• Conventional treatments don’t address the root cause — In one study, patients with stable coronary artery disease (people who had chronic but not immediately life-threatening blockages), stents and bypass surgery did not significantly lower the risk of heart attack or death compared to medical therapy alone.

In fact, the main benefit came down to symptom relief only. As I noted in my paper, “in stable CAD [coronary artery disease], revascularization primarily serves as a symptom-relieving intervention rather than a life-prolonging one, prompting a reevaluation of routine invasive approaches.”

• Stents come with their own complications — Within the first year, around 1% of patients who underwent stent procedures developed a particular thrombosis, a dangerous blood clot forming inside the stent.

In addition, between 5% and 10% of patients face in-stent restenosis, wherein the previously treated artery narrows again, requiring repeat procedures. Even if the stent stays open, the untreated parts of your arteries keep developing new blockages. Furthermore, the literature highlights that 20% to 30% of patients develop new arterial lesions within five years after a stent procedure.

• CABG saves lives, but the trade-offs are serious — This procedure provides more durable blood flow, especially if you have multiple arterial blockages. Statistics show that about 90% of patients who undergo CABG achieve full revascularization, compared to 60% to 70% with PCI.

However, CABG carries a 1% to 2% risk of death during the operation, a 5% risk of wound infections, and a 10% to 20% chance of cognitive decline afterward, particularly for elderly patients. More importantly, vein grafts used in the surgery also wear out — half of saphenous vein grafts fail within 10 years.

• The biology behind these limitations — Both PCI and CABG acutely address blood flow, but fail to tackle the root of atherosclerosis. As noted in my study, atherosclerosis is fueled by an interplay of several factors, particularly endothelial injury, lipid buildup, and inflammation.

In fact, about 30% to 40% of CAD patients show elevated inflammatory biomarkers like interleukin-6 (IL-6) or C-reactive protein (CRP), yet these markers aren’t changed by simply inserting a stent or graft.

• Enhanced external counterpulsation (EECP) — This is a noninvasive therapy that uses inflatable cuffs wrapped around your legs, which helps improve blood flow to the heart. The devices are carefully timed to inflate when your heart relaxes and deflate when the heart contracts. Essentially, the entire process changes how your blood will flow through the vessels by triggering the release of nitric oxide. Published research shows that there’s a 20% to 30% improvement in endothelial function.

While promising, EECP has not yet been proven to reduce the risk of “hard” outcomes like heart attacks, so more research is still needed in this area. Moreover, the mechanics of EECP aren’t fully understood yet, so more testing will be needed to fine-tune its benefits further. That said, early research shows that it may be able to help with conditions like heart failure and peripheral artery disease.

Again, more research will be needed, but the overall sentiment is positive — with enough data, EECP is poised to become a part of cardiovascular management, especially since it is a noninvasive procedure.

• A closer look at outcomes shows the limits — Statins reduce the relative risk of major cardiovascular events by about 25% to 35% in high-risk populations. But even with best statin pharmacotherapies available, the literature shows that this method has its own shortcomings.

For example, one study noted that rosuvastatin reduced major adverse cardiovascular events (MACE) by 44% in patients. However, it had the side effect of increasing high-sensitivity CRP (hs-CRP),³ which is associated with significantly increased risks for multiple heart-related conditions, including heart attack, stroke, peripheral arterial disease, and heart failure, even when traditional cardiovascular risk factors are controlled for.

• Statins come with their own problems — Around 10% to 15% of statin users noted that they experienced myalgia (muscle weakness), causing 1% to 2% of them to discontinue the treatment.

Even worse, severe side effects such as rhabdomyolysis, a dangerous breakdown of muscle tissue that can lead to kidney damage, and hepatotoxicity, toxic injury to the liver that impairs its ability to function, have been reported. The risk for Type 2 diabetes also increases over the course of four to five years.

• Modern diets load the body with LA at levels far above what humans historically consumed — Among early civilizations, the daily intake of LA was only around 2.8%, but today this has ballooned to 7.2%. Much of the increase was due to the old belief that the polyunsaturated fats (PUFs) in vegetable oils were healthier compared to saturated fats from animal sources.

• The anatomy of LA — This omega-6 PUF contains two bisallylic double bonds, making it susceptible to bonding with hydrogen. Once it’s inside your system and bonds with the cardiolipin in your mitochondrial membrane, the molecule turns into a substrate for lipid peroxidation. Thus, it produces reactive oxygen species (ROS) that hamper mitochondrial function, which leads to my next point below.

• Mitochondrial disruption quickly changes the chemistry of your arteries — Damaged mitochondria produce excess ROS, which injure the inner lining of your arteries, making them sticky to cholesterol and immune cells. In this environment, arterial plaques not only form — they grow aggressively.

The published literature emphasizes that oxidized LDL (OxLDL) cholesterol, which is directly fueled by LA breakdown products, is far more dangerous than total LDL alone because it drives this sticky, inflammatory process.

• How LA contributes to clogged arteries — LA becomes incorporated into LDL cholesterol, and the more you get it from your diet, the more OxLDL is produced. According to one of the studies I cite in my paper, “replacing saturated fat with LA-rich vegetable oil increased cardiovascular mortality by 62% over five years, despite lowering serum cholesterol by 8 mg/dL.”⁴

• Cutting LA intake has measurable cardiovascular benefits — In the table below, I show the results of a 12-week study when participants reduced their LA intake to less than 5 grams per day.

• The numbers don’t lie — These reductions are statistically significant. In essence, restricting LA intake positively affects low-grade vascular inflammation, even if weight loss or a calorie deficit hasn’t been implemented.

• LA takes years to clear up — LA has a half-life of two years. This means that even if you follow a low-LA diet for an entire year, you’ll only be removing about 30% of prior accumulation. Nonetheless, health benefits can be expected even before other interventions are implemented.

• Sources of LA — The most apparent source of LA is industrialized vegetable oils, such as soybean, corn, and safflower oils. However, less obvious sources include conventionally raised poultry and pork because of their feed, which is high in LA.

• Intravenous ethylenediaminetetra-acetic acid (EDTA) chelation — EDTA is a compound that chelates minerals such as calcium, iron, and copper. However, the issue here is that EDTA does its task indiscriminately, making it an impractical choice since your body needs these nutrients to function properly.

Moreover, EDTA takes a long time for its benefits to appear. Prior research showed that it needs to circulate in your system for hours to provide a measurable benefit, and it needs to be repeated many times, too.

• Nanoparticle-facilitated chelation — Instead of sending EDTA through the bloodstream in a scattershot way, research shows that nanoparticles can be used to deliver EDTA (or other chelators) directly to plaque sites. In particular, this approach doesn’t need to be administered intravenously anymore. New formulations making use of liposomal vesicles can be taken orally, making it a convenient way for patients to receive treatment.

• Don’t rely on this new technology alone — While nanoliposomal chelation sounds promising, there are knowledge gaps regarding long-term safety, scalability, and biodegradability. Thus, more research is needed, and it shouldn’t be used as a crutch — a multifaceted approach (such as minimizing LA intake) will still yield the best results.

• Heart disease care is expensive — One of the strongest cases for focusing on prevention is the health care costs. For example, CABG costs around $100,000 per procedure, and there’s only a 50% compliance rate for lifestyle changes afterward.

• Health care only focuses on one approach — Another problem with a symptom-based approach to treating heart disease is focusing on one strategy only. For example, clinical trials focus on single interventions only, and do not focus on synergistic benefits when multiple methods are used simultaneously.

• Address inflammation at its source — Again, many Americans are consuming far too much LA in their diets, which causes inflammation that leads to heart disease. Therefore, limiting your LA intake below 5 grams daily is a strategy you can implement right away that has an immediate impact on your health.

If you can get your LA intake to below 2 grams, that’s even better. To help you measure your intake, I recommend you sign up for the Pax health platform, which contains the Seed Oil Sleuth. This feature helps calculate the LA in your food to a tenth of a gram.

• Dietary changes are easier to implement — In relation to the point above, published literature shows that minimizing LA intake yields 70% to 90% compliance rate with the help of dietary counseling. This is far more cost-effective rather than expensive cardiovascular treatments.

• Consider nanoliposomal chelation — Paired with dietary LA restriction, this approach can yield substantial benefits to your cardiovascular health. What’s great about this technology is that it’s easy to ingest, and costs an estimated 80% less compared to intravenous methods. Remember, the technology is new and more research is required, but again, the results are promising.