists.

If I was going into the emergency room with a heart attack, I wouldn’t be looking for Dr. Lauren Lattanza as much as I wouldn’t be looking for Dr. Jack Wolfson. I would be looking for somebody with a bullet or in the stent to help open up my blood vessel to prevent a worsening of a heart attack or a bigger heart attack. There’s value in that. God bless the men and women physicians who work in emergency situations. When we are talking about primary and secondary prevention, those medical doctors have nothing, and that’s where you and I shine and can help people to keep them out of the emergency room, which we are good at.

I’m so appreciative of you. Anyone who’s reading this, grab a free coaching call and hook up with Dr. Lattanza, one of the coaches with myself. Read all of our information and share our show and our videos. Sharing this stuff may save someone’s life. The more we share this health and wellness information, the more we are going to help people achieve that 100-year heart. Thank you all for reading.

About Dr. Jack Wolfson

HHS 43 | Vascular Health

Jack Wolfson D.O., F.A.C.C., is a board-certified cardiologist who uses nutrition, lifestyle, and supplements to prevent and treat heart disease. He completed a 4-year medical degree, 3-year internal medicine residency and, 3-year cardiology fellowship. He served as the Chief Fellow of his cardiology program, managing all of the other cardiology trainees.

Dr. Wolfson then joined the largest cardiology group in the state of Arizona and spent 10 years as a hospital-based cardiologist performing angiograms, pacemakers, and other cardiac procedures. He was the Chairman of Medicine, Director of Cardiology and, Director of Cardiac Rehabilitation.

He was selected by his peers as one of the Arizona “Top Docs” in 2011. In 2012, Dr. Wolfson founded Natural Heart Doctor to offer patients the ultimate in holistic heart care. People worldwide consult with Dr. Wolfson, traveling to Arizona or virtually for natural heart care.

Dr. Wolfson has appeared on every major news station and major newspaper along with hundreds of appearances at live events, podcasts, and online interviews. He has taught medical doctors and practitioners from all over the world.

Dr. Wolfson was recognized as one of the Top 50 Holistic Medical Practitioners. The Paleo Cardiologist, The Natural Way to Heart Health is the first book by Dr. Wolfson and is an Amazon best-seller. He is also a contributing author to The Textbook of Integrative Cardiology.

About Dr. Lauren Lattanza

HHS 43 | Vascular Health

As a Naturopathic Physician, Dr. Lattanza is trained to treat the whole person and get to the root cause of disease. Knowing that the world we live in is full of toxic elements, sedentary lifestyles, nutrient-depleted food sourcing, and environmental chemicals, it is Dr. Lattanza’s goal and passion to identify the often overlooked causes of disease. She offers specialized testing and treatments to optimize patients’ health which can prevent, decrease, or eliminate the need for pharmaceuticals.

Dr. Lattanza is based in Scottsdale, Arizona, and helps patients across the US reclaim vitality and work towards their 100 year heart.

About Dr. Keith Smigiel NP, DC

Dr. Keith Smigiel

Dr. Keith Smigiel is a regenerative medicine physician and pain management specialist. He takes an integrative approach to medicine, focusing on customized solutions tailored to individual needs. Using advanced, non-surgical treatments, Dr. Smigiel stimulates your body’s ability to naturally heal itself.

Dr. Smigiel helps people suffering from conditions such as chronic pain and erectile dysfunction, to hair loss and weight gain. Combining treatments such as PRP Therapy, Ozone, Neural Prolotherapy, and IV Infusions with functional rehabilitation, he helps you look and feel better.

He heals the body, instead of just treating the symptoms!

With his professional qualifications as a certified family nurse practitioner, a doctor of chiropractic, and a fellow of the International Academy of Medical Acupuncture, Dr. Smigiel offers patients comprehensive care from a broad perspective of conventional and alternative medicine. He also has extensive experience in functional rehabilitation and chronic pain management.

Dr. Smigiel is married to Angela and has two children, Sophia and Larz. When he’s not busy helping patients, he enjoys hiking, mountain biking, motocross, and boating.

About Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller, M.D., Ph.D., FHRS

Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

As a Fellow of the Heart Rhythm Society (FHRS) and Certified Cardiac Device Specialist (CCDS), Kneller provides comprehensive patient care, combining best medical practice with invasive procedures using state-of-the-art technologies to treat heart rhythm disorders.

Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

Dr. Lattanza Office Visit with Patient

As a Naturopathic Physician, I am trained to treat the whole person and get to the root cause of disease.

I went to Arizona State University where I graduated with a bachelor’s degree in psychology with a depth in physiology and minor in Spanish. After my undergraduate degree I was working on prerequisite classes towards medical school, which is when I came to learn that my values identified best with the principles of naturopathic medicine. I knew that I wanted to help patients identify the causes of disease and be able to offer treatments which would improve their health rather than simply treating symptoms.

I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

As a Spanish speaking student, I was able to volunteer with community clinics around Phoenix and provide free healthcare to low-income families. Due to this combined exposure, I came to find my passion in treating cardiometabolic and digestive disorders that are all too common, yet largely preventable. I took the opportunity to learn the broad spectrum of healthcare so I can ensure that I am able to provide my patients with the best options.

About Dr. Jack Wolfson DO, FACC

Dr. Wolfson Office Visit with Patient

Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

For more than two decades, more than one million people have enjoyed the warmth, compassion, and transformational power of his natural heart health courses and events.

Dr. Wolfson is the founder of Natural Heart Doctor Scottsdale, his heart health practice in Arizona, and Natural Heart Doctor, an online resource center with natural health information. Doctors from across the globe reach out to Dr. Wolfson for training and education in holistic health practices.

He has been named one of America’s Top Functional Medicine Doctors and is a five-time winner of the Natural Choice Awards as a holistic M.D. Dr. Wolfson’s work has been covered by more than 100 media outlets, including NBC, CNN, and the Washington Post. His book “The Paleo Cardiologist: The Natural Way to Heart Health” was an Amazon #1 best-seller.

Dr. Wolfson and his wife Heather have four children and are committed to making the world a better place to live. They provide for those in need (including animals) and support natural health causes through their philanthropic efforts.


Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.


Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.