| I asked them to answer the question: What do you tell the patient who says, "I'll do anything, but I never want to have heart disease," or, "I have had a heart attack, and I never want another"?
One panelist replied, "Have him eat beans, beans, and more beans." Another, Professor T. |
| During that procedure, the doctors discovered that he had sustained a massive heart attack, and they reported that there was too much muscle damage to allow surgery. No one told Jim the whole story at the time, but one of the physicians did tell Jim's wife, Sue, that he didn't have long to live and she might have to go back to work as a teacher to support their two small children.
A month later, Jim felt considerably better. He underwent a second catheterization. |
Donna Jackson Nakazawa
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 THE COLD, HARD NUMBERS
Most of us, at some juncture in our lives, have played out in our minds how devastating it would be to have our doctor hand down a cancer diagnosis or to warn us that we are at risk for a heart attack or stroke. Magazine articles, television dramas, and news headlines all bring such images home. But consider an equally devastating health crisis scenario, one that you rarely hear spoken about openly, one that receives almost no media attention. |
Paul D. Blanc, M.D.
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 The FDA, compromised by leadership gaps, has been criticized in the debacle over aspirin-like drugs causing heart attack and for its failure to gauge accurately the potential risk of adolescent suicide following antidepressant use.11 This scrutiny is consistent with the FDA's primary jurisdictional responsibility for medications, but its recent track record hasn't indicated any better control of other substances in our environment that we are liable to ingest, such as herbal supplements and chemical additives.
The story of ephedra serves as one example of another such substance. |
| This is the case with stroke, for example, as well as heart attack and Parkinson's disease, all of which are common health problems that have been linked to carbon disulfide.
Moreover, despite carbon disulfide's many years of study, possible new dangers from it continue to emerge. In September 2000, the American Journal of Kidney Diseases reported the case of a man who first came to medical attention at age forty-five, suffering from diffuse vascular disease, kidney disease, and neurological complaints. |
Donna Jackson Nakazawa
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| She knew that if it progressed it could easily block the flow of oxygen to her heart or lungs, causing a heart attack or even a life-threatening heart infection known as endocarditis. Jan took a dose of the antibiotics that she and David always carried in their first aid kit when traveling, and they stopped at a pharmacy for a heating pad to wrap around her arm to help disperse the clot—both standard protocol. They passed a road sign pointing to a local hospital along the deserted highway. David looked at Jan questioningly.
She shook her head no. |
Benjamin H. Natelson, M.D.
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 However, a number of large studies have found that these newer drugs have a higher rate of potentially lethal side effects, such as heart attack or stroke, than the old fashioned NSAIDs. Two of them—Vioxx and Bextra—have been taken off the market. Although Celebrex is still available, I think its risk for people taking it chronically outweighs any potential benefit over ibuprofen. Whether these toxicities extend to the older class of NSAIDs is currently not known but is a question undergoing research. |
Paul D. Blanc, M.D.
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| A middle-aged worker had fatally collapsed on the job from what, at first, seemed to be an ordinary heart attack. Then the paramedics, attempting to reach the victim, were themselves suddenly overcome with severe symptoms of nausea and light-headedness. They became even more alarmed when several of the dead victim's younger coworkers reported, in broken English, that they, too, were ill with headache, nausea, and dizziness. Such symptoms were frequent in the plant, they readily admitted.
The industrial operations at the facility, which was housed in a converted warehouse, were quite simple. |
Craig Pepin-Donat
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 Given the state of health for the average person today, the last thing we should be thinking about is making sure we get a few drinks in everyday to reduce our risk of a heart attack or stroke. We would all be better served if we focused our attention on the lifestyle choices that caused us to get into the sad shape we are in. If we can teach ourselves to accept the consequences of those decisions, we can start making better decisions for our survival. |
| Do you think they would agree with that if you died of a heart attack or some other self-inflicted, preventable disease because you failed to place your health at the top of your priority list? Time takes on a whole new meaning when you look at everything from that perspective.
Nothing can outrank the priority of your body and your health, except perhaps your family, but even fulfilling that obligation is dependent on you maintaining good health. So get obsessed about it and stay obsessed about it. If you are going to be addicted to something, get addicted to health and fitness. |
| As the FDA continued to ponder this alarming information, Merck finally came forward with results of a new trial that continued to show increased risk for heart attack and stroke and pulled the drug before the agency could take action. The FDA's position was that this was just one mistake with one drug among hundreds of other "good drugs." However, FDA researcher David J. Graham posted details about the magnitude of the mistake on the agency
Web site. "From 1999 to 2003, there were an estimated 92,791,000 prescriptions for Rofecoxib (Vioxx), of which 17.6 percent were high-dose. |
Anne Harrington
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 In one, a business executive with a high-pressure job and a terrible temper resists the advice of friends and family to calm down and is finally felled by a massive heart attack. In another, a man suffers from a chronic disorder that only flares up at socially inconvenient times, leading his wife to conclude that he is being manipulative or acting out some kind of repressed anger. |
| The discovery of the Type A personality and his apparent vulnerability to heart attack had roots in a far more broadly based set of public health concerns in the postwar period. This was a period of sharply rising levels of coronary heart disease in the American population. Once seen as a relatively rare disease in the United States and Europe, by the second half of the twentieth century, heart disease had come to be called the silent epidemic of the times, responsible for some 30 percent of deaths in industrialized countries—the largest single cause of death from any disease. |
| The chances of dying of a heart attack for those in the bottom tier of the civil service hierarchy were more than 2.5 times greater than for those in the top tier. Potentially, this made sense: people of lower socioeconomic status might not eat as healthy a diet, might smoke more, and so on. What was far more puzzling was this: across the entire civil service hierarchy, people in higher grades of employment were healthier than their immediate subordinates. |
Jeffrey M. Smith
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 He had a heart attack and died soon after. No one at the time knew to question whether the corn was the culprit.
It took the FDA nine months to develop and execute a test to see if StarLink's Bt protein was a human allergen. Even then, officials claimed that it wasn't definitive. A scientist working for StarLink's producer, Aventis, acknowledged that there is no way to ensure that a novel protein is not an allergen, other than "giving it to a lot of people and seeing what happens. |
Anne Harrington
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| To Lynch, it seemed clear even in the 1970s that the executive with Type A behavior was primarily at risk of heart attack not because he was so overworked but because his relentless workaholism had pushed away everyone who might otherwise have loved him:
While the great majority of the individuals they examined were married, Friedman and Rosenman observed that the Type A personality engaged in a life-style that guaranteed a high degree of social isolation, not only from acquaintances but also from the immediate family. |
| What they did not do, however, was reduce patients' risk of death or of a second heart attack. The quality of life of the patients in the active treatment group was better; but they did not live longer, on average, than the patients in the control group.50
Lisa Berkman, lead author of the 1976 Alameda County study, was one of the principal investigators on this study. In the fall of 2006, she spoke bravely and honestly to a class of my undergraduate students at Harvard about the disappointing results. "Have you ever seen 'nothing'? |
Craig Pepin-Donat
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| Over the years I was also prescribed multiple types of non-steroidal anti-inflammatory drugs including Vioxx, Celebrex and Bextra, all of which have been proven to increase the risk of having a heart attack. During the time I took these three drugs, none of them helped. Ultimately, I made the decision to stop taking these medications. If you don't feel that you are getting results from a drug, why continue to take it? Yes, there are drugs that "take time" to get the benefit, and there are others that you cannot stop taking all at once without withdrawal symptoms or other health risks. |
Tori Hudson, N.D.
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 In a study of patients with previous history of heart attack, niacin was found to decrease the risk of repeat MI and death in patients with and without metabolic syndrome.238
Conventional practitioners and alternative practitioners alike acknowledge that several grams of niacin per day will lower total cholesterol and LDL cholesterol, raise HDL,239 and decrease atherosclerosis both alone and when used with conventional treatments like statins. |
Michael Pollan
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 The Lyon Diet Heart Study found that the Mediterranean diet, when compared to a Western diet, offered protection against a second heart attack during the four years patients were followed. (Michel de Lorgeril et al., "Mediterranean Diet,Traditional Risk Factors, and the Rate of Cardiovascular Complications after Myocardial Infarction," Circulation, 1999:99; 779-85.)
« HAVE A GLASS OF WINE WITH D I N N E R . Wine may not be the X factor in the French or Mediterranean diet, but it does seem to be an integral part of those dietary patterns. |
Mike Adams
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 Angina attacks are painful and often terrifying, especially if a sufferer mistakes the attack for a heart attack. However, angina is both treatable and preventable with many inexpensive, common natural substances. By treating angina instead of just idly suffering from it, you'll save yourself from needless pain and reduce your risk for more serious heart problems, such as heart attack and cardiac arrest. |
Carol Simontacchi
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 As early as 1999, the National Academy of Science warned that COX-2 inhibitors increase the risk of stroke, heart attack, and blood-clotting disorders. Then in 2001, cardiologists at the Cleveland Clinic analyzed clinical trials of COX-2 inhibitors to determine if these drugs have any effect on cardiovascular health. In a trial involving 8,059 people given either Vioxx or the NSAID diclofenac, patients taking the COX-2 drug were found twice as likely to suffer a cardiovascular event such as heart attack or stroke. |
Michael Pollan
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| It's important to note that the diagnostic criteria for heart attack have changed over time, as has the size of the population.) fat leads to heart disease, unless you can also demonstrate that serum cholesterol is a cause of heart disease and not, say, just a symptom of it. And though evidence for a link between cholesterol in the diet and cholesterol in the blood has always been tenuous, the belief that the former contributed to the latter has persisted, perhaps because it makes such intuitive sense—and perhaps because it has been so heavily promoted by the margarine makers. |
| While the Institute of Medicine at the National Academy of Sciences found little conclusive evidence that eating fish would do your heart much good (and might hurt your brain, because so much fish is contaminated with mercury), a Harvard study brought the hopeful piece of news that simply by eating a couple of servings of fish each week (or by downing enough fish oil tablets) you could cut your risk of dying from a heart attack by more than a third. |
Fred A. Baughman, Jr., M.D. and Craig Hovey
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 Ljubisa Dragovic, the teenager had died of a heart attack—a heart attack caused by Ritalin. The Death Certificate fingered the best known of the drugs prescribed to treat attention deficit/ hyperactivity disorder (ADHD), "Death caused from long term use of Methylphenidate (Ritalin)," it read. Matthew had started taking the drug at the age of seven after being diagnosed with ADHD. After eight years of it, his life was over.
Because the death was sudden, with no cause apparent at first, Dr. |
Tori Hudson, N.D.
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| Other women may experience significanr, more serious side effects such as complete hair loss, blood clots, high blood pressure, heart attack, and elevated liver enzymes.
There are many kinds of birth control pills today, and fortunately they are significantly lower in dose and cause far fewer side effects than in the past. The pills vary in their estrogen and progestin dosages and contain different kinds of estrogens and progestins. A woman may tolerate one pill poorly and another very well. |
| For those at higher risk (a history of a nonfatal heart attack, older age, high blood pressure, smoker, abnormal cholesterol levels, diabetes, obesity, and being sedentary), appropriate testing is very important to prevent future cardiac events. It is important to make a distinction between routine screening and tests done for individuals who are symptomatic or who are suspected to have CAD. For women who have a normal resting electrocardiogram (ECG) and who have good exercise tolerance, a routine exercise treadmill test with ECG is recommended as the initial test to evaluate suspected CAD. |
| Whereas high blood pressure was predictive of a heart attack 25 percent of the time, and high cholesterol 29 percent of the time, low blood levels of vitamin E was predictive almost 70 percent of the time.174
There are, though, negative studies on vitamin E's effect in cardiovascular disease. Although vitamin E was shown in animal studies to be beneficial for hypertension,175- 176 a human trial found that relatively modest doses, 500 IU mixed tocopherols per day for six weeks, led to an increase in blood pressure and heart rate in diabetic patients. |
Caldwell B. Esselstyn, Jr., M.D.
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 The next day, at his wife's insistence, he went to a local emergency room, where he was told he was having a heart attack.
Jim was rushed by ambulance to a hospital in Columbus for an urgent angiogram, which revealed significant blockages in his coronary arteries. A doctor inserted a catheter in order to put a stent in place. Suddenly, Jim couldn't breathe. He had "a terrible taste" in his mouth. He started shaking. He was experiencing anaphylactic shock, a life-threatening reaction to the dye used for the angiogram. |
Tori Hudson, N.D.
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| This is then correlated with expected rates of death or heart attack. Prevention strategies are then determined for each woman. In general, the risk of heart disease and heart events are low in premenopausal women and therefore screening is less important until menopause. Important exceptions to this are women who have diabetes, women with peripheral arterial disease, and overweight women with polycystic ovarian syndrome.
The U.S. Preventive Services Task Force (USPSTF) recommends against routine screening in adults who are low risk for CAD. |
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