Health 101: How to Prevent Heart attacks / Cardiac Arrest for Longevity
A modern, effective strategy for preventing heart attacks shifts the focus from outdated cholesterol models to the root causes of arterial disease: chronic inflammation and metabolic dysfunction.
The accumulation of calcium in arteries, known as vascular calcification, is not a disease itself but a late-stage symptom of a systemic breakdown in how the body manages inflammation and nutrients.
Disclaimer: This information is for educational purposes only. It is not a substitute for professional medical advice. Always consult with a qualified healthcare professional before beginning any new supplement regimen or making significant changes to your diet or lifestyle.
The Core Problem: An Inflammatory Disease, Not a Plumbing Issue
The old view of heart disease as a simple plumbing problem of clogged pipes is inaccurate. The modern understanding reframes it as a complex inflammatory process driven by damage to the arteries' inner lining.
The Shift from Cholesterol to Systemic Health: The traditional focus on LDL cholesterol (LDL-C) is incomplete. While LDL particles are a necessary component of plaque, they are not the sole cause. The more critical factors are the total number of atherogenic particles (accurately measured by ApoB) and the presence of inflammation, which allows these particles to penetrate the artery wall.
The True Cause: Endothelial Dysfunction and Plaque Rupture: A heart attack is most often an abrupt event caused by the rupture of an unstable plaque lesion, which triggers a blood clot that instantly blocks blood flow. The process unfolds as follows:
Initial Injury: The process begins with damage to the artery's delicate inner lining, the endothelium. This is primarily driven by high blood sugar (insulin resistance), high blood pressure, toxins (like those from smoking), and oxidative stress.
Inflammatory Response: The body’s immune system responds to the injury, embedding inflammatory cells into the artery wall.
Particle Infiltration & Oxidation: Lipoprotein particles get trapped in the damaged arterial wall and become oxidized, triggering more inflammation and forming unstable, lipid-rich "soft" plaque.
Flawed Stabilization (Calcification): In a dysfunctional attempt to wall off the inflamed plaque, the body deposits calcium into it. This turns the soft plaque into a hard, brittle lesion.
Rapture and Clotting: This hardened, inflamed plaque is prone to cracking. The body's clotting response to the crack can form a thrombus (clot) that completely blocks the artery, causing a heart attack or stroke.
The Primary Drivers of Arterial Damage
To prevent heart disease, you must address the factors causing the initial endothelial injury.
Metabolic Dysfunction (Insulin Resistance): This is arguably the single most significant driver of atherosclerosis. When your cells become resistant to the hormone insulin, it leads to chronically high levels of both insulin and glucose in the blood. This damages the endothelial lining through glycation (glucose sticking to proteins and causing stiffness) and oxidative stress.
Chronic Systemic Inflammation: This is the underlying fire that fuels the entire disease process. Key drivers include a poor diet (especially high intake of industrial seed oils), lack of sleep, chronic stress, and gut dysbiosis.
Nutrient Dysregulation: The body's system for managing minerals, particularly the interplay between calcium, vitamin D, vitamin K2, and magnesium, can break down. High-dose, isolated calcium supplementation without adequate cofactors can overwhelm this system, providing excess raw material for arterial calcification.
High Phosphate Intake: A diet high in phosphoric acid, commonly found in sodas and many processed foods, can disrupt the delicate calcium-phosphate balance, promoting the formation of calcium-phosphate deposits in arteries.
A Practical Prevention Framework
A robust prevention strategy is layered, starting with the most impactful foundational habits and progressing to targeted interventions.
Tier 1: Foundational Lifestyle (The 80% Solution)
These non-negotiable pillars have the greatest impact on reversing metabolic dysfunction and quelling inflammation.
Dietary Strategy: Aggressively eliminate foods that cause metabolic damage.
Foods to Remove: Sugar in all forms, refined carbohydrates (flour, pasta, white rice), and industrial seed oils (soybean, corn, canola, sunflower, safflower oils).
Foods to Prioritize: A whole-foods diet rich in high-quality protein (meat, fish, eggs), healthy fats (avocado, olive oil, butter), and fiber-rich, nutrient-dense vegetables. Focus on getting key nutrients from food first:
Calcium: Dairy, leafy greens (kale, collards), and canned sardines/salmon (with bones).
Magnesium: Spinach, almonds, pumpkin seeds, and avocados.
Vitamin K2: Natto (fermented soybeans), goose liver, and certain hard cheeses (Gouda, Brie).
Exercise Protocol: A combination of cardiovascular and strength training is critical for metabolic health.
Zone 2 Cardio: 3-4 sessions per week for 45+ minutes (e.g., brisk walking, cycling where you can hold a conversation). This builds mitochondrial efficiency, improving your cells' ability to use fuel.
Resistance Training: 2-3 sessions per week. Building muscle mass dramatically improves insulin sensitivity by creating a large reservoir for glucose to be stored, keeping it out of the bloodstream.
Sleep: Consistently achieving 7-8 hours of high-quality sleep is non-negotiable. Sleep deprivation is a potent independent driver of insulin resistance and inflammation.
Tier 2: Targeted Nutrient & Supplement Support (The Next 15%)
Supplements can correct deficiencies and provide therapeutic benefits that complement lifestyle changes. They should be used to support, not replace, a healthy foundation.
The Calcium Management Team: These nutrients work in synergy to ensure calcium goes to bones and teeth, not arteries.
Vitamin K2 (as MK-7): The "traffic cop" 🚦. It activates proteins that direct calcium. It tells osteocalcin to bind calcium to bone and activates Matrix Gla Protein (MGP) to actively remove calcium from soft tissues like arteries. A typical dose is 100–300 mcg/day.
Magnesium: The "gatekeeper" 🚪. It relaxes blood vessels and regulates calcium's entry into cells, acting as a natural calcium channel blocker. Most people are deficient. Aim for 200–400 mg/day of elemental magnesium from highly absorbable forms like glycinate, threonate, or citrate.
Vitamin D3: Essential for absorbing calcium from the gut, but it must be paired with K2 to ensure proper direction of that calcium.
Metabolic & Anti-Inflammatory Support:
Omega-3 Fatty Acids (EPA & DHA): High-dose fish oil (2-4 grams of combined EPA+DHA) is a powerful tool to reduce systemic inflammation.
Berberine: A plant alkaloid that is highly effective for improving insulin sensitivity by activating an enzyme called AMPK, similar to the prescription drug Metformin.
A Note on Calcium-D-Glucarate: ⚠️ This is not a calcium supplement for bone health. Its active component, glucarate, supports a specific liver detoxification pathway (glucuronidation). The calcium content is minimal and only serves as a stabilizing agent.
Tier 3: Advanced Diagnostics & Interventions (The Final 5%)
This tier is for precisely quantifying your risk and guiding aggressive prevention under professional care.
Essential Blood Testing: Go beyond the standard panel to get a true picture of your metabolic health and cardiovascular risk.
Apolipoprotein B (ApoB): A direct measurement of the number of all potentially artery-clogging particles. This is superior to LDL-C. Ideal < 80 mg/dL.
Lipoprotein(a) or Lp(a): A highly inflammatory lipoprotein whose level is almost entirely genetic. High Lp(a) is a significant and independent risk factor and should be tested at least once in your life.
Fasting Insulin: A direct marker of insulin resistance. It will rise years before blood sugar does. Ideal < 5 µIU/mL.
hs-CRP (high-sensitivity C-Reactive Protein): A key marker of systemic inflammation. Ideal < 1 mg/L.
Triglyceride/HDL Ratio: A powerful proxy for insulin resistance. Ideal < 1.5.
Imaging: Coronary Artery Calcium (CAC) Score:
What it is: A simple CT scan (no contrast dye) that measures the amount of calcified, hardened plaque in your coronary arteries. It is the single most powerful predictor of future cardiac events.
Interpreting the Score:
0: Very low risk.
1-100: Mild disease.
101-400: Moderate disease.
>400: Severe disease.
Practicality: The test is widely available and typically costs between $100-$300 out-of-pocket.
Medical Therapies: For individuals with an elevated CAC score or very high genetic risk (e.g., high Lp(a)), lifestyle may not be enough. Consultation with a preventative cardiologist is critical. Medications like statins, PCSK9 inhibitors, ezetimibe, or aspirin are powerful tools in the right context.
Implementation and Considerations
Cost and Accessibility: Foundational lifestyle changes are free. For diagnostics, direct-to-consumer labs offer panels for ApoB, hs-CRP, and fasting insulin for $50-$150. A CAC score is an out-of-pocket expense. A preventative cardiologist consultation may or may not be covered by insurance and can range from $300-$1000+.
Ethical Considerations & Risk: It is unwise and potentially dangerous to self-diagnose and treat based on this information alone. The primary risk is misinterpreting lab results and applying interventions (like high-dose supplements) that are unnecessary or harmful without a complete clinical picture. This information should be used to facilitate an informed discussion with a qualified healthcare professional.
Useful Resources: For deeper dives into this modern approach, resources from experts like
Dr. Peter Attia Dr. Paul Saladino Ivor Cummins