Case Studies: Preventing Heart Disease:

| March/April 2002

Patients come to my clinic predominantly to find solutions to specific ailments and to relieve particular symptoms. But during our first session, I often remind them to look at the big picture. Achieving better sleep and more regular bowel movements may be of little use if a major heart attack or stroke occurs. Along with incorporating a stress-reducing yoga practice and bowel-moving fiber in the form of more fruits and vegetables for improved quality and length of life, a patient should consider what habits might help slow the process of cardiovascular heart disease. This process is often silent, occurring at the cellular level, where subtle microinflammation of blood vessels inexorably leads to scarring, as well as hardening and blockage of the vessels. This process, which develops slowly (and often unseen) is a major factor in heart attack and stroke, the first and second leading causes of death in most of the world’s technologically developed countries. Dramatically, studies show that most adults likely have some stage of this disease process taking place in our bodies.

Judy’s case

As I sat talking with Judy during our first session, she expressed surprise that at forty-eight she should even think about heart disease as an important health consideration. But recent statistics show that after menopause, women are about 70 percent as likely to die from a heart attack or stroke as men—these catastrophic events being the top two killers of both women and men. And after fifty-five, women are also just as likely as men to have high blood pressure.

Judy had high blood pressure and hypercholesterolemia (high total blood cholesterol), according to her doctor, who prescribed a diuretic and a beta-blocker to reduce her blood pressure from 150/90 to 135/78. Most medical authorities agree that when positive lifestyle changes don’t lower blood pressure to about 135/80, patients should receive antihypertensive drugs.

High-quality controlled studies have shown that a combination of beta-blockers and diuretics are the best drugs to decrease the risk of dying from heart attack and stroke among people older than sixty. However, this benefit is not as well established for borderline hypertensives nor for younger people, such as Judy. She told me she wanted to be around to see her grandkids grow up but had doubts whether antihypertensives and cholesterol-lowering drugs might help her live longer, have more energy, and feel better in the long run. I acknowledged that medical science hasn’t proven these issues with certainty, but it is known that these drugs have a number of serious and even life-threatening side effects.

Weighing the options

I try to help patients identify and evaluate all of their options when heart disease is present. Drugs are certainly one option, and a popular one, based on the number of yearly prescriptions that are written. And if drugs are effective, why does cardiovascular disease continue to progress in many cases? You may not be surprised to hear that nearly 1 million angioplasties (increasing vessel size by inserting a tube or balloon) and more than half a million bypass surgeries are performed in the United States each year.

Judy was aware that Dean Ornish, M.D., and other researchers have shown that a total program for cardiovascular health can reverse hardening and blockage of arteries and reduce the risk of dying from heart attack and stroke. She knew about the importance of practicing daily stress-releasing activities such as yoga, walking, and aerobic exercise. She also understood that diet (especially avoiding foods containing refined fat and sugar and eating a variety of whole, high-fiber, high-antioxidant foods such as fresh fruits and vegetables) was something she could control to significantly increase her chances of spending twenty years with her grandchildren.

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