From the Journal of the Colorado Dental Association Autumn 2024
By Dr. Bradley Bale
Imagine if the many chronic health conditions that harm and kill millions of people every year could be traced back to a single event within the body. Think of the implications — instead of chasing after the myriad outcomes and tackling them with diverse and occasionally successful interventions, we could target the cause. Two American senior specialists in cardiovascular care, Dr. Bradley Bale and Dr. Amy Doneen have spent the last 20 years combining their different areas of expertise to focus on arterial disease. They have seen how heart attacks, strokes, and other chronic diseases of aging — such as dementia, heart failure, kidney failure, peripheral arterial disease, erectile dysfunction, and loss of vision — can all be traced back to arterial disease. The team has gone one step deeper and designed a medical approach that addresses a specific source event behind arterial disease. Their robust approach is having a positive impact on cardiovascular disease’s unwanted supremacy as the world’s number one cause of death, disability and healthcare cost burden.
Dr. Bale and Dr. Doneen knew that arterial disease was linked to other diseases and that there was a reason for that. The thousands of kilometers of blood vessels that run throughout our body, connecting our organs, are like the infrastructural network of roads, rail and pipelines that service every major city. If unhealthy, they do not operate smoothly, causing blockages and congestion, affecting the organs. For, arguably, the body’s two most important organs, the outcome is an increased risk of heart attack and stroke. They understood that despite significant advances in diagnosing and treating cardiovascular disease, it remained the leading cause of death and impaired health globally; a different approach to the disease was therefore needed.
Given the scale and scope of the cardiovascular system, the opportunities for disruption and disease are numerous, but one event merits special attention: oxidative stress (OS). This condition occurs when there is an imbalance between the production of harmful free radicals —highly reactive molecules — and the body’s ability to neutralize or detoxify them. OS affects lipoproteins — the complex fat and protein particles that course through our vessels — and the smooth muscle cells in arterial walls. The latter become genetically transformed, generating a sticky substance in the arterial wall, resulting in the lipoproteins (cholesterol) getting trapped in them and ultimately causing arterial disease. This retention of cholesterol encourages further oxidation and triggers the body’s immune response, resulting in inflammation in the artery. The fatty cholesterol deposits build up, producing plaque. When the condition becomes chronic, the arterial walls stiffen and clog, a condition called atherosclerosis.
Oxidative stress is the ‘critical link” between cholesterol and inflammation. It is the main driver behind arterial disease. Preventing it is vital to addressing the condition. They have designed a treatment regime that respects the complexities of OS causation and is straightforward enough for fellow healthcare practitioners to apply and customize to a specific patient’s needs. The management program is holistic and requires an interdisciplinary approach. For example, oral health is a critical element.
Their method utilizes six basic steps. The first involves educating patients and practitioners on the fact that a blood clot in the arterial system blocks the flow of blood, leading to events like heart attacks and strokes. Additionally, most of these obstructions are silent and lead to chronic diseases of aging like dementia, kidney failure, erectile dysfunction, peripheral arterial disease, and vision changes. The second step assesses for the presence of arterial disease. The third step is identifying arterial inflammation (“fire”) resulting from OS. Extinguishing or limiting any future “fires” requires identifying the root cause of OS — the fourth step. Ignore the root cause and it is only a matter of time before another, possibly fatal, flare-up occurs. The fifth step is setting individualized goals of therapy anchored in the sixth step, genetics.
With the above knowledge, a practitioner can design an optimal intervention for the patient, providing achievable goals for long-term health. Because numerous sources of OS are modifiable, including poor diet, physical inactivity, weight problems, sleep disturbances, infection, periodontal disease, gut dysbiosis, vitamin D deficiency, hypertension, nicotine addiction, prediabetes, and various psychosocial issues, treatment can involve any one or a combination of proven interventions, including lifestyle changes and medication. Utilizing genetics to provide individualized care to each patient ensures the success of this approach.
Two real-world evidence research studies of data from patients treated by Dr. Bale and Dr. Doneen have highlighted the method’s success. One, by the Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, examined treatment results in a cohort of 324 patients treated for five years and showed comprehensive reductions in cardiovascular disease risk[i]. A Texas Tech Health Science Center study analyzed data from the treatment of 576 patients over eight years. It showed regression of artery disease.[ii]
Unfortunately, many people still believe cardiovascular disease is inevitable. The reality is exciting: a person can live a long, healthy life without suffering the consequences of arterial disease. Doctors can now tell patients with arterial disease that there is a cure.
Article originally written for and published by Membership Matters, A publication of the Oregon Dental Association, V29, Issue 2, February 2024. Reprinted with permission from the Oregon Dental Association and Dr. Bradley Bale.
Dr. Bale and Dr. Doneen published, ”Healthy Heart, Healthy Brain: The Personalised Path to Protect Your Memory, Prevent Heart Attacks and Strokes, and Avoid Chronic Illness.” This book won the 2023 Gold Nautilus Book Award in the Health, Healing, and Wellness category and the American Society for Journalists and Authors’ (ASJA) 2023 June Roth Memorial Award for Outstanding Medical Book.
Dr. Amy Doneen is an expert in Arteriology, which is the study and focus of systemic arterial health – preventing heart attacks, strokes, type 2 Diabetes and chronic disease. She is the co-founder of the BaleDoneen Method® and has worked with Dr. Bradley Bale on this method since 1999.
Dr. Bradley Bale is a heart attack and stroke prevention specialist. He is currently a clinical associate professor at Washington State University College of Medicine, assistant professor at the University of Kentucky College of Dentistry and adjunct professor in the school of nursing at Texas Tech Health Sciences Center. He also runs a private practice in Gallatin, Tennessee.
[i][i] Cheng, H. G., Patel, B. S., Martin, S. S., Blaha, M., Doneen, A., Bale, B., Jones, S. R. (2016). Effect of comprehensive cardiovascular disease risk management on longitudinal changes in carotid artery intima-media thickness in a community-based prevention clinic. Archives of Medical Science, 12(4), 728-735. https://doi.org/10.5114/aoms.2016.60955
[ii] Feng, Du PhD; Esperat, M. Christina PhD, RN, FAAN; Doneen, Amy L. RN, BSN, MSN, ARNP; Bale, Bradley MD; Song, Huaxin PhD; Green, Alexia E. PhD, RN, FAAN. Eight-Year Outcomes of a Program for Early Prevention of Cardiovascular Events: A Growth-Curve Analysis. The Journal of Cardiovascular Nursing 30(4):p 281-291, July/August 2015. | DOI: 10.1097/JCN.0000000000000141
