Heart Disease Has Two Components
The path to a heart attack is a two-step process. First "foam cells" (macrophages filled with oxidized-LDL) adhere to the artery lining. These cells promote the infiltration of various substances through the artery wall into its middle layer. Now the artery can be said to be "diseased" as a plaque is formed in the artery interior. As the plaque expands, the wall is pushed out and the opening where the blood flows through is narrowed. Thus, blood flow is decreased to the heart tissue. The narrowed artery also damages the blood platelets passing through, making the blood "sticky" and encouraging clot formation at the plaque site.

Figure 2 shows the relationship between the two steps. Until recently, most of the emphasis of vitamin E research has been on its ability to safely prevent clots from forming. Now many researchers are looking at how vitamin E prevents the first steps in this process from occurring as well. The process is further explained in my new book, "The New Supernutrition."

The Pioneers of Treating Heart Disease and Vitamin E
Drs. Evan and Wilfrid Shute used vitamin E in their treatment of heart disease. It was their great clinical success with tens of thousands of heart patients that led to my 1974-5 study of vitamin E and the prevention of heart disease. I was researching how the antioxidant nutrients slowed the aging process, and I kept getting asked about vitamin E and heart disease. My study was designed to learn more about how much and how well vitamin E helped people. It was a coincidence that these data were so striking that I could discover the relationship between vitamin E and the prevention of heart disease.

The Drs. Shute were physicians and they were trained to think primarily in terms of cure, rather than prevention. They recognized coronary thrombosis for what it is -- blood clots forming in the coronary arteries that prevent blood from nourishing the heart. This leads to death of tissue (an infarct) in the heart (myocardium) -- hence the term "myocardial infarction."

The Drs. Shute knew that vitamin E helped keep the blood free-flowing and their observations convinced them that vitamin E would also help dissolve clots. They also found that vitamin E sped healing of the heart and facilitated the growth of new blood vessels around the damaged area (collateral circulation).

Earlier I mentioned that angina pains occur most frequently in vitamin E deficient persons. The Drs. Shute knew this, and found that vitamin E supplementation relieved angina -- although not as well as nitroglycerine. Eventually, the Drs. Shute expanded their thoughts to prevention. Hopefully, my study encouraged their thinking. They had good reason to believe that vitamin E could help keep clots from forming in the first place, and thus prevent heart attacks. Dr. Evan Shute pointed out in a Shute Institute booklet, "Prevention is everything. Fortunately, alpha-tocopherol offers hope in this respect, for vitamins characteristically prevent what they relieve." However, he had no formal studies to prove his point -- only clinical observations of thousands of patients.

In 1974, Dr. Evan Shute wrote to me explaining that "my brother keeps quoting Kay and Ochsner on antithrombin, but I believe that vitamin E is a fibrinolysin and acts in that way to protect against clotting, etc." [32]

Reducing heart attacks by reducing the tendency of blood to clot is a different concept than preventing damage to arteries which narrows them and induces clots to form. Preventing clots is attacking the problem at the second stage, whereas preventing plaque formation is to attack at the first stage. It is better to keep the arteries from being narrowed in the first place, as this ensures an adequate blood flow to all of the heart tissue. Isn't it fortunate that vitamin E will stop both processes?

The Drs. Shute had no studies or knowledge of using vitamin E to prevent the atherosclerotic process -- that is they saw no relationship as to how vitamin E could prevent cholesterol deposits. However, they knew that cholesterol deposits were not just simply a matter of eating cholesterol. In fact, in 1974, Dr Evan Shute wrote to me saying in several letters that he appreciated my views on cholesterol. "I was especially struck with the item on cholesterol, as I, like you, don't believe in it." [33]

Dr. Evan Shute reviewed and critiqued my manuscript for "Supernutrition: Megavitamin Revolution" and kindly offered suggestions. He told me that my stance on cholesterol was especially helpful and wished me "good luck." He commented, "The clouds don't look so dark as they did 25 years ago. A fellow needs lot of patience." [33]

In 1977, Dr. Evan Shute reviewed my book, "Supernutrition For Healthy Hearts." In the review, he said, " Richard Passwater,

Ph. D. does an excellent job in his new book, "'Supernutrition For Healthy Hearts.' He explains, once and for all, that cholesterol does not cause heart disease...It is one of the best books I have on my shelves and I highly recommend it as part of your library."

Later, his son, Vere Shute, wrote to tell me not only did Dr. Shute highly recommend my book, but that the Shute Institute provided patients with copies of both "Supernutrition: Megavitamin Revolution" and "Supernutrition For Healthy Hearts." [34] I remember many extensive talks with Dr. Evan Shute in which we chatted about how vitamin E helped so many conditions from healing the heart to wound healing. He wrote in 1974, "The fibroblasts are inhibited and the epithelial cells have a chance to cover the wounds over before the granulation tissue pushes up from beneath." [32] I was given - and still treasure - his lecture slides of 1949 showing how vitamin E "miraculously" healed patients suffering from burns, diabetic gangrene, and other otherwise disfiguring problems.

I toured with Dr. Wilfrid Shute throughout Australia in 1980. He told me that he found my study enlightening and that he also liked my observation that the heart disease death rate started declining in pace with the increasing use of vitamin E supplements.

Prodding the Establishment to Consider Vitamins
Yes, I have been on a mission! I am glad that the establishment is now taking vitamins seriously. I used to be part of the "establishment. I was a research biochemist for Allied Chemical Corporation, F & M Scientific Corporation, Baxter-Travenol Laboratories, and American Gerontological Research Laboratories.

However, my studies showing the antioxidant vitamins slowed the aging process, and prevented cancer were not well accepted at that time. I remember how my research was criticized in Chemical & Engineering News . Although I was able to successfully defend my research in Chemical & Engineering News and to publish in American Laboratory and International Laboratory , I was unable to publish anywhere else because of the suggestion that vitamin supplements were beneficial. [35-38] That's why I took my research directly to the public with "Supernutrition: Megavitamin Revolution" in 1975, and with the heart study in 1976.

In 1978, I challenged the AHA to debate me. On Good Morning America, I debated a leading cholesterol and heart disease researcher from the University of Miami, and he admitted that dietary cholesterol was not important to normal healthy persons. On the backcover of my book, "Supernutrition for Healthy Hearts," I challenged in large print -- "No one has ever shown that eating cholesterol causes heart disease. If anyone can step forward and prove that eating cholesterol causes heart disease, I will donate all of my proceeds from this book to the American Heart Association."

Indeed, I have been on a mission. I have challenged researchers and cajoled them into checking out this research. Maybe I didn't have the patience at first that Dr. Evan Shute mentioned, but I did have persistence.

There were clues in several papers in obscure journals that "know-it-alls" never bothered to look for, let alone study. And when I would show these to vitamin E critics, they would simply dismiss them as "not a controlled double-blind cross-over study," or "that's just an animal study" or "too few people in the study" or whatever they wished to use as an excuse for not wanting to pay attention. They had closed minds and didn't want to be confused by facts. The last thing they wanted was an "interesting lead" regarding vitamins.

I made this my goal -- to force them to pay attention and not just offer lame excuses. I went on the lecture circuit to pointedly goad the critics into trying to prove me wrong or to shut up. They ignored me at first, but I became more sophisticated in how I could bring pressure upon them to try the studies I proposed. Those who were open-minded enough to look into vitamin E, became interested, but they still had to bootleg the research because they couldn't get funding. Eventually, the little presentations and abstracts at meetings - given as "tack-ons" to other research, turned into scientific papers and now it seems even into full clinical studies.

Today I am pleased that so many heart researchers and a growing number of AHA officials are in agreement with the what I have been teaching for twenty years. Life can be rewarding!

True, the news about cancer and antioxidants that the establishment became excited about in 1991 is essentially the same as I reported in 1973. The news that is now interesting the AHA is what I suggested in 1972 and determined in 1974-5. But, until the establishment is convinced, the job is not done. More research and clinical trials are needed. They are underway regarding the cancer studies, but the heart studies are not even designed yet. However, last year, the National Heart, Lung and Blood Institute brought together about 30 scientists involved in this research to consider designing such clinical trials for antioxidants and heart disease.

I believe that many of you would be interested in the story about how difficult it was for vitamin E to be introduced to the health food market, so I will discuss the battle fought by Jud Ryon in the 1940s in an upcoming article.

1. Vitamins may cut heart disease risk. Raeburn, Paul Associated Press (Jan. 13, 1992)

2. Press Conference Prevention Magazine and Richard A. Passwater National Press Club, Washington, DC, (Dec. 24, 1975)

3. Physician health habits Bennett, William Ira Harvard Health Letter (Jan. 1992)

4. Beta-carotene reduces heart risk in the Physicians Health Study: Preliminary data. Hennekens, Charles Amer. Heart Assoc., 63rd Sci. Sess., Dallas (Nov. 14, 1990)

5. Dietary Cholesterol: Is it Really Related to Heart Disease? Passwater, R. A. American Laboratory 4 (9) 23- 35 (1972); International Laboratory (January/February 1973)

6. Supernutrition: Megavitamin Revolution Passwater, Richard A. Dial Press, NY (1975)

7. Supernutrition For Healthy Hearts Passwater, Richard A. Dial Press, NY (1977)

8. Plasma vitamins E and A inversely correlated to mortality from ischemic heart disease in cross-cultural epidemiology. Gey, K. Fred and Puska, Pekka In: Vitamin E: Biochemistry and Health Implications. Diplock, A. et al, Eds., Ann. N. Y. Acad. Sci. pp 268-82 (1989)

9. On the existence of a hitherto unrecognized dietary factor essential for reproduction. Evans, H. M. and Bishop, K. S. Science 56:650-1 (1922)



10. Expected gains in life expectancy from various coronary heart disease risk factor modifications. Goldman, Lee; Weinstein, Milton C. and Tsevat, Joel Circulation 83(4):1194-1201 (April 1991)

11. The New Supernutrition Passwater, Richard A. Pocket Books, NY (1991) Vitamins may help curb heart disease. Friend, Tim USA Today, Life section, p1 (January 13, 1992)