Low Plasmalogens in Midlife Predict Later Heart Disease

June 26, 2023

Low Plasmalogens in Midlife Predict Later Heart Disease

We have known for some time that folks on dialysis have much more heart disease and die of heart attacks at about 4 times the rate of the rest of the population. They make pretty good "canaries" to monitor why their heart disease is so much worse than in the general population. We have also learned recently that their level of DHA-plasmalogens correlates precisely, and inversely, with their risk of heart attack and their ability to export HDL particles. When they export HDLs from the cell, the blood level goes up, and it is generally recognized that high levels of HDLs are protective from heart disease.  

We also know in a landmark study from Korea following 16 million people for 10 years that the optimal level of total cholesterol was 210-240. Our guidelines for cholesterol in America are to treat anyone with statins for cholesterol over 200. Very simple and very off-the-mark. It's not the main show.

What is going on in a cell over cholesterol? How do plasmalogens fit in? Here is the explanation. Every cell must, must have cholesterol. It is a very rigid molecule and makes good building blocks for a cellular membrane. Much of the outer membrane of any given cell is composed of cholesterol. Now, 75% of a body's cholesterol is made in the liver with the final 25% coming from the food we eat. In the process of absorbing it in our gut, the cholesterol is attached to another lipid molecule and tucked into LDL particles to carry it around in the blood to give it to cells that need it. Every cell in the body has LDL receptors to take up cholesterol. If blood levels of cholesterol are low, that means somewhere in the body there are cells taking it up avidly. That is not a good situation. When cholesterol levels are high, the cell is happy and has enough. It's HDLs that tell the real story. The content of plasmalogen lipids in mitochondrial membranes affects the fluidity of the mitochondrial membrane and is closely monitored to keep the function of the mitochondria in good shape. When the fluidity is just right, HDL gets exported because there is just enough cholesterol to make the membrane at perfect fluidity. HDL going up means happy, functioning mitochondria. But not too high. Just 60-90. How to get there? Intermittent fasting, avoiding sugar, and resistance exercise all help.

The question arises, how do we predict who will have a heart attack down the road? The cholesterol model shows unequivocally that people live longer with total cholesterol of 230 rather than 180. The cholesterol model is broken. What gives? This week's featured paper is on just that. Mid-life plasmalogens predict future heart attacks better than cholesterol. 1,852 participants, mean age 59 were followed for 16 years for possible cardiac events. What was unique was the use of metabolomics, meaning, measuring a wide range of blood compounds, not just one or two. That is the exact same process Goodenowe did with Alzheimer's patients in the Rush Catholic Clergy study. He examined 25,000 metabolites. In this study, a total of 1228 metabolites were followed by mass spectroscopy. Not as big a screen but still huge. Three different plasmalogen species were found to be associated with future heart attacks in an inverse fashion. The lower the level, the more likely the heart attack. They also found two amino acid metabolites, and a bilirubin degradation product, all of which have anti-inflammatory properties to be inversely associated with heart disease. Cholesterol didn't make the list.

We also know that heart disease is ongoing for decades before it becomes clinically dangerous. It all starts, way back with "sheer stress" on the wall of the artery. Guess what plays a central role in signaling and responding to sheer stress? Well, nitric oxide is possibly the main actor, but plasmalogens are playing a role in mediating that response.

Once you have lack of nitric oxide and lower plasmalogens, then you get LDLs accumulating and foam cells,,,and, and, and finally a heart attack. Cholesterol then shows up as the plugging event. Reducing cholesterol with a statin begs the issue. It's not at the starting point. It is a passive participant, but not the director. The slight anti-inflammatory effect of statins gives them their measured benefit in heart disease, but there are other better alternatives.

www.What will Work for me. You want to predict your risk of future heart attacks? Get a Prodrome Scan. It is the only company on the market right now giving us insight into plasmalogen content. I got one and I was half a standard deviation below average, meaning I was headed for trouble. I'm now taking plasmalogen supplements every day, in part because my mother had dementia. But my father had a heart attack. And Nitric Oxide every day too. No statin for me. They are bad for your brain, bad for your diabetes risk, bad for your muscles. You just don't need to lower your cholesterol. You need to fast, exercise, eat less sugar, don't smoke, eat 5 servings of vegetables every day (Nitric oxide galore), and make sure you are on B vitamins, K2, D, NAC and creatine/choline.....and make sure your plasmalogens are robust.

References: MedRxiv, Atherosclerosis, Neph Dial Trans, Atherosclerosis, Eur Jr Prev Cardiol, FASEB

Pop Quiz

1. What are plasmalogens?                            Answer: part of membranes all over the body that give the membrane fluidity, and the ability to shape-shift allowing membrane fusion, and they have a vinyl ether bond n the surface of the membrane, giving them the role of anti-oxidant of first resort.

2. What is the problem with being the antioxidant of first resort?                           Answer: In oxidizing environments, you become depleted. COVID is one example. It is particularly oxidiizing, leaving membranes badly depleted and struggling to catch back up. Hence, long COVID. Yes, you can fix long COVID with Plasmalogens therapy.

3. How do plasmalogens intersect with cholesterol?                           Answer: They modulate how much cholesterol to keep inside the cell, and how much to send back out. The yin and yang of membranes are that cholesterol brings strength and rigidity and structure, and plasmalogens bring fluidity, function, and protection. Balance.

4. What predicts future heart attack better, cholesterol or plasmalogens?                           Answer: If you don't know this answer, go back and read the whole article again.

5. If you want to prevent a future heart attack what will help you more, statins or plasmalogens?             Answer: Plasmalogens have been found, by metabolomics, to be the best, underline best, most accurate chemical in your body to predict longevity. Taking a statin, as proven by Oxford's review of the 5 largest statin studies, will add 1 day to your life. What is still missing is a 25-year study of plasmalogen replacement to prove it. The discovery is still too recent and too fresh.