Heart risk

Heart disease: knowing the risk

by Barry Bittman, MD

One hundred years from now, as the great scientists of the 21^st century look back at us from an historical perspective, I wonder what they will be thinking?

One thing is for certain. Extraordinary findings just released from the latest Framingham Heart Study conducted over the last 50 years are bound to draw their attention. According to a recent article in the British journal, Lancet, “one third of women and half of men age 40 or younger are destined to develop coronary artery disease in their lifetimes.”

The question for the next millennium is: “Will these statistics improve or worsen?” If forced to answer this question today, I’d say we’re in trouble!

Approximately one half million Americans die from coronary artery disease, (clogging of heart blood vessels) each year. While some tend to blame the condition on genetics, there’s more to heart disease than just heredity. Just consider the fact that around the turn of the last century, coronary artery disease did not exist.

The first case was actually reported in the Journal of the American Medical Association by Dr. James Herrick in 1908. You might assume that medical investigators didn’t have the tools to recognize the disease in the early 1900s. That is clearly not the case. After reading Herrick’s findings, a dedicated 10 year autopsy search performed by world-renowned cardiologist, Dr. Paul Dudley White revealed only a handful of cases.

Frankly, coronary artery disease is the most deadly condition of our modern era. It is also the most expensive, with a total cost to our society of over one quarter trillion dollars per year. Although thought to be declining over the last few decades, a study by the National Institutes of Health performed in the fall of 1997 revealed an increasing incidence of the disease. Not surprisingly, this may be due to factors that we do not wish to face.

First and foremost, we must take a closer look at how we live. Diet, activity level, smoking and stress play key roles in the development of coronary artery disease. Yet, most are not willing to accept the fact that lifestyle changes are the only real defense against this disorder.

Some believe that medical science will come to our rescue and discover an easier solution. I personally doubt that a “simple fix” will ever exist. Just look at the statistics: coronary artery bypass procedures and angioplasties (router-rooter for blood vessels) combined are performed on almost a million people in our country each year. Despite open FDA floodgates resulting in the release of countless new medicines, coupled with advanced diagnostic procedures, we are not winning the war. Why are our overall projections so bleak?

For one thing, yuppies are coming of age, and despite their determination in the sixties, they have not been taking care of themselves. Add to it the fact that the population over age 65 is expected to double within 50 years, and the challenge that awaits our future scientists is brought to light. If you factor in technological automation, lack of physical activity, diet, smoking, and societal stress, the real picture becomes clearer.

While the course of medicine in the future is uncertain, we do know what we are dealing with today. Heart disease is not an unexplained challenge lurking beyond our recognition. It is not a devastating process for which there is no treatment. It is a well-studied, easily diagnosed condition that can, in most cases, be treated and prevented if we take the proper initiatives to do so.

The only issue that remains is our willingness to take this matter seriously. Diseases that take fewer lives such as cancer are more feared. Yet, even after a bypass procedure, people return to their old habits that accelerated the disease initially.

The challenges that will await medical scientists in the future depend, to a great extent, on our choices today. Will they look back and laugh at what we have done to ourselves, or will they be inspired by the way we took this issue to heart¾ Mind Over Matter!