Got Heart Disease? You May Fare Better When the Heart Doctor’s Away
Cardiology is a multi-billion dollar industry. Gleaming heart hospitals, brimming with the latest, most expensive high-tech equipment are major centers of income generation in many communities. Given that heart disease is still the leading cause of death, it’s no wonder we’ve invested so heavily in these shining palaces of invasive cardiac care. Open heart-bypass procedures are a modern medical miracle. They’ve enabled thousands upon thousands of sick people to live longer. Right?
Not so fast. Some cardiologists, including Michael D. Ozner, M.D—author of books such as “The Miami Mediterranean Diet,” and “The Great American Heart Hoax”—contend that most heart doctors in this country are far too quick to reach for the knife. They’re too likely to turn to stents, or invasive, expensive procedures such as balloon angioplasty, or multiple coronary-blood-vessel bypass. Dr. Ozner and others have made the case that research has seldom shown these procedures really make a lasting difference. Better, they argue, to address the underlying, longterm problem, than to throw a “band-aid” remedy at it.
In the vast majority of cases, the underlying problem involves atherosclerosis. It’s a form of inflammatory disease that affects the delicate lining of the blood vessels. It begins with “endothelial dysfunction” and ends with the complete blockage of a coronary artery or blood vessel in the brain. These events may result in heart attack or stroke. They can cause severe disability, or even sudden death.
So what’s the more logical, natural, long-term solution? I hope you’re not too surprised: better diet and more exercise. Maybe a cholesterol-lowering statin drug, too. Period. Believe it or not, extensive research has never concluded that all the billions of dollars being spent on invasive cardiac procedures are any better at prolonging lives than good old lifestyle changes, which can eliminate inflammation and improve the health of the blood vessels, and thus, the heart.
I know it sounds too good to be true. Why would many thousands of experts across the country convince us to spend so very much on technology that’s no more likely to save lives in the longterm than good old healthy living, which is available to virtually anyone with a will and access to fresh air and good, whole foods?
Why, indeed. It’s tempting to suggest that food and exercise are far cheaper than gleaming heart hospitals and everything they represent (highly-trained surgeons, extraordinarily expensive and invasive procedures, high-tech equipment). Not surprisingly, this approach to cardiac care also generates astounding profits. I’m sure many of these experts truly believe they’re doing the best they know how to address a clear and present danger in society: rampant heart disease.
But I also think they have little incentive to review all the available evidence dispassionately. When one becomes so specialized, and invests so much time and energy into one’s training, it’s simply not within human nature to then say, “But look, all this research keeps showing that our high-tech procedures yield no better long-term outcomes than non-invasive lifestyle interventions. Maybe I should stop cutting people open and counsel them to start eating organic vegetables instead.” It might be the better course of action, but what heart surgeon is going to admit it? Perhaps they think that, even if they received this sage advice, most patients would be unwilling or unable to implement it. It does take effort, after all.
Stop back tomorrow for the second installment in this series on modern cardiac care in America. I think you’ll be amazed by what I have to share.
Ozner, Michael D. The Great American Heart Hoax: Lifesaving Advice Your Doctor Should Tell You about Heart Disease Prevention (But Probably Never Will). BenBella Books. Jan. 2010.
, , , . Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.JAMA Intern Med. 2015 Feb 1;175(2):237-44. doi: 10.1001/jamainternmed.2014.6781.