Bottom Line Health
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| Heart patients in the United States receive more blood transfusions than heart patients in many other countries, which may indicate that doctors in this country are too liberal in recommending this procedure, researchers say.
THE RESEARCH
Researchers at Duke Clinical Research Institute in Durham, North Carolina, analyzed 24,000 patient records from 16 countries and found that transfusion rates for US heart patients were 84% higher than in Europe, 72% higher than in Canada, 70% higher than in Australia, New Zealand and Latin America, and 38% higher than in Asia. |
Caldwell B. Esselstyn, Jr., M.D.
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 Kills
A number of years ago, when I was beginning my research project in coronary artery disease, a prominent local physician who disagreed with me announced that he believed in "dietary moderation" for his heart patients. Translation: I don't care if my heart patients eat some fat. That's a fairly common sentiment among my medical colleagues. But what are the facts?
In science, a review of many studies on the same subject is referred to as a meta-analysis. |
Andreas Moritz
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 A number of the heart patients who received the actual bypass surgery also reported relief of pain. If the "success" rate in the bypass group is higher than in the placebo group, then the bypass operation is considered to be an effective method to relieve chest pain.
An early carefully controlled study with patients suffering from angina pectoris showed that 5 out of 8 patients who had genuine surgery and 5 out of 9 patients who only received a sham operation, felt much better afterward. |
| A major three-year double-blind control study {New England Journal of Medicine, 1997) conducted by The Digitalis Investigation Group showed that out of 3,397 heart patients who received digitalis, 1,181 patients had died by the end of the study period. Compare this with the 1,194 who died out of 3,403 patients who had received a placebo, and it becomes clear that digitalis is no better than a sugar pill in preventing death through heart disease. Still it remains the preferred treatment (over the placebo). |
| The body remembers a loving touch more vividly than spoken words and it reproduces the same drugs whenever it links into the "touching" feeling through remembering. heart patients especially need to feel that they are loved and cared for because their hearts have lost the sweetness of life that is naturally present in a committed and loving relationship where emotional exchange is most common. Many heart disease victims isolated themselves from such intimacy before they became ill, by overloading themselves with work, commitments, deadlines and too many social engagements. |
| Since heart patients may have hundreds of vulnerable plaques, surgeons cannot go after all of them. In fact, coronary artery surgery does nothing to the soft plaque, which is the real time bomb ticking in the coronaries of heart disease patients.
Other dangers lurk in a hospital's operating room. According to a New England Journal of Medicine report, 1,500 patients a year in the U.S. leave the operating table with some of the hospital's equipment still inside them. |
| Most heart patients have hundreds of vulnerable plaque sites in their arteries. Since it is impossible to replace all these injured, plaque-ridden sections, the currently applied interventional procedures are unable to prevent heart attacks. Regardless, this doesn't mean that fewer bypasses or stent operations are performed. The multi-billion dollar stent business seems, in fact, unstoppable.
Heart researchers and some cardiologists are becoming increasingly frustrated with the fact that their findings are not being taken seriously enough by the health practitioners and their patients. |
Jonny Bowden, Ph.D., C.N.S.
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 Rounding out the quartet with D-ribose and magnesium, as suggested by Sinatra, is a great idea, especially for heart patients. (Magnesium helps because it is critical for the making of ATP, has an important effect on cellular metabolism, has been found helpful in a wide range of cardiac
Ribose and Fibromyalgia
Just as we went to press, my friend and go-to guy for all things related to Fibromyalgia and Chronic Fatigue Syndrome, Jacob Teitelbaum, M.D., wrote to tell me of a just-published study showing that in Chronic Fatigue and Fibromyalgia patients, ribose increased energy an average of 45%. |
Anne Harrington
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 Unmarried heart patients who said no were three times more likely to die within five years. Do you live alone?
Heart-attack survivors who said yes were more than twice as likely to die within a year.2
The numbers here tell a story, a story based on a narrative template I call "healing ties." I might almost as readily have called it "fractured ties," because it is a narrative that skirts the border between melancholy and hope. |
Connie Bennett, C.H.H.C. with Stephen T. Sinatra, M.D.
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 Patrick Fratellone, who runs a cardiology, infectious-diseases, and internal medicine practice in New York City, also insists that "stabilizing blood glucose is essential to help heart patients heal."
Like many cardiologists, Dr. Fratellone hears "horror stories" from patients flirting with disastrous dietary behavior—cereal, white bread, or bagel for breakfast, fast food for lunch, and maybe a few vegetables and protein for dinner.
"The higher the carbohydrate intake, the higher your triglycerides will be. When your triglycerides go up, your HDL or 'good' cholesterol goes down. |
Caldwell B. Esselstyn, Jr., M.D.
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| For instance, we can approach insurance companies, employers, and representatives of labor with a modest proposition: that heart patients targeted for the mechanical intervention of bypass surgery or stenting should first try twelve weeks of arrest-and-reverse therapy—plant-based nutrition plus, where necessary, cholesterol-reducing drug therapy. |
| Two of my original heart patients had strokes before joining my nutrition program. William Morris had just one stroke. Emil Huffgard had three. As a result, both had suffered impairment of their walking. More than twenty years later, both of these men are alive and well. Neither has had any further strokes. The same plant-based nutrition that saved their hearts also saved their brains.
I have mentioned previously that several of my patients have also noted a distinct improvement in their sex lives. And recent research confirms a strong connection between impotence and cardiovascular disease. |
| Three out of four of the heart patients involved seem to do very well under this regimen. But it was not a complete success. Even with their cholesterol levels satisfactorily reduced, one out of every four of the patients in the study sustained a new cardiovascular event or died within two and a half years of starting this treatment.7
I was struck by the fact that there were so many problems even though both total cholesterol and LDL levels in those patients were reduced well into the range I suggest and often below that. |
Andreas Moritz
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| Furthermore, while you may believe that aspirin is good for getting rid of a headache, a new study reveals that certain heart patients may actually be at greater risk for heart attacks if they use aspirin, as reported in the July 2004 issue of the American Heart Journal. The lead researcher of the study, Dr. John G. F. Cleland, University of Hull, England, stated that any theoretical benefit of using aspirin after a heart attack "is outweighed by real evidence of harm." Discontinuing the treatment once it has been started is also problematic. |
KC Craichy
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 In addition, prayer may reduce the number of complications experienced by hospitalized heart patients. heart patients who were prayed for by others, but were not aware of being the object of prayers, had an 11 percent reduction in medical complications ot the need for surgery or medication while in the hospital. |
Anne Harrington
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| I have recently watched with a certain sense of wistfulness as at least some subsequent efforts to test the therapeutic efficacy of such ties with cancer and heart patients have failed to show any obvious beneficial effects.
Stress, in contrast, struck me from the outset as a deeply unwieldy concept that, notwithstanding its apparent hard-nosed roots in the laboratory, had come to stand in for virtually every class of human unease, distress, and malaise—to the detriment of all involved. One anecdote in particular, which I heard in the late 1990s, clarified the issues for me here. |
KC Craichy
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| In addition, prayer may reduce the number of complications experienced by hospitalized heart patients. heart patients who were prayed for by others, but were not aware of being the object of prayers, had an 11 percent reduction in medical complications ot the need for surgery or medication while in the hospital. |
Jonathan V. Wright, M.D. and Alan R. Gaby, M.D.
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 Magnesium deficiency also increases the risk of heart-rhythm disturbances (arrhythmias), the most common cause of sudden death in heart patients.3
Heart patients develop magnesium deficiency for several different reasons. Low dietary intake (too much sugar and fat, not enough whole grains and vegetables) is certainly one factor. Drugs given to patients with CHF, particularly diuretics (water pills) and digoxin, also deplete the body of magnesium. In addition, the failing heart becomes less efficient at hanging onto the magnesium it already has. |
Tori Hudson, N.D.
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 Walking program for heart patients:373
Distance
Time
Weeks
(miles)
(min/mile)
1-2
1
20
3-4 l
17-20
5-6 l
15
7-8
1.5
15
9-10
1.5
14
To maintain the conditioning effect, exercise 20 to 30 minutes three to five times a week. If you stop exercise for more than two weeks, start again at a lower level and gradually build back up to your original program. |
Michael Pollan
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 Adding omega-3 fatty acids to the diet (that is, eating more of a certain kind of fat) "substantially reduces coronary and total mortality" in heart patients, and replacing saturated fats with polyunsaturated fats lowers blood cholesterol, which they deem an important risk factor for CHD. (Some researchers no longer do, pointing out that half the people who get heart attacks don't have elevated cholesterol levels, and about half the people with elevated cholesterol do not suffer from CHD. |
Bottom Line Health
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| Very low levels of low-density lipoprotein (LDL) cholesterol, the so-called "bad" cholesterol, seem to be safe for heart patients who are taking statins, researchers report.
Patients who are taking high doses of statins can see their LDL cholesterol drop from more than 200 milligrams per deciliter (mg/dL) past a target goal of 70 to 80 mg/dL to as low as 40 mg/dL. Whether such low cholesterol levels are safe has been the subject of debate.
"We looked at patients who got to ultra-low [LDL] cholesterol levels, and wanted to make sure that was safe," says study coauthor Dr. Christopher P. |
| THE RESEARCH
Researchers at Duke Clinical Research Institute in Durham, North Carolina, analyzed 24,000 patient records from 16 countries and found that transfusion rates for US heart patients were 84% higher than in Europe, 72% higher than in Canada, 70% higher than in Australia, New Zealand and Latin America, and 38% higher than in Asia. South Africa was the only country that had higher transfusion rates than the US.
Blood transfusions are not like giving a patient an aspirin or Tylenol. |
| Self-defense: Before accepting a transfusion, heart patients should ask their doctors whether their blood counts could recover on their own.
Sunil V. Rao, MD, assistant professor of medicine, division of cardiology, Duke University Medical Center, Durham, NC.
New Heart Drug Doesn't Miss a Beat
L. Brent Mitchell, MD, director, Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.
Joseph P. Mathew, MD, associate professor of anesthesiology, Duke University Medical Center, Durham, NC.
The Journal of the American Medical Association. |
| Stuart Connolly of McMaster University in Hamilton, Ontario, included 412 heart patients who received implantable defibrillators at 39 medical centers in the United States, Canada and Europe. Some of the patients were given beta blockers, the standard treatment. Others received beta blockers plus amiodarone, a drug that reduces arrhythmias, or abnormal heartbeats. (For more information about amiodarone, see page 192.) And a third group received sotalol, another anti-arrhythmia drug. |
Mike Adams, the Health Ranger
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 Many of the studies on vitamin E, by the way, were conducted on dying heart patients who were only expected to live two weeks, regardless of what they took.
A third way to distort the science is to confuse people with statistical obfuscation. The reporting on this particular study, for example, confuses absolute risk with relative risk. Vitamin A, according to the reports on this study, increased mortality risk by 16 percent. But that is a relative risk number, meaning that if 1 person out of 100 normally died, then 1. |
John J. Ratey, MD
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 Often used for heart patients to reduce blood pressure, beta-blockers break the anxiety feedback loop to the brain that otherwise keeps the amygdala on alert. In quelling the bodily symptoms of anxiety, beta-blockers diffuse panic attacks before they explode. They're also useful for people with social anxiety or stage fright. It's exceedingly common for classical musicians to take beta-blockers before performances because it prevents them from sweating and tensing up, which can really interfere with their ability to play. (It must be hard to play a trombone with stiff lips! |
Connie Bennett, C.H.H.C. with Stephen T. Sinatra, M.D.
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| Even more curious—many of my heart patients don't even know they have insulin resistance or diabetes before I diagnose them. Many of these patients come to me with a big belly, low levels of HDL (the "good" cholesterol), high triglycerides, and high blood pressure. We now call this scenario metabolic syndrome.
Too many physicians send these people away with four or five different prescriptions to treat each problem separately when what they really need is to exercise regularly and change their diets—cut out the very foods that are causing their high blood sugar levels and insulin surges. |
Stephen T. Sinatra, M.D.
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 The effect of these nutrients on cellular energy has now been experienced by thousands of heart patients, who improved the quality of their lives by the simple supplementation with these "twin pillars" of cardiac health.
Now a new nutrient, D-ribose, has arrived on the scene, heralding a second generation of metabolic cardiology. In combination, these nutrients provide the metabolic support hearts and other body tissues need to generate and maintain the energy required to promote health and vitality. |
Ron Garner
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 He states that "testosterone is the heart-protective hormone of the male body,"10 and suggests that after reading chapter 3 of his book, most male heart patients will show the information to their doctors and demand a test of their testosterone levels.
Hemorrhoids
Hemorrhoids, or piles, as they are more commonly known, are the engorgement and swelling of the veins of the rectum. Hemorrhoids can result from straining to have bowel movements during constipation, or from pregnancy. |
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