Fairfax County Taxpayer's Alliance Home Search FCTA Publications - Monthly Msgs - Reports - Bulletins - Handouts - Great Reads Fairfax Co - Taxes & Budget - Gov't Schools - Pensions - Transportation - Misc / Other Beyond Fx - Virginia - National - World Miscellaneous - Health - Environment - Potpourri About Us - Who We Are - Calendar - Support FCTA A A

"The Clot Thickens" - A Summary

The enduring mystery of heart disease

-- David Swink, 2026-03-01

Having just read Dr. Malcolm Kendrick's 300-page book The Clot Thickens, where he dispenses with the current "diet-heart cholesterol" hypothesis in favor of the 150-year-old "blood-clot" hypothesis, I found it useful to take notes, and attempt to condense his main points into a 3-4 page summary, as follows:

Cholesterol and Saturated Fat:

• Athereosclerosis affects only arteries, not veins, but is still referred to as cardiovascular disease (CVD).

• The French eat lots of saturated fats, but have comparatively low rates of CVD.

• Saturated fat cannot raise cholesterol/LDL levels.

• Replacing saturated with polyunsaturated fats ==> 70% increase in CVD.

• Raised cholesterol does not cause heart disease. Like "Goldilocks and the Three Bears", CVD mortality measured higher when either cholesterol was "too high" or "too low", but was lowest when cholesterol was "juuuust right". Ergo, cholesterol is not a factor in heart disease.

Blood Clots and CVD:

• Enter the 150-year-old alternate hypothesis for CVD: Blood clot!

• CVD is a slow process, which starts when the artery wall lining is damaged in some way, triggering blood clot formation to cover the wound -- like a scab does when you cut your skin. A new layer of arterial lining then grows over top of this "scab", drawing it into the artery wall to create a small raised area, or plaque.

• Repeated damage to the same area will lead to plaques getting bigger -- eventually severely narrowing the artery wall and constricting normal blood flow.

• Choleaterol, found in plaques, arrived there as free cholesterol as found in red blood cells -- not LDL.

• LDL exists in two versions. Version 1 (LDL) simply transports cholesterol; version 2 (Lp(a)) is LDL with an additional protein (apolipoprotein(a)) attached to it. Lp(a) is attracted to areas of arterial damage, and binds with exposed proteins in the arterial wall, creating a strong "plug" to prevent blood loss. Lp(a) in plaques is often misidentified as LDL.

Vitamin C and Lp(a):

• Most mammals synthesize their own vitamin C. Humans do not, and must acquire it through food.

• Vitamin C is required to manufacture collagen, without which your blood vessels begin to crach and leak, leading to scurvy and bleeding to death.

• Lp(a) tothe recue, attracted to and patching the areas of arterial damage to prevent blood loss,while you suck that lemon or lime to acquire your required vitamin C.

Nitric Oxide (NO):

• Opens up (dilates) blood vessels throughout the body, stimulates new endothelial progenitor (arterial lining repair) cells in the bone marrow, and improves insulin sensitivity.

• Created naturally by exposure to sunlight and manufactured in the nasal passages to increase oxygen intake by opening up the blood vessels in the lungs. (So breathe through your nose!)

• Ingested as L-arginine, sildenafil (Viagra), certain veggies, dark chocolate, red wine, and meat/animal organs.

Odds and Ends:

• BMI (Body Mass Index), has a Goldilocks-like effect as did cholesterol ... Maximum longevity: BMI of 25-30; shorter lifespan: BMI <25 or >30.

• Dehydration can trigger blood clots.
  
  

• NSAIDs (like ibuprofen and naproxen) increase the risk of blood clots and can damage the arterial lining.

• Magnesium is a very important mineral available in most drinking water, but not in "soft" water or water provided via desaliination.

• Maximum life-years lost by various things:
  - 24 years: Drug and accohol abuse
  - 20 years: Raised blood sugar/type 2 diabetes
  - 20 years: Significant mental illness
  - 10 years: Smoking
  - 5 years: Lack of exercise
  - 4 years: Air polution
  - 2 years: Use of PPIs
  - 18 months: Raised blood pressure
  - 18 months: Periodental disease

• Most inportant supplements to take (or to avoid):
  - Vitamin D (in the winter)
  - Vitamin C
  - Potassium (instead of NaCl)
  - L-arginine/citruline
  If yoy already have diagnosed heart disease:
  - Chondroitin sulphate
  - Thiamine
  - Co-enzyme Q10
  - Consider Viagra
  - Consider aspirin, low-dose
  - Avoid non-steroidal drugs, long term, if possible
  - Avoid proton pump inhibitors, long term, if possible
  If you have diabetes:
  - Low-carb diet
  - Short burst exercise
  - Reduce alcohol
  - Consider chelation therapy