By Andreas Moritz
Heart attacks can occur in a number of ways:
- The connective tissues surrounding the heart cells may become so densely congested that the heart cells simply die a painless death of suffocation.
- An angina attack may occur, meaning that acidification and low oxygenation have destroyed the heart muscles.
- The basal membranes of the capillaries and arteries are blocked and can no longer supply oxygen to the heart. A heart attack then occurs at the location where the storage capacity for protein was first exceeded.
- A blood clot breaks loose from a congested and injured blood vessel, enters the heart and blocks its oxygen supply. The same scenario can cause a stroke.
Research Questions Value of Opening Arteries
The emerging understanding of the causes of heart attack raises the question of the value or usefulness of opening blocked arteries. For one thing, the increasingly popular aggressive treatments of opening arteries with bypass surgery, angioplasty and stints do little or nothing to prevent the recurrence of an occlusion. Although bypass surgery was found to extend the lives of some patients with severe illness,it does nothing to prevent heart attacks. As we shall see, heart attacks don’t occur because of an arterial blockage, as most people assume, but because of one of the four reasons mentioned above. Overall, none of the currently used surgical procedures have been shown to significantly lower the mortality rate from heart disease.
One of the main reasons for the poor success rate of these treatments is that the majority of heart attacks do not originate with obstructions that narrow arteries. To tackle the heart disease epidemic, which is spreading like wildfire in most industrialized nations and now also in developing nations, we need to rely mostly on preventative strategies. However, these approaches cost next to nothing and are therefore not financially lucrative for those in charge of health care. The preventative measures include eating less protein, regular exercise, early bedtimes, regular mealtimes and balanced meals, drinking enough water, avoiding junk foods, giving up smoking, reducing alcohol consumption, removing stress sources, etc.
The old model of understanding heart disease is rapidly falling apart, much to the surprise of heart specialists. “There has been a culture in cardiology that the narrowings were the problem and that if you fix them the patient does better,” said Dr. David Waters, a cardiologist at the University of California at San Francisco. This theory made so much sense to the surgeons, cardiologists and laypeople that for decades hardly anyone questioned it, except those few (including myself) who were more interested in discovering the true causes of heart disease. The newest scientific discoveries now finally expose this theory’s major flaws, with little room for discussion.
Until recently,it was believed that coronary disease evolved like sludge building up in a pipe. Plaque accumulates slowly, over decades, and once a coronary artery is blocked completely, no blood can get through to the heart and the patient suffers a heart attack. In order to prevent this catastrophe from happening, the most apparent rational “solution” to this problem was to perform bypass surgery or angioplasty to replace or open the narrowed artery before it would close completely. The assumption that this would avert heart attacks and prolong life seemed indisputable. But as medical research shows, this theory is no longer valid (it actually never was) and therefore, is misleading. A study published in the New England Journal of Medicine by the Coronary Artery Bypass Surgery Cooperative Study Group clearly demonstrated that the three-year survival rate for heart disease patients undergoing bypass surgery is almost the same as for patients who have no surgery.
According to numerous heart disease studies, most heart attacks do not occur because an artery is narrowed by plaque. Instead, researchers say, heart attacks occur when an area of plaque bursts in a coronary artery, causing formation of blood clots that abruptly block blood flow to the heart. In fact, in 75 to 80 percent of cases, the hardened plaque obstructing an artery is not a culprit and should not even be considered for bypass surgery or stinting. The most dangerous type of plaque is soft and fragile. It produces no symptoms and would not even be seen as an obstruction to blood flow. The soft, newly-formed patches of plaque are much more likely to break off than old, hard ones; and when they do, blood clots are formed that enter the heart, causing a heart attack. Therefore, creating a bypass around the hardened parts of an artery does nothing to lower the risk of a future heart attack. For this reason, many heart attacks occur in people who don’t have any arterial occlusions. Accordingly, a person may have no problem jogging one day, but suffer a heart attack (or stroke) the next day. If a narrowed artery were the culprit, the person would not even be able to exercise due to severe chest pain or breathing restriction.
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 stint operations are performed. The multi-billion dollar stint 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. “There is just this embedded belief that fixing an artery is a good thing,” said Dr. Eric Topol, an interventional cardiologist at the Cleveland Clinic in Ohio. It has almost become fashionable to have one’s arteries fixed, just in case. Dr. Topol points out that more and more people with no symptoms are now getting stints. In 2004, over one million Americans opted for a stint operation.
Although many doctors know that the old heart disease theory no longer holds true, they feel pressured to open blocked arteries anyway, regardless of whether patients have symptoms or not. Dr. David Hillis, an interventional cardiologist at the University of Texas Southwestern Medical Center in Dallas, explained: “If you’re an invasive cardiologist and Joe Smith, the local internist, is sending you patients, and if you tell them they don’t need the procedure, pretty soon Joe Smith doesn’t send patients any more. Sometimes you can talk yourself into doing it even though in your heart of hearts you don’t think it’s right.”
According to Dr. Topol, a patient typically goes to a cardiologist with a vague complaint like indigestion or shortness of breath, or because a scan of the heart indicated calcium deposits or a buildup of plaque. Doing his job, the cardiologist follows the standard procedures and puts the patient in the cardiac catheterization room, examining the arteries with an angiogram. If you live in a developed country like America and are middle-aged or older, you are most likely to have arteriosclerosis, and the angiogram will show a narrowing. It won’t take much convincing to tell you that you need a stint. “It’s this train where you can’t get off at any station along the way,” Dr. Topol said. “Once you get on the train, you’re getting the stints. Once you get in the cath lab, it’s pretty likely that something will get done.”
Dr. Hillis believes the American psyche is convinced that the worth of medical care is directly related to its aggressiveness. Hillis has tried to explain the evidence to his patients, but with little success. “You end up reaching a level of frustration,” he said. “I think they have talked to someone along the line who convinced them that this procedure will save their life. They are told if you don’t have it done you are, quote, a walking time bomb.”
Even more disquieting, Dr. Topol said, is that stinting can actually cause minor heart attacks in about 4 percent of patients. This means that, out of the 1 million stint patients in 2004, 40,000 ended up suffering heart damage from a procedure meant to prevent it, heart damage that they may never have developed without undergoing the procedure. According to a report published in the New England Journal of Medicine (October 15, 2004), the two stints that are currently approved by the Food and Drug Administration (FDA), the Cordis Cypher sirolimus-eluting stint and the Boston Scientific Taxus Express paclitaxel-eluting stint, have been associated with highly publicized adverse events after they were approved for marketing.
Bypass, angioplasty and stint operations are really not about preventing heart attacks per se. The obvious purpose of these procedures is symptom relief. Patients are satisfied that “something” was done, relieved of the anxiety of dying from a sudden heart attack. And the doctors are satisfied that their patients are happy. The drug industry is satisfied because the patients are doomed to taking expensive drugs for the rest of their lives.
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This is an excerpt from my book TIMELESS SECRETS OF HEALTH & REJUVENATION
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