Eliminating 90% of Heart Disease Risk

“Eliminating 90% of Heart Disease Risk” Medical myths and
dogmas die hard. Researchers creating a
new body of knowledge for prevention and control of heart disease had
to disprove and displace a bunch of doozies, like we used to think that heart
disease was just an inevitable consequence of aging or that
cholesterol and blood pressure just naturally
go up as we age. All these are now bygone notions,
refuted by massive data, but other long-standing myths and dogmas
about our #1 killer epidemic persist, for example this notion that
major risk factors like cholesterol account for a minority of risk and that many
people have heart attacks with no risk factors, so it’s just kind of a crap shoot –
not much we can do about it. Wrong. There are rare genetic conditions
that give people high cholesterol no matter what
they eat, but such genetic defects occur
in no more than 1 in 200 people. This means, of course, that most
persons with atherosclerosis acquire it by what they
put in their mouth. The INTERHEART study showed that
for men and women, old and young, and in all areas of the world,
9 potentially modifiable factors like diet, exercise, and smoking, accounted for more than 90% of the proportion
of the risk of having a heart attack. And this has been confirmed
in prospective studies. Follow men over time and those
making healthy lifestyle choices are associated with
a 90% drop in risk. Same with women,
92% of the risk gone. Same with diabetes—91% of cases could be
contributed to bad habits and behaviors. And the same healthy lifestyle,
which includes not smoking, eating a healthy diet, exercising, and
maintaining an optimal body weight, may reduce the risk of multiple
chronic diseases at the same time— not just heart disease and
diabetes but stroke as well. Up to 80% of strokes avoidable
with simple lifestyle changes. How does this all
compare to drugs? Why change our diet, lose weight,
start exercising if we can just
pop some pills? Pharmacological therapies, including
cholesterol lowering statin drugs and blood pressure pills typically only
reduce cardiovascular disease risk not by 90% but only
by 20% to 30%. So even on drugs, 70 to 80%
of heart attacks still occur. One of the great things
about this study, the Harvard Health Professional’s Follow-up, is that they also looked at
the effect of lifestyle changes on people already
on medications. Even those on blood pressure and
cholesterol lowering drugs may still be able to get a further 78% drop
in risk by eating and living healthfully. So the choice isn’t
diet or drugs. Cardiovascular medications should
be used as an adjunct to, not just a replacement for,
healthy lifestyle practices. It takes time for new science to trickle
down into mainstream medical practice. The practice of cardiology and medicine
in general may correspond, on average, to what was being published
10 or 20 years before. So it’s important to know if your
doctor’s still stuck back practicing 20th century medicine.

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