21 September 2004

A wake-up call for Baby Boomers. That's what many newscasters were calling the recent emergency heart surgery performed on former President Bill Clinton. But the underlying message was not: "Wake up and get heart healthy." It was: "Wake up and take your drugs."

Coincidentally, just one week before President Clinton was admitted to the hospital, a major new study on heart disease risk - reported in The Lancet - delivered just the opposite message: "Wake up and get heart healthy. No medication necessary."

But for those who are long-time HSI members and e-Alert readers, no wake-up call was required, because the Lancet study revealed specific details about heart disease risk that we first told you about nearly three years ago.

Presidential privilege

According to White House medical reports, President Clinton was taking the cholesterol-lowering statin drug Zocor when he left office in 2001. But after he lost weight and his cholesterol dropped, he stopped taking the drug.

Naturally, this detail was pounced on by mainstream doctors who crowed, "See what happens when you don't take your pills?"

ABC news stated that some cardiologists predict that Clinton "will have to take a much higher dose of a cholesterol-lowering drug for the rest of his life." No surprise there. After a heart bypass, statin therapy is mainstream medicine's recommended standard of care.

But in a Newsday report, Dr. Valavanur Subramanian, chairman of cardiovascular surgery at New York's Lenox Hill Hospital, noted that two of the three arteries used in Clinton's operation were mammary arteries, taken from his chest. Dr. Subramanian described these arteries as "extraordinarily resistant to cholesterol
buildup."

So you have to wonder; if the new arteries resist cholesterol so efficiently, then why put him on a high dose of statins? The answer: Well... because that's just the way they do it! But that's only the start. According to Dr. Subramanian, Clinton's doctors will probably also recommend taking a daily aspirin, along with a
diruretic drug (to prevent buildup of fluid), and a beta blocker (to help regulate heartbeat).

That's an impressive drug cocktail. And potentially quite dangerous when you add up the known side effects. So if you happen to be an FOB (friend of Bill's), please forward this e-Alert to him, because there's a new study he should know about before he sends a truck to his local pharmacy to pick up an oversized crate
of pills.

Ratio days

The new study is titled INTERHEART, and the editors of The Lancet call it possibly the most "robust" study ever conducted on heart attack risk factors. About 15,000 heart attack patients were matched with the same number of subjects who had not experienced any heart problems. The subjects were recruited from
all over the world, and were examined by more than 260 researchers who gathered data on a variety of heart disease risks for about a decade.

Here's fair warning: Those who buy the concept that the number one risk factor for heart attacks is either high cholesterol or elevated levels of LDL (the "bad" cholesterol), will be disappointed in this study, because NEITHER of them showed up among the top causes of heart attacks.

According to INTERHEART, the factor that rates as the number one risk of heart attack is an unacceptable ratio of apolipoproteinB (apoB) to apolipoproteinA1 (apoA1). And if that looks like Greek at first, don't worry, it's actually pretty simple. Apolipoprotein is cholesterol's protein component. ApoB is the protein found in
LDL, and apoA1 is found in HDL. The ideal apo ratio is one apoB to two apoA1.

In other words, elevated LDL alone (the condition statins are used to treat) was not found to be a major factor in heart attack risk. It's all about the apo ratio.

More to come...

The INTERHEART study was launched more than a decade ago when the importance of other factors that put the heart at risk were not yet widely known; factors such as triglycerides, homocysteine and C-reactive protein. Hopefully an INTERHEART II study is underway that will take these elements into consideration. In the meantime, the factors that the INTERHEART team found to be most important after apo ratio were (from greater to lesser risk): cigarette smoking, diabetes, high blood pressure, excessive abdominal fat, stress, inadequate intake of fruits and vegetables, and lack of exercise.

In the conclusion to the study, researchers wrote that the relative risk for heart attack can be lowered by about 80 percent just by doing three things: eating plenty of fruits and vegetables, getting regular exercise, and avoiding smoking. Note that this list does not include statin drugs.

There's the REAL wake up call for Baby Boomers.

Jenny Thompson
Health Sciences Institute