In medical affairs of heart, most disease is preventable
March 12, 2007

Initially, I thought it was a rather inappropriate and tasteless joke. On Valentine's Day, while the rest of the country was gifting chocolate hearts and roses, PBS aired a documentary titled "A Hidden Epidemic -- Heart Disease in America."

Yet, as I watched it, riveted to my couch, I was convinced that it is a "must watch" for every American on any day. Why? According to the documentary, " One in every two men and one in three women will eventually develop heart disease. Half of us will die from heart disease, and 80 percent of us will die with it."

The documentary told a compelling story of Phillip, a 44-year-old father, who died two weeks after his wife gave birth to their second child. He had thought he was in great health except that he was recently discovered to have high blood pressure and high cholesterol.
While watching Phillip's wife tell the tragic story with their baby in her arms, I remembered my cousin who became a widow in her mid-40s because her husband died of complications of hypertension.

Another story was about Tom, a World War II veteran who became progressively debilitated from heart disease. I remembered the time my dad had angioplasty and bypass surgery.

The documentary unraveled the recent history of the heart disease epidemic in America. One hundred years ago, heart disease was the 10th leading cause of death; today it is No. 1.

It was during World War II that young soldiers became hooked on smoking, with the free cigarettes given to them. When they came home, their wives started smoking, too. The automobile and the television made us a "couch potato" society. The diet changed radically. Every day, one out of four Americans eats fat-laden fast foods. These were the lifestyle choices that silently but surely led to heart disease.

Studies from the Framingham Heart Study in Massachusetts, where I did my medical school training, introduced a new phrase to the vocabulary of medicine: "risk factors." These are conditions that may increase the chances of a disease -- hence diabetes, smoking, obesity, lack of exercise, high cholesterol are all risk factors for heart disease.

Medical knowledge on the subject, too, was at first limited. The benefits of statin drugs for high cholesterol were proved only a decade ago. Before this, doctors were reluctant to believe that cholesterol over 200 would lead to heart disease. High blood pressure was thought to be a normal aging process, yet now we know that any pressure above 120 over 80 is harmful.

The documentary showed how new technology, intravascular ultrasound, is changing the way we think about and diagnose heart disease -- it is not just blocked plumbing but an inflammatory process.

The documentary showed that in women the symptoms of heart disease show up differently -- unusual fatigue, shortness of breath, back and neck pain and indigestion, while in men it would be chest pain or heaviness radiating to the arm.

The most eye-opening fact was this: Eighty percent of heart disease is preventable.

Pushing heart disease back to the 10th position among leading causes of death, as it was in the year 1900, may seem overambitious -- yet it is very possible. Imagine if all the 93 million people who watched the Super Bowl watched this Valentine's Day documentary -- I am sure a change would occur. Remember, 80 percent of heart disease is preventable.

Perhaps we can hope that by next Valentine's Day, there will be many healthier hearts in America.

The documentary can be watched in its entirely at http://pbs.org/wgbh/takeonestep/

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