Heavy Metals and Their Link to Heart Disease

The purpose of this article is to bring to light the connection between coronary artery disease and heavy metals like mercury and lead. The naysayers say there is no such connection and that an old, proven therapy like intravenous “chelation therapy’ is bogus.

Why did I say ‘proven’? Well, because in the early 1960’s, published studies in mainstream medical journals clearly demonstrated the benefits of intravenous administered EDTA chelation therapy in relieving symptomatic angina – chest pain due to coronary heart disease. Clark and Mosher reported an 87% improvement of coronary artery disease symptoms in the American Journal of Cardiology (1960). Then, in 1963, one of the principle investigators of this therapy did an about-face and wrote an article stating that chelation therapy was of no benefit for cardiovascular disease. The interesting thing about this article was that he cited no study for his conclusion.

I think that part of the problem with understanding chelation therapy may have come from chelation doctors themselves. Since its inception and for many decades afterwards, it was the belief that chelation therapy worked simply because it was binding to calcium in hardened atherosclerotic plaque and “dissolving” the blockage in the arteries. While there was an experimental study published in the journal Surgery in 1962 by Wilder showing that disodium EDTA was releasing calcium from plaque, there has not, at least to my understanding, been a long term study proving this as the true mechanism for chelation therapy.

In today’s prevailing medical ideology, coronary heart disease is simply due to excess “LDL” cholesterol and that all one needs is a high dose of a statin drug such as Lipitor or Crestor, as advertised on television. If this were the truth, why have people benefited from chelation therapy over the past 4 decades, and why are there more and more articles discussing the link between heavy metals and coronary heart disease and – even worse – cardiovascular “mortality”? Let’s explore this.

The first thing to understand, in my opinion, is that disease is often due to excess inflammation and to oxidation that is out of control. The fact that this concept was first published in 1957 in the Journal of Gerontology by Dr. Denhan Harman is interesting because this concept underlies the benefits of chelation therapy as well as of statin drug use and both their benefits in coronary artery disease therapy.

Let’s first consider the following few articles regarding toxic heavy metals. Please bear in mind that the metals in consideration are matters of disease causation from chronic micro-dose exposure, not from the massive-dose exposure that most people and doctors imagine, as if someone drank a gallon of leaded paint.

The first article from the March 26, 2003 issue of the Journal of the American Medical Association, Vol. 289, No. 12 by Nash, et al, it is shown that women in their 40s and 50s, who are moving from perimenopause to early menopause and who were in the upper half of the normal blood lead level, had a statistically significant higher incident rate of elevated blood pressure compared to those women who were in the lower half of the normal lead level. The article then clearly discusses the mechanism of how lead, which is stored and later released from our bones as we age, will enter the blood stream and deposit in arteries, thus inhibiting the relaxation and dilation of these very arteries. The end result is a more narrowed artery. If you’ve ever tried to suck through a skinny straw versus a wide fat straw, you’ve probably noticed that it required more force to do so. Likewise, your heart has to exert more pressure and force to pump blood through narrowed arteries versus wider dilated arteries. (Many of our prescription drugs lower blood pressure by causing a relaxation of the arteries!)

A key point of this article is that the lead levels that caused hypertension were in the standard “normal range”. Clearly, it does not require massive dose exposure to bring about a “toxic” effect from this heavy metal. This hypertension is a result of normal bone aging and thinning causing a release of stored lead from the bones in microgram doses. I also found it interesting that nowhere in the article do the authors indicate the approved therapy for lead detoxification, which is intravenous EDTA chelation. I guess they’re content to prescribe another drug, which only treats the number but doesn’t really get to the root of the problem.

Before going on, I should add that our body is exposed to environmental heavy metals like lead and mercury from our drinking water, food, dental amalgams, old leaded paints, and largely from atmospheric contamination from coal burning plants, the vast majority occurring in China. (Texas also has its share of coal burning plants.) The body attempts to eliminate these heavy metals via its own chelating molecule, glutathione. But unfortunately, much of the heavy metals are stored in connective tissue like our bones. This explains why, in the above study, the women were getting more micro-dose exposure of lead from their own osteopenia, or thinning of the bones!

The journal Circulation (2006; 114: 1388-1394) explored the relationship between blood lead levels above 10 micrograms/dL and illness and concluded that “lead exposures remain a significant determinant of cardiovascular mortality in the general population, constituting a major health problem.” (Emphasis mine) The standard lead range in many laboratories is “normal” up to 25 or even 50 mcg/dL! Again, I point out that the article failed to discuss how intravenous EDTA chelation therapy is the approved therapy for lead removal from the body.

A similar statement was made in the April 2009 issue of Environmental Health regarding lead:
“Lead is a multi-targeted toxicant, affecting cardiovascular, renal, and nervous systems and may contribute to morbidity and mortality…” (Emphasis mine)

The conclusion of this article was that older women with higher concentrations of blood lead might be at higher risk for death from coronary artery disease. Again, we see a correlation between lead in microgram doses and cardiovascular disease and mortality.

A more recent study published in Circulation (2009; 120: 1056-1064) by Weisskopf, et al, also concludes that blood lead levels have been associated with increased “mortality” due to cardiovascular disease. The article very importantly makes the distinction that the lead exposure is a cumulative result over years of exposure versus the sudden massive dose toxicity we all think of when we hear the word “toxicity”. They point to the notion that serum blood testing may have severe limitations on accurately diagnosing total body concentration of lead and propose the idea of using bone x-rays as an alternative and more accurate way to determine lead accumulation. (Blood serum levels only show what is floating through the blood stream, not what is buried in the body’s tissues.)

The principle investigator, Dr. Weisskopf states:
“The findings with bone lead are dramatic. It is the first time we have a biomarker of cumulative exposure to lead and the strong findings suggest that … past exposures to lead represent an important predictor of cardiovascular death…” (Emphasis mine)

It was also found that men with the highest level of bone lead concentrations were at a six times higher risk for cardiovascular disease compared to men with the lowest lead levels. What might the reasons be for lead and this link to cardiovascular death? According to the authors, there are several mechanisms, one being an increase in oxidative stress from the lead. In the 1957 article I quoted that disease and aging is a problem of inflammation and oxidation. Oxidation is what causes iron to rust. Oxidation is what causes our LDL, “bad’ cholesterol, to become problematic. Oxidation can cause blood vessel inflammation and atherogenic disease.

Lastly, I don’t want to leave the toxic metal mercury out of the discussion. There was a press release in May 30, 2007 from the Ohio State University Medical Center’s lipid studies center announcing that “mercury’s link to heart disease can be traced to activation of [an enzyme] which triggers a process leading to plaque buildup in blood vessel walls” (also published in the International Journal of Toxicology). (Emphasis mine.)

To summarize, we live in a toxic world with daily environmental exposures to lead and mercury, as well as a host of other toxic metals and poisons, which biologically accumulate in the body, especially in our bones. As we begin to age, there is a process of normal bone thinning which releases micro-doses of these toxic metals back into the blood stream and tissues. The end effects of this re-exposure are in the multitudes, however, for the purpose of this article and the topic of chelation therapy for cardiovascular disease, I’d like to highlight the following tidbits:

Lead is proven to cause blood vessel narrowing and hypertension (AMA Journal)
Lead is proven to be a causative factor for death due to cardiovascular disease (Circulation Journal, Environmental Health)
Lead causes oxidative destruction (Circulation Journal)
Mercury can trigger plaque formation in the coronary arteries (International Journal of Toxicology)

Given that the original studies on EDTA chelation were proven to have a benefit by relief of angina in patients with cardiovascular disease and given that the FDA-approved therapy for lead detoxification is EDTA chelation therapy, perhaps mainstream medicine needs to reconsider their flawed notion that chelation is a useless treatment for heart disease. By today’s standard of medical care, lead and mercury are not even on the radar screen! Yet, by the above studies it is clear that lead and mercury do play a role in not only cardiovascular “disease”, but also cardiovascular “mortality”! It is my contention, as well as that of thousands of other doctors worldwide that EDTA chelation still should play a significant role in the treatment of coronary artery disease. The mechanism of benefit is probably that of heavy metal removal and not a “rotor-rooter’ effect of calcium removal. In an already diseased and narrowed artery from atherosclerosis, the relief of angina symptoms as proven in the 1960’s studies on EDTA could have been because of lead removal from the arteries and subsequent increase in blood vessel diameter and improved blood flow dynamics.

Also, one has to consider the reduction in oxidative damage to the arteries and cholesterol by steady removal of lead and mercury. One of the more current understandings of statin cholesterol drug benefits is their anti-inflammatory effect. It remains to be proven that massive lowering of LDL and total cholesterol extends life. In fact, considering that our natural anabolic (build, repair, restore) hormones like testosterone and estrogen all derive from cholesterol, we might be doing more harm than good in the current severe lowering of total cholesterol as practiced by pharmaceutical driven mainstream medicine. Cholesterol is required in optimal brain neurotransmitter functioning and this may explain why there is an ever-increasing occurrence of elderly individuals who suffer from a “statin drug cognitive dysfunction syndrome”.

It is my opinion that intravenous EDTA chelation therapy, along with other complimentary types of therapy, need to be one part of the overall plan of optimally treating cardiovascular disease. The above studies, while not clinical trials on chelation therapy, are highly suggestive that toxic metals like lead and mercury are causative factors in heart disease and that some form of chelation therapy would be beneficial. Indeed, it is the anecdotal evidence of people receiving benefit from chelation therapy over a time span of 50 years that supports this.

Ron Manzanero, M.D.
Austin Integrative Medicine

*This is only the opinion of this writer, and is it is solely intended for intellectual consideration and not to replace any therapy that is considered to be the current standard of approved medical care. Anyone reading this should carefully consult with their personal physician before embracing any of the ideas presented here.